Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Original and 2018 Lake Louise Criteria for Diagnosis of Acute Myocarditis: Results of a Validation Cohort.

Purpose To compare the diagnostic performance of the original Lake Louise criteria (LLC) and the 2018 LLC for the diagnosis of acute myocarditis and simultaneously validate previously reported cutoff values for parametric mapping techniques. Materials and Methods A total of 40 patients with acute myocarditis and 26 control participants underwent cardiac MRI. Cardiac MRI protocol allowed for assessment of T2 signal intensity ratio, early gadolinium enhancement ratio, late gadolinium enhancement, T1 relaxation times, extracellular volume fraction, and T2 relaxation times. The original and the 2018 LLC were assessed, and differences between sensitivities and specificities were calculated with the McNemar test. Results The 2018 LLC yielded a sensitivity of 87.5% (95% confidence interval [CI]: 73.9%, 94.5%) and a specificity of 96.2% (95% CI: 81.1%, 99.3%). The original LLC had a sensitivity of 72.5% (95% CI: 57.2%, 83.9%) and a specificity of 96.2% (95% CI: 81.1%, 99.3%). Sensitivity of the 2018 LLC was significantly higher compared with the sensitivity of original LLC (P = .031). No differences in specificity were observed between both scores (P = .999). Conclusion Multiparametric cardiac MRI has a high diagnostic value for the diagnosis of patients clinically suspected of having acute myocarditis. The 2018 LLC further improve the diagnostic performance of cardiac MRI by increasing its sensitivity. An implementation of the new score into routine diagnostic protocols should be considered. © RSNA, 2019See also the commentary by Gutberlet and Lücke in this issue.Supplemental material is available for this article.
PRIMARY CUTANEOUS MELANOMA: A COMPLICATION OF INFLIXIMAB TREATMENT?

58-year-old male, presenting a circular heterogeneously pigmented lesion, 15mm in greatest diameter, located to the abdominal wall. The patient claimed to have this lesion for "over 30 years," which nevertheless, had "begun to grow" since 3 years. This lesion was submitted to surgical excision under local anesthesia, whose histological examination confirmed the clinical diagnosis of malignant melanoma with 0.65 mm thick. The patient suffered from ulcerative colitis, and had started because of failure of prior therapy (5-ASA, corticosteroids, azathioprine) treatment with infliximab 5mg/kg intravenous 3 years ago. After the diagnosis of malignant melanoma a widening excision was performed and contact with the assistant Gastroenterologist was established, with infliximab therapy being suspended. Conclusion: Our case highlights the need for a complete dermatological observation before the start of anti-TNF-α as well as consultations for regular follow-up.
Comparative study of pulse oximetry and ankle-brachial index as a screening test for asymptomatic peripheral vascular disease in type 2 diabetes mellitus against color doppler ultrasonography as reference standard

Background: Currently about 35 million Indians are reported to suffer from diabetes mellitus, a significant proportion of whom are either undiagnosed or diagnosed but undertreated leading to poor glycemic control. This leads to accelerated development of macrovascular complications like Peripheral Vascular Disease (PVD). As most of the patients are asymptomatic, hence, early detection and treatment of PVD in patients with diabetes mellitus carries utmost importance.Methods: The present study was undertaken in SGRDIMSAR, Amritsar on 100 patients of type 2 Diabetes Mellitus with asymptomatic PVD. The diagnostic accuracy of Ankle-Brachial Index (ABI) and pulse oximetry as a screening tool was compared against Color Doppler ultrasonography as the reference standard.Results: The sensitivity, specificity, positive predictive value and negative predicted value of pulse oximetry to diagnose asymptomatic PVD in diabetics was found to be 98.31% (95% CI: 90.91-99.96), 41.46% (95% CI: 26.32- 57.89), 70.73% (95% CI: 65.08-75.81) and 94.44% (95%CI: 70.19-99.19) respectively. The sensitivity, specificity, positive predictive value and negative predicted value of ABI to diagnose asymptomatic PVD in diabetics was found to be 77.97% (95% CI: 65.27-87.71), 97.56% (95% CI: 87.14-99.94), 97.87% (95% CI: 86.85-99.69) and 75.47% (95% CI: 65.51-83.29) respectively.Conclusions: Pulse oximetry is better than ABI for the screening for asymptomatic PVD among diabetics. However, ABI is more accurate as compared to pulse oximetry in diagnosing asymptomatic PVD in diabetics.
Effect of brain derived neurotrophic factor-expressing mesenchymal stromal cells and chondroitinaseABC on chronic canine spinal cord injury

Successful repair of spinal cord injury (SCI) is a major issue in veterinary neurosurgery. Multipotent mesenchymal stromal cells (MSCs) have effective potentials of neuronal regeneration. Besides, chondroitinaseABC (chABC) and neuronal factors such as brain-derived neurotrophic factor (BDNF) are widely investigated to repair chronic SCI. Single treatments with those factors, for neurotropic effects or lysis of chondroitin sulfate proteoglycans as barrier to neuronal regeneration have been evaluated. It was hypothesized that combination therapy with factors having different traits could be more effective
Effects of different intensities of endurance training on serum fibroblast growth factor level, glucose, and insulin resistance in streptozotocin-diabetic male rats

Background and aims: Fibroblast growth factor 21 (FGF21) is a myokine which is produced and secreted by skeletal muscle. Given the inconsistent results on the relationship between the intensity of training and the improvement of blood indices in diabetic patients, the current research investigated the effect of endurance training at different intensities on serum FGF21 level, glucose, and insulin resistance in streptozotocin (STZ)-diabetic male rats. Methods: To this end, 50 rats (with a mean weight of 23.28±25.05 g) were randomly divided into healthy (non-diabetic) control, diabetic control, as well as low, moderate, and high-intensity endurance training groups. Diabetes was induced in all rats by the injection of STZ. Three days after STZ injection, the blood samples were taken from the cut tip of the tails, and those rats with blood glucose levels above 300 mg/dL were considered diabetic and included in the study. The program included 8-week aerobic training at different intensities. The blood samples (5 cc) were directly collected from the hearts 48 hours after the last training session, followed by measuring the serum FGF21 level, glucose, and insulin. Finally, the analysis of variance and Bonferroni post-hoc test were used for inter-group comparison and the significance level was considered <0.05. Results: Based on the results, the serum glucose level, insulin resistance, and FGF21 reduced after eight weeks of endurance training. The reduction of FGF21 in higher intensity endurance training group was greater compared to the other groups (P<0.05) and the reduction of glucose in moderate intensity group was more significant in comparison to that of the other groups (P<0.001). However, the insulin level increased, which was more pronounced in the moderate intensity training group compared to the other groups (P=0.002). Conclusion: Overall, both moderate and high-intensity endurance training led to a comparatively more effective reduction in blood glucose and insulin resistance. Therefore, these two parameters may have a protective effect on the complications associated with diabetes in the rats.
The role of lexical acquisition in simultaneous bilingualism

This thesis addresses a central issue within the field of Bilingual First Language Acquisition (BFLA) by exploring the extent to which the two languages can affect each other during development. The aim of this work is twofold. Firstly, it proposes a particular formalisation of the acquisition process which is based on a set of assumptions that are mostly drawn from standard linguistic theory. It then argues for a theory of the acquisition of lexical properties that is based on the interaction between two higher level systems. The first of these is a system dedicated to organising the developing lexicon into paradigms while the second is an informationally monotonic updating system whose role is to add newly acquired lexical information to those items that are not yet fully developed. It is then argued that this model can accommodate transfer effects as an inevitable consequence of BFLA. Given that the lexicon of a bilingual child is larger than that of monolinguals, the updating mechanism has a wider field of application and therefore---besides over-generalisation---transfer effects will also obtain. An important consequence of this claim is that the only difference between a monolingual and a bilingual child lies in the domain within which the updating mechanism applies. The fact that language production in bilingual children differs from that of monolinguals does not force the postulation of special bilingual strategies but can be accounted for by appealing to the very two aspects that monolinguals and bilinguals do not have in common, namely the input and the number of developing lexical sets. A substantial part of the thesis is dedicated to evaluating the empirical coverage of this model. This involves discussion of data from case-studies as well as experimental work both old and new.
NEED OF CULTURALLY COHERENT CARE FOR PEOPLE WITH CARDIOVASCULAR DISEASE AT THE END OF THEIR LIFE

El objetivo del estudio fue conocer las prácticas de cuidado que identifican los cuidadores familiares de personas con enfermedad cardiovascular al final de la vida. Se realizó una investigación cualitativa, que utilizó el método etnográfico particularista, en Medellín, Colombia, entre septiembre de 2014 y junio de 2015. Las participantes fueron mujeres cuidadoras familiares de personas con enfermedad cardiovascular en la etapa final de la vida. El estudio fue efectuado en tres escenarios de cuidado: domicilios, instituciones hospitalarias y centro geriátrico con unidad de cuidados paliativos. Con base en el análisis de los datos, emergió la categoría “Prácticas de Cuidado”, que contiene cuatro subcategorías: a) Estar pendientes: insistir al paciente, brindar cuidados respiratorios, alimentarios, de hidratación, temperatura corporal, eliminación urinaria y fecal, movilidad y postura, cuidados de la piel, higiene y estéticos; b) Mitigar el dolor y el sufrimiento; c) Cuidados espirituales; y d) Cuidados paliativos. Del estudio se concluye que unas buenas prácticas cuidantes exigen conocimientos específicos por parte de las cuidadoras familiares, de las personas con enfermedad cardiovascular en la etapa final de la vida, así como de la patología misma. Además, se requiere un abordaje desde la multidimensionalidad humana para tomar decisiones acertadas y respetuosas culturalmente, con cuidados orientados al binomio (pacientecuidador familiar).
Sonic hedgehog pathway mediates genistein inhibition of renal cancer stem cells

Cancer stem cells (CSCs) have been implicated in the genesis, progression and recurrence of renal cancer. The sonic hedgehog (Shh) pathway serves a critical role in maintaining the stemness of CSCs. Genistein, a major isoflavone component extracted from soybeans and soy products, has been demonstrated to possess anticancer activity. However, the effects of genistein on renal CSCs and its underlying mechanisms remain to be fully elucidated. The aim of the present study was to investigate the role of the Shh pathway in genistein inhibition of renal CSCs. The results of the present study demonstrated that expression levels of renal CSC markers were markedly upregulated in the sphere-forming cells, which were isolated and enriched from 786-O and ACHN cells in a tumor sphere formation assay, and more cells were arrested at the G0/G1 phase instead of the S1 phase compared with the adherent cells. Furthermore, the present study demonstrated that genistein could effectively diminish the activity of renal CSCs by suppressing tumor sphere formation, decreasing renal CSCs markers, inhibiting proliferation and inducing apoptosis. Additionally, the downregulation of Shh pathway activity could inhibit renal CSCs. Genistein exhibited an inhibitory effect on renal CSCs by attenuating the activation of the Shh pathway. In conclusion, the results illustrated the role of the Shh pathway in regulating renal CSC traits and the intervention of renal CSCs by genistein, which could provide novel insights into the molecular mechanisms of renal CSC intervention.
Constraint Fluids on GPU

The processing power of graphics hardware has increased tremendously in the last several years and they are therefore used more and more outside of their intended domain of graphics rendering. This thesis describes the implementation and results of a fluid simulator, using the constraint fluid method, which harnesses the processing power of modern GPUs, in particular NVIDIA’s CUDA platform. As demonstrated in this thesis, particle systems with hundreds of thousands of particles can be simulated and visualized at interactive rates and systems containing up to a million particles can be run at a few frames per second. The biggest performance bottleneck is currently in the solver, in particular the lack of a working preconditioned Conjugate Gradient implementation.
Audio-Visual Person Recognition Using Deep Convolutional Neural Networks

Protection of data integrity and person identity has been an active research area for many years. Among the techniques investigated, developing multi-modal recognition systems using audio and face signals for people authentication holds a promising future due to its ease of use. A challenge in developing such a multi-modal recognition system is to improve its reliability for a practical application. In this paper, an efficient audio-visual bimodal recognition system which uses Deep Convolution Neural Networks (CNNs) as a primary model architecture. First, two separate Deep CNN models are trained with the help of audio and facial features, respectively. The outputs of these CNN models are then combined/fused to predict the identity of the subject. Implementation details with regard to data fusion are discussed in a great length in the paper. Through experimental verification, the proposed bimodal fusion approach is superior in accuracy performance when compared with any single modal recognition systems and with published results using the same data-set.
The frequency of rhythm and conduction abnormalities and benefits of 24-hour Holter electrocardiogram on detecting these abnormalities in patients with acute rheumatic fever.

Acute rheumatic fever (ARF) is the most common acquired heart disease among children living in developing countries (1). During the acute phase of the disease, cardiac arrhythmias and conduction disorders can be seen (2-4). First degree atrioventricular (AV) block, which is a minor diagnostic criterion of the disease, is frequently seen, while advanced AV block, supraventricular tachycardia, bundle branch blocks, junctional rhythm, premature contractions and ventricular tachycardia are rarely seen (3-7). Although 12-lead electrocardiogram is sufficient for determining the cardiac rhythm in most of the cases, 24-hour Holter monitoring may be useful in the cases of possible paroxysmal rhythm or conduction abnormalities (3,4). The aim of this study is to provide an overview of the frequency of arrhythmias and conduction disorders in children with ARF.
‘What’s the point in extending your life if this is your life’: A qualitative exploration of pre-surgery, short-term and long-term responses to bariatric surgery

ABSTRACT This study examined experiences of weight, physical activity, diet, and quality of life of individuals prior to and following bariatric surgery. Twenty-seven people participated who represented three periods related to bariatric surgery: pre-surgery; short-term post-surgery (i.e., 1–2 years) and long-term post-surgery (i.e., 3–7 years). A qualitative descriptive design was adopted, with data collected through interviews and analysed using thematic analysis. Themes in the pre-surgery period were identified as follows: a) Growing up: Variation by family and ability, b) Weight gain: Transitions, traumas, and triggers; c) Perceptions of self: Hate, loathing, and worthlessness; d) Spiralling weight: Lack of control over vicious cycles of dieting and weight gain, and; e) Surgery: A final and essential lifeline. Short-term post-surgery themes were: a) Physical changes: Rapid weight loss and enhanced health versus hesitation and disappointment; b) Physical activity: Changes in engagement and perceptions despite ongoing barriers; c) Finding oneself: Increased emotional wellbeing, self-concept and confidence, and; d) Quality of life: Renewed physical capabilities and capacity but some continuing challenges. In the long-term following surgery, themes of: a) Weight plateau/regain: Disappointment and feelings of failure, and; b) Excess fat: Frustration and feelings of vulnerability emerged from the data. It is evident that participants go on an extended journey in the years before and after bariatric surgery and experience a range of both positive and negative outcomes. Overall, the findings highlight the importance of practitioners understanding individual’s overall journeys when seeking to help them lose weight and improve psychological health.
Late Gadolinium Hyperintensity (LGH) of Colorectal Liver Metastases (CRLM) on Magnetic Resonance Imaging (MRI)

SUMMARY) Late gadolinium hyperintensity (LGH) of solid focal liver lesions on MRI with extracellular contrast agents is typically considered a “benign” finding seen most commonly with hemangiomas, but has also been observed with colorectal liver metastases (CRLM). In the first part of this thesis, we determined the prevalence of LGH in CRLM on MRI with extracellular contrast agents. In a retrospective cohort of 134 patients with 232 pathologyconfirmed CRLMs, the prevalence of LGH in CLRMs was 47.8% (95% CI: 39.7%-56.0%). It is also known that some CRLMs demonstrate tumour fibrosis, a finding that is associated with long-term survival. LGH with extracellular contrast agents in CRLMs may be due to leakage of contrast and progressive accumulation in the extracellular space of fibrotic tumours. In the second part of this thesis, we determined whether LGH is associated with tumour fibrosis and overall survival in patients with CRLM using extracellular contrast agents. In a retrospective cohort of 121 surgical patients who received preoperative MRI with extracellular contrast agents after chemotherapy, LGH was associated with tumour fibrosis (R=0.43, p<0.001) and with improved survival with a hazard ratio of 0.32 (95% CI: 0.14-0.75, p=0.008). If LGH occurs due to leakage of extracellular contrast into fibrotic tumour, then LGH would not occur in CRLM using intravascular contrast agents, which are larger molecules bound to albumin and stay within the vascular space. Therefore, in the final part of the thesis, we determined the prevalence of LGH with intravascular contrast agents and determined the diagnostic accuracy of liver MRI using intravascular contrast agents. In a prospective cohort of 48 patients with known colorectal cancer who were referred for an MRI of the liver, we performed MRI with an intravascular contrast agent. The prevalence of LGH was 11.9% (95% CI: 4.0% to 19.9%). The diagnostic accuracy of MRI with the intravascular contrast agent for diagnosing CRLM was high with a per-lesion sensitivity and specificity of 0.99 and 0.91 respectively. In summary, LGH of CRLM on MRI with extracellular contrast agents is common and is associated with tumour fibrosis and overall survival. In contrast, LGH of CRLMs on MRI with intravascular contrast agents is uncommon, leading to an excellent diagnostic accuracy of MRI performed with intravascular contrast agents for diagnosing CRLM, and may be a useful diagnostic problem-solving tool.
The Treatment of Malignant Melanoma

Philosophy ofTreatment Clinical observation indicates that aggressive behaviour by the melanocyte does not go unchallenged. The wide range in the recorded behaviour of malignant melanoma can be more readily understood if we accept the interplay of varying degrees of malignant propensities of the tumour with varying degrees and modes of the host's defences. It is not unusual to find a state of delicately balanced symbiosis between tumour and host where both survive for many years. On rare occasions it is evident that the host is successful in overcoming the tumour (Everson & Cole 1966). Treatment could be realistically aimed firstly at eradicating the disease; secondly controlling the tumour by removing as much tumour as possible, with minimum interference of host defence mechanisms, or perhaps even active boosting of those defence mechanisms; and thirdly it could be aimed at palliation for the effects of uncontrollable tumour. Accurate diagnosis must come before effective and humane treatment. Good working rules of treatment are a compromise between less extensive surgery for good tumours and singularly ineffective massive resections for bad tumours. With increasing knowledge, we may be able to draw up treatment regimes which are suitably tailored to the prognostic features of any particular tumour. Attention has been drawn (Petersen et al. 1962) to the prognostic significance of host sex and age, tumour site and rate of growth, and also to the remarkably reliable relationship between Lloyd's histological staging and prognosis. This staging can be translated to a clinical level quite accurately and, recently, Clark's classification (Clark et al. 1969) along similar lines has received international recognition. The undesirable side-effects of treatment on the host must be kept to the minimum consistent with maximum effectiveness in destroying or controlling the tumour. Fine judgement may be necessary in individual cases, where, for instance, the quality of limited life may depend on the degree of disability and disfigurement produced.