Miracle-dz/UniFAR-FTUs huggingface dataset:
Precipitating Factors for Hospitalization with Heart Failure: Prevalence and Clinical Impact Observations from the Gulf CARE (Gulf aCute heArt failuRe rEgistry)

Objective: Despite the expanding burden of heart failure (HF) worldwide, data on HF precipitating factors (PFs) in developing countries, particularly the Middle East, are very limited. We examined PFs in patients hospitalized with acute HF in a prospective multicenter HF registry from 7 countries in the Middle East. Method: Data were derived from the Gulf CARE (Gulf aCute heArt failuRe rEgistry) for a prospective, multinational, multicenter study of consecutive patients hospitalized with HF in 47 hospitals in 7 Middle Eastern countries between February 2012 and November 2012. PFs were determined by the treating physician from a predefined list at the time of hospitalization. Results: The study included 5,005 patients hospitalized with acute HF, 2,276 of whom (45.5%) were hospitalized with acute new-onset HF (NOHF) and 2,729 of whom (54.5%) had acute decompensated chronic HF (DCHF). PFs were identified in 4,319 patients (86.3%). The most common PF in the NOHF group was acute coronary syndromes (ACS) (39.2%). In the DCHF group, it was noncompliance with medications (27.8%). Overall, noncompliance with medications was associated with a lower inhospital mortality (OR 0.47; 95% CI 0.28–0.80; p = 0.005) but a higher 1-year mortality (OR 1.43; 95% CI 1.1–1.85; p = 0.007). ACS was associated with higher inhospital mortality (OR 1.84; 95% CI 1.26–2.68; p = 0.002) and higher 1-year mortality (OR 1.62; 95% CI 1.27–2.06; p = 0.001). Conclusion: Preventive and therapeutic interventions specifically directed at noncompliance with medications and ACS are warranted in our region.
Estimation and Correlation of MMP-8 Levels in GCF and Serum with Wound Healing and Clinical Outcomes of Coronally Advanced Flap and Sub-Epithelial Connective Tissue Graft for Root Coverage - A Controlled Clinical Trial.

BACKGROUND AND OBJECTIVES The success of any surgical procedure is predominately influenced by the pattern of its wound healing. The objective of the present study was to assess gingival crevicular fluid (GCF) and serum matrix metalloproteinase-8 (MMP-8) levels during the early healing phase of root coverage procedures. MMP-8 levels on days four and seven were correlated with the wound healing index (WHI) to evaluate the presence of MMP-8 during early post-surgical wound healing after root coverage procedures. MATERIALS AND METHODS Fifteen isolated maxillary Miller's Class I/Class II recession defects in systemically and periodontally healthy patients in the age range of 25 - 57 years were treated with coronally advanced flap and sub-epithelial connective tissue graft (CAF + SCTG). GCF and serum samples were collected at baseline, day four, day seven and six months after surgery from the gingival sulcus of the recession defect. A contralateral tooth with clinically healthy gingiva was used as control and samples were collected from this site too at the same time intervals. MMP-8 levels in GCF and serum were measured using enzyme-linked immunosorbent assay (ELISA). Wound Healing Index was assessed on days four and seven. Mean root coverage (MRC) and complete root coverage (CRC) were assessed six months post-operatively. RESULTS Statistically signifi cant reduction in recession depth was observed with MRC of 88.67%. GCF and serum MMP-8 levels were significantly elevated on days four and seven post-surgery (p less than 0.001) in the test site and reduced to baseline levels after six months. Weak positive correlation was observed between wound healing index and GCF MMP-8 levels on days four and seven. Moderate positive correlation was noted between serum MMP-8 levels and root coverage outcomes. However, this correlation was not statistically signifi cant (p greater than 0.05). CONCLUSION The present prospective study showed satisfactory post-surgical healing and root coverage outcome. MMP-8 levels and its increase/decrease during the early wound healing follows the expected temporal pattern. No significant correlation was noted between MMP-8 levels during early wound healing and root coverage outcomes.
Mode and Frame Matter: Assessing the Impact of Survey Mode and Sample Frame in Choice Experiments

Background. Choice experiments (CE) are applied in health economics to elicit public preferences and willingness to pay (WTP). CEs are frequently administered as Internet-based surveys. Internet surveys have recognized advantages, but concerns exist about the representativeness of Internet samples, data quality, and the impact on elicited values. Aim. We conducted the first study in health comparing an Internet-based CE survey with the more traditional general population mail survey. We also compared the Internet-based and mail CE surveys with computer-assisted personal interviews (CAPIs), which are commonly used to elicit health state valuations. Methods. Two separate samples were drawn from 2 United Kingdom (UK) volunteer Internet panels (IPs), CAPIs were undertaken with respondents sampled from UK Census Output Areas, and mail surveys were sent to UK households drawn from the postcode address file (PAF). Each mode received more than 1000 respondents. We compared modes and frames using objective measures (response rate, sample representativeness of the UK population, elicited values, theoretical validity, and cost per response) and subjective/self-reported measures (time taken to complete the study, perceived study consequentiality, and stated attribute nonattendance). This study intentionally confounded the survey modes and sample frame by choosing sample frames that are typically used by researchers for each mode. Results. Estimated WTP differs across mode-frame pairs. On most measures, CAPIs dominated. They are more expensive, however. On all measures, except response rates, Internet surveys dominated the mail survey. They were also cheaper. Conclusion. Researchers using IPs should pay attention to response rates and be aware that the quality of IPs differs. Given the importance of perceived consequentiality and attribute attendance in CEs, future research should address their impact across modes and frames.
Sexual Homicide in France and Canada: An International Comparison

Despite a recent increase in the number of studies published on sexual homicide (SH), several of these studies have been based on small and nonrepresentative samples. This study aims to describe and compare two samples of SH from France (n = 412) and Canada (n = 350) where data have been collected and coded with the same tool. The data include variables related to the crime, the offender, and the victim characteristics. The overarching goal is to further the knowledge about French SH and to assess the possibility of merging French and Canadian cases to create a cross-national database of 772 cases of SH. Among the 126 variables included in the comparative analysis, 31 (24.60%) presented significant differences between the two samples. Overall, findings suggest that SH cases between the two countries are more similar than they are different.
Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data

Supplemental digital content is available in the text. ABSTRACT Purpose Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. Methods We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. Results Exercise interventions had statistically significant beneficial effects on fatigue (β = −0.17; 95% confidence interval [CI], −0.22 to −0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = −0.18; 95% CI −0.28 to −0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = −0.29; 95% CI, −0.39 to −0.20) than supervised interventions with a longer duration. Conclusions In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration.
Value-based decision making: An interactive activation perspective.

Prominent theories of value-based decision making have assumed that choices are made via the maximization of some objective function (e.g., expected value) and that the process of decision making is serial and unfolds across modular subprocesses (e.g., perception, valuation, and action selection). However, the influence of a large number of contextual variables that are not related to expected value in any direct way and the ubiquitous reciprocity among variables thought to belong to different subprocesses suggest that these assumptions may not always hold. Here, we propose an interactive activation framework for value-based decision making that does not assume that objective function maximization is the only consideration affecting choice or that processing is modular or serial. Our framework holds that processing takes place via the interactive propagation of activation in a set of simple, interconnected processing elements. We use our framework to simulate a broad range of well-known empirical phenomena-primarily focusing on decision contexts that feature nonoptimal decision making and/or interactive (i.e., not serial or modular) processing. Our approach is constrained at Marr's (1982) algorithmic and implementational levels rather than focusing strictly on considerations of optimality at the computational theory level. It invites consideration of the possibility that choice is emergent and that its computation is distributed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Usefulness of raw bioelectrical impedance parameters in tracking fluid shifts in judo athletes

Abstract Bioelectrical impedance (BI) has been widely used but clarification about the behaviour of raw BI measurements under specific athletic conditions is required. Thus, we determined the usefulness of raw BI measures in tracking body fluids changes during the preparation period prior to competition in elite Judo athletes. At baseline (weight stability), 27 male athletes were evaluated (23.2 ± 2.8y) and again 1–3 days before competition (∼1–2 months apart). Athletes were free to gain/lost weight based upon specific competition needs. Using dilution techniques (deuterium and bromide), total-body water (TBW) and extracellular water were estimated, and intracellular water calculated as TBW minus extracellular water. Body fluid distribution was determined as Extra-to-/Intracellular water (E/I). Fat and fat-free mass (FFM) was assessed by dual-energy x-ray absorptiometry. Resistance, reactance, and phase angle (PhA) were obtained from bioelectrical impedance spectroscopy (50-kHz frequency). No differences in raw BI measures were observed between athletes that lost (N = 17) or gain weight (N = 10), except for fat, FFM, extracellular water, and EI (p < 0.05). After adjusting for FFM and height, resistance explained TBW (β = −0.047, p = 0.002) and extracelular water (β = −0.025, p = 0.001). Reactance explained ECW (β = −0.098, p = 0.004) and EI (β = −0.004, p = 0.006), while PhA predicted TBW (β = 1.609, p = 0.047), ICW (β = 1.899, p = 0.001) and EI (β = −0.056, p = 0.001). Regardless of body composition changes, athletes who increase reactance and resistance reduced extracellular water and body fluids while those who raised PhA increased intracellular water. Judo athletes who reduced weight, decreased FFM but cellular health was not compromised, as PhA remained stable and, consequently, cell hydration.
Acute Neuromuscular and Microvascular Responses to Concentric and Eccentric Exercises With Blood Flow Restriction.

Lauver, JD, Cayot, TE, Rotarius, TR, and Scheuermann, BW. Acute neuromuscular and microvascular responses to concentric and eccentric exercises with blood flow restriction. J Strength Cond Res XX(X): 000-000, 2019-The purpose of this study was to investigate the effects of the addition of blood flow restriction (BFR) during concentric and eccentric exercises on muscle excitation and microvascular oxygenation status. Subjects (N = 17) were randomly assigned to either a concentric (CON, CON + BFR) or eccentric (ECC, ECC + BFR) group, with one leg assigned to BFR and the other to non-BFR. Surface electromyography and near-infrared spectroscopy were used to measure muscle excitation and microvascular deoxygenation (deoxy-[Hb + Mb]) and [total hemoglobin concentration] during each condition, respectively. On separate days, subjects completed 4 sets (30, 15, 15, 15) of knee extension exercise at 30% maximal torque, and 1 minute of rest was provided between the sets. Greater excitation of the vastus medialis was observed during CON + BFR (54.4 ± 13.3% maximal voluntary isometric contraction [MVIC]) and ECC + BFR (53.0 ± 18.0% MVIC) compared with CON (42.0 ± 10.8% MVIC) and ECC (46.8 ± 9.6% MVIC). Change in deoxy-[Hb + Mb] was greater during CON + BFR (10.0 ± 10.4 μM) than during CON (4.1 ± 4.0 μM; p < 0.001). ECC + BFR (7.8 ± 6.7 μM) was significantly greater than ECC (3.5 ± 4.7 μM; p = 0.001). Total hemoglobin concentration was greater for ECC + BFR (7.9 ± 4.4 μM) compared with ECC (5.5 ± 3.5 μM). The addition of BFR to eccentric and concentric exercises resulted in a significant increase in metabolic stress and muscle excitation compared with non-BFR exercise. These findings suggest that although BFR may increase the hypertrophic stimulus during both modes of contraction, BFR during concentric contractions may result in a greater stimulus.
An evaluation of the different types of labor pain relief, preferred methods of pain relief, and effects of social media on awareness and knowledge among pregnant women

Objectives: To evaluate the attitudes of pregnant women towards different forms of labor pain relief, preferred methods of pain relief, and the effects of social media on their awareness and knowledge. Methods: This was a cross-sectional study conducted between April and August 2017 in the Maternity and Children’s Hospital, Najran, Saudi Arabia. A total of 416 pregnant women were interviewed and analyzed using IBM Statistical Package for Social Sciences version 20 (IBM Corp, Armonk, NY, USA). Results: A total of 62.7% were aware of labor pain. However, 58.7% of the total sample group was unaware of labor pain relief, and 79.8% of the total sample group was unaware of the different forms of labor pain relief available. Educational level was significantly associated with awareness and knowledge of labor pain relief (p=0.001). The majority of pregnant women obtained information from friends (57.5%); and only 16.1% of women received information from their health care providers. Conclusion: Most of the pregnant women recruited into this study had insufficient awareness of labor pain and methods of pain relief. They acquired their information from their friends and families rather than from their health care providers.
Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients With Heart Failure With Reduced Ejection Fraction: The DEFINE-HF Trial.

Outcome trials in patients with type 2 diabetes mellitus have demonstrated reduced hospitalizations for heart failure (HF) with sodium-glucose co-transporter-2 inhibitors. However, few of these patients had HF, and those that did were not well-characterized. Thus, the effects of sodium-glucose co-transporter-2 inhibitors in patients with established HF with reduced ejection fraction, including those with and without type 2 diabetes mellitus, remain unknown. DEFINE-HF (Dapagliflozin Effects on Biomarkers, Symptoms and Functional Status in Patients with HF with Reduced Ejection Fraction) was an investigator-initiated, multi-center, randomized controlled trial of HF patients with left ventricular ejection fraction ≤40%, New York Heart Association (NYHA) class II-III, estimated glomerular filtration rate ≥30 mL/min/1.73m 2 , and elevated natriuretic peptides. In total, 263 patients were randomized to dapagliflozin 10 mg daily or placebo for 12 weeks. Dual primary outcomes were (1) mean NT-proBNP (N-terminal pro b-type natriuretic peptide) and (2) proportion of patients with ≥5-point increase in HF disease-specific health status on the Kansas City Cardiomyopathy Questionnaire overall summary score, or a ≥20% decrease in NT-proBNP. Patient characteristics reflected stable, chronic HF with reduced ejection fraction with high use of optimal medical therapy. There was no significant difference in average 6- and 12-week adjusted NT-proBNP with dapagliflozin versus placebo (1133 pg/dL (95% CI 1036–1238) vs 1191 pg/dL (95% CI 1089–1304), P =0.43). For the second dual-primary outcome of a meaningful improvement in Kansas City Cardiomyopathy Questionnaire overall summary score or NT-proBNP, 61.5% of dapagliflozin-treated patients met this end point versus 50.4% with placebo (adjusted OR 1.8, 95% CI 1.03-3.06, nominal P =0.039). This was attributable to both higher proportions of patients with ≥5-point improvement in Kansas City Cardiomyopathy Questionnaire overall summary score (42.9 vs 32.5%, adjusted OR 1.73, 95% CI 0.98–3.05), and ≥20% reduction in NT-proBNP (44.0 vs 29.4%, adjusted OR 1.9, 95% CI 1.1–3.3) by 12 weeks. Results were consistent among patients with or without type 2 diabetes mellitus, and other prespecified subgroups (all P values for interaction=NS). In patients with heart failure and reduced ejection fraction, use of dapagliflozin over 12 weeks did not affect mean NT-proBNP but increased the proportion of patients experiencing clinically meaningful improvements in HF-related health status or natriuretic peptides. Benefits of dapagliflozin on clinically meaningful HF measures appear to extend to patients without type 2 diabetes mellitus. URL: https://www.clinicaltrials. gov . Unique identifier: NCT 02653482.
Cemiplimab-rwlc as first and only treatment for advanced cutaneous squamous cell carcinoma

ABSTRACT Introduction: In September of 2018, the United States Federal Drug Administration (FDA) approved cemiplimab-rwlc (Libtayo) for advanced cutaneous squamous cell carcinoma (CSCC). Cemiplimab is an intravenous human monoclonal antibody directed against programmed cell death-1 receptor (PD-1). Cemiplimab blocks T-cell inactivation and enhances the immune system’s anti-tumor response. Areas Covered: We review CSCC and the studies leading to cemiplimab’s approval, including common side effects and safety issues experienced during the clinical trials. Expert Opinion: Immunotherapy, specifically checkpoint inhibitors, represents an increasingly utilized class of medications that is proving to be an effective treatment option for those with certain cancers. Over time, immunotherapy is likely to be the standard of care for immune-sensitive tumors. There are many challenges that the field faces, including the identification of reliable biomarkers to better predict response, decreasing toxicity, and the potential treatment of organ transplant patients.
Risk for Thyroid Cancer Recurrence Is Higher In Men Than In Women Independent of Disease Stage At Presentation.

BACKGROUND Well-differentiated thyroid cancer (DTC) presents at a more advanced stage in men than in women, and the mortality in men is higher than that in women. However, it is not clear whether DTC recurrence is affected by sex independent of stage at presentation. The objective of the present study was to assess if male sex is an independent risk factor for recurrence of DTC Methods: The Canadian Collaboration Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe patterns of care for thyroid cancer. We included patients from the CANNECT registry with DTC diagnosed at age 18 or older between 2000 and 2010. We compared men and women with respect to presentation, management and recurrence risk, stratified for American Joint Committee on Cancer (AJCC) stage. RESULTS We included 2595 patients, 2067 (79.7%) women and 528 (20.3%) men. Men presented with more advanced AJCC stage (P<0.001), T stage (P<0.001), N stage (P<0.001) and M stage (P=0.002) There was no difference in follow-up duration between women (7.7±4.0 [mean±SD] years) and men (7.7± 4.0 years, p=0.985). Overall recurrence was 2.2 % (n=46) for women and 8.5% (n=45) for men (P<0.001). In multivariate analysis adjusted for AJCC stage, men were at significantly greater risk for DTC recurrence than women (adjusted hazard ratio 2.72 (95% CI 1.78-4.20; P<0.001). In multivariate analysis adjusted for TNM stage, men were at significantly greater risk for DTC recurrence than women (adjusted hazard ratio 2.31 (95% CI 1.48-3.60; P<0.001). CONCLUSIONS Our study confirms that the risk for recurrence of DTC is higher in men than in women. Although men tend to present with more advanced stage disease, the difference in recurrence risk persists when adjusted for stage of presentation. It needs to be determined whether sex should influence follow-up intensity and/or duration.
Why suspects confess: The power of outcome certainty.

OBJECTIVE In custodial interrogations, suspects tend to give disproportionate weight to immediate outcomes relative to future outcomes when deciding whether to confess or deny guilt. The current research examined whether the perceived (un)certainty of an immediate outcome influences suspects' short-sighted confession decisions. HYPOTHESES We hypothesized that suspects are more likely to make short-sighted confession decisions when an immediate punishment is certain versus uncertain and that the effects of a certain immediate punishment become stronger the longer suspects are interrogated. METHOD Using the repetitive question paradigm, college student participants (N = 164, 57% women, 87% Caucasian, M age 18.9 years) admitted or denied 20 illegal and unethical behaviors in an interview. Participants' admissions and denials received either an immediate punishment (answering repetitive questions) or a future punishment (meeting with a police officer in several weeks to discuss their misconduct). In addition, we manipulated participants' perceptions of the immediate punishment to be either certain or uncertain. RESULTS Participants showed greater short-sightedness in their admission decisions when they perceived the immediate punishment to be certain versus uncertain. Moreover, the influence of the certain immediate punishment on participants' admission decisions tended to increase over time. CONCLUSIONS These findings provide empirical evidence that the certainty of immediate outcomes may contribute to suspects' shorted-sighted confession decisions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).