Miracle-dz/UniFAR-FTUs huggingface dataset:
How I diagnose and manage Philadelphia chromosome-like acute lymphoblastic leukemia

Advances in our understanding of mechanisms of leukemogenesis and driver mutations in acute lymphoblastic leukemia (ALL) lead to a more precise and informative sub-classification, mainly of B-cell ALL. In parallel, in recent years, novel agents have been approved for the therapy of B-cell ALL, and many others are in active clinical research. Among the newly recognized disease subtypes, Philadelphia-chromosome-like ALL is the most heterogeneous and thus, diagnostically challenging. Given that this subtype of B-cell ALL is associated with a poorer prognosis, improvement of available therapeutic approaches and protocols is a burning issue. Herein, we summarize, in a clinically relevant manner, up-to-date information regarding diagnostic strategies developed for the identification of patients with Philadelphia-chromosome-like ALL. Common therapeutic dilemmas, presented as several case scenarios, are also discussed. It is currently acceptable that patients with B-cell ALL, treated with an aim of cure, irrespective of their age, be evaluated for a Philadelphia-chromosome-like signature as early as possible. Following Philadelphia-chromosome-like recognition, a higher risk of resistance or relapse must be realized and treatment should be modified based on the patient’s specific genetic driver and clinical features. However, while active targeted therapeutic options are limited, there is much more to do than just prescribe a matched inhibitor to the identified mutated driver genes. In this review, we present a comprehensive evidence-based approach to the diagnosis and management of Philadelphia-chromosome-like ALL at different time-points during the disease course.
Optical Properties, Morphology, and Stability of Iodide-Passivated Lead Sulfide Quantum Dots

Iodide atomic surface passivation of lead chalcogenides has spawned a race in efficiency of quantum dot (QD)-based optoelectronic devices. Further development of QD applications requires a deeper understanding of the passivation mechanisms. In the first part of the current study, we compare optics and electrophysical properties of lead sulfide (PbS) QDs with iodine ligands, obtained from different iodine sources. Methylammonium iodide (MAI), lead iodide (PbI2), and tetrabutylammonium iodide (TBAI) were used as iodine precursors. Using ultraviolet photoelectron spectroscopy, we show that different iodide sources change the QD HOMO/LUMO levels, allowing their fine tuning. AFM measurements suggest that colloidally-passivated QDs result in formation of more uniform thin films in one-step deposition. The second part of this paper is devoted to the PbS QDs with colloidally-exchanged shells (i.e., made from MAI and PbI2). We especially focus on QD optical properties and their stability during storage in ambient conditions. Colloidal lead iodide treatment is found to reduce the QD film resistivity and improve photoluminescence quantum yield (PLQY). At the same time stability of such QDs is reduced. MAI-treated QDs are found to be more stable in the ambient conditions but tend to agglomerate, which leads to undesirable changes in their optics.
Visit-to-visit blood pressure variation and outcomes in heart failure with reduced ejection fraction: findings from the Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms trial.

BACKGROUND Visit-to-visit office blood pressure (BP) variability (BPV) has been associated with morbidity and mortality outcomes in several cardiovascular conditions. The aim of this study was to evaluate the association between BPV and outcomes in patients with heart failure and reduced ejection fraction and the effect of eplerenone on BPV. METHODS AND RESULTS We evaluated the associations between BPV, calculated as SBP coefficient of variation (SBP-CoV = SD/mean × 100%), and the primary composite endpoint of cardiovascular mortality or heart failure hospitalization (HFH), and its components, in 2549 patients from the Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms trial. Lower SBP-CoV was independently associated with a higher risk of all the studied outcomes, while higher as well as lower SBP-CoV were associated with a higher risk of cardiovascular death. After a median follow-up period of 21 months the risk of the composite outcome of cardiovascular death or HFH was almost double in the lower SBP-CoV tertile as compared with the intermediate tertile [adjusted hazard ratio: 2.01, 95% confidence interval (1.62-2.51), P < 0.001]. The relationship between SBP-CoV and outcomes was not modified by eplerenone (P value for interaction = 0.48). An interaction was detected between mean SBP and SBP-CoV for the primary outcome (P = 0.048) and for HFH (P = 0.018). The effect modification was slight, but lower SBP-CoV was associated with worse outcomes in patients with both low and high SBP, while this interaction was less clear for patients with SBP in the 'normal' range. CONCLUSION In our patients with heart failure and reduced ejection fraction and mild symptoms, both a lower and higher SBP-CoV were associated with worse outcomes. SBP-CoV did not modify the benefit of eplerenone. Further studies are warranted to clarify the role of BPV in heart failure. CLINICALTRIALS. GOV IDENTIFIER NCT00232180.
Adverse childhood experiences and adult mood problems: evidence from a five-decade prospective birth cohort

Abstract Background Retrospectively recalled adverse childhood experiences (ACEs) are associated with adult mood problems, but evidence from prospective population cohorts is limited. The aims of this study were to test links between prospectively ascertained ACEs and adult mood problems up to age 50, to examine the role of child mental health in accounting for observed associations, and to test gender differences in associations. Methods The National Child Development Study is a UK population cohort of children born in 1958. ACEs were defined using parent or teacher reports of family adversity (parental separation, child taken into care, parental neglect, family mental health service use, alcoholism and criminality) at ages 7–16. Children with no known (n = 9168), single (n = 2488) and multiple (n = 897) ACEs were identified in childhood. Adult mood problems were assessed using the Malaise inventory at ages 23, 33, 42 and 50 years. Associations were examined separately for males and females. Results Experiencing single or multiple ACEs was associated with increased rates of adult mood problems after adjustment for childhood psychopathology and confounders at birth [2+ v. 0 ACEs – men: age 23: odds ratio (OR) 2.36 (95% confidence interval (CI) 1.7–3.3); age 33: OR 2.40 (1.7–3.4); age 42: OR 1.85 (1.4–2.4); age 50: OR 2.63 (2.0–3.5); women: age 23: OR 2.00 (95% CI 1.5–2.6); age 33: OR 1.81 (1.3–2.5); age 42: OR 1.59 (1.2–2.1); age 50: OR 1.32 (1.0–1.7)]. Conclusions Children exposed to ACEs are at elevated risk for adult mood problems and a priority for early prevention irrespective of the presence of psychopathology in childhood.
What predicts nonword repetition performance?

ABSTRACT Despite the widespread use of nonword repetition in child neuropsychological research and clinical practice, the specific cognitive, linguistic and motor processes that contribute to variability in performance are unclear. The aim of this work was to determine the role of phonological memory, word reading, oromotor sequencing, and oromotor control on nonword repetition performance in the context of children’s speech and language abilities. Ninety one children between the ages of 9 and 11 years, with a broad range of speech and language abilities participated in the study. Hierarchical regression was used to a) evaluate the contribution of phonological memory, word reading, oromotor sequencing and oromotor control to nonword repetition and b) determine whether speech and/or language ability moderated the relationship between these specific skills and nonword repetition performance. Results showed all four predictor variables were related to nonword repetition performance, accounting for 59% of variance. The variable with the strongest association with nonword repetition was phonological memory, followed by oromotor sequencing ability, word reading, and oromotor control. Contrary to expectations, neither speech nor language ability were significantly associated with the degree to which these specific skills were drawn upon to perform the nonword repetition task. These findings underline the multidimensional nature of the nonword repetition task and provide further evidence of the major contributions made by phonological memory, word reading, speech sequencing and control to performance on this task. Further, findings suggest that speech and language ability, as measured here, do not significantly influence the skills employed for nonword repetition performance.
Indigenous irrigants as potent antimicrobials in endodontic treatment: An in vitro study

Background: The success of an endodontic treatment depends on effective disinfection and complete sealing of root canal. The irrigants that are currently used in the field of endodontics have certain limitations, so the quest for an ideal root canal irrigant continues. Nowadays, the use of herbal extracts such as Triphala and liquorice are used for their potent antimicrobial activity and less side effects. Aim: This study aims (1) to evaluate the antimicrobial efficacy of Triphala and liquorice against Enterococcus faecalis. (2) To determine any cytotoxic effect on isolated human periodontal ligament (PDL) fibroblasts. Materials and Methods: The antimicrobial efficacy of Triphala and liquorice extracts was analyzed at different concentrations (12.5, 25, 50, 75, and 100 mg/ml) using the well-diffusion method. Three percent sodium hypochlorite (NaOCl) and distilled water were taken as positive and negative controls. Minimum inhibitory concentration of the active extract was determined by the broth dilution assay. Human PDL fibroblast tissue culture was used to assess the cytotoxicity of the preparations. The data thus obtained were subjected to statistical analysis. Results: The results showed that the mean antimicrobial efficacy of Triphala and liquorice at 50 mg/ml is 20.33 and 9.33, respectively, which are statistically significant (P < 0.0001) as compared with a concentration 12.5 and 25 mg/ml. 50 mg/ml showed significant results (P < 0.001) on comparing with hypochlorite. Triphala and liquorice showed no cytotoxic effect as compared to NaOCl on human PDL fibroblasts. Conclusion: Among the three tested materials Triphala showed the highest antimicrobial efficacy followed by NaOCl and liquorice.
Diagnostic Accuracy and Scope of Intraoperative Transoral Ultrasound and Transoral Ultrasound–Guided Fine-Needle Aspiration of Retropharyngeal Masses

SUMMARY: The use of transoral sonography–guided fine-needle aspiration for intraoperative localization of retropharyngeal masses has been described by Fornage et al. The purpose of this study was to assess the accuracy of this technique. We reviewed the images and medical records of 26 patients with a retropharyngeal lesion suspicious for a metastatic lymph node of Rouviere identified on CT and/or PET/CT. There were 14 patients with a history of thyroid cancer, 7 with mucosal squamous cell carcinoma, 1 with renal cell carcinoma, 1 with parotid acinic cell cancer, 1 with metastatic colon adenocarcinoma, and 2 with no history of cancer. Intraoperative transoral sonography was performed using a commercially available endovaginal transducer. A transoral sonography–guided fine-needle aspiration was performed with a 25-cm-long 20-ga Chiba needle through a needle guide attached to the transducer shaft. Cytopathologic results were categorized as malignant, benign, or nondiagnostic. Transoral sonography and transoral sonography–guided fine-needle aspiration were performed in all patients. A diagnostic specimen was obtained in 25 of 26 (96%) patients with a 100% overall accuracy. Twelve patients underwent subsequent transoral resection of the retropharyngeal mass. In each patient, surgical pathology confirmed the fine-needle aspiration biopsy result. In 4 patients, transoral sonography–guided injection of methylene blue was used to facilitate intraoperative localization of the metastatic retropharyngeal mass. Transoral sonography and transoral sonography–guided fine-needle aspiration of suspicious masses in the retropharyngeal space are highly accurate procedures for identification and cytologic evaluation of benign and metastatic lymph nodes of Rouviere and for presurgical localization.
Comparison of Solute Removal Properties Between High‐Efficient Dialysis Modalities in Low Blood Flow Rate

Blood flow (Qb) is one of the dialysis parameters most strongly influencing the performance of dialysis modalities. However, few studies have compared different dialysis modalities in patients with low Qb. We conducted a prospective, single‐center study in 21 patients. Each patient underwent four dialysis sessions with routine dialysis parameters: high‐flux hemodialysis (HD), predilution hemodiafiltration (pre‐HDF), expanded HD (HDx), and postdilution HDF (post‐HDF). The removal ratios (RR) of urea, creatinine, ß2‐microglobulin, myoglobin, prolactin, α1‐microglobulin, free kappa and lambda immunoglobulin light chains (ķFLC and λFLC), α1‐acid glycoprotein, and albumin were compared intraindividually. A proportional part of the dialysate was collected to quantify albumin loss. There were no differences in urea and creatinine RRs. The β2‐microglobulin RR was higher in pre‐HDF and post‐HDF. Myoglobin and prolactin RRs were higher with HDx and post‐HDF. The α1‐microglobulin and α1‐acid glycoprotein RRs were significantly higher with post‐HDF than with other treatments, and RRs obtained with HDx were higher than obtained with HD and pre‐HDF. Free ķFLC and λFLC RRs showed the following results in ascending order: HD, pre‐HDF, HDx, and post‐HDF, most of them with statistical significance. Albumin loss varied from 0.45 g with HD to 3.5 g with post‐HDF. The global removal score values were 41.0 ± 4.8% with HD, 44.0 ± 5.2% with pre‐HDF, 49.5 ± 4.6% with HDx, and 54.8 ± 5.3% with post‐HDF, with significant differences between all treatment modalities. In conclusion, this study confirms the superiority of post‐HDF over high‐flux HD, pre‐HDF, and HDx in patients with low Qb. HDx was the closest alternative to post‐HDF and was clearly superior to HD and pre‐HDF. Finally, pre‐HDF was also superior to HD. With this Qb, there was a higher risk of underdialysis, both diffusive and convective, especially in patients with a session duration of less than 5 h.
Eating Occasions, Obesity and Related Behaviors in Working Adults: Does it Matter When You Snack?

Reported relationships between frequency, type, and timing of eating occasions and obesity-risk among adults are mixed while associations with obesogenic eating behaviors remain unexplored. The Physical Activity and Changes in Eating (PACE) study was a group-randomized controlled trial to prevent weight gain among 34 small worksites in Seattle from 2005–2009. Baseline surveys assessed body mass index (BMI), obesogenic eating behaviors (e.g., fast food and distracted-eating), and eating occasions (i.e., snacks and meals) among 2265 employees. BMI and waist circumference were measured on a subset (n = 567). Time-periods for analyses included: morning (12:00 a.m. to 10:59 a.m.), mid-day (11:00 a.m. to 4:29 p.m.), and evening (4:30 p.m. to 11:59 p.m.). Multilevel linear models estimated associations between snack timing, obesity, and related behaviors while adjusting for meal timing, gender, and worksite random effects. Greater morning snacking was associated with increased fruit and vegetable consumption, while greater evening snacking was associated with higher BMI, higher obesogenic dietary index (intake of fast food, French fries, and soft drinks), and higher percent time eating while distracted. Associations with mid-day snacking were mixed. Patterns of association were consistent across repeated and objective measures. Findings suggest that evening snacking is more detrimental to healthy weight compared to snacking at other times of day. Reducing evening snacks may be an important and simple message for population-level obesity prevention efforts.
An observational study of pregnancy and post‐partum outcomes in women with prolactinoma treated with dopamine agonists

In women with prolactinoma medical treatment with dopamine agonists (DA) can restore fertility. A number of studies have established the safety of DA during pregnancy and the impact of pregnancy and lactation on remission of prolactinoma. However, the total number of reported cases remains modest and further evidence is needed.
To study the profile of Candida isolates and antifungal susceptibility pattern of neonatal sepsis in a tertiary care hospital of North India

Abstract Aims and objective To study the profile of Candida infection and antifungal susceptibility (AFS) pattern in neonatal sepsis. Materials and methods In this prospective observational study, 850 blood samples were collected and processed from neonates who were suspected clinically to have sepsis. The blood culture that showed growth of Candida was further processed for species identification. Antifungal susceptibility was done as per the National Committee for Clinical Laboratory Standards (NCCLS)/Clinical Laboratory Standards Institute (CLSI) M44-A-2 guidelines by disc diffusion method and automated vitek-2 compact system. Candidemia was diagnosed by isolation of Candida species from at least one positive blood culture containing pure growth of Candida species with supportive clinical features. Results Candida species were isolated in 32 specimens of the total 322 culture-positive cases. The most common isolate was Candida tropicalis (14/32; 43.75%) followed by Candida albicans (7/32; 21.87%) and Candida glabrata (6/32; 18.75%). The three most common neonatal risk factors for candidemia were low birth weight, prolonged use of intravenous antibiotics and presence of central venous line. Non-albicans Candida (NAC) showed good sensitivity to fluconazole as compared to Candida albicans. The fluconazole sensitivity of Candida tropicalis, Candida glabrata, and Candida parapsilosis was 93, 67, and 100%, respectively, whereas it was 57% in Candida albicans. The sensitivity to amphotericin B was 95% among all Candida isolates. All NAC were sensitive to amphotericin B, while only 72% Candida albicans were sensitive to amphotericin B. Conclusions The incidence of neonatal sepsis secondary to NAC is increasing and has replaced Candida albicans as a major cause of neonatal fungal sepsis. Low birth weight is the most important risk factor for Candida sepsis. The resistance of Candida albicans is increasing for both fluconazole and amphotericin B when compared to NAC. Increasing antifungal resistance warrants its judicious use both for prophylaxis and treatment.
The Importance of Considering Alexithymia during Initial Stages of Intimate Partner Violence Interventions to Design Adjuvant Treatments

Empirical evidence supports that individuals with alexithymia might be prone to certain types of violence, such as intimate partner violence against women (IPVAW). Moreover, considering that alexithymia is directly involved in behavior regulation, problems due to identifying and regulating emotional states might be postulated as responsible, at least in part, for the success of psychotherapeutic treatments designed for decreasing the future risk of reoffending. Therefore, we assessed whether alexithymia was a good predictor of the discontinuation of treatment (dropout) and the risk of recidivism during the initial stages of intervention in a sample of men convicted of IPVAW perpetration (n = 118), while controlling for potential confounding variables (i.e., socio-demographic characteristics, impulsivity, and drug misuse). Our data demonstrate that high alexithymic traits lead to dropout and a high risk of recidivism during the initial stages of treatment, remaining significant even after including potential confounding variables. Even though impulsivity and drug misuse increase the amount of explained variance, none of them moderates the association of alexithymia with dropout and/or reoffending. It should be noted that this study identified alexithymia as a direct modulator of violence due to its effects on discontinuing IPVAW treatment during initial stages. Therefore, as we gain knowledge analyzing the relationships between previously mentioned factors, it could be applied to develop valid screening methods along with strengthening current rehabilitation programs and designing adjuvant treatments to increase their effectiveness.
Counselling before first trimester abortion and acceptability of the procedure: results from a Slovenian cross-sectional study

Abstract Objectives: In Slovenia, first-trimester abortion is performed at the woman’s request, either surgically under general anaesthesia or medically with mifepristone and misoprostol, in a public hospital. Our study aimed to evaluate pre-abortion counselling and to reveal differences in acceptability and satisfaction with the two abortion methods. Methods: A cross-sectional study was carried out at Ljubljana University Medical Centre between January and June 2015. Women requesting termination of a pregnancy up to 10 weeks’ gestation voluntarily completed an anonymous questionnaire after the procedure and were divided into a surgical and a medical abortion group. Results: Of the 266 women who were invited to take part, 229 accepted; 16.6% chose a surgical abortion, 83.4% a medical abortion. The most frequent reason cited for requesting an abortion was economic/housing problems. Most women who chose a surgical abortion did so because it was faster, whereas most women who chose a medical abortion did so on the advice of a primary care gynaecologist. Women choosing a surgical abortion had more previous pregnancies and presented with a higher gestational age pregnancy. The choice of method was not related to the woman’s age. There were no differences in acceptability of the two procedures. Pain during the procedure was, however, more severe in the medical abortion group (p = .026), along with bleeding, nausea and chills; there were no differences in severity of vomiting, diarrhoea, dizziness or headache between the groups. Women in the surgical abortion group reported higher satisfaction with the method (p < .001). The study revealed a low frequency of pre-abortion contraceptive counselling. Conclusion: The most common reason given for choosing a surgical abortion was the speed of the procedure; for a medical abortion, it was on the advice of a primary care gynaecologist. Satisfaction was higher with the surgical abortion method. There were no differences in general acceptability of the methods.