Miracle-dz/UniFAR-FTUs huggingface dataset:
Scoring System Prognostic of Outcome in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome.

PURPOSE To develop a system prognostic of outcome in those undergoing allogeneic hematopoietic cell transplantation (allo HCT) for myelodysplastic syndrome (MDS). PATIENTS AND METHODS We examined 2,133 patients with MDS undergoing HLA-matched (n = 1,728) or -mismatched (n = 405) allo HCT from 2000 to 2012. We used a Cox multivariable model to identify factors prognostic of mortality in a training subset (n = 1,151) of the HLA-matched cohort. A weighted score using these factors was assigned to the remaining patients undergoing HLA-matched allo HCT (validation cohort; n = 577) as well as to patients undergoing HLA-mismatched allo HCT. RESULTS Blood blasts greater than 3% (hazard ratio [HR], 1.41; 95% CI, 1.08 to 1.85), platelets 50 × 10(9)/L or less at transplantation (HR, 1.37; 95% CI, 1.18 to 1.61), Karnofsky performance status less than 90% (HR, 1.25; 95% CI, 1.06 to 1.28), comprehensive cytogenetic risk score of poor or very poor (HR, 1.43; 95% CI, 1.14 to 1.80), and age 30 to 49 years (HR, 1.60; 95% CI, 1.09 to 2.35) were associated with increased hazard of death and assigned 1 point in the scoring system. Monosomal karyotype (HR, 2.01; 95% CI, 1.65 to 2.45) and age 50 years or older (HR, 1.93; 95% CI, 1.36 to 2.83) were assigned 2 points. The 3-year overall survival after transplantation in patients with low (0 to 1 points), intermediate (2 to 3), high (4 to 5) and very high (≥ 6) scores was 71% (95% CI, 58% to 85%), 49% (95% CI, 42% to 56%), 41% (95% CI, 31% to 51%), and 25% (95% CI, 4% to 46%), respectively (P < .001). Increasing score was predictive of increased relapse (P < .001) and treatment-related mortality (P < .001) in the HLA-matched set and relapse (P < .001) in the HLA-mismatched cohort. CONCLUSION The proposed system is prognostic of outcome in patients undergoing HLA-matched and -mismatched allo HCT for MDS.
Prenatal early food and multiple micronutrient supplementation trial reduced infant mortality in Bangladesh, but did not influence morbidity

A previous maternal and infant nutrition intervention in rural Matlab, Bangladesh, showed that prenatal nutrient supplements improved child survival, but had no effect on size at birth. This secondary analysis examined whether prenatal multiple micronutrient supplements (MMS), on their own or combined with an early invitation to receive prenatal food supplements, affected child morbidity.
Drenching/bolus gun injuries in sheep

OVER the past 10 years, the Veterinary Laboratories Agency (VLA) in England and Wales has confirmed over 270 cases of severe pharyngeal injury and its sequelae in sheep following the use of a drenching/bolus gun (VIDA data). These cases were confirmed by individual postmortem examinations, and it is likely, therefore, that many more sheep will have been affected on these and other farms during this same time period. Both the VLA and the Scottish Agricultural College (SAC) have reported on this previously (SAC 2002, VLA 2002, 2006, 2011). During the last three months of 2010, however, a number of particularly serious incidents have been investigated whereby a significant number of affected animals have died or were culled on welfare grounds. In one case, a total of 500 ewes were dosed orally with a vitamin/mineral supplement using a conventional drenching gun. Six ewes died within the first 24 hours, and a further 40 …
Evidence-Based Versus Personalized Prostate Cancer Screening: Using Baseline Prostate-Specific Antigen Measurements to Individualize Screening.

the need for prostate biopsy. These trials include the US Prostate, Lung, Colorectal, andOvarian Cancer ScreeningTrialthatrandomly assigned 76,685 men age 55 to 74 years to annual screening versus usual care and recommended aprostate biopsy for aPSA.4ng/mL or suspicious digital rectal examination. This study found no difference in prostate cancer mortality between the screening and usual care groups. 9 However, these results are not surprising, given that approximately 90% of men in the usual care arm had PSA testing (more than in the screening arm). 10 Therefore, the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial is not informative regarding the efficacy of screening versus no screening. The European Randomized Study of Screening for Prostate Cancer randomly assigned 162,388 menage55 to69yearstoscreening and control arms. 11 This study reported a significant reduction in metastatic disease and prostate cancer death with PSA screening at 2to 4-year intervals, primarily using a PSA threshold of 3 ng/mL. The Goteborg population-based randomized trial in Sweden randomly assigned 20,000 men to PSA screening every 2 years beginning at age 50 years and found the greatest overall reduction in prostate cancer mortality reported to date. 12 This may imply that more frequent screening in younger men accounts for the better results observed in this population compared with the rest of the European trial. Indeed, a recent study comparing men age 50 to 54 years from this trial to age-matched Swedish men from the pre-PSA era found that screening in this age group was associated with a large reduction in metastatic disease (incidence rate ratio, 0.43; 95% CI, 0.22 to 0.79) and prostate cancer death (incidence rate ratio, 0.29; 95% CI, 0.11 to 0.67). 13 However, since the time of these randomized trials, numerous studies suggest offering screening at an even earlier age. In a large prospective US screening study, our group reported that men with a baseline PSA level in their 40s above the age-specific median of 0.7 ng/mL had a significantly higher risk of future prostate cancer diagnosis and aggressive disease. 14 Conversely, among men with a baseline PSA level below the age-specific median in their 40s, only 0.3% reached the PSAthreshold for biopsy of 2.5 ng/mLwithin the next 5 years, and only one was diagnosed with prostate cancer before age 50 years. 15
Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline.

PURPOSE To provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors. METHODS An ASCO-convened expert panel conducted a systematic literature search of studies investigating chronic pain management in cancer survivors. Outcomes of interest included symptom relief, pain intensity, quality of life, functional outcomes, adverse events, misuse or diversion, and risk assessment or mitigation. RESULTS A total of 63 studies met eligibility criteria and compose the evidentiary basis for the recommendations. Studies tended to be heterogeneous in terms of quality, size, and populations. Primary outcomes also varied across the studies, and in most cases, were not directly comparable because of different outcomes, measurements, and instruments used at different time points. Because of a paucity of high-quality evidence, many recommendations are based on expert consensus. RECOMMENDATIONS Clinicians should screen for pain at each encounter. Recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new-onset pain should be evaluated, treated, and monitored. Clinicians should determine the need for other health professionals to provide comprehensive pain management care in patients with complex needs. Systemic nonopioid analgesics and adjuvant analgesics may be prescribed to relieve chronic pain and/or to improve function. Clinicians may prescribe a trial of opioids in carefully selected patients with cancer who do not respond to more conservative management and who continue to experience distress or functional impairment. Risks of adverse effects of opioids should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at www.asco. org/chronic-pain-guideline and www.asco. org/guidelineswiki.
Compliance of Resident and Staff Physicians With IDSA Guidelines for the Diagnosis and Treatment of Streptococcal Pharyngitis

Abstract: We evaluated physician's compliance with the Infectious Disease Society of America guidelines for diagnosis and management of group A streptococcal (GAS) pharyngitis in the emergency room. Of the 1423 episodes of acute pharyngitis evaluated, 38% received care by supervised resident physicians. Physicians prescribed antibiotics for 75% of the episodes. Diagnostic tests were obtained in only 519 episodes (36%). Among patients tested, 38% had positive results for GAS. Among patients with negative rapid antigen detection test and/or throat culture, 25% were inappropriately treated with antibiotics. Eighty-nine percent of patients who were not tested with rapid antigen detection test or culture were prescribed an antibiotic. As the number of clinical criteria increased, the likelihood for diagnostic testing for GAS decreased, whereas the likelihood for antibiotic treatment increased. There was no difference in disease management by resident or staff physicians. We conclude that both resident and staff physicians in this emergency room setting exhibited limited compliance with the Infectious Disease Society of America guidelines for GAS pharyngitis.
Influence of head positioning on the assessment of Chiari-like malformation in Cavalier King Charles spaniels

Chiari-like malformation (CM) is almost omnipresent in the Cavalier King Charles spaniels (CKCS), often leading to syringomyelia (SM). Morphometric studies have produced variable results concerning relationship between the brain parenchyma within the caudal cranial fossa (CCF) and SM. The present study assesses the effect of head position, one potential confounder. Magnetic resonance images of CKCS with CM were reviewed in extended and flexed head positions. Volumes were calculated from transverse T2-weighted brain images. Mid-sagittal images were used for measurement of cerebellar herniation and CSF space between cerebellum and brainstem. Fourteen CKCS were included into the study, seven dogs with CM and seven with CM/SM. There was no difference between the relative brain parenchyma within the CCF in extended position and flexed position, or the brain parenchyma within the rostral and middle cranial fossae proportion. Cerebellar herniation and CSF space between cerebellum and brainstem were significantly increased in the flexed position. Cerebellar herniation and CSF space differed significantly between CM and CM/SM in a flexed head position. Volumetric measurements did not vary with head position. Cerebellar herniation and CSF space between the cerebellum and the brainstem were larger in a flexed head position.
The ECASS 3-Hour Cohort

Objectives: (1) To determine whether and how outcome measurements in the ECASS trial are influenced by a shorter time window (0–3 vs. 3–6 h) between onset of symptoms and start of thrombolytic therapy using recombinant tissue plasminogen activator (rt-PA) in acute ischemic stroke. (2) To discuss the results of the ECASS 0- to 3-hour cohort with the results of the National Institute of Neurological Disorders and Stroke Study (NINDSS). Design and Analysis: Analysis of the 0- to 3-hour and the 3- to 6-hour cohort in accordance with the ECASS protocol. Comparative analysis of the ECASS and NINDSS results following the NINDSS protocol using dichotomized endpoints. Main Outcome Measures: Primary endpoints: modified Rankin Scale, Barthel Index; secondary endpoints: combined Barthel/Rankin, long-term Scandinavian Stroke Scale, National Institutes of Health Stroke Scale, mortality at 30 and 90 days, occurrence of intracranial hemorrhage. NINDS trial endpoint: favorable outcome as defined in the NINDS trial. Results: In ECASS, 87 patients were randomized within 3 h of stroke onset. Differences in favor of rt-PA treatment can be found for all primary and secondary outcome measures in the ECASS 0- to 3-hour cohort, except for mortality at day 30, which is somewhat higher in the rt-pA-treated group. However, due to the small sample size, the differences do not reach statistical significance. Early infarct signs (as defined by the ECASS protocol) are found as early as 2 h after stroke onset. Parenchymal hemorrhages are found significantly more often among rt-PA-treated patients. The results in the ECASS 0- to 3-hour cohort fit well with the results in NINDSS. Conclusion: Data from the 3-hour ECASS cohort support the efficacy of early thrombolytic therapy in acute hemispheric stroke patients. Comparing bleeding complications between the ECASS and NINDSS is difficult because of differences in the definition and occurrence of hemorrhagic events.
In situ hybridisation for the detection of Leishmania species in paraffin wax-embedded canine tissues using a digoxigenin-labelled oligonucleotide probe

The diagnosis of canine leishmaniosis (CanL) is currently predominantly achieved by cytological or histological identification of amastigotes in biopsy samples, demonstration of specific anti-Leishmania antibodies and PCR-based approaches. All these methods have the advantage of being sensitive and more or less specific; nevertheless, most of them also have disadvantages. A chromogenic in situ hybridisation (ISH) procedure with a digoxigenin-labelled probe, targeting a fragment of the 5.8S rRNA was developed for the detection of all species of Leishmania parasites in routinely paraffin wax-embedded canine tissues. This method was validated in comparison with traditional techniques (histology, PCR), on various tissues from three dogs with histological changes consistent with a florid leishmaniosis. Amastigote forms of Leishmania gave clear signals and were easily identified using ISH. Various tissues from 10 additional dogs with clinical suspicion or/and a positive serological test but without histological presence of amastigotes did not show any ISH signals. Potential cross-reactivity of the probe was ruled out by negative outcome of the ISH against selected protozoa (including the related Trypanosoma cruzi) and fungi. Thus, ISH proved to be a powerful tool for unambiguous detection of Leishmania parasites in paraffin wax-embedded tissues.
Liver carnitine content in chronic alcoholics in alcohol withdrawal

Objectives: The aims of the study were to investigate whether liver carnitine levels in alcoholics were higher than in controls, to investigate whether liver carnitine levels were affected by a short period of abstinence from alcohol and whether any relationship existed between liver carnitine content and the degree of liver fat deposition. Design: Liver biopsy and blood samples were obtained from 17 'heavy drinkers' (14 men and three women) without overt liver disease on admission to hospital and after 9–11 days of abstinence. Thirteen men undergoing elective gallbladder extirpation served as controls. Methods: Liver carnitine levels were determined and expressed per gram non-collagen protein (NCP). The volume density of fat in hepatocytes was estimated by a morphometric point counting technique. Results: The mean liver carnitine content in the alcoholics was the same as that in the controls [5.5±1.1 (mean±5D)μmol/g NCP] on admission (5.7±1.5) but differed after a period of abstinence (6.6 ±1.4, P < 0.02). The carnitine content increased significantly during abstinence (P < 0.05). The volume density of fat decreased from 18 to 8%. No relationship was found between the carnitine levels and the degree of fat deposition. Conclusions: On admission, the liver carnitine content was the same as in the controls. Liver carnitine content increased after 9–11 days of abstinence. This may have been due to an increased demand for carnitine induced by the excessive metabolism of alcohol and or fat.
Relationship between occupational noise exposure and hypertension: Cross-sectional evidence from real-world

Background Occupational noise is one of the most common and prevalent occupational hazards worldwide and may induce adverse auditory and/or non-auditory health effects. However, the relationship between occupational noise exposure and hypertension is controversial and has long been debated. Methods Based on large sample cross-sectional data from all registered occupational health examination units from 2021 to 2022 (N = 101,605), this study aimed to analyze the prevalence of hearing loss and hypertension and to explore the influencing factors of hypertension of workers in Wuhan. Descriptive statistics, univariate analyses and multivariate analyses were used. Forest plot and nomograms were constructed for the visualization of predictive results. The ROC curve, AUC, C-index and calibration curves were used to assess the predictive accuracy and validity. DCA was performed to evaluate the net benefit that workers could receive. Results Higher rate of high-frequency hearing loss (25.3%), speech frequency hearing loss (8.8%), ECG abnormalities (31.9%) and hypertension (21.0%) were found in workers exposed to occupational noise in Wuhan. Occupational noise exposure (OR = 1.09, 95% CI: 1.01–1.18, p = 0.04), growth of age (OR: 1.07, 95% CI: 1.07–1.07, p < 0.001), overweight (OR: 1.82, 95% CI: 1.73–1.92, p < 0.001), obesity (OR: 3.62, 95% CI: 3.42–3.83, p < 0.001), hyperglycemia (OR: 1.84, 95% CI: 1.73–1.96, p < 0.001), hypercholesterolemia (OR = 1.34; 95% CI 1.22–1.48; p < 0.001), ECG abnormalities (OR = 1.11; 95% CI 1.07–1.15; p < 0.001) and family history of hypertension (OR = 1.69; 95% CI 1.58–1.81; p < 0.001) were risk factors of hypertension for workers. Male workers had a relatively higher hypertension risk than female workers (OR = 1.61; 95% CI 1.54–1.69; p < 0.001). Ear protective measures could not reduce the risk of hypertension in workers. Our nomogram has good predictive accuracy and validity. A dynamic nomogram to predict the workers' risk of hypertension was established publicly available online. Conclusion Occupational noise exposure may elevate workers' hypertension risk. More effective and relevant prevention measures should be taken. Our nomogram may help identify high-risk workers and facilitate timely interventions.
Impact of the cost of cancer treatment: an internet-based survey.

PURPOSE Despite considerable discussion in the medical literature and lay press regarding the increasing cost of cancer care, there is limited information available on the perceived impact of treatment costs on individual patients and their families. METHODS To directly address this issue, patients with cancer who had participated in an Internet-based oncology decision-support program and agreed to receive information concerning potential future surveys were asked via e-mail to complete a questionnaire dealing with treatment-related medical expenses. RESULTS Of 39,882 invitations sent to patients with cancers of the breast, colon, lung, and prostate, 1,767 (4.4%) were returned, which included a wide spectrum of disease, demographics, and annual incomes. Since diagnosis, 20% and 4% of patients reported having spent out of pocket more than $10,000 and more than $50,000, respectively, on treatment and medical care. Overall, 19% of patients and 39% of individuals with a yearly income of less than $40,000 reported the financial costs of treating their cancer had caused a "large amount of distress. " Furthermore, although overall, 9% of patients stated they had decided "to not have a recommended cancer treatment because it was too expensive," this percentage increased to 25% for individuals with an income of less than $40,000. CONCLUSION This survey suggests that a substantial proportion of patients and their families experience considerable distress associated with the cost of cancer care delivery. Furthermore, these costs affect the decision of patients with cancer to receive recommended treatment. This is a particularly serious issue for individuals with a modest annual income.
Pegfilgrastim on the Same Day Versus Next Day of Chemotherapy in Patients With Breast Cancer, Non-Small-Cell Lung Cancer, Ovarian Cancer, and Non-Hodgkin's Lymphoma: Results of Four Multicenter, Double-Blind, Randomized Phase II Studies.

PURPOSE To compare data on severe (grade 4) neutropenia duration and febrile neutropenia incidence in patients receiving chemotherapy with pegfilgrastim administered the same day or 24 hours after chemotherapy. PATIENTS AND METHODS These were similar, randomized, double-blind phase II noninferiority studies of patients with lymphoma or non-small-cell lung (NSCLC), breast, or ovarian cancer. Each study was analyzed separately. The primary end point in each study was cycle-1 severe neutropenia duration. Approximately 90 patients per study were to be randomly assigned at a ratio of 1:1 to receive pegfilgrastim 6 mg once per cycle on the day of chemotherapy or the day after (with placebo on the alternate day). RESULTS In four studies, 272 patients received chemotherapy and one or more doses of pegfilgrastim (133 same day, 139 next day). Three studies (breast, lymphoma, NSCLC) enrolled an adequate number of patients for analysis. However, in the NSCLC study, the neutropenic rate was lower than expected (only two patients per arm experienced grade 4 neutropenia). In the breast cancer study, the mean cycle-1 severe neutropenia duration was 1.2 days (95% confidence limit [CL], 0.7 to 1.6) longer in the same-day compared with the next-day group (mean, 2.6 v 1.4 days). In the lymphoma study, the mean cycle-1 severe neutropenia duration was 0.9 days (95% CL, 0.3 to 1.4) longer in the same-day compared with the next-day group (mean, 2.1 v 1.2 days). In the breast and lymphoma studies, the absolute neutrophil count profile for same-day patients was earlier, deeper, and longer compared with that for next-day patients, although the results indicate that same-day administration was statistically noninferior to next-day administration according to neutropenia duration. CONCLUSION For patients receiving pegfilgrastim with chemotherapy, pegfilgrastim administered 24 hours after chemotherapy completion is recommended.
Clinical Audit of the Outcome of Individualised Occupational Therapy Goals

To reflect on clinical effectiveness and revise practice to ensure quality of patient care, the Community Occupational Therapy Service in Leicester developed an individualised outcome measure and audit system. Audits were undertaken in 1997 and 1998 and the results showed a positive outcome in 88% and 90% of individual goals respectively. Improvements to practice achieved through auditing the outcomes of occupational therapy were increased patient involvement in goal setting, improved documentation and treatment planning and positive marketing of the service to general practitioners.
Religiousness, Current Substance Use, and Early Risk Indicators for Substance Abuse in Nursing Students

&NA; Nursing students have been targeted by the American Nurses' Association (ANA) for efforts focused on the prevention of substance abuse. This study surveyed 241 nursing students enrolled in their first year of nursing courses at seven faith‐based colleges and universities. The purposes were to investigate the prevalence of current substance use and the number of early risk indicators for substance abuse and dependence among nursing students, and to examine the relationships among religiousness, current substance use, and early risk indicators for substance abuse. Efinger's Alcohol Risk Survey, the CAGE Questionnaire, and the Intrinsic/Extrinsic‐Revised Scale were used to collect data. Twenty‐four percent of respondents reported current substance use, 15% scored in the probable abuse/dependence category: those who were more religious tended to have lower prevalence rates of substance use as well as fewer numbers of early risk indicators.