Miracle-dz/UniFAR-FTUs huggingface dataset:
Road traffic mortality in the Slovak Republic in 1996–2014

ABSTRACT Objective: Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996–2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users. The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996–2014. Methods: Data on overall mortality in the Slovak Republic for the period 1996–2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates. Results: Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996–2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25–64 and 15–24 years old. Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25–64 and in male motorcycle users. Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996–2008 to 7.69 per 100,000 person years in the period 2009–2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups. Conclusions: The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25–64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention.
Comparison of crash rates and rear-end striking crashes among novice teens and experienced adults using the SHRP2 Naturalistic Driving Study

ABSTRACT Objective: Motor vehicle crashes are the leading cause of death for teens. Previous teen and adult crash rates have been based upon fatal crashes, police-reported crashes, and estimated miles driven. Large-scale naturalistic driving studies offer the opportunity to compute crash rates using a reliable methodology to capture crashes and driving exposure. The Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study contains extensive real-world data on teen and adult driving. This article presents findings on the crash rates of novice teen and experienced adult drivers in naturalistic crashes. Methods: A subset from the SHRP2 database consisting of 539 crash events for novice teens (16–19 years, n = 549) and experienced adults (35–54 years, n = 591) was used. Onboard instrumentation such as scene cameras, accelerometers, and Global Positioning System logged time series data at 10 Hz. Scene videos were reviewed for all events to identify rear-end striking crashes. Dynamic variables such as acceleration and velocity were analyzed for rear-end striking events. Number of crashes, crash rates, rear-end striking crash severity, and rear-end striking impact velocity were compared between novice teens and experienced adults. Results: Video review of the SHRP2 crashes identified significantly more crashes (P < 0.01) and rear-end striking crashes (P < 0.01) among the teen group than among the adult group. This yielded crash rates of 30.0 crashes per million miles driven for novice teens compared to 5.3 crashes per million miles driven for experienced adults. The crash rate ratio for teens vs. adults was 5.7. The rear-end striking crash rate was 13.5 and 1.8 per million miles driven for novice teens and experienced adults, respectively. The rear-end striking crash rate ratio for teens vs. adults was 7.5. The rear-end striking crash severity measured by the accelerometers was greater (P < 0.05) for the teen group (1.8 ± 0.9 g; median = 1.6 g) than for the adult group (1.1 ± 0.4 g; median = 1.0 g), suggesting that teen crashes tend to be more serious than adult crashes. Increased rear-end striking impact velocity (P < 0.01) was also observed for novice teens (18.8 ± 13.2 mph; median = 18.9 mph) compared to experienced adults (3.3 ± 1.2 mph; median = 2.8 mph). Conclusion: To our knowledge, this is the first study to compare crash rates between teens and adults using a large-scale naturalistic driving database. Unlike previous crash rates, the reported rates reliably control for crash type and driving exposure. These results conform to previous findings that novice teens exhibit increased crash rates compared to experienced adults.
Spontaneous clearance of hepatitis C virus in an interleukin 28B favorable genotype highly prevalent area

from the first reference is, ‘‘Undifferentiated and differentiated MSC do not elicit alloreactive lymphocyte proliferative responses and modulate immune responses. The findings support that MSC can be transplantable between HLA-incompatible individuals. ’’ The abstract of the second reference mentions, ‘‘In vitro data suggest that MSCs have low inherent immunogenicity as they induce little, if any, proliferation of allogeneic lymphocytes. Instead, MSCs appear to be immunosuppressive in vitro. They inhibit T-cell proliferation to alloantigens and mitogens and prevent the development of cytotoxic T-cells. In vivo, MSCs prolong skin allograft survival and have several immunomodulatory effects, which are presented and discussed in the present study. Possible clinical applications include therapy-resistant severe acute graft-versus-host disease, tissue repair, treatment of rejection of organ allografts and autoimmune disorders. ’’
The casualties from electric bike and motorized scooter road accidents

ABSTRACT Objective: The objective of this study was to describe demographic and injury characteristics of hospitalized injured patients involved in e-bike and motorized scooter accidents at a national level in Israel divided by different road user groups: riders and pedestrians. Methods: This was a retrospective study based on data from the National Trauma Registry, between January 1, 2013, and December 31, 2015. All hospitalized casualties due to the involvement of an e-bike or motorized scooter were included. The type of hospitalized road user was further categorized and described by different variables. Results: During the study period, the Israel Trauma Registry identified 795 hospitalized patients due to an e-bike or motorized scooter accident, with a dramatic 6-fold increase from 2013 to 2015. Although the majority of the injured patients were riders, 8% were pedestrians. Among the total casualties, 33% were children aged 0–14 years and among pedestrians 42% were children and 33% were seniors (ages 60+). Five persons died in hospital, 3 riders and 2 pedestrians. Conclusions: E-bike and motorized scooter riders represent the majority of patients hospitalized due to related traffic incident. This finding questions the social and economic advantages of electric-powered 2-wheeled vehicles.
Stress Ratings and Health Promotion Practices Among RNs: A Case for Action

Objective: The objective of this study was to investigate associations between RN perceptions of their stress levels, health-promoting behaviors, and associated demographic variables. Background: Stress and burnout are occupational hazards resulting in absenteeism, illness, and staff turnover, factors important to nurse administrators. Personal health behaviors among nurses have been linked to less stress and the delivery of health-promotion teaching. Method: An electronic survey with 2 standardized measures and demographic questions was completed by 2,247 staff nurses from a large Midwestern academic medical center. Findings: Stress levels were inversely correlated with overall health-promoting behavior scores. Outside caregiver responsibilities were associated with higher stress and lower health-promoting behaviors scores. Conclusions: Findings support work-site interventions that promote nurses’ health and wellness, reduce work and home stress, and influence positive patient care and outcomes.
MicroRNAs: New tools for diagnosis, prognosis, and therapy in hepatocellular carcinoma?

MicroRNAs (miRNAs) are evolutionarily conserved small noncoding RNAs involved in the regulation of gene expression and protein translation. Many studies have shown that they play a crucial role in driving organ and tissue differentiation during embryogenesis and in the fine‐tuning of fundamental biological processes, such as proliferation and apoptosis. Growing evidence indicates that their deregulation plays an important role in cancer onset and progression as well, where they act as oncogenes or oncosuppressors. In this review, we highlight the most recent findings regarding the role of miRNAs in hepatocellular carcinoma (HCC) by analyzing the possible mechanisms by which they contribute to this neoplasm. Moreover, we discuss the possible role of circulating miRNAs as biomarkers, a field that needs urgent improvement in the clinical surveillance of HCC, and the fascinating possibility of using them as therapeutic targets or drugs themselves. (HEPATOLOGY 2013)
Food Allergy–Related Quality of Life After Double-Blind, Placebo-Controlled Food Challenges in Adults, Adolescents, and Children

JL van der Velde, BM Flokstra-de Blok, H de Groot. J Allergy Clin Immunol. 2012;130(5):1136–1143.e2 To investigate the self-reported impact of a double-blind, placebo-controlled food challenge (DBPCFC) on the health-related quality of life (HRQL) of children, adolescents, and adults with food allergy. Children 8 to 12 years old ( n = 77), adolescents 13 to 18 years old ( n = 71), and adults ( n = 73) with clinical suspicion of food allergy who were awaiting DBPCFC. Because there was a long wait time for DBPCFCs, the designated experimental group was expected to have …
The prevalence and correlates of texting while driving among a population-based sample of Ontario students

Abstract Objective: Texting while driving (TWD) has a deleterious impact on driving performance and may pose a significant challenge to traffic safety. This challenge may be particularly relevant for young and inexperienced drivers. This study examined the prevalence and risk factors of writing text messages or emails while driving during the past 12 months. Method: This study analyzed a subpopulation of 1,133 licensed students 16 years of age or older from the 2013 Ontario Student Drug Use Survey (OSDUHS), a population-based survey of students in Ontario, Canada. Results: Our results indicate that 36% of licensed drivers reported writing a text message while driving during the past 12 months; of those who did, 56% reported doing so 4 or more times. Graduated licensing was the strongest factor predicting TWD. Compared to students with the more restrictive G1 license, students with a G2 or full license were 9.4 times more likely to report TWD after controlling for the effect of all other factors. Older students, white students, and students attending school in urban centers were more likely to report TWD, and the amount of time spent on social media sites, being a passenger with a driver using substances, and past-year collisions were also significantly associated with TWD. Gender differences and participation in driver education training were not associated with TWD. Conclusions: This research demonstrates that TWD is an extremely common behavior among licensed student drivers in Ontario, particularly among those who have passed the first stage of graduated licensing. TWD is associated with other risky driving behaviors and outcomes, and the findings from this study underscore the need to better understand the harms associated with this behavior.
Roles of dendritic cells in murine hepatic warm and liver transplantation‐induced cold ischemia/reperfusion injury

Dendritic cells (DCs) induce and regulate both innate and adaptive immune responses; however, their in vivo functional importance in hepatic ischemia/reperfusion (IR) injury is perplexing. We hypothesized that liver‐resident DC and locally recruited blood‐borne DC might have distinctive roles in hepatic IR injury. We tested this hypothesis by using DC‐deficient, fms‐like tyrosine kinase 3 ligand (Flt3L) knockout (KO) mice in hepatic warm (70% partial clamping for 60 minutes) and cold IR injury (liver transplant [LTx] with 24‐hour cold storage). Flt3L KO liver and lymphoid organs contained virtually no CD11c+F4/80− DC. Hepatic warm IR injury was significantly lower in Flt3L KO than in wildtype (WT) mice with lower alanine aminotransferase (ALT) levels, reduced hepatic necrosis, and lower neutrophil infiltration. Hepatic messenger RNA (mRNA) and protein levels for inflammatory cytokines (tumor necrosis factor alpha [TNFα], interleukin [IL]‐6) and chemokines (CCL2, CXCL2) were also significantly lower in Flt3L KO than in WT mice, indicating that lack of both liver‐resident and blood‐borne DC ameliorated hepatic warm IR injury. Adoptive transfer of splenic or hepatic WT DC into Flt3L KO or WT mice increased hepatic warm IR injury, suggesting injurious roles of DC infusion. When Flt3L KO liver was transplanted into WT mice, ALT levels were significantly higher than in WT to WT LTx, with enhanced hepatic necrosis and neutrophil infiltration, indicating a protective role of liver‐resident DC. Conclusion: Using both warm and cold hepatic IR models, this study suggests differential roles of liver‐resident versus blood‐borne DC, and points to the importance of the local microenvironment in determining DC function during hepatic IR injury. (HEPATOLOGY 2013;57:1585–1596)
The use of clozapine in older people

The reintroduction of clozapine, a novel antipsychotic agent with complex dopaminergic activity extending across the full range of dopamine receptors and serotonin (5HT), noradrenergic and cholinergic receptor blocking activity (Coward, 1992), to the psychiatrist’s pharmacopoeia represents an important extension of the treatments available for refractory schizophrenia (Lancet, 1989). While there has been extensive use of the drug in America and Europe (see Mortimer, 1991 and Stephens, 1990 for reviews), experience in this country is only just beginning to develop (Adams and Essali, 1991; Ball and Lipsedge, 1991). Studies suggest that patients of all ages have been treated with the drug (eg Povlsen et al., 1985; Meltzer, 1992) but there is a paucity of evidence as to the efficacy of the medication in elderly patients per se or their tolerance of side-effects. Described below is a woman of 69 with chronic schizophrenia treated with clozapine and the issues raised in treating the elderly with the drug are discussed.
Sleep and Ethnicity

Over the last decade, there has been increasing interest in how health and disease differ between different racial and ethnic groups. For example, there is a substantial literature on hypertension (Hertz, Unger, Cornell, & Saunders, 2005; Lindhorst, Alexander, Blignaut, & Rayner, 2007) where it is known that the prevalence is higher in African Americans, and that this increased prevalence may be related to diet and socioeconomic status (SES). It is known that hypertension in African Americans is associated with comorbidity such as increased risk of stroke, heart disease, and kidney disease. These studies have led to studies of differential treatment effects, which can then lead to improvement in health care for African Americans. Less is known about the prevalence, etiology, course, impact, and treatment across ethnic groups for common sleep disorders such as sleep-disordered breathing, narcolepsy, insomnia, periodic limb movements, and restless legs. Some studies examined health-related quality of life and sleep in different ethnic groups and found that there are differences among minority and non-minority groups (Baldwin et al., 2010; Stepnowsky, Johnson, Dimsdale, & Ancoli-Israel, 2000). Jean-Louis and colleagues (2008) found that even among ethnic groups previously assumed to be homogenous, there are differences in symptoms of insomnia, with different factors influencing each ethnic group. Yet, many studies are still not exploring these issues. In this special issue of Behavioral Sleep Medicine, we begin this exploration by presenting six studies that examine different racial and ethnic groups and different questions about how sleep and sleep disorders differ between the different groups. Four of the articles examine different aspects of sleep, and two examine aspects of sleep disorders.
Chronic Insomnia and Health Care Utilization in Young Adults

Chronic insomnia is prevalent, contributes a significant economic burden, and people with insomnia have increased health care utilization (HCU). The purpose of this study was to investigate the relationship between chronic insomnia and HCU in a population with fewer medical/mental health problems, using current operational definitions of chronic insomnia and multiple measures of HCU. Participants with chronic insomnia had greater HCU than normal sleepers. Participants with chronic insomnia plus a comorbid condition had greater HCU than normal sleepers with a medical/mental health problem and participants with only chronic insomnia. The relationship between chronic insomnia and HCU was moderated by comorbid medical/mental health problems. Early identification and intervention of chronic insomnia may help reduce HCU and costs associated with chronic insomnia.
Surgical therapies, part III: melanocyte transplants

ABSTRACT: Melanocyte transplantation is currently the most effective treatment modality for patients who have stable depigmentation unresponsive to traditional medical therapies. Patient selection is extremely important since patients with active vitiligo or large areas of depigmentation will not respond well to this treatment method. This article discusses techniques available for harvesting and preparing donor tissue, preparing the depigmented recipient site, applying the melanocytes, and caring for the transplantation site postoperatively. Common complications and responses are also discussed. Many variations in the transplantation procedure exist, allowing practitioners to tailor the treatment to the facilities available and to individual patient needs. Melanocyte transplantation is becoming a more commonly utilized treatment option that is likely to increase in the future as medical therapies capable of halting the progression of vitiligo become available.
A randomized, double‐blind comparison of two dosage levels of recombinant factor VIIa in the treatment of joint, muscle and mucocutaneous haemorrhages in persons with haemophilia A and B, with and without inhibitors

Recombinant factor VIIa (rFVIIa) was developed to provide an improved procoagulant component capable of ‘by‐passing’ inhibitor antibodies in the treatment of haemophilic patients. The primary objective of this study was to compare the efficacy of two dosage regimens of rFVIIa (given intravenously at periodic intervals) in the treatment of joint, muscle and mucocutaneous haemorrhages in persons with haemophilia A and B with and without inhibitors. The study was designed as a randomized, double‐blind, parellel group, international multicenter trial. Patients were randomly allocated to treatment A: 35 μ kg−1 or B:␣70 μ kg−1, in blocks of 2. Within each block, one patient was assigned to the 35 μ kg−1 dosing regimen and the other to 70 μ kg−1 dose. One hundred and fifty subjects from 20 sites were screened for this study and 116 had baseline assessments. Of these, 84 were treated on the protocol and 32 were not treated in the study, in most cases because they did not return to the clinic with an eligible bleeding episode. One hundred and seventy‐nine bleeding episodes were treated, of which 145 (81%) were acute haemarthroses. Both treatments were efficacious, with 71% having an excellent (59% and 60%) or effective (12% and 11%) response. Overall, the mean and median number of doses given per episode of joint bleeding were 3.1 and 2, respectively. The mean number of doses was 3.1 for the 70 μ kg−1 group and 2.7 for the 35 μ kg−1 group (P value = 0.142). The study concluded that rFVIIa in a dosage of 35 μ kg−1 or 70 μ kg−1 is both safe and reasonably effective in the treatment of joint or muscle haemorrhages in haemophilic patients with inhibitor antibodies to factor VIII or factor IX. It is concluded that the appropriate dose for the treatment of joint and peripheral muscle bleeding in haemophilic patients with inhibitors is 35–70 μ kg−1 given at 2–3 h intervals until haemostasis is achieved.
Chronic wounds – is cellular ‘reception’ at fault? Examining integrins and intracellular signalling

As with all physiologic processes, chronic wounds are associated with unique intracellular and cellular/extracellular matrix (ECM) receptor types and signalling messages. These cellular receptors mediate responses of the epidermis to provisional wound matrix and change in form and number in cases of impaired wound healing. Integrins are the major cell‐surface receptors for cell adhesion and migration and epidermal keratinocytes express several integrins that bind ECM ligands in provisional wound ECM. Integrin receptors and more particularly integrin clusters and focal adhesion points appear to influence epidermal and dermal cell matrix interactions, cell motility, cell phenotype and ultimate healing trajectory. In chronic wounds, a variety of changes in receptors have been identified: decreased integrin α5β1 receptors affect the integration of fibronectin and subsequent keratinocyte migration; integrin αvβ6 stimulate transforming growth factor (TGF)‐β and may increase the susceptibility to ulceration and fibrosis; however, TGF‐β signal receptors have been found to be dysfunctional in many chronic wounds; additionally receptor interactions result in increased senescent cells including fibroblasts, myofibroblasts and even keratinocytes – this produces a degradative ECM and wound bed and corrosive chronic wound fluid. The activation or inhibition of integrin receptors by various agents may provide an excellent means of influencing wound healing. This process offers an earlier intervention into the wound healing cascade promoting intrinsic healing and elaboration of growth factors and ECM proteins, which may be more cost effective than the traditional attempts at extrinsic addition of these agents.