Miracle-dz/UniFAR-FTUs huggingface dataset:
Primary and Secondary Central Nervous System Involvement in Acute Myeloid Leukemia

Introduction: Central Nervous System involvement (CNSi) in patients with Acute Myeloid Leukemia (AML) rarely occurs. It is not well characterized clinically and lacks standardized treatments. Patients and methods: A retrospective analysis of 77 consecutive AML patients with primary and secondary CNSi during 2004-2016 was performed in eight Polish haematological centres. Results: 77 patients (38 with primary CNSi-AML) were included. Median age was 44 years in both groups. Elevated lactate dehydrogenase activity was found in the majority of subjects. Patients in primary CNSi-AML group more often had myelomonocytic and monoblastic AML subtypes (68.4%) compared to secondary CNSi AML (43.5%) (p=0.039). There were no differences between both groups in the number of leukocytes or the proportion of blast cells rates in peripheral blood or bone marrow at AML diagnosis. There were also no statistically significant differences between both groups in the incidence of cytogenetic or molecular abnormalities. In both groups, CNSi was most frequently found in the cerebrospinal fluid and the most common neurological symptom was headache. The following manifestations were more frequent in secondary than in primary CNSi-AML: lower extremity weakness (38.46% vs. 13.16%; p=0.023), paraesthesia (38.46% vs. 13.16%; p=0.023), motor deficits (31.58% vs. 10.53%; p=0.047), and asymmetry of reflexes (26.32% vs. 2.7%; p=0.007). Median pleocytosis was also significantly higher in secondary than in primary CNSi-AML: 27 (IQR 2-146) vs. 2 (IQR: 1-12; p=0.004). Both groups had rather short Overall Survival (OS), with a median of 16.6 months (9.9-NA) for patients with primary CNSi-AML and 15.4 months (10.1-21.1) for patients with secondary CNSi. Conclusion: Patients with CNSi AML were relatively young, having high lactate dehydrogenase activity and high rates of the myelomonocytic and monoblastic/monocytic AML subtypes. The advisability of undertaking CNS examination and prophylaxis in patients with such characteristics thus merits further reassessment.
A multiple marker level-set method for simulation of bubbly flows

A multiple marker level-set (MLS) method is introduced for Direct Numerical Simulation of bubbles and droplets, which is integrated in a finite-volume framework on collocated unstructured grids of arbitrary element type. The MLS method is based on the idea of describing separate interfaces in the disperse phase with different levelset functions to prevent numerical and potentially unphysical coalescence of bubbles or droplets without excessive refinement. Thus, bubbles or droplets are able to approach each other closely, within the size of one grid cell, and can even collide, while artificial merging of the interfaces is prevented. The accuracy of the computational method implemented is examined for the problem of a single bubble rising in quiescent liquid. For the validation of the multiple marker level-set method we study the gravity-driven impact of a droplet on a liquid-liquid interface and finally it is applied on simulation of gravity-driven bubbly flow in a vertical pipe.
Effectiveness and Tolerability of Repeated Courses of Viscosupplementation in Symptomatic Hip Osteoarthritis: A Retrospective Observational Cohort Study of High Molecular Weight vs. Medium Molecular Weight Hyaluronic Acid vs. No Viscosupplementation

Background: Nonsurgical management of symptomatic hip osteoarthritis needs real-world evidence. We evaluated the effectiveness and tolerability of US-guided intra-articular treatment of two hyaluronic acids (HAs) commercially available in Italy and investigated predictors of response. Methods: Outpatient records including three cohorts: 122 subjects treated with medium (1,500–3,200 kDa; Hyalubrix®) molecular weight (MW) or high (hylan G-F20; Synvisc®) MW HAs and 20 controls taking NSAIDs/analgesics on demand were retrospectively analyzed. Pain VAS score, WOMAC, NSAID/analgesic consumption, and causes of suspension were available at 1, 6, 12, and 24 months after first administration. As selection bias usually affects observational retrospective studies, a quasi-randomization process was attained by performing propensity score approach. Results: Propensity score adjustment successfully allowed comparisons among balanced groups of treatments. VAS and WOMAC considerably decreased over time in treated groups independently of the radiological grade (p<0.001). On the other hand, the control group showed only a slight and rather uneven variation in VAS. Mean score changes were comparable in both HA cohorts from the earliest stages (ΔVAS(HA1,500–3,200kDa)T1vsT0 = −20%; ΔVAS(hylan G-F20)T1vsT0 = −23%/ΔWOMAC(HA1,500–3,200kDa)T1vsT0 = −17%; ΔWOMAC(hylan G-F20)T1vsT0 = −19%), reaching a further substantial reduction after 12 months (ΔVAS(HA1,500–3,200kDa)T12vsT0 = −52%; ΔVAS(hylan G-F20)T12vsT0 = −53%/ΔWOMAC(HA1,500–3,200kDa)T12vsT0 = −45%; and ΔWOMAC(hylan G-F20)T12vsT0 = −47%). Almost 11% (=13/122) of ineffectiveness and few moderate local side effects 3% (=4/122) were detected. Conclusions: Viscosupplementation in a real-life setting seems to provide a sound alternative in pain management in comparison to oral NSAIDs/analgesics, guaranteeing a reduced intake of pain killer medications. Analgesic effectiveness, functional recovery, and reduced joint stiffness extend and improve over 12 and 24 months, suggesting that repeated administrations achieve an additive effect.
Selection criteria and colpotomic approach for safe minimally invasive radical hysterectomy in early-stage cervical cancer

Objective To evaluate oncologic outcomes of minimally invasive radical hysterectomy (RH) in early cervical cancer before and after the application of parametrial invasion (PMI) criterion on magnetic resonance imaging (MRI) and vaginal colpotomy (VC). Methods A total of 216 International Federation of Gynecology and Obstetrics stage IB–IIA cervical cancer patients who underwent minimally invasive RH was identified between April 2006 and October 2018. Patients were classified into the pre-PMI intracorporeal or VC (IVC) (n=117) and post-PMI VC groups (n=99). In the pre-PMI IVC group, PMI criterion (intact stromal ring) on MRI was not applied and the patients received IVC. In the post-PMI VC group, surgical candidates were selected using the PMI criterion on MRI and all patients received VC only. Oncologic outcomes and prognostic factors associated with disease recurrence were analyzed. Results The rate of positive vaginal cuff margins in the pre-PMI IVC group was higher than that in the post-PMI VC group (11.1% vs. 1.0%, p=0.003). Two-year disease-free survival was different between the 2 groups (84.5% in pre-PMI IVC vs. 98.0% in post-PMI VC groups, p=0.005). Disrupted stromal ring on MRI (hazard ratio [HR]=20.321; 95% confidence interval [CI]=4.903–84.218; p<0.001) and intracorporeal colpotomy (HR=3.059; 95% CI=1.176–7.958; p=0.022) were associated with recurrence. Conclusion The intact cervical stromal ring on MRI might identify the low-risk group of patients in terms of PMI and lymphovascular/stromal invasion in early cervical cancer. Minimally invasive RH should be performed in optimal candidates with an intact stromal ring on MRI, using VC.
Mutated WT1, FLT3-ITD, and NUP98-NSD1 Fusion in Various Combinations Define a Poor Prognostic Group in Pediatric Acute Myeloid Leukemia

Acute myeloid leukemia is a life-threatening malignancy in children and adolescents treated predominantly by risk-adapted intensive chemotherapy that is partly supported by allogeneic stem cell transplantation. Mutations in the WT1 gene and NUP98-NSD1 fusion are predictors of poor survival outcome/prognosis that frequently occur in combination with internal tandem duplications of the juxta-membrane domain of FLT3 (FLT3-ITD). To re-evaluate the effect of these factors in contemporary protocols, 353 patients (<18 years) treated in Germany with AML-BFM treatment protocols between 2004 and 2017 were included. Presence of mutated WT1 and FLT3-ITD in blasts (n=19) resulted in low 3-year event-free survival of 29% and overall survival of 33% compared to rates of 45-63% and 67-87% in patients with only one (only FLT3-ITD; n=33, only WT1 mutation; n=29) or none of these mutations (n=272). Including NUP98-NSD1 and high allelic ratio (AR) of FLT3-ITD (AR ≥0.4) in the analysis revealed very poor outcomes for patients with co-occurrence of all three factors or any of double combinations. All these patients (n=15) experienced events and the probability of overall survival was low (27%). We conclude that co-occurrence of WT1 mutation, NUP98-NSD1, and FLT3-ITD with an AR ≥0.4 as triple or double mutations still predicts dismal response to contemporary first- and second-line treatment for pediatric acute myeloid leukemia.
Recognition of activities of daily living

Activities of daily living (ADL) are things we normally do in daily living, including any daily activity such as feeding ourselves, bathing, dressing, grooming, work, homemaking, and leisure. The ability or inability to perform ADLs can be used as a very practical measure of human capability in many types of disorder and disability. Oftentimes in a health care facility, with the help of observations by nurses and self-reporting by residents, professional staff manually collect ADL data and enter data into the system. Technologies in smart homes can provide some solutions to detecting and monitoring a resident’s ADL. Typically multiple sensors can be deployed, such as surveillance cameras in the smart home environment, and contacted sensors affixed to the resident’s body. Note that the traditional technologies incur costly and laborious sensor deployment, and cause uncomfortable feeling of contacted sensors with increased inconvenience. This work presents a novel system facilitated via mobile devices to collect and analyze mobile data pertaining to the human users’ ADL. By employing only one smart phone, this system, named ADL recognition system, significantly reduces set-up costs and saves manpower. It encapsulates rather sophisticated technologies under the hood, such as an agent-based information management platform integrating both the mobile end and the cloud, observer patterns and a time-series based motion analysis mechanism over sensory data. As a single-point deployment system, ADL recognition system provides further benefits that enable the replay of users’ daily ADL routines, in addition to the timely assessment of their life habits.
Practice Variation in the Care of Subclinical Hypothyroidism During Pregnancy: A National Survey of Physicians in the United States

Abstract Evidence regarding the effects of subclinical hypothyroidism (SCH) on adverse pregnancy outcomes and the ability of levothyroxine (LT4) treatment to prevent them is unclear. Available recommendations for the management of SCH during pregnancy are inconsistent. We conducted a nationwide survey among physicians assessing their knowledge of and current practices in the care of SCH in pregnancy and compared these with the most recent American Thyroid Association (ATA) recommendations. In this cross-sectional study, an online survey was sent to active US members of the Endocrine Society. This survey included questions about current practices and clinical scenarios aimed at assessing diagnostic evaluation, initiation of therapy, and follow-up in pregnant women with SCH. In total, 162 physicians completed the survey. ATA guidelines were reviewed by 76%, of whom 53% indicated that these guidelines actually changed their practice. Universal screening was the preferred screening approach (54%), followed by targeted screening (30%). For SCH diagnosis, most respondents (52%) endorsed a TSH level >2.5 mIU/L as a cutoff, whereas 5% endorsed a population-based cutoff as recommended by the ATA. The decision to initiate treatment varied depending on the specific clinical scenario; however, when LT4 was initiated, respondents expected a small/very small reduction in maternofetal complications. In conclusion, despite recently updated guidelines, there is still wide variation in clinical practices regarding the care of women with SCH in pregnancy. Highly reliable randomized trials are required to evaluate the effectiveness of the most uncertain treatment practices on the care of pregnant women with SCH.
Mobile Learning Game Effectiveness in Cognitive Learning by Adults: A Comparative Study

Background. The effectiveness of digital game-based learning is an important issue. Mobile learning games (MLG) are rapidly growing trends among the digital game-based learning genre. Although many studies have been conducted and mobile games have been shown to have an unquestionable potential as a learning method, their effectiveness has not been fully proven, and the positive impacts and outcomes of mobile learning games with respect to learning have yet to be investigated. Aim. The study aimed at capturing the cognitive learning outcomes and the process of knowledge acquisition. The study has demonstrated both positive and negative cognitive learning effects of using mobile learning game in comparison with the textbook learning process. Methodology. This article presents a comparative study conducted on a group of 160 freshman students majoring in management and finance. The participants of the study, divided into subgroups, were taught using either textbook-based learning or a mobile learning game. Three tests were applied to measure their performance: a pre-test at the beginning of the experiment, and two post-tests, the first administered directly after the learning process and the second 2-3 weeks after the initial learning. Results and recommendations. MLG have been proven to create many positive effect for learning. It is as effective in transferring factual knowledge as textbook learning, when measured directly after the learning process. In longer term, the effects are blurred because the affective effects interfere with the measurement.
Prevalence of Candida blood stream infections among children in tertiary care hospital: detection of species and antifungal susceptibility

Background Of all blood stream infections (BSI), candidaemia poses the greatest threat with a high fatality rate among children. There has been an increase in the number of reports of non-C. albicans species and antifungal resistance has progressively emerge. Aim The present study aimed to demonstrate the prevalence of candidaemia among children and to characterize the involved species and their susceptibility to antifungal agents. Methodology Microbes were isolated from blood samples and identified via standard microbiological procedures. Chromogenic media was used to characterize the Candida species. The susceptibility of the isolates to the antifungal agents; caspofungin, amphotericin, itraconazole, and fluconazole was determined with the E-test. Statistical methods The data were analysed with Statistical Package for the Social Science SPSS; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows. Comparisons between the study groups were performed using the Chi square (χ2) test. p-values less than 0.05 were considered significant. Results Candidaemia accounted for 17.3% of all BSIs. C. albicans and non-C. albicans species accounted for 36% and 64% of the cases of candidaemia, respectively. Caspofungin, amphotericin, itraconazole, and fluconazole antifungals had activities of 99%, 97%, 73% and 64%, respectively. In total, 64% of patients with candiaemia died. Conclusion The prevalence of candidaemia was high, the fatality rate was alarming and non-C. albicans species were predominant. Fluconazole was the least effective of the tested antifungal agents owing to the high level of resistance.
Factors contributing to the occurrence of cancer metastasis to brain

1 Kilpauk Medical College, Chennai, India 2 Directorate of Public Health and Preventive Medicine, Chennai, India Attributed to: Radiation Oncology Department, Government Royapettah Hospital, Kilpauk Medical College, Chennai *Corresponding Author Vidhya Narasimhan Mailing address: F3, Kanakadhara Tiruvengadam, 7/3, Cart track road, T Nagar, Chennai, India, 600017 Abstract In a cancer patient when there is metastasis to brain the prognosis becomes very poor. But only some patients get metastasis to brain. In this study, in patients with brain metastasis, the demographic profile, the site of primary tumour, stage at diagnosis, histopathology, immunohistochemistry and extent of dissemination, have been analysed to throw light on susceptibility to metastasis brain. 35 patients with brain metastasis treated in a period of 5 years were studied retrospectively. 40% of the patients were young (age group 3145 years) and 50 % presented with only headache. There was strong association between occurrence of multiple metastasis brain (against single lesion brain) and visceral /bone spread. Breast was the most common primary site in the whole group while lung was commoner in exclusive brain metastasis subset and patients in stage four at initial presentation itself. This signifies the need for screening for lung malignancy in the high risk group to detect at an earlier stage. Lung cancer patients have 4 times more chance of having brain metastasis with no visceral or bone metastasis. In breast cancer 17% patients have exclusive brain metastasis. In 2 patients PET CT detected asymptomatic metastatic lesions brain.
Effects of an Algorithm-based Education Program on Nursing Care for Children with Epilepsy by Hospital Nurses

Purpose Epilepsy is the most common neurological disorder in childhood. Hospital nurses, who are the first to recognize seizures in epilepsy patients in the ward environment, possess expertise related to epilepsy and play a central role in epilepsy management. The purpose of this study was to develop an algorithm-based education program and to improve nurses’ knowledge and self-efficacy related to providing nursing care to children with epilepsy. Methods The education program consisted of lectures on the definition, cause, classification, diagnosis, treatment, and nursing of epilepsy based on a booklet, as well as practice using an algorithm for nursing interventions when a child experiences a seizure. Twenty-seven nurses working at pediatric neurological wards and a pediatric emergency room participated in the education program. The data were analyzed using descriptive statistics and the paired t-test. Results Nurses’ knowledge and self-efficacy showed a statistically significant improvement after participation in the education program on nursing care for children with epilepsy. Conclusion The application of this education program for hospital setting is expected to improve nurses' capability to care for children with epilepsy, thereby contributing to a higher quality of nursing.
Predictors for Salivary Gland Cancer Recurrence at Two Tertiary Hospitals in Saudi Arabia

Background Tumors of salivary glands are enlarged as a low-risk mass and mostly benign in nature. The treatment of salivary gland malignancy remains quite challenging because of its relative infrequency, unreliable biological manners, and risk of re-emergence. For effective treatment planning, prediction of factors associated with the recurrence of salivary gland malignancy is essential. Aim The objective of this study was to identify the factors associated with recurrence of salivary gland malignancy at two tertiary hospitals in Saudi Arabia. Material and methods A cross-sectional study was conducted at two tertiary hospitals in Saudi Arabia, where data of patients were recorded from the medical records of hospitals from 2012 to 2018. 63 patients who were diagnosed with salivary gland malignancy, whether originated from parotid, submandibular, sublingual, and minor salivary glands were included in the study. Descriptive statistics are shown in mean, frequency, and percentages, while comparative analysis was done using the Chi-square test, where p < 0.05 is considered significant. Results This study included 63 participants. The majority of malignant salivary gland cancers arise from the parotid gland (47.6%), and mucoepidermoid carcinoma was the commonest form of malignancy in 36.5% of the studied population. Out of 63 patients, 17 had a recurrence of cancer, and the initial advanced stage of the disease is apparently associated with the re-emergence of salivary gland cancer. Conclusion The initial advanced stage of cancer has a significant role in the recurrence of salivary gland malignancy. As salivary gland malignancy is rare and has unreliable behavior, establishing an adequate treatment plan prediction for recurrence is essential.
Upper Gastrointestinal Endoscopic Outcomes in Patients with Gastrointestinal Symptoms: Retrospective Analysis at a Tertiary Care Hospital

Background: Endoscopic procedures are frequently performed to rule out any disease process which eventuates with either a positive or negative outcome. Association of patient demographics, clinical features with endoscopic outcomes are of paramount importance for better understanding and practice of endoscopy. Objectives: This study aimed to determine the frequency of positive endoscopic findings in patients with gastrointestinal symptoms compared to those with negative findings. As a secondary objective, the association between relevant demographics, symptoms, laboratory investigations and procedural outcomes of the participants and positive endoscopic findings were also assessed. Methods: A retrospective analysis of all the patients who underwent esophagogastroduodenoscopy from January 2017 to December 2017 was conducted. A total of 1066 endoscopy records were retrieved and using a convenience sampling technique, relevant data were manually entered to the questionnaires. Records with incomplete or inconsistent data were disregarded as per the exclusion criteria, resulting in 1011 patient records ultimately utilized for the study. All data were entered and analyzed using IBM SPSS 23.0. Results: The study comprised a total of 1011 patients where 52.2% were females and 47.8% males while the mean age of patients was 42.16 ± 15.45. Positive endoscopic findings were observed in 88.1%, where the most common finding was gastritis (49.1%). Approximately 14.5% had positive investigation findings for HBsAg and 23.1% were seropositive for anti-HCV antibody. P-values statistically significant were for age (p = 0.044), hematemesis (p = 0.002), betel quid addiction (p = 0.044), anti-HCV antibody (p = 0.043), HCV-RNA (p = 0.041) and “H. pylori” antigen (p = 0.032). Conclusion: Both genders were almost equally included where most patients presented between the 3rd and 5th decades of life. A high incidence of gastritis was noted. Positive endoscopic findings were associated with betel quid addiction and with Hepatitis C infection.
Predicting Network Faults using Random Forest and C5.0

The Internet is an enabling technology that assists daily and business activities. However, a network fault could prevent the user from accessing the internet thus creating trouble tickets. Ideally, accurate prediction prior to network fault allows the telco to respond before the customer raises a trouble ticket. Current research focuses on forecasting the quantity of trouble ticket using historical trouble ticket. To improve the prediction of network fault, the customer trouble ticket data is augmented to include internet usage data and signal measurement data. Random Forest (RF) and C5.0 Decision Tree algorithms are used to derive predictive models. Experiment results reveal that RF shows higher AUC score as compared to C5.0 Decision Tree. RF is able to identify the important features while C5.0 Decision Tree is able to list decision rules that describe the relation among selected features.