Miracle-dz/UniFAR-FTUs huggingface dataset:
Health-related quality of life in patients with multiple myeloma on novel agents: Report from a tertiary cancer center in rural India

Background: Multiple myeloma is a disease where health-related quality of life (HRQoL) is an important treatment end point. There are limited quality of life data of patients on novel antimyeloma agents, especially from developing countries. Methods: All adult patients diagnosed with multiple myeloma who were on novel agents for a period of at least one year and attended our clinic between July 15, 2015 and July 30, 2015 were included in the study. They were asked to fill local language versions of European Organization for Research and Treatment of Cancer Questionnaire Core 30 (EORTC QLQ-C30), supplemented by the myeloma-specific module, and the outcomes were analyzed. Mean scores of the study population were compared with EORTC reference values. A higher score for a functional domain indicates a higher level of functioning, whereas a higher symptom score indicates a higher symptomatic burden. Results: Of the total 64 patients, median age was 60 years and 60% (n = 38) were females. Median duration from diagnosis was 23 months (12–92 months). Mean QoL score for global quality of life was 55.3 and was comparable to the reference score. Our patients had significantly lower physical function score and higher financial strain compared to the reference population. The most common symptom was pain (60%), and the most common adverse effect was peripheral neuropathy (60%). Sixty-five percent of the patients were worried about future health and 42% about dying. Conclusion: Our patients with multiple myeloma have lower HRQoL compared to the reference population in many domains, despite being on novel agents.
Once-a-week versus once-every-3-weeks cisplatin in patients receiving chemoradiation for locally advanced head-and-neck cancer: A survey of practice in India

Purpose: High-dose (100 mg/m2) cisplatin with radiotherapy is the standard practice in locally advanced head-and-neck squamous cell carcinoma. Use of this regimen in resource- constrained and economically constrained countries like India is difficult. Methods: This study was a cross-sectional survey conducted among Indian oncologists treating head-and-neck cancer. The survey consisted of 25 questions relevant to general day-to-day practice in head-and-neck oncology. It included questions regarding the most common drug used in the concurrent chemoradiation (CRT) setting, the most common schedule of administration of cisplatin, the doses used in once-a-week or once-every-3-week cisplatin chemoradiotherapy, toxicities, and preventive strategies. Descriptive analysis was performed using SPSS software version 20. Results: Responses were obtained from 257 oncologists practicing in various oncology centers throughout the country. The agent most commonly used for radiosensitization was cisplatin (n = 243; 94.6%). The once-a-week regimen of cisplatin was the favored regimen (87.9%, n = 226). The reason for favoring the once-a-week regimen was better tolerance (n = 153, 59.5%). The once-every-3-weeks cisplatin schedule was prescribed for >50% of head-and-neck cancer patients by 23 participants only (8.9%). Conclusion: In this nationwide Indian survey, the majority of clinicians preferred the once-a-week cisplatin schedule for CRT in locally advanced head-and-neck cancer patients, due to better tolerance.
Serum magnesium concentration a need for revision especially in renal failure

Dear Editor, Plasma magnesium concentration is kept within narrow limits. In states of negative magnesium balance, initial losses come from the extracellular space while equilibrium with bone stores does not begin for several weeks. Normal plasma magnesium concentration based on literature is 1.7–2.1 mg/dL (0.7–0.9 mmol, or 1.4–1.8 mEq/L). [1] Half of the total body magnesium is present in soft tissue and another half in bone and 1% is present in the blood. Assessment of total magnesium store is impossible at now and serum magnesium level evaluation cannot show total serum status, magnesium ion measurement has been done in selected centers without approved more beneficial yields. Magnesium has a long biological half‐life after oral supplementation and equilibrates slowly in most tissue including serum. It has been shown that at cut‐off levels of 1.94 mg/dL and 2.19 mg/dL clinical magnesium deficiency occurred in 10% and 1%, respectively. It was shown that serum magnesium concentration (SMC) lower than 2.1 mg/dL increases the risk of Diabetes mellitus type 2 and levels of 0.85 mmol/L or 2.1 mg/dL can be considered as an reasonable lower limit of SMC. [2] Importance of new definition for hypomagnesemia has been more prominent in special conditions because of hypomagnesemia increase mortality in septic and critically ill patients by mechanisms such as increased need for mechanical ventilation and longer duration of ventilation support, irreversible renal dysfunction. in a study magnesium level of 1.5 mg/dL versus 2 mg/dL increases the risk of bacterial infection. [3] In end‐stage renal disease magnesium level below 1.94 mg/dL increase death risk of coronary heart disease up to 33% make that authors were debated about validity of SMC in an accepted reference of 1.7–2.67 mg/dL as a confidential clinical useful reference in clinical affairs; for example the role of magnesium as a protective against vascular calcification in chronic kidney disease is well known and serum magnesium lower than 1.94 mg/dL has been approved that can be associated with increased mortality that obligate clinician to change lower cut off level of SMC as low as 0.8 mmol/L (1.94 mg/dL) but it may not be enough because in patients under hemodialysis after 3 years followed up was shown that serum magnesium under 2.77 mg/dL was associated with higher mortality compared to higher 2.77 mg/dL. [4] Other study goes beyond and shows serum magnesium over 3 mg/dL can decrease soft tissue calcification[5] it can explain why in patients under maintenace hemodialysis normal serum magnesium levels was associated with higher cardiovascular mortality compared to patients with hypermagnesemia. [6]
Alignment of Inhaled Chronic Obstructive Pulmonary Disease Therapies with Published Strategies. Analysis of the Global Initiative for Chronic Obstructive Lung Disease Recommendations in SPIROMICS

Rationale: Despite awareness of chronic obstructive pulmonary disease (COPD) treatment recommendations, uptake is poor. The Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) spans 2010‐2016, providing an opportunity to assess integration of 2011 Global Initiative for Obstructive Lung Disease (GOLD) treatment strategies over time in a large observational cohort study. Objectives: To evaluate how COPD treatment aligns with 2011 GOLD strategies and determine factors associated with failure to align with recommendations. Methods: Information on inhaled medication use collected via questionnaire annually for 4 years was compiled into therapeutic classes (long‐acting antimuscarinic agent, long‐acting &bgr;‐agonist, inhaled corticosteroids [ICS], and combinations thereof). Medications were not modified by SPIROMICS investigators. 2011 GOLD COPD categories A, B, C, and D were assigned. Alignment of inhaler regimen with first‐/second‐line GOLD recommendations was determined, stratifying into recommendation aligned or nonaligned. Recommendation‐nonaligned participants were further stratified into overuse and underuse categories. Results: Of 1,721 participants with COPD, at baseline, 52% of regimens aligned with GOLD recommendations. Among participants with nonaligned regimens, 46% reported underuse, predominately owing to lack of long‐acting inhalers in GOLD category D. Of the 54% reporting overuse, 95% were treated with nonindicated ICS‐containing regimens. Among 431 participants with 4 years of follow‐up data, recommendation alignment did not change over time. When we compared 2011 and 2017 recommendations, we found that 47% did not align with either set of recommendations, whereas 35% were in alignment with both recommendations. Conclusions: Among SPIROMICS participants with COPD, nearly 50% reported inhaler regimens that did not align with GOLD recommendations. Nonalignment was driven largely by overuse of ICS regimens in milder disease and lack of long‐acting inhalers in severe disease.
The impact of acupuncture on IVF success rates: A randomised controlled trial

Background: Clinical trials to assess the benefits of acupuncture on in vitro fertilisation (IVF) treatment have differed in study design, protocol, outcome measures and commercial bias. This heterogeneity has precluded any firm conclusion regarding the efficacy, or otherwise, of acupuncture in this field. To address this, 15 international acupuncturists with experience in treating women during IVF participated in Delphi questionnaires and reached a consensus protocol to be used in future research. We were among the first to adopt this newly agreed standard protocol. The aim of this study was to address whether the agreed acupuncture consensus protocol is beneficial for IVF outcomes and may be offered to women undergoing IVF. Methods: An randomised controlled trial, in which 157 women were randomised to receive either acupuncture treatment three times in the treatment cycle in addition to our standard IVF protocol (n = 79) or no acupuncture treatment (n = 78) in their first or second IVF cycle. They were between 23 and 43 years with body mass index below 30. The study group (n = 79) received acupuncture based on the Delphi consensus protocol, between days 6 and 8 of ovarian stimulation, and twice on the day of embryo transfer, before and after transfer. The IVF practitioner was blinded to the randomisation. The primary end point was live birth. Results: Fifteen out of 79 women in the intervention group withdrew from the study compared to 9/78 women from the control group (P < 0.001). A per-protocol analysis revealed that the rate of live births (27/64, 42% vs. 11/69, 15.94%, P = 0.001) and positive pregnancy tests (34/64, 53% vs. 19/69, 27.53%, P = 0.013) were significantly higher in the acupuncture group compared with the control group. Conclusion: The results of this study imply that acupuncture may be offered as a possible method of improving IVF outcome. This study followed a widely approved consensus protocol hoping to settle disagreement in the literature and resolve previous disparity. Trial Registration: ClinicalTrials NCT02683967.
Outcomes and prognostic factors of surgical management of floating knee injuries

Background Floating knee injuries are complex injuries that are generally caused by a high-energy trauma such as a motorcycle or a car accident. Local trauma to the musculoskeletal and the soft tissues is often extensive and life-threatening; associated injuries may also be present, producing a challenging problem to manage. In this study, the authors presented the outcome of these injuries after surgical management. Patients and methods In this prospective study, 32 patients with 34 floating knee injuries were managed over a 3-year period; both fractures of the floating knee injury were fixed surgically by different modalities. The associated injuries were managed appropriately. Fractures were classified according to Fraser classification, and the outcome was evaluated by the Karlstrom criteria. Results The main mode of injury was motorcycle accident (62.2%). Twenty-nine (90.3%) patients had associated visceral or skeletal injuries. The complications presented in 17 (50%) patients. According to the Karlstrom criteria, the end results were as follows: excellent − 15 (44%), good − seven (20.6%), acceptable − eight (23.6%), and poor − four (11.8%). Conclusion The optimal final outcome of floating knee injuries was achieved with appropriate management of the associated injuries, intramedullary nailing of both the fractures and early aggressive postoperative rehabilitation. The associated injuries and the type of fracture (open, intra-articular, comminution, knee ligament injuries) are the prognostic indicators in the floating knee.
Prevalence of intestinal parasites and risk factors with emphasis on Enterobius vermicularis in children of daycares and preparatory schools of the city of Khodabandeh, Northwestern Iran

Introduction: Intestinal parasitic infections (IPIs) are considered as a common cause of morbidity and mortality in children in the developing countries. The present study was aimed at examining the status of IPIs in the children of daycares and preparatory schools in the city of Khodabandeh located at Northwestern Iran. Materials and Methods: A total of 520 daycare and preprimary school-age children in the northwest of Iran were tested for the presence of intestinal parasites using direct smear and the standard formalin-ethyl acetate sedimentation techniques. Furthermore, the specific “scotch tape” test was used to identify the eggs of pinworm Enterobius vermicularis. Results: Of total 520 children, 55 cases (10.6%) were infected to intestinal parasites, including 9.2% monoparasitism and 1.4% double-parasitism. The prevalence rate for protozoan infections was 7.3% and 3.65% for helminths. Giardia lamblia infection was shown to have the highest prevalence rate among intestinal protozoa by 3.26%. The prevalence rate for E. vermicularis was 3.5% using “scotch tape” test and stool examination. There was a significant correlation between infection with intestinal parasites and daycares (P = 0.004). A significant inverse correlation was established between anal itching (as a sign of E. vermicularis infections) and hand-washing in children using soap or hand-washing liquid (P = 0.004). Conclusions: Infection with intestinal parasites in children of nursery schools and preschools of the study region, compared to the previous situation, is considerably decreased.
SNPs in dopamine D2 receptor gene (DRD2) and norepinephrine transporter gene (NET) are associated with continuous performance task (CPT) phenotypes in ADHD children and their families

Haplotype‐tagging SNP analyses were conducted to identify molecular genetic substrates of quantitative phenotypes derived from performance on a Continuous Performance Task (CPT). Three hundred sixty‐four individuals were sampled from 152 families ascertained on the basis of at least one child having ADHD. Probands, their affected and unaffected siblings, and parents were administered a CPT. Four different components of performance were analyzed and tested for association with SNPs from 10 candidate genes involved in monoaminergic function. After correcting for multiple comparisons and controlling for multiple individuals from the same family, significant associations were identified between commission errors and SNPs in the DRD2 gene (rs2075654, rs1079596), and between reaction time variability and a SNP in the NET gene (rs3785155). These findings suggest that commission errors and reaction time variability are excellent candidates as ADHD endophenotypes based on previously published criteria. Results also shed light on the molecular genetic basis of specific processes that may underlie the disorder. © 2008 Wiley‐Liss, Inc.
“False Memory” Is a Linguistic Convenience

The term false memory describes outcomes to various procedures and techniques, such as coming to believe that suggested false events occurred, acceptance of postevent misinformation, and recognition of critical lures in the Deese−Roediger−McDermott (DRM) procedure. The literature to date has indicated that these memory errors intercorrelate poorly, if at all. However, issues with sample size and measurement reliability may have affected prior estimates. This study examined links among these 3 techniques in a sizable sample (N = 360), with attention to the reliability of procedures and measures. Weak but statistically reliable correlations emerged between false-event suggestion and postevent misinformation, and between postevent misinformation and DRM intrusions; correlations between false-event suggestion and DRM were weak and inconsistent. These effects were influenced by largely independent underlying mechanisms. The term false memory lacks precision and requires qualification.
Analogs of Microgravity : Space Research without Leaving the Planet Hindlimb unloading : rodent analog for microgravity

Globus RK, Morey-Holton E. Hindlimb unloading: rodent analog for microgravity. J Appl Physiol 120: 1196–1206, 2016. First published February 11, 2016; doi:10.1152/japplphysiol.00997. 2015. —The rodent hindlimb unloading (HU) model was developed in the 1980s to make it possible to study mechanisms, responses, and treatments for the adverse consequences of spaceflight. Decades before development of the HU model, weightlessness was predicted to yield deficits in the principal tissues responsible for structure and movement on Earth, primarily muscle and bone. Indeed, results from early spaceflight and HU experiments confirmed the expected sensitivity of the musculoskeletal system to gravity loading. Results from human and animal spaceflight and HU experiments show that nearly all organ systems and tissues studied display some measurable changes, albeit sometimes minor and of uncertain relevance to astronaut health. The focus of this review is to examine key HU results for various organ systems including those related to stress; the immune, cardiovascular, and nervous systems; vision changes; and wound healing. Analysis of the validity of the HU model is important given its potential value for both hypothesis testing and countermeasure development.
Improving MPI Multi-threaded RMA Communication Performance

One-sided communication is crucial to enabling communication concurrency. As core counts have increased, particularly with many-core architectures, one-sided (RMA) communication has been proposed to address the ever increasing contention at the network interface. The difficulty in using one-sided (RMA) communication with MPI is that the performance of MPI implementations using RMA with multiple concurrent threads is not well understood. Past studies have been done using MPI RMA in combination with multi-threading (RMA-MT) but they have been performed on older MPI implementations lacking RMA-MT optimizations. In addition prior work has only been done at smaller scale (<=512 cores). In this paper, we describe a new RMA implementation for Open MPI. The implementation targets scalability and multi-threaded performance. We describe the design and implementation of our RMA improvements and offer an evaluation that demonstrates scaling to 524,288 cores, the full size of a leading supercomputer installation. In contrast, the previous implementation failed to scale past approximately 4,096 cores. To evaluate this approach, we then compare against a vendor optimized MPI RMA-MT implementation with microbenchmarks, a mini-application, and a full astrophysics code at large scale on a many-core architecture. This is the first time that an evaluation at large scale on many-core architectures has been done for MPI RMA-MT (524,288 cores) and the first large scale application performance comparison between two different RMA-MT optimized MPI implementations. The results show a 8.6% benefit to our optimized open source MPI for a full application code running on 512K cores.
Cost-Effective, Safe, and Personalized Cell Therapy for Critical Limb Ischemia in Type 2 Diabetes Mellitus

Cell therapy is a progressively growing field that is rapidly moving from preclinical model development to clinical application. Outcomes obtained from clinical trials reveal the therapeutic potential of stem cell-based therapy to deal with unmet medical treatment needs for several disorders with no therapeutic options. Among adult stem cells, mesenchymal stem cells (MSCs) are the leading cell type used in advanced therapies for the treatment of autoimmune, inflammatory and vascular diseases. To date, the safety and feasibility of autologous MSC-based therapy has been established; however, their indiscriminate use has resulted in mixed outcomes in preclinical and clinical studies. While MSCs derived from diverse tissues share common properties depending on the type of clinical application, they markedly differ within clinical trials in terms of efficacy, resulting in many unanswered questions regarding the application of MSCs. Additionally, our experience in clinical trials related to critical limb ischemia pathology (CLI) shows that the therapeutic efficacy of these cells in different animal models has only been partially reproduced in humans through clinical trials. Therefore, it is crucial to develop new research to identify pitfalls, to optimize procedures and to clarify the repair mechanisms used by these cells, as well as to be able to offer a next generation of stem cell that can be routinely used in a cost-effective and safe manner in stem cell-based therapies targeting CLI.
Should a Multigene Signature be Used in all Luminal Early Breast Cancers

Background: Multigene signatures refine the risk of recurrence and guide adjuvant chemotherapy decision in luminal breast cancers. The decision to perform the assay is highly variable among oncologists. In order to guide the appropriate clinical group in whom to perform a genomic signature, our study analyzed in a homogeneous cohort which clinical risk groups triggered the use of the PAM50-based signature and their concordance with the genomic risk. Methods: A real life cohort of 222 early breast cancer patients with hormone receptor positive and HER2 negative disease had a commercial PAM50-based assay (Prosigna®) performed at our institution. The assay provided the risk group, the 10-year risk of distant recurrence and the intrinsic molecular subtype of breast cancer. Results: Based on nodal involvement, Ki67, tumor grade, mitotic index, and tumor size, no clinical pattern could identify a specific genomic risk group. The discordance with the genomic risk was high in patients with clinical low risk tumors, both in node negative and node positive patients. Up to 60% of them had a 10% or more risk of distant recurrence. Moreover, we identified a subgroup of luminal A tumors with a high genomic risk of recurrence. Genomic risk and intrinsic subtype were strong determinants of chemotherapy decision. Conclusions: Clinical profiles could not reliably identify genomic risk groups and guide the decision to use a multigene signature. Significant discordance with the genomic risk was observed within low clinical risk and luminal A tumors.