Miracle-dz/UniFAR-FTUs huggingface dataset:
Genetic Characterization and Risk Stratification of Acute Myeloid Leukemia

Abstract The most common acute leukemia in adults is acute myeloid leukemia (AML). The pathophysiology of the disease associates with cytogenetic abnormalities, gene mutations and aberrant gene expressions. At the molecular level, the disease manifests as changes in both epigenetic and genetic signatures. At the clinical level, two aspects of AML should be taken into account. First, the molecular changes occurring in the disease are important prognostic and predictive markers of AML. Second, use of novel therapies targeting these molecular changes. Currently, cytogenetic abnormalities and molecular alterations are the common biomarkers for the prognosis and choice of treatment for AML. Finding a panel of multiple biomarkers is a crucial diagnostic step for patient classification and serves as a prerequisite for individualized treatment strategies. Furthermore, the most important way of identifying relevant targets for new treatment approaches is defining specific patterns or a spectrum of driver gene mutations occurring in AML. Then, an algorithm can be established by the use of several biomarkers, to be used for personalized medicine. This review deals with molecular alterations, risk stratification, and relevant therapeutic decision-making in AML.
Risk Profile and Prediction of Long-Term Ischemic Stroke Mortality

Background—Multinational comparisons demonstrate marked ethnic and regional variation in stroke mortality and risk-factor distribution. We assessed the role of ethnicity and estimated the cumulative effect of multiple risk factors on long-term ischemic stroke mortality. Methods and Results—Civil servants and municipal employees in Israel (n=9734 men; age, ≥42 years), chosen by stratified sampling in 6 prespecified areas of birth (those born in Israel and those who were immigrants from 5 other regional-ethnic strata), were included in the Israeli Ischemic Heart Disease (IIHD) Project. Over a 21-year follow-up period, age-adjusted mortality rates per 10 000 person-years attributed to ischemic stroke (n=282; International Classification of Diseases [ICD]-9 codes 433 to 438) were higher among immigrants to Israel from northern Africa and the Mideast (17.1 to 19.0), than from 3 parts of Europe (11.3 to 12.4). Crude rates per 1000 subjects observed in those born in Asia or Africa (29.4 to 31.2) exceeded rates p.
Current Status of Colonization and Infection by Multiresistant Bacteria in the Spanish Intensive Care Unit: Resistance Zero Program

Current medicine, highly technified, and capable of amazing achievements, is not possible without the support of antibiotics. The problem of antibiotic resistance is almost as old as the antibiotics themselves. But at present, it is a serious threat to public health. We have to fight against antibiotic resistance in the hospital and in the out-of-hospital environment. The Resistance Zero program, promoted by the Spanish Society of Intensive Medicine, has achieved through a multidisciplinary approach with collaboration between doctors, nurses, cleaning staff and microbiologists, to control the colonization and infection by multiresistant germs in the environment of the Intensive Care Unit. the prevention of its spread/cross colonization, and the elimination of reservoirs. The MRBs in follow-up are: MRSA, VRE, Enterobacteria resistant to third generation cephalosporins, especially the ESBL producers, and those resistant to carbapenems, especially the carbapenemase producers; P. aeruginosa resistant to> = 3 families of antibiotics including: carbapenems, cephalosporins, piperaziline/tazobactam, fluoroquinolones, aminoglycosides, colistin; and Acinetobacter baumannii resistant to carbapenems.
A retrospective study on clinicopathological correlation of cutaneous tuberculosis

Background: Cutaneous tuberculosis is a curable chronic infectious disease. The clinical presentation and histopathological interpretation of skin biopsy may show variations as various types of the disease exist. The clinical diagnosis should be confirmed by histopathological features before starting treatment for particular type of the disease.Methods: A retrospective hospital based study was conducted among patients in Chengalpattu medical college for last 3 years (May 2015 – April 2018) who had cutaneous tuberculosis. Skin biopsy taken from active lesion was stained with routine haematoxylin and eosin (H & E) stain.Results: Out of 20 cases, male to female ratio was 1.5:1. The age of the patients ranged from 11-68 years. Clinically, lupus vulgaris was the most common type of cutaneous tuberculosis with 35% cases followed by tuberculosis verrucosa cutis 20% cases, scrofuloderma 15% and atypical mycobacterial infections 10%, and least common types are lichen scrofulosorum 5% which correlates with the previous study of Aruna et al. Characteristic tuberculoid granulomas were seen in 71.4% cases of lupus vulgaris, all cases of scrofuloderma, lichen scrofulosorum and 80% of tuberculosis verrucosa cutis. The clinical and histopathological correlation was seen in 17 cases (85%). Conclusions: There can be overlap between different types of cutaneous tuberculosis with various other dermatological diseases, both clinically and morphologically and so correlation of clinical and histopathological features appears to be more useful for accurate diagnosis and typing of cutaneous tuberculosis. High clinical suspicion is necessary in cutaneous tuberculosis and early diagnosis and treatment are essential to prevent its complications.
Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review

Background Communication with patients has always been a major concern in nursing care. Invasive mechanically ventilated (IMV) patients suffer from a communication barrier due to the presence of the endotracheal tube (ETT), which makes them unable to communicate through speech. Aim The purpose of this review is to examine available evidence regarding existing knowledge, skills, perceptions and barriers to IMV patient communication in order to guide the development of strategies that enhance effective communication with these patients. Methods A review of the published literature was conducted between January 2010 and December 2016. Results The literature support clear and concise communication in all areas of care, especially when patients suddenly become speechless. Invasive mechanically ventilated patients want to be heard, have control over their treatment and contribute to decisions concerning their health. Conclusion There is a need for the establishment of an effective nurse -patient communication strategy, which may include determining the mode of communication used by the patient, waiting and giving time to allow a patient to participate in the communication, confirming the message that was communicated with a patient himself/ herself, and the use of assistive and augmented communication to support comprehension when needed.
A taxonomic revision of the genus Conidiobolus (Ancylistaceae, Entomophthorales): four clades including three new genera

Abstract The genus Conidiobolus is an important group in entomophthoroid fungi and is considered to be polyphyletic in recent molecular phylogenies. To re-evaluate and delimit this genus, multi-locus phylogenetic analyses were performed using the large and small subunits of nuclear ribosomal DNA (nucLSU and nucSSU), the small subunit of the mitochondrial ribosomal DNA (mtSSU) and the translation elongation factor 1-alpha (EF-1α). The results indicated that the Conidiobolus is not monophyletic, being grouped into a paraphyletic grade with four clades. Consequently, the well-known Conidiobolus is revised and three new genera Capillidium, Microconidiobolus and Neoconidiobolus are proposed along with one new record and 22 new combinations. In addition, the genus Basidiobolus is found to be basal to the other entomophthoroid taxa and the genus Batkoa locates in the Entomophthoraceae clade.
UvA-DARE ( Digital Academic Repository ) Electrical brain responses to beat irregularities in two cases of beat deafness

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Prevalencia de adicción a internet y su relación con disfunción familiar en adolescentes

Prevalence of Internet addiction and its relation to family dysfunction in adolescents. Objective: To determine the prevalence of Internet addiction and its relation to family factors such as family dysfunction in adolescents. Design: Descriptive cross-sectional study. Location: Educational units of the city of Loja, Ecuador. Participants: 390 adolescents between 15 and 19 years old were included in the sample, designated by stratified randomization of the educational units of the city of Loja. Main measures: Socio-demographic and family characterization questionnaire, questionnaire on stratification of the socioeconomic level, the family function test (FFSIL) and the Internet Addiction Test (IAT). Results: Adolescents with Internet addiction (IA) had more family dysfunction when they came from small families (p<0.002), when social networks were the most frequently used service (p <0.034) and when they belonged to the typical middle socioeconomic stratum (p <0.025). There was a greater Internet addiction among adolescents in the first year of high school (p <0.003); in those who use more than 17 hours of internet a week (p <0.008) and in adolescents with good living conditions (p <0.005). Within the dimensions of family functionality, a higher IA rate was observed in adolescents with low cohesion (p <0.028), low harmony (p <0.0001), low affectivity (p <0.023) and low communication (p<0.021). Conclusions: The overall prevalence of Internet addiction in our country was higher than that found in other countries. However, severe addiction recorded similar values. In addition, adolescents with family dysfunction, from small families, from the typical middle socioeconomic stratum and who use more social networks, are at higher risk for internet addiction. The same happens for adolescents with low levels of cohesion, harmony, affectivity and communication.
Efficacy of Paracetamol versus Celebrex on the Control of Post Operative Complications of Lower Third Molars

Aims: To compare the efficacy of celebrex 400 mg orally one time daily with paracatamol 1000 mg orally four times daily on reducing post operative oral complication (facial swelling, trismus and pain) after third molar surgery. Materials and Methods: A total of 45 patients (24 females, 21 males) with impacted lower third molars divided into two groups; Group I: Twenty patients treated with paracetamol 1000 mg orally four times daily. Group II: Twenty five patients treated with celebrex 400 mg orally one time daily. Results: The mean age of patients was (29.17 ± 5.0) in group I and (27.1± 4.9) in group II with no significant differences, with a higher percentage of mesioangular impaction 40% among other type of impaction in two groups. Patients in group II suffer from less facial swelling and trismus with a significant differences p ≤ 0.05 compared with group I, but the two groups showed no significant differences in related to pain (p> 0.05) after third molar's surgical removal. Conclusions: Celebrex is more effective than paracetamol with less frequency of administration and longer duration of action in reducing post operative oral complication (swelling and trismus), but with some analgesic effect after surgical removal of lower third molars.
Diagnostic Test of Platelet Lymphocyte Ratio for Screening of Complex Coronary Lesion in Different Age Group of Acute Coronary Syndrome

Background: Increasing of ACS case with complex coronary lesion and in increase needs of CABG, we need tools to help in stratification of high risk patient that can be used in daily clinical practice, and even can be used in first line of health care facilities in Indonesia. By doing early stratification of high risk patient, hopefully it can decrease the morbidity and mortality in ACS cases. Aim: Evaluate diagnostic accuracy of PLR in identifying a complex coronary lesion and optimal cut-off point of PLR between ≤ 45 years old group and >45 years old group subjects. Method: This is a cross sectional study which was conducted retrospectively in ACS patients from January 2012 until July 2015. The inclusion criteria are adult ACS patients (age ≥18 years old) diagnosed with ACS and who underwent coronary angiography during hospitalization. The diagnostic accuracy was determined by calculating the sensitivity, specificity, Positive Likelihood Ratio (LR+), and Negative Likelihood Ratio (LR-). The cut-off point was determined using ROC curve. Results: The proportion of complex coronary lesion in this study was 47.2%. The optimal cut-off point in ≤ 45 year’s old group was 111.06 with sensitivity, specificity, LR+, and LR─ respectively 91.3%, 91.9%, 11.27 and 0.09. The optimal cut-off points in >45 years old groups was 104,78 with sensitivity, specificity, LR+, and LR─ respectively 91.7%, 58.6%, 2.21 and 0.14. Conclusion: The optimal cut-off point of ≤ 45 years old groups is 111.06 and for >45 years old group is 104.78 with AUC 93.9% (p<0.001) 77.3% (p<0.001), respectively.
Are geometric morphometric analyses replicable? Evaluating landmark measurement error and its impact on extant and fossil Microtus classification

Abstract Geometric morphometric analyses are frequently employed to quantify biological shape and shape variation. Despite the popularity of this technique, quantification of measurement error in geometric morphometric datasets and its impact on statistical results is seldom assessed in the literature. Here, we evaluate error on 2D landmark coordinate configurations of the lower first molar of five North American Microtus (vole) species. We acquired data from the same specimens several times to quantify error from four data acquisition sources: specimen presentation, imaging devices, interobserver variation, and intraobserver variation. We then evaluated the impact of those errors on linear discriminant analysis‐based classifications of the five species using recent specimens of known species affinity and fossil specimens of unknown species affinity. Results indicate that data acquisition error can be substantial, sometimes explaining >30% of the total variation among datasets. Comparisons of datasets digitized by different individuals exhibit the greatest discrepancies in landmark precision, and comparison of datasets photographed from different presentation angles yields the greatest discrepancies in species classification results. All error sources impact statistical classification to some extent. For example, no two landmark dataset replicates exhibit the same predicted group memberships of recent or fossil specimens. Our findings emphasize the need to mitigate error as much as possible during geometric morphometric data collection. Though the impact of measurement error on statistical fidelity is likely analysis‐specific, we recommend that all geometric morphometric studies standardize specimen imaging equipment, specimen presentations (if analyses are 2D), and landmark digitizers to reduce error and subsequent analytical misinterpretations.
Chlamydia pneumoniae but Not Cytomegalovirus Antibodies Are Associated With Future Risk of Stroke and Cardiovascular Disease

Background and Purpose—Several cross-sectional and prospective studies have indicated that high titers of antibodies to Chlamydia pneumoniae and cytomegalovirus (CMV) are associated with coronary heart disease. The aim of the present study was to examine whether elevated titers of antibodies to these pathogens are predictive of not only coronary but also cerebrovascular disease. Methods—Serum titers of antibodies to C pneumoniae (IgM, IgG, IgA, IgG immune complex) and CMV (IgG) were determined at baseline (n=130) and after 3.5 years (n=111) in a total sample of 152 men. All individuals had treated hypertension and at least 1 additional risk factor for cardiovascular disease (hypercholesterolemia, smoking, or diabetes mellitus) and constituted 93% of a randomly selected subgroup (n=164) of patients participating in a multiple risk factor intervention study. Results—Elevations of any or both of the IgA or IgG titers to C pneumoniae at entry or after 3.5 years were found in 84 cases (55%). Of those with high.
Primary Care Physicians’ Barriers to Initiate Insulin in Type 2 Diabetes Mellitus : A Survey from the Eastern Province, Saudi Arabia

Background: The majority of type 2 diabetic patients seek care at the primary care level. With rising prevalence, the primary health care (PHC) physicians will have a greater role which will mandate further involvement in diabetes management, including starting and monitoring insulin. Objectives: To explore barriers that PHC physicians in the Eastern Province, KSA, face in initiating insulin therapy for type 2 diabetes mellitus. Methods and Material: A self-administered questionnaire was used among PHC physicians in the Eastern Province (Dammam and Qatif) during January and February 2014. We used a validated tool to assess barriers related to insulin therapy centered on 4 main themes: issues with doctor’s experience; explanation burden; concerns about patients’ burden and regarding insulin therapy. Results: A total of 194 primary care physicians were surveyed, with an overall response rate of 84%. The majority of the physicians (80.9 %) were doctors with no postgraduate training, and 19.1% had postgraduate qualifications. Half of the physicians reported that they have no experience with the initiation of insulin. One third of the physicians perceived their current experience as a barrier to the initiation of insulin for their patients. There were significant variations in perceived barriers among trained and untrained doctors. Conclusions: This study showed that PHC physicians faced many problems in initiating insulin for type 2 diabetic patients. Organizing focused CPD sessions and implementing clear guidelines supported with insulin initiating algorithm will make insulin initiation easier. The PHC system should provide supporting staff such as chronic care nurses, dieticians, diabetic educators and pharmacists to work in a collaborative team with PHC physicians.
Endometrial lesion’s pattern in different age groups

Background. Endometrial polyps (EP) take an important part in the structure of intrauterine pathology and could be associated with abnormal uterine bleeding (AUB), infertility and the risk of endometrial cancer (EC) development. The data concerning EP’s prevalence and combination with other endometrium pathology’s forms in women of different age varies widely. It causes difficulties for understanding the magnitude of the problem and finding solutions for management. Aim. To evaluate the prevalence of EP and other endometrium conditions at different ages. Materials and methods. Based on the study of 4059 histological samples we analysed the EP’s prevalence and association with other intrauterine pathology in women of different age groups. Results. EP was diagnosed in 27.4% of samples. It’s frequency varied from 21.7 to 27.3% in reproductive age and 45% in postmenopausal women. 19.8% of EP were concomitant with chronic endometritis (CE), 3.7% with endometrial hyperplasia (EH). Conclusions. EP take 1st place in the structure of intrauterine pathology during all age periods. Their prevalence is 2.7 times higher than CE, and 4.5 times higher than EH.
Safety and efficacy of fimasartan with essential hypertension patients in real world clinical practice: data from a post marketing surveillance in Korea

The safety and efficacy of fimasartan have been evaluated through post-marketing surveillance in real world clinical practice. The multi-center, prospective, open-label and non-interventional study. A total of 3,945 patients (3,729 patients for safety assessment and 3,473 patients for efficacy assessment) were screened in patients with essential hypertension in 89 study centers from 9 September 2010 through 8 September 2016. Among the total patients, 2,893 patients (77.6%) were administered fimasartan for 24 weeks or longer and were classified as ‘patients with long-term follow-up’, and the additional safety and efficacy analysis were performed. The improvement was defined as systolic blood pressure (SBP) controlled to ≤ 140 mmHg or decreased SBP differences ≥ 20 mmHg after treatment or diastolic blood pressure (DBP) controlled to ≤ 90 mmHg or decreased DBP differences ≥ 10 mmHg after treatment. Adverse drug reactions (ADRs) were reported in 3.8% patients; dizziness, and hypotension were the most frequently reported ADRs in total patients. The results of patients with long-term follow-up were comparable with total patients. The overall improvement rate in all efficacy assessment at the last visit was 87.1% (3,025/3,473 patients). The overall improvement rate of the patients with long-term follow-up was 88.9%. Fimasartan was well tolerated, with no new safety concerns identified and an effective treatment in the real world clinical practice for Korean patients with hypertension.
Effectiveness of individualized physical rehabilitation programs on post-mastectomy pain in breast cancer survivors

The aim of the study was to determine the effectiveness of individualized physical rehabilitation programs targeted at reducing post-mastectomy pain in breast cancer survivors.Overall, 115 women with post-mastectomy pain were enrolled. The subjects had undergone surgical treatment and adjuvant radiation therapy for breast cancer. They were randomly assigned for the first (group A, n = 45), second (group B, n = 40), and third individualized physical rehabilitation program (group C, n = 30). The first program included aqua aerobics (aqua jogging, aqua building, aqua stretching), conditional swimming, and recreational aerobics; the second program included conditional swimming and Pilates exercises; the third program included yoga-based exercises and stretching. All participants received 140 sessions of rehabilitation intervention during the year and were evaluated at the beginning of the study, at 6, and at 12 months.It was observed that most of the investigated pain characteristics in all studied groups steadily improved during the year of rehabilitation. After 6 months of rehabilitation, the average value of cognitive quality of pain was statistically higher in group C compared with group A by 0.43 points (p < 0.01). The findings suggest that the first individualized physical rehabilitation program brought about the greatest pain reduction in the affected breast and upper extremity in breast cancer survivors of the studied groups.