Miracle-dz/UniFAR-FTUs huggingface dataset:
Online Pharmacy Accessibility of Imatinib, An Oral Chemotherapy Medication.

BACKGROUND Since prices of imatinib (Gleevec) remain high, patients on oral chemotherapy are looking for alternative methods to access this life-saving medication. We assessed the accessibility of imatinib through online pharmacies and analyzed each website for medication safety, price, and marketing tactics. METHODS We searched the term "buy imatinib online" using 4 commonly used internet search engines (Google, Bing, Yahoo! , and DuckDuckGo) and screened web pages displayed in the first 10 pages. Websites were included if they were published in English, sold imatinib, were free to access, and offered shipping in the United States. Websites were classified using LegitScript's categorization as "certified," "unclassified," "unapproved," or "rogue. " We analyzed information on websites' patient safety characteristics, marketing techniques, pricing, domain registration information, and IP addresses. RESULTS Of the 44 online pharmacies identified, only 3 (7%) were certified, and the remainder were classified as rogue (52%; n=23), unapproved (30%; n=13), or unclassified (11%; n=5). Thirteen online pharmacies (30%; 9 rogue, 4 unclassified) sold imatinib without a prescription. Nearly one-quarter (n=10) of online pharmacies selling imatinib did not include drug-related warnings on their websites, and nearly half (n=21) did not limit the purchasable quantity. More than three-quarters (n=34) of online pharmacies selling imatinib did not offer pharmacist consultations, even though nearly all websites extended offers to speak with sales associates (91%; n=40). Most online pharmacies selling imatinib claimed price discounts (95%; n=42), but fewer provided bulk discounts (23%; n=10) or coupons (34%; n=15). One-third of rogue pharmacies selling imatinib (n=7) claimed to be registered or accredited on their websites. CONCLUSIONS The lack of safety measures taken by illegitimate online pharmacies endangers patient safety because they allow patients to purchase imatinib without appropriate evaluation for response, drug interactions, and adverse effects. Healthcare providers need to be aware of this practice and should assure patient access to imatinib through safe and legitimate pharmacies.
Subject Disciplines as the Opportunity for Group Action: A Measured Critique of Subject Sub-cultures

An ultra-fast terminator for laser pulses is provided in which plasma produced by firing a laser-triggered spark gap is used to speed and enhance the formation of a highly opaque plasma across the focal plane of a laser beam. The additional plasma contributed by the spark gap serves to prevent leakage of the beam past the plasma created by the laser itself.
Abnormal brain iron accumulation in obstructive sleep apnea: A quantitative MRI study in the HypnoLaus cohort

Obstructive sleep apnea syndrome (OSA) may be a risk factor for Alzheimer's disease. One of the hallmarks of Alzheimer's disease is disturbed iron homeostasis leading to abnormal iron deposition in brain tissue. To date, there is no empirical evidence to support the hypothesis of altered brain iron homeostasis in patients with obstructive sleep apnea as well. Data were analysed from 773 participants in the HypnoLaus study (mean age 55.9 ± 10.3 years) who underwent polysomnography and brain MRI. Cross‐sectional associations were tested between OSA parameters and the MRI effective transverse relaxation rate (R2*) – indicative of iron content – in 68 grey matter regions, after adjustment for confounders. The group with severe OSA (apnea‐hypopnea index ≥30/h) had higher iron levels in the left superior frontal gyrus (F3,760 = 4.79, p = 0.003), left orbital gyri (F3,760 = 5.13, p = 0.002), right and left middle temporal gyrus (F3,760 = 4.41, p = 0.004 and F3,760 = 13.08, p < 0.001, respectively), left angular gyrus (F3,760 = 6.29, p = 0.001), left supramarginal gyrus (F3,760 = 4.98, p = 0.003), and right cuneus (F3,760 = 7.09, p < 0.001). The parameters of nocturnal hypoxaemia were all consistently associated with higher iron levels. Measures of sleep fragmentation had less consistent associations with iron content. This study provides the first evidence of increased brain iron levels in obstructive sleep apnea. The observed iron changes could reflect underlying neuropathological processes that appear to be driven primarily by hypoxaemic mechanisms.
OSU‐T315 and doxorubicin synergistically induce apoptosis via mitochondrial pathway in bladder cancer cells

Bladder cancer (BC) is a common urological malignancy that still lacks an effective treatment. Doxorubicin (Dox) has been widely used in the treatment of various cancers, including BC. However, chemoresistance often hampers the clinical application of Dox, therefore, it is necessary to develop effective strategies to improve its efficacy. By using high‐throughput screening, we identified OSU‐T315, an integrin‐linked kinase (ILK) inhibitor, that can augment the cytotoxicity of Dox against BC cells. We found that OSU‐T315 and Dox synergistically induce apoptosis of BC cells via mitochondrial pathway in a caspase‐dependent. Mechanically, it was found that OSU‐T315 and Dox synergistically induced activation of Bax which is critical for the induction of apoptosis. Moreover, it was also found that the downregulation of BCL‐2 and MCL‐1 is essential for the activation of BAX induced by OSU‐T315 and Dox. OSU‐T315 was found to downregulate MCL‐1 via the GSK‐3β/FBXW7 axis in BC cells. Our findings suggest that combined treatment with OSU‐T315 and Dox may be a promising strategy to treat BC.
Evaluation of Automated Enforcement Program in Amman

This study aims, in a first attempt, to evaluate the effectiveness of using the Automated Enforcement Program (AEP) to improve traffic safety in Amman, Jordan. The evaluation of the program on crashes and violations was examined based on a “ before-and-after ” study using the paired t-test at 95 percent confidence level. Twenty one locations including signalized intersections monitored by red light cameras and arterial roads monitored by excessive speed cameras were selected. Nine locations were used to study the effectiveness of the program on violations, and twelve locations were used to determine the effectiveness of the program on frequency and severity of crashes. Data on number and severity of crashes were taken from Jordan Traffic Institution. Among the general findings, it was found that the AEP was generally associated with positive impact on crashes. Crash frequency was significantly reduced by up to 63%. Crash severities were reduced by up to 62.5%. Also, traffic violations were significantly reduced by up to 66%. Finally, drivers’ opinion and attitude on the program was also analyzed using a questionnaire survey. The questionnaire survey revealed that 35.5% of drivers are unaware of AEP in Amman, 63.9% of drivers don’t know the camera locations, most drivers knew about excessive speed and red light running penalties, most drivers reduce their speed at camera locations, 44.4% of drivers think that the program satisfies its objective in improving traffic safety and 52% of drivers encourage increasing the number of camera devices in Amman.
Recent expansion of the non‐recombining sex‐linked region on Silene latifolia sex chromosomes

Evolution of a non‐recombining sex‐specific region on the Y (or W) chromosome (NRY) is a key step in sex chromosome evolution, but how recombination suppression evolves is not well understood. Studies in many different organisms indicated that NRY evolution often involves several expansion steps. Why such NRY expansions occur remains unclear, although it is though that they are likely driven by sexually antagonistic selection. This paper describes a recent NRY expansion due to shift of the pseudoautosomal boundary on the sex chromosomes of a dioecious plant Silene latifolia. The shift resulted in inclusion of at least 16 pseudoautosomal genes into the NRY. This region is pseudoautosomal in closely related Silene dioica and Silene diclinis, indicating that the NRY expansion occurred in S. latifolia after it speciated from the other species ~120 thousand years ago. As S. latifolia and S. dioica actively hybridise across Europe, interspecific gene flow could blur the PAR boundary in these species. The pseudoautosomal genes have significantly elevated genetic diversity (π ~ 3% at synonymous sites), which is consistent with balancing selection maintaining diversity in this region. The recent shift of the PAR boundary in S. latifolia offers an opportunity to study the process of on‐going NRY expansion.
Predicted Batrachochytrium dendrobatidis infection sites in Guyana, Suriname, and French Guiana using the species distribution model maxent

The fungal pathogen Batrachochytrium dendrobatidis (Bd) which causes that amphibian disease chytridiomycosis is expanding its worldwide range from an Asian origin, infecting amphibians in a growing number of countries. Modelling the potential range of this amphibian pathogen using environmental variables and presence data could advance our understanding of at-risk areas and species in locations with limited surveillance to date. We used a species distribution model to assess Bd habitat suitability in the three Guiana’s (Guyana, Suriname, and French Guiana) in South America. The model output showed that all three countries have substantial areas where Bd could grow and proliferate, and maximum temperature of the warmest month was the top predictor of suitable Bd habitat, inversely correlated with modeled Bd occurrence. Predicted Bd infection areas in Guyana and French Guiana were large and localized whereas possible sites in Suriname were more scattered throughout the country. The areas projected as potential suitable in Suriname were mostly high elevation regions. These results could help inform efficiencies for development of a proactive monitoring program that could alert managers of novel Bd outbreaks for focused mitigation actions to forestall the spread of this amphibian disease.
A survey of pediatric neuropsychologists serving inpatient rehabilitation, Part II: billing, time allocation and tracking, and professional identity and perceptions

ABSTRACT Professional challenges have been documented in broad surveys of neuropsychologists. While previous surveyors have included pediatric neuropsychologists, few, if any, have specifically examined practices among those who primarily work in pediatric inpatient rehabilitation settings. Therefore, the aim of this study was to survey neuropsychologists in this setting. Thirty neuropsychologists from the U.S. and one from Canada that work in inpatient pediatric rehabilitation participated in an online survey. Most respondents (83.3%) billed for their inpatient time. Sixty-four percent indicated that payor type (private vs. public) affected services a moderate amount to a lot; this was primarily due to payor’s influence on length of stay. Most providers had productivity expectations (66.7%). Among those that had productivity expectations, three-quarters used “hours billed;” 37.5% were solely or additionally tracked by relative value units (RVUs). The majority of respondents conducted some type of clinical data collection, usually for research purposes. With respect to professional identity, most respondents indicated positivity about their role. The top challenges endorsed were related to workload/ability to meet the patients’ needs and billing/productivity. Issues related to billing and payor may influence aspects of pediatric inpatient rehabilitation neuropsychological care. Managing challenges related to billing and the time demands associated with providing inpatient services were top concerns for many respondents. Most sites surveyed were involved in data collection, usually for research purposes; increased data collection efforts are needed to aid with program development and evaluation and to demonstrate the added value of neuropsychological services from a patient care perspective.
Trial of Erythropoietin for Hypoxic-Ischemic Encephalopathy in Newborns.

BACKGROUND Neonatal hypoxic-ischemic encephalopathy is an important cause of death as well as long-term disability in survivors. Erythropoietin has been hypothesized to have neuroprotective effects in infants with hypoxic-ischemic encephalopathy, but its effects on neurodevelopmental outcomes when given in conjunction with therapeutic hypothermia are unknown. METHODS In a multicenter, double-blind, randomized, placebo-controlled trial, we assigned 501 infants born at 36 weeks or more of gestation with moderate or severe hypoxic-ischemic encephalopathy to receive erythropoietin or placebo, in conjunction with standard therapeutic hypothermia. Erythropoietin (1000 U per kilogram of body weight) or saline placebo was administered intravenously within 26 hours after birth, as well as at 2, 3, 4, and 7 days of age. The primary outcome was death or neurodevelopmental impairment at 22 to 36 months of age. Neurodevelopmental impairment was defined as cerebral palsy, a Gross Motor Function Classification System level of at least 1 (on a scale of 0 [normal] to 5 [most impaired]), or a cognitive score of less than 90 (which corresponds to 0.67 SD below the mean, with higher scores indicating better performance) on the Bayley Scales of Infant and Toddler Development, third edition. RESULTS Of 500 infants in the modified intention-to-treat analysis, 257 received erythropoietin and 243 received placebo. The incidence of death or neurodevelopmental impairment was 52.5% in the erythropoietin group and 49.5% in the placebo group (relative risk, 1.03; 95% confidence interval [CI], 0.86 to 1.24; P = 0.74). The mean number of serious adverse events per child was higher in the erythropoietin group than in the placebo group (0.86 vs. 0.67; relative risk, 1.26; 95% CI, 1.01 to 1.57). CONCLUSIONS The administration of erythropoietin to newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy did not result in a lower risk of death or neurodevelopmental impairment than placebo and was associated with a higher rate of serious adverse events. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT02811263.).
Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy: 20-year follow-up of the TIMIC trial

Abstract Aims Long-term results of the Tailored IMmunosuppression in virus-negative Inflammatory Cardiomyopathy (TIMIC) trial protocol have been evaluated. Methods and results Eighty-five patients with endomyocardial biopsy-proven virus-negative chronic inflammatory cardiomyopathy were enrolled in the randomized, double-blind, placebo-controlled TIMIC trial and received prednisone and azathioprine (n = 43) vs. placebo (n = 42) for 6 months. Immunosuppressive treatment promoted an improvement in cardiac function in 88% of the cases compared with none of the patients in the placebo group, which were switched to a 6-month immunosuppressive therapy at the end of the 6-month study period. Long-term (up to 20 years) clinical outcomes of the whole cohort of 85 patients originally enrolled in the TIMIC trial (Group A) were compared with those of a 1:2 propensity score-matched control cohort of patients untreated with the TIMIC protocol (Group B) and followed for a comparable period of time. The primary outcome was a composite of cardiovascular death and heart transplantation. At long-term follow-up, the risk of cardiovascular death [hazard ratio (HR) 6.77; 95% confidence interval (CI) 2.36–19.45] and heart transplantation (HR 7.92; 95% CI 1.80–34.88) was significantly higher in Group B patients. Group A showed a persistent improvement in the left ventricular ejection fraction compared with Group B (HR 7.24; 95% CI 3.05–17.18). A higher number of Group B patients underwent implantable cardioverter defibrillator implantation. The incidence of recurrent myocarditis was similar between groups, and patients with evidence of a recurrent cardiac inflammatory process promptly responded to a TIMIC protocol application. Conclusion Virus-negative inflammatory cardiomyopathy benefits from immunosuppressive therapy even after long-term follow-up. Recurrence appears to respond to a new TIMIC protocol application.
Predictors of iron versus erythropoietin responsiveness in anemic hemodialysis patients

Anemia protocols for hemodialysis patients usually titrate erythropoietin (ESA) according to hemoglobin and iron according to a threshold of ferritin, with variable response seen. A universally optimum threshold for ferritin may be incorrect, and another view is that ESA and iron are alternative anemia treatments, which should be selected based on the likely response to each. Hemodialysis patients developing moderate anemia were randomised to treatment with either an increase in ESA or a course of intravenous iron. Over 2423 patient‐months in 197 patients, there were 133 anemia episodes with randomized treatment. Treatment failure was seen in 20/66 patients treated with ESA and 20/67 patients treated with iron (30.3 vs. 29.9%, p = 1.0). Successful ESA treatment was associated with lower C‐reactive protein (13.5 vs. 28.6 mg/L, p = 0.038) and lower previous ESA dose (6621 vs. 9273 μg/week, p = 0.097). Successful iron treatment was associated with lower reticulocyte hemoglobin (33.8 vs. 35.5 pg, p = 0.047), lower hepcidin (91.4 vs. 131.0 μg/ml, p = 0.021), and higher C‐reactive protein (29.5 vs. 12.6 mg/L, p = 0.085). A four‐variable iron preference score was developed to indicate the more favorable treatment, which in a retrospective analysis reduced treatment failure to 17%. Increased ESA and iron are equally effective, though treatment failure occurs in almost 30%. Baseline variables including hepcidin can predict treatment response, and a four‐variable score shows promise in allowing directed treatment with improved response rates.
Safety assessment of coordinated signalized intersections in a connected vehicle environment: a microsimulation approach

Abstract In this study, the safety impact of the coupled implementation of signal coordination and connected vehicles (CVs) is examined in a microsimulation environment created in VISSIM. The Surrogate Safety Assessment Model (SSAM) was implemented to generate results of surrogate safety measures. The findings provided evidence that CVs can improve the safety performance at all market penetration rates (MPRs) of CVs in terms of all performance metrics. In addition, further safety improvements were achieved at higher CV MPRs. It was observed that coordinated signals had lower likelihoods of experiencing collisions compared to uncoordinated signals. Specifically, coordinated signals showed significantly higher time-to-collision (TTC) and post-encroachment time (PET) values when compared to uncoordinated signals at the 100% CV MPR only. Moreover, the impact of CV technologies on reducing the total number of conflicts (TNC) would be stronger than that of traffic signal coordination alone while both would lead to reductions in the TNC.
Comparison of bone mineral density and Fracture Risk Assessment Tool in Saudi women with and without type 2 diabetes mellitus

Objectives: To compare the bone mineral density and the fracture risks in Saudi women with and without type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study was carried out at Taibah Early Diagnostic Center, Al Madinah Al Munawarah, Saudi Arabia. A total of 465 women with and without T2DM aged ≥40 years who visited the center for a dual-energy X-ray absorptiometry scan between December 2020 and July 2021 were randomly selected. The 10-year probabilities of major osteoporotic fracture (MOF) and hip fracture (HF) were calculated using the Abu Dhabi Fracture Risk Assessment Tool (FRAX) with and without adjustment for T2DM. The adjustment was made by setting rheumatoid arthritis as the equivalent risk for T2DM in the FRAX. Bone mineral density values and the FRAX scores were compared between women with T2DM and non-diabetes. Results: Of 465 women, 214 had T2DM, and 251 were non-diabetics. The mean age of women was 59.42±7.9 years. There were no significant differences in mean age, menopausal status, height, weight, and body mass index between T2DM and non-diabetic women. Bone mineral density values and the unadjusted FRAX scores were comparable between the 2 groups. However, after adjusting FRAX for T2DM, the FRAX for MOF and HF became significantly higher in T2DM women (p=0.000 and p=0.004). Conclusion: In Saudi women with T2DM, unadjusted FRAX underestimated the risk of MOF and HF. Type 2 diabetes mellitus should be included as one of the clinical risk factors for fracture in future versions of the FRAX score.
Efficacy and tolerability of three topical acne treatments by body mass index: post hoc analysis including overweight and obese patients

Abstract Background Acne prevalence may be higher in overweight/obese individuals, potentially due to hormonal, inflammatory, and/or dietary factors. However, the effects of body mass index (BMI) on topical acne treatments are largely unknown. Methods Post hoc analyses of changes in inflammatory/noninflammatory lesions and treatment success were conducted using phase 3 data: clindamycin phosphate/benzoyl peroxide (CP/BPO) 1.2%/3.75% gel (NCT01701024); tretinoin 0.05% lotion (NCT02965456 and NCT02932306; pooled); and tazarotene 0.045% lotion (NCT03168321 and NCT03168334; pooled). Data were analyzed by BMI subgroups: <25kg/m2 (underweight-to-normal), 25-<30kg/m2 (overweight), and ≥30kg/m2 (obese). Results Among participants analyzed (CP/BPO = 495; tretinoin = 1,636; tazarotene = 1,612), ∼20–25% were overweight and 15–20% were obese. At week 12, mean percent changes from baseline in inflammatory lesions were: CP/BPO (overweight: −63.2%, obese: −56.0%); tretinoin (−57.6%, −53.1%); tazarotene (−59.9%, −56.8%). Mean changes in noninflammatory lesions were: CP/BPO (−54.2%, −50.8%); tretinoin (−51.6%, −44.9%); tazarotene (−56.7%, −54.6%). Treatment success rates with active treatment ranged from 16.2% to 33.5% across BMI groups. Conclusions CP/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion, and tazarotene 0.045% lotion were all effective in reducing acne lesions by ≥45% in overweight/obese patients with moderate-to-severe acne, comparable to the underweight-to-normal group. Efficacy of these topical acne treatments is not greatly impacted by BMI and may be affected more by the formulation.