Miracle-dz/UniFAR-FTUs huggingface dataset:
Adolescents and young adults (AYA) with acute myeloid leukemia (AML): real-world long-term results and age-specific outcomes

Abstract Opposing acute lymphoblastic leukemia, sparse data about AYAs with acute myeloid leukemia (AML) is available. Overall, 125 AYAs (age 10–35 years) treated during the last two decades were evaluated and compared to 385 older patients. CBF leukemia was more frequent in AYAs (21.6% vs. 8%, p < 0.001); however, many presented high-risk features. AYAs showed improved complete remission rate (CR, 80% vs. 65%, p = 0.01), lower cumulative incidence of relapse and TRM and longer survival (5 year-OS 53% vs. 24%, p < 0.0001), observed mainly in intermediate-risk karyotype. Adolescents displayed even better outcomes (5 year-OS 69%). AlloHCT in CR1 was beneficial for nonadolescent AYAs (5 year-OS 66.7% vs. 44.4% without HCT, p = 0.04). Among 50 APL patients, 19 AYAs experienced better outcomes than older, mainly attributed to reduced treatment-related mortality (TRM, 5% vs. 19%, p = 0.1). We observed an important (>10%) survival gain for AYAs during the last decade. However, AYAs have still unmet needs to obtain optimal cure rates.
Benefits of tailored hepatocellular carcinoma screening in patients with cirrhosis on cancer‐specific and overall mortality: A modeling approach

To validate cancer screening programs, experts recommend estimating effects on case fatality rates (CFRs) and cancer‐specific mortality. This study evaluates hepatocellular carcinoma (HCC) screening in patients with cirrhosis for those outcomes using a modeling approach. We designed a Markov model to assess 10‐year HCC‐CFR, HCC‐related, and overall mortality per 100,000 screened patients with compensated cirrhosis. The model evaluates different HCC surveillance intervals (none, annual [12 months], semiannual [6 months], or quarterly [3 months]) and imaging modalities (ultrasound [US] or magnetic resonance imaging [MRI]) in various annual incidences (0.2%, 0.4%, or 1.5%). Compared to no surveillance, 6‐month US reduced the 10‐year HCC‐CFR from 77% to 46%. With annual incidences of 0.2%, 0.4%, and 1.5%, the model predicted 281, 565, and 2059 fewer HCC‐related deaths, respectively, and 187, 374, and 1356 fewer total deaths per 100,000 screened patients, respectively. Combining alpha‐fetoprotein screening to 6‐month US led to 32, 63, and 230 fewer HCC‐related deaths per 100,000 screened patients for annual incidences of 0.2%, 0.4%, and 1.5%, respectively. Compared to 6‐month US, 3‐month US reduced cancer‐related mortality by 14%, predicting 61, 123, and 446 fewer HCC‐related deaths per 100,000 screened patients with annual incidences of 0.2%, 0.4%, and 1.5%, respectively. Compared to 6‐month US, 6‐month MRI (−17%) and 12‐month MRI (−6%) reduced HCC‐related mortality. Compared to 6‐month US, overall mortality reductions ranged from −0.1% to −1.3% when using 3‐month US or MRI. A US surveillance interval of 6 months improves HCC‐related and overall mortality compared to no surveillance. A shorter US interval or using MRI could reduce HCC‐CFR and HCC‐related mortality, with a modest effect on overall mortality.
Network analysis based on big data in social media of Korean adolescents’ diet behaviors

Adolescents are increasingly interested in weight control; hence, proper health education is important for helping them control their weight properly. This study was designed to pick out social media words that express adolescents’ diet behaviors, and identify the associations and types between such words and the behaviors. It used text-mining techniques and semantic network analysis for related big data collected from the Internet on adolescents’ diet behaviors. Text mining was used to extract meaningful information from unstructured text data, whereas semantic network analysis was used to understand the relationships between keywords. The top five keywords were “obesity,” “health,” “exercise,” “eat,” and “increase” in online news, and “exercise,” “eat,” “weight loss,” “obesity,” and “health” in blogs. The betweenness centrality of “appearance” was particularly higher than that of other centralities in online news. As a result of the CONCOR analysis, eight clusters each were identified in online news and blogs. This study’s results will serve as a basis for weight management-related intervention strategies, reflecting the perspectives of adolescents. It also has significance as basic data to provide correct information, and establish desirable weight control in the future.
Open-label, rapid initiation pilot study for extended-release buprenorphine subcutaneous injection

ABSTRACT Background: For patients with opioid use disorder, buprenorphine extended-release injection (BUP-XR) achieves sustained therapeutic plasma concentrations, controls craving and withdrawal symptoms, and improves patient outcomes. Given retention challenges during transmucosal buprenorphine (BUP-TM) induction, assessing methods to quickly achieve sustained buprenorphine concentrations is important. Objectives: This open-label, single-group, single-center pilot study (NCT03993392) evaluated safety and tolerability of initiating BUP-XR following a single BUP-TM 4 mg dose. Methods: Eligible participants abstained from short and long-acting opioids for 6 and 24 hours, respectively. If the Clinical Opiate Withdrawal Scale (COWS) was ≥8, BUP-TM 4 mg was administered. Participants not exhibiting hypersensitivity, precipitated opioid withdrawal (POW), or sedation symptoms within 1 hour received BUP-XR 300 mg (assessed as inpatients for 48 hours and outpatients to Day 29). Endpoints were COWS score increase ≥6, independent adjudication of POW, and opioid use. Results: Twenty-six participants (14 male) received BUP-TM, 24 received BUP-XR, and 20 completed the study. After injection, COWS scores decreased from pre-BUP-TM baseline of 14.6 ± 4.1 to 6.9 ± 4.1 at 6 hours and 4.2 ± 3.2 at 24 hours. Most participants (62.5%) experienced maximum COWS scores pre-BUP-XR; 2 experienced a COWS score increase ≥6, occurring at 1 and 2 hours post-BUP-XR. By adjudication, 2/24 participants experienced POW. Irritability, anxiety, nausea, and pain were the most frequent adverse events (AEs) with no serious AEs. Conclusions: Results support increased flexibility for initiating BUP-XR. Initiating BUP-XR 300 mg following a single BUP-TM 4 mg dose was well tolerated. Although some participants initially experienced withdrawal symptoms after injection, significant symptomatic improvement was observed in all participants within 24 hours.
Long-Term Outcomes and Genetic Predictors of Response to Metastasis-Directed Therapy Versus Observation in Oligometastatic Prostate Cancer: Analysis of STOMP and ORIOLE Trials

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co‐primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. The initial STOMP and ORIOLE trial reports suggested that metastasis-directed therapy (MDT) in oligometastatic castration-sensitive prostate cancer (omCSPC) was associated with improved treatment outcomes. Here, we present long-term outcomes of MDT in omCSPC by pooling STOMP and ORIOLE and assess the ability of a high-risk mutational signature to risk stratify outcomes after MDT. The primary end point was progression-free survival (PFS) calculated using the Kaplan-Meier method. High-risk mutations were defined as pathogenic somatic mutations within ATM, BRCA1/2, Rb1, or TP53. The median follow-up for the whole group was 52.5 months. Median PFS was prolonged with MDT compared with observation (pooled hazard ratio [HR], 0.44; 95% CI, 0.29 to 0.66; P value < .001), with the largest benefit of MDT in patients with a high-risk mutation (HR high-risk, 0.05; HR no high-risk, 0.42; P value for interaction: .12). Within the MDT cohort, the PFS was 13.4 months in those without a high-risk mutation, compared with 7.5 months in those with a high-risk mutation (HR, 0.53; 95% CI, 0.25 to 1.11; P = .09). Long-term outcomes from the only two randomized trials in omCSPC suggest a sustained clinical benefit to MDT over observation. A high-risk mutational signature may help risk stratify treatment outcomes after MDT.
Efﬁciency of Osmotic Dehydration of Pomegranate Seeds in Polyols Solutions Using Response Surface Methodology

: This study investigates the inﬂuence of polyol compounds (sorbitol and erythritol) on the osmotic dehydration process of pomegranate seeds. The efﬁcacy of the osmotic dehydration process was estimated based on the determination of water loss, weight reduction, solid gain, and effective diffusivity and also through a comparison of the results obtained between sucrose and polyol osmotic solutions. Response surface methodology was used to optimize the osmotic process. Quality attributes of pomegranate seeds were determined through the assessment of physical (texture and color) characteristics. This innovative research applies alternative solutions in the osmotic process, which until now, have not been commonly used in the osmotic dehydration of pomegranate seeds processing by researchers worldwide. Results revealed the excellent correlation of experimental values with the model. Erythritol and sorbitol exhibit stronger efﬁciency than sucrose. However, erythritol was not satisfactory due to the high solid gain. Therefore, the sorbitol osmotic agent seems to be the most suitable for the osmotic dehydration of pomegranate seeds. The optimal condition for maximum water loss (38.61%), weight reduction (37.77%), and effective diffusivity (4.01 × 10 − 8 m 2 /s) and minimum solid gain ( − 0.37%) were 13.03 min, 27.77 ◦ Brix, and 37.7 ◦ C, using a sorbitol solution. Results of texture and color revealed the major impact of erythritol and sorbitol osmotic agents on seed characteristics during the osmotic dehydration process.
Three‐dimensional architecture of human medial gastrocnemius fascicles in vivo: Regional variation and its dependence on muscle size

Fascicle architecture (length and pennation angle) can vary regionally within a muscle. The architectural variability in human muscles has been evaluated in vivo, but the interindividual variation and its determinants remain unclear. Considering that within‐muscle non‐uniform changes in pennation angle are associated with change in muscle size by chronic mechanical loading, we hypothesized that the regional variation in fascicle architecture is dependent on interindividual variation in muscle size. To test this hypothesis, we reconstructed fascicles three‐dimensionally along and across the whole medial gastrocnemius in the right lower leg of 15 healthy adults (10 males and 5 females, 23.7 ± 3.3 years, 165.8 ± 8.3 cm, 61.9 ± 11.4 kg, mean ± standard deviation) in neutral ankle joint position with the knee fully extended, using magnetic resonance diffusion tensor imaging and tractography. The 3D‐reconstructed fascicles arose from the deep aponeurosis with variable lengths and angles both in sagittal and coronal planes. The fascicle length was significantly longer in the middle (middle‐medial: 52.4 ± 6.1 mm, middle‐lateral: 52.0 ± 5.1 mm) compared to distal regions (distal‐medial: 41.0 ± 5.0 mm, distal‐lateral: 38.9 ± 3.6 mm, p < 0.001). The 2D pennation angle (angle relative to muscle surface) was significantly greater in distal than middle regions, and medial than lateral regions (middle‐medial: 26.6 ± 3.1°, middle‐lateral: 24.1 ± 2.3°, distal‐medial: 31.2 ± 3.6°, distal‐lateral: 29.2 ± 3.0°, p ≤ 0.017), while only a proximo‐distal difference was significant (p < 0.001) for 3D pennation angle (angle relative to line of action of muscle). These results clearly indicate fascicle's architectural variation in 3D. The magnitude of regional variation evaluated as standard deviation across regions differed considerably among individuals (4.0–10.7 mm for fascicle length, 0.9–5.0° for 2D pennation angle, and 3.0–8.8° for 3D pennation angle), which was positively correlated with the muscle volume normalized to body mass (r = 0.659–0.828, p ≤ 0.008). These findings indicate muscle‐size dependence of the variability of fascicle architecture.
Carcinoma of unknown primary: Molecular tumor board‐based therapy

A 36- year- old an A comput-erized tomography (CT) scan of the abdomen and pelvis showed multiple, hypodense lesions within the left hepatic lobe that were concerning for metastatic disease. The largest liver lesion (3.1 × 2.2 cm) was bi-opsied, and pathology was consistent with metastatic, moderately differentiated adenocarcinoma. Immunohistochemistry (IHC) stains performed for further characterization of the tumor were positive for cytokeratin 7 (CK7) and CDX2 and negative for CK20, HepPar- 1, Napsin A, and GATA- 3, consistent with adenocarcinoma. The differential diagnosis included primary cholangiocarcinoma versus metastatic carcinoma of upper gastroesophageal or pancreaticobiliary origin. Of note, it was also suspected that the patient had amoebiasis, and she was on treatment with antibiotics. She later transferred her care to our university hospital. A follow- up CT scan of the abdomen and pelvis performed a few weeks after the initial presentation demonstrated hypodense liver lesions involving the right and left lobes as well as peripancreatic and gastrohepatic lymph nodes, which were suspicious for malignancy. Because the liver biopsy could not identify the primary tumor conclusively, subsequent endoscopic ultrasound and fine- needle aspiration of the peripancreatic lymph node were performed almost a month after the initial presentation.
Exploring the knowledge, attitude and practice towards disaster medicine preparedness and readiness: A prescriptive insight by the community pharmacists in the United Arab Emirates

Background Proper disaster preparedness by community pharmacists has the potential to counter many of the factors that cause threats and high-risk outcomes. Their preparedness and awareness may also help health practitioners and governments to improve disaster response planning. Objectives This aims to explore the knowledge, attitude, and practice (KAP) towards disaster medicine preparedness and readiness among community pharmacists in the United Arab Emirates (UAE). Method A cross-sectional study was conducted over the ten months among licensed community pharmacists who had three months’ professional experience or more. Face-to-face interviews were carried out and a structured questionnaire was used for data collection. Logistic regression models were used to determine the factors influencing aboucine preparedness and readiness. SPSS Version 24 was used to analyze the data collected. Results A total of 500 community pharmacists participated in the study. The average knowledge score was 25.6% with a 95% confidence interval (CI) of [21.7%, 29.4%]. Better knowledge scores were observed in the male gender (OR 2.43; 95% CI 1.05–3.72), participants aged ≥ 31 years old (OR 2.97; 95% CI 1.16–7.6), postgraduates (OR 4.36; 95% CI 2.6–7.3), participants from independent Pharmacies (OR 6.5; 95% CI 4.04–10.4 3), chief pharmacists (OR 3.1; 95% CI 1.86–5.07), participants with 16 years and more experience years (OR 2.42; 95% CI 1.063–5.522) and participants who graduated from regional/international universities (OR 5.92; 95% CI 2.65–13.2). Better attitude and practice about disaster medicine preparedness were observed in postgraduates (OR 2.54; 95% CI 1.26–pharmacists from independent pharmacies (OR 1.35; 95% CI 2.43–2,.66), and chief pharmacists (OR 1.26; 95% CI 1.17–1.35). Conclusions It’s essential to provide a continuing education program using different educational strategies urgently needed to improve community pharmacy competencies (e.g. knowledge attitudes, and perceptions) to improve the skills and practices regarding disaster medicine preparedness and readiness.
Network modeling of major depressive disorder symptoms in adult women

Abstract Background Major depressive disorder (MDD) is one of the growing human mental health challenges facing the global health care system. In this study, the structural connectivity between symptoms of MDD is explored using two different network modeling approaches. Methods Data are from ‘the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD)’. A cohort of N = 2163 American Caucasian female-female twins was assessed as part of the VATSPSUD study. MDD symptoms were assessed using personal structured clinical interviews. Two network analyses were conducted. First, an undirected network model was estimated to explore the connectivity between the MDD symptoms. Then, using a Bayesian network, we computed a directed acyclic graph (DAG) to investigate possible directional relationships between symptoms. Results Based on the results of the undirected network, the depressed mood symptom had the highest centrality value, indicating its importance in the overall network of MDD symptoms. Bayesian network analysis indicated that depressed mood emerged as a plausible driving symptom for activating other symptoms. These results are consistent with DSM-5 guidelines for MDD. Also, somatic weight and appetite symptoms appeared as the strongest connections in both networks. Conclusions We discuss how the findings of our study might help future research to detect clinically relevant symptoms and possible directional relationships between MDD symptoms defining major depression episodes, which would help identify potential tailored interventions. This is the first study to investigate the network structure of VATSPSUD data using both undirected and directed network models.
Use of contraception and attitudes towards contraceptive use in Swedish women: an internet-based nationwide survey

Abstract Purpose Explore contraceptive use, unmet need of and attitudes towards contraceptive use in Sweden. Secondly, to investigate knowledge of contraceptives, prevalence and outcomes of unintended pregnancies. Materials and methods Internet based e-survey of Swedish women aged 16–49. The e-survey contained 49 questions with both spontaneous and multi-choice character on demographics, contraceptive use, knowledge of and attitudes towards contraception, importance of monthly bleeding, and experience of unintended pregnancy. The e-survey was closed when reaching the estimated sample size of 1000 respondents. Results A total of 1016 women participated, whereof 62.4% used contraception, 31.8% did not and 5.8% had stopped in the last 12 months. Unmet need for contraception was estimated at 17.2%. At least one unintended pregnancy was experienced by 19.9%. All women rated effectiveness as the most important characteristic of a contraceptive method. Conclusions Use of contraception in Swedish women remains low, 62.4%, and the unmet need for contraception has increased to 17.2%. Method effectiveness and health benefits of hormonal contraception should be emphasised during contraceptive counselling, and actions are needed to target groups with low use of effective contraception as well as to reach those who never seek contraception. KEY MESSAGE Close to one third of Swedish women do not use contraception and one fifth have experienced at least one unintended pregnancy. Unmet need for contraception is high despite easy access and subsidies for young women.
Microstructural changes along the cingulum in young adolescents with psychotic experiences: An along‐tract analysis

Psychotic experiences (PEs) such as hallucinations and delusions are common among young people without psychiatric diagnoses and are associated with connectivity and white matter abnormalities, particularly in the limbic system. Using diffusion magnetic resonance imaging (MRI) in adolescents with reported PEs and matched controls, we examined the cingulum white matter tract along its length rather than as the usually reported single indivisible structure. Complex regional differences in diffusion metrics were found along the bundle at key loci following Bonferroni significance adjustment (p < .00013) with moderate to large effect sizes (.11–.76) throughout all significant subsegments. In this prospective community‐based cohort of school‐age children, these findings suggest that white matter alterations in the limbic system may be more common in the general non‐clinical adolescent population than previously thought. Such white matter alternations may only be uncovered using a similar more granular along‐tract analysis of white matter tracts.
Use of Phenobarbitone for Palliative Sedation in Dyspneic Crises Due to COVID-19 Pneumonia – A Case Series

Abstract Patients who suffer from dyspnea while dying from COVID-19 are treated with opioids and benzodiazepines. In some instances, patients may experience refractory dyspnea at the end of life. Palliative sedation can be prescribed to alleviate such patients’ suffering. We describe two patients being treated for severe COVID-19 pneumonia in a tertiary hospital. Both developed intractable dyspneic crises despite high-dose opioids and benzodiazepines. This led to their requirement of palliative sedation in the general ward using subcutaneous phenobarbitone (phenobarbital). We outline clinical considerations for the use of palliative sedation in COVID-19 related dyspnea. In particular, we discuss the evidence for, benefits and limitations of using phenobarbitone for palliative sedation in COVID-19 patients.
The melatonin contained in beer can provide health benefits, due to its antioxidant, anti-inflammatory and immunomodulating properties.

Beer is a drink that is part of the diet of many peoples, it is a fermented beverage with a low alcohol content originating from cereal fermentation (barley or wheat) and contains melatonin. Melatonin (N-acetyl-5-methoxytryptamine) is a molecule with a wide range of antioxidant, oncostatic, immunomodulatory, and cytoprotective properties. The aim of this work was to review the data supporting the idea that moderate consumption of beer, because of its melatonin content, is particularly useful in the diets of healthy subjects and in other physiological situations (pregnancy, menopause, old age, …), through food products as functional tools. Methods: Data source: a) The MEDLINE / PubMed search was conducted from 1975 to April 2022, and b) Our own experience and published studies on melatonin, the immune system, and beer. In this perspective, we provide a background on the mechanisms of melatonin generation in beer, its concentrations, and its possible effects on health. Conclusions: Melatonin contained in beer, as part of the diet of healthy individuals and in some special physiological situations, could act as a protective factor and improve the quality of life of those who drink it in moderation. This article is protected by copyright. All rights reserved.
The Impact of the COVID-19 Pandemic on Staff in Violence Against Women Services

The COVID-19 pandemic has been harmful to survivors of abuse. Less understood is the impact on staff in the violence against women (VAW) service sector. Using interpretive description methodology, we examined staff experiences during the pandemic in Ontario, Canada, and found four core themes: (1) the emotional toll of the work; (2) remote (doesn't) work; (3) work restructuring; (4) efforts to stay well and subthemes nuancing staff experiences in a sector vulnerable to vicarious trauma. This research underscores the need to mitigate experiences of stress, heavy workloads, and guilt for staff in VAW services during crises and provides action-oriented recommendations.