Miracle-dz/UniFAR-FTUs huggingface dataset:
Strength training with blood flow restriction – a novel therapeutic approach for older adults with sarcopenia? A case report

Introduction A 91-year-old sedentary man presenting exhaustion, lower-limb weakness, hypertension, and history of multiple falls was diagnosed with sarcopenia – appendicular skeletal muscle mass index (ASM) of 7.10 kg/m2. Purpose To investigate the effects of strength training performed with low intensity in isolation (LI) or with blood flow restriction (LI-BFR) on strength, muscle mass, IGF-1, endothelial function, microcirculation, inflammatory biomarkers, and oxidative stress. Methods In the first 3 months, LI was performed with intensity corresponding to 30% of 1 repetition maximum, followed by 1 month of inactivity, and another 3 months of LI-BFR (similar load than LI concomitant to BFR equivalent to 50% of resting systolic blood pressure). Results LI-BFR, but not LI improved muscle mass, ASM, handgrip strength, isokinetic peak torque, IL-6, and IGF-1. Endothelial function, red blood cell velocity, and concentrations of C-reactive protein, and soluble intercellular adhesion molecules-1 improved after both LI and LI-BFR. Endothelin-1 and oxidative stress increased after LI-BFR, and lowered after LI. Conclusion LI-BFR, but not LI improved strength, muscle mass, IGF-1, endothelial function, and selected inflammatory markers in a nonagenarian sarcopenic patient. These results are promising and suggest that LI-BFR should be considered as an alternative to prevent muscle loss and improve functional fitness in frail older populations.
Feasibility randomized controlled trial of a one-day CBT workshop (‘DISCOVER’) for 15- to 18-year-olds with anxiety and/or depression in clinic settings

Abstract Background: ‘DISCOVER’ one-day cognitive behavioural therapy (CBT) workshops have been developed to provide accessible, developmentally sensitive psychological support for older adolescents experiencing emotional difficulties. Previous school-based evaluations of the DISCOVER model have shown positive outcomes. Aims: The current study aimed to test the model for clinically referred adolescents, in real-world settings. Method: A randomized controlled trial (RCT) assessed feasibility, acceptability and preliminary outcomes of the DISCOVER intervention, in comparison with usual care, for 15- to 18-year-olds with emotional difficulties. Participants were recruited from outpatient clinic waiting lists in UK child and adolescent mental health services (CAMHS). Research feasibility indicators included rates of recruitment, randomization, intervention participation (group workshops and individualized follow-up telephone calls), and data collection (at baseline and 8-week follow-up). Intervention acceptability was assessed using a structured service satisfaction questionnaire and semi-structured qualitative interviews with intervention participants. Preliminary clinical outcomes were explored using adolescent-reported validated measures of depression, anxiety and well-being. Results: n = 24 participants were randomized to intervention and usual care groups. Workshop attendance was good and high levels of treatment satisfaction were reported, although feasibility challenges emerged in recruitment and randomization. Trends were found towards potential improvements in anxiety and well-being for the intervention group, but the effect estimate for depression was imprecise; interpretability was also limited due to the small sample size. Conclusions: DISCOVER appears to be a feasible and acceptable intervention model for clinically referred 15- to 18-year-olds with emotional difficulties. A full-scale RCT is warranted to evaluate effectiveness; protocol modifications may be necessary to ensure feasible recruitment and randomization procedures.
Infective Endocarditis in Children With Congenital Heart Disease Cumulative Incidence and Predictors

C ongenital heart disease (CHD) represents a predispos-ing cardiac condition for the development of infective endocarditis (IE) and is increasing in prevalence. Improved survival of patients with CHD, in particular those with severe defects, 3 has implications on the size of the population and the types of CHD lesions among patients at risk of IE. In addition , the use of prosthetic material to correct or palliate CHD lesions puts these patients at a higher risk of IE. In developed countries, CHD is the most prevalent underlying cardiac condition in children with IE. 4–12 However, the risk of IE in a population-based cohort of children with CHD has never been reported, and the identification of CHD lesions at highest risk of IE has relied primarily on case series reports. Comparisons of risk of IE between cardiac conditions are 1 important consideration in the development of IE prevention guidelines. The American Heart Association guidelines for the prevention of IE were revised in 2007 with restrictions in the groups of patients for whom antibiotic prophylaxis was indicated before invasive medical procedures. 13 In 2008, the development group of the National Institute for Health and Clinical Excellence clinical guidelines made 2 research recommendations regarding prophylaxis against IE, one of which was: " What is the risk of developing IE in those with acquired valvular disease and structural congenital heart disease? Such research should use a population-based cohort study design to allow direct comparison between groups and allow estimation of both relative and absolute risk. " 14 We sought to address these questions in patients with CHD by determining the cumulative incidence and predictors for the development of IE in a large population-based cohort of affected children. Quebec is Canada's second most populated province with nearly 8 million inhabitants. 15 A unique healthcare number is assigned Background—The American Heart Association guidelines for prevention of infective endocarditis (IE) in 2007 reduced the groups of congenital heart disease (CHD) patients for whom antibiotic prophylaxis was indicated. The evidence base in CHD patients is limited. We sought to determine the risk of IE in children with CHD. Methods and Results—We performed a population-based analysis to determine the cumulative incidence and predictors of IE in children (0–18 years) with CHD by the use of the Quebec CHD Database from 1988 to 2010. In 47 518 children with CHD followed for 458 109 patient-years, 185 cases of IE were …
Inverted Internal Limiting Membrane Flap Technique: Is It the Best Option for Macular Holes?

Abstract Surgical treatment is generally necessary to repair full-thickness macular holes (FTMH). Although vitrectomy with or without internal limiting membrane (ILM) peeling remains the standard surgical technique, the inverted ILM flap procedure has increasingly assumed a role in the primary surgical repair of FTMHs. Some vitreoretinal surgeons reserve this technique to treat large or myopic holes, whereas others use it routinely in all cases. This paper is a comprehensive review of the current scientific evidence on the anatomical and functional outcomes of the inverted ILM flap technique in the repair of macular holes, following the International Vitreomacular Traction Study (IVTS) group classification.
Prevalence of rheumatic heart disease among primary school students in mid-eastern Ethiopia

Objective: To determine the prevalence of rheumatic heart disease (RHD) among primary school students in Shashemene town of Oromia regional state of Ethiopia. Method: Using a cross sectional study design and a multistage sampling technique, pupils were selected from public and private primary schools in Shashemene town. They were clinically screened for evidence of RHD by auscultating for significant murmurs. The students with significant murmurs then had echocardiographic evaluation to confirm the presence of RHD. Results: Out of the 1874 students recruited, 956 (51.01%) were females while 918 (48.99%) were males. The mean age of the students was 8.86 ± 2.14 years. 1162 (62.01%) and 712(37.99%) respectively were recruited from public and private schools. Of the 1874 students, fifteen (0.80%) had significant murmur. Only six of the fifteen had RHD, giving a prevalence of 3.2/1000 students. Four of the students with RHD were females and the rest two were males, all from public school and in the low socioeconomic class. Conclusion: The prevalence of RHD in this study is low compared to similar studies conducted previously in the country. The true prevalence may be underestimated since higher prevalence is obtained from echocardiographic screening compared to clinical screening.
Carbon Ion Beam Reirradiation in Recurrent High-Grade Glioma

Background: Patients with recurrent glioma after prior radiotherapy have a poor prognosis. Carbon ion beam radiotherapy offers highly conformal dose distributions and more complex biological radiation effects eventually resulting in optimized normal tissue sparing and improved outcome. The aim of this study was to analyze toxicity, local control and overall survival after reirradiation of recurrent high-grade glioma with carbon ion radiotherapy. Methods: Between 10/2015 and 12/2018, 30 patients (median age: 59 years) with recurrent high-grade glioma were reirradiated with carbon ion beams and retrospectively analyzed. Diagnosis of recurrent glioma was based on magnetic resonance imaging. Thirteen patients had repeated resection prior to reirradiation and 24 patients underwent additional chemotherapy. The median initial radiation dose was 60 Gy and the median time interval between the initial and repeated radiotherapy was 10 months. The reirradiation dose was 45 Gy (relative biological effectiveness) applied in 15 fractions. All patients received regular follow-up imaging after reirradiation. Kaplan-Meier estimation, log rank test and Cox regression analysis were used for statistical assessment. Results: Applying common toxicity criteria, there were no grade 5 or 4 adverse events, while 8 patients showed grade 3 adverse events. The median follow-up after reirradiation was 11 months and the median overall survival after diagnosis of recurrent high-grade glioma was 13 months. The 6-, 12- and 24-month overall survival rates after diagnosis of recurrent high-grade glioma were 76%, 50% and 19%, respectively. Upon multivariate Cox regression analysis, a Ki67 score of the initial tumor histology of less than 20% was prognostic. Repeated resection or chemotherapy for the recurrent disease did not result in signi ﬁ cantly prolonged survival. Conclusion: Carbon ion reirradiation in recurrent high-grade glioma is safe and feasible. No radiation-associated grade 4 toxicities were documented and treatment was tolerated well.
Neuromuscular Electrical Stimulation and Volitional Exercise for Individuals With Rheumatoid Arthritis: A Multiple-Patient Case Report

Background and Purpose: Muscle atrophy is common in patients with rheumatoid arthritis (RA). Although neuromuscular electrical stimulation (NMES) is a viable treatment for muscle atrophy, there is no evidence about the use of NMES in patients with RA. The purposes of this multiple-patient case report are: (1) to describe the use of NMES applied to the quadriceps femoris muscles in conjunction with an exercise program in patients with RA; (2) to report on patient tolerance and changes in lean muscle mass, quadriceps femoris muscle strength (force-producing capacity), and physical function; and (3) to explore how changes in muscle mass relate to changes in quadriceps femoris muscle strength, measures of physical function, and patient adherence. Case Description: Seven patients with RA (median age=61 years, range=39–80 years) underwent 16 weeks of NMES and volitional exercises. Lean muscle mass and strength of the quadriceps femoris muscle and physical function were measured before and after treatment. Outcomes: One patient did not tolerate the NMES treatment, and 2 patients did not complete at least half of the proposed treatment. Patients who completed the NMES and volitional exercise program increased their lean muscle mass, muscle strength, and physical function. Discussion: Because of the small sample, whether NMES combined with exercises is better than exercise alone or NMES alone could not be determined. However, the outcomes from this multiple-patient case report indicate that NMES is a viable treatment option to address muscle atrophy and weakness in patients with RA. Strategies to increase tolerance and adherence to NMES are warranted.
Neuromuscular Electrical Stimulation and Dynamic Bracing as a Treatment for Upper-Extremity Spasticity in Children with Cerebral Palsy

We have investigated a therapeutic regimen using neuromuscular electrical stimulation (NMES) and dynamic bracing to assess their effectiveness in reducing upper-extremity spasticity in children with cerebral palsy. Nineteen patients between 4 and 21 years of age with documented diagnoses of spastic cerebral palsy were treated. The patients included in the study followed a regimen of two 30-minute sessions of NMES of the antagonist extensors combined with dynamic orthotic traction during the day. A static brace was used at night. Spasticity of the wrist and fingers was assessed periodically using the Zancolli classification. Treatment ranged from 3 to 43 months. After treatment with electrical stimulation and dynamic bracing, all the patients moved up 1 to 3 levels in the Zancolli classification and showed a marked improvement in upper-extremity function. These results show that combining NMES and dynamic orthotic traction dramatically decreases spasticity of the upper extremity in young patients with cerebral palsy.
Effect of plant spacing and cultivars on growth and production of pea under dry land conditions.

Four Plant spacing (i.e. 10 , 12, 14 and 16) cm. between Plants and two pea cultivars i.e. Santi and Parafield under dry land conditions Ninevah on two growth seasons 2009/2010 and 2010-2011 . Results indicated that Plant spacing was affected significantly on number of days to 50% flowering, number of days to 90% maturation , first pod height, number of pods/plant , number of seeds/plant , weight of 100seeds, biological yield and , dry seed yield (economic yield) Kg/ha and harvest index in the two growing seasons . The second Plant spacing gave the highest dry seed yield (1323.74)kg/ha in the first growing season . Results indicated that Parafield cultivar gives the highest dry seed yield (1291.81)kg/ha in the first growing season .
INSIDER THREAT DETECTION DATA AUGMENTATION USING WCGAN-GP

x Acknowledgements . xi Chapter
Treatment of intracranial aneurysms with the Enterprise stent: a multicenter registry.

OBJECT The development of self-expanding stents dedicated to intracranial use has significantly widened the applicability of endovascular therapy to many intracranial aneurysms that would otherwise have been untreatable by endovascular techniques. Recent Food and Drug Administration approval of the Enterprise Vascular Reconstruction Device and Delivery System (Cordis) has added a new option for self-expanding stent-assisted intracranial aneurysm coiling. METHODS The authors established a collaborative registry across multiple institutions to rapidly provide largevolume results regarding initial experience in using the Enterprise in real-world practice. Ten institutions (University at Buffalo, Thomas Jefferson University, University of Florida, Cleveland Clinic, Northwestern University, West Virginia University, University of Puerto Rico, Albany Medical Center Hospital, the Neurological Institute of Savannah, and the Barrow Neurological Institute) have provided consecutive data regarding their initial experience with the Enterprise. RESULTS In total, 141 patients (119 women) with 142 aneurysms underwent 143 attempted stent deployments. The use of Enterprise assistance with aneurysm coiling was associated with a 76% rate of > or = 90% occlusion. An inability to navigate or deploy the stent was experienced in 3% of cases, as well as a 2% occurrence of inaccurate deployment. Procedural data demonstrated a 6% temporary morbidity, 2.8% permanent morbidity, and 2% mortality (0.8% unruptured, 12% ruptured). CONCLUSIONS The authors report initial results of the largest series to date in using the Enterprise for intracranial aneurysm treatment. The Enterprise is associated with a high rate of successful navigation and low occurrence of inaccurate stent deployment. The overall morbidity and mortality rates were low; however, caution should be exercised when considering Enterprise deployment in patients with subarachnoid hemorrhage as the authors' experience demonstrated a high rate of associated hemorrhagic complications leading to death.
Functional outcome of repeat Descemet membrane endothelial keratoplasty (DMeK) for corneal decompensation following graft failure after primary DMeK

Purpose: To evaluate if repeat Descemet membrane endothelial keratoplasty (DMEK) is appropriate to achieve functional improvements in patients with corneal decompensation from secondary graft failure after primary DMEK. Methods: This is a retrospective monocentric cohort study including 13 eyes of 13 patients with repeat DMEK for corneal decompensation following primary DMEK. Eyes with primary DMEK only and comparable preoperative corrected distance visual acuity (CDVA) served as control. Main outcome parameter was CDVA. Secondary outcome measures were central corneal thickness (CCT), endothelial cell density, and rebubbling rate (RR). Results: The average time interval ( ± SD) between primary and secondary DMEK was 12.5 ± 6 months. Preoperative CDVA (logMAR) was 1.97 ± 0.90 in the repeat DMEK group and 1.38 ± 0.92 in the primary DMEK group. At 6 months, both groups showed significant improvement in visual acuity (repeat DMEK group, 0.49 ± 0.35, P , 0.01 and primary DMEK group, 0.40 ± 0.36, P , 0.01). CDVA did not differ significantly between both groups at all time points examined (1, 3, and 6 months postoperatively). Mean CCT values at 3 and 6 months postoperatively did not differ significantly between the two groups ( P . 0.05). The RR was 23% (n = 3) in both groups. Conclusion: Repeat DMEK is a useful therapeutic approach in the setting of corneal decompensation following primary DMEK. Functional results of repeat DMEK, visual acuity in particular, are comparable to patients with single DMEK only. Key topics include: Optometry; Visual science; Pharmacology and drug therapy in eye diseases; Basic Sciences; Primary and Secondary eye care; Patient Safety and Quality of Improvements.
1 Comparative Effectiveness Review Number 102 Screening for Methicillin-Resistant Staphylococcus Aureus ( MRSA ) Executive Summary Background

Methicillin-resistant Staphylococcus aureus (MRSA) emerged as a clinically relevant human pathogen more than five decades ago.1 The virulent bacterium was first detected in hospitals and other health care facilities where vulnerable hosts, frequent exposure to the selective pressure of intensive antimicrobial therapy, and the necessity for invasive procedures created a favorable environment for dissemination. MRSA emerged as an important cause of healthcare-associated infections, particularly central line–associated bloodstream infection, ventilatorassociated pneumonia, and surgical site infection (SSI). Despite the adoption of infection-control measures, the incidence of MRSA infection at most U.S. hospitals steadily increased for many years,2 but it is now decreasing.3-6 Burton and colleagues4 found a 49.6-percent decrease in the overall incidence of MRSA central line– associated bloodstream infection in U.S. intensive care units (ICUs) from 1997 to 2007. In a study of nine U.S. metropolitan areas, Kallen and colleagues6 found a reduction in the incidence rate of hospital-onset invasive MRSA infections of 9.4 percent per year from 2005 to 2008 (95% confidence interval [CI], 14.7 to 3.8%; p=0.005). Effective Health Care Program
NETWORK STRUCTURE AND AUDITOR COMPENSATION: EVIDENCE FROM A BIPARTITE NETWORK

This paper examines the relationship between the extent of knowledge flow during audit practice (measured by the local network clustering coefficient) and auditor compensation. We exploit a unique bipartite (i.e. two-mode) network composed of individual auditors assigned to different audit engagements from an audit firm for one full year to determine our local network clustering coefficient and auditor compensation data from this audit firm’s personnel records. Informed by social networks theory and determinants of wage in labor economics, we find a positive association between local network clustering and auditor compensation, which is both statistically and economically significant. Our results are robust to alternative measures of local network clustering coefficient, alternative explanations of structural holes and centrality, alternative linear specification and endogeneity concern. Furthermore, we find that this positive association may be primarily driven by seniors working on audit engagements. Overall, our results suggest that embeddedness within knowledge networks plays an important role for auditor compensation.
Journal Pre-proof Incidence and Risk Factors of Immediate Hypersensitivity Reactions and Immunisation Stress-related Responses with COVID-19 mRNA Vaccine Stress-related with mRNA

Background: With the implementation of mass vaccination campaigns against COVID-19, the 27 safety of vaccine needs to be evaluated. Objective: We aimed to assess the incidence and risk factors for immediate hypersensitivity 29 reactions (IHSR) and immunisation stress-related responses (ISRR) with the Moderna COVID-19 30 vaccine. Methods: This nested case-control study included recipients who received the Moderna vaccine at a 32 mass vaccination centre, Japan. Recipients with IHSR and ISRR were designated as cases 1 and 2, 33 respectively. Controls 1 and 2 were selected from recipients without IHSR or ISRR and matched (1 34 case: 4 controls) with cases 1 and cases 2, respectively. Conditional logistic regression analysis was 35 used to identify risk factors associated with IHSR and ISRR. 36 Results: Of the 614,151 vaccine recipients who received 1,201,688 vaccine doses, 306 recipients 37 (cases 1) and 2,478 recipients (cases 2) showed 318 events of IHSR and 2,558 events of ISRR, 38 respectively. The incidence rates per million doses were estimated as – IHSR: 266 cases, ISRR: 39 2,129 cases, anaphylaxis: 2 cases, and vasovagal syncope: 72 cases. Risk factors associated with 40 IHSR included female, asthma, atopic dermatitis, thyroid diseases, and history of allergy; for ISRR, 41 the risk factors were younger age, female, asthma, thyroid diseases, mental disorders, and a history 42 of allergy and vasovagal reflex. 43 Conclusion : In the mass vaccination settings, the Moderna vaccine can be used safely owing to the low incidence rates of IHSR and anaphylaxis. However, providers should be aware of the occurrence of ISRR. Although recipients with risk factors are associated with slightly increased risks of IHSR and ISRR, this is not of sufficient magnitude to warrant special measures regarding vaccination. What is already known about this topic? Although studies have estimated a low incidence rate of 51 anaphylaxis to mRNA vaccines and identified several potential risk factors, there exists a 52 knowledge gap regarding the incidence and risk factors for non-serious IHSR and ISRR. 53 What does this article add to our knowledge? Adverse events were more commonly classified as 54 ISRR, instead of IHSR, and the incidence rates of IHSR was very low. We found that the several 55 risk factors associated with increased risk of IHSR and ISRR. 56 How does this study impact current management guidelines? Though recipients with risk factors 57 are associated with increased risks of IHSR and ISRR, their incidence rates were low. Hence, these 58 risk factors are not of sufficient magnitude to warrant special measures regarding their vaccination. Baseline clinical characteristics (age, sex, comorbidities of hypertension, dyslipidaemia, cardiovascular diseases, asthma, atopic dermatitis, thyroid diseases, malignancy and mental disorders, and history of episodes for and and vasovagal episode)