Miracle-dz/UniFAR-FTUs huggingface dataset:
A five‐year follow‐up of untreated patients with chronic lymphocytic leukaemia treated with ofatumumab and chlorambucil: final analysis of the Complement 1 phase 3 trial

The Complement 1 trial investigated the efficacy and safety of ofatumumab + chlorambucil with chlorambucil monotherapy in patients with previously untreated chronic lymphocytic leukaemia (CLL). On long‐term follow‐up in the chemoimmunotherapy arm vs. the chemotherapy arm there was an estimated 12% (not significant) and 39% risk reduction in overall survival and progression‐free survival, respectively. A high rate (61%) of treatment with next‐line therapies in both the treatment arms may dilute any potential OS difference and confound the interpretation of the OS results. Addition of ofatumumab to chlorambucil demonstrated clinical benefit and tolerability as a frontline treatment option in patients unfit for fludarabine‐containing therapy, with no new safety concerns.
Motivations Influencing Caffeine Consumption Behaviors among College Students in Korea: Associations with Sleep Quality

Caffeinated beverages are a part of daily life. Caffeinated beverages such as coffee, tea, energy drinks, and soft drinks are easy to purchase and are frequently consumed by young college students. Moreover, smoking influences the consumption of caffeinated beverages. The concentration of caffeine in these products is an attractive factor for individuals that desire the effects of caffeine; however, abusing such products may lead to poor sleep quality. The motivations that drive caffeinated beverage consumption were investigated in this study through a survey. Self-reported questionnaires were distributed on campus to students enrolled at a university in Korea. The motivations of the students for consuming each caffeinated beverage and their sleep quality were investigated. The results of exploratory factor analysis showed the motivations for caffeinated beverage consumption were alertness, taste, mood, socialization, health benefits, and habit. The motivations for consuming each caffeinated beverage product were different. For instance, coffee consumption was motivated by a desire for alertness (B = 0.107, SE = 0.049, t = 2.181, p < 0.05) and by habit (B = 0.345, SE = 0.046, t = 7.428, p < 0.001), whereas tea consumption was influenced by socialization (B = 0.142, SE = 0.060, t = 2.357, p < 0.05). Energy drink consumption was motivated by a desire for alertness (B = 0.100, SE = 0.034, t = 2.966, p < 0.01) and health benefits (B = 0.120, SE = 0.051, t = 2.345, p < 0.05), while the consumption of soft drinks was not motivated by any specific factors. Caffeinated beverage consumption did not show a significant relationship with sleep quality, although the general sleep quality of the respondents was poor. Smoking status showed significant differences in coffee and tea consumption as well as sleep quality. Smokers had a higher intake of coffee and a lower intake of tea than non-smokers. No interaction effect between smoking and coffee on sleep quality was found. Labeling detailing the amount of caffeine in products is necessary and a cautionary statement informing consumers that smoking cigarettes enhances the effects of caffeine should be included.
Violence Exposure and Mental Health Among Resettled Refugees: A Systematic Review

Refugee populations are often characterized by their high exposure to violence, which are tied to various challenges upon resettlement. This systematic review synthesizes the empirical literature related to violence exposure for refugees resettled in high-income countries and the impact of that exposure on mental health symptoms. The authors reviewed quantitative studies published from 2000 to 2018 and found 12 studies met criteria for inclusion. Studies were excluded if the study did not include a measured mental health outcome, if violence exposure was not measured and reported on distinctly from nonviolent exposures, if the sample did not include a refugee population, or if the relationship between violence exposure and mental health of refugees was not empirically examined. Overall, studies found that resettled refugee populations were more likely to have higher rates of violence exposure than comparison groups. This violence exposure was significantly related to higher mental health symptoms, including symptoms of depression, anxiety, and, most commonly reported, posttraumatic stress disorder. However, there is substantial heterogeneity in measurement of violence exposure, particularly in the use of author-created scales. The vast majority of included studies examined only exposure to violence prior to resettlement. The review shows significant evidence for the effect of violence prior to resettlement on mental health after resettlement and reveals a need for improved measurement and definitions of violence exposure at different time points for resettled refugee populations. Assessing current exposure to violence is an important step for effective intervention related to mental health dilemmas for refugee populations.
Genetics of physiological dysregulation: findings from the long life family study using joint models

Recently, Mahalanobis distance (DM) was suggested as a statistical measure of physiological dysregulation in aging individuals. We constructed DM variants using sets of biomarkers collected at the two visits of the Long Life Family Study (LLFS) and performed joint analyses of longitudinal observations of DM and follow-up mortality in LLFS using joint models. We found that DM is significantly associated with mortality (hazard ratio per standard deviation: 1.31 [1.16, 1.48] to 2.22 [1.84, 2.67]) after controlling for age and other covariates. GWAS of random intercepts and slopes of DM estimated from joint models found a genome-wide significant SNP (rs12652543, p=7.2×10-9) in the TRIO gene associated with the slope of DM constructed from biomarkers declining in late life. Review of biological effects of genes corresponding to top SNPs from GWAS of DM slopes revealed that these genes are broadly involved in cancer prognosis and axon guidance/synapse function. Although axon growth is mainly observed during early development, the axon guidance genes can function in adults and contribute to maintenance of neural circuits and synaptic plasticity. Our results indicate that decline in axons’ ability to maintain complex regulatory networks may potentially play an important role in the increase in physiological dysregulation during aging.
Zika Virus Circulates at Low Levels in Western and Coastal Kenya.

Zika virus (ZIKV) was discovered over 70 years ago in East Africa but little is known about its circulation and pathogenesis there. We screened 327 plasma samples collected 2-12 months after febrile illness in Western and coastal Kenya (1993-2016) for binding and neutralizing antibodies to distinguish ZIKV and Dengue virus (DENV) responses, which we found were common in coastal Kenya. Two cases had durable ZIKV-specific antibodies and two cases had ZIKV antibodies at similar levels as DENV antibodies. This suggests low-level ZIKV circulation in Kenya over two decades and sets a baseline for future surveillance efforts in East Africa.
Assessment of Job Stress for Nurses in Psychiatric Hospitals at Baghdad City

Objectives: The aim of study is to assess job stress for nurses who are working in psychiatric hospitals in Baghdad city and its relation to socio-demographic characteristics of the nurses. Methodology: descriptive analytic study was conducted on 100 nurses were present in at three psychiatric hospitals in Baghdad city. The data are collected through the use of constructed questionnaire which divided into two sections; the 1st section included general information (demographical characteristic) of nurses. The 2nd section was based on job stress scale; it's consisting five domains which are: Dealing with patients and their families, Workload, problems with doctors, Problems with supervisors and Conflict relating peers. The content validity of the instrument was established through penal of (11) experts. Reliability of the questioner was 93%. Descriptive data analysis was done through frequency, percentage mean, standard deviation and inferential data analysis was done by Independent t-test, Analysis of variance (ANOVA). Results: the results show the majority of nurses were middle age male, married, graduated of nursing institutes, have less than or equal 5 years of experienced in psychiatric hospitals, most of them participated in training courses related to psychiatric mental health care inside Iraq, while few of them participated in the courses outside Iraq. Results revealed that both nurses (male& female) suffering of moderate level of stress in their work in all of domains and there was a significant relationship between nurse's stress and their training courses especially outside the country. Conclusion: the results revealed that job stress in all domains were found moderate among nurses in psychiatric mental health hospitals because of lack of participation in training courses and especially outside country. Recommendation: Reconsider and improving of employees in psychiatric nursing profession by establishing training courses (especially in psychiatry- mental health nursing) inside and outside of country in order to develop nurses' skills according to scientific programs through development of nurse's abilities and performance.
Tri-ponderal mass index and body mass index in prediction of pediatric metabolic syndrome: the CASPIAN-V study

ABSTRACT Objective Body mass index (BMI) and tri-ponderal mass index (TMI) are anthropometric measures to evaluate body adiposity in the various age groups. The present study aims to compare the predictive value of TMI and BMI for metabolic syndrome (Mets) in children and adolescents of both genders. Subjects and methods A cross-sectional study conducted on 3731 Iranian children and adolescents aged 7-18 years obtained from the fifth survey of ‘Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease’ (CASPIAN-V) study. The predictive value of BMI and TMI for MetS were determined using Receiver-operator curves. Logistic regression analysis was used to assess the relationship between these indices with MetS. Results 52.6% of participants were boys. The mean (standard deviations) age for boys and girls were 12.62 (3.02) and 12.25 (3.05) years, respectively. In boys, the area under the curve (AUC) of TMI was greater than BMI for all age groups. AUC of TMI was also greater than BMI for age group of 11-14 years (AUC = 0.74; 95% CI (0.67, 0.81)) in girls. Furthermore, our findings showed that odds ratio of Mets for TMI was greater than BMI in age groups of 11-14 years (OR = 1.33 vs 1.22) and 15-18 years (1.16 vs 1.15) in girls and boys, respectively. Conclusion TMI and BMI had moderate predictive value for identifying MetS. However, TMI was a better predictor of MetS than BMI in both genders, especially in age groups of 11-14 and 15-19 years for girls and boys.
Proportion of Patients in Phase 1 Oncology Trials Receiving Treatments that are Ultimately Approved.

BACKGROUND Phase 1 oncology trials are often regarded as a therapeutic option for patients. However, such claims have relied on surrogate measures of benefit, such as objective response. METHODS Using a systematic search of publications, we assessed the therapeutic value of phase 1 cancer trial participation by determining the probability that patients will receive active doses of treatments that eventually receive FDA approval or an NCCN guideline recommendation for their indication. ClinicalTrials.gov, Pubmed, ASCO reports, NCCN Guidelines and Drugs@FDA were searched between May 1, 2018 and July 31, 2018. All statistical tests were two-sided. RESULTS 1000 phase 1 oncology trials initiated between 2005 and 2010 and enrolling 32,582 patients were randomly sampled from 3229 eligible trials on ClinicalTrials.gov. A total of 386 (1.2%) patients received a treatment that was approved by the U.S. Food and Drug Administration for their malignancy at a dose delivered in the trial; including NCCN guideline recommendations, the number and proportion are 1168 (3.6%). Meta regression showed a statistically significantly greater proportion of patients receiving a drug that was ultimately FDA approved in biomarker trials (rate ratio = 4.49, 95%CI = 1.53 to 13.23, p = 0.006) and single-indication trials (rate ratio = 3.32, [1.21 - 9.15], p = 0.02; proportions were significantly lower for combination vs. monotherapy trials (rate ratio = 0.09, [0.01 - 0.68], p = 0.02). CONCLUSIONS One in 83 patients in phase 1 cancer trials received a treatment that was approved for their indication at the doses received. Given published estimates of serious adverse event rates of 10-19%, this represents low therapeutic value for phase 1 trial participation.
Screening Tools for Autism Spectrum Disorder in Primary Care: A Systematic Evidence Review

Through a systematic review of ASD screening studies conducted in PC or similar settings, in this article, we capture what is known about available tools. CONTEXT: Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD). OBJECTIVES: We systematically reviewed evidence for universal screening of children for ASD in PC. DATA SOURCES: We searched Medline, PsychInfo, Educational Resources Informational Clearinghouse, and Cumulative Index of Nursing and Allied Health Literature. STUDY SELECTION: We included studies in which researchers report psychometric properties of screening tools in unselected populations across PC and PC-like settings. DATA EXTRACTION: At least 2 authors reviewed each study, extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS: We found evidence for moderate to high positive predictive values for ASD screening tools to identify children aged 16 to 40 months and 1 study for ≥48 months in PC and PC-like settings. Limited evidence evaluating sensitivity, specificity, and negative predictive value of instruments was available. No studies directly evaluated the impact of screening on treatment or harm. LIMITATIONS: Potential limitations include publication bias, selective reporting within studies, and a constrained search. CONCLUSIONS: ASD screening tools can be used to accurately identify percentages of unselected populations of young children for ASD in PC and PC-like settings. The scope of challenges associated with establishing direct linkage suggests that clinical and policy groups will likely continue to guide screening practices. ASD is a common neurodevelopmental disorder associated with significant life span costs.1,2 Growing evidence supports functional gains and improved outcomes for young children receiving intensive intervention, so early identification on a population level is a pressing public health challenge.3,4
CD44 inhibition attenuates EGFR signaling and enhances cisplatin sensitivity in human EGFR wild-type non-small-cell lung cancer cells

Cluster of differentiation 44 (CD44) as a transmembrane glycoprotein is found to be expressed in non-small cell lung cancer (NSCLC), is significantly associated with NSLC progression, metastasis and drug resistance. This study aimed to explore whether CD44 inhibition improves the sensitivity of epidermal growth factor receptor (EGFR) wild-type NSCLC cells to cisplatin and how it affects wild-type EGFR in NSCLC cells. Small interfering RNA was used to knockdown CD44 expression in EGFR wild-type NSCLC cell line H460. Results suggested that CD44 downregulation reduced cell growth, promoted G0/G1 cell cycle arrest and induced cell apoptosis in H460 cells and these effects were evidently enhanced when in combination with cisplatin. Deactivation of EGFR signaling pathway including EGFR phosphorylation and its downstream molecules, targets ERK, AKT1 and SRC which were also observed in CD44-silenced H460 cells with or without EGF stimulation. Furthermore, the CD44 expression level was positively correlated with wild-type EGFR level in human lung adenocarcinoma tissues and CD44 inhibition significantly accelerated the degradation of EGFR, indicating that enhanced sensitivity of H460 cells to cisplatin by downregulation of CD44 might be due to EGFR degradation. This study demonstrated that suppression of CD44 deactivated EGFR signals in NSCLC cells with wild-type EGFR, thereby contributing to the inhibition of cell proliferation and the reinforcement of cisplatin sensitivity. It is suggested that downregulation of CD44 could be a novel potential therapeutic strategy for the treatment of EGFR wild-type NSCLC.
Outcomes of Laparoscopic Surgery in Colorectal Cancer Patients With Dialysis

Background/Aim: To investigate the outcomes of laparoscopic surgery in colorectal cancer patients with dialysis. Patients and Methods: Fourteen dialysis (dialysis group) and 567 non-dialysis (non-dialysis group) patients who underwent laparoscopic and open surgery for colorectal cancer between April 2008 and December 2015 were included. Short-term and long-term outcomes were compared between the groups. A 1:2 propensity score matching was performed to compare long-term outcomes. Results: All the dialysis patients underwent laparoscopic surgery. There were no significant differences in operative outcomes and postoperative short-term outcomes between the two groups. In the whole cohort, overall survival of dialysis patients was shorter than that in the non-dialysis ones (p=0.020), while disease-free survival did not differ between the two groups. After matching, there was no significant difference between the groups in overall or disease-free survival. Conclusion: Laparoscopic colorectal cancer surgery for dialysis patients seems safe and feasible and associates with comparable short-term outcome and recurrence rate to non-dialysis patients.
Impact of improved observed hand hygiene on bloodstream infection rates in Ireland. A prospective segmented regression analysis, 2009–2016

Abstract Participation in European surveillance for bloodstream infection (BSI) commenced in Ireland in 1999 with all laboratories (n = 39) participating by 2014. Observational hand hygiene auditing (OHHA) was implemented in 2011. The aim of this study was to evaluate the impact of OHHA on hand hygiene compliance, alcohol hand rub (AHR) procurement and the incidence of sensitive and resistant Staphylococcus aureus and Enterococcus faecium and faecalis BSI. A prospective segmented regression analysis was performed to determine the temporal association between OHHA and outcomes. Observed hand hygiene improved from 74.7% (73.7–75.6) in 2011 to 90.8% (90.1–91.3) in 2016. AHR procurement increased from 20.1 l/1000 bed days used (BDU) in 2009 to 33.2 l/1000 BDU in 2016. A pre-intervention reduction of 2% per quarter in the ratio of methicillin sensitive Staphylococcus aureus BSI/BDU stabilized in the time period after the intervention (P < 0.01). The ratio of Methicillin resistant Staphylococcus aureus (MRSA) BSI/BDU was decreasing by 5% per quarter pre-intervention, this slowed to 2% per quarter post intervention, (P < 0.01). There was no significant change in the ratio of vancomycin sensitive (P = 0.49) or vancomycin resistant (P = 0.90) Enterococcus sp. BSI/BDU post intervention. This study shows national OHHA increased observed hand hygiene compliance and AHR procurement, however there was no associated reduction in BSI.
The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

Dry eye disease (DED) is a multifactorial disease of the ocular surface system whose chore mechanisms are tear film instability, inflammation, tear hyperosmolarity and epithelial damage. In recent years, novel therapies specifically targeting inflammation and oxidative stress are being investigated and used in this field. Therefore, an increasing body of evidence supporting the possible role of different micronutrients and nutraceutical products for the treatment of ocular surface diseases is now available. In the present review, we analyzed in detail the effects on ocular surface of omega-3 fatty acids, vitamins A, B12, C, D, selenium, curcumin and flavonoids. Among these, the efficacy of omega-3 fatty acid supplementation in ameliorating DED signs and symptoms is supported by robust scientific evidence. Further long-term clinical trials are warranted to confirm the safety and efficacy of the supplementation of the other micronutrients and nutraceuticals.
ERβ and NFκB—Modulators of Zearalenone-Induced Oxidative Stress in Human Prostate Cancer Cells

Nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) is commonly expressed in prostate cancer (PCa) cells and is associated with increased proliferation, metastases and androgen independence. Zearalenone (ZEA) is one of the most common mycotoxins contaminating food, which might mimic estrogens and bind to estrogen receptors (ERs). The ratio of androgens to estrogens in men decreases physiologically with age, and is believed to participate in prostate carcinogenesis. In this study, we evaluated the role of NFκB and ERβ in the induction of oxidative stress in human PCa cells by ZEA. As observed, ZEA at a dose of 30 µM induces oxidative stress in PCa cells associated with DNA damage and G2/M cell cycle arrest. We also observed that the inhibition of ERβ and NFΚB via specific inhibitors (PHTPP and BAY 117082) significantly increased ZEA-induced oxidative stress, although the mechanism seems to be different for androgen-dependent and androgen-independent cells. Based on our findings, it is possible that the activation of ERβ and NFΚB in PCa might protect cancer cells from ZEA-induced oxidative stress. We therefore shed new light on the mechanism of ZEA toxicity in human cells.
How young patients with cancer perceive the COVID‐19 (coronavirus) epidemic in Milan, Italy: Is there room for other fears?

The rapid spread of coronavirus disease 2019 epidemic in Italy, in particular in the Milan focal point, required drastic measures and led to panic in the population. While in our center we did not change our approach to the treatment of our young patients with cancer, we developed a qualitative survey to assess their perception of the risk and level of stress. The survey showed that a relatively large proportion of young patients felt personally at risk of severe complications. We believe that we need to adequately inform our patients, focusing on hygienic measures and personal protection and prompt reporting of any suspicious symptoms.
Intelligent Driving Assistant Based on Road Accident Risk Map Analysis and Vehicle Telemetry

Through the application of intelligent systems in driver assistance systems, the experience of traveling by road has become much more comfortable and safe. In this sense, this paper then reports the development of an intelligent driving assistant, based on vehicle telemetry and road accident risk map analysis, whose responsibility is to alert the driver in order to avoid risky situations that may cause traffic accidents. In performance evaluations using real cars in a real environment, the on-board intelligent assistant reproduced real-time audio-visual alerts according to information obtained from both telemetry and road accident risk map analysis. As a result, an intelligent assistance agent based on fuzzy reasoning was obtained, which supported the driver correctly in real-time according to the telemetry data, the vehicle environment and the principles of secure driving practices and transportation regulation laws. Experimental results and conclusions emphasizing the advantages of the proposed intelligent driving assistant in the improvement of the driving task are presented.