Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcomes in Pediatric Acute Lymphoblastic Leukemia—A Single-Center Romanian Experience

Background: This study evaluates the main (para)clinical aspects and outcomes in a group of Romanian children diagnosed with acute lymphoblastic leukemia (ALL), under the conditions of antileukemic treatment according to an adapted ALL IC Berlin–Frankfurt–Munster (BFM) 2002 protocol. Methods: We performed a retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016. Standard forms were used for data collection of variate clinical and paraclinical parameters. Results: The children were predominantly male (64.8%) and their median age at diagnosis was 5 years. A total of 107 patients were diagnosed with precursor B-cell acute lymphoblastic leukemia (BCP)-ALL and 18 with T-cell acute lymphoblastic leukemia T-ALL. Multiplex reverse transcription polymerase chain reaction RT-PCR assay for ETV6-RUNX1, BCR-ABL, E2A-PBX1, KMT2A-AFF1, and STIL-TAL1 fusion genes was performed in 111 patients. ETV6-RUNX1 translocation was detected in 18.9% of patients, while BCR-ABL1 and E2A-PBX1 rearrangements were seen in 2.7% and 3.6%, respectively. Complete remission at the end of induction phase was obtained in 89.6% of patients. The overall relapse rate was 11.2%, with 11 early and 3 late relapses. The 5-year overall survival rate in BCP-ALL was 81.6% and in T-ALL 71.4%. Conclusions: The 5-year overall and event-free survival rates in our study were slightly lower than those reported in developed countries, so the patients’ outcomes are encouraging.
Effect of family history, occupation and diet on the risk of Parkinson disease: A case-control study

Background The aetiology of Parkinson’s disease (PD) is still very controversial, with a peculiar lack of established risk factors or protective behavior. Methods We carried out a case–control study of 634 idiopathic PD patients admitted from 2011 to 2015 to two hospitals located in central Italy and 532 controls matched by hospital, gender and age (± 5 years). The study questionnaire included questions on host factors, family history, residence, occupation and lifestyle. Odds ratios (ORs) for PD and 95% confidence intervals (CIs) were estimated with logistic regression, adjusting for actual and potential confounders. Results A lower OR was observed in females (0.74; 95%CI:0.58–0.96), while older age classes showed a constantly increased risk for PD (p<0.005) starting from the class 65–69 years. Subjects who reported a first degree relative affected by PD showed a borderline increase which was more evident in those enrolled in the urban center of Rome (OR = 1.65; 95%CI: 1.09–2.50). Significant reduction of the risk was associated to current smoking (OR = 0.48; 95%CI: 0.24–0.54), and to vegetables consumption (p<0.03), while borderline increases were associated to meat and cold cut consumption. Occupational activities classified according to ISCO-08 categories did not show increased risk, while higher ORs’ were found for pilots and physicians. Conclusions The results from this study confirmed the higher risk of PD in males and in elderly, and the inverse association with smoking habit. The possible etiological role of familial clustering, dietary habit, and some job tasks is suggested.
Diversity Patterns of Bermuda Grass along Latitudinal Gradients at Different Temperatures in Southeastern China

Cynodon dactylon (L.) Pers. (common Bermuda grass) has a limited capacity to grow at low temperatures, which limits its geographical range. Exploring its evolutionary relationship across different environmental gradients is necessary to understand the effects of temperature change on the genetics of common Bermuda grass. In this study, high-throughput transcriptome sequencing was performed on 137 samples of C. dactylon from 16 latitudinal gradients to explore the differential molecular markers and analyze genetic diversity and structure along latitudinal gradients at different temperatures. We primarily sampled more high-quality single nucleotide polymorphisms (SNPs) from populations at lower and middle latitudes. Greater intraspecific genetic variation at each level of temperature treatment could be due to factors such as wind pollination and asexual breeding. Populations of C. dactylon at high latitudes differed from populations at middle and low latitudes, which was supported by a principal component analysis (PCA) and genetic structure analysis, performed at different temperatures. We observed more genetic variation for low-latitude populations at 5 °C, according to an analysis of three phylogenetic trees at different temperature levels, suggesting that low temperatures affected samples with low cold resistance. Based on the results of phylogenetic analysis, we found that samples from high latitudes evolved earlier than most samples at low latitudes. The results provide a comprehensive understanding of the evolutionary phenomenon of landscape genetics, laying the groundwork for future structural and comparative genomic studies of C. dactylon.
Revisiting patient-related barriers to cancer pain management in the context of the US opioid crisis.

ABSTRACT Patient fear of addiction is a well-documented barrier to the use of analgesic medications for cancer pain control. Over the past 2 decades in the US, an "opioid crisis" has arisen, accompanied by risk messages delivered through news outlets, public health education, and patient-provider communication. The purpose of this study was to determine if patient-related barriers to cancer pain management-specifically, fears of addiction-and related pain outcomes (pain severity, pain interference with daily life, and adequacy of pain management) have worsened over the last 20 years. A sample of 157 outpatients with active recurrent or active metastatic cancer completed the Barriers Questionnaire-II (BQ-II) and measures of pain and analgesic use. We identified 7 comparison studies published between 2002 and 2020 that reported patient-related barriers using the BQ-II. Significant linear relationships were found between later year of publication and greater fear of addiction (Harmful Effect subscale score, B=.0350, R2=.0347, F1,637=23.19, p<.0001) and between year of publication and more pain management barriers overall (total BQ-II score, B=.039, R2=.065, F1,923=73.79, p<.0001). Relationships between BQ-II scores (harmful effect and total) and pain outcomes did not change over time. Despite worsening in patient-related barriers, the proportion of patients with adequate versus inadequate analgesic use did not differ over time. Notably, 40% of participants reported inadequate analgesic use, a statistic that has not improved in 20 years. Additional research is necessary to clarify factors contributing to changing beliefs. Findings indicate a continuing need for clinical and possibly system/policy-level interventions to support adequate cancer pain management.
Myocarditis and coronary aneurysms in a child with acute respiratory syndrome coronavirus 2

A 6‐year‐old African boy with multi‐viral infection including parvovirus B19 and severe acute respiratory syndrome coronavirus 2 was admitted for persistent fever associated with respiratory distress and myocarditis complicated by cardiogenic shock needing ventilatory and inotropic support. Coronary aneurysms were also documented in the acute phase. Blood tests were suggestive of macrophage activation syndrome. He was treated with intravenous immunoglobulins, aspirin, diuretics, dexamethasone, hydroxychloroquine, and prophylactic low molecular weight heparin. Normalization of cardiac performance and coronary diameters was noticed within the first days. Cardiac magnetic resonance imaging, performed 20 days after the hospitalization, evidenced mild myocardial interstitial oedema with no focal necrosis, suggesting a mechanism of cardiac stunning related to cytokines storm rather than direct viral injury of cardiomyocytes.
Complexation of bis(trimethylsilyl)acetylene by decamethylhafnocene to give the hafnacyclopropene Cp*2Hf (η2 -Me3Sic2SiMe3 ) : An unusually strong metal-alkyne interaction

The complexes Cp2Hf(PMe3)(η2-Me3SiC2SiMe3) (3) and Cp*2Hf(η2-Me3SiC2SiMe3) (4), as the first examples of well-defined hafnium alkyne complexes with a simple intact alkyne, are described; 4 displays an unusually strong interaction of the alkyne with hafnium, in comparison to analogous compounds of titanium and zirconium.
Equestrian Road Safety in the United Kingdom: Factors Associated with Collisions and Horse Fatalities

Simple Summary Horse riders report they frequently experience incidents with other road users, including dangerous near-misses and accidents. The British Horse Society has been collecting information about horse-related road incidents via their website since 2010. The aim of this study was to describe the incidents reported, how they have changed over time and across different UK regions, and the factors which may increase or reduce the risk of collision incidents and those resulting in horses being killed. Road rage and speeding were reported in 40% of incidents while drivers passing the horse too closely were reported in over 80% of incidents. Close passing distance, alone or when combined with speeding, contributed significantly to collisions while speeding alone contributed significantly to horse deaths. Wearing high visibility clothing reduced the risk of having a collision. A horse death caused by a road accident was almost 12 times as likely to result in severe to fatal injury to the rider/handler. Loose horses were more likely to be killed than ridden horses or those pulling a horse-drawn vehicle. Driver behaviour of how to pass horses safely on UK roads needs further improvement and will help reduce the risk of collisions and horse and human fatalities. Abstract Over 60% of UK horse riders report having experienced a road-related near-miss or accident. The aim of this study was to describe horse-related road incidents (n = 4107) reported to the British Horse Society (2010–2020) and to identify factors associated with higher odds of collisions with another vehicle and horse fatalities using multivariable logistic regression modelling. Drivers passed the horse too closely in 84.2% of incidents while road rage and speeding were reported in 40.3% and 40.1% of incidents, respectively. Close passing distance alone (odds ratio [OR] 18.3, 95% confidence interval [CI] 6.5, 51.6) or in combination with speeding (OR 4.4, CI 1.7, 11.7) was associated with higher collision odds compared to speeding alone. Speeding was, however, associated with higher horse fatality odds (OR 2.3, CI 1.2, 4.6). Wearing high visibility clothing reduced odds of collision (OR 0.2, CI 0.1, 0.4). A fatal injury to a horse was almost 12 times as likely to result in severe to fatal rider/handler injury. Loose horses contribute significantly to road-related horse fatalities. Driver behaviour of how to pass horses safely on UK roads needs further improvement and will help reduce the risk of collisions and horse and human fatalities.
Child health services during a COVID-19 outbreak in KwaZulu-Natal Province, South Africa.

BACKGROUND Current evidence indicates that children are relatively spared from direct COVID-19-related morbidity and mortality, but that the indirect effects of the pandemic pose significant risks to their health and wellbeing. OBJECTIVES To assess the impact of the local COVID-19 outbreak on routine child health services. METHODS The District Health Information System data set for KwaZulu-Natal (KZN) provincial health services was accessed, and monthly child health-related data were extracted for the period January 2018 - June 2020. Chronological and geographical variations in sentinel indicators for service access, service delivery and the wellbeing of children were assessed. RESULTS During April - June 2020, following the start of the COVID-19 outbreak in KZN, significant declines were seen for clinic attendance (36%; p=0.001) and hospital admissions (50%; p=0.005) of children aged <5 years, with a modest recovery in clinic attendance only. Among service delivery indicators, immunisation coverage recovered most rapidly, with vitamin A supplementation, deworming and food supplementation remaining low. Changes were less pronounced for in- and out-of-hospital births and uptake rates of infant polymerase chain reaction testing for HIV at birth, albeit with wide interdistrict variations, indicating inequalities in access to and provision of maternal and neonatal care. A temporary 47% increase in neonatal facility deaths was reported in May 2020 that could potentially be attributed to COVID-19-related disruption and diversion of health resources. CONCLUSIONS Multiple indicators demonstrated disruption in service access, service delivery and child wellbeing. Further studies are needed to establish the intermediate- and long-term impact of the COVID-19 outbreak on child health, as well as strategies to mitigate these.
Can Talented Youth Soccer Players Who Have Undergone Anterior Cruciate Ligament Reconstruction Reach the Elite Level?

Background: Anterior cruciate ligament (ACL) ruptures are common in soccer players, and reconstructive surgery is often performed to restore knee stability and enable a return to play. Purpose: To investigate whether an ACL reconstruction for talented youth soccer players affects their potential to become elite players at the senior level. Study Design: Cohort study; Level of evidence, 3. Methods: All soccer players who participated in the Swedish National Elite Camp for 15-year-old players between 2005 and 2011 (N = 5285 players; 2631 boys and 2654 girls) were matched with the Swedish National Knee Ligament Registry to identify the players who had undergone ACL reconstruction. Information on player participation in Swedish league games and level of play was collected from the Swedish Football Association’s administrative data system. The players with an ACL reconstruction who were injured at the ages of 15 to 19 years were compared with the rest of the players who participated in the National Elite Camp to see whether an early ACL reconstruction affected whether they remained active as soccer players and their chance to play at the elite level as seniors. Results: A total of 524 (9.9%) players had undergone an ACL reconstruction, and 292 (5.5%; 75 male and 217 female) had sustained their injury at age 15 to 19 years. During the follow-up period, 122 (23.3%) players underwent ACL reconstruction: revision (11.5%; n = 60) or contralateral (11.8%; n = 62). Male and female soccer players undergoing an ACL reconstruction at age 15 to 19 years experienced no significant effect on being active or playing at the elite level in the season that they turned 21 years old. Of the youth players who underwent ACL reconstruction, 12% of the male players and 11.5% of the female players progressed to the elite level at the age of 21 years compared with 10.3% of the men and 11.1% of the women among the uninjured players. Conclusion: ACL reconstructive surgery in talented youth soccer players offers them the opportunity to become elite players as seniors and permits an activity level on a par with that of their uninjured peers. However, almost 1 in 4 requires further ACL surgery, so the players’ future knee health should be considered when deciding on a return to play.
Organ Donation Authorization After Brain Death Among Patients Admitted to PICUs in the United States, 2009-2018.

OBJECTIVES To identify trends in and factors associated with pediatric organ donation authorization after brain death. DESIGN Retrospective cohort study of data from Virtual Pediatric Systems, LLC (Los Angeles, CA). SETTING Data from 123 PICUs reporting to Virtual Pediatric Systems from 2009 to 2018. PATIENTS Patients less than 19 years old eligible for organ donation after brain death. MEASUREMENTS AND MAIN RESULTS Of 2,777 eligible patients, 1,935 (70%) were authorized for organ donation; the authorization rate remained unchanged over time (ptrend = 0.22). In a multivariable logistic regression model, hospitalizations lasting greater than 7 days had lower odds of authorization (adjusted odds ratio, 0.5; p < 0.001 vs ≤ 1 d) and White patients had higher odds than other race/ethnicity groups. Authorization was higher for trauma-related encounters (adjusted odds ratio, 1.5; p < 0.001) and when donation was discussed with an organ procurement organization coordinator (adjusted odds ratio, 1.7; p < 0.001). Of 123 hospitals, 35 (28%) met or exceeded a 75% organ donation authorization target threshold; these hospitals more often had an organ procurement organization coordinator discussing organ donation (85% vs 72% of encounters; p < 0.001), but no difference was observed by PICU bed size. CONCLUSIONS Organ donation authorization after brain death among PICU patients was associated with length of stay, race/ethnicity, and trauma-related encounter, and authorization rates were higher when an organ procurement organization coordinator was involved in the donation discussion. This study identified factors that could inform initiatives to improve the authorization process and increase pediatric organ donation rates.
Musculoskeletal Pain and Non-Classroom Teaching in Times of the COVID-19 Pandemic: Analysis of the Impact on Students from Two Spanish Universities

The lockdown, due to the coronavirus, has led to a change in lifestyle and physical activity in Spanish university students. The objective of this study was to analyze the prevalence of musculoskeletal pain and changes in physical activity and self-perceived stress in the student bodies of two Spanish Universities during the lockdown. A cross-sectional study was carried out in a sample of 1198 students (70.6% women). The main instruments used for measuring were the Standardized Kuorinka Modified Nordic Questionnaire and the Perceived stress scale (the questionnaire regarding the practice of physical activity). A reduction in the prevalence of musculoskeletal pain (p < 0.001) was identified in the sample of men and women, an increase (12.5%) in the frequency of carrying out physical activity from moderate to frequent, and the preference for strength training (15.1%), especially among women, was identified. All of this may be taken into account by health institutions when implementing measures to encourage physical activity in both suitable amounts and types, which improves the quality of life of the students.
Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes

Objective To describe the disruptions in care experienced by persons with Multiple Sclerosis in Italy due to the COVID-19 pandemic and the self-reported impact on their health and wellbeing. Methods A cross-sectional online survey was completed by 2722 persons with Multiple Sclerosis, after Italy instituted a national lockdown in response to the pandemic. Results Persons with Multiple Sclerosis reported that the pandemic caused broad disruptions to usual health and social care services, which impacted on their health and wellbeing. Disruptions in care were consistently associated with negative self-reported impacts on the expected progression of the disease, on out-of-pocket expenditure and on carer’s stress. Psychological consequences were associated with interruption to usual psychological support, and concerns about the safety of care delivered in person. Conclusions The quality of life of persons with Multiple Sclerosis depends greatly on prompt access to a broad range of health and care services. Negative psychological impacts reported by persons with Multiple Sclerosis with less severe disabilities show that accessible integrated services are crucial for maintenance of their wellbeing. Most persons with Multiple Sclerosis with more severe disability experienced negative impacts on perceived health. Their carers compensating for lack of social input resulted in care overburden. As continuity of care is crucial for persons with Multiple Sclerosis, as well as for persons with chronic conditions in general, strategies must be in place to ensure it is included in future pandemic response plans.
Could Altered Evoked Pain Responsiveness Be a Phenotypic Biomarker for Alzheimer’s Disease Risk? A Cross-Sectional Analysis of Cognitively Healthy Individuals

Background: This study evaluated whether the apolipoprotein ɛ4 (APOE4) allele, a genetic marker associated with increased risk of developing late-onset Alzheimer’s disease (AD), was associated with differences in evoked pain responsiveness in cognitively healthy subjects. Objective: The aim was to determine whether individuals at increased risk of late-onset AD based on APOE allele genotype differ phenotypically in their response to experimentally-induced painful stimuli compared to those who do not have at least one copy of the ɛ4 allele. Methods: Forty-nine cognitively healthy subjects aged 30–89 years old with the APOE4 allele (n = 12) and without (n = 37) were assessed for group differences in pain thresholds and affective (unpleasantness) responses to experimentally-induced thermal pain stimuli. Results: Statistically significant main effects of APOE4 status were observed for both the temperature at which three different pain intensity percepts were reached (p = 0.040) and the level of unpleasantness associated with each (p = 0.014). APOE4 positive participants displayed lower overall pain sensitivity than those who were APOE4 negative and also greater overall levels of pain unpleasantness regardless of intensity level. Conclusion: Cognitively healthy APOE4 carriers at increased risk of late-onset AD demonstrated reduced thermal pain sensitivity but greater unpleasantness to thermal pain stimuli relative to individuals at lower risk of late-onset AD. These results suggest that altered evoked pain perception could potentially be used as a phenotypic biomarker of late-onset AD risk prior to disease onset. Additional studies of this issue may be warranted.