Miracle-dz/UniFAR-FTUs huggingface dataset:
Efficacy and safety of Nab-paclitaxel in breast cancer: a meta-analysis

Worldwide breast cancer is the leading cause of cancer related death in women. Paclitaxel is an effective drug used for the treatment of breast cancer but it has many side effects. Nab-paclitaxel (nanoparticle albumin-bound paclitaxel) is an FDA approved drug for the treatment of breast cancer. Currently many clinical trials are conducted to deliver nab-paclitaxel into the tumor cells. But the efficacy and safety of this nab-paclitaxel over conventional paclitaxel still remains questionable. So, we performed a meta-analysis to evaluate the efficacy and safety of nab-paclitaxel in breast cancer treatment.Electronic databases were searched for the suitable studies using key terms “nab-paclitaxel”, “paclitaxel”, and “clinical trial” with the combination of “breast cancer” up to August 11, 2019. Risk ratio (RR) and odds ratio (OR) with corresponding 95% confidence intervals (CIs) were calculated. All statistical analyses were performed by the Open Meta-Analyst program. A total of eight studies which fulfilled our criteria were included in this study. For efficacy we retrieved data of 12 months progression free survival, 24 months progression free survival, and overall survival (up to 3 years) and for the safety we took data of nausea, anemia, leukopenia, neutropenia, fatigue, diarrhea and pain.We did not found any difference in efficacy of nab-paclitaxel over paclitaxel (12 months progression free survival-RRFE= 0.86, 95%CI= 0.77-0.97, p= 0.02, I2= 25.07%; 24 months progression free survival-RRFE= 0.86, 95% CI= 0.64-1.16, p= 0.34, I2= 0%; and 3 years survival-RRFE= 1.20, 95%CI= 0.92-1.56, p= 0.16, I2= 37.55%). The meta-analysis of studies used nab-paclitaxel showed reduced adverse effect of anemia (ORFE= 1.66, 95% CI= 1.26-2.19; p= <0.001; I2= 0%) and leukopenia (ORFE= 1.37; 95%CI= 1.06-1.75; p= 0.01; I2= 48.63%). However, in case of other adverse effects no significant association was found with nab-paclitaxel (nausea-ORFE=1.15, 95%CI= 0.94-1.41, p= 0.15, I2= 50.12%; neutropenia-ORRE= 0.75, 95%CI= 0.30-1.87, p= 0.54, I2= 94.45%; fatigue-ORRE= 1.11, 95%CI= 0.77-1.62, p= 0.55, I2= 56.02; diarrhea-ORFE= 1.11, 95%CI= 0.77-1.62, p= 0.55; I2= 34.26; pain-ORRE= 1.15, 95%CI= 0.78-1.69, p= 0.45, I2= 52.96%). In conclusion the use of nab-paclitaxel has reduces the side effects of anemia and leukopenia in breast cancer treatment in comparison to paclitaxel but nab-paclitaxel has no effect on the overall survival of the patients.
The Berg balance scale for assessing dynamic stability and balance in the adult spinal deformity (ASD) population.

Background Adult spinal deformity (ASD) is a prevalent condition in individuals over the age of 65; leading to impaired standing balance and abnormal gait patterns. This functional impairment may be due to the fixed sagittal or coronal malalignment; associated spinal stenosis or deconditioning. The Berg balance scale (BBS) was developed to measure balance by assessing the performance of functional tasks. The purpose of this study is to determine if BBS is a useful metric for evaluating functional status in ASD patients. Methods ASD patients who required fusion from the thoracic spine to the pelvis from 2014 to 2016 were enrolled and asked to complete the BBS prior to and six months after surgery. BBS were obtained by a certified physical therapist. Standard demographic; radiographic and surgical data were collected. The Oswestry disability index (ODI), EuroQOL-5D and numeric rating scales (0 to 10) for back and leg pain were assessed at baseline and post-intervention. Results Of 21 patients enrolled; 19 completed pre- and post-surgery BBS. The mean age was 59.8±13.3 years with 14 females. There was a statistically significant improvement in all outcome scores and radiographic parameters after surgery; but no difference in BBS. Only one patient had a BBS score low enough to be considered a medium fall risk. There was no difference in the pre-op BBS scores in the four patients that had revision surgery compared to those that did not. Conclusions In this small pilot study; BBS did not appear to be associated with measures of clinical and radiographic improvement in ASD patients. The test was also potentially problematic in that it has a ceiling effect and required significant time with a trained physical therapist for administration. Continued effort to identify a viable measure of balance dysfunction in ASD patients is warranted.
Patterns and predictors of contraceptive usage among HIV-positive women of reproductive age attending PMTCT/ART clinics in Ogbomoso, Nigeria

Objective: the objective of the study is to assess the patterns and predictors of contraceptive usage among HIV positive women of reproductive age attending PMTCT/ART clinics in Ogbomoso, Oyo state, Nigeria. Methods: it was a cross-sectional descriptive cross-sectional study conducted among HIV positive women of reproductive age group selected using multi-stage sampling technique. Data was collected using a pre-tested semi-structured interviewer administered questionnaire and analyzed using Statistical Package for Social Sciences. The questions about knowledge of and attitude towards contraception were scored, and categorized as good or poor knowledge, favourable or unfavourable attitude. Univariate, bivariate, and multivariate analyses assessed predictors of contraceptive usage. A bivariate logistic regression model which used p<0.05 as the entry criterion, was generated to calculate the odds ratios and 95% confidence intervals respectively. Results: age ranges from 16 to 48 years with mean age 31.8 + 7.8 years. Majority are within age range of 25-35 years 110 (40.7%), Christians 178 (65.9%), Yoruba 235 (87%), educated 246 (91.1%) and within monogamous settings 179 (66.3%). About half of the respondents 158 (58.5%) had favorable attitude and adequate knowledge respectively. There is a significant difference (p<0.05) between education and categorized knowledge on usage of contraception. Those who have adequate knowledge are twice more likely to use contraception compared to those with inadequate knowledge. Those who are less educated are 3.3 times less likely to use contraception compared to those that are educated. Conclusion: The findings in this study showed that about half of the respondents had high knowledge and favorable attitude on family planning. Keywords: reproduction, education, health, virus, knowledge
Difficulties of Management of Multiple Synchronous Bone Tumors in Li-Fraumeni Syndrome

Li-Fraumeni syndrome is a rare inherited disease characterized by the early onset of multiple primary malignant tumors. Sarcomas account for more than 30% of all malignant tumors occurring at pediatric age. Furthermore, it was shown that the rates of second cancer were higher in childhood cancer survivors. We report the case of a patient with Li-Fraumeni syndrome who was referred to us with three synchronous skeletal tumors. This unique situation led to difficulties for the medical team regarding the diagnosis of malignancy and the surgical treatment to propose. The discovery of multiple lesions in the extension assessment underlines the usefulness of whole-body imaging for the follow-up of patients with germline TP53 mutations. Most recent guidelines now recommend annual whole-body MRI for screening for cancer patients carrying germline TP53. With this report, we aim to share our experience with this rare situation in order to improve care about these specific cases.
Preliminary Outcomes, Acceptability, and Feasibility of a Brief Crisis Response Planning Intervention for Reducing Suicide Risk in Primary Care Behavioral Health Patients

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few developed protocols for management of suicide risk in this setting. This study aimed to evaluate the preliminary outcomes, acceptability, and feasibility of a brief crisis response planning intervention for patients at a moderate risk for suicide in a primary care behavioral health (PCBH) setting. The outcomes examined included change in suicidal cognitions, suicidal intent, hope, and coping efficacy. Twenty-two adult primary care patients at moderate risk for suicide participated in this study, which involved filling out selfreport measures before and after creating a crisis response plan with a behavioral health consultant (BHC). Patients were contacted four months after their initial visit to complete followup measures and respond to open-ended questions about the intervention. So far, 16 patients have participated in the follow-up interview. BHCs were also interviewed about their perceptions of the intervention. Paired-samples t-tests evaluated changes from preto post-treatment, and within-subjects repeated measures ANOVAs evaluated changes across time. Thematic analysis was used to analyze responses to open-ended questions. Patients showed declines in suicidal intent within session and at follow-up. Patients did not show increases in hope or coping efficacy within session, but did demonstrate increases at follow-up. Patients did not demonstrate changes in suicidal cognitions. Patients and BHCs alike found the intervention helpful, and few had concerns about the implementation of this intervention in the PCBH model. Findings provide preliminary evidence that moderate suicide risk can be managed in primary care through integration of BHCs into the primary care team.
Revealing Stroke Analysis Markers for Studying Heterogeneous Disease State of Stroke

Early diagnosis of Stroke is challenging due to a lack of dependable diagnostic tests. Currently, the mainstay in early detection is by monitoring health an individual through traditional risk factors such as hypertension. Seeking new determinants, relevant to millennial life style, is therefore warranted. This study reveals new Stroke Analysis Markers (SAM) including Phosphodiesterase-4D involved in cardioembolic stroke. In addition to traditional factors, new millennial risk factors such as molecular and cellular determinants were studied based on 68 years of stroke research data from 1951 to 2019. The rs152312 SNP from stroke patients of deCODE was queried in eNSEMBL, BLAST and other databases to study PDE4D isoforms. In addition, the role of infection, immune cells, inflammation, gut microbial dysbiosis, the prevalence pattern of stroke in geographically different populations were analyzed. This study identified five new millennial risk factors as potentially helpful Stroke Analysis Markers for stroke by conjoining them as a single set of five parasol factors. They include genomic, microbiologic, immunologic, socio-epigenetic factors including two contig and alternative splicing markers along with their prevalence patterns among various populations. Taking appropriate preventive management by monitoring these new risk factors in high-risk individuals during annual checkup could help physicians to make an informed decision. Though significant challenges remain to be solved further large-scale studies on parasol factors will certainly unlock the secrets of early prediction of stroke.
Clinical features of pregnancy in multidrug-resistant tuberculosis and type I diabetes mellitus comorbidities (a case report).

Clinical features of pregnancy in multidrug-resistant tuberculosis and type I diabetes mellitus comorbidities (a case report). Raznatovska O.M. , Fedorec A.V. , Shalmina M.O. , Grekova T.A. Objective – to update the literature data with the clinical features of pregnancy in multidrug-resistant tuberculosis (MRD-TB) and type 1 diabetes mellitus (T1DM) comorbidities based on an example from own clinical experience. A clinical case of pregnancy course in MRD-TB and T1DM comorbidities was described based on our own clinical experience. We report the clinical case of newly diagnosed MRD-TB in a 38-year-old woman suffering from T1DM. Her general condition was unstable from satisfactory to moderately severe despite an adequate treatment of MRD-TB and T1DM with manifestations of intoxication syndrome and nephropathy. Adenomyosis with periodic bloody vaginal discharge was diagnosed. There was no clinical-radiological dynamics and sputum culture conversion. After an intensive phase of antimycobacterial therapy within 3 months, the patient got pregnant. Based on the medical indications (MRD-TB, absence of sputum culture conversion and clinical-radiological dynamics, moderate severity of T1DM, nephropathy) and adenomyosis with bloody vaginal discharge, the patient was requested to induce the pregnancy termination, and she consented. On month 7 of antimycobacterial therapy, an extensive drug-resistance of Mycobacterium tuberculosis
Cardiac stunning during haemodialysis: the therapeutic effect of intra-dialytic exercise

Abstract Background Cardiovascular risk is elevated in end-stage renal disease. Left ventricular (LV) dysfunction is linked to repetitive transient ischaemia occurring during haemodialysis (HD). Cardiomyocyte ischaemia results in ‘cardiac stunning’, evidenced by regional wall motion abnormalities (RWMAs). Ischaemic RWMA have been documented during HD resulting in maladaptive cardiac remodelling and increased risk of heart failure. Intra-dialytic exercise is well tolerated and can improve quality of life and functional capacity. It may also attenuate HD-induced cardiac stunning. Methods This exploratory study aimed to assess the effect of intra-dialytic cycle ergometry on cardiac stunning. Twenty exercise-naïve participants on maintenance HD (mean ± SD, 59 ± 11 years) underwent resting echocardiography and maximal cardiopulmonary exercise testing. Subsequently, cardiac stunning was assessed with myocardial strain-derived RWMAs at four time points during (i) standard HD and (ii) HD with 30 min of sub-maximal intra-dialytic cycle ergometry at a workload equivalent to 90% oxygen uptake at the anaerobic threshold (VO2AT). Central haemodynamics and cardiac troponin I were also assessed. Results Compared with HD alone, HD with intra-dialytic exercise significantly reduced RWMAs after 2.5 h of HD (total 110 ± 4, mean 7 ± 4 segments versus total 77 ± 3, mean 5 ± 3, respectively; P = 0.008). Global cardiac function, intra-dialytic haemodynamics and LV volumetric parameters were not significantly altered with exercise. Conclusions Intra-dialytic exercise reduced cardiac stunning. Thirty minutes of sub-maximal exercise at 90% VO2AT was sufficient to elicit acute cardio-protection. These data potentially demonstrate a novel therapeutic effect of intra-dialytic exercise.
Regulatory T Cells (Treg) Are Depressed in Patients with Relapsed/Refractory Multiple Myeloma (MM) and Increases towards Normal Range in Responding Patients Treated with Lenalidomide (LEN).

CD4+CD25+Foxp3+ regulatory T cells (Tregs) are a group of immune-suppressive T cells responsible for the maintenance of self-tolerance and autoimmunity. Increased Tregs have been implicated in suppression of tumour-immunity, and are associated with poor prognosis in gastric, oesophageal and ovarian cancers. Conversely, reduced Tregs are associated with aggressive disease and poor prognosis in lymphoproliferative disorders such as follicular lymphoma and Hodgkin lymphoma. Meanwhile, conflicting literature exists with regards to the role of Tregs in the pathogenesis of multiple myeloma (MM). Lenalidomide (LEN) is an immunomodulatory drug (ImiD™) that increases T cell numbers and function in vitro but the impact on Tregs in vivo is unknown. As part of an ongoing clinical trial of low-dose lenalidomide, peripheral blood lymphocyte subsets (LSS) and Treg numbers were examined in patients [n=18, median age 67 years (49–77)] with relapsed/refractory MM at baseline and at various time points during treatment with combination LEN (15mg/o/d d1–21q28)-dexamethasone (dex) (20mg/o/d d1–4,9–12,17–20 q28), in order to measure changes induced by LEN-dex treatment. Results were compared to 10 age matched healthy donors. LSS and Tregs were assessed by flow cytometry, with Tregs strictly defined as CD4+CD25hiCD127dimFOXP3+. At baseline, MM patients had depressed B cells (median 0.76 vs. 3.2 ×105/ml; p=0.02) and CD3+ T cells (median 7.2 vs. 12.1 ×105/ml; p
Perancangan Meja Laptop Portable Yang Ergonomis Untuk Penyandang Cerebral Palsy Dengan Pendekatan Antropometri

Hampir disemua jenjang pendidikan, komputer/laptop telah dikenalkan sejak dini sebagai salah satu mata pelajaran. Salah satu sekolah yang sudah menggunakan komputer atau laptop sebagai media belajar adalah sekolah SLB Prof. Dr. Sri Soedewi. Sekolah SLB. Prof. Dr. Sri Soedewi adalah sekolah luar biasa yang terdiri dari pelajar SD, SMP dan SMA, dari semua kelainan yaitu Tuna Netra, Tuna Rungu, Tuna Daksa, Grahita dan Autis. Responden pada penelitian ini adalah para penyandang Cerebral Palsy campuran. Artinya cerebral palsy diserta oleh gejala penyakit lain, penyandang berada pada kursi roda, tidak bisa melakukan mobilitas (duduk dan berdiri) tanpa bantuan orang lain. Dalam proses kegiatan belajar kondisi para penyandang cerebral palsy harus diperhatikan. Fasilitas yang disediakan pun harus sesuai dengan kondisinya. Perancangan meja laptop portable yang ergonomis dapat diperoleh dengan pendekatan antropometri sesuai dengan postur tubuh siswa-siswi penyandang cerebral palsy, sehingga memberikan kenyamanan, keamanan serta mengurangi rasa sakit saat menggunakan laptop.
Maternal and Fetal Toxicity of Carisoprodol Drug (Somadril Compound) on Pulmonary Tissues of Albino Rats

Carisoprodol is a common muscle relaxant indicated as adjunctive therapy in acute, painful musculoskeletal cases. This current study aimed to investigate the histopathological, histochemical and immunohistochemical effects in the lung tissue of the pregnant rats and their fetuses after carisoprodol treatment. The present study was applied on twenty seven pregnant female rats and they were randomly divided into three groups (nine pregnant female rats in each group). Rats of the first (control) group were administered oral doses of distilled water. Rats of the second (S1) and third groups (S2) were administered oral doses of carisoprodol in the distilled water equivalent to 10.8 mg and 21.6 mg/100g body weight/day respectively for fifteen days from the six to the twenty day of gestation. Several histopathological, histochemical and some immunohistochemical changes were studied to detect the pathological changes. Maternal and fetal pulmonary tissues of both treated groups showed numerous degenerative changes post-treatment with carisoprodol, the severity of these changes was more obvious in the fetal lung tissue of both groups. Also, carisoprodol treated rats showed a marked increase in caspase-3 content in the maternal and fetal pulmonary tissues. Treatment of pregnant rats with carisoprodol drug led to numerous dystrophic changes in both maternal and fetal lung tissues.
Detection and Genotyping of HHV-8 in Australia and Kenya: Disease Associations with Special reference to Kaposi's Sarcoma and Castleman's Disease

HHV-8, the aetiological agent of Kaposi’s sarcoma (KS), multicentric Castleman’s disease (MCD) and primary effusion lymphoma (PEL) has been characterised in several parts of the world but largely overlooked in Australia, perhaps because highly active antiretroviral therapy (HAART) has drastically reduced the incidence of HHV-8-associated diseases in the most at-risk population, namely those with HIV disease. Previously, Australian researchers have looked briefly at the sexual behaviours associated with risk of transmission of HHV-8, at molecular methods for detecting the presence of this virus, and have genotyped just eight clinical isolates. Now, the re-emergence of HHV-8 disease associated with increased lifespan in HIV-positive individuals has created a need to better understand the biological importance of this virus, including in Australia and in the developing world. While report of KS and HHV-8 have been previously published from Australia, this project establishes the first research group devoted to the understanding of HHV-8 from an Australian perspective, develops validated quantitative molecular detection methods for HHV-8 in blood and oral fluids, and then characterises the viruses detected via phylogenetic analyses.
Dexamethasone as an Adjuvant in the Axillary Echoguided Block: Prospective Single-Blind, Non-Randomized Study

Background : Dexamethasone has been used for some years as an adjunct to local anesthetics in peripheral nerve blocks. Recently studies suggest its effectiveness in prolonging the duration of postoperative analgesia. The primary objective of this study was to evaluate the efficacy of dexamethasone as adjuvant in the axillary ultrasound guided block. Methods: Adults who required upper limb surgery in a scheduled or emergency mode were prospectively divided into two groups of 30 patients. An axillary block under ultrasound guidance was performed with an equimolar mixture of lidocaine 2%-0.5% bupivacaine associated with dexamethasone in the dexamethasone group and without dexamethasone in the control group. The evaluation of the block was done by a blind operator of the block technique. All the parameters of the nerve block as well as the delay of the demand in analgesic were noted. The study was analyzed per protocol. Results: A total of sixty patients were grouped into two equitable groups. Demographic parameters were similar between two groups. The duration and the time of installation of the axillary block were respectively 13.76min (7-30) for the control group against 12.76min (5-20) for the dexamethasone group (p = 0.27) and 11.36min (5-30) for the control group 11.66 (5-30) for the dexamethasone group (p = 0.81). The duration of sensory block was extended in the dexamethasone group by about 56% compared to the control group. The motor block was also 21.5% longer in the dexamethasone group. The delay in the use of analgesics was significantly longer in the dexamethasone group with better EVS scores compared to the control group. Plexus neuropathy was found postoperatively. Conclusion: The use of dexamethasone as an adjuvant in the axillary block prolongs postoperative analgesia in a clinically significant manner and also leads to a decrease in analgesic consumption.
Epidemiology and Outcomes of Early-Onset and Late-Onset Adenovirus Infections in Kidney Transplant Recipients

Abstract Objective Adenovirus (ADV) infection after kidney transplantation (KT) causes significant morbidity. Patient characteristics and outcomes of ADV infection in KT recipients were investigated. Method All adult KT recipients with ADV infection between January 2015 and June 2019 were included. ADV infection/disease was defined as detection of ADV DNA in clinical specimens/plus symptoms. Clinical and laboratory findings, treatments, and outcomes were assessed. Results Adenovirus infection was diagnosed in 24 of 751 (3.2%) KT recipients. Twenty (83%) were male with a median age of 47 years (interquartile range [IQR], 36–58). Fifteen (63%) underwent deceased donor KT, and 13 (54%) received induction therapy. Twenty-one (88%) and 4 (17%) patients developed hemorrhagic cystitis and disseminated disease, respectively. There were equal distributions of early-onset (EOI) (≤3 months) and late-onset (LOI) (>3 months) infections. Patients who were diagnosed with EOI had lower median absolute lymphocyte counts compared with those with LOI (735/mm3 [IQR, 543–1123] vs 1122/mm3 [IQR, 784–1344], P = .04). All achieved resolution after reduction of their immunosuppression regimen and 13 (54%) received cidofovir therapy. Eighteen (75%) developed allograft dysfunction, of which 67% were transient. One (4%) underwent nephrectomy for allograft failure and 1 (4%) died (non-ADV–related). Patients with EOI were more likely to receive cidofovir therapy (75% vs 33%, P = .04) and develop other opportunistic infections (75% vs 8%, P < .001). Conclusions Adenovirus infection after KT typically involves a genitourinary system and transiently impairs an allograft function. Those who developed early infection tend to have more lymphopenia, coinfection, and receive antiviral therapy.