Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effect of Exercise Training on Fibrinogen and Viscosity of Plasma: Comparing Endurance Continuous, Circuit Resistance and High Intensity Interval Trainings in Young Obese Men

Objectives: Theaimof thepresentresearchwastoinvestigatetheeﬀectsof endurancecontinuoustraining(ECT),circuitresistance training (CRT), high intensity interval training (HIT) on ﬁbrinogen and plasma viscosity in young obese men. Methods: For this purpose, 44 young obese men voluntarily participated in the study, and randomly assigned into (CRT; n = 11), (ECT; n = 11), and (HIT; n = 11), and control group (Con; n = 11). ECT was done with 70% VO2max, while, HIT performed with 6 set of 3 minutesrunningat90% of VO2max. Also,CRTwasdoneat11stationswith20% 1RM,3timesaweekfor12weeks. Bloodsampleswere gathered before and after training protocols and ﬁbrinogen and viscosity were measured in the plasma. To analyze the ﬁbrinogen and viscosity, the blood samples were taken before and 72 hours after the last session of exercises. Results: Theresultsshowedthatthereisnosigniﬁcantdiﬀerencebetween,HITandCRTintheﬁbrinogenandviscosityaftertraining (P > 0.05). However, the ﬁbrinogen decreased signiﬁcantly in the CRT (P = 0.001), HIT (P = 0.001) and ECT (P = 0.035) than control. Also, viscosity signiﬁcantly decreased in the CRT (P = 0.001), HIT (P = 0.002) and ECT (P = 0.002) than control. Conclusions: Finally, it can be said that none of continuous endurance, circuit resistance and high intensity interval training is preferable to improve plasma ﬁbrinogen and viscosity. Although, they can reduce the levels of these indicators after 12 weeks.
Estimation of Total Costs in Pediatric and Young Adult Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia Receiving Tisagenlecleucel from a U.S. Hospital’s Perspective

BACKGROUND: Tisagenlecleucel was approved for the treatment of pediatric and young adult patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (ALL) based on the pivotal ELIANA trial. OBJECTIVE: To comprehensively evaluate the total costs associated with tisagenlecleucel treatment, including costs from pre- to postinfusion periods of tisagenlecleucel in addition to the cost of tisagenlecleucel. METHODS: An economic model was developed to estimate total costs associated with tisagenlecleucel treatment from the time of leukapheresis to 2 months postinfusion from a U.S. hospital’s perspective. Costs were estimated based on resource use and safety management from the ELIANA trial and were considered during the pretreatment, tisagenlecleucel infusion, and follow-up periods of treatment. Cost components included leukapheresis, lymphodepleting chemotherapy, tisagenlecleucel infusion and hospital administration, inpatient and intensive care unit admissions, medical professional visits, laboratory tests and procedures, and management of major adverse events. Scenario analyses were conducted by varying key assumptions related to adverse events and hospitalization. RESULTS: The total cost associated with tisagenlecleucel treatment among pediatric and young adult patients with r/r ALL was estimated to be $612,779, of which $137,636 (22.5%) was in addition to the list price of tisagenlecleucel ($475,000) and the associated administration cost of $143.08. The top 3 drivers of the additional cost were adverse event management ($70,968; 51.6%), inpatient and intensive care unit admissions not attributed to adverse events ($57,952; 42.1%), and laboratory tests and procedures ($5,209; 3.8%). The costs incurred during the pretreatment, infusion, and follow-up periods were $29,002, $476,659, and $107,118, respectively. In the scenario analyses, the total costs ranged from $483,169 (tisagenlecleucel treatment in the outpatient setting without adverse events) to $672,373 (tisagenlecleucel treatment in the inpatient setting with grade 3/4 cytokine release syndrome and B-cell aplasia). CONCLUSIONS: In this economic model, tisagenlecleucel treatment among pediatric and young adult patients with r/r ALL was estimated to cost $612,779. The cost of care in addition to the price of tisagenlecleucel accounted for 22.5% of the total, with adverse event management and inpatient and intensive care unit admissions being main drivers. Further studies are warranted to assess the cost of tisagenlecleucel treatment in the context of current standards of care in real-world clinical practice.
The Regression Model of Risk Factors Associated with Maternal Mortality in Tanzania

Maternal mortality is one of the statistics showing the largest degree of disparity between the developed and developing countries. According to literature up to 2016 Tanzania was among the countries with unacceptably maternal mortality ratio and claimed to be still very far from reaching the Millennium developing goals. This study aimed at modeling of risk factors for maternal mortality using pre collected data Based on Tanzania Demographic Health Survey (TDH 2015 -16. Therefore secondary data were used to build the model. Data were reanalyzed by descriptive statistics using statistical software package STATA version 13. Based on data the result indicates that mortality was about 345 per 100,000 live births. The contributing factor was identified as education [OR= 0.81), Age group between 20 to 24 (OR = 2.84), distance to the health center (OR = 0.89), Marital status (OR = 1.39). It is concluded that, the risk factor of maternal death is age groups 20 – 24 and 25 – 29 years especially in the mainland rural. Keywords : Martenal Motility, Regression model, Prevalence on maternal DOI : 10.7176/JHMN/67-06 Publication date :October 31 st 2019
Perinatal depression: prevalence, outcomes and screening tools - a review of the literature

Perinatal depression (PD) is a depressive disorder in women that occurs either during pregnancy and/ or within 12 months after delivery. PD has adverse outcomes not only for mothers, but also for their children and their family/husband. A review of literature was conducted to present a comprehensive review of the available research into depression, its prevalence, risk factors and the screening tools in the context of the perinatal period. The literature will provide the background for understanding perinatal depression and will support the need for the most appropriate perinatal mental health screening-tool, particularly depression in midwifery care.
Dose Optimization in Computer Tomography Pediatric Cranial Scans

Background and Objective: Nowadays, Computer Tomography is one of the best radiological imaging technics which can give right diagnostic information, among the detection of multiphasic adenomas, the detection of cardiac, cerebral and vascular abnormalities. Although these good qualities, this technic is too radiant for the patient. In this paper, we based on the irradiation doses delivered from the current protocols to find a practical method of their optimization during the pediatric cranial scan. Materials and Methods: This work relies on a collection of data from patients in the hospitals, so that analyze them, give the conclusions and, propose an optimal practical method to decrease the irradiation doses. To collect data, we performed a prospective study of seventeen months (from December 2017 to May 2019) carried out simultaneously in three hospitals of the city: The Centre Medical la Cathedrale (H1), the Yaounde Central Hospital (H2) and the Yaounde Gyneaco-Obstetric and pediatric hospital (H3). This study included a total of 192 cases of cerebral trauma, of which 11 cases excluded for incomplete information. The dosimetry quality control (CTDIvol) using the PMMA phantoms of 16 cm and 32 cm fulfilled. The scanographic parameters of the patient acquisition protocol were recorded and analyzed. Some of those parameters were modified and entered the CT with the help of a biomedical engineer to reduce the delivered dose. The relationship between CTDIvol and kV is statistically significant (p < 0.05) to identify significant differences in obtained results before and after the optimization of protocols. Results: Among patients, 172 are boys, and the remaining 9 are girls all were in the 0 to 15 age group. CTDIvol values varied from 34.2 mGy to 107.8 mGy and PDLs from 107.8 mGy.cm to 2214.5 mGy.cm in H1. In H2, CTDIvol varied from 5.8 mGy to 44 mGy and PDLs from 91.4 mGy.cm to 665.5 mGy.cm. CTDIvol varied between 9.34 mGy to 92.81 mGy and PDLs from 162.38 mGy.cm to 2713.67 mGy.cm in H3. All values are taken at 75th percentile, with or without contrast injection. Conclusion: The implementation of the optimization of protocols requires the display of the CT parameters to use and to respect during the traumatic brain tests. With displaying and respecting protocol, the CTDIvol decreased by almost 50 per cent.
Identification of a CD8+ T-cell response to a predicted neoantigen in malignant mesothelioma

ABSTRACT Neoantigens present unique and specific targets for personalized cancer immunotherapy strategies. Given the low mutational burden yet immunotherapy responsiveness of malignant mesothelioma (MM) when compared to other carcinogen-induced malignancies, identifying candidate neoantigens and T cells that recognize them has been a challenge. We used pleural effusions to gain access to MM tumor cells as well as immune cells in order to characterize the tumor-immune interface in MM. We characterized the landscape of potential neoantigens from SNVs identified in 27 MM patients and performed whole transcriptome sequencing of cell populations from 18 patient-matched pleural effusions. IFNγ ELISpot was performed to detect a CD8+ T cell responses to predicted neoantigens in one patient. We detected a median of 68 (range 7–258) predicted neoantigens across the samples. Wild-type non-binding to mutant binding predicted neoantigens increased risk of death in a model adjusting for age, sex, smoking status, histology and treatment (HR: 33.22, CI: 2.55–433.02, p = .007). Gene expression analysis indicated a dynamic immune environment within the pleural effusions. TCR clonotypes increased with predicted neoantigen burden. A strong activated CD8+ T-cell response was identified for a predicted neoantigen produced by a spontaneous mutation in the ROBO3 gene. Despite the challenges associated with the identification of bonafide neoantigens, there is growing evidence that these molecular changes can provide an actionable target for personalized therapeutics in difficult to treat cancers. Our findings support the existence of candidate neoantigens in MM despite the low mutation burden of the tumor, and may present improved treatment opportunities for patients.
Predicting 30-day mortality and 30-day re-hospitalization risks in Medicare patients with heart failure discharged to skilled nursing facilities: development and validation of models using administrative data.

Background Despite the growing importance of skilled nursing facility care for Medicare patients hospitalized with heart failure, no risk prediction models for these patients exist. Objectives To develop and validate separate predictive models for 30-day all-cause mortality and 30-day all-cause re-hospitalization. Design Retrospective cohort study using a nationwide Medicare claims data cross-linked with Minimum Data Set 3.0. Setting 11,529 skilled nursing facilities in the United States (2011-2013). Participants 77,670 hospitalized heart failure patients discharged to skilled nursing facilities (randomly split into development (2/3) and validation (1/3) cohorts). Measurements Using data on patient sociodemographic and clinical characteristics, health service use, functional status, and facility-level factors, we developed separate prediction models for 30-day mortality and 30-day re-hospitalization using logistic regression models in the development cohort. Results Within 30 days, 6.8% died and 24.2% were re-hospitalized. Thirteen patient-level factors remained in the final model for 30-day mortality and 10 patient-level factors for re-hospitalization with good calibration. The area under receiver operating characteristic curves were 0.71 for 30-day mortality and 0.63 for re-hospitalization in the validation cohort. Conclusions Among Medicare patients with heart failure discharged to skilled nursing facilities, predicting 30-day mortality and re-hospitalization using administrative data is challenging. Further work identifying factors for re-hospitalization remains needed.
Cultural Predictors of Asian/Pacific Islander Women’s HIV/AIDS Protective Behaviors

Understanding the HIV/AIDS risk behaviors among heterosexual Asian/Pacific Islander (API) women requires an examination of the circumstances which place heterosexual women at risk of AIDS, as well as the cultural factors which affect API sexuality. Research has been conducted on samples of women, one of the fastest growing populations to be infected with HIV/AIDS, as well as API populations, who are susceptible to HIV infection as any other ethnic group. There is, however, a paucity of research concerning the sexuality of API women. Previous research regarding HIV/ AIDS risk factors for women may not be culturally sensitive. Additionally, research pertaining to APis may not address gender constructs. The current study addresses the sexuality of API women by examining sexual attitudes and behaviors, as well as cultural variables in a sample of unmarried, heterosexual, college API women. Standard multiple regressions were performed to examine the relationship among sexual assertiveness, condom self-efficacy, decisionmaking in relationships and condom frequency, acculturation and individualism/collectivism. Results suggest that acculturation may have an impact on API sexual behaviors, such as the age of sexual initiation . Once sexually active, however, acculturation does not appear to affect sexual behaviors or attitudes. Sexual behaviors of sexually active APis in this study are similar to non-Asian female college samples. Additionally, sexual assertiveness pregnancy/STD prevention emerged as a strong indicator of condom use among women who are sexually active.
Comparison of functional outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction with and without use of dedicated zig for femoral and tibial tunnel preparation

Aim: To compare the functional outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction with and without use of dedicated zig for femoral and tibial tunnel preparation. Materials and Methods: Forty patients with ACL deficient knees fulfilling the inclusion criteria were selected and after careful alternate randomization, twenty each underwent ACL reconstruction surgery with and without using dedicated zig for tibial and femoral tunnel preparation respectively. Post operatively patients were followed up regularly with clinical evaluation based on IKDC (International Knee Documentation Committee) and modified Lysholm’s score and knee stability tests viz. anterior drawer, lachman’s and pivot shift tests. Final evaluation was done at 6 months and results were compared between the two techniques. Results: Forty patients ranging from 18 to 42 years, with mean age of 26.4 years in zig group and 24.6 years in freehand group with complete ACL tear included in study. All cases in both groups were males and sports injury being the most common mode of injury in both groups. Post operatively none of patient shows frank laxity in both groups. Average IKDC and modified Lysholm’s score at 6 month were 74.6/92.2 and 73.67/93.9 respectively. No major complication was noted and functional results were comparable between two groups. Conclusions: Functional results with both techniques are good and comparable and choice depends on surgeon’s skills and preference.
Are Long Noncoding RNAs New Potential Biomarkers in Gastrointestinal Stromal Tumors (GISTs)? The Role of H19 and MALAT1

Long noncoding RNAs (lncRNAs) are emerging as key regulators of genetic and epigenetic networks, and their deregulation may underlie complex diseases, such as carcinogenesis. Several studies described lncRNA alterations in patients with solid tumors. In particular, HOTAIR upregulation has been associated with tumor aggressiveness, metastasis, and poor survival in gastrointestinal stromal tumor (GIST) patients. We analyzed expression levels of other lncRNAs, H19 and MALAT1, in FFPE tissue specimens from 40 surgically resected and metastatic GIST patients, using real-time PCR analysis. H19 and MALAT1 were both upregulated in 50% of GIST patients. MALAT1 lncRNA expression levels seem to be correlated with c-KIT mutation status. The percentage of both H19 and MALAT1 upregulation was significantly higher in patients with time to progression (TTP) < 6 months as compared to patients with TTP > 6 months. The median TTP was significantly lower in patients with both H19 and MALAT1 lncRNA upregulation as compared to those with lncRNA downregulation. These data suggest a potential role for both H19 and MALAT1 lncRNAs as prognostic biomarker for the clinical selection of the best candidate to first-line treatment with imatinib.
Treatment Seeking Practices for Diarrhea and Acute Respiratory Infections in Haryana: Need to Curb High Antibiotic Use

Background: Acute Respiratory Infection and Diarrheal infection are two life threatening but preventable diseases. In India, 30-35% hospital admissions are for ARI. A similar trend is seen in case of diarrheal diseases accounting to nearly one third of pediatric admissions and 17% of deaths. Objectives: To assess the treatment seeking practices, especially antibiotic and ORS use for ARI and diarrhea. Methodology: A descriptive study was conducted in various subcentres of 10 districts (Faridabad, Palwal, Mewat, Rewari, Bhiwani, Narnaul, Ambala, Fatehabad, Panipat and Kaithal) of the state of Haryana aimed at covering 25 children per sub centre randomly selected and spatially separated. A total of 2914 children were assessed during this study. Field workers interviewed caretakers of children in various villages of each sub centre to collect information from 5 children per village on an average. Results: A total of 36% children reported of an acute respiratory infection, diarrhea was observed in a total of 9% cases and both ARI as well as diarrhea were found in 2%. Out of all the ARI cases surveyed, 27.1% caretakers had resorted to home care, antibiotics were given by 41.7% caretakers & 13.3% caretakers took the children to seek medical advice. In case of diarrhea, 10.4% caretakers gave home care, 50% gave ORS, 8.8% gave antibiotics and medical advice was sought by 7.6% of the caretakers. Conclusions: There seems to be very high antibiotic use for ARI and low ORS use for diarrhea.
Diet Indices Reflecting Changes to Dietary Guidelines for Americans from 1990 to 2015 Are More Strongly Associated with Risk of Coronary Artery Disease Than the 1990 Diet Index

ABSTRACT Background The Dietary Guidelines for Americans (DGAs) provide dietary recommendations for the general population with the intent of preventing chronic disease such as cardiovascular disease. An evaluation of whether updated versions of the DGAs accomplish this goal is lacking. Objective The objective of this project was to determine whether updates to DGAs over time, reflected in subsequent versions of diet quality indices, strengthened the associations between diet quality and risk of cardiovascular disease outcomes. Methods Dietary data collected using an FFQ in the Framingham Heart Study Offspring cohort were used to assess adherence to sequential versions of the Healthy Eating Index (HEI) (1990, 2005, 2010, and 2015) and Alternative HEI (2000 and 2010) (n = 3267). We conducted prospective analyses using Cox regression to estimate the associations between diet indices and incident cardiovascular disease outcomes. Results Among the 3267 study participants, 54% were female, mean age was 55 y, and BMI was 27 kg/m2. There were a total of 544 events for the composite outcome of cardiovascular diseases (324 coronary artery disease events, 153 stroke events, and 187 heart failure events). Adherence to any dietary index was inversely associated with risk of cardiovascular disease, coronary artery disease, and heart failure, but not stroke. Compared with HEI-1990, scores for the more recent diet indices were more strongly associated with coronary artery disease risk, but not cardiovascular disease, heart failure, or stroke. Conclusions More recent iterations of diet indices, reflecting updates to the DGAs over time, are more strongly associated with risk of incident coronary artery disease than the original diet index (HEI-1990).
Offspring self-disclosure predicts substance-related outcomes in an emergency department sample of young adults with traumatic injury

ABSTRACT Background: Hundreds of thousands of individuals visit the emergency department (ED) every year, with many visits occurring following alcohol misuse. Parent–child relationship factors are associated with alcohol-related outcomes. For example, offspring choice to self-disclose information about their lives to parents, rather than parents actively soliciting this information, is associated with substance use. However, it is unclear whether self-disclosure uniquely predicts alcohol-related outcomes in a young adult ED sample. Methods: Data were collected from young adults (age 18–30 years) visiting an ED for a traumatic injury (n = 79). Participants were about 24.4 years old, majority male (53.7%), and Caucasian (76%; 24% African-American). A bifactor model within a structural equation model tested unique effects of self-disclosure on age at first drink, propensity for risky drinking, and likelihood of consuming substances prior to ED visit, over and above parental solicitation and a general factor and gender. Results: Those who shared more information with their caregivers reported an older age at first drink, lower propensity for risky drinking and lower propensity to consume substances prior to their ED visit. Conclusions: These findings suggest that self-disclosure may be a unique risk factor in the initiation of alcohol use, development of problem use, and consequences following use.