Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Characteristics And Outcome Of Biphenotypic Acute Leukemia: 10 Case Reports And Literature Review

Background Biphenotypic acute leukemia (BAL), or mixed-phenotype acute leukemia (MPAL) represents a rare subgroup of acute leukemia which co-expresses markers for either more than one lineage in a homogenous blast population or the coexistence of two blast populations of different lineages. Proper diagnosis and classification of BAL are extremely important for patients’ outcome since BAL usually has a poor prognosis. Purpose The objective of this study was to identify the incidence of biphenotypic acute leukemia, their clinical characteristics and outcome of BAL patients with the chemotherapy treatment and Hematopoietic Stem Cell Transplantation (HSCT) after initial complete remission. Patients and methods Ten cases of biphenotypic acute leukemia were analyzed for their clinical characteristics, immunological phenotypes, chemotherapy methods for induction initial complete remission and outcome data, including induction chemotherapy, complete remission (CR) and the overall survival time, relapse and death. This study was an observational, retrospective, and descriptive study of the clinical aspects of BAL. Cytogenetics and fusion genes analysis were also done with bone marrow samples using G-banding analysis and karyotyped according to the International System for Human Cytogenetic Nomenclature. The fusion genes’ mutational status was determined by real-time PCR (RT-PCR). Gene mutation analyses were conducted with next-generation sequencing method. Results Among 10 BAL patients, 4 cases carried B/Myeloid phenotype, 4 cases carried T/Myeloid phenotype and 2 cases carried T/B phenotype. Cytogenetic analysis showed that 3 of the 10 cases had clonal abnormalities. Of the four cases of fusion gene aberration, two patients had RUNX1 gene mutation, one patient had BCR/ABL fusion gene mutation, and one patient had JAK1, JAK3, FBXW7 mutation. Overall, 5 of 8 (62.5%) BAL patients with chemotherapy achieved complete remission (CR) after their initial induction therapy. In the AML-directed therapy group, 1 of 2 (50%) patients achieved CR. Meanwhile, 4 of 6 (66.7%) patients achieved CR after ALL-directed induction chemotherapy. Two patients received Hematopoietic Stem Cell Transplantation (HSCT) after initial CRs, one patient died two months after transplantation due to pulmonary infection, and another patient is still alive. With an average of 14.3 (4.0–42.0) months’ follow-ups, the median survival time was 7 months. Although patients achieved CR after initial chemotherapy, the relapse rate was very high and the CR rate after relapse was very low. Conclusion Our results confirmed that BAL is a rare malignancy with a very poor prognosis. Patients with ALL-directed chemotherapy achieved a better CR rate compared to those with AML-directed chemotherapy. Patients should receive HSCT after initial CR whenever it is possible.
Health-related quality of life in survivors of childhood acute lymphoblastic leukaemia

Leukemia treatment has been implicated to be responsible for a diversity of long-term adverse effects (Pui 2008), which can occur even years after diagnosis and can seriously impair survivors’ performance status and quality of life (Campbell et al. 2007, Zeltzer et al. 2008). The aim of the present work was to assess health-related quality of life in long-term survivors of acute lymphoblastic leukemia (ALL), and to find out whether vocational rehabilitation can promote the coping at work of young people who take part in a training intervention or help them find employment. Neuropsychological testing was performed on 64 survivors. Cranial irradiation had been administered to 44 of the survivors, while 20 survivors had been treated solely with chemotherapy. A control group consisted of 45 healthy young adults. We found that young adult survivors of childhood ALL treated with cranial irradiation had clear progressive deficits in their neurocognitive functioning at a mean of 20 years after diagnosis compared with healthy controls. Non-irradiated ALL survivors performed significantly better, but even they had statistically significant impairments in some of the neuropsychological test scores compared with the controls. Rand-36-Item health Survey (RAND-36) was used to assess subjective HRQoL, depressive symptoms were assessed with Beck Depression Inventory (BDI-21), and mental distress with General Health Questionnaire (GHQ-12) in 74 survivors of ALL. The control group consisted of 146 healthy young adults selected from local population registry. ALL survivors showed good HRQoL scores in comparison to the control group. Patients who had been treated for an ALL relapse and had received the most intensive chemoand radiotherapy had significantly higher scores on mental health and vitality than the controls. Survivors of ALL report fewer depressive symptoms and equal mental well-being compared to healthy controls. Nine out of 63 survivors were selected for rehabilitation based on their occupation and psychosocial difficulties. The occupational rehabilitation course improved physical fitness and decreased overweight in longterm survivors of ALL, but impaired their HRQoL. Our findings support the idea that ALL survivors’ subjective experience of well-being is possibly affected by a repressive adaptive style.
HOW TO STOP THE SPREADING OF SUPER BACTERIA

According to the World Health Organization (WHO), the number of antibiotic-resistant bacteria has increased exponentially, currently causing about 700,000 deaths each year. The exaggerated use of antibiotics used in the treatment of human and veterinary infections has contributed to the appearance and spread of multidrug resistant strains, making antibiotics obsolete and contributing to the unfavorable prognosis of several infections. Present day, the most critical problem for public health is the growing number of bacteria resistant to Beta-lactam antibiotics such as penicillins , cephalosporins , cepamycin and carbapenems , widely used in human and veterinary medicine. In fact, enterobacteria producing extended-spectrum Beta-lactamase (ESBL) have been classified as critical priority pathogens by WHO . In this review, we will explain the mechanisms of antimicrobial resistance and discuss potential solutions to prevent further spread.
Nurses' experiences of full scope LPN practice in acute care

The practice of licensed practical nurses (LPNs) in acute care in British Columbia (BC) is undergoing a shift to incorporate the enhanced range of entrylevel competencies introduced by the College of LPNs of British Columbia in 2000. The full range of new LPN competencies, which now constitute full scope, became a requirement for practical nurse licensure in BC in 2007 and are challenging LPNs and Registered Nurses (RNs) alike to reexamine and redefine the LPN role and LPN/RN relations in acute care. Research exploring the experiences of RNs and LPNs, in their own words, with full scope LPN practice in acute care staff mixes has not previously been conducted in BC. This qualitative descriptive study explored the perceptions of 5 RNs and 4 LPNs working in RN/LPN skill mixes, in various Lower Mainland acute care settings where the LPNs work to full scope. Conventional qualitative content analysis was used to analyze the data from one in-depth interview and 8 shortanswer surveys. Analysis of one in-depth interview with an LPN yielded 3 categories: professionalism, receptivity, and appropriateness. Analysis of the 8 survey responses from RNs and LPNs yielded 3 categories as well, namely: defining the role, determining the impact and determining the fit of the role. Findings in this study indicate that overall, both RNs and LPNs report that clear communication, LPN role clarity, experience working together over time, and a supportive work environment contribute to positive experiences of the RN/LPN skill mix. Feelings of burden, inconsistent teamwork, lack of respect, concerns about patient acuity levels, and varied perceptions of the ability of LPNs and RNs to assume responsibility for patient care present areas of challenge in the
Postępy w leczeniu samoistnego włóknienia szpiku Advances in the therapy of primary myelofibrosis

Primary myelofibrosis (PMF) harbors the worst prognosis among the Philadelphia chromosome-negative chronic myeloproliferative neoplasms. The most important clinical issues in the course of this disorder are: progressive fibrosis of the bone marrow, splenomegaly and systemic symptoms. The current clinical management has limited efficacy and is largely palliative. Allogeneic hematopoietic stem cell transplantation is currently the only therapeutic approach potentially curative, but it is complicated by relatively high treatment-related mortality and morbidity. Among other drugs that are currently in clinical trials for PMF, pomalidomide and three JAK-2 inhibitors (CYT387, TG101348 and INCB018424) appear to be the most promising compounds due to their effectiveness suggested by the preliminary results. Introduction of JAK-2 inhibitors for management of PMF resultes in the significant improvement in reduction of splenomegaly and systemic symptoms and, moreover, may further improve the outcome of patients with PMF.
Effects of sodium‐glucose co‐transporter‐2 inhibitors in type 2 diabetes in women versus men

Sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors prevent cardiovascular complications in type 2 diabetes. We aimed to study whether they have similar effects in women and men by summarizing the effects of SGLT2 inhibitors compared to placebo on vascular and safety outcomes stratified by sex. We included patients with type 2 diabetes enrolled in the EMPA‐REG OUTCOME, CANVAS Program, DECLARE TIMI‐58 and CREDENCE trials. There were no differences in the risk ratios between men and women, SGLT2 versus control (placebo), for vascular efficacy outcomes or death (all P for interaction ≥.12), with clear protection shown against major adverse cardiovascular events, heart failure, vascular death and total mortality. SGLT2 inhibitor treatment was also associated with similar relative risks in women and men for the safety outcomes of amputation, fracture, genital infection and urinary tract infection (all P for interaction ≥.17). SGLT2 inhibition provided similar protection against vascular risks and death, and similar risks of serious adverse events, for women and men.
The Role of HMG COA Reductase Inhibitors on the Progression of Coronary Artery Disease: Focus on Prediction Model

Abstract Currently, an integrated site-specific and patient-specific comprehensive predictive model of plaque progression in various CVD is not available. In this study, we considered medical records of 256 patients obtained within the EU H2020 SMARTool project which is carefully designed to collect the features from various domains relevant for disease which are used in everyday clinical practice. The database contains detailed information of patients with suspected CAD disease regarding the clinical status, risk factors, routine blood analyses, CAD morphology and progression and current therapy. Results showed that there was statistically significant difference of values of this parameter for the SMARTool patients with and without disease progression, measured at the follow-up, F(1,250)=33.39, p < 0.001, while the CAD Score in the follow-up is significantly different from the score measured at the initial time point, F(1,254)=76.244, p < 0.001. The significant interaction of statins is achieved with aspirin F(1,252)= 3.921, p=0.049, while interactions with other medicaments are insignificant for CAD Score. The results showed that there was no significant interaction of statins and dyslipidemia, F(1,251)=0.877, p = 0.350. Also, there was no significant interaction of statins and hypertension, F(1,245)=0.283, p=0.596. The CAD score in the baseline was significantly different among patients who were further prescribed with therapy than those who were not, and this trend remained unchanged after a given time period, i.e. those patients who were at risk had progression in addition to statins, but the combination of statins and aspirin was shown as effective in decreasing the CAD Score. The Random Forest classifier applied on 24 selected features is the most reliable among all tested ML algorithms for the prediction of CAD progress.
Evaluation of quality of life, depression and satisfaction in patients treated at the Physiotherapy teaching clinic of the State University of Northern Paraná (Uenp)

Abstract Introduction: Patient satisfaction is an important indicator of care quality and can be used to set goals and identify areas for improvement. Objective: To evaluate the satisfaction, quality of life and depressive symptoms of patients at the Uenp (State University of Northern Paraná) Physiotherapy teaching clinic. Method: Cross-sectional, quantitative descriptive study. Sixty-one patients completed a sociodemographic questionnaire, the “Instrument to assess patient satisfaction with physical therapy in the public health system”, the short-form-36 health survey (SF-36) to evaluate quality of life, and the Beck Depression Inventory (BDI) to determine the presence of depression. For statistical analysis, data were described using means and standard deviations, the Shapiro-Wilk test was applied to assess normality, and the variables were analyzed by Pearson’s correlation coefficient, with p ≤ 0.05 considered statistically significant. Results: The patient-therapist relationship was largely classified as “excellent”; the most common response for the item “respect and interest shown to patients” was also “excellent”. Patients scored well on the SF-36, indicating good quality of life; the highest scores were obtained in the “mental health” domain (65.04 ± 23.25). Regarding the depression, most patients (52.44%) displayed depressive symptoms. Correlation between satisfaction and the BDI showed a statistically significant difference in twelve dimensions. Comparison between the SF-36 and BDI indicated a statistically significant difference in eight domains. Conclusion: Patients are satisfied with the treatment received and the competence of the health care team at the clinic.
Analysis of urinary sphingolipids using liquid chromatography‐tandem mass spectrometry in diabetic nephropathy

Sphingolipids, such as ceramides and sphingosine, are involved in the pathogenesis of diabetes; however, the modulation of urinary sphingolipids in diabetic nephropathy has not been fully elucidated. Therefore, we aimed to develop a simultaneous measurement system for urinary sphingolipids using liquid chromatography‐tandem mass spectrometry and to elucidate the modulation of urinary sphingolipids in diabetic nephropathy.
MOLECULAR MARKERS IN IMMUNE RESPONSE MANIFESTATIONS (review)

t Genetically controlled immune system is responsible for population heterogeneity on the immune response. This review focuses on molecular mechanisms of cell-mediated and antibody-mediated immune response and molecular markers for genomic selection. Genotypic differences between individuals in terms of tolerance/susceptibility to infectious diseases are characteristic of animal populations (S.C. Bishop et al., 2014). Data massive indicates multiple SNPs associated with high and low immune responses of animals, providing the possibility of calculating the coefficients of genomic breeding values for this attribute. There is a need to assess the dispersion of indirect genetic effects that help to open up new possibilities for the control of infectious diseases through selection. However, it should be noted that the quantitative genetic analysis based on individual animal disease status covers only part of the total genetic variation that affects the dynamics of infectious diseases in populations. Estimation of gene expression patterns in a particular immune response is considered as the most valuable (V.V. Firstova et al., 2010). Study of the major histocompatibility complex (MHC-B) 209296 bp region in birds with high-density SNP chips allowed the authors to determine 45 key genes which affect MHC-B diversity through recombination. The findings extend the understanding of the contribution of recombination to the diversity of MHC-B haplotypes, including the ability to identify hot spots and recombination estimation of recombination frequency (J.E. Fulton et al., 2016). The causative mutations related to the basic genetic variability of innate and adaptive immune responses in chickens are mapped (A. Slawinska et al., 2013). Search for causal mutations responsible for genetic variation in the immune response can be used as an approach to diagnostic tests. E.g., SNP associated with susceptibility to tuberculosis are detected (M.L. Bermingham et al., 2014). Immune response falls into a category of complex and quantitative traits that are under control of multiple genes with a no- ticeable influence of the environment. Obviously, some genes of common universal action may participate in innate and adaptive immunity. We can assume that such immunity has predominantly additive mode of inheritance (M. Siwek et al., 2015). Breeding for diseases resistance is greatly difficult because of low heritability and lack of estimates for comprehensive genetic assessment of the disease resistance variability. Growing genomic evaluations of the animals has created a basis for the use of molecular markers in breeding to increase animal resistance to diseases. Studies of the genome and the overall adaptive immune response associations in different species of farm animals provide an important start-ing point for the implementation of such plans. Identification of potential biological pathways and genes associated with immune response can assist in advancing the understanding of the important processes in animal resistance or susceptibility to
Sonographic measurement of spleen dimensions in healthy adults in North-Western Nigeria

Introduction: In the last two decades sonography has become the most important imaging modality for the study of the spleen. Different studies have been conducted in different parts of the world so as to determine the normal reference values of splenic dimension using ultrasound scan in healthy adults, and the values obtained have been diverse, thus prompting more work that tends to establish normal values for different regions based on geographic and racial differences. Materials and Methods: A prospective study of normal spleen dimensions using ultrasound in 400 Nigerian adults at Aminu Kano Teaching Hospital was conducted. Sonographic measurement of splenic dimensions was performed with the patient in supine and right lateral decubitus position. Height and weight were measured using the standard anthropometric technique. The data were analysed using computer-based SPSS Version 16.0 software for Windows (SPSS Inc., Chicago, IL, USA). Results: There were 212 males and 188 females, their age ranged between 20 and 70 years. The mean age of the subjects and (±standard deviation) were 33.0 years (±12.0), mean height was 1.64 m (±0.1) and mean weight was 61.4 kg (±11.0). The mean splenic length, width and depth for the subjects studied were 101.6 mm (±13.7), 46.8 mm (±8.2), and 86.8 mm (±12.7), respectively. Conclusion: The mean spleen dimensions obtained in this study were similar to those obtained in other regions of Nigeria but slightly lower than those reported from studies among Caucasians confirming the need for normal values for each region. There was positive correlation between subjects height and weight with splenic length (P < 0.001 and P < 0.001), depth (P < 0.01 and P < 0.001) and width (P < 0.01 and P < 0.001).
Acute Upper Gastrointestinal Tract Obstruction: A Complication of Abdominoplasty following Adjustable Gastric Banding

Abdominoplasty performed after bariatric surgery has become an integral part of the surgical treatment of morbidly obese patients. A 45-year-old woman underwent abdominoplasty 2 years after placement of a gastric band, following massive weight loss. Two days after the procedure, she developed signs and symptoms suggestive of acute abdomen. An abdominal X-ray showed dilation above the level of the stomach antrum and distal esophagus. CT scan revealed complete migration of the gastric band below the junction between the body and antrum of the stomach. Three hypotheses were formulated as potential explanations for the cause of malposition of the gastric band. We report a case of acute upper gastrointestinal tract obstruction following abdominoplasty secondary to gastric band malposition. This complication has only rarely been reported in the literature.
An Investigation of Posttraumatic Growth Experienced By Parents After a Miscarriage

AN INVESTIGATION OF POSTTRAUMATIC GROWTH EXPERIENCED BY PARENTS AFTER A MISCARRIAGE Barbara Elizabeth Powell Boyd Old Dominion University, 2019 Chair: Dr. Christopher Sink This quantitative study examined relationships between demographic and pregnancy loss related predictors and scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996). Participants included 355 women and men who had experienced at least one miscarriage before January 1, 2018. Data were collected through an online survey that consisted of the 21-item PTGI and a demographic and pregnancy loss related factors information sheet. Demographic information collected included gender, age, ethnicity, race, annual household income, and relationship status. Pregnancy loss related factors collected included number of pregnancies, number of miscarriages, length of gestation, assistance with conceiving, and whether the participant sought formal mental health support after the loss. Data analysis included descriptive statistics related to demographics and pregnancy loss related factors, correlations, validity and reliability analyses, and multiple regression analyses. Findings indicate several relationships between factors and PTGI scores, as well as predictions made through multiple regression analyses. Finally, limitations and implications for future research are discussed.