Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence, risk factors and consequences of falls among elderly subjects living in the community A criteria-based analysis

In order to obtain an overview of the incidences, risk factors and health consequences of falls among elderly persons living in the community from the available literature, a Medline computer search of publications over the period 1981-1994 was carried out. Fourteen studies met the following inclusion criteria: i) the study is an original investigation of falls among the elderly, ii) the study deals with the incidence, risk factors and/or consequences of falls among the elderly and iii) the study refers to a population at risk consisting of persons aged 60 years or over belonging to a population relevant to general practice. The selected studies were subjected to a methodological assessment on the basis of 10 methodological criteria. All the studies were independently assessed by 1 author and 1 assistant to obtain a methodological consensus. The relevant outcomes of these studies are reported. Pooling of data was not performed because of relevant differences between the studies. Two studies met all methodological criteria and 2 other studies were second best. These 4 studies were given preference. Approximately 30% of subjects older than 65 years fall at least once a year and approximately 15% fall recurrently. The main risk factors for falls among the elderly belong to the intrinsic (patient-related) risk factors: cognitive impairment, balance and gait disorders, use of sedatives and hypnotics, a history of stroke, advanced age, arthritis of the knee and a high level of dependence. Extrinsic (environment-related) risk factors did not play a significant role in any of the studies. Not all studies dealt with the health consequences of falls among the elderly. Major injuries were reported in 0.5-9% and fractures in 3-14%.
Improving rates of maternal immunization: Challenges and opportunities

ABSTRACT Objectives: An increasing number of vaccines are recommended or are being developed for use during pregnancy to protect women, fetuses, and/or newborns. For vaccines that are already recommended, vaccine uptake is variable and well below desired target. We reviewed the literature related to factors that affect a healthcare provider’s recommendation and a woman’s willingness to be vaccinated during pregnancy. Design: A scoping review of published literature from 2005 to 2015 was undertaken and all relevant articles were abstracted, summarized, and organized thematically. Results: Barriers and facilitators were identified that either decreased or increased the likelihood of a healthcare provider offering and a pregnant woman accepting vaccination during pregnancy. Concern about the safety of vaccines given during pregnancy was the most often cited barrier among both the public and healthcare providers. Other barriers included doubt about the effectiveness of the vaccine, lack of knowledge about the burden of disease, and not feeling oneself to be at risk of the infection. Major facilitators for maternal immunization included specific safety information about the vaccine in pregnant women, strong national recommendations, and healthcare providers who both recommended and provided the vaccine to their patients. Systems barriers such as inadequate facilities and staffing, vaccine purchase and storage, and reimbursement for vaccination were also cited. Evidence-based interventions were few, and included text messaging reminders, chart reminders, and standing orders. Conclusions: In order to have an effective vaccination program, improvements in the uptake of recommended vaccines during pregnancy are needed. A maternal immunization platform is required that normalizes vaccination practice among obstetrical care providers and is supported by basic and continuing education, communication strategy, and a broad range of research.
Peptide/protein vaccine delivery system based on PLGA particles

abstract Due to the excellent safety profile of poly (D,L-lactide-co-glycolide) (PLGA) particles in human, and their biodegradability, many studies have focused on the application of PLGA particles as a controlled-release vaccine delivery system. Antigenic proteins/peptides can be encapsulated into or adsorbed to the surface of PLGA particles. The gradual release of loaded antigens from PLGA particles is necessary for the induction of efficient immunity. Various factors can influence protein release rates from PLGA particles, which can be defined intrinsic features of the polymer, particle characteristics as well as protein and environmental related factors. The use of PLGA particles encapsulating antigens of different diseases such as hepatitis B, tuberculosis, chlamydia, malaria, leishmania, toxoplasma and allergy antigens will be described herein. The co-delivery of antigens and immunostimulants (IS) with PLGA particles can prevent the systemic adverse effects of immunopotentiators and activate both dendritic cells (DCs) and natural killer (NKs) cells, consequently enhancing the therapeutic efficacy of antigen-loaded PLGA particles. We will review co-delivery of different TLR ligands with antigens in various models, highlighting the specific strengths and weaknesses of the system. Strategies to enhance the immunotherapeutic effect of DC-based vaccine using PLGA particles can be designed to target DCs by functionalized PLGA particle encapsulating siRNAs of suppressive gene, and disease specific antigens. Finally, specific examples of cellular targeting where decorating the surface of PLGA particles target orally administrated vaccine to M-cells will be highlighted.
Comprehensive safety assessment of a human inactivated diploid enterovirus 71 vaccine based on a phase III clinical trial

abstract Human enterovirus 71 (EV71) is a causative agent of hand, foot, and mouth disease (HFMD). In a previous phase III trial in children, a human diploid cell-based inactivated EV71 vaccine elicited EV71 specific immune responses and protection against EV71 associated HFMD. This study aimed to assess the factors influencing the severity of adverse events observed in this previous trial. This was a randomized, double-blinded, placebo-controlled, phase III clinical trial of a human diploid vaccine carried out in 12,000 children in Guangxi Zhuang Autonomous Region, China (ClinicalTrials.gov: NCT01569581). Solicited events were recorded for 7 days and unsolicited events were reported for 28 days after each injection. Age trend analysis of adverse reaction was conducted in each treatment group. Multiple logistic regression models were built to identify factors influencing the severity of adverse reactions. Fewer solicited adverse reactions were observed in older participants within the first 7 days after vaccination (P < 0.0001), except local pain and pruritus. More severe adverse reactions were observed after the initial injection than after the booster injection. Serious cold or respiratory tract infections (RTI) were observed more often in children aged 6–36 months than in older children. Only the severity of local swelling was associated with body mass index. Children with throat discomfort before injection had a higher risk of serious cold or RTI. These results indicated that the human diploid cell-based vaccine achieved a satisfactory safety profile.
Conséquences de l'exposition aux faibles débits de dose. Apport de l'expérimentation animale

L'exposition des animaux de laboratoire aux differents types de rayonnements induit des cancers en relation avec les doses absorbees dans les tissus. La forme des relations dose-effet est tres variable. Il est important de distinguer quelles tumeurs sont comparables aux tumeurs humaines. Celles qui presentent le plus d'analogie ne repondent que rarement a la relation classique lineo-quadratique ; neanmoins, une forte attenuation de l'induction est mise en evidence a faible debit de dose. Des relations a quasi-seuil existent apres exposition de certains tissus a des rayonnements de fort TLE. Ces constatations mettent en doute la validite de la generalisation de la theorie duale des radiobiologistes, situant l'origine de la relation dose-effet dans l'induction des evenements au sein de la molecule d'ADN. Une alternative existe dans les phenomenes de collaborations cellulaires, elle suppose que l'efficacite par unite de dose decroit constamment en fonction inverse du debit.
Chikungunya Patient presented with Arthritis: A Case Report

Chikungunya is an arthropod borne viral disease considered as the new emerging infectious disease in many countries of Asia, Africa, Europe and America. In this present case report a 45 year old lady was presented with multiple joint pains following exanthematous febrile illness. Laboratory result revealed this case as positive for chikungunya. DOI: http://dx.doi. org/10.3329/jcamr.v1i1. 19562 J Curr Adv Med Res 2014;1(1):21-22
The Neurology of Eye Movements (Contemporary Neurology Series)

During the last three decades the clinical recognition of eye movement disorders has advanced rapidly from descriptive phenomenology to accurate recording of eye movements and the presentation of specific pathophysiologic mechanisms for the abnormal movements observed in patients. This subject, which appears dauntingly complex to the uninitiated, was first distilled into a comprehensive yet clinically useful form by Leigh and Zee in the first edition of The Neurology of Eye Movements . Now, 8 years later, the second edition has incorporated the major advances made in the last decade, including those of 1990. The format of the second edition is identical to that of the first. The book is divided into two major sections: part 1 summarizes the results of basic research on eye movements, with an emphasis on the clinical relevance of this research, and part 2 builds on this framework to interpret the pathophysiologic mechanisms of the signs and
Vaccine hesitancy: More than a movement

ABSTRACT Vaccines are some of if not the most successful public health endeavors ever put into practice. Countless lives have been saved and the occurrences of vaccine preventable diseases are at a fraction of the rate experienced before vaccines. Vaccines and the realization of their compulsory scheduling are highly studied, safe, and purposeful. Despite these realities, there are an alarming number of parents who do not permit the vaccination of their children as scheduled. This is known in the health community as vaccine hesitancy and commonly portrayed in popular media as anti-vaccination sediment. This analysis opens with the topic as it was addressed during a September 2015 debate for the Republic Party's 2016 presidential nomination. Some key historical aspects of vaccine hesitancy are presented. This history leads to a description of the 2014–2015 measles outbreak in California. The factors that aide in the recruitment of under vaccination are then explored. Finally, select strategies to control, combat, and potentially attenuate vaccine hesitancy are presented.
To close the childhood immunization gap, we need a richer understanding of parents' decision-making

ABSTRACT Vaccination is widely acknowledged as one of the most successful public health interventions globally and in most high-income countries childhood vaccination coverage rates are moderately high. Yet in many instances, immunisation rates remain below aspirational targets and have shown only modest progress toward those targets in recent years, despite concerted efforts to improve uptake. In part, coverage rates reflect individual parents' vaccination attitudes and decisions and, because vaccination decision-making is complex and context-specific, it remains challenging at individual and community levels to assist parents to make positive decisions. Consequently, in the search for opportunities to improve immunisation coverage, there has been a renewed research focus on parents' decision-making. This review provides an overview of the literature surrounding parents' vaccination decision-making, offering suggestions for where efforts to increase vaccination coverage should be targeted and identifying areas for further research.
Seroprevalence of poliovirus antibodies in the Kansas City metropolitan area, 2012–2013

ABSTRACT No indigenous cases of poliomyelitis have occurred in the US since 1979; however the risk of importation persists until global eradication is achieved. The seropositivity rate for different age cohorts with exposures to different poliovirus vaccine types and wild virus in the US are not presently known. A convenience sample was conducted in the Kansas City metropolitan area during 2012–2103 with approximately 100 participants enrolled for each of 5 age cohorts categorized based on vaccine policy changes over time in the US. Immunization records for poliovirus vaccination were required for participants <18 y of age. We evaluated the prevalence of serum antibodies to all 3 poliovirus serotypes. Seroprevalence was evaluated by demographics as well as between polio serotypes. The overall seroprevalence to poliovirus was 90.7%, 94.4%, and 83.3%, for types 1, 2, and 3, respectively. Seroprevalence was high (88.6%–96.2%) for all 3 types of poliovirus for the 6–10 y old age group that was likely to have received a complete schedule of IPV-only vaccination. Children 2–3 y of age, who have not yet completed their full IPV series, had lower seroprevalence compared with all older age groups for types 1 and 2 (p-value <0. 05). Seroprevalence was high for all 3 types of poliovirus in the population surveyed. Seroprevalence for subjects aged 2–3 y was lower than all other age groups for serotypes 1 and 2 highlighting the importance of completing the recommended poliovirus vaccine series with a booster dose at age 4–6 y.
Determination of the Attitudinal Character by Self‐Evaluation for the Maximum Entropy OWA Approach

The attitudinal character plays an important role in the maximum entropy ordered weighted averaging (MEOWA) approach. We propose a self‐evaluation model to determine the attitudinal character for each alternative in multicriteria decision making with MEOWA operators. The value of the attitudinal character determined for each alternative by self‐evaluation may be different; and each alternative can reach its highest rank with MEOWA weights, when the attitudinal character is determined for it. Then, to obtain an overall set of MEOWA weights by different attitudinal character values, the preemptive goal programming (PGP) model proposed by Wang can be used. Finally, the evaluation process of the service quality for five online stores is given to illustrate the application of the proposed method.
Hepatitis B virus vaccination in HIV-infected people: A review

ABSTRACT HBV immunization is highly recommended in people infected with HIV. However, the classical schedule used in the general population has been shown to be insufficient in people living with HIV. This review summarizes the main studies dealing with HBV vaccination in people living with HIV, depending on their baseline status (in particular, never vaccinated, already vaccinated, or with an isolated anti-HBc serological profile). It shows that reinforced 40µg intramuscular HBV vaccination schedules are now frequently recommended, either initially in people never vaccinated, or in the lack of an anamnestic response in other situations. Adjuvants cannot be currently recommended. Anti-HBs titers have to be checked 1 to 2 months following the last vaccine dose, and annually thereafter a booster is necessary if antiHBs titers decrease below 10 mIU/mL. In patients with a CD4 cell count <200/µL, guidelines recommend starting the vaccination regimen as soon as possible after HAART has been started.
A recombinant multi-epitope protein MEP1 elicits efficient long-term immune responses against HIV-1 infection

ABSTRACT The effective protective HIV vaccine should elicit either protective antibodies or effective T cell response, or both. To improve the efficacy of HIV-1 vaccines, HLA polymorphism and HIV-1 diversity are 2 key factors to be considered for vaccine development. In this study, we expressed a recombinant multi-epitope protein MEP1 which has the same amino acid sequence as a DNA vaccine for Chinese population in our previous report. We found that MEP1 alone could elicit moderate levels of humoral and cellular immune responses, but these responses could not provide protection from challenge with a recombinant virus rTTV-lucgag, which expresses Gag of HIV-1 CRF_07BC. Nevertheless, when MEP1 was immunized with aluminum adjuvant, both humoral and cellular immune responses were significantly increased, and they were protective against virus infection; meanwhile, MEP1 with aluminum not only elicited early (10 d post immunization) but also a long-term (at least 44 weeks post immunization) immune responses in BALB/c mice. These results suggested that MEP1 has the potential to be developed as an effective vaccine candidate, and that suitable adjuvant is necessary for this protein to generate protective immune responses.
In vivo Diagnosis of Hollervorden‐Spatz Disease

The authors present the MRI findings of two children with insidious walking difficulties, signs of corticospinal tract involvement, and signs and symptoms of extrapyramidal dysfunction such as rigidity and generalized dystonia, the latter with predominance of otomandibular involvement. In one child, MRI revealed prominent hypo‐intensity in the globus pallidas and in the substantia nigra on IYweighted spin echo images, consistent with iron deposition and thus with previous postmortem findings of Hallervorden‐Spatz disease. In the other case, the hypo‐intensity was restricted to the globus pallidus, in which a small area of hyperintensity in its internal segment was demonstrated–the so called “eye‐of‐the‐tiger‘ sign. The authors propose that a combination of previously mentioned neurological signs with these specific MRI findings is highly suggestive of an in vivo diagnosis of the late infantile type of HSD.
The dark side of the QT interval. The Short QT Syndrome: pathophysiology, clinical presentation and management

A large number of studies has been carried out to investigate the pathophysiology and the clinical implications of QT interval prolongation in the ECG over recent years (1, 2, 3, 4, 5, 6). It was only in the last decade, however, that the scientists have focused on the specular aspects of the long QT syndrome (LQTS), and it is now well established that the abnormal shortening of the QT interval is associated with meaningful clinical consequences and adverse outcomes. The aim of the present article is to summarize knowledge and existing evidence about the Short QT Syndrome (SQTS). SQTS is a rare, albeit largely underdiagnosed, genetically determined disease, which is characterized by a high tendency to develop life-threatening arrhythmias. The two clinical landmarks of SQTS are the presence of a short QT interval (i.e., less than 320 ms) in a structurally normal heart. The disease is now classified as a “channellopathy”, and is principally caused by a defective functioning of both potassium and calcium ion channels. The underlying genetic anomalies cause an abnormal ripolarization and a reduced refractoriness of myocardiocites. Pharmacologic treatments are mainly tailored to slow the conduction and to prolong the refractory period of myocardiocites. The implantable cardioverter and defibrillator (ICD) is currently considered the therapeutic gold standard (7).
Human Vaccines & Immunotherapeutics: News

The 9-valent HPV vaccine (Gardasil 9, Merck) protected against > 90% of cervical, vulvar and vaginal cancer cases six years after the first dose. The randomized double-blind Phase 3 trial, which enrolled > 14,000 female subjects aged 16–26, found persistent antibody responses against all nine HPV strains five years after vaccination. The participants will be followed for additional 10 years. The nine strains targeted by the vaccine cause 90% of cervical cancers and genital warts. Although the immunization rates are on the rise in the US, the Centers for Disease Control and Prevention (CDC) estimated that only »40% of teens complete the schedule.
Diabetes Epidemic Is a Worldwide Threat

Each triennium the International Diabetes Federation (IDF) hosts a worldwide Congress at which physicians, nurses, patients, and scientists share their knowledge, experience, and concerns regarding progress in the fight against diabetes. The most recent Congress was held in late August 2003, in Paris. More than 17,000 people participated. This included representatives of 180 national diabetes associations from around the world. Sir George Alberti, the outgoing president of the IDF, opened the meeting with a plenary address. He highlighted some of the demographic issues that are creating a worldwide threat from diabetes. Certainly, here in the United States, we see dramatic increases in the prevalence rates of diabetes and obesity. These are particular issues in several ethnic communities including Hispanic, Native-American, and African-American populations. We know very well that changes in lifestyle, including decreasing physical activity and expanded dietary intake, are major contributors. It should be no surprise that this same issue is occurring not only in other developed countries but increasingly within …
Cytokine production in whole-blood cultures following immunization with an influenza vaccine

ABSTRACT A clinical trial of a quadrivalent split influenza vaccine was performed in the 2014/15 season. Sixty-four subjects aged 6 months to 18 years were enrolled in order to investigate the relationship between cellular and humoral immune responses. Subjects were categorized into two groups by measuring neutralizing antibodies: non-primed naïve/primed or seroconverted/non-seroconverted groups. Whole-blood cultures were stimulated with the H1N1 split antigen before immunization and one month after the first and second immunizations for subjects < 13 years and before and one month after the first dose for those ≥ 13 years in order to investigate cytokine production. Significant amounts of IL-2, IL-12, IL-13, MCP-1, MIP-1β, and TNF-α were detected from one month after the first dose in the naïve group. In addition to these cytokines, the production of IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17, G-CSF, and IFN-γ was enhanced one month after the second dose. No significant increase was noted in the primed group, except in the production of IL-10. In seroconverted subjects, the production of IL-2, IL-4, IL-8, IL-10, G-CSF, MCP-1, TNF-α, and IFN-γ increased one month after the first dose, which was earlier than in the naïve group, whereas no significant cytokine response was noted in subjects without seroconversion. Subjects ≥ 13 years were primed and the production of G-CSF, IL-4, and IL-1β increased in subjects with seroconversion. Whole-blood cultures were also stimulated with the H3N2 split antigen and similar cytokine profiles were obtained. Many cytokines and chemokines, including inflammatory cytokines, were produced in seroconverted, but not non-seroconverted subjects.