Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors related to an adverse outcome for stroke in a Bogota hospital. Case-control study

ResuMen OBJETIVOS: determinar los factores de riesgo para resultado adverso entre los pacientes con ataque cerebrovascular (ACV) isquémico agudo. MATERIALES Y MÉTODOS: se realizó un estudio retrospectivo de casos y controles. Se analizaron pacientes con un desenlace adverso al egreso con una escala de Rankin modificada mayor o igual a 3, contra los pacientes con un desenlace calificado como favorable por una escala menor o igual a 2. Se compararon los 2 grupos para determinar los factores que podrían estar relacionados con un desenlace adverso. Como desenlace secundario se analizaron los factores de riesgo asociados con mortalidad intrahospitalaria. En cuanto a las técnicas estadísticas, se realizó un análisis univariado y otro multivariado por regresión logística, con ajuste por variables como la edad y la severidad, medidas por la escala de NIHSS, conocidos previamente como factores de riesgo para desenlace adverso. RESULTADOS: los factores de riesgo relacionados con un desenlace adverso entre los pacientes con ACV isquémico agudo fueron los antecedentes de hipertensión arterial, fibrilación auricular, la etiología cardioembólica y el hecho de ser candidato a trombolisis. Como factor protector se encontró la rápida mejoría. CONCLUSIONES: los factores de riesgo encontrados en el estudio para desenlace adverso en ACV isquémico agudo son similares a los descritos previamente, aunque estos se han relacionado con desenlace en general, no solo para la entidad analizada.
Les nouvelles approches thérapeutiques dans le traitement des cancers colorectaux métastatiques : les thérapies ciblées

Avec trente-six mille nouveaux cas par an en France, les cancers colorectaux representent un enjeu important de sante publique. Les campagnes de depistage mises en place recemment facilitent le diagnostic de cette pathologie et ameneront un plus grand nombre de patients a recevoir un traitement. Les chimiotherapies traditionnellement utilisees 5-fluorouracile et acide folinique associes a l'irinotecan et l'oxaliplatine ne parviennent pas toujours a des resultats concluants, notamment en cas de cancer metastatique. L'arrivee des therapies ciblees represente un veritable espoir pour le traitement des cancers colorectaux metastatiques. Il s'agit de molecules qui vont cibler l'EGFR induisant une reduction de la proliferation cellulaire, de l'angiogenese tumorale, de la mobilite et de l'envahissement cellulaire ainsi qu'une favorisation de l'apoptose, ou le VEGF entrainant une diminution de l'angiogenese tumorale, de la permeabilite vasculaire et de la dissemination metastatique. Ces nouvelles therapies, utilisees seules ou en association aux chimiotherapies traditionnelles, transforment considerablement l'approche therapeutique de ce type de pathologie et semblent avoir un bel avenir devant elles. Les recherches continuent et paraissent prometteuses.
Chemical-Modified mRNA Therapy for Cystic Fibrosis by Targeting Lung Cells

Itishri Sahu, A. K. M. Ashiqul Haque, Georg R Schweizer, Brian Weidensee, Petra Weinmann, Brigitta Loretz, Claus Michael Lehr, Tatjana Michel, Hans Peter Wendel, and Michael S. D. Kormann Kinder Klinik, University Klinik Tuebingen, Tuebingen, Germany; Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarbrucken, Germany; Department of Pharmacy, Saarland University, Saarbrucken, Germany; Department of Thoracic and Cardiovascular Surgery, Clinical Research Laboratory, University Medical Center, Tuebingen, Germany
Everolimus for the treatment of refractory seizures associated with tuberous sclerosis complex (TSC): current perspectives

Abstract Up to 90% of patients with tuberous sclerosis complex (TSC) have epilepsy, and in over half of patients seizure control cannot be achieved by regular antiepileptic drugs. The underlying problem is mTOR hyperactivation due to loss of function of the TSC proteins. Treatment with everolimus, an mTOR inhibitor, has been shown to be of great benefit to TSC patients, both in reducing tumor growth and as a treatment for intractable epilepsy. Up to 40% of TSC patients with intractable epilepsy show a clinically relevant seizure response to everolimus. It has not yet fully lived up to its promise as a disease-modifying drug, however, as half of TSC patients with intractable epilepsy do not show a clinically relevant seizure frequency reduction. There is no evidence yet of a positive effect on the cognitive and neuropsychiatric deficits in TSC patients. In preclinical studies, mTOR inhibition can rescue abnormal neuronal migration and synapse formation that is caused by mTOR hyperactivation. These studies show a critical time window that suggests that mTOR inhibition may be most beneficial in young children. The trials done so far have not studied treatment in children under 2 years of age, although case series suggest that the safety profile is similar to that in older children. Further studies into the optimal time window, dosing schedules and possibly combination with other drugs may further improve the benefit of everolimus for TSC patients.
Parametric survival analysis using R: Illustration with lung cancer data.

BACKGROUND Cox regression is the most widely used survival model in oncology. Parametric survival models are an alternative of Cox regression model. In this study, we have illustrated the application of semiparametric model and various parametric (Weibull, exponential, log-normal, and log-logistic) models in lung cancer data by using R software. AIMS The aim of the study is to illustrate responsible factors in lung cancer and compared with Cox regression and parametric models. METHODS A total of 66 lung cancer patients of African Americans (AAs) (data available online at http://clincancerres.aacrjournals.org) was used. To identify predictors of overall survival, stage of patient, sex, age, smoking, and tumor grade were taken into account. Both parametric and semiparametric models were fitted. Performance of parametric models was compared by Akaike information criterion (AIC). "Survival" package in R software was used to perform the analysis. Posterior density was obtained for different parameters through Bayesian approach using WinBUGS. RESULTS The illustration about model fitting problem was documented. Parametric models were fitted only for stage after controlling for age. AIC value was minimum (462.4087) for log-logistic model as compared with other parametric models. Log-logistic model was the best fit for AAs lung cancer data under study. CONCLUSION Exploring parametric survival models in daily practice of cancer research is challenging. It may be due to many reasons including popularity of Cox regression and lack of knowledge about how to perform it. This paper provides the application of parametric survival models by using freely available R software with illustration. It is expected that this present work can be useful to apply parametric survival models.
Risk Factors Associated With Malaria Mortality in Tshwane District, South Africa: A Retrospective Cohort Study, 2011-2014

Background: Tshwane District in Gauteng Province identifies malaria cases from endemic provinces and neighbouring countries as well as Odyssean malaria cases. Objectives: To assess changes in malaria morbidity and mortality and to determine risk factors associated with malaria mortality in Tshwane District during 2011-2014. Methods: A retrospective cohort study was conducted using malaria surveillance data collected by the Communicable Disease Control Directorate in Tshwane district over a period of four years. Only laboratory confirmed cases were enrolled in the study. Secondary death audits were reviewed. Logistic regression determined risk factors associated with malaria mortality. Results: During 2011-2014, 964 cases were identified. Of these, the median age was 28 years (range: 4 months to 79 years), 71.7% (n=691) were males. The majority of cases, 96.6% (n=931), had travelled to malaria endemic areas within South Africa and neighbouring countries. Of those who travelled to endemic malaria provinces in South Africa, 62.5% (40/64) went to Limpopo. Malaria cases decreased from 333 in 2011 to 229 in 2014. There were 20 deaths (2.1%) and 19 (2.0%) Odyssean malaria cases. Age, gender and malaria season were not associated with mortality. History of travel to a malaria endemic area was a protective factor for mortality (aOR 0.2, 95%CI: 0.36 to 0.78, p=0.021). Conclusion: In this non-endemic district, a number of malaria cases have been reported. Public awareness regarding uptake of antimalarial prophylaxis before and during travel to endemic areas could lead to a reduction in mortality and morbidity in South Africa.
Factors associated with improvement in symptoms and quality of life for first-line EGFR-tyrosine kinase inhibitor treatment in patients with EGFR-mutated non-small-cell lung cancer - A multicenter prospective SMILE study

Introduction: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a standard first-line treatment for advanced EGFR-mutated NSCLC patients. Factors associated with symptoms and quality of life (QOL) improvements have not been investigated. Methods: We conducted a multicenter, prospective study to evaluate improvements in QOL and symptoms in NSCLC patients treated with first-line EGFR-TKIs. QOL was assessed using the instrument of Functional Assessment of Cancer Therapy-Lung questionnaire (FACT-L) and Treatment Outcome Index (TOI). Assessment of symptoms was evaluated using the Lung cancer subscale (LCS). Results: Eligible subjects included 280 patients for endpoint analyses. The mean FACT-L score increased by 4.0 ± 15.56 at Week 2 (p<0.001), 5.1 ± 18.48 at Week 4 (p<0.001), and 4.2 ± 20.27 at Week 12 (p=0.001). Similarly, a 2.3 ± 11.65 (p<0.001), 3.2 ± 13.59 (p<0.001), and 2.4 ± 14.34 (p=0.009) increase in mean TOI score were observed at Weeks 2, 4 and 12, respectively. For LCS, it was slightly increased by 1.7 ± 4.61, 2.0 ± 5.50, and 2.0 ± 5.36 at Weeks 2, 4, and 12 (all p<0.001), respectively. Subgroup analyses showed patients who were ex-smokers or with at least 3 metastatic sites were associated with symptoms improvement. Patients who were ex-smokers, with at least 3 metastatic sites, a PS of 1, or treated with gefitinib were associated with QOL improvement. Conclusions: In EGFR -mutated NSCLC patients who were treated with first-line EGFR-TKIs, these ex-smokers or with 3 or more metastatic sites were associated with improvements in symptoms and QOL.
The Efficacy of Serum Biomarkers and Ultrasound Parameters in Prediction of Outcome in Threatened Abortion

Background: miscarriage, also known as a spontaneous loss of pregnancy before the fetus reaches viability. Objectives: the aim of this study is to evaluate the association between ultrasonographic findings and maternal serum biomarkers levels and prediction of pregnancy outcome in threatened miscarriage. Patients and Methods: a prospective observational study was conducted at Al-Zahraa University Hospital through the period from April 2018 to May 2019 involving 76 women in their first trimester threatened abortion. Results: there was a statistically significant difference between group 1 and group 2 regarding cancer antigen (CA) 125, β-hCG, progesterone, yolk sac diameter (YSD), fetal heart rate (FHR) and crown-rump length (CRL). The sensitivity, specificity, PPV and NPV of CA 125 at 37.2 IU/ml were 86.0, 84.3, 84.6 and 85.7, respectively, for β-hCG at 19447 IU/ml were 80.6, 78.0, 78.4 and 79.8, respectively, for progesterone at 12.3 ng/ml were 90.1, 88.0, 88.2 and 89.8, respectively, and for FHR at 122 b pm were 96.1, 94.1 respectively. Conclusion: combining of measurement of serum progesterone at a level of 12.3 ng/ml to FHR at 122 bpm represent noninvasive, early, fast and excellent predictor of pregnancy outcome in women with threatened abortion.
Safety and Activity of Metronomic Temozolomide in Second-Line Treatment of Advanced Neuroendocrine Neoplasms

Background. Platinum-based chemotherapy is the mainstay of front-line treatment of patients affected by pluri-metastatic intermediate/high grade NeuroEndocrine Neoplasms (NENs). However, there are no standard second-line treatments at disease progression. Previous clinical experiences have evidenced that temozolomide (TMZ), an oral analog of dacarbazine, is active against NENs at standard doses of 150 to 200 mg/mq per day on days 1 to 5 of a 28-day cycle, even if a significant treatment-related toxicity is reported. Methods. Metastatic NENs patients were treated at the ENETS (European NeuroEndocrine Tumor Society) center of excellence of Naples (Italy), from 2014 to 2017 with a second-line alternative metronomic schedule of TMZ, 75 mg/m2 per os “one week on/one week off”. Toxicity was graded with NCI-CTC criteria v4.0; objective responses with RECIST v1.1 and performance status (PS) according to ECOG. Results. Twenty-six consecutive patients were treated. Median age was 65.5 years. The predominant primary organs were pancreas and lung. Grading was G2 in 11 patients, G3 in 15. More than half of patients had a PS 2 (15 vs. 11 with PS 1). The median time-on-temozolomide therapy was 12.2 months (95% CI: 11.4–19.6). No G3/G4 toxicities were registered. Complete response was obtained in 1 patient, partial response in 4, stable disease in 19 (disease control rate: 92.3%), and progressive disease in 2. The median overall survival from TMZ start was 28.3 months. PS improved in 73% of patients. Conclusions. Metronomic TMZ is a suitable treatment for G2 and G3 NENs particularly in PS 2 patients. Prospective and larger trials are needed to confirm these results.
Effects of Age and Sex on Weight-Loss Dynamics in Obese Patients Undergoing Very Low Calorie Treatment

Background and Significance: Although known to effectively provoke large scaled weight-loss, less is known regarding age- and sex-related influences on treatment outcomes of bariatric patients treated with a very-low calorie diet (VLCD) program. Purpose: This study retrospectively examined body composition and metabolic changes induced by a 12-wk proprietary VLCD treatment in obese patients while assessing age and sex differences. Methods: Male (n=16) and female (n=16) patients underwent 12 weeks of VLCD under standard medical care. Results: Older patients exhibited a greater relative loss of FFM compared to younger patients (p=0.004). Older patients also lost a greater proportion of total weight-loss as FFM (p=0.003) and lower proportion as FM (p=0.003) compared to the young group. This age-specific difference in weight-loss composition was driven by the older males. Conclusion: The results demonstrate the need for special clinical considerations for VLCD treated patients, such as older adults and perhaps older males specifically, who demonstrate a reduced quality of weight-loss compared to their younger counterpart.
Image annotation based on positive-negative instances learning

Automatic image annotation is now a tough task in computer vision, the main sense of this tech is to deal with managing the massive image on the Internet and assisting intelligent retrieval. This paper designs a new image annotation model based on visual bag of words, using the low level features like color and texture information as well as mid-level feature as SIFT, and mixture the pic2pic, label2pic and label2label correlation to measure the correlation degree of labels and images. We aim to prune the specific features for each single label and formalize the annotation task as a learning process base on Positive-Negative Instances Learning. Experiments are performed using the Corel5K Dataset, and provide a quite promising result when comparing with other existing methods.
Variations in Weight Control Behaviors and Body Image Dissatisfaction Among Preadolescents in a Low-Income Community in Fresno, California

Purpose: This study sought to determine whether healthy, overweight, and obese preadolescents living in low-income neighborhoods differ in regards to body image and weight control behaviors. It is critical to identify early precursors to body image issues so that optimal prevention programs can be implemented. Subjects: The sample consisted of 64 preadolescents ages 8 to13 years, including 29 male (45%) and 35 female (55%) fourth, fifth, and sixth graders living in low-income neighborhoods in Fresno, California. Measures: (a) Height and weight were measured to calculate BMI-for-age (kg/m2 ), and (b) the CDC 13- question Body Image Survey was administered. Analysis: ANOVA was used to compare differences in body image and weight control behaviors by weight category (healthy, overweight, obese). Results: The obese group reported more body image dissatisfaction than did the healthy and overweight groups. Obese preadolescents were less happy with their body image and dieted more than healthy weight preadolescents. Overweight preadolescents were more similar in behaviors to healthy weight preadolescents than obese preadolescents. Conclusions: Low self-esteem related to weight may be exacerbated in the adolescent years when new pressures and challenges emerge. Targeting preadolescent overweight and obese individuals with body image issues may be useful in ameliorating some of the problems that are magnified in adolescence, such as dieting and eating disorders.
Predictors of Distant Metastasis in Patients with Cervical Cancer Treated with Definitive Radiotherapy

Objective: To identify the predictors of distant metastasis in patients with cervical cancer treated with definitive radiotherapy and develop a model for predicting distant metastasis. Methods: We reviewed the clinical records of patients with cervical cancer treated with definitive radiotherapy (IMRT) at Peking Union Medical College Hospital between January 2011 and December 2015. Eligible patients were randomly assigned into model development cohort and validation cohort in a 2:1 ratio. Distant metastasis rate (DMR) was calculated with Kaplan-Meier method. Univariate and multivariate analyses using cox proportional hazard model was performed to identify the risk factors of distant relapse. Based on the identified risk factors for distant metastasis, a model for predicting distant metastasis was developed and validated. A two-side P<0.05 was defined as statistically significant. Results: A total of 1193 patients were eligible for this analysis including 797 patients in the model development cohort and 396 patients in the validation cohort. The median follow-up durations of the model development cohort and the validation cohort were 28.7 months (range: 2.5-83.9 months) and 30.9 months (1.9-83.5 months). The 2-year distant metastasis rates (DMR) for patients in the model development cohort and validation cohort were 13.3% and 12.8%. Non-squamous cell carcinoma (non-Scc), common iliac lymph nodes metastasis (LNM) and bilateral pelvic LNM (PLNM) were identified as risk factors for distant metastasis. In the model development cohort, significant difference between high-risk group (with 2-3 risk factors) and low-risk group (with 0-1 risk factor) regarding DMR was observed (39.3% vs 19.3%, P<0.001). Similar conclusions were observed in the validation cohort (high-risk group vs low-risk group, 47.6% vs 10.9%, P<0.001) Conclusion: We successfully developed a model for predicting distant metastasis in patients with cervical cancer receiving definitive radiotherapy based on the three identified risk factors for distant metastasis. This model would help us distinguish patients with high risk of distant relapse from others.
Modeling Chronic Diseases in Relation to Risk Factors

In most countries, non-communicable diseases have taken over infectious diseases as the most important causes of death. Many non-communicable diseases that were previously lethal diseases have become chronic, and this has changed the healthcare landscape in terms of treatment and prevention options. Currently, a large part of healthcare spending is targeted at curing and caring for the elderly, who have multiple chronic diseases. In this context prevention plays an important role, as there are many risk factors amenable to prevention policies that are related to multiple chronic diseases. This article discusses the use of simulation modeling to better understand the relations between chronic diseases and their risk factors with the aim to inform health policy. Simulation modeling sheds light on important policy questions related to population aging and priority setting. The focus is on the modeling of multiple chronic diseases in the general population and how to consistently model the relations between chronic diseases and their risk factors by combining various data sources. Methodological issues in chronic disease modeling and how these relate to the availability of data are discussed. Here, a distinction is made between (a) issues related to the construction of the epidemiological simulation model and (b) issues related to linking outcomes of the epidemiological simulation model to economic relevant outcomes such as quality of life, healthcare spending and labor market participation. Based on this distinction, several simulation models are discussed that link risk factors to multiple chronic diseases in order to explore how these issues are handled in practice. Recommendations for future research are provided.
Resistance Training Combined With Stretching Increases Tendon Stiffness and Is More Effective Than Stretching Alone in Children With Cerebral Palsy: A Randomized Controlled Trial

Aim: Stretching is often used to increase/maintain muscle length and improve joint range of motion (ROM) in children with cerebral palsy (CP). However, outcomes at the muscle (remodeling) and resulting function appear to be highly variable and often unsatisfactory. During passive joint rotation, the Achilles tendon lengthens more than the in-series medial gastrocnemius muscle in children with CP, which might explain the limited effectiveness of stretching interventions. We aimed to ascertain whether increasing tendon stiffness, by performing resistance training, improves the effectiveness of passive stretching, indicated by an increase in medial gastrocnemius fascicle length. Methods: Sixteen children with CP (Age median [IQR]: 9.6 [8.6, 10.5]) completed the study. Children were randomly assigned to a combined intervention of stretching and strengthening of the calf muscles (n = 9) or a control (stretching-only) group (n = 7). Medial gastrocnemius fascicle length at a resting ankle angle, lengthening during passive joint rotations, and tendon stiffness were assessed by combining dynamometry and ultrasound imaging. The study was registered on clinicaltrials.gov (NCT02766491). Results: Resting fascicle length and tendon stiffness increased more in the intervention group compared to the control group (median [95% CI] increase fascicle length: 2.2 [1.3, 4.3] mm; stiffness: 13.6 [9.9, 17.7] N/mm) Maximum dorsiflexion angle increased equally in both groups. Conclusion: This study provides proof of principle that a combined resistance and stretching intervention can increase tendon stiffness and muscle fascicle length in children with CP. This demonstrates that remodeling of muscle structure is possible with non-invasive interventions in spastic CP.