Notes

Comparison involving a few prognostic rating systems in the group of 146 cases of continual myelomonocytic leukemia (CMML): M . d . Anderson prognostic report (MDAPS), CMML-specific prognostic credit rating technique (CPSS) and Mayo prognostic style. A detailed review of prognostic elements throughout CMML.
As a result, stroke care in LMICs is patchy, fragmented and often results in poor patient outcomes. Reconfiguration of LMIC health systems is thus required to optimise access to quality acute stroke care. We therefore propose a ten-point framework to be adapted to country-specific health system capacity, needs and resources Emergency medical transport and treatment services, scaling-up interventions and services for acute stroke care, clinical guidelines for acute stroke treatment and management, access to brain imaging services, human resource capacity development strategies, centralisation of stroke services, tele-stroke care, public awareness campaigns on early stroke symptoms, establish stroke registers and financing of stroke care in LMICs. While we recognise the challenges of implementing the recommendations in low resource settings, this list can provide a platform as well serve as the starting point for advocacy and prioritisation of interventions depending on context.
To identify a parsimonious set of markers that optimally predicts subsequent clinical progression from normal to mild cognitive impairment (MCI).

250 clinically normal adults (mean age=73.6years, SD=6.0) from the Harvard Aging Brain Study were assessed at baseline on a wide set of markers, including magnetic resonance imaging markers of gray matter thickness and volume, white matter lesions, fractional anisotropy, resting state functional connectivity, positron emission tomography markers of glucose metabolism and β-amyloid (Aβ) burden, and a measure of vascular risk. Participants were also tested annually on a battery of clinical and cognitive tests (median follow-up=5.0years, SD=1.66). We applied least absolute shrinkage and selection operator (LASSO) Cox models to determine the minimum set of non-redundant markers that predicts subsequent clinical progression from normal to MCI, adjusting for age, sex, and education.

23 participants (9.2%) progressed to MCI over the study period (mean years of followratification by identifying clinically normal individuals who are most likely to develop clinical symptoms and would likely benefit most from therapeutic intervention.The present study investigated functional connectivity and white matter integrity of the fronto-parietal network (FPN) to reveal the neural mechanisms that underlie late-life depression (LLD). Fifty patients with LLD and 40 non-depressed controls were included in the study. A multi-parametric approach was used by applying independent component analysis (ICA) to estimate functional connectivity of the FPN and by applying tract-based spatial statistics to examine white-matter integrity in tracts to the FPN. Patients with LLD exhibited functional abnormalities in the right inferior frontal gyrus, middle frontal gyrus, and inferior parietal gyrus and lower white matter fractional anisotropy in the right inferior fronto-occipital fasciculus, anterior thalamic radiation, and uncinate fasciculus. Alterations of functional connectivity and white matter fractional anisotropy in these regions were negatively correlated with the severity of symptomatic anxiety in LLD patients. The right inferior frontal gyrus might be a crucial hub in transferring information between these abnormal regions. Significant correlations were found between anxiety symptoms and brain alterations, suggesting that impairments in the FPN network might be involved in symptomatic anxiety in elderly individuals with depression.
This is a brief report of a systematic review and meta-analysis which examined the effectiveness of early childhood educational programs for preventing teenage pregnancy by synthesizing randomized control trials.

The search terms included 'children', 'early childhood intervention', and 'teen pregnancy'. Databases, bibliographies, grey literature, and policy reports were searched in February and March 2018 and included studies with interventions implemented with participants from birth to 5 years old.

Only four randomized control trials were eligible for inclusion. Individually, only two of the studies reported a significant effect of early childhood education. There was a significant effect for the primary outcome of teenage pregnancy prevention in the meta-analysis (RR 0.70, 95% CI 0.54-0.89). However, the evidence was very weak. The meta-analysis results were weighted heavily by one study. Additionally, the included studies were conducted decades ago, lacked rigor, and varied considerably by curricululdhood education for preventing teenage pregnancy. Future studies need to be designed to address the methodological challenges noted here to determine what facets of early childhood education most effectively prevent teenage pregnancy. Randomized control trials, while challenging to implement, are best suited to determine the true causal effect of early childhood education for preventing teenage pregnancy.
To compare non-pharmacological interventions in their ability to prevent delirium in critically ill patients, and find the optimal regimen for treatment.

Literature searches were conducted using PubMed, Embase, CINAHL, and Cochrane Library databases until the end of June 2019. We estimated the risk ratios (RRs) for the incidence of delirium and in-hospital mortality and found the mean difference (MD) for delirium duration and the length of ICU stay. The probabilities of interventions were ranked based on clinical outcomes. The study was registered on PROSPERO (CRD42020160757).

Twenty-six eligible studies were included in the network meta-analysis. Studies were grouped into seven intervention types physical environment intervention (PEI), sedation reducing (SR), family participation (FP), exercise program (EP), cerebral hemodynamics improving (CHI), multi-component studies (MLT) and usual care (UC). In term of reducing the incidence of delirium, the two most effective interventions were FP (risk ratio (Rptimal intervention techniques for preventing delirium and reducing ICU length of stay in critically ill patients by way of utilizing several interventions simultaneously. Additionally, family participation as a method of patient-centered care resulted in better outcomes for reducing the incidence of delirium.
Whether tumor mutation burden (TMB) affects prognosis and immune infiltration of tumor patients is controversial. We designed and conducted a multi-omics study with the aim of investigating the prognostic value of TMB and the relationship between TMB and immune infiltration in head and neck squamous cell carcinoma (HNSCC).

TMB scores were calculated from the mutation data of 506 HNSCC samples from The Cancer Genome Atlas (TCGA), and the patients were divided into low- and high-TMB groups according to the TMB score quartiles. Differentially expressed genes (DEGs) between the low-TMB and high-TMB groups were identified. Immune cell infiltration and survival analyses were conducted between groups.

High TMB in HNSCC patients was associated with a poor prognosis, large primary tumor size, advanced clinical stage and a human papillomavirus (HPV)-negative status. A total of 576 DEGs were identified, and gene set enrichment analysis (GSEA) revealed that the DEGs in the low-TMB group were enriched in immune-related pathways. Four hub genes were significantly associated with prognosis, and mutations in these genes affected immune infiltration. The estimated fractions of B memory cells and CD4+ memory resting cells were higher in the low-TMB group than in the high-TMB group, and B cell and CD4+T cell infiltration was positively correlated with prognosis in HNSCC patients.

HNSCC patients with low TMB have better prognoses than those with high TMB, and TMB might affect B cell and CD4+T cell infiltration.
HNSCC patients with low TMB have better prognoses than those with high TMB, and TMB might affect B cell and CD4+T cell infiltration.
The prognostic nutritional index (PNI) is an index reflecting the nutritional and inflammatory status of patients and is explored for prognosis in nasopharyngeal carcinoma (NPC). However, the data are conflicting. In the current study, a meta-analysis was performed to comprehensively clarify the association between PNI and prognosis of NPC.

PubMed, Web of Science, the Cochrane library, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched up to July 25, 2020. Hazard ratio (HR) and with 95% confidence interval (CI) were calculated to assess the impact of PNI on the survival outcomes of patients with NPC.

A total of 10 studies containing with 4511 patients were identified. The pooled results showed that NPC patients with a low PNI would have a worse overall survival (OS) (HR=1.89, 95%CI=1.59-2.25, p<0.001), distant metastasis-free survival (DMFS) (HR=2.01. 95%CI=1.66-2.43, p<0.001), progression-free survival (PFS) (HR=1.59, 95%CI=1.32-1.91, p<0.001), and locoregional recurrence-free survival (LRRFS) (HR=1.51, 95%CI=1.04-2.21, p=0.032). Subgroup analysis showed that the low PNI was still a significant prognostic factor for OS and DMFS.

Our meta-analysis demonstrated that a low PNI was significantly correlated to poor OS, DMFS, PFS, and LRRFS in NPC. Therefore, we suggest PNI applied as an indicator for prediction of the short- and long- term survival outcomes in patients with NPC.
Our meta-analysis demonstrated that a low PNI was significantly correlated to poor OS, DMFS, PFS, and LRRFS in NPC. Therefore, we suggest PNI applied as an indicator for prediction of the short- and long- term survival outcomes in patients with NPC.
In spite of the prevalence of occupational neck disorders as a result of work force fluctuating from industry to sedentary office work, most cervical spine computational models are not capable of simulating occupational and daily living activities whereas majority of cervical spine models specialized to simulate crash and impact scenarios. Therefore, estimating spine tissue loads accurately to quantify the risk of neck disorders in occupational environments within those models is not possible due to the lack of muscle models, dynamic simulation and passive spine structures.

In this effort the structure, logic, and validation process of an electromyography-assisted cervical biomechanical model that is capable of estimating neck loading under three-dimensional complex motions is described. this website The developed model was designed to simulate complex dynamic motions similar to work place exposure. Curved muscle geometry, personalized muscle force parameters, and separate passive and (electromyography-driven) active muscle force components are implemented in this model.

Calibration algorithms were able to reverse-engineer personalized muscle properties to calculate active and passive muscle forces of each individual.

This electromyography-assisted cervical spine model with curved muscle model is capable to accurately predict spinal tissue loads during isometric and dynamic head and neck activities. Personalized active and passive muscle force algorithms will help to more robustly investigate person-specific muscle forces and spinal tissue loads.
This electromyography-assisted cervical spine model with curved muscle model is capable to accurately predict spinal tissue loads during isometric and dynamic head and neck activities. Personalized active and passive muscle force algorithms will help to more robustly investigate person-specific muscle forces and spinal tissue loads.
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