Miracle-dz/UniFAR-FTUs huggingface dataset:
Serum Alanine Aminotransferase Elevations in Survivors of Childhood Cancer: A Report From the St. Jude Lifetime Cohort Study

The purpose of this study was to define the prevalence of and risk factors for elevated serum alanine aminotransferase (ALT) level among adult childhood cancer survivors (CCS). The study cohort comprised 2,751 CCS from the St. Jude Lifetime Cohort Study (>10 years postdiagnosis, age ≥18 years). Serum ALT level was graded using the Common Terminology Criteria for Adverse Events v. 4.03. Modified Poisson regression models were used to estimate relative risks and 95% confidence intervals for the association between demographic and clinical factors and grades 1‐4 ALT on the selected models. A total of 1,339 (48.7%) CCS were female; 2,271 (82.6%) were non‐Hispanic white. Median age at evaluation was 31.4 years (interquartile range [IQR] = 25.8‐37.8); median elapsed time from diagnosis to evaluation was 23.2 years (IQR = 17.6‐29.7). A total of 1,137 (41.3%) CSS had ALT > upper limit of normal (Common Terminology Criteria for Adverse Events v. 4.03 grade 1—1,058 (38.5%); grade 2—56 (2.0%); grade 3—23 (0.8%); grade 4—none). Multivariable models demonstrated non‐Hispanic white race/ethnicity, age at evaluation in years, being overweight or obese, presence of the metabolic syndrome, current treatment with atorvastatin or rosuvastatin or simvastatin, hepatitis C virus infection, prior treatment with busulfan or thioguanine, history of hepatic surgery, and the percentage of liver treated with ≥10 Gray, ≥15 Gray, or ≥20 Gray were associated with elevated ALT. Conclusion: Grade 3 or 4 hepatic injury is infrequent in CCS. Mild hepatic injury in this group may be amenable to lifestyle modifications.
Occupational exposure limits for manufactured nanomaterials, a systematic review

Abstract Background: The toxicological properties of manufactured nanomaterials (MNMs) can be different from their bulk-material and uncertainty remains about the adverse health effects they may have on humans. Proposals for OELs have been put forward which can be useful for risk management and workers’ protection. We performed a systematic review of proposals for OELs for MNMs to better understand the extent of such proposals, as well as their derivation methods. Methods: We searched PubMed and Embase with an extensive search string and also assessed the references in the included studies. Two authors extracted the data independently. Results: We identified 20 studies that proposed in total 56 OEL values. Of these, two proposed a generic level for all MNMs, 14 proposed a generic OEL for a category of MNMs and 40 proposed an OEL for a specific nanomaterial. For specific fibers, four studies proposed a similar value but for carbon nanotubes (CNTs) the values differed with a factor ranging from 30 to 50 and for metals with a factor from 100 to 300. The studies did not provide explanations for this variation. We found that exposure to MNMs measured at selected workplaces may exceed even the highest proposed OEL. This indicates that the application and use of OELs may be useful for exposure reduction. Conclusion: OELs can provide a valuable reference point for exposure reduction measures in workplaces. There is a need for more and better supported OELs based on a more systematic approach to OEL derivation.
Perfil demográfico e sócio-econômico do estudante de enfermagem da UECE

The study approaches the main characteristics of nursing students concerning demographic aspects, demographic mobility, instruction level, occupational situation, attendance to another University Course, information about career and the oportunity of work among other items. As an instrument to collect data, we have used a questionnaire with open and closed questions. The data analysis was based on the students' answers, having as a direction a critical view on these data, which have been compiled in tables. The research outcome revealed that most nursing students are female (88%); 57% come from Fortaleza - CE and 60.2% still live under their parents' guardianship. From the investigated students 18.7% parents have graduated from a University and 88.4% have lived in rented houses.
The integrated biomarker response: a suitable tool to evaluate toxicity of metal-based nanoparticles

Abstract Nanotechnology is a much promising field of science and technology with applications in a wide range of areas such as electronics, biomedical applications, energy and cosmetics. Metal-based engineered nanoparticles (ENPs) are common in many technological applications; some of the most common nanoparticles available commercially are silver, gold, copper oxide (CuO), zinc oxide (ZnO) and cadmium sulphide (CdS). The toxicity of metal-based NPs may be either due to their specific physical characteristics as NPs or to the specific toxicity of metals released from NPs under environmental conditions. In this study we evaluated the toxicity effects of a range of ENPs (Ag, Au, CuO, CdS, ZnO) along with a control containing equivalent quantities of dissolved metal on two endobenthic species: the ragworm Hediste diversicolor and the bivalve Scrobicularia plana. A suite of complementary biomarkers was used to reveal toxicity effects. A common challenge in multibiomarkers studies is to go beyond an independent interpretation of each one, and to assess a global response of individuals. The Integrated Biomarker Response (IBR) was calculated for both species exposed to the different metal-based ENPs studied or to their dissolved metal counterpart to provide efficient and easy tools for environmental managers. We evidence that metal-based NPs lead to an overall difference in biological responses from that of their dissolved counterparts. The IBR could thus be considered as an efficient tool to transfer research results to stakeholders with possible implementation for regulatory purposes.
The feasibility and effectiveness of emergency department based hypertension screening: A systematic review

Purpose: Hypertension is a highly prevalent risk factor for cardiovascular disease, and its early identification and management results in reductions in morbidity and mortality. Our objectives were to: (1) determine the extent to which the emergency department (ED) has been used to screen patients for undiagnosed hypertension; (2) estimate the incidence of undiagnosed hypertension in the ED population; (3) identify and describe the programs for ED hypertension screening; and (4) determine the feasibility of ED‐based hypertension screening programs and the requirements for further study. Data sources: An online search of databases (i.e., OVID Search, CINAHL, Scopus, Web of Science), unpublished sources (i.e., ProQuest Dissertation & Theses and Papers First), and grey literature (i.e., OpenSIGLE and the New York Academy of Grey Literature) was conducted. A manual search of the reference lists of relevant studies was also completed. Conclusion: Hypertension screening in the ED is feasible. Individuals with elevated blood pressure (BP) in the ED should be referred for follow‐up. Further study is needed to develop an ED screening tool that is predictive of persistently elevated BP in undiagnosed individuals. Implications for practice: Nurse practitioners in the ED should identify patients with elevated BP, provide hypertension education, and ensure appropriate intervention and referral.
Lipid Peroxides and Essential Fatty Acids in Patients with Coronary Heart Disease

Coronary heart disease (CHD) is considered to be more common among Indians than Western populations. In patients confirmed to have CHD, plasma lipid peroxides were found to be high, whereas the n-6 fatty acid gamma-linolenic acid and the metabolites of alpha-linolenic acid (n-3 fatty acid), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were significantly lower in the plasma phospholipid fraction. EPA and DHA and anti-oxidant vitamin E are believed to have a protective action against CHD. These results suggest that increased formation of lipid peroxides and low plasma levels of EPA and DHA are closely associated with CHD in Indians. If so, this suggests that supplementation of EPA and DHA and anti-oxidants such as vitamin E may be indicated to prevent CHD in Indians.
Involvement of the cytokine–IDO1–AhR loop in zinc oxide nanoparticle-induced acute pulmonary inflammation

Abstract Zinc oxide nanoparticles (ZnONPs) are widely used in our daily life, such as in sunscreens and electronic nanodevices. However, pulmonary exposure to ZnONPs causes acute pulmonary inflammation, which is considered as an initial event for various respiratory diseases. Thus, elucidation of the underlying cellular mechanisms of ZnONPs can help us in predicting their potential effects in respiratory diseases. In this study, we observed that ZnONPs increased proinflammatory cytokines, accompanied with an increased expression of aryl hydrocarbon receptor (AhR) and its downstream target cytochrome P450 1A1 (CYP1A1) in macrophages in vitro and in mouse lung epithelia in vivo. Moreover, zinc nitrate, but not silica or titanium dioxide nanoparticles (NPs), had similar effects on macrophages, indicating that the zinc element or ion released from ZnONPs is likely responsible for the activation of the AhR pathway. Cotreatment with an AhR antagonist or AhR knockout reduced ZnONPs-induced cytokine secretion in macrophages or mice, respectively. Furthermore, kynurenine (KYN), an endogenous AhR agonist and a tryptophan metabolite catalyzed by indoleamine 2,3-dioxygenase (IDO), was increased in the serums of mice that aspirated ZnONPs. Consistently, ZnONPs increased IDO1 expression in lung cells in vitro and in vivo. Finally, AhR knockout reduced ZnONPs-induced pulmonary inflammation, cytokine secretion and KYN production in mice, suggesting that AhR activation is involved in ZnONPs-induced cytokine secretion and pulmonary inflammation. In summary, we demonstrated that the pulmonary exposure of ZnONPs stimulated the cytokine–IDO1–AhR loop in the lungs, which has been implied to play roles in immune dysfunctions.
Liver Complications Following Treatment of Hematologic Malignancy With Anti‐CD22‐Calicheamicin (Inotuzumab Ozogamicin)

Treatment of hematological malignancy with antibody‐drug conjugates (ADCs) may cause liver injury. ADCs deliver a toxic moiety into antigen‐expressing tumor cells, but may also injure hepatic sinusoids (sinusoidal obstruction syndrome; SOS). We studied patients who received an anti‐CD22/calicheamicin conjugate (inotuzumab ozogamicin; InO) to gain insight into mechanisms of sinusoidal injury, given that there are no CD22+ cells in the normal liver, but nonspecific uptake of ADCs by liver sinusoidal endothelial cells (LSECs). Six hundred thirty‐eight patients (307 with acute lymphocytic leukemia [ALL], 311 with non‐Hodgkin’s lymphoma [NHL]) were randomized to either InO or standard chemotherapy (controls). While blinded to treatment assignment, we reviewed all cases with hepatobiliary complications to adjudicate the causes. Frequency of SOS among patients who received InO was 5 of 328 (1.5%), compared to no cases among 310 control patients. Drug‐induced liver injury (DILI) developed in 26 (7.9%) InO recipients and 3 (1%) controls. Intrahepatic cholestasis (IHC) was observed in 4.9% of InO recipients and in 5.5% of controls. Subsequent to the randomization study, 113 patients with ALL underwent allogeneic hematopoietic cell transplantation (HCT); frequency of SOS in those previously exposed to InO was 21 of 79 (27%) versus 3 of 34 (9%) in controls. An exploratory multivariate model identified a past history of liver disease and thrombocytopenia before conditioning therapy as dominant risk factors for SOS after transplant. Conclusion: Frequencies of SOS and DILI after inotuzumab ozogamicin treatment were 1.5% and 7.9%, respectively, compared to none and 1% among controls who received standard chemotherapy. These data suggest that ADCs that do not target antigens present in the normal liver have a relatively low frequency of SOS, but a relatively high frequency of DILI.
Titanium dioxide nanoparticle exposure alters metabolic homeostasis in a cell culture model of the intestinal epithelium and Drosophila melanogaster

Abstract Nanosized titanium dioxide (TiO2) is a common additive in food and cosmetic products. The goal of this study was to investigate if TiO2 nanoparticles affect intestinal epithelial tissues, normal intestinal function, or metabolic homeostasis using in vitro and in vivo methods. An in vitro model of intestinal epithelial tissue was created by seeding co-cultures of Caco-2 and HT29-MTX cells on a Transwell permeable support. These experiments were repeated with monolayers that had been cultured with the beneficial commensal bacteria Lactobacillus rhamnosus GG (L. rhamnosus). Glucose uptake and transport in the presence of TiO2 nanoparticles was assessed using fluorescent glucose analog 2-(N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-2-deoxyglucose (2-NBDG). When the cell monolayers were exposed to physiologically relevant doses of TiO2, a statistically significant reduction in glucose transport was observed. These differences in glucose absorption were eliminated in the presence of beneficial bacteria. The decrease in glucose absorption was caused by damage to intestinal microvilli, which decreased the surface area available for absorption. Damage to microvilli was ameliorated in the presence of L. rhamnosus. Complimentary studies in Drosophila melanogaster showed that TiO2 ingestion resulted in decreased body size and glucose content. The results suggest that TiO2 nanoparticles alter glucose transport across the intestinal epithelium, and that TiO2 nanoparticle ingestion may have physiological consequences.
The impact of familism on physical and mental health among Hispanics in the United States

The rapidly expanding number of Hispanics living in USA has increased the need for their inclusion in research on physical and mental health. Current studies that have explored health outcomes among Hispanics have often noted an ‘epidemiological paradox’, in which there is a discrepancy between their minority status and positive health outcomes when compared with other racial/ethnic groups. Certain socio-cultural variables, in particular the value placed on family, have been largely implicated in these findings. This review will provide a summary of the literature exploring familism within the structure of the Hispanic family and its potential impact on health. We will focus on research exploring the plausible impact that family and familism values may have on the physical health (particularly within the HIV, diabetes, and breast cancer literature) and also on health behaviours of Hispanics, as well as its effect on mental health (particularly related to acculturative stress and caregiver stress). Throughout the review, we highlight some of the potential mechanisms by which familism may impact on the health status of Hispanics. We conclude the review by noting some of the clinical and ethical implications of this research, and by offering suggestions for future work in this area.
Comprehensive Textbook of Psychiatry, IV

Study Guide and Self-examination Review for Modern Synopsis of Comprehensive Textbook of Psychiatry, IV, by Harold I. Kaplan and Benjamin J. Sadock, ed 2; 551 pp, with illus, paper, $22.95, Baltimore, Williams & Wilkins, 1985. Since the first edition of the Comprehensive Textbook of Psychiatry appeared in 1967, subsequent versions of the text have served to reflect the evolution of pyschiatry in further establishing its theoretical and scientific basis. The fourth edition in this series is generally consistent with this tradition, encapsulating the trends and significant advances that have occurred in the field as of mid-1983 to late 1983, when most of the chapters were written or revised. For example, the chapter on affective disorders has been expanded and reorganized and contains new sections on epidemiology, biochemistry, genetics, and pharmacotherapy, which provide comprehensive summaries of the wealth of recent psychiatric research in this area. The chapters on child and adolescent
Scale quality: alpha is an inadequate estimate and factor-analytic evidence is needed first of all

ABSTRACT Cronbach's alpha is a commonly reported estimate to assess scale quality in health psychology and related disciplines. In this paper, we argue that alpha is an inadequate estimate for both validity and reliability – two key elements of scale quality. Omega is a readily available alternative that can be used for both interval and ordinal data. More importantly, we argue that factor-analytic evidence should be presented before assessing the internal structure of a scale. Finally, pointers for readers and reviewers of manuscripts on making judgements about scale quality are provided and illustrated by examples from the field of health psychology.
Corticosteroids in Solid Organ Transplantation: Update and Review of the Literature

Corticosteroids have been a constant in immunosuppressive regimens since the beginning of solid organ transplantation. Although the use of corticosteroids allowed the advancement of transplantation in the early years, this came at the price of numerous adverse events for patients. As the survival of transplanted organs has risen over the past several years, increasing attention has been focused on the management of long-term complications. Many of these long-term complications are directly related to the toxicities of immunosuppressive agents. Due to these toxicities, we have seen a resurgence in immunosuppressive protocols that utilize regimens designed to minimize these long-term complications. This has been accomplished by avoiding, reducing or withdrawing one or more medications from the multi-drug regimens. Corticosteroids, with their plethora of side affects, have been of major interest to the transplant community in terms of minimizing side affects by limiting exposure.
Meaning in life and physical health: systematic review and meta-analysis

ABSTRACT This systematic review and meta-analysis aimed to clarify the associations between meaning in life and physical health using random-effects models. Conceptualisation of meaning (order in world vs. purpose in life), type of health indicators, participants’ health status, and age issues were investigated as moderators. Systematic searches of six databases resulted in inclusion of k = 66 studies (total N = 73,546). Findings indicated that meaning in life and physical health formed weak-to-moderate associations (the overall estimate of the average effect = 0.258). Conceptualisation of meaning, participants’ health status, and their age did not moderate these associations. Operationalisation of health moderated the relationship between meaning in life and health. The strongest associations were found for subjective indicators of physical health. Significant albeit weak associations between meaning in life and objective indices of health were found. Furthermore, stronger effects were observed when the measures of meaning combined items referring to meaning in life and meaning-related sense of harmony, peace, and well-being, compared to measures focusing solely on meaning in life. Overall, the results point to the potential role of meaning in life in explaining physical health.
Evaluation of a Multifaceted Intervention to Reduce Health Disparities in Hepatitis C Screening: A Pre‐Post Analysis

Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety‐net health system. We performed a multifaceted intervention that included provider and patient education, an electronic medical record–enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the preintervention and postintervention groups and used a generalized linear mixed model for patients observed in both preintervention and postintervention time frames. Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened (P < 0.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high‐risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), human immunodeficiency virus–positive patients, and homeless patients. Postintervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with more than one prior primary care appointment. Conclusion: Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels.
On boredom: A close encounter with encapsulated parts of the psyche

The psychoanalytical literature has numerous scattered references to the analyst’s experience of boredom, especially amongst writers working with primitive mental states. In the present paper, the author tries to gather some of these references in an attempt to integrate the various facets of this widespread phenomenon, and reflect on some clinical issues and dilemmas it raises. It is suggested that the experience of boredom in analysis may be a reaction to an encounter with a hidden, encapsulated part of the psyche, a bidimensional area of experience in which mental activity has been suspended, and experience remains meaningless. This is a barren area of lack, an encounter with the autistic core of the psyche. However, boredom may also be an experiential expression of despair, a re‐living of primitive object relations with an emotionally non‐existent primary object. Through bringing the emptiness and desolation into analysis, the individual makes room for the empty, blunt, dead inner object which resides within him, and that needs to be integrated into the psyche. This inner object is a vital part of the patient’s inner world, part of his history, and can neither be erased nor filled in order to eradicate the emptiness. This is illustrated by clinical material from patients along the spectrum of autism, autistic reaction following trauma and autistic barriers in neurotic patients.