Miracle-dz/UniFAR-FTUs huggingface dataset:
Managing the risk of venous thromboembolism in transgender adults undergoing hormone therapy

Introduction: Venous thromboembolism (VTE) is a potential risk of estrogen therapy. However, data show an improvement in the quality of life for transgender people who use feminizing hormone therapy. With few transgender-specific data, guidance may be drawn from cisgender (nontransgender) data, with a focus on hormonal birth control and postmenopausal hormone replacement therapy (HRT). The aim of this review is to examine the degree to which routes of administration, patient comorbidities, and type of hormone utilized affect the safety of estrogen therapy. Methods: We identified 6,349 studies by searching PubMed with the terms “transgender”, “estrogen”, “VTE”, and “HRT”. Of these, there were only 13 studies between 1989 and 2018 that investigated the effects of hormone therapy, including types of estrogens used, in transgender women and men. Results: The data suggest that the route of hormone administration, patient demographics, and patient comorbidities all affect estrogen’s link with VTE. For example, avoiding ethinyl estradiol might make the use of hormone therapy in trans feminine individuals safer than oral birth control. Data from both cis and trans groups suggest additional VTE risk associated with the use of progestins. While transdermal estrogens dosed up to 0.1 mg/day or below appear lower risk for VTE than other forms of estrogen, it is unclear whether this is related to the delivery method or a dose effect. Finally, even if the risk from exogenous estrogen use remains significant statistically, the absolute clinical risk remains low. Conclusion: Clinicians should avoid the use of ethinyl estradiol. Additionally, data suggest that progestins should be avoided for transgender individuals. Further study of the relationship between estrogen use and the risk of VTE will serve to inform the safest care strategies for transgender individuals.
Chlorins e6 loaded silica nanoparticles coated with gastric cancer cell membrane for tumor specific photodynamic therapy of gastric cancer

Background: Photodynamic therapy (PDT) is widely recognized as a promising way to cure cancer. However, the limited tumor homing property of currently available drug delivery systems (DDSs) is the bottleneck for the delivery of photodynamic agents. Purpose: In our study, we decorated silica nanoparticles (SLN) with cell membrane (CM) derived from SGC7901 cells to construct carrier (CM/SLN) which was able to to specifically target the homogenous SGC7901 cells. Materials and methods: Furthermore, the decent drug loading capability of CM/SLN was adopted to load photodynamic agent chlorins e6 (Ce6) to finally construct aDDS suitable for tumor-targeted PDT of gastric cancer. Results: The experimental results suggested that CM/SLN/Ce6 was nano-sized particles with good dispersion and stability in physiological conditions. Moreover, due to the modification of CM,CM/SLN/Ce6 could specifically target the homogenous SGC7901 cells both in vitro and in vivo. Most importantly, further in vivo results demonstrated that the CM/SLN/Ce6 showed a better anticancer outcome compared to SLN/Ce6. Conclusion: CM/SLN/Ce6 might be a promising platform for effective tumor targeted PDT of gastric cancer.
Alcohol consumption, tobacco smoking, betel quid chewing and oral health associations with hypopharyngeal cancer among men in Central South China: a case–control study

Background Hypopharyngeal cancer has relatively high incidence rates in China, especially in high-risk areas. However, data on the role of major risk factors in these areas of China are still limited. Methods We have evaluated the roles of alcohol, tobacco and betel quid consumption, and oral health, based on 278 hypopharyngeal cancer cases and 693 controls from two centers in Central South China. The odds ratio (OR) and 95% confidence interval (CI) values were estimated using logistic regression. Results We found that alcohol drinkers had a risk of hypopharyngeal cancer that was up to seven times higher than that for those who had never drunk. A very strong effect of traditional liquor as compared to other alcohol types was observed, with the OR reaching 11.26 (CI 6.53–19.41) for this cancer. Tobacco smokers were up to four times more likely to develop hypopharyngeal cancer than never smokers. The OR for betel quid chewing was 1.86 (CI 1.26–2.75) as compared to never users. Poor oral hygiene had a risk of hypopharyngeal cancer that was two times higher than that for normal oral hygiene. Conclusion In this study, we have shown for what is believed to be the ﬁrst time the association of increased hypopharyngeal cancer incidence with alcohol, tobacco, betel quid and oral hygiene in China. Alcohol may play a larger role for hypopharyngeal cancer in this population than in populations in other areas.
Comparative review of drug–drug interactions with epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small-cell lung cancer

Abstract The development of small-molecule tyrosine kinase inhibitors (TKIs) that target the epidermal growth factor receptor (EGFR) has revolutionized the management of non-small-cell lung cancer (NSCLC). Because these drugs are commonly used in combination with other types of medication, the risk of clinically significant drug–drug interactions (DDIs) is an important consideration, especially for patients using multiple drugs for coexisting medical conditions. Clinicians need to be aware of the potential for clinically important DDIs when considering therapeutic options for individual patients. In this article, we describe the main mechanisms underlying DDIs with the EGFR-TKIs that are currently approved for the treatment of NSCLC, and, specifically, the potential for interactions mediated via effects on gastrointestinal pH, cytochrome P450-dependent metabolism, uridine diphosphate-glucuronosyltransferase, and transporter proteins. We review evidence of such DDIs with the currently approved EGFR-TKIs (gefitinib, erlotinib, afatinib, osimertinib, and icotinib) and discuss several information sources that are available online to aid clinical decision-making. We conclude by summarizing the most clinically relevant DDIs with these EFGR-TKIs and provide recommendations for managing, minimizing, or avoiding DDIs with the different agents.
Long noncoding RNA DANCR contributes to docetaxel resistance in prostate cancer through targeting the miR-34a-5p/JAG1 pathway

Background: Chemotherapy is one of the available options for prostate cancer (PC). However, the acquisition of chemoresistance has become a major cause of chemotherapy failure. The long noncoding RNA DANCR is demonstrated to serve as an oncogene in various human cancers, including PC. However, the potential role of DANCR in docetaxel (DTX) resistance of PC and its underlying mechanism remains unclear. Methods: The abundance of DANCR, miR-34a-5p, and JAG1 mRNA was examined by quantitative reverse transcription PCR. The Cell Counting Kit-8 (CCK8) was used to determine the 50% inhibitory concentration value. Cell viability was evaluated by CCK8 and colony-formation assays. Transwells were utilized to analyze cell migration and invasion ability. The protein levels of LRP, P-gp, MRP1, and JAG1 were measured by Western blot assay. The target relationship between DANCR and miR-34a-5p, as well as miR-34a-5p and JAG1, was demonstrated by dual-luciferase, RNA immunoprecipitation, and RNA pull-down analysis. Tumor xenograft was undertaken to confirm the effect of DANCR on DTX resistance in PC. Results: DANCR and JAG1 were significantly upregulated, but miR-34a-5p was downregulated in DTX-resistant PC. Silencing of DANCR improved the DTX efficacy in DTX-resistant PC cells. DANCR served as a competing endogenous RNA of miR-34a-5p, leading to the derepression of miR-34a-5p target JAG1, which eventually triggered the resistance to DTX in DTX-tolerated PC. Conclusion: The DANCR/miR-34a-5p axis enhanced DTX resistance of PC via targeting JAG1, providing a novel insight to improve chemotherapy for PC.
Ezrin promotes pancreatic cancer cell proliferation and invasion through activating the Akt/mTOR pathway and inducing YAP translocation

Background Ezrin and YAP are abnormally expressed in various cancers, and play pivotal roles in cancer initiation and development. However, the mechanisms of Ezrin in pancreatic cancer have not been fully elucidated. In this study, we aimed to elucidate the functions and mechanisms of Ezrin in the pathogenesis of pancreatic cancer. Methods Effects of Ezrin deregulation on pancreatic cancer phenotype were determined in Capan-1 and BxPC-3 cells using MTT, colony formation, transwell, wound-healing, and chick chorioallantoic membrane assays. To find out the underlying mechanism of Ezrin, multiple assays were performed to detect the effect of Ezrin on Akt pathway activation and YAP expression. Then, Ezrin and YAP expression was analyzed in pancreatic cancer and normal pancreas samples. Finally, the prognostic value of Ezrin and YAP was evaluated in pancreatic cancer patients. Results Ezrin promoted proliferation, invasion, epithelial-mesenchymal transition (EMT) progression, and angiogenesis of pancreatic cancers. Mechanistically, Ezrin activated Akt/mTOR pathways and induced YAP phosphorylation and nucleus translocation. The PI3K/Akt pathway inhibitor, rapamycin, and LY294002 could partially attenuate the effect of Ezrin on cell proliferation, invasion, EMT progression, and YAP phosphorylation and translocation. Moreover, both Ezrin and YAP were significantly overexpressed in pancreatic cancer tissues compared with adjacent normal pancreas, and correlated with poor prognosis in pancreatic cancer patients. Multivariate survival analysis showed that Ezrin was an independent prognostic marker for pancreatic cancer. Furthermore, the expression status of Ezrin and YAP had positive correlations in pancreatic cancer tissues. Conclusion Ezrin promoted pancreatic cancer proliferation, invasion, migration, and EMT progression, partially through activating the PI3K/Akt pathway, and also regulated YAP phosphorylation and translocation, partially through the PI3K/Akt pathway. Ezrin and YAP were significantly overexpressed in pancreatic cancers, and correlated with poor prognosis in pancreatic cancer patients.
Green nanotechnology: a review on green synthesis of silver nanoparticles — an ecofriendly approach

Background: Nanotechnology explores a variety of promising approaches in the area of material sciences on a molecular level, and silver nanoparticles (AgNPs) are of leading interest in the present scenario. This review is a comprehensive contribution in the field of green synthesis, characterization, and biological activities of AgNPs using different biological sources. Methods: Biosynthesis of AgNPs can be accomplished by physical, chemical, and green synthesis; however, synthesis via biological precursors has shown remarkable outcomes. In available reported data, these entities are used as reducing agents where the synthesized NPs are characterized by ultraviolet-visible and Fourier-transform infrared spectra and X-ray diffraction, scanning electron microscopy, and transmission electron microscopy. Results: Modulation of metals to a nanoscale drastically changes their chemical, physical, and optical properties, and is exploited further via antibacterial, antifungal, anticancer, antioxidant, and cardioprotective activities. Results showed excellent growth inhibition of the microorganism. Conclusion: Novel outcomes of green synthesis in the field of nanotechnology are appreciable where the synthesis and design of NPs have proven potential outcomes in diverse fields. The study of green synthesis can be extended to conduct the in silco and in vitro research to confirm these findings.
Fixed-Time Schedule Effects on Participant Responding: An Evaluation Of Similar vs. Dissimilar Schedule Programs Using a Group Design Approach

iv Introduction . 1 Method . 36 Design, Participants, Setting, and Apparatus . 36 Measurement . 36 Procedures . 37 Instructions . 37 Response Training . 37 Noncontingent Reinforcement . 38 Data Analyses . 39 Results . 41 Testing Statistical Assumptions . 41 Treatment Effectiveness . 41 Discussion . 44 References . 56 Appendix: Institutional Review Board Approval . 66 Vita . 67
A Descriptive Study to Assess the Level of Smartphone Addiction and Quality of Sleep among Student Nurses in Selected College of Nursing, New Delhi

Background: Diabetes Mellitus (DM) has emerged as an epidemic problem in Egypt. The global increase in the prevalence of Diabetes Mellitus is attributed to many risk factors, as inactive lifestyles. Many risk factors have been identified as modifiable or non modifiable risk factors. Risk Reduction Intervention is a cornerstone for prevention and controls many of chronic diseases. Aim, the present study was to examine the effect of risk reduction intervention on reducing selected Un-Healthy Life-Style of modifiable risk factors Diet and Exercise among adult Women with Type 2 Diabetes Mellitus. Methods: Design: A quasi experimental design was used. Sample: A convenience Sample of 104 adult women who diagnosed as type 2 diabetes was selected. Setting: this study was conducted in the out-patient clinics of Teaching Hospital in Shebin El-Kom City. Tools for data collection: A) Interviewing questionnaire to collect socio-demographic characteristics, B), 24 hours dietary recall questionnaire, C) Exercise questionnaire and C) Bio-physiological Measurements: to measure BMI & blood chemistry. Results: Regarding total calories per day, a dramatic decrease was observed in the Mean ± SD in post than pre intervention (1503. 1 ± 412.9to 2030.9 ±892.4 respectively). Also total Cholesterol, a decrease was observed in the Mean ± SD in post than pre intervention 189.28±32.9 to 203.97±47.3 respectively). Also redacting random blood sugar was observed in post than pre intervention (157.5±37.9 than 227.8±128.9 to respectively). Conclusions: Implementation of risk reduction interventions was more effective and can favorably decrease some of modifiable risk factors among adult diabetic women. Recommendation: Encourage nurses to provide health education about risk reduction interventions to enhance adoption of healthy lifestyle behavior.
The effect of feeding with hemp and Camelina cakes on the fatty acid profile of duck muscles

Abstract. Camelina (Camelina sativa L. Crantz) and hemp (Cannabis sativa L.) seed cakes are rich sources of n-3 polyunsaturated fatty acids (PUFAs). This study was carried out to investigate the effects of Camelina and hempseed cakes in the diet of ducks on the intramuscular fatty acid profile. Male ducks (n = 99) were randomly allocated to 3 dietary treatments: Control or C group (wheat–soybean-meal–barley-based diet with 15–20 % rapeseed cake), Experimental 1 or HEM group (with hempseed cake added at 15–20 % instead of rapeseed cake), and Experimental 2 or CAM group (with Camelina cake added at 15–20 % instead of rapeseed cake). All groups received the diets ad libitum. At 49 days of age, six ducks from each group were slaughtered for analysis of the fatty acid composition in the breast and leg muscles. Feeding ducks with the diet enriched with Camelina cake resulted in significantly higher amounts of n-3 α-linolenic fatty acid (ALA) (P≤0.01) and total n-3 PUFA (P≤0.01) in breast and leg muscles, while eicosatrienoic fatty acid (ETE) (P≤ 0.01) was higher in the leg muscle. The ratios of n-6 ∕ n-3 and linoleic ∕ α-linolenic fatty acids (P≤ 0.01) decreased significantly compared to the Control and HEM groups of ducks. Feeding ducks with the diet enriched with hempseed cake resulted in significantly higher amounts of linoleic (LA) (P≤ 0.01), total n-6 PUFA (P≤ 0.05–P≤ 0.01) and n-6 γ-linolenic (GLA) (P≤ 0.01) fatty acid. Our study showed that using Camelina cake as supplementation in duck diets opens a possibility to develop functional food, i.e. meat with a significantly higher content of ALA, total n-3 PUFA and the lowest ratios of n-6 ∕ n-3 fatty acids in ducks' muscles. A duck diet with hempseed cake produces exceptional-quality meat with an enriched content of n-6 GLA.
Does Routine Anti-Osteoporosis Medication Lower the Risk of Fractures in Male Subjects? An Updated Systematic Review With Meta-Analysis of Clinical Trials

Background: Several epidemiological articles have reported the correlations between anti-osteoporosis medication and the risks of fractures in male and female subjects, but the specific efficacy of anti-osteoporosis medication for male subjects remains largely unexplored. Objective: The aim of this study was to evaluate the correlation between anti-osteoporosis medication and the risk of fracture in relation to low bone mass [including outcomes of osteoporosis, fracture, and bone mineral density (BMD) loss] in male subjects analyzed in studies within the updated literature. Methods: Randomized controlled trials (RCTs) that analyzed the effectiveness of a treating prescription for male subjects with osteoporosis (or low BMD) and that focused on the outcomes of fracture were included. Relevant studies from Embase, Web of Science, PubMed, and Chinese database of CNKI were retrieved from inception to January 30th, 2019. Two staff members carried out the eligibility assessment and data extraction. The discrepancies were settled by consultation with another researcher. We calculated the pooled relative risks (RRs) based on 95% confidence intervals (CIs). Results: Twenty-seven documents (28 studies) with 5,678 subjects were identified. For the category of bisphosphonates, significant results were observed in pooled analyses for decreased risk of the vertebral fracture domain (RR, 0.44 [95% CI, 0.31–0.62]), nonvertebral fracture domain (RR, 0.63 [95% CI, 0.46–0.87]), and clinical fracture domain (RR, 0.59 [95% CI, 0.48–0.72]) compared with those of controls. Participants with bisphosphonates had a 56% (95% CI = 38–69%) lower risk of vertebral fractures, 37% (95% CI = 13–54%) lower risk of nonvertebral fractures, and 41% (95% CI = 28–52%) lower risk of clinical fractures. Furthermore, meta-analyses also demonstrated a decreased risk of the vertebral fracture domain via treatment with risedronate (RR, 0.45 [95% CI, 0.28–0.72]) and alendronate (RR, 0.41 [95% CI, 0.23–0.74]), but not with calcitriol, calcitonin, denosumab, ibandronate, monofluorophosphate, strontium ranelate, teriparatide, or zoledronic acid, compared with that of controls. Conclusions: This systematic review confirms that bisphosphonates were connected with a decreased risk of vertebral fractures, nonvertebral fractures, and clinical fractures for male subjects with osteoporosis. Future research is needed to further elucidate the role of nonbisphosphonates in treating fractures of osteoporosis subjects.
Post-hepatectomy biliary fistula: from risk factors to the role of drain placement and management-still a lot to be answered.

Hepatic resection represents the gold-standard treatment for different liver diseases. Among postoperative complications, bile leak remains one of the most common sources of morbidity, which can lead to an increase of hospital stay, need of invasive procedure and potentially death (1). The definition and acknowledge of risk factors for the development of biliary fistula as well as its early detection and optimal management is, in this sense, of crucial importance.
Healthcare Professionals' Knowledge of Neonatal Resuscitation in Ethiopia: Analysis from 2016 National Emergency Obstetric and Newborn Care Survey

Background Birth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the principal causes of neonatal mortality in Ethiopia. Adequate knowledge of newborn resuscitative procedures plays an important role in early diagnoses and suitable management. However, there are limited data on healthcare professionals' knowledge about neonatal resuscitation. Thus, this study aimed to determine the knowledge of healthcare professionals about neonatal resuscitation and factors affecting it. Methods Data from the Ethiopian 2016 national Emergency Obstetric and Newborn Care survey of 3,804 health facilities that provided maternal and newborn health services were analyzed. We have included 3804 healthcare providers, who attended the largest number of deliveries in the last month prior to the survey, and assessed their knowledge of neonatal resuscitation. It was also determined whether certain factors were associated with healthcare providers' knowledge through linear regression method. Result The overall knowledge score of the healthcare providers about neonatal resuscitation ranged from 12 to 24 out of 37 items (with mean score of 18.4 (±5.47) and mean score percentage of 49%). The findings showed that providers trained on neonatal resuscitation (β=2.65, 95% CI: 0.65, 4.62; p <0.00), facilities that had guideline of neonatal resuscitation (β=2.50, 95% CI: 0.60, 3.52; p =0.01), and availability of essential equipment (β=0.95, 95% CI: 0.44, 1.45; p =0.02) were significantly associated with sufficient knowledge of neonatal resuscitation in Ethiopia. Conclusion Overall knowledge of neonatal resuscitation was insufficient. Trained healthcare providers, having guideline on neonatal resuscitation, and availability of essential equipment were significantly associated with knowledge of neonatal resuscitation. Competency and simulation-based in-service training and refresher training complemented by supportive supervision and mentorship are helpful ways to put up providers capability to perform neonatal resuscitation.
HISTOMORPHOLOGICAL FEATURES OF ATHEROSCLEROSIS IN THE LEFT ANTERIOR DESCENDING CORONARY ARTERIES AMONG BLACK KENYANS

The pattern of coronary artery atherosclerosis is valuable in informing mitigation strategies for coronary heart disease. Histomorphological data on this disease among Africans living in Sub Saharan Africa are, however, scarce. The left anterior descending is one of the most commonly afflicted arteries. This study, therefore, examined the left anterior descending artery of 213 black Kenyans [Mean age 36.8 years, range 5 – 82 years] who had died of non cardiovascular causes for features of atherosclerosis. The individuals were divided into male and female, then into 10-yr age groups. Specimens were obtained from the proximal segment of the artery during autopsy at the Department of Human Anatomy University of Nairobi, Kenya. They were processed routinely for paraffin embedding and sectioning. Five micron sections were stained with Haematoxylin/Eosin and Mason’s trichrome and examined with light microscope. Micrographs of representative features were taken using a high resolution digital camera. At least one feature of atherosclerosis was present in 54 (25.4%) of the individuals. The features observed included severe intimal hyperplasia (34; 63%), disintegration of the internal elastic lamina [30; 55.6%]; atherosclerotic plaque (20; 37%), adventitial thicknening (14; 26%) and mural neovascularization (10; 18.5%). The mean age of those with features of atherosclerosis was 38.4 years, range 6 – 62 years with 25 (46.3%) being aged 40 years and below. Of these, the male: female ratio was 1.7:1. In conclusion, features of atherosclerosis are present in over 25% of the population studied. The disease affects young people, including women. Proactive preventive measures including follow – up should commence early, and involve both men and women
Increasing Evidence for the Association of Breast Implant-Associated Anaplastic Large Cell Lymphoma and Li Fraumeni Syndrome

We report a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) occurring in a 53-year-old female with Li Fraumeni syndrome (LFS) with a prior history of breast cancer. We present the clinical features, investigation, and management of this patient and potential mechanisms that could explain the increasing association of BIA-ALCL and LFS.