Miracle-dz/UniFAR-FTUs huggingface dataset:
Preventative and Therapeutic Effects of Metformin in Gastric Cancer: A New Contribution of an Old Friend

Abstract Gastric cancer (GC) is a cancer with high prevalence, and is one of the leading causes of cancer death worldwide. Metformin is a widely used hypoglycemic agent for type-2 diabetes mellitus (T2DM). Recently, metformin has drawn increasing attention in the field of cancer research for its emerging anti-cancer roles. However, the efficacy and underlying molecular mechanisms of metformin in the prevention and treatment for GC remain controversial. This review summarized the present clinical and mechanistic studies that investigated the efficacy of metformin in GC. It was found that the majority of clinical studies affirmed protective roles of metformin in both gastric cancer risk and survival rate. In addition, metformin’s effects in the prevention and treatment for GC involve multiple pathways mainly via AMPK and IGF-1R. It was concluded that metformin presents a unique opportunity for application against GC, but further clinical and mechanistic investigations are required to solidify the roles of metformin in GC.
Primary Group A Streptococcal Peritonitis in a Previously Healthy Female Teenage Patient

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Infectious Diseases Brief Report
The role of pattern recognition receptors in host cell signaling and phagosome maturation during infection with Leishmania

by Rachel E. Kasuboski-Polando Leishmaniasis is a devastating group of diseases causing substantial mortality and morbidity throughout the world. Leishmania are obligate intracellular organisms infecting and replicating inside hosts’ macrophages; making them ideal to model and understand interactions between host and parasite. Leishmania entry is receptor mediated through engagement of receptors recognizing molecular patterns on parasites surface, such as lipophosphoglycan (LPG). Macrophages have several cell surface receptors recognizing pathogenic organisms, in particular major receptors for Leishmania entry are complement receptor 3 (CR3), mannose receptor (MR), Fc receptor (FcR), and toll-like receptors (TLRs). CR3 recognizes complement, which coats pathogens for clearance by the immune system. While MR is involved in recognizing sugar side chains present on surfaces of pathogens leading to phagocytosis by macrophages. The Fc Receptor (FcR), Rachel E. Kasuboski-Polando not technically a pattern recognition receptor like CR3 and MR, is integral for pathogen entry through recognition of the Fc portion of antibodies. This dissertation focuses on identification of host cell signaling and characterizing phagosome maturation during Leishmania infection. Use of MR has not been well characterized such as CR3 or FcR during Leishmania infection. Our studies indicate that MR is not essential for in vivo Leishmania infection, WT or MR knock out mice infected with L. major or L. donovani do not display differences during infection. Analysis of cytokine production and MAPK signaling also are not different between WT and MR knock out mice. Leishmania survive inside macrophages by delaying phagosome maturation through preventing fusion with lysosomes. This delay allows parasites time to differentiate into more microbiocidal resistant life stage. Our data is the first step toward characterizing a role for macrophage receptors and their influence on phagosome maturation. The major receptors implicated in Leishmania entry, MR, CR3, FcγR, and TLRs, are all necessary for delaying phagosome maturation and none of these receptor deficient macrophages exhibit actin retention around Leishmania phagosomes. Using different serum components such as complement and antiLeishmania antibodies allowed us to force parasites through certain receptors. Thus, receptor engagement and opsonization both influence Leishmania phagosome maturation and potentially parasite
Determinants of Severe Acute Malnutrition Among HIV-positive Children Receiving HAART in Public Health Institutions of North Wollo Zone, Northeastern Ethiopia: Unmatched Case–Control Study

Background Over half of the children living with HIV/AIDS suffer from severe acute malnutrition especially in countries having food insecurity like Ethiopia. However, determinants of severe acute malnutrition among HIV-positive children receiving care and treatment in antiretroviral therapy clinics in Ethiopia are not abundantly investigated. The aim of this study was to assess the determinants of severe acute malnutrition among HIV-positive children receiving highly active antiretroviral therapy in public health institutions of the North Wollo Zone, Northeastern Ethiopia. Methods An institutional-based unmatched case–control study was conducted on 204 under-fifteen, HIV-positive children (68 cases and 136 controls). The data were collected by reviewing medical records and by interviewing attendants. Binary and multiple logistic regressions were employed, and odds ratio with 95%CI was used to interpret results. A p-value of <0.05 was considered as a significant difference between cases and controls for the exposure variable of interest. Results A total of 204 under-fifteen, HIV-positive children were included in this study. Of them, 49.5% were males. About 79.4% of those children had acquired HIV infection through vertical transmission. Poor adherence to ART Adj-OR: 5.72 (1.08–30.27), duration on ART Adj-OR: 5.54 (1.44–21.24), severe immunodeficiency Adj-OR: 6.41 (1.09–37.86), advanced WHO clinical stage Adj-OR: 3.58 (1.03–12.43), oropharyngeal disease Adj-OR: 4.72 (1.13–19.73) and chronic diarrhea Adj-OR: 3.98 (1.05–15.04) were identified to be determinants of SAM in those children. Conclusion Determinant factors for SAM among HIV-positive children were chronic diarrhea, severe immunodeficiency, duration and adherence to ART, oropharyngeal disease and advanced WHO clinical stage. Therefore, it is better if interventions are developed and implemented to address these identified factors.
UPLC-MS/MS Measurement of the Effect of Isavuconazole, Itraconazole and Fluconazole on the Pharmacokinetics of Selinexor in Rats

Objective An ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method for the determination of selinexor was established to investigate the effects of isavuconazole, itraconazole and fluconazole on the pharmacokinetics of selinexor in rats, respectively. Methods Twenty-four healthy male rats were randomly divided into four groups: group A, normal saline; group B, isavuconazole (20 mg/kg); group C, itraconazole (20 mg/kg); and group D, fluconazole (20 mg/kg). After 30 min of oral administration of normal saline, isavuconazole, itraconazole, and fluconazole, all the rats were given selinexor (8 mg/kg). The plasma concentration of selinexor was estimated by UPLC-MS/MS, and the pharmacokinetic parameters of selinexor were calculated by Drug and Statistics (DAS) 2.0 software. Results Under these experimental conditions, the method showed good linearity and stability. Intraday and interday accuracy and sample recovery were acceptable. Compared with group A, the Cmax, AUC(0−t) and AUC(0−∞) of selinexor in group B increased by 59.05%, 31.69%, and 31.45%; the Cmax, AUC(0−t) and AUC(0−∞) of selinexor in group C increased by 56.14%, 25.34%, and 25.08%; the Cmax, AUC(0−t) and AUC(0−∞) of selinexor in group D increased by 43.44%, 29.16%, and 31.96%, respectively. The Tmax of the experimental groups were extended, and CLz/F was also significantly reduced. Conclusion These results indicated that isavuconazole, itraconazole, and fluconazole have significant inhibitory effects on selinexor pharmacokinetics and increased selinexor plasma exposure in rats. Therefore, when these drugs were used in combination, clinicians should pay attention to the changes in treatment effects and the occurrence of adverse reactions caused by the drug-drug interactions.
Delayed muscle soreness, muscle function and evidence of leukocytes in human skeletal muscle following eccentric exercise

The three primary purposes of these studies were to 1) characterize the time course and the relationships among delayed onset muscle soreness, eccentric muscle torque, serum creatine phosphokinase and urinary hydroxyproline in response to two exercise durations; 2) to examine whether there was increased presence of leukocytes in the exercised muscle compared to the contra-lateral non-exercised muscle; and 3) to determine the time course and the relationships among eccentric muscle torque, muscle fatigue, range of motion, the presence of leukocytes, and delayed onset muscle soreness following the eccentric exercise. In the first study, the dependent variables were measured before and after 180 (shorter duration) and 300 (longer duration) eccentric repetitions of the quadriceps muscles. Eccentric torque of the quadriceps muscles was evaluated utilizing the same parameters of range of motion and velocity of movement as the exercise stimulus. Muscle soreness was evaluated by the Descriptor Differential Scale which reflects the sensory (intensity of soreness) and affective (unpleasantness) components of the discomfort. In the second study, a radionuclide technique was used to determine the presence of leukocytes in the exercised muscle. Muscle fatigue was assessed with a power spectrum analysis. The greatest intensity of soreness and unpleasantness was between 20 and 48 hours postexercise. The presence of leukocytes in the exercised muscle was significantly greater than in the contra-lateral non-exercised muscle. Additional data collection before 24 hours post exercise revealed a biphasic response in eccentric torque, not reported previously in humans. Eccentric torque declined immediately after the exercise stimulus and again at 20 to 24 hours post-exercise. Fatigue of the vastus lateralis muscle was most evident at 2 hours post-exercise. The greatest loss of range of motion occurred at 24 hours post exercise. Significant correlations were found between unpleasantness and creatine phosphokinase, intensity of soreness and creatine phosphokinase, and unpleasantness and
The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens

INTRODUCTION: Exocrine pancreatic function is a critical host factor in determining the intestinal microbiota composition. Diseases affecting the exocrine pancreas could therefore influence the gut microbiome. We investigated the changes in gut microbiota of patients with chronic pancreatitis (CP). METHODS: Patients with clinical and imaging evidence of CP (n = 51) were prospectively recruited and compared with twice the number of nonpancreatic disease controls matched for distribution in age, sex, body mass index, smoking, diabetes mellitus, and exocrine pancreatic function (stool elastase). From stool samples of these 153 subjects, DNA was extracted, and intestinal microbiota composition was determined by bacterial 16S ribosomal RNA gene sequencing. RESULTS: Patients with CP exhibited severely reduced microbial diversity (Shannon diversity index and Simpson diversity number, P < 0.001) with an increased abundance of facultative pathogenic organisms (P < 0.001) such as Enterococcus (q < 0.001), Streptococcus (q < 0.001), and Escherichia.Shigella (q = 0.002). The CP-associated changes were independent of exocrine pancreatic insufficiency. Short-chain fatty acid producers, considered protective for epithelia such as Faecalibacterium (q < 0.001), showed reduced abundance in patients with CP. Of 4 additional patients with CP previously treated with antibiotics (ceftriaxone and metronidazole), 3 patients were characterized by distinct Enterococcus overgrowth. DISCUSSION: CP is associated with marked gut microbiota dysbiosis, greatly reduced diversity, and increased abundance of opportunistic pathogens, specifically those previously isolated from infected pancreatic necrosis. Taxa with a potentially beneficial role in intestinal barrier function are depleted. These changes can increase the probability of complications from pancreatitis such as infected fluid collections or small intestinal bacterial overgrowth (see Graphical Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A383).
Preoperative Fibrinogen-Albumin Ratio Index (FARI) is a Reliable Prognosis and Chemoradiotherapy Sensitivity Predictor in Locally Advanced Rectal Cancer Patients Undergoing Radical Surgery Following Neoadjuvant Chemoradiotherapy

Background Inflammatory response and nutritional status are associated with cancer development and progression. The purpose of this study was to explore whether the preoperative fibrinogen-albumin ratio index (FARI) is related to prognosis and chemoradiotherapy outcome of radical surgery after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC). Methods In total, 123 patients with LARC who underwent radical surgery after NCRT between June 2012 and December 2018 were collected in this study. Time-dependent receiver operating characteristic (ROC) curve analysis was made to evaluate the ability of the markers for forecasting prognosis. The correlation between FARI and clinicopathological parameters was analyzed. The Kaplan–Meier survival analysis, univariate and multivariate analysis based on Cox proportional hazards models, and subgroup analysis were performed to evaluate overall survival (OS) and disease-free survival (DFS). A nomogram was constructed to evaluate the predictive role of FARI in DFS. Results The ROC curve analysis showed that the ability of FARI on DFS prediction was superior to those of other inflammatory markers and carcinoembryonic antigen (CEA) (P<0.05). Based on the Youden’s index, the optimal cut-off value of FARI was 8.8%. High FARI patients (>8.8%) showed a poor response to NCRT and a decreased DFS rate (P<0.05). In addition, multivariate analysis revealed that FARI (HR=3.098, P=0.033), neutrophil-to-lymphocyte ratio (NLR), and postoperative T stage were independent prognostic factors for DFS in TNM stage III LARC patients. However, FARI failed to distinguish patients with poor OS. Harrell’s concordance index (C-index) of the nomogram containing FARI (0.807) was obviously higher than that without it (0.732) among LARC patients who underwent radical surgery after NCRT. Moreover, multivariate analysis revealed FARI (OR=3.044, P=0.012) as an independent predictor for response to NCRT. Conclusion Among LARC patients who underwent radical surgery after NCRT, preoperative FARI is an independent prognostic factor for DFS and an independent predictor for response to NCRT.
Factors Associated with Burnout Among Physicians: An Evaluation During a Period of COVID-19 Pandemic

Purpose The aim of the study is to evaluate the prevalence and extent of burnout among physicians and investigate the factors related with burnout and the influence of the fight against coronavirus (COVID-19) on the burnout syndrome. Methods A cross-sectional survey design was adopted and conducted on 200 actively working physicians in Izmir/Turkey. Personal Information Form and Maslach Burnout Inventory were used in the survey. Results The findings showed that the emotional exhaustion level of the physicians was medium, the levels of depersonalization and personal accomplishment were low, and the level of total burnout was low. It was observed that the burnout levels of males and females, and married and single physicians were similar. The emotional exhaustion level of 18–23-year-old physicians was lower than the rest of the physicians. Physicians’ level of satisfaction with their income is not effective on burnout. The burnout level of physicians who did not choose their profession willingly was determined to be higher than the burnout level of the physicians who chose their profession willingly. One important finding showed that the burnout level of physicians who actively involved in the fight against COVID-19 was lower than the burnout level of the physicians who did not actively involve in the fight against COVID-19. Conclusion Although the impact of some demographic variables, such as gender, marital status and satisfaction of income on burnout, was similar among the groups, total burnout level was lower in physicians who actively fought with the virus. This result may suggest that those physicians who were actively involved in the fight against COVID-19 had a high sense of meaningfulness of work which will result in high satisfaction with the work itself and, thus, creating less burnout. Also, they had a stronger feeling of personal accomplishment as they faced the immediate outcomes of their care for people infected by COVID-19.
From cancer to rejuvenation: incomplete regeneration as the missing link (part II: rejuvenation circle)

In the first part of our study, we substantiated that the embryonic reontogenesis and malignant growth (disintegrating growth) pathways are the same, but occur at different stages of ontogenesis, this mechanism is carried out in opposite directions. Cancer has been shown to be epigenetic-blocked redifferentiation and unfinished somatic embryogenesis. We formulated that only this approach of aging elimination has real prospects for a future that is fraught with cancer, as we will be able to convert this risk into a rejuvenation process through the continuous cycling of cell dedifferentiation–differentiation processes (permanent remorphogenesis). Here, we continue to develop the idea of looped ontogenesis and formulate the concept of the rejuvenation circle.
COVID-19 Contact-Tracing Technology: Acceptability and Ethical Issues of Use

Background The contact-tracing COVID-19 technology allows for tracing people that come in contact to individuals with COVID-19 wherever they are located. The number of tracing COVID-19 infection technology and devices is rapidly increasing. This has prompted many researchers to study the acceptability and ethical issues related to the implementation of such technology. Aim The purpose of this study was to determine the acceptability of COVID-19 contact-tracing technology and ethical issues of use. Methods A cross-sectional questionnaire-based study was used. The target population was Jordanian adults (>18 years). The survey was distributed to a convenience sample of 2000 general public in Jordan. Results The results found that the number of people who accept to use COVID-19 contact-tracing technology was 71.6%. However, the percentage of people who were using this technology was 37.8. The main ethical concerns for many of participants were privacy, voluntariness, and beneficence of the data. Only income and living area were predictors for acceptability and use of tracing technology (p≤ 0.01). Conclusion The majority of Jordanians accept the implementation of contact-tracing technology for COVID-19 infection. Among ethical concerns of the implementation of such technology were privacy, beneficence and voluntariness. Implications The results of this study would help in improving the state of science regarding acceptability to use contact-tracing technology for health purposes. Moreover, the present findings provide evidence of predictors of acceptance and ethical concerns among Jordanian population about COVID-19 contact-tracing technology.
Risk Assessment of Repeated Suicide Attempts Among Youth in Saudi Arabia

Introduction Although the incidence of suicide attempts continues to increase among youth in Saudi Arabia, no risk assessment tool has been established for suicide attempt repetition in the country’s youth population. The objective of the study was to develop risk assessment of suicide attempt repetition among youth in Saudi Arabia. Methods This is a retrospective study of youth (10–24 years) with intentional suicide attempt(s) who presented to the emergency departments (ED) at King Abdullah Specialist Children’s Hospital (KASCH) and King Abdulaziz Medical City-Riyadh (KAMC-R), Saudi Arabia between 1 January 2015 and 31 December 2017. We excluded youth having unintentional suicide attempts. Data were retrieved for the 157 eligible as having attempted suicide. Results Forty-one of 157 (26.1%) had repeated suicide attempts (95% confidence limits: 19.433.7%). Four independent factors were identified that were associated with an increased risk of repeated suicide attempts: age (adjusted odds ratio [aOR] = 1.147, 95% confidence interval (CI) = 11.015–1.297, P=0.028), family problems (aOR = 4.218, 95% CI = 1.690–10.528, P=0.002), psychiatric disorders (aOR = 3.497, 95% CI = 1.519–8.051, P=0.003), and hospitalization (aOR = 5.143, 95% CI = 1.421–18.610, P=0.013). This risk model showed adequate utility with an area under the receiver operating characteristic (ROC) curve (AUC): 77.9%, 95% CI: 69.486. 3% with optimism-corrected AUC = 71.8%. Youden index defined a probability of ≥0.38 to predict a high risk of repeated suicide attempts. Conclusion The risk of repeated suicide attempts among Saudi youth was high, compatible with what has been reported among youth in England and in France. Age, family problems, psychiatric disorders, and hospitalization are risk factors for repeated suicide attempts. A prevention program for suicide attempts in youth may take into account family problems, screening for psychiatric disorders, and suicidal behavior.
A new record of critically endangered Saussurea bogedaensis (Asteraceae) from Dzungarian Gobi, Mongolia

Abstract A species in the family Asteraceae, Saussurea bogedaensis, was newly described from Bogeda Mountain in Xinjiang, China and is a critically endangered species in China. Morphological and genetic characteristics confirm the presence of this species in Mongolia, as it was found in Baitag Bogd Mountain (in the Dzungarian Gobi). In addition, the distribution and conservation status of S. bogedaensis are provided.
The Correlation of Type 2 Diabetes Status with Bone Mineral Density in Middle-Aged Adults

Background Bone metabolism can be influenced by type 2 diabetes mellitus (T2DM). However, the relationship between T2DM and bone mineral density (BMD) remains inconsistent. This study explored the differences in BMD in middle-aged adults with and without T2DM. Methods We conducted a cross-sectional study of 4986 participants aged 40–59 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2011–2018. We performed multivariable logistic regression models to evaluate the associations between T2DM status, serum glucose, glycohemoglobin (HbA1c), disease duration and lumbar BMD. Results There was a positive association between T2DM status and lumbar BMD in all three models (model 1: β=0.039, 95% CI: 0.025–0.052; model 2: β=0.045, 95% CI: 0.031–0.059; model 3: β=0.035, 95% CI: 0.014–0.055). In the subgroup analysis stratified by gender, this positive association existed in both gender after adjusting for confounders (males: β=0.033, 95% CI: 0.003–0.062; females: β=0.035, 95% CI: 0.008–0.062). Besides, there were no significant associations of serum glucose, HbA1c, disease duration with lumbar BMD in both genders with T2DM. Conclusion This study indicated that middle-aged adults with T2DM had significantly higher lumbar BMD compared with those without DM.