Miracle-dz/UniFAR-FTUs huggingface dataset:
Phase IIIb Safety and Efficacy of Intravenous NEPA for Prevention of Chemotherapy‐Induced Nausea and Vomiting (CINV) in Patients with Breast Cancer Receiving Initial and Repeat Cycles of Anthracycline and Cyclophosphamide (AC) Chemotherapy

Abstract Background NEPA, a combination antiemetic of a neurokinin‐1 (NK1) receptor antagonist (RA) (netupitant [oral]/fosnetupitant [intravenous; IV]) and 5‐HT3RA, palonosetron] offers 5‐day CINV prevention with a single dose. Fosnetupitant solution contains no allergenic excipients, surfactant, emulsifier, or solubility enhancer. A phase III study of patients receiving cisplatin found no infusion‐site or anaphylactic reactions related to IV NEPA. However, hypersensitivity reactions and anaphylaxis have been reported with other IV NK1RAs, particularly fosaprepitant in patients receiving anthracycline‐cyclophosphamide (AC)‐based chemotherapy. This study evaluated the safety and efficacy of IV NEPA in the AC setting. Materials and Methods This phase IIIb, multinational, randomized, double‐blind study enrolled females with breast cancer naive to highly or moderately emetogenic chemotherapy. Patients were randomized to receive a single 30‐minute infusion of IV NEPA or single oral NEPA capsule on day 1 prior to AC, in repeated (up to 4) cycles. Oral dexamethasone was given to all patients on day 1 only. Results A total of 402 patients were included. The adverse event (AE) profiles were similar for IV and oral NEPA and consistent with those expected. Most AEs were mild or moderate with a similarly low incidence of treatment‐related AEs in both groups. There were no treatment‐related injection‐site AEs and no reports of hypersensitivity or anaphylaxis. The efficacy of IV and oral NEPA were similar, with high complete response (no emesis/no rescue) rates observed in cycle 1 (overall [0–120 hours] 73.0% IV NEPA, 77.3% oral NEPA) and maintained over subsequent cycles. Conclusion IV NEPA was highly effective and safe with no associated hypersensitivity and injection‐site reactions in patients receiving AC. Implications for Practice As a combination of a neurokinin‐1 (NK1) receptor antagonist (RA) and 5‐HT3RA, NEPA offers 5‐day chemotherapy‐induced nausea and vomiting prevention with a single dose and an opportunity to improve adherence to antiemetic guidelines. In this randomized multinational phase IIIb study, intravenous (IV) NEPA (fosnetupitant/palonosetron) was safe and highly effective in patients receiving multiple cycles of anthracycline‐cyclophosphamide (AC)‐based chemotherapy. Unlike other IV NK1RAs, the IV NEPA combination solution does not require any surfactant, emulsifier, or solubility enhancer and contains no allergenic excipients. Hypersensitivity reactions and anaphylaxis have been reported with other IV NK1RAs, most commonly with fosaprepitant in the AC setting. Importantly, there were no injection‐site or hypersensitivity reactions associated with IV NEPA.
Genome-wide association study of drought tolerance and biomass allocation in wheat

Genome wide association studies (GWAS) are important in discerning the genetic architecture of complex traits such as biomass allocation for improving drought tolerance and carbon sequestration potential of wheat. The objectives of this study were to deduce the population structure and marker-trait association for biomass traits in wheat under drought-stressed and non-stressed conditions. A 100-wheat (Triticum aestivum L.) genotype panel was phenotyped for days to heading (DTH), days to maturity (DTM), shoot biomass (SB), root biomass (RB), root to shoot ratio (RS) and grain yield (GY). The panel was sequenced using 15,600 single nucleotide polymorphism (SNPs) markers and subjected to genetic analysis using the compressed mixed linear model (CMLM) at false discovery rate (FDR < 0.05). Population structure analysis revealed six sub-clusters with high membership ancestry coefficient of ≤0.65 to their assigned sub-clusters. A total of 75 significant marker-trait associations (MTAs) were identified with a linkage disequilibrium threshold of 0.38 at 5cM. Thirty-seven of the MTAs were detected under drought-stressed condition and 48% were on the B genome, where most quantitative trait loci (QTLs) for RB, SB and GY were previously identified. There were seven pleiotropic markers for RB and SB that may facilitate simultaneous selection. Thirty-seven putative candidate genes were mined by gene annotation on the IWGSC RefSeq 1.1. The significant MTAs observed in this study will be useful in devising strategies for marker-assisted breeding for simultaneous improvement of drought tolerance and to enhance C sequestration capacity of wheat.
Individual-, Community-, and Health System–Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development

Purpose The purpose of this integrative review is (1) to elucidate the unique barriers faced by inner-city African Americans for type 2 diabetes (T2DM) care; (2) to identify effective interventions/programs for optimal T2DM care at the individual, community, and health systems levels; and (3) to integrate 2 behavioral models and 1 social ecological model for framing interventions for inner-city African American to optimize T2DM care. Methods PRISMA guidelines were followed to systematically search PubMed, PsychInfo, and CINAHL. Integration of models was based on underlying principles of social ecological models. Results The search returned 1183 articles. Forty-six articles were synthesized after applying inclusion criteria. Multiple barriers for the individual level, community level, and health system level were identified. Major barriers include lack of knowledge, lack of social support, and self-management support. Interventions identified in this review show that among inner-city African Americans with T2DM, the focus is placed at the health systems level, with very limited focus toward addressing individual- and community-level barriers. Final synthesis includes development of a new integrated model that explains barriers to care across multiple levels. Conclusions These findings highlight the fragmentation that may be occurring between policy, research, and practice for achieving health equity and addressing health disparities for T2DM care among inner-city African Americans. The new model is an important step in the pursuit of equity in T2DM by specifying the complex barriers that occur across multiple levels. The application of this model using the 2017 National Standards for Diabetes–Self Management Education and Support are discussed.
Environmentally friendly films combining bacterial cellulose, chitosan and polyvinyl alcohol: Effect of water activity on barrier, mechanical and optical properties.

The interest in developing new materials intended for food packaging based on bacterial cellulose is growing in the recent years. Flexible and transparent films from bacterial cellulose-chitosan-polyvinyl alcohol have shown excellent UV-barrier properties. However, this material interacts with ambient moisture modifying its water activity due to its hydrophilic nature. In this work, a study was carried out to evaluate the changes caused by the water activity. Results showed a plasticizing effect of water molecules increasing the water vapour permeability of the samples from 1.86·10-12 to 1.17·10-11 g/m·s·Pa, the percentage of elongation from 3.25 to 36.55% and the distance to burst from 0.64 to 5.12 mm. The increase of the water activity dropped the Young's modulus and tensile strength. The values of the UV-barrier were maintained at the wide range of water activity. Consequently, water molecules do not affect the UV-barrier properties of the films.
Phytofabrication of Silver/Silver Chloride Nanoparticles Using Aqueous Leaf Extract of Oedera genistifolia: Characterization and Antibacterial Potential

In this present study, silver nanoparticles (Ag/AgCl NPs) were synthesized using an aqueous leaf extract of Oedera genistifolia as a reducing agent. The biosynthesized Ag/AgCl NPs was characterized by UV-visible spectrophotometry, transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). In addition, sequel to antibacterial assay, the cytotoxic effect of the phytofabricated Ag/AgCl NPs was assessed against the HeLa cell line (human cervix adenocarcinoma). The results of the characterization of the synthesized Ag/AgCl NPs indicate the successful synthesis using plant extract as a reducing agent, with UV-Vis spectra between 290–360 nm. TEM results showed that Ag/AgCl NPs was spherical in shape with an average size of 34.2 nm. EDX analysis revealed that the particles were predominantly composed of carbon, oxygen, chlorine, and silver, while FTIR identified major phytochemical compounds, which could be responsible for bio-reducing and capping potential. XRD analysis showed the crystallinity of Ag/AgCl NPs, with a face-centred cubic structure. The studied Ag/AgCl NPs had no cytotoxic effect on HeLa cells and exhibited antibacterial activity (minimum inhibitory concentration (MIC) 0.25–1 mg/mL; minimum bactericidal concentration (MBC) 2–16 mg/mL) against both the Gram-negative and Gram-positive bacteria investigated. Findings from this study suggest that this plant as a good candidate for producing new antibacterial drugs.
Total Versus Completion Thyroidectomy: A Multidimensional Evaluation of Long-Term Vocal Alterations

Background: Total thyroidectomy (TT) and completion thyroidectomy (CT) are two common surgical operations that are frequently followed by vocal symptoms despite preservation of the recurrent laryngeal nerve (RLN) and of the external branch of superior laryngeal nerve (EBSLN). The aim of this study was to analyze vocal alterations through endoscopic findings, videolaryngostroboscopy (VLS), acoustic vocal parameters and impact on patients’ quality of life after surgery in the absence of laryngeal nerve injury. Methods: We enrolled 198 patients who underwent thyroidectomy by the same surgeon. One hundred twenty-six patients underwent TT (group TT) while 72 underwent CT (group CT). All patients underwent preoperative VLS and Voice Handicap Index (VHI) assessment and postoperative VHI, VLS and Acoustic Voice Analysis with Multidimensional Voice Program Analysis 12 to 18 months after surgery. Results: We observed a statistically significant higher rate of EBSLN injury in CT compared to TT. Even in the absence of RLN and EBSLN injury, patients who underwent TT and CT presented slightly worse acoustic vocal parameters and VHI scores compared to healthy controls. Interestingly, some acoustic vocal parameters and VHI scores were significantly worse in group CT compared to group TT. Conclusions: The higher rate of EBSLN injury in CT rather than in TT suggests a higher surgical risk in CT. The vocal parameters of loudness and self-perception of voice were significantly worse after CT, suggesting a larger trauma in patients’ vocal outcome in CT if compared to TT, although these alterations were not reported as psychologically limiting daily life of patients. Nevertheless, the existence of multiple factors contributing to vocal alterations after thyroidectomy highlight the importance of a routine comprehensive functional voice analysis before and after surgery.
Using Didactics and Simulation to Enhance Comfort, Knowledge, and Skills of Nonsurgical Trainees Caring for Patients With Tracheostomy and Laryngectomy.

INTRODUCTION Management of tracheostomy and laryngectomy is an important skill for physicians who often care for patients with multiple, comorbid, chronic medical conditions. There is little published literature on training for tracheostomy and laryngectomy care during nonsurgical specialty residencies. This project was designed to assess and improve comfort with, knowledge of, proficiency in tracheostomy and laryngectomy care. METHODS This prospective observational study comprised 122 physician trainees from internal medicine, emergency medicine, and anesthesia training programs at the University of Arkansas for Medical Sciences participating in a simulation-based curriculum from April 2016 to December 2016. The curriculum included didactic session, hands-on experience performing a tracheostomy change, and practicing emergency scenarios on interactive, high-fidelity simulation mannequins. Preintervention and postintervention assessments of self-perceived comfort, objective knowledge, and tracheostomy change proficiency were performed and results compared. RESULTS Self-perceived comfort improved from a mean Likert score from 2.12 to 4.43 (P = 0.009). Knowledge mean scores improved from 57% to 82% (P < 0.001) on multiple-choice testing. Tracheostomy change proficiency mean scores improved from 41% to 84% (P < 0.001) of proficiencies correctly performed. Six-month follow-up assessment of comfort and knowledge showed statistically significant retention of comfort (P = 0.002) and knowledge (P = 0.026). CONCLUSIONS Comprehensive tracheostomy and laryngectomy education, which combines enhancement of knowledge with simulation of both routine and emergent aspects of care, is an effective strategy in improving confidence with, knowledge of, proficiency in tracheostomy and laryngectomy care. Retention of confidence and knowledge was demonstrated 6 months later.
Multimodality screening and prevention of cervical cancer in sub-Saharan Africa: a collaborative model.

PURPOSE OF REVIEW Although cervical cancer continues to decrease in incidence throughout the developed world because of rigorous screening and vaccination campaigns, the disease remains a major cause of cancer-related morbidity and mortality in resource-limited regions including sub-Saharan Africa. This review summarizes current efforts to implement cost-effective and widespread cervical cancer education, screening, and community-based interventions in Africa and the challenges faced by local healthcare workers. RECENT FINDINGS Effective screening with cytology (with or without high-risk human papillomavirus [HPV] DNA testing) as well as HPV self-sampling remains problematic in African countries because of a paucity of cytopathologists and resources. Accordingly, visual inspection of the cervix with acetic acid (VIA) with cryotherapy triage has gained traction in mass-screening campaigns because of low-cost supplies. SUMMARY Public education to facilitate screening is essential. VIA remains a strong community-based approach. The involvement of technology in teaching local providers, advertising screenings to the community, and helping improve follow-up may also improve screening efforts. Ultimately, the best form of prevention is through HPV vaccination, which also requires implementation of ongoing public education programs.
Assessment of the real-world safety profile of vedolizumab using the United States Food and Drug Administration adverse event reporting system

Vedolizumab is the first gut-selective integrin blocker indicated for patients with Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to examine the adverse events (AEs) profile of vedolizumab compared to anti-tumor necrosis factors (anti-TNFs) indicated for CD and UC using the FDA Adverse Event Reporting System (FAERS) database. AE reports with vedolizumab (5/20/2014–6/30/2015) and CD/UC-indicated anti-TNF drugs (adalimumab, infliximab, certolizumab pegol, and golimumab, during 8/1/1998–6/30/2015) as primary suspects were extracted from the FAERS database. AEs associated with vedolizumab were compared for signals of disproportionate reporting against anti-TNF drugs and all other drugs (1969–6/30/2015), using the proportional reporting ratio (PRR) and the empirical Bayesian geometric mean (EBGM) algorithms. The search retrieved 499 reports for vedolizumab and 119,620 reports for anti-TNFs, with 35.9% and 32.1% of these, respectively, being serious AEs. With the PRR approach, vedolizumab-associated reports had signals for 22 groups of AEs (9 were associated with serious outcomes) relative to anti-TNFs and had 34 signals relative to all other drugs. Signals detected included those reported as warnings in prescribing information and new AEs related to cardiovascular disease. Due to the voluntary nature of FAERS, this finding should be considered hypothesis generating (rather than hypothesis testing). Longer-term observational studies are required to evaluate the safety of vedolizumab.
The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with implications on long-term outcomes. Metabolic disorders including diabetes mellitus and obesity are independent predictors of atrial fibrillation and present therapeutic targets to reduce both the incidence and duration burden of atrial fibrillation. The presence of pericardial fat in direct contact with cardiac structures, as well the subsequent release of proinflammatory cytokines, may play an important role in this connection. Atrial fibrillation is an independent predictor of cognitive impairment and dementia. While clinical stroke is a major contributor, other factors such as cerebral hypoperfusion and microbleeds play important roles. New evidence suggests that atrial fibrillation and cognitive impairment may be downstream events of atrial cardiomyopathy, which may be caused by several factors including metabolic syndrome, obesity, and obstructive sleep apnea. The mechanisms linking these comorbidities to cognitive impairment are not yet fully elucidated. A clearer understanding of the association of AF with dementia and cognitive impairment is imperative. Future studies should focus on the predictors of cognitive impairment among those with AF and aim to understand the potential mechanisms underlying these associations. This would inform strategies for the management of AF aiming to prevent continued cognitive impairment.
mTORC1 Mediates Lysine-Induced Satellite Cell Activation to Promote Skeletal Muscle Growth

As the first limiting amino acid, lysine (Lys) has been thought to promote muscle fiber hypertrophy by increasing protein synthesis. However, the functions of Lys seem far more complex than that. Despite the fact that satellite cells (SCs) play an important role in skeletal muscle growth, the communication between Lys and SCs remains unclear. In this study, we investigated whether SCs participate directly in Lys-induced skeletal muscle growth and whether the mammalian target of rapamycin complex 1 (mTORC1) pathway was activated both in vivo and in vitro to mediate SC functions in response to Lys supplementation. Subsequently, the skeletal muscle growth of piglets was controlled by dietary Lys supplementation. Isobaric tag for relative and absolute quantitation (iTRAQ) analysis showed activated SCs were required for longissimus dorsi muscle growth, and this effect was accompanied by mTORC1 pathway upregulation. Furthermore, SC proliferation was governed by medium Lys concentrations, and the mTORC1 pathway was significantly enhanced in vitro. After verifying that rapamycin inhibits the mTORC1 pathway and suppresses SC proliferation, we conclude that Lys is not only a molecular building block for protein synthesis but also a signal that activates SCs to manipulate muscle growth via the mTORC1 pathway.
Child protection, domestic violence, and ethnic minorities: Narrative results from a mixed methods study in Australia

Objective To help address a long-standing gap in research and knowledge, this paper explores the issue of what service providers need to be aware of to best meet the needs of ethnic minority children and families who have come to the attention of child protection authorities and have substantiated reports of domestic violence. Method The results are written in narrative form, combining informed insider perspectives with a small subset of data drawn from a larger rigorous mixed methods study in Australia, that involved an exhaustive literature review, review of 120 randomly selected case files, and in-depth qualitative interviews with 29 ethnic minority families involved in the child protection system and 17 child protection caseworkers. Results and significance Three issues for ethnic minorities relating to the nexus of child protection and domestic violence are identified: (i) being in the child protection system tarnishes family name, which is greatly valued, leading to a preference for child maltreatment and family violence to remain private, and for compliance with Apprehended Violence Orders (AVOs) and service uptake/engagement to be low, (ii) family cohesion is also highly valued, so family violence victims may sacrifice their own personal safety to protect the family unity and cultural safety of their children, and (iii) family violence interacts with cultural factors for ethnic minorities but does occur in all families; attributing it to race or culture would be racism. Several implications for practice are identified, falling under a broad umbrella approach that asks for child protection authorities and family violence agencies to work collaboratively. A call for empirically rigorous future research is also made to ensure practice is evidence-based.
Target‐controlled infusion of dexmedetomidine effect‐site concentration for sedation in patients undergoing spinal anaesthesia

Dexmedetomidine has been a preferred sedative for patients undergoing regional anaesthesia and is mostly administered via conventional zero‐order infusion. Recently, a pharmacokinetic‐pharmacodynamic (PKPD) model of dexmedetomidine has been published, but no external validation has been reported in clinical trials. We aimed to administer target‐controlled infusion (TCI) of dexmedetomidine at the effect‐site concentration (Ce) to patients undergoing spinal anaesthesia and investigate the relationship between dexmedetomidine Ce and the sedative effects.
Ecological and Evolutionary Dynamics of Aresian and Erosian Economy

In this paper we explore the ecodynamics of economic transformation of Central-East –European late socialist industries under the pressure of globalization. We use both term ARES and Eros in allegoric sense and as an acronym of Accumulation, Risk, Environmental degradation In this framework we deconstruct the process of the neoliberal transformation of local economies. Deconstruction of informational, technological and social dynamism also helps to reveal the hierarchical ranks of the four environmental actors feedingt the ARESian dynamics of contemporary economical and social