Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical benefits and adverse effects of genetically-elevated free testosterone levels: a Mendelian randomization analysis

Testosterone products are increasingly being prescribed to males for a variety of possible health benefits but the causal relationship between testosterone and health-related outcomes is unclear. Evidence from well-powered randomized controlled trials are difficult to obtain, particularly regarding effects on long-term or adverse outcomes. We sought to determine the effects of genetically-predicted calculated free testosterone (CFT) on 23 health outcomes.Genetic variants associated with CFT were determined from 136,531 white British males in the UK Biobank. One-sample and two-sample Mendelian randomization (MR) analyses were performed to infer the effects of genetically-predicted CFT on 23 health outcomes selected based on relevance with known or suspected effects of testosterone therapy.In males from the UK Biobank, 81 independent genetic variants were associated with CFT levels at genome-wide significance (p<5×10−8). Each 0.1 nmol/L increase in genetically-predicted CFT was associated with clinical benefits on increased heel bone mineral density (0.053 SD; 95% CI = 0.038 to 0.068; p=8.77×10−12) and decreased body fat percentage (−1.86%; 95% CI = −2.35 to −1.37; p=1.56×10−13), and adverse effects on increased risk of prostate cancer (OR=1.28; 95% CI=1.11 to 1.49; p=1.0×10−3), risk of androgenic alopecia (OR=1.82; 95% CI = 1.55 to 2.14; p=3.52×10−13), risk of benign prostate hyperplasia (BPH) (OR=1.81; 95% CI = 1.34 to 2.44; p=1.05×10−4) and hematocrit percentage (1.49%; 95% CI = 1.24 to 1.74; p=3.49×10−32). Long-term elevated free testosterone levels cause prostate cancer, BPH, and hair loss while reducing body fat percentage and increasing bone density. It also has a neutral effect on type 2 diabetes, cardiovascular and cognitive outcomes. Well powered randomized trials are needed to address the effects of shorter term use of exogenous testosterone on these outcomes.
Calcifediol Decreases Interleukin-6 Secretion by Cultured Human Trophoblasts From GDM Pregnancies

Abstract Gestational diabetes mellitus (GDM) is often characterized by low maternal calcifediol (25OHD) and high inflammation levels. This study aimed to determine whether placental protein expressions of CYP27B1, vitamin D receptor (VDR), and CYP24A1 are impaired in GDM and to investigate the effect of a 25OHD treatment on IL-6 secretion by GDM trophoblasts compared with normoglycemic (NG) trophoblasts. Placental tissue samples were harvested to determine protein expression of CYP27B1, VDR, and CYP24A1 by immunoblots. Isolated trophoblasts were stimulated with 25OHD concentrations (25 to 2000 nM) once a day for 3 days and IL-6 secretion was quantified (ELISA). We recruited 17 NG women, 19 women with GDM treated with diet and exercise alone (GDM-d) and 9 women with GDM who necessitated insulin therapy (GDM-i). Protein expressions of CYP27B1 and VDR were significantly higher in placental tissue from GDM-d women compared with NG women (both P = 0.02), whereas no differences were detected between GDM-i and NG placental tissues. In cultured trophoblasts (two groups; n = 5 NG and n = 5 GDM-d), exposure to increasing 25OHD concentrations significantly decreased IL-6 secretion in the GDM-d group only (P = 0.006). After treatment with 25OHD (2000 nM), IL-6 secretion was lower in the GDM-d group compared with the NG group (P = 0.03). Our results suggest an upregulation of the VDR-1,25(OH)2D complex bioavailability in GDM-d placentas, possibly reflecting a compensatory mechanism aiming to ensure that vitamin D can exert its genomic and nongenomic effects in the target cells of the placental-fetal unit. Our findings support an anti-inflammatory effect of vitamin D at the feto-maternal interface in GDM-d pregnancies.
Acquired Hemophilia A (FVIII Deficiency) Associated with Papillary Thyroid Cancer: Treatment with Recombinant Porcine FVIII

Acquired hemophilia A (AHA) is a rare autoimmune disorder caused by autoantibodies against Factor VIII (FVIII). It has a high mortality due to bleeding complications. FVIIa-based bypassing agents are the first line of treatment but not always effective. Recombinant porcine (rp) FVIII (Obizur®) was recently approved for rescue treatment but with little evidence-based information regarding efficacy. We report a case of papillary thyroid cancer associated with AHA malignancy that responded to a single dose of rpFVIII after failure to achieve hemostasis with FVIIa-based bypassing products.
Prostate Diseases and the Metabolic Syndrome

The overall aim of this thesis was to explore the association between the components of the metabolic syndrome (MetS), including vitamin D, and lower urinary tract symptoms (LUTS). The focus was on the relationship between diseases of the prostate, mainly benign prostatic enlargement (BPE) and prostate cancer (PC). The study cohort consisted of 3,014 Swedish men aged 69-81 enrolled in the Swedish arm of the Osteoporotic Fractures in men (MrOs) study. The study participants were randomly selected using population registries and then contacted and asked to participate in the study. The selected men were asked to fill in questionnaires regarding a variety of items such as daily activities and physical exercise, eating-, drinkingand smoking habits, medication, past and present history of diseases, voiding habits, surgery and current treatment. They underwent investigations regarding bone mineral density, measurements of body composition such as height, weight, body mass index, body fat mass and lean mass and blood samples were obtained for analyses of a variety of variables. In a subgroup of this cohort (1,010 individuals) more extended analyses were performed. Furthermore, in a small cohort (184 individuals), the prostate gland volumes were measured through transrectal ultrasonography. Lower urinary tract symptoms were measured by the International Prostate Symptom Score and urinary incontinence (UI) was evaluated by a questionnaire. The cohort has been followed for more than 10 years. The MrOs register was coordinated with the Swedish Death Register, the Swedish Cancer Register, and the National Prostate Cancer Register. This investigation showed that LUTS and UI were neither associated with any major component of the MetS, nor associated with serum levels of vitamin D. However, serum levels of serotonin were negatively associated with LUTS and UI, while fasting glucose and adiponectin were positively associated with LUTS. Benign prostatic enlargement was associated with low levels of vitamin D, serum calcium, sex hormonebinding globulin and high-density lipoprotein cholesterol. Individuals with type 2 Diabetes mellitus (T2DM) had a decreased risk of being diagnosed with incident prostate cancer. Increased levels of vitamin D were associated with increased risk of being diagnosed with PC. Individuals with low serum c-reactive-protein levels and taller individuals had a higher risk of developing PC. Plasma levels of osteocalcin, a protein produced by osteoblasts, were lower in individuals with T2DM, and higher in individuals with incident PC. The overall conclusions in the present thesis were that vitamin D was negatively associated with BPE and positively associated with PC, however, not associated with LUTS. In addition, the end-point component of MetS, T2DM, was positively associated with BPE but inversely associated with incident PC, and finally, that osteocalcin was positively associated with incident PC.
Experiences of family care during breast cancer: the perspective of caregivers.

OBJECTIVE To describe the experience of family care to women with breast cancer during treatment from the perspective of caregivers in the Mexican context. METHOD Qualitative phenomenological study. In-depth interviews were conducted with caregivers of women who survived breast cancer. Participants were selected by intentional, cumulative and sequential sampling. A conventional content analysis was performed. RESULTS Participation of seven caregivers, who reported their positive and negative experiences when assuming their role as informal caregivers in the family context. On the strength of the reciprocity of care and its reward, prevailed critical moments, negative feelings, and lack of support resources during the experience. This enables the understanding of the informal care bond in order to enhance it with coping strategies and specific guidance from the nursing staff. CONCLUSION Participants experienced a transformation in their identity as caregivers and by being aware of their experience, they could describe their qualities, which increased their coping strategies with the disease and the care challenges.
The immune status of patients with frontal bone trauma with implant SYNTEKIST used in surgical treatment

E-mail: eskulap20009@gmail.com Aim. To determine the influence of a biocomposite on the state of the immune system of patients with trauma to the frontal bone at 1 month after surgical treatment. Materials and Methods. 20 patients with frontal bone fracture treated surgically with and without a SYNEKIST biocomposite were examined; 10 patients served as control. Immunoglobulins M, G, A, and E were determined in the blood serum using enzyme-linked immunosorbent assay. We also determined the content of prodefensin (lactoferrin, an indicator of the acute phase of inflammation), interleukins IL-1β, and interleukin-10. Results. On presentation and during the first days, the patients with trauma to the frontal bone had a decreased level of IgM which, however, reached the control level and was practically the same in both groups. There were no changes in other immunoglobulins in a month. The level of pro-inflammatory Il-a was increased on admission with a significant decrease within the first month in both treatment approaches. The on-admission level of proinflammatory cytokines did not differ significantly from the control while its level increased in the patients undergone the surgical treatment using a biocomposite material. The level of lactoferrin decreased to normal ranges in both treatment approaches. Conclusions. The advantage of the surgical treatment using a biocomposite material lies in the restoration of the IgM level and activation of antiinflammatory mechanisms, Il-10, in particular, in 1 month.
Comparative study of electroencephalographic findings in patients with depression and schizophrenia

Introduction: Schizophrenia and depression are two major and very common mentaldisorders worldwide. Many clinical questionnaire and scales have been formulated todiagnose these cases. Standard (qualitative) electroencephalography (EEG) has alsobeen routinely employed in the diagnostic evaluation of patients of these disorders.However quantitative EEG (qEEG) has not been frequently used in evaluation of thesedisorders. Qualitative EEG (qEEG) findings differ between patients with schizophreniaand patients with depression, but results are not consistent. We performed this study todetermine the differences in EEG parameters(qualitative and quantitative) betweenpatients with schizophrenia, patients with depression, and healthy subjects.Materials and Methods: Our study included 69 patients with schizophrenia, 69patients with depression, and 138 healthy subjects. All patients and healthy subjectswere aged between 18-50 years. All clinical diagnoses were made according to DSM-IVdiagnostic criteria. Standard EEG was performed on all study participants and artefact-free 100-second epochs were selected from the recorded material and analysed withFast Fourier Transformation (FFT) analysis.Observations and Result: Of the entire sample of patients, 40.58% had abnormal EEG.Patients with schizophrenia when compared with healthy subjects showed increaseddelta, theta, and beta activity and decreased alpha activity. Patients with depression alsoshowed similar results, but in fewer regions. In patients with schizo-phrenia, deltapower over some frontal regions was increased in comparison with those in patientswith depression. Schizophrenic patients and healthy subjects showed interhemisphericasymmetry, but it was absent in patients with depression.Conclusion: Abnormal EEG findings in patients with schizophrenia and depression isnot very common. However, on qEEG, the patients with schizophrenia had in-creaseddelta power in comparison to patients with depression. Hence, qEEG may have a rolein clinical differentiation between these two mental disorders and it may be especiallyimportant in cases of negative-symptom schizophrenia.Key words: Schizophrenia, Depression, quantitative electroencephalography(qEEG).
Self-control as a predictor of drug use: A study with university students in Botswana

The study examined the relatonship between self-control and drug use among university students in Botswana. Bandura’s social cognitve theory of self-regulaton provided the theoretcal framework for the study. Among the 269 partcipants with a mean age of 20.9 years (SD = 1.8), 72.9% were female and 27.1% were male. Instruments employed were the Brief Self-control Scale and the Drug Abuse Screening Test. Drug users had signifcantly lower self-control scores than non-drug users (t = 4.57, p = 0.000). Levels of drug use were negatvely associated with self-control (r = -0.33, p = 0.006). Partcipants who had stopped using drugs had signifcantly higher self-control scores (t = 2.38, p = 0.020). Low self-control, male gender and higher level of studies explained between 16.9% (Cox & Snell) and 29.9% (Nagelkerke) of the variaton in whether or not students had used drugs, with self-control having the strongest predictve ability (p = 0.001). The results of this study imply that self-control does play a pertnent role in whether or not young people engage in drug use. The results are discussed with regard to drug use preventon and treatment strategies that should equip young people with skills and techniques in self-control to protect them against drug use and abuse. Keywords : Botswana, drug use, gender, self-control, self-regulaton, university students
New Evidence on the Effects of Mandatory Waiting Periods for Abortion

Beyond a handful of studies examining early-adopting states in the early 1990s, little is known about the causal effects of mandatory waiting periods for abortion. In this study we evaluate the effects of a Tennessee law enacted in 2015 that requires women to make an additional trip to abortion providers for state-directed counseling at least 48 hours before they can obtain an abortion. Our difference-in-differences and synthetic-control estimates indicate that the introduction of the mandatory waiting period caused a 53-69 percent increase in the share of abortions obtained during the second trimester. Our analysis examining overall abortion rates is less conclusive but suggests a reduction caused by the waiting period. To put these estimates into context, we provide back-of-the-envelope calculations on the additional monetary costs that Tennessee's MWP imposes on women seeking abortions.
Thirty-Day Readmissions after Early versus Delayed Discharge after Uncomplicated Transcatheter Aortic Valve Replacement: Insights from the Nationwide Readmissions Database

Early discharge after transcatheter aortic valve replacement (TAVR) has generally shown to be safe; however, studies have been limited to single centers or trial populations, making their generalizability unclear. This study sought to examine the rate of rehospitalization after early vs. late discharge following uncomplicated TAVR in an unselected population, to explore the variability in early discharge across sites, and to investigate factors associated with failure of early discharge. Using the National Readmission Databases (1/2014-9/2015), we compared 30-day readmission rates between early (<3 days) vs late (≥3 days) discharges after uncomplicated transfemoral TAVR (propensity matched cohort) using Kaplan-Meier methods. Additionally, we examined factors associated with failure of early discharge using logistic regression and testing for interactions of patient factors with discharge strategy. Among 4,955 hospitalizations for uncomplicated TAVR, 1857 (37%) were discharged early with substantial site-level variability (range 0-87%; median odds ratio 3.69). In the propensity matched cohort (n=3346), there were similar rates of 30-day readmission by discharge strategy (early vs. late: 10.3% vs. 10.6%; stratified log-rank p=0.555). There was a statistically significant interaction between discharge strategy and number of chronic
Atovaquone-Proguanil in Combination With Artesunate to Treat Multidrug-Resistant P. falciparum Malaria in Cambodia: An Open-Label Randomized Trial.

Background Recent artemisinin-combination therapy failures in Cambodia prompted a search for alternatives. Atovaquone-proguanil (AP), a safe, effective treatment for multidrug-resistant Plasmodium falciparum (P.f.), previously demonstrated additive effects in combination with artesunate (AS). Methods Patients with P.f. or mixed-species infection (n = 205) in Anlong Veng (AV; n = 157) and Kratie (KT; n = 48), Cambodia, were randomized open-label 1:1 to a fixed-dose 3-day AP regimen +/-3 days of co-administered artesunate (ASAP). Single low-dose primaquine (PQ, 15 mg) was given on day 1 to prevent gametocyte-mediated transmission. Results Polymerase chain reaction-adjusted adequate clinical and parasitological response at 42 days was 90% for AP (95% confidence interval [CI], 82%-95%) and 92% for ASAP (95% CI, 83%-96%; P = .73). The median parasite clearance time was 72 hours for ASAP in AV vs 56 hours in KT (P < .001) and was no different than AP alone. At 1 week postprimaquine, 7% of the ASAP group carried microscopic gametocytes vs 29% for AP alone (P = .0001). Nearly all P.f. isolates had C580Y K13 propeller artemisinin resistance mutations (AV 99%; KT 88%). Only 1 of 14 treatment failures carried the cytochrome bc1 (Pfcytb) atovaquone resistance mutation, which was not present at baseline. P.f. isolates remained atovaquone sensitive in vitro but cycloguanil resistant, with a triple P.f. dihydrofolate reductase mutation. Conclusions Atovaquone-proguanil remained marginally effective in Cambodia (≥90%) with minimal Pfcytb mutations observed. Treatment failures in the presence of ex vivo atovaquone sensitivity and adequate plasma levels may be attributable to cycloguanil and/or artemisinin resistance. Artesunate co-administration provided little additional blood-stage efficacy but reduced post-treatment gametocyte carriage in combination with AP beyond single low-dose primaquine.
HOXC13-AS-miR-122-5p-SATB1-C-Myc feedback loop promotes migration, invasion and EMT process in glioma

Purpose Differentially expressed long non-coding ribonucleic acids (lncRNAs) have been reported as a key factor of glioma carcinogenesis, but the underlying mechanism involved is still unknown. Materials and methods In the present study, lncRNA HOXC13 antisense RNA (HOXC13-AS) was identified as a potential oncogene in glioma, and Western blotting, wound healing and Transwell assays were carried out to explore the effects of HOXC13-AS on the epithelial-mesenchymal transition (EMT) process as well as the migration and invasion of glioma cells. Results A further mechanistic study showed that HOXC13-AS sponged miR-122-5p to indirectly regulate SATB1 expression and affect the EMT process via the Wnt/β-catenin pathway. Meanwhile, the promoter activity was significantly increased via c-Myc, a key factor of the Wnt/β-catenin pathway, thus forming a positive HOXC13-AS-miR-122-5p-SATB1-c-Myc feedback loop to drive the malignant behavior in glioma. Discussion This study evidences the constitutive HOXC13-AS-miR-122-5p-SATB1-c-Myc feedback loop and provides a potential therapeutic target for glioma treatment.
Comparative assessment of natural radioactivity and radiological hazards in building tiles and sharp sand sourced locally and those imported from China and India

Background: Thirteen (13) types of building tiles and Sharp sand commonly used for building purposes were collected for their radionuclide contents analysis. Both imported and locally produced building tiles were examined. Materials and Methods: The samples of tiles and sand were crushed to powder and they were prepared such that their content could be examined by the use of gamma-ray spectrometry. Results: The average activity concentration of 238U (60.61 Bq/kg), 232Th (76.55 Bq/kg) and 40K (528.40 Bq/kg) for all the samples were observed to be higher than the world recommended standard of 35, 30 and 400 Bq/kg respectively. The external and internal hazard indexes were estimated for all the building materials, the average results were found to be below the recommended limits. However, samples 3 and 6 reported internal hazard indices of 1.08 and 1.06 respectively, which are higher than the world standard. Furthermore, the estimated absorbed dose rates were observed to be within the recommended safe limits. Moreover, a comparative study of the products revealed that the results of the measured parameters from both India and China products are far higher than Nigeria products by a factor of about 1.34. Conclusion: The results obtained showed the following trend of activity concentration for the analyzed samples, India > China > Nigeria, which implies that a long exposure to both India and China products poses higher risk to the inhabitants.
Outcome of tibial plateau fractures treated by hybrid and Ilizarov external fixation

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures pose a challenge to the treating surgeon especially in cases with compromised soft tissue envelope. External fixation achieves good results with minimal complications. The objective of our study was to evaluate the functional outcome of tibial plateau fractures treated by Ilizarov and hybrid external fixation. </p><p class="abstract"><strong>Methods:</strong> 46 patients with tibial plateau fractures were analysed. 6 were lost to follow-up. 20 patients were treated by Ilizarov method and 20 by hybrid external fixation. <strong></strong></p><p class="abstract"><strong>Results:</strong> Mean time for union was 24.5 weeks in Ilizarov fixator group and 28 weeks in hybrid fixator group. Mean Lysholm’s score was 86.1 in Ilizarov cases and 83.4 in hybrid fixator cases. The mean knee society score in Ilizarov fixation cases was 78.5 and 77.3 in hybrid fixator cases. At one year by Lysholm score 6 patients had fair, 10 had good and 4 had excellent result in Ilizarov group and 1 had poor, 8 had fair, 8 had good and 3 had excellent results in hybrid group. 15 patients in Ilizarov method had good and excellent knee society scores and 12 patients had good and excellent results and 1 patient had poor score in Hybrid fixator group. </p><p class="abstract"><strong>Conclusions:</strong> External fixation in complicated tibial plateau fractures gives acceptable outcomes. Ilizarov external fixator has an advantage of earlier mobilization and earlier union but requires longer operation time and a bulky apparatus. Hybrid fixator on the other hand has lesser operating time and simpler construct but has less stability and longer union time. </p>