Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison of Sexual Function in Primiparous Women Pre-Pregnancy and Postpartum: Difference of the Sexual Function after the Normal Vaginal Delivery and the Cesarean Section

Introduction: Sexual function is undoubtedly an important dimension of adult life. Due to all the conflicting results with regard to sexual function after the normal vaginal delivery (NVD) or the Cesarean Section (CS), in the present study, we aimed to compare the sexual function in women pre-pregnancy and postpartum and also after the NVD and CS. Materials and Methods: In this cohort study, two groups of healthy women, with antenatal normal pregnancies, who underwent NVD (n = 90) and CS (n = 113), were prospectively studied. The sexual function of the participants was assessed through a Female Sexual Function Index (FSFI) questionnaire in two stages: once before pregnancy and then within 3 to 6 months after delivery, which lasted from June 2011 to September 2012. The data were analyzed by descriptive and inferential statistics. Data were analyzed using chi-square test, Mann-Whitney test, and T Test. Results: Based on the data gathered from 206 women who completed the FSFI questionnaire in two stages, the mean (±SD) self-reported timing of the resumption of sexual activity was 8.9 ± 1.3. There was no significant statistical difference found between the two groups by timing of the resumption of sexual activity in NVD and CS groups. There was also no statistically significant difference found in the overall sexual function scores between the two groups (NVD vs. CS). The average score for female sexual function in desire, arousal, orgasm, and satisfaction within 3 to 6 months after delivery was significantly lower than that of their pre-pregnancy period (p < 0.004). The mean coitus in postpartum period was 1.84 ± 1.20 per week. Conclusion: Based on the findings of this study, there was no significant relationship between the mode of delivery and changes in sexual function. Therefore, it can be claimed that CS is not preferred to NVD with regard to preserving normal sexual functioning.
Advances in Brief SPRY 2 Is an Inhibitor of the Ras / Extracellular Signal-Regulated Kinase Pathway in Melanocytes and Melanoma Cells with Wild-Type BRAF but Not with the V 599 E Mutant

BRAF mutations result in constitutively active BRAF kinase activity and increased extracellular signal-regulated kinase (ERK) signaling and cell proliferation. Initial studies have shown that BRAF mutations occur at a high frequency in melanocytic nevi and metastatic lesions, but recent data have revealed much lower incidence of these mutations in early-stage melanoma, implying that other factors may contribute to melanoma pathogenesis in a wild-type (WT) BRAF context. To identify such contributing factors, we used microarray gene expression profiling to screen for differences in gene expression between a panel of melanocytic and melanoma cell lines with WT BRAF and a group of melanoma cell lines with the V599E BRAF mutation. We found that SPRY2, an inhibitor homologous to SPRY4, which was previously shown to suppress Ras/ERK signaling via direct binding to Raf-1, had reduced expression in WT BRAF cells. Using small interfering RNA-mediated SPRY2 knockdown, we showed that SPRY2 acts as an inhibitor of ERK signaling in melanocytes and WT BRAF melanoma cells, but not in cell lines with the V599E mutation. We also show that SPRY2 and SPRY4 directly bind WT BRAF but not the V599E and other exon 15 BRAF mutants. These data suggest that SPRY2, an inhibitor of ERK signaling, may be bypassed in melanoma cells either by down-regulation of its expression in WT BRAF cells, or by the presence of the BRAF mutation.
Nursing Advocacy during a Military Operation

Advocacy is an essential component of the registered nurse’s professional role, yet experts provide no consistent definition of advocacy. The purpose of this study was to explore the experiences of military nurses as they engage in advocating practices and to describe their shared practices and common meanings. Heideggerian hermeneutic phenomenology, provided the framework and method for this study. Twenty-four U.S. Army nurses were individually interviewed and the researcher kept interview observational notes. The constant comparative method of analysis was used. The stories of these nurses revealed one constitutive pattern—safeguarding—and four related themes. The themes were advocating as protecting, advocating as attending the whole person, advocating as being the patient’s voice, and advocating as preserving personhood. One conclusion was that military nurses must be prepared for the important safe-guarding role. They must be coached in how to deal with other members of the health team on the patient’s behalf.
Identification and Targeting of Costimulation‐Resistant T cells in Renal Transplantation

Suppressing the T cell response in transplantation remains an enormous challenge given the diversity of functional T-lymphocyte subsets with the potential to mediate allograft rejection. In humans, alloreactive T cells are similarly represented among naive T cells, which have never been activated and among memory T cells generated from prior antigen exposure (1). In adult transplant patients, memory T cells comprise approximately one-half of circulating T cells and are distinguished from naive T cells by their increased expression of integrins, rapid production of effector cytokines, reduced CD28 costimulation requirements and diverse distribution in lymphoid and nonlymphoid tissue sites. These enhanced activation properties of memory T cells suggest that immunosuppression regimes that curtail activation of naive T cells, may not be comparably effective with memory T cells. In mouse transplantation models, the presence of memory T cells can interfere with tolerance induction strategies in vivo (2). In humans, determining whether memory T cells are adequately suppressed is more difficult to test, as one is limited to ex vivo analysis of memory T cells from peripheral blood. Such analysis provides information regarding pathway utilization, but in vivo effects must be inferred from patient outcomes.
Alterations of photophobic motile response in Stentor by cyclic guanosine 3',5'-monophosphate-elevating agents

The effects of exogenous cyclic nucleotides and modulators of the cyclic nucleotide signaling pathway on the step-up photophobic response have been studied in the ciliate Stentor coeruleus. To attain this, the latency time for the ciliary stop response and the ciliary reversal duration has been estimated using microscope videorecording and dark-field macro-photography. Membrane-permeable, slowly hydrolyzable analogs of cyclic GMP, 8-Br-cGMP and db-cGMP, significantly increase the latency time of ciliary stop response and decrease the period of ciliary reversal. By contrast, cyclic AMP analogs, 8-Br-cAMP or db-cAMP, had no measurable effect on the photophobic response parameters. The effects of the exogenous cGMP are mimicked by the application of the non-specific PDE inhibitor IBMX or zaprinast, a specific cGMP-PDE inhibitor. These behavioral observations suggest that in vivo, the internal level of presumed cGMP, but not cAMP, is possibly a limiting factor for the time course of the motile avoiding response of Stentor, and they further support the hypothesis that cGMP metabolism may play a role in photosignal transduction in these cells.
Morphology of the cloaca in the estuarine crocodile, Crocodylus porosus, and its plastic response to salinity

The cloacal complex of Crocodylus porosus is composed of three chambers (proctodaeum, urodaeum, and coprodaeum) separated by tight, muscular sphincters. The proctodaeum is proximal to the cloacal vent and houses the genitalia. The urodaeum is the largest chamber, is capable of storing large quantities of urine, and is lined with an epithelium with the capacity for transepithelial water and ion exchange. The coprodaeum, the most orad cloacal chamber, is a small, only marginally expandable chamber that has an epithelium composed almost entirely of mucus‐secreting cells. The coprodaeum and lower intestine are reported to be the site(s) for urine modification in birds and bladderless lizards. A radiographic trace of urine storage in C. porosus kept for 2 months under hyperosmotic conditions showed no signs of retrograde movement of urine into the coprodaeum or rectum. Instead, urine was stored in the urodaeum of C. porosus. Examination of the mucosal surface of the urodaeum by SEM showed a plastic response to environmental salinity, with a possible increase in surface area in animals kept in hyperosmotic water compared with animals from fresh water. We propose the urodaeum as the primary site for postrenal modification of urine in C. porosus. J. Morphol. 245:168–176, 2000 © 2000 Wiley‐Liss, Inc.
A two-stage model for development of antibody-producing cells.

This model divides plasma cell differentiation into two developmental stages within the framework of the clonal selection theory. The first stage occurs within specific induction micro-environments, independently of foreign antigens, and involves the generation of multiple clones of B-lymphocytes from stem cells of haematogenous origin. During this stage, diversity of immunoglobulin classes is generated by an orderly intraclonal switch from IgM to IgG to IgA; the antibodies made are incorporated into the cell surface. The second stage occurs in the circulation and in peripheral lymphoid tissues; it involves clonal selection of B-lymphocytes by antigens with subsequent proliferation and differentiation to become either memory cells or antibody-producing plasma cells.
Trends in Emergency Admissions

Part one of this series discusses how the more widely recognised factors, such as an ageing population, re-admissions and increasing expectations of medicine, only contribute to a baseline increase in emergency admissions. Seasonal variation is discussed in the context of the predictability, or otherwise of emergency admissions, in response to changes in the weather and the wider environment. However, these are unable to explain the observed cyclical events occurring in medicine every 4-6 years, and even longer cycles in surgical and trauma admissions. These cycles are discussed in part two, while part three investigates the implications on bed planning. The current methods for estimating the size of hospitals and bed pools within hospitals are shown to be inappropriate to the real needs of emergency care.
Just Doing What They Gotta Do

For single African American custodial fathers, parenting stress is exacerbated by the cultural expectation that Black fathers are “normally” absent and by the clustering of stresses that Black men are more likely to encounter. This sample of African American fathers have used a repertoire of problem-focused and cognitive coping strategies, including some that are frequently considered “culturally specific. ” Twenty Black single custodial fathers are interviewed and their narratives are analyzed for concepts and thematic categories related to stress and coping. Their narratives indicate that certain strategies are avoided because (a) these strategies are not available to them and (b) they desire to present themselves as independent and competent, thus resisting stereotypes and building a sense of efficacy.
1 Rapid Internationalization of SMEs from Resource Based View : A longitudinal Study of a Pharmaceutical company in Iran

In current global economy with hyper competition in home market, access to foreign markets has become a must for most of SMEs; therefore, SMEs internationalization has received great attention. However, internationalization of SMEs from developing countries in general and rapid internationalization in particular has remained largely unsearched. This longitudinal study was carried out with the aim of exploring the pattern of successful internationalization of an active pharmaceutical ingredient B2B SME from the resource based view (RBV). The study covers the company’s activities for establishment in foreign markets over a 12-year period (2000 2011) during which it entered 25 countries and increased its export by 20 times. The results of the study show that the internationalization behavior of the studied SME can be explained by a combination of three main critical resources such as entrepreneurial orientation, networking capability and adaptive production capability. These three resources have played crucial role as source of competitive advantage across foreign markets over time. Furthermore, although the RBV was constant during the period studied, the resources as bases for creating competitive advantages were changed from tangible to more intangible sources. The study has significant managerial and academic implications.
Metabolism of caffeine in non-insulin dependent diabetic patients by physiologically based pharmacokinetic modelling

Introduction: In vitro and earlier animal studies implicated altered metabolism of caffeine as a probe for CYP1A2 enzyme activity in diabetic disease state. However clinical studies in humans reported controversial findings. This study is aimed to compare the differences in the metabolism of caffeine in Non-Insulin Dependent Diabetes Mellitus (NIDDM) patients and in healthy subjects by using Physiologically Based Pharmacokinetic (PBPK) modelling with SimCYP simulator. Methodology: A mechanistic Physiologically Based Pharmacokinetic (PBPK) model based disposition study for caffeine in healthy subjects and in diabetic patients using SimCYP simulator was performed by altering the CYP1A2 abundance as reported earlier. Prior to using the model for predictions in diabetic patients, model was validated for accuracy by comparing the model predicted and observed pharmacokinetics of caffeine from four independent clinical trials in healthy subjects. Results and Conclusions: Results from the study confirmed the accuracy of the default SimCYP model for predicting caffeine pharmacokinetics in healthy Caucasian subjects. PBPK model for NIDDM patients found that Caucasian diabetic patient’s caffeine clearance is 37% higher in comparison with healthy subjects and there by reduced exposure of the drug in diabetic patients suggesting a similar fate for other CYP1A2 substrates. Simulations also suggested a clinical trial design that could be utilized to further study the real differences in caffeine disposition in diabetic patients in comparison to healthy subjects.
Gender and birth trauma in full-term infants

Objective: To investigate the association between gender and birth trauma in full-term infants. Methods: A retrospective, cohort, case-control study was conducted. All singleton full-term neonates born in 1986–2009 and diagnosed with birth trauma (ICD9-CM codes 767.0–767.9) were identified from the hospital’s computerized birth-discharge records. The study group was matched in a 2:1 ration with neonates delivered immediately after each index case of neonatal trauma. Results: Of the 118, 280 singleton full-term infants delivered during the study period, 2876 (24/1000) experienced birth trauma. The most frequent birth traumas were scalp injury (63.9%) and clavicle fracture (32.1%). The overall risk of birth trauma was unrelated to fetal gender. However, fetal male gender was a significant and independent risk factor for scalp injury (OR = 1.31, 95%–CI 1.15–1.49), and female fetal gender was a significant and independent risk factor for clavicle fracture (OR = 1.27, 95%–CI 1.09–1.49). The significance of these associations persisted even after adjustment for potential confounders including mode of delivery, gestational age, neonatal length, timing of delivery, head circumference, parity, and birth weight. Conclusion: Fetal gender appears to be a predisposing risk factor for specific types of birth trauma. Further studies are needed to investigate the reasons for this observation.
Microfat Grafting in Nasal Surgery.

BACKGROUND Injectable fillers are sometimes necessary to correct slight skin irregularities. However, there have been reports of necrosis after injection of alloplastic materials and heterogeneous transplants. On the other hand, the advantages of autogenous tissue grafts over those fillers are well established. Volumetric reshaping of the face with autologous tissue injection is a popular and reliable method with good long-term results. However, procedures performed on the fragile skin of the nose are prone to complications. OBJECTIVES The author conducted a study of injectable autologous microfat grafting to the nose in patients with secondary nasal deformities. METHODS During a 5-year period, 313 patients who had secondary nasal deformities with slight skin irregularities or severe nasal skin damage were treated with microfat grafting. At each patient's first injection session, excess harvested fat was cryopreserved for subsequent injection. To correct minor irregularities, 0.3 to 0.8 mL of microfat was injected during each session; for major irregularities or defects, 1 to 6 mL was required for each session. RESULTS One to 3 injections of microfat provided satisfactory results in all patients who had minor irregularities. For patients with multiple and severe irregularities, 3 to 6 injections were necessary and resulted in high patient satisfaction. In another group of patients, with severe traumatic skin damage, 6 to 16 injections were necessary for reconstruction. After repeated injections, each patient's skin damage was repaired. CONCLUSIONS Autologous microfat injection appears to be safe and effective for correcting slight irregularities of the nose. LEVEL OF EVIDENCE 4.
Broadband printed slot antenna for the fifth generation (5G) mobile and wireless communications

In this paper, a broadband elliptical-shaped slot antenna for the future fifth generation (5G) wireless applications is proposed. The antenna has a compact size of 0. 5λ0 × 0. 5λ0 at 30 GHz. It consists of a circular shaped radiating patch fed by a 50-Ω microstrip line via proximity-feed technique. An elliptically shaped slot is etched in the ground plane to enhance the antenna bandwidth. A stub has been added to the microstrip line feed to achieve better impedance matching bandwidth of the antenna. Simulated results indicate that the proposed 5G antenna yields a broadband impedance bandwidth larger than 67% (from 20 GHz to beyond 40 GHz) for S11 less than -10 dB. The achieved bandwidth covers both future 5G bands (28/38 GHz). The proposed antenna provides almost omni-directional patterns, relatively flat gain, and high radiation efficiency through the frequency band excluding the rejected band.
Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.

BACKGROUND Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety. METHODS Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival. RESULTS A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P<0.001 by the log-rank test). The two-year survival rate was 26.5 percent with radiotherapy plus temozolomide and 10.4 percent with radiotherapy alone. Concomitant treatment with radiotherapy plus temozolomide resulted in grade 3 or 4 hematologic toxic effects in 7 percent of patients. CONCLUSIONS The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity.
Rabbit technologies: adoption studies in the Ashanti Region of Ghana

The study focused on identifying the main factors affecting the adoption of technologies in the rabbit industry. Data was collected through the use of the snowball sampling technique. The stocking technology was the highest adopted technology by the rabbit farmers. There is a clear evidence to prove that overall adoption of rabbit technologies among rabbit farmers was low. Adoption of rabbit technologies was dependent on age, marital status, type of farming and main purpose of entering the rabbit business. Majority of the respondents were faced with time constraints in rabbit technology adoption. Technology oriented programmes must still be organised and intensified among rabbit farmers since overall adoption among rabbit farmers was low. Key words: Adoption, breeding, feeding, Ghana, housing, rabbit, technology.
Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery

Aim: The purpose of this study was to compare the perioperative advantage and disadvantage between general (GA) and spinal anesthesia (SA). Material and Methods: Sixty patients (randomize GA,n=30, SA,n=30) undergoing lumbar disc surgery were enrolled. Patients were matched for demographic data, perioperative physiological changes, pain score, amount of blood loss, surgeon ‘satisfaction, perioperative complications and length of stay in hospital. Results: Intraoperatively and postoperatively, the incidence of tachycardia and hypertension were more frequent with GA (p<0.05). The surgeon's satisfaction was reported to be higher in the GA group (p<0.05). Anesthetic and operative times were longer for patients in GA group (p<0.05), in whom more nausea, vomiting, pain and greater requirements for antiemetic and pain medication were also during PACU (p<0.05). 24 hours after surgery, PACU time, ambulation of day of surgery, hospital stay, requirement of antiemetic and analgesic medication, pain score, nausea, urinary retention and headache were similar in two groups (p>0.05), however vomiting was more frequent in GA group in this period (p<0.05). Conclusion: For patients undergoing lumbar disc surgery, spinal anesthesia was as safe and effective as general anesthesia. Specific advantages to spinal anesthesia include decreased antiemetic and analgesic medication and reduced overall complication rate.
The health status of Saudi women: findings from a national survey.

Background We conducted a large national survey in the Kingdom of Saudi Arabia in 2013. We report on the health status of Saudi women and their health challenges. Methods A total of 10 735 participants, including 5482 women, completed the survey and were invited to local health clinics for biomedical exams. Results About 33.5% of women were obese and 28.0% were overweight. Hypertension was higher among women who were separated, divorced or widowed [adjusted odds ratios (AOR) ¼ 1.6; 95% conﬁdence interval (CI): 1.1–2.4], were obese (AOR ¼ 2.2; 95% CI: 1.6–3.0) and had never received a routine medical exam or last received one prior to the last 2 years (AOR ¼ 1.8; 95% CI: 1.3–2.4). Older women (AOR ¼ 1.0; 95% CI: 1.0–1.1) and those who were separated, divorced or widowed (AOR ¼ 1.9; 95% CI: 1.1–3.3) were more likely to be diabetics. A large proportion of diabetic women were undiagnosed (48.4%), and 27.8% of those receiving treatment had uncontrolled diabetes. Conclusions Our study revealed that women need to improve their health behaviors in order to reduce the burden of chronic diseases in the Kingdom. Saudi women need to be involved in the design and implementation of disease prevention and health