Miracle-dz/UniFAR-FTUs huggingface dataset:
Nursing international student mobility in the University of São Paulo.

OBJECTIVE To characterize the experiences of undergraduate students of the School of Nursing of the University of São Paulo (EEUSP) who participated in international mobility programs between January 2011 and July 2017. METHOD Exploratory, descriptive study with quantitative approach. Of 68 reports, only 38 (56%) were considered valid and were submitted to descriptive statistical analysis. Data were categorized in general, institutional, academic and cultural aspects and cost of living. RESULTS The main destination was Portugal and the years with most participation were 2012 and 2013. The mean stay was six months and the students took a mean of three to four courses. The main funder was the university of origin. CONCLUSION Academic activities were limited to theoretical and practical courses, with little insertion in research. There is a need to increase investment in learning other languages and to expand partnerships with larger centers of foreign education and research.
Protective Effects of Nintedanib against Polyhexamethylene Guanidine Phosphate-Induced Lung Fibrosis in Mice

Nintedanib (NDN), a tyrosine kinase inhibitor, has been shown to have anti-tumor, anti-inflammatory, and anti-fibrotic effects in several reports. We investigated the protective effects of NDN against polyhexamethylene guanidine phosphate (PHMG)-induced lung fibrosis in mice. The following three experimental groups were evaluated: (1) vehicle control; (2) PHMG (1.1 mg/kg); and (3) PHMG & NDN (60 mg/kg). PHMG induced pulmonary inflammation and fibrosis by intratracheal instillation in mice. In contrast, NDN treatment effectively alleviated the PHMG induced lung injury, and attenuated the number of total cells and inflammatory cells in the bronchoalveolar lavage fluid, including the fibrotic histopathological changes, and also reduced the hydroxyproline content. NDN also significantly decreased the expression of inflammatory cytokines and fibrotic factors, and the activation of the NLRP3 inflammasome in lung tissues. These results suggest that NDN may mitigate the inflammatory response and development of pulmonary fibrosis in the lungs of mice treated with PHMG.
Simultaneous treatment of parapelvic renal cysts and stones by flexible ureterorenoscopy with a novel four-step cyst localization strategy

ABSTRACT Objective: To assess the safety, feasibility, and efficacy of simultaneous treatment of parapelvic renal cysts and stones by flexible ureterorenoscopy with a novel four-step cyst localization strategy in selected patients. Patients and Methods: We retrospectively reviewed 11 consecutive cases of parapelvic renal cysts with concomitant calculi treated by flexible ureterorenoscopy and laser lithotripsy (FURSL). Marsupialization was performed subsequently with holmium: YAG laser in our institution. Fragmentation was used to manage renal stones and a novel four-step cyst localization strategy was applied in each case for marsupialization. Results: There were no intraoperative complications. Two cases of cystitis were reported postoperatively. The mean operative times of FURSL and marsupialization were 23.6 ± 3.9 minutes and 29.1 ± 9.7 minutes, respectively. During marsupialization, seven patients underwent the first two steps of the new strategy, two patients underwent three steps and two patients underwent all four steps. The mean reduction in hemoglobin level was 4.7 ± 1.7 g / L (range 3-8 g / L). The mean length of hospital stay was 1.2 ± 0.4 days. During a mean follow-up duration of 18 months, all cases remained stone-free and there was no stone recurrence. Parapelvic cysts became undetectable in eight cases and decreased in size by at least half in three cases. Conclusion: With appropriate patient selection, FURSL and marsupialization with a four-step cyst localization strategy is feasible, safe, and effective in treating parapelvic renal cysts with concomitant calculi.
Impact of Tumor Deposits on Oncologic Outcomes in Stage III Colon Cancer

BACKGROUND: The prognosis of tumor deposits in stage III colon adenocarcinoma is poorly described. OBJECTIVE: The purpose of this study was to determine the impact of tumor deposits on oncologic outcomes in patients with stage III colon cancer. DESIGN: This was a multicenter retrospective cohort study. SETTINGS: The 2010 to 2014 National Cancer Database was queried for patients with resected stage III colon adenocarcinoma on final pathology. PATIENTS: Patients were divided into 3 groups: lymph nodes+tumor deposits–, lymph nodes+tumor deposits+, and lymph nodes–tumor deposits+. MAIN OUTCOME MEASURES: The main outcome was 5-year overall survival. RESULTS: Of 74,577 patients, there were 55,800 patients with lymph nodes+tumor deposits–, 13,740 patients with lymph nodes+tumor deposits+, and 5037 patients with lymph nodes–tumor deposits+. The groups had similar patient and facility characteristics, but patients with lymph nodes+tumor deposits+ had more advanced tumor characteristics. Patients with lymph nodes–tumor deposits+ were less likely to receive adjuvant systemic therapy (52% vs 74% lymph nodes+tumor deposits– and 75% lymph nodes+tumor deposits+, p < 0.001) and had a longer delay to initiation of adjuvant treatment (>8 weeks; 43% vs 33% lymph nodes+tumor deposits– and 33% lymph nodes+tumor deposits+, p < 0.001). Patients with lymph nodes+tumor deposits+ had the lowest 5-year overall survival (46.0% vs 63.4% lymph nodes+tumor deposits– vs 61.9% lymph nodes–tumor deposits+, p < 0.001). On multivariate analysis, patients with lymph nodes–tumor deposits+ had similar 5-year overall survival compared with patients with lymph nodes+tumor deposits– with ⩽3 positive lymph nodes (HR, 0.93; 95% CI, 0.87–1.01). Patients with lymph nodes+tumor deposits+ had worse prognosis regardless of the number of involved lymph nodes (⩽3 +lymph nodes: HR, 1.37; 95% CI, 1.28–1.47 and ≥4 +lymph nodes: HR, 1.30; 95% CI, 1.22–1.38). Of those not receiving adjuvant treatment, patients with lymph nodes–tumor deposits+ were younger and had more adverse tumor features than lymph node+ disease. Lymph nodes–tumor deposits+ was independently associated with less delivery of adjuvant systemic therapy (OR, 0.81; 95% CI, 0.80–0.82). LIMITATIONS: This study was limited by its retrospective analysis of a prospective database. CONCLUSIONS: The prognosis of patients with N1c disease is similar to nodal involvement without tumor deposits, yet these patients were less likely to receive adjuvant systemic therapy. Improvement in the delivery of appropriate care in these patients may increase survival and should be a target of future quality initiatives. See Video Abstract at http://links.lww. com/DCR/A666.
The Distinct Role of Small Heat Shock Protein 20 on HCV NS3 Expression in HEK-293T Cell Line

Background: Hepatitis C (HCV) is known as a serious blood-borne disease that infects millions of people globally. NS3 is a conserved non-structural sequence of hepatitis C virus which has a major role in activating specific CTL responses. As known, there is no effective vaccine against HCV infection, thus it is required to design a specific regimen of vaccination. Recently, the strong immunological properties of Heat shock proteins (Hsps) led to their use as immunomodulators and an antigen carrier for subunit vaccine candidates. In the current study, the role of Hsp20 was evaluated as a HCV NS3 gene carrier in mammalian cell line. Methods: At first, the recombinant plasmids of pEGFP-Hsp20, pEGFP-NS3, and pEGFP-Hsp20-NS3 were constructed and their accuracy was confirmed by digestion and sequencing. Then, all recombinant plasmids were transfected into HEK293T cells by Lipofectamine and TurboFect gene delivery systems. Finally, the expression of proteins was assessed by fluorescent microscopy, western blotting, and flow cytometry. Results: In western blotting, the 47, 59, and 79 kDa bands were detected for pEGFP-Hsp20, pEGFP-NS3, and pEGFP-Hsp20-NS3, respectively. The percentage of NS3-Hsp20-GFP protein expression was ∼67% by TurboFect and ∼50% by Lipofectamine indicating high potency of TurboFect delivery system. Furthermore, the expression of Hsp20 (∼83%) was higher than NS3 (∼58%) in the cells transfected by TurboFect using flow cytometry analysis. This result was confirmed in the expression of Hsp20-NS3 fusion (∼67%) in which Hsp20 increased the delivery of HCV NS3 in vitro. The same data were obtained by Lipofectamine transfection reagent. Conclusion: Briefly, our data confirmed the role of Hsp20 as a suitable antigen carrier for DNA vaccine design.
Carotid intima-media thickness, flow-mediated dilatation and proteinuria in patients of human immunodeficiency virus-positive patients: A case–control study

Introduction: Endothelium-dysfunction (ED) is a surrogate marker of coronary atherosclerotic disease. Carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), and proteinuria are surrogate markers of ED. Few studies have shown that patients with HIV have impaired endothelial function and are thus at risk of accelerated atherosclerosis. Materials and Methods: The present study assessed ED in HIV patients by various biophysical parameters as brachial artery FMD, CIMT, and proteinuria. A total of 43 HIV-infected patients were compared with 25 healthy controls who were healthy. Results: Mean age of patients with HIV was 33.84 ± 5.61 years while that of healthy controls was 31.48 ± 5.40 years. Male to female ratio among cases was 24:19 while among controls was 17:8. Mean CIMT was significantly higher among cases than control (0.513 ± 0.079, 0.452 ± 0.050 mm, respectively, P = 0.001). Percentage change in FMD was significantly lower among cases than control (3.27 ± 2.01, 6.96 ± 1.28, respectively, P = 0.001). Urine protein grading was significantly different between cases and controls (P = 0.007), with stable HIV cases having significantly higher urine protein grading compared to healthy controls. However, no correlation was seen between CIMT, FMD, and proteinuria overall among cases and controls. Conclusions: HIV-infected patients have significant impairment of endothelial function, in the form of increased CIMT, impaired FMD, and more proteinuria as compared to healthy controls.
Effect of the comprehensive voice rehabilitation program in teachers with behavioral dysphonia.

PURPOSE Analyze the effects of the Comprehensive Vocal Rehabilitation Program (CVRP) and the motivational stages during speech therapy in teachers with behavioral dysphonia. METHODS Retrospective, longitudinal, observational study using data from the medical records of 33 teachers regarding auditory-perceptual, acoustic, self-perception analyses and the Voice Handicap Index (VHI-10) protocol in pre- and post-speech therapy situations, and motivational stages of adherence to treatment. RESULTS Auditory-perceptual assessment of the voice showed that 64.7% of the participants improved voice quality post-speech therapy. Comparison between the pre- and post-speech therapy moments showed that 82.4% of the teachers improved their voice according to self-perception. The VHI-10 showed no statistically significant difference between the pre- and post-speech therapy moments (p=0.879). Acoustic analysis of the voice showed improvement in the means of all evaluated parameters. Statistically significant correlation was observed in the analysis between the pre- and post-speech therapy moments only for the variables maximum phonation time and shimmer. Most of the teachers were at the stage of contemplation on the URICA-VOICE scale. No statistical significance was observed in the correlation analysis between VHI-10, auditory-perceptual assessment of the voice, maximum phonation time, and parameters of acoustic analysis with vocal self-perception of teachers and with auditory-perceptual assessment of voice. CONCLUSION The use of CVRP for the treatment of behavioral dysphonia presented positive results in the pre- and post-speech therapy evaluation. As for motivation, the teachers strongly believed in the possibility of facing the problem, but still without much effort to change this situation.
Characteristics of Colon-Derived Uremic Solutes.

BACKGROUND AND OBJECTIVES Colon microbial metabolism produces solutes that are normally excreted in the urine and accumulate in the plasma when the kidneys fail. This study sought to further identify and characterize human colon-derived uremic solutes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Colon-derived solutes normally excreted in the urine were identified by comparing urine from controls (n=17) and patients with total colectomies (n=12), using an established metabolomic platform. Colon-derived solutes that accumulate in kidney failure were then identified by comparing the plasma of the control patients with that of patients on dialysis (n=14). RESULTS Ninety-one urinary solutes were classified as colon-derived on the basis of the finding of a urine excretion rate at least four-fold higher in control patients than in patients with total colectomies. Forty-six were solutes with known chemical structure, 35 of which had not previously been identified as colon-derived. Sixty of the colon-derived solutes accumulated in the plasma of patients with ESKD to a degree greater than urea and were therefore classified as uremic. The estimated urinary clearance for 27 out of the 32 colon-derived solutes for which clearance could be calculated exceeded that of creatinine, consistent with tubular secretion. Sulfatase treatment revealed that 42 out of the 91 colon-derived solutes detected were likely conjugates. CONCLUSIONS Metabolomic analysis identified numerous colon-derived solutes that are normally excreted in human urine. Clearance by tubular secretion limits plasma levels of many colon-derived solutes.
The Pattern of Stability and Change in Parental Locus of Control Over 6 Years and Teacher Ratings of Child Behavior

A previous study from our group showed that parents’ locus of control (LOC) obtained before the birth of their child was associated with the child’s behavior at school in School Years 3 (ages 7–8) and 6 (ages 10–11). Here we examine whether a change in parental LOC over the first 6 years of the child’s life was associated with differences in his or her behavior as rated by their teachers. As before, we use data from the Avon Longitudinal Study of Parents and Children (ALSPAC). A modified version of the adult Nowicki–Strickland internal–external LOC scale was completed by mothers and fathers in their own home during pregnancy and 6 years later. Externality was defined as a score greater than the median and internality as equal to, or less than, the median. Outcomes were the five individual subscales and the total difficulties of Goodman’s Strengths and Difficulties Questionnaire (SDQ) completed by the children’s class teachers at the end of School Years 3 and 6. As predicted, we found that parents who remained externally oriented, or became external, had children with more behavioral difficulties in primary school compared with parents who remained or became internal. Type of behavior difficulties varied somewhat with whether mothers or fathers remained or changed toward externality. These results support the possibility that changes in parental LOC are associated with children’s personal and social adjustment. Consequently, programs to change parental LOC may be worth evaluating.
Evaluation of Water Indices for Surface Water Extraction in a Landsat 8 Scene of Nepal

Accurate and frequent updates of surface water have been made possible by remote sensing technology. Index methods are mostly used for surface water estimation which separates the water from the background based on a threshold value. Generally, the threshold is a fixed value, but can be challenging in the case of environmental noise, such as shadow, forest, built-up areas, snow, and clouds. One such challenging scene can be found in Nepal where no such evaluation has been done. Taking that in consideration, this study evaluates the performance of the most widely used water indices: Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), Modified NDWI (MNDWI), and Automated Water Extraction Index (AWEI) in a Landsat 8 scene of Nepal. The scene, ranging from 60 m to 8848 m, contains various types of water bodies found in Nepal with different forms of environmental noise. The evaluation was conducted based on measures from a confusion matrix derived using validation points. Comparing visually and quantitatively, not a single method was able to extract surface water in the entire scene with better accuracy. Upon selecting optimum thresholds, the overall accuracy (OA) and kappa coefficient (kappa) was improved, but not satisfactory. NDVI and NDWI showed better results for only pure water pixels, whereas MNDWI and AWEI were unable to reject snow cover and shadows. Combining NDVI with NDWI and AWEI with shadow improved the accuracy but inherited the NDWI and AWEI characteristics. Segmenting the test scene with elevations above and below 665 m, and using NDVI and NDWI for detecting water, resulted in an OA of 0.9638 and kappa of 0.8979. The accuracy can be further improved with a smaller interval of categorical characteristics in one or multiple scenes.
Nurses’ Intention to Leave the Organization: A Mediation Study of Professional Burnout and Engagement

Abstract The nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses’ intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses’ participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β = –.45, p < .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β = –.11, p < .001) and job engagement feelings (β = –.15, p < .001) were both significant mediators between nurses’ decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses’ professional well-being are two crucial strategies to reduce nurses’ turnover intentions.
Small-Band-Gap Halide Double Perovskites.

Despite their compositional versatility, most halide double perovskites feature large band gaps. Herein, we describe a strategy for achieving small band gaps in this family of materials. The new double perovskites Cs2 AgTlX6 (X=Cl (1) and Br (2)) have direct band gaps of 2.0 and 0.95 eV, respectively, which are approximately 1 eV lower than those of analogous perovskites. To our knowledge, compound 2 displays the lowest band gap for any known halide perovskite. Unlike in AI BII X3 perovskites, the band-gap transition in AI2 BB'X6 double perovskites can show substantial metal-to-metal charge-transfer character. This band-edge orbital composition is used to achieve small band gaps through the selection of energetically aligned B- and B'-site metal frontier orbitals. Calculations reveal a shallow, symmetry-forbidden region at the band edges for 1, which results in long (μs) microwave conductivity lifetimes. We further describe a facile self-doping reaction in 2 through Br2 loss at ambient conditions.
Combination of Electroconvulsive Therapy and Clozapine in Treatment-Resistant Schizophrenia

Objective This study aimed to investigate the effectiveness and tolerability of the combination of electroconvulsive therapy (ECT) in patients with clozapine-treated schizophrenia. Methods Patients with clozapine-treated schizophrenia during five years of pre-determined period were recruited from Electronic Medical Record. Clinical effects of acute ECT on psychotic symptoms were investigated. We also tried to identify predictive variables requiring maintenance treatment of ECT. Results Fourteen patients received ECT and clozapine and sixteen were treated with clozapine alone. In the ECT group, which could be refined as clozapine-resistance, PANSS total score was significantly reduced by 19.0±9.9 points, corresponding to a reduction rate of 18.5±8.3%. The clinical remission defined as 20% PANSS reduction criteria was achieved at 42.9%. The subscale factors were significantly reduced, among which the negative symptom was the least. There was no difference in demographic and clinical information between patients receiving and not receiving maintenance ECT, and not all patients seemed to need maintenance ECT if clozapine is continued. Conclusion Combination of ECT and clozapine in patients with clozapine-resistant schizophrenia resulted in a rapid and substantial reduction of psychotic symptoms. Further studies are needed to improve the effectiveness and tolerability of ECT.
Biphasic renal synovial sarcoma with extensive venous tumor thrombosis: A rare presentation

Primary renal synovial sarcoma (SS) is a very rare soft-tissue tumor arising from the kidney. These tumors histologically closely resemble other sarcoma variants. Immunohistochemical and cytogenetic techniques remain the cornerstone in achieving the correct diagnosis. Radical surgical excision is the primary treatment for local tumor control and alleviation of symptoms. Adjuvant chemotherapy, at present, has only a limited role. We report a unique case of a 21-year-old young male with the diagnosis of a biphasic renal SS with extensive venous system thrombosis involving the inferior vena cava, bilateral iliac, and femoral vessels which was managed by radical nephrectomy and tumor thrombectomy followed by adjuvant chemotherapy.
Robust Implicit Backpropagation

Arguably the biggest challenge in applying neural networks is tuning the hyperparameters, in particular the learning rate. The sensitivity to the learning rate is due to the reliance on backpropagation to train the network. In this paper we present the first application of Implicit Stochastic Gradient Descent (ISGD) to train neural networks, a method known in convex optimization to be unconditionally stable and robust to the learning rate. Our key contribution is a novel layer-wise approximation of ISGD which makes its updates tractable for neural networks. Experiments show that our method is more robust to high learning rates and generally outperforms standard backpropagation on a variety of tasks.
Economic complexity unfolded: Interpretable model for the productive structure of economies

Economic complexity reflects the amount of knowledge that is embedded in the productive structure of an economy. It resides on the premise of hidden capabilities—fundamental endowments underlying the productive structure. In general, measuring the capabilities behind economic complexity directly is difficult, and indirect measures have been suggested which exploit the fact that the presence of the capabilities is expressed in a country’s mix of products. We complement these studies by introducing a probabilistic framework which leverages Bayesian non-parametric techniques to extract the dominant features behind the comparative advantage in exported products. Based on economic evidence and trade data, we place a restricted Indian Buffet Process on the distribution of countries’ capability endowment, appealing to a culinary metaphor to model the process of capability acquisition. The approach comes with a unique level of interpretability, as it produces a concise and economically plausible description of the instantiated capabilities.