Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving The Oral Absorption Of Nintedanib By A Self-Microemulsion Drug Delivery System: Preparation And In Vitro/In Vivo Evaluation

Objective Nintedanib (NDNB) is a triple receptor tyrosine kinase inhibitor with poor solubility in neutral conditions and low bioavailability. A self-microemulsifying drug delivery system (SMEDDS) of NDNB was developed to improve drug solubility in physical conditions and absorption in vivo. Methods The NDNB-SMEDDS formulation was optimized via pseudo-ternary phase diagrams. The physicochemical properties of NDNB-SMEDDS, viz., morphological observation, droplet size, stability, compatibility and in vitro release were investigated. The permeability of NDNB-SMEDDS was detected using both a Caco-2 cell monolayer in vitro and an intestinal perfusion study in vivo. Furthermore, the pharmacokinetic characteristics of NDNB-SMEDDS were evaluated. Results The optimal formulation was composed of MCT as an oil phase, RH 40 as a surfactant and ethylene glycol as a co-surfactant. The average droplet size of the microemulsion was about 23 nm with good stability within 30 days. The formulation did not exhibit any obvious cytotoxic effect on Caco-2 cells. Permeability of nintedanib in a Caco-2 cell monolayer was enhanced by 2.8-fold upon incorporation in SMEDDS compared with the drug solution. The intestinal perfusion study demonstrated that the Papp of NDNB-SMEDDS increased by 3.0-fold in the entire intestine and 3.2-fold in the colon in comparison with the drug solution. The pharmacokinetics study showed that the AUC of the NDNB-SMEDDS increased significantly. Conclusion This study showed that the self-microemulsion formulations could improve the absorption of nintedanib, and can thus serve as a promising carrier for the oral delivery of nintedanib.
The Prognostic Value Of Lymph Node Ratio In Patients With N2 Stage Lung Squamous Cell Carcinoma: A Nomogram And Heat Map Approach

Background Lymph node ratio (LNR), defined as the ratio of the number of positive lymph nodes to the total of all resected nodes, has been reported to be a predictor of survival of patients with several types of cancer. However, the prognostic value of LNR and other factors in patients with resected N2 stage lung squamous cell carcinoma has never been considered. Methods Data from 1778 patients with resected N2 stage lung squamous cell carcinoma were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The optimal cutoff value of LNR was identified by X-tile. A multivariable Cox model and corresponding nomogram were constructed to predict overall survival (OS) and cancer-specific survival (CSS). Both the cutoff value of LNR and the model were further validated in 146 similar patients treated in Zhongshan Hospital. Heat maps were created to visualize the distribution of LNR and the number of positive lymph nodes with the predicted survival probabilities. Results The optimal cutoff value for LNR was identified as 0.42. Multivariable analysis showed that age, sex, tumor laterality, type of surgery, T stage, chemotherapy and LNR were independently correlated with OS. Harrell’s C-index of the nomogram (0.64) was significantly higher than the index of the T stage-based model (0.54). Calibration curves showed good agreement between predicted and observed survival probabilities. The robustness of the model was also demonstrated by external validation. Conclusion LNR less than 0.42 was associated with improved OS and CSS for patients with resected N2 stage lung squamous cell carcinoma.
Gender differences in grief narrative construction: a myth or reality?

ABSTRACT Background: Narratives play a central role in the recovery process following death, and linguistic properties of grief narratives can serve as indicators of adjustment to loss. The present study examined whether bereaved men and women differ in how they discuss their loss, and how linguistic markers relate to psychological functioning. Positive associations were hypothesized between first-person singular pronoun use and psychological distress. Gender differences were expected for different emotion and social process words, and overall word use. Exploratory analyses were conducted to assess the relationship between linguistic markers and psychosocial outcomes for men and women separately. Method: 50 bereaved widow(er)s and parents (29 women, 21 men; M Age = 71.16 years, SD = 9.95) completed psychosocial self-report questionnaires and individual in-depth interviews. Grief narratives were analysed using Linguistic Inquiry and Word Count (LIWC), a software program that quantifies words into linguistic and psychological categories. Results: Contrary to our hypothesis, first-person pronoun use was not related to psychological distress. Although gender differences emerged in self-reported psychosocial outcomes, we failed to find the predicted gender differences in linguistic markers (emotion and social process words, overall word count). Exploratory analyses revealed additional associations between linguistic markers and psychosocial outcomes, and gender differences in these relationships. Notably, first-person pronoun use was related to heightened grief avoidance. Furthermore, various linguistic markers were associated with increased depression levels in females, but not males. In contrast, nonfluencies were positively associated with indicators of psychological distress in men only. Conclusion: In line with the gender similarities hypothesis, analyses suggest similarities between men and women’s discussion of their grief experience. Associations between linguistic markers and psychological adjustment indicate that grief narratives contain meaningful indices of underlying health. HIGHLIGHTS • Narratives constitute one way to make sense of loss. • The present study investigated linguistic properties of grief narratives, explored gender differences in linguistic markers, and their relationship to mental health. • Associations between linguistic markers and psychological adjustment indicate that grief narratives contain meaningful indices of underlying health. For instance, first-person pronoun use was positively associated with grief avoidance. • Men and women are more similar than different in discussing loss, despite self-reported differences in adjustment.
The impact of systemic precision medicine and immunotherapy treatments on brain metastases

Metastases from melanoma, lung and breast cancer are among the most common causes of intracranial malignancy. Standard of care for brain metastases include a combination of surgical resection, stereotactic radiosurgery, and whole-brain radiation. However, evidence continues to accumulate regarding the efficacy of molecularly-targeted systemic treatments and immunotherapy. For non-small cell lung cancer (NSCLC), numerous clinical trials have demonstrated intracranial activity for inhibitors of EGFR and ALK. Patients with melanoma brain metastases may benefit from systemic therapy using BRAF-inhibitors with and without trametinib. Several targeted options are available for breast cancer brain metastases that overexpress HER2, although agents with intracranial activity are still needed for other molecular subtypes. Immune checkpoint inhibitors including anti-CTLA-4 and anti-PD-1/PD-L1 antibodies are yielding impressive responses in intracranial manifestations of metastatic melanoma and NSCLC. Given the promising early results with these emerging therapies, management of eligible patients will require increased multidisciplinary discussion incorporating novel systemic treatment approaches prior or in addition to local therapy.
Standardized measurement of auricle: A method of high-precision and reliability based on 3D scanning and Mimics software

Objective measurement is important for diagnosing congenital or acquired auricular abnormalities and the evaluation of therapeutic efficacy. However, methods applied in the past were mostly inaccurate and unreliable. The present study aimed to introduce five standardized indices for auricle measurement and present a highly precise and reliable methodology combining three-dimensional (3D) scanning techniques and the Materialise Mimics software for the evaluation of auricle sizes. A total of 20 normal ears were measured independently by four surgeons using the standardized digital method with 3D scanning technique and the traditional manual method. Parameters of the auricle, including the length and width, arc length, cranioauricular height and angle were measured using the Mimics software. Paired t-test, Wilcoxon signed rank test and intra-class correlation coefficients (ICC) were performed on the data to assess the precision, uniformity and observer independence of the method. Pearson's product moment correlation was calculated to assess the correlation between auricle length and width in addition to the correlation between cranioauricular height and angle. No significant differences were indicated between measurements of five auricular parameters made by two surgeons using the digital method. However, significant differences were found using the manual method (P<0.01). ICC values derived from digital measurements ranged from 0.901 to 0.987, whereas those derived from manual measurements ranged from 0.526 to 0.807. These results suggested that the standardized digital method was replicable and reliable compared with the traditional manual method. Pearson's coefficient analysis showed that there was a significant correlation between cranioauricular height and angle (P<0.05), but no correlations were found between the height and width of the auricle (P>0.05). Taken together, data from the present study suggested that measurements of the length and width, arch length, and cranioauricular height and angle of auricles using the standardized digital method combining 3D scanning with the Mimics software were comprehensive, precise, convenient, repeatable and reliable.
The Role Of Progestogens In Threatened And Idiopathic Recurrent Miscarriage

Abstract It is well known that progesterone plays a major role in the maintenance of pregnancy, particularly during the early stages, as it is responsible for preparing the endometrium for implantation and maintenance of the gestational sac. The management of pregnant women at risk of a threatened or idiopathic recurrent miscarriage is complex and critical. Therefore, a group of obstetricians and gynecologists practicing in Saudi Arabia gathered to update the 2014 Saudi guidelines for threatened and recurrent miscarriage management. In preparation, a literature review was conducted to explore the role of oral, vaginal, and injectable progestogens: this was used as a basis to develop position statements to guide and standardize practice across Saudi Arabia.
Effect of educational intervention on the knowledge of rabies among medical school students of Chennai

BACKGROUND: Although rabies is highly fatal, with timely and correct postexposure prophylaxis (PEP) of animal bite victims, it could be prevented. Medical school students should be trained about the appropriate rabies management during their formative years so that they put the right practice later on. The study was conducted to assess the knowledge about rabies epidemiology and prophylaxis among medical students and to find the effect of an educational intervention. MATERIALS AND METHODS: This was a quasi-experimental study conducted with 156 third academic year medical school students at a tertiary care teaching hospital. The study participants were given health education intervention. A study tool assessed the knowledge of study participants on domains such as epidemiology of rabies, pre-exposure prophylaxis (PrEP) and PEP, and national program guidelines of rabies prevention. The study tool was administered before and after the intervention. The impact of educational intervention was measured with scores. Wilcoxon signed-rank test was applied to test the difference. RESULTS: The overall total mean pretest total score was 14.9 (±3.7) and posttest score was 22.7 (±3.23) for a maximum score of 29. The mean pretest scores for epidemiology, PrEP and PEP and national program components were 6.09, 7.95, and 0.85 respectively. Likewise, the mean posttest scores were 8.09, 13.26, and 1.35 respectively. There were a statistically significant improvement in the scores after health education intervention. CONCLUSIONS: After educational intervention, there were statistically significant improvement in the scores of all the three domains. PrEP and PEP and national program domain of rabies need to be emphasized during formative years.
Health services utilization among slum dwellers: An experience from Iran

INTRODUCTION: Health services utilization is a complex behavioral phenomenon affected by multiple factors including availability, distance, cost and quality of health services as well as personal attitudes, cultural beliefs, and socioeconomic characteristics. This study aimed to assess the status of health-care utilization among dwellers of slums in one of the Iran's big cities. METHODS: This was a cross-sectional study in which 559 slums people were selected using a random clustered sampling method. Data on health services utilization were collected using health equity assessment and response tool questionnaire. Data analysis was performed using descriptive statistics and logistic regression analysis through SPSS ver. 22. RESULTS: In this study, 42.5% (238) people who required outpatient services. 21% (118) of them were able to use them. Furthermore, among the families, who needed outpatient services during the past month, 15% (38) were able to use the services for at least once. Regarding inpatient services, 62% (349) of people needed hospitalization, of which 31% (175) were able to be hospitalized. Age (P = 0.2), gender (P = 0 <001), marital status (P = 0 <001), income status (P = 0.1), and education (P = 0.21) determined utilization of outpatient services; however, inpatient services utilization was affected by age (P = 0.03), gender (P = 0.02), marital status (P = 0 <001), and income status (P = 0.32). The final model of multiple regression showed that, there was a relationship between age (odds ratio [OR] =1.7, confidence interval [CI] 95% = 0.47–0.88), marital status (OR = 2.78, CI 95% = 0.64–1.2), and the use of inpatient services. CONCLUSION: The utilization of health services in slum areas is not desirable. As it was showed that the utilization of health services in slums people is a multifactorial event; thus, proper planning and policy for this increasingly demand are essential.
Psychometric Analysis Of The Sleep Hygiene Index And Correlation With Stress And Anxiety Among Saudi University Students

Aims This study aimed to assess the psychometric properties of the Sleep Hygiene Index (SHI) instrument in screening poor sleep hygiene practices among Saudi university students. As a secondary goal, the association of sleep hygiene practices with stress and anxiety scores were assessed. Methods Two-hundred and four healthy college and university students aged 18 to 25 years participated in this cross-sectional questionnaire-based survey. Participants were asked to complete the English version of the SHI instrument, the Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder (GAD-7) scale, and to provide demographic details. Results The average scores for the SHI, the GAD-7, and the PSS-10 were 6.6, 5.3, and 16.2, respectively. The internal consistency of the SHI was adequate (McDonald’s Omega 0.76). The corrected item-total correlations for all the items were fair (range, 0.31–0.50). A statistically significant positive correlation/association of the SHI scores with the PSS score, GAD-7, and self-reported poor sleep were obtained in this sample of Saudi university students. Factor analysis favored a 4-factor model of the SHI in the study sample. Conclusion The SHI scale demonstrated an adequate level of internal consistency as a self-reported instrument in the assessment of sleep hygiene among Saudi university students. In addition, poor sleep hygiene was correlated with stress and anxiety scores.
An Enhanced Deep Convolutional Model for Spatiotemporal Image Fusion

Earth observation data with high spatiotemporal resolution are critical for dynamic monitoring and prediction in geoscience applications, however, due to some technique and budget limitations, it is not easy to acquire satellite images with both high spatial and high temporal resolutions. Spatiotemporal image fusion techniques provide a feasible and economical solution for generating dense-time data with high spatial resolution, pushing the limits of current satellite observation systems. Among existing various fusion algorithms, deep-learning-based models reveal a promising prospect with higher accuracy and robustness. This paper refined and improved the existing deep convolutional spatiotemporal fusion network (DCSTFN) to further boost model prediction accuracy and enhance image quality. The contributions of this paper are twofold. First, the fusion result is improved considerably with brand-new network architecture and a novel compound loss function. Experiments conducted in two different areas demonstrate these improvements by comparing them with existing algorithms. The enhanced DCSTFN model shows superior performance with higher accuracy, vision quality, and robustness. Second, the advantages and disadvantages of existing deep-learning-based spatiotemporal fusion models are comparatively discussed and a network design guide for spatiotemporal fusion is provided as a reference for future research. Those comparisons and guidelines are summarized based on numbers of actual experiments and have promising potentials to be applied for other image sources with customized spatiotemporal fusion networks.
The body speaks: physical and psychological aspects of stress in nursing professionals

Objetivo: Identificar os efeitos do estresse no corpo fisico e mental dos profissionais de enfermagem que atuam na UTI de um hospital universitario em Natal, RN. Metodo: Tratou-se de um estudo qualitativo de abordagem descritiva realizado junto a vinte e um profissionais de enfermagem da referida instituicao. A coleta de dados se deu a partir de uma entrevista semiestruturada. Esta iniciou apos a aprovacao do estudo no CEP-HUOL sob no de CAAE No 0037.0. 294.000-11. A analise desses dados se deu por analise de conteudo. Resultados: A categoria resultante da analise desses dados foi intitulada de “o corpo que sofre: as manifestacoes do estresse” e dentre os sintomas mais evidenciados pelos entrevistados destaca-se o cansaco fisico e mental; dores musculares, desequilibrio no ciclo do peso. Conclusao: Esses sintomas contribuem para o estresse profissional e diminuem a qualidade de vida desses trabalhadores em seu ambiente de atuacao.
Mental Disorder Comorbidity in Te Rau Hinengaro: The New Zealand Mental Health Survey

Objective: To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. Method: A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12 992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. Results: Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). Conclusion: The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.
Management of Eclampsia in an Unbooked Primigravida: A Case Report Showing the Impact of Cultural and Socio-Economic Factors on Health Outcomes

Eclampsia is characterised by the occurrence of one or more generalised tonic-clonic seizures in patients with severe preeclampsia in the absence of other neurologic conditions. The clinical features of eclampsia can present at any time during pregnancy, but are more common from the second trimester to the puerperium. This report presents the challenges encountered in the management of eclampsia in a remote setting of a developing country and the influence of cultural and socio-economic factors on health outcomes associated with this condition.
N ov 2 01 9 Deformations of Asymptotically Conical G 2 Instantons

We develop the deformation theory of instantons on asymptotically conical G2 manifolds, where an asymptotic connection at infinity is fixed. A spinorial approach is adopted to relate the space of deformations to the kernel of a twisted Dirac operator on the G2 manifold and to the eigenvalues of a twisted Dirac operator on the nearly Kähler link. As an application, we use this framework to the calculate the infinitesimal deformations of the instanton of Günaydin-Nicolai which lives on R. We identify all of the deformations and show that the moduli space is a smooth manifold. Finally, we prove that connections in the moduli space are G2-invariant and by classifying such connections we prove a uniqueness result for this instanton.