Miracle-dz/UniFAR-FTUs huggingface dataset:
Population Pharmacokinetics of Intranasal Dexmedetomidine in Infants and Young Children

Background: Intranasal dexmedetomidine provides noninvasive, effective procedural sedation for pediatric patients, and has been widely used in clinical practice. However, the dosage applied has varied fourfold in pediatric clinical studies. To validate an appropriate dosing regimen, this study investigated the pharmacokinetics of intranasal dexmedetomidine in Chinese children under 3 yr old. Methods: Intranasal dexmedetomidine 2 µg · kg−1 was administered to children with simple vascular malformations undergoing interventional radiological procedures. A population pharmacokinetic analysis with data from an optimized sparse-sampling design was performed using nonlinear mixed-effects modeling. Clearance was modeled using allometric scaling and a sigmoid postmenstrual age maturation model. Monte Carlo simulations were performed to assess the different dosing regimens. Results: A total of 586 samples from 137 children aged 3 to 36 months were included in the trial. The data were adequately described by a two-compartment model with first-order elimination. Body weight with allometric scaling and maturation function were significant covariates of dexmedetomidine clearance. The pharmacokinetic parameters for the median subjects (weight 10 kg and postmenstrual age 101 weeks) in the authors’ study were apparent central volume of distribution 7.55 l, apparent clearance of central compartment 9.92 l · h−1, apparent peripheral volume of distribution 7.80 l, and apparent intercompartmental clearance 61.7 l · h−1. The simulation indicated that at the dose of 2 µg · kg−1, 95% of simulated individuals could achieve a target therapeutic concentration of 0.3 ng · ml−1 within 20 min, and the average peak concentration of 0.563 ng · ml−1 could be attained at 61 min. Conclusions: The pharmacokinetic characteristics of intranasal dexmedetomidine were evaluated in Chinese pediatric patients aged between 3 and 36 months. An evidence-based dosing regimen at 2 µg · kg−1 could achieve a preset therapeutic threshold of mild to moderate sedation that lasted for up to 2 h. Based on pharmacokinetic data in a cohort of children aged 3 months to 3 yr, intranasal dexmedetomidine 2 µg · kg−1 would provide a therapeutic threshold of mild to moderate sedation lasting for up to 2 h.
Willingness to Discuss End-of-Life Care Wishes Among Rural Black/African American Residents of the Alabama Black Belt

Willingness for end-of-life discussion and related factors among rural Blacks/African Americans of the Alabama Black Belt have not been well-studied. This study aims to assess their willingness for the discussion and examine its relationship with social determinants of health (SDH) and demographic factors. A cross-sectional survey was conducted with a convenience sampling of 182 participants. Most participants were willing to discuss end-of-life wishes with family (77.1%) or doctors (72.1%). Controlling for demographics, results from binary logistic regressions showed those with hospice awareness were more likely to have willingness for discussion with family (OR = 10.07, p < .01) and doctors (OR = 7.23, p < .05). Those who were older (50+) were less likely to have willingness for discussion with doctors (OR = 0.19, p < .05), whereas those who were more socially isolated were less likely to have willingness for discussion with family (OR = 0.53, p < .05). Therefore, end-of-life discussion efforts should focus on older, socially isolated individuals and consider hospice awareness.
Risk Factors for Intimate Partner Violence in the Context of Disasters: A Systematic Review

Women are at increased risk for experiencing intimate partner violence (IPV) in the context of disasters. However, the factors that increase this risk are not well understood. The purpose of the current study was to systematically review the literature on IPV in the context of disasters. The first aim was to identify risk factors predicting women’s exposure to IPV. The second aim was to identify disaster-specific risk factors for IPV. The third aim was to construct a social ecological framework of risk factors for IPV in disasters at the individual, relationship/household, community, and structural levels. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA; Moher et al., 2009). Articles were identified using keywords in seven ProQuest databases. Of the 67 articles identified for full-text review, 24 were eligible for inclusion. Studies were evaluated based on critical appraisal of methodology using an adapted version of the Mixed Methods Appraisals Tool (MMAT; Hong et al., 2018). Findings suggest that disasters give rise to unique risk factors across social ecologies which interact with pre-existing characteristics of social vulnerability to increase women’s risk of IPV. Findings inform violence prevention strategies within the context of disaster response and therefore have implications for research, policy, and practice.
Gain-Loss Framing and Social Distancing: Temporal Framing’s Role as an Emotion Intensifier

ABSTRACT Effective health communication requires various strategies. This study focused on two framing strategies closely relevant to health issues. Specifically, it examined how temporal framing moderates the effects of gain-loss framing on social distancing with particular attention to the underlying affective mechanisms of these interactions. A 2 (temporal framing: proximal vs. distal) X 2 (gain-loss framing: gain vs. loss) randomized experiment was conducted with 114 undergraduate students in Korea. The results showed that loss-framing was more effective than gain-framing when presented in temporally proximal frames, but such differences diminished when presented in temporally distal frames. The interaction effects of temporal framing and gain-loss framing had indirect effects on attitudes via fear and anger. They also had an indirect effect on intentions via fear. This study’s results enhance our understanding of framing effects by testing the interaction effects between two types of framing in the context of social distancing and clarifying affective mediating processes through which framing exerts its effects. These findings have practical implications for designing effective health messages.
Factors influencing posttraumatic growth among nurses caring for COVID‐19 patients: A path analysis

Abstract Aims Based on Calhoun and Tedeschi's posttraumatic growth model, this study aimed to establish a path model of posttraumatic growth among nurses who provided care for coronavirus disease 2019 (COVID‐19) patients and to examine the associations between the relevant variables. Background There are increasingly many studies examining the psychological health status of nurses caring for patients on the front lines of COVID‐19. However, research results showing the effects of various variables affecting nurses' posttraumatic growth through positive psychological transformation are insufficient. Methods This cross‐sectional study was based on a sample of 229 nurses who cared for COVID‐19 patients for more than 1 month in South Korea from April to May 2021. Results The fitness of the modified path model (χ 2 = 1.380, p = .502, GFI = 0.99, CFI = 1.00, NFI = 0.99, RMSEA = 0.00 and TLI = 1.01) was higher than that of the hypothesis path model (χ 2 = 124.133, p < .001, GFI = 0.85, CFI = 0.66, NFI = 0.65, RMSEA = 0.36 and TLI = 0.15). Deliberate rumination had directly influenced posttraumatic growth and posttraumatic stress disorder and social support had a direct and indirect effect on posttraumatic growth. Self‐disclosure indirectly influenced posttraumatic growth through deliberate rumination but was not significant. Conclusions In order to improve posttraumatic growth of nurses caring for COVID‐19 patients, it is necessary to provide and support opportunities for self‐disclosure. Implication for Nursing Management The results of this study can help institutions and nurse managers comprehensively understand the factors affecting posttraumatic growth of nurses caring for COVID‐19 patients in the front lines and determine basic strategies based on the importance of these factors.
Characteristics Associated With Loneliness and Coping Skills Utilization During the COVID-19 Pandemic

Although stay-at-home orders and physical distancing measures are vital to managing the COVID-19 outbreak, there is concern these limitations on in-person contact may increase feelings of loneliness. The present study examined loneliness in relation to living situation, psychiatric symptoms, and coping skills utilization during the COVID-19 pandemic. The aim was to identify demographic and psychological factors that may contribute to greater feelings of loneliness. A sample of 125 adults (18 years and older) completed measures on loneliness, psychiatric symptoms, and coping skills in September 2020. Multiple regression analysis indicated living situation moderates the relationship between hours spent having remote conversations and loneliness. Remote conversation hours were associated with decreased loneliness in those living alone but was not associated with loneliness in those living with others. Multivariate regression analysis indicated that substance use and self-blame were associated with increased loneliness whereas the use of emotional support to cope with pandemic-related stress was associated with decreased loneliness. The current study highlights the importance of finding alternative ways to remain socially connected, particularly for those living alone. Increasing access to videoconferencing technology and promoting help-seeking behaviors may be a promising approach to manage loneliness during times of increased social isolation.
Pharmacokinetics and Dose Optimization Strategies of Para-Aminosalicylic Acid in Children with Rifampicin-Resistant Tuberculosis

Treatment options for children with Rifampicin-resistant tuberculosis (RR-TB) remain limited, and para-aminosalicylic acid (PAS) is still a relevant component of treatment regimens. Prevention of resistance to companion drugs by PAS is dose related, and at higher concentrations, PAS may exhibit significant bactericidal activity in addition to its bacteriostatic properties. ABSTRACT Treatment options for children with Rifampicin-resistant tuberculosis (RR-TB) remain limited, and para-aminosalicylic acid (PAS) is still a relevant component of treatment regimens. Prevention of resistance to companion drugs by PAS is dose related, and at higher concentrations, PAS may exhibit significant bactericidal activity in addition to its bacteriostatic properties. The optimal dosing of PAS in children is uncertain, specifically for delayed-release granule preparations, which are the most used. A population pharmacokinetic model was developed describing PAS pharmacokinetics in children receiving routine RR-TB treatment. Model-based simulations evaluated current World Health Organization (WHO) weight-band doses against the adult pharmacokinetic target of 50 to 100 mg/liter for peak concentrations. Of 27 children included, the median (range) age and weight were 3.87 (0.58 to 13.7) years and 13.3 (7.15 to 30.5) kg, respectively; 4 (14.8%) were HIV positive. PAS followed one-compartment kinetics with first-order elimination and transit compartment absorption. The typical clearance in a 13-kg child was 9.79 liters/h. Increased PAS clearance was observed in both pharmacokinetic profiles from the only patient receiving efavirenz. No effect of renal function, sex, ethnicity, nutritional status, HIV status, antiretrovirals (lamivudine, abacavir, and lopinavir-ritonavir), or RR-TB drugs was detected. In simulations, target concentrations were achieved only using the higher WHO dose range of 300 mg/kg once daily. A transit compartment adequately describes absorption for the slow-release PAS formulation. Children should be dosed at the higher range of current WHO-recommended PAS doses and in a once-daily dose to optimize treatment.
First principles study of SnX2 (X = S, Se) and Janus SnSSe monolayer for thermoelectric applications

Tin-based chalcogenides are of increasing interest for thermoelectric applications owing to their low-cost, earth-abundant, and environmentally friendly nature. This is especially true for 2D materials, in which breaking of the structural symmetry plays a crucial role in tuning the electronic properties. 2D materials present a unique opportunity to manipulate the electronic and thermal properties by transforming a monolayer into a Janus monolayer. In the present work, we have investigated the thermoelectric properties of hexagonal SnS2, SnSe2 monolayer, and Janus SnSSe monolayer. Density functional theoretical calculations points out the hexagonal Janus SnSSe monolayer as a potential high-performing thermoelectric material. Results for the Janus SnSSe monolayer show an ultra-low thermal conductivity originating from the low group velocity of the low-lying optical modes, leading to superior zT values of 0.5 and 3 at 300 K and 700 K for the p-type doping, respectively.
Comparison of strength testing modalities in dysferlinopathy

Dysferlinopathy demonstrates heterogeneity in muscle weakness between patients, which can progress at different rates over time. Changing muscle strength due to disease progression or from an investigational product is associated with changing functional ability. The purpose of this study was to compare three methods of strength testing used in the Clinical Outcome Study (COS) for dysferlinopathy to understand which method and which muscle groups were most sensitive to change over time.
PENERAPAN METODE SELEKSI FITUR UNTUK MENINGKATKAN HASIL DIAGNOSIS KANKER PAYUDARA

Tujuan utama penelitian ini adalah untuk meningkatkan peforma klasifikasi pada diagnosis kanker payudara dengan menerapkan seleksi fitur pada beberapa algoritme klasifikasi. Penelitian ini menggunakan database kanker payudara Wisconsin Breast Cancer Database (WBCD). Metode seleksi fitur F-score dan Rough Set akan dipasangkan dengan beberapa algoritme klasifikasi yaitu SMO ( S equential Minimal Optimization ), Naive Bayes, Multi layer Perceptron , dan C4.5. Penelitian ini menggunakan 10 fold cross validation sebagai metode evaluasi. Hasil penelitian menunjukkan algoritme klasifikasi MLP dan C4.5 mengalami peningkatan peforma klasifikasi secara signifikan setelah dipasangkan dengan seleksi fitur rough set dan F-score, Naive Bayes menunjukan peforma terbaik ketika dipasangkan dengan metode seleksi fitur F-score saja, sedangkan SMO tidak menunjukkan peningkatan peforma klasifikas ketika dipasangkan pada kedua seleksi fitur. Kata kunci: kanker payudara, seleksi fitur, klasifikasi.
Front‐line staff perspectives on a caring culture in Chinese hospitals: Validation of a Chinese version of the Culture of Care Barometer

Abstract Aims The aim of this study is to examine the psychometric properties of the Chinese version of the Culture of Care Barometer in health care organizations. Background There is a lack of tools to gauge the caring culture in Chinese hospitals. The Culture of Care Barometer is a psychometrically sound measure for caring culture developed in Western settings. Methods This study was guided by Sousa and Rojjanasrira's methodological approach. A total of 2365 staff were recruited from two tertiary hospitals. The Barometer was administered with the Hospital Culture Evaluation Index and Minnesota Satisfaction Questionnaire. Results The content validity index was calculated as 0.99. The goodness‐of‐fit indices, apart from the model chi‐square, which was statistically significant, all exceeded established thresholds for adequate fit. The internal consistency was very satisfactory. Pearson's correlation indicated that the tool has good concurrent and convergent validity. Conclusions The Barometer is a reliable and valid instrument to assess front‐line staff perspectives on a caring culture in Chinese hospitals. Implications for Nursing Management Nursing managers can use the Barometer to gauge the caring culture in China. Tailored interventions can be designed to address specific domains, and additional support can be provided to more vulnerable departments or staff groups.
An evaluation of a student-led career profiling project to support the exploration of a career in general practice and other specialties

Background Choosing medical careers is complex but the undergraduate period is formative. St George’s University of London (SGUL) students called for greater careers information. Aim To develop and evaluate students’ careers resources. Design & setting A quality improvement student–staff project at SGUL, UK. Method A ‘Plan-Do-Study-Act’ (PDSA) cycle was completed. For the ‘Plan’ element, students’ career intentions and information preferences were surveyed. For the ‘Do’ element, video interviews with clinicians and infographic posters were produced and published on SGUL’s virtual learning environment. For the ‘Study’ element, feedback questionnaires were thematically analysed using Kirkpatrick’s framework. For the ‘Act’ element, the model was rolled out across SGUL programmes. Results In the ‘Plan’ stage, 79 students ranked interest in specialties, with general practice being the second most popular. Students were unconfident in how to pursue careers and wanted more information. For the ‘Do’ element, 13 careers videos and infographics were created for 10 specialties. The ‘Study’ questionnaire showed changes across three of the four levels in Kirkpatrick’s model of evaluation of training. Level 1 (Response): students found resources helpful and accessible. Level 2 (Learning): students reported increased understanding of careers. Level 3 (Transfer): students planned using checklists and made career comparisons by specialty. Level 4 (Results): students’ career choices were not demonstrated, but there were tentative proxy measures such as copying and modelling career routes and choices. ‘Act’ involved rolling out and regularly updating resources. Conclusion This PDSA model enabled development of resources by students mapped to students’ needs. Changes were demonstrated in relation to students’ response, learning, and transfer, with tentative suggestions of impact on career choice.
Enhancing the efficiency of the intermediate band solar cells by introducing: carrier losses, alloying and strain

A detailed balance model is used to determine the efficiency of intermediate band solar cell including carrier losses from the intermediate band. The effect of the energy gap of the host semiconductor is examined as a function of the intermediate band position in the energy gap and the host semiconductor energy gap. Generally the optimal intermediate band level decreases within the energy gap to mitigate the carrier losses, and carrier losses are less detrimental to small energy gap materials. We therefore focus on the role of carrier losses in wide bandgap semiconductor intermediate band solar cell systems, such as the GaN semiconductor with an Mn impurity band. Experimentally Mn acceptor level in the GaN energy gap is 1.8 eV above the valence band, which is 199 meV off the ideal intermediate band and reduces the efficiency to 21.36%. We demonstrate how carrier losses can be introduced into the system to shift the optimum IB position. Introducing carrier losses shifts the optimal intermediate band position to 1.8 eV above the valence band and increases the efficiency to 23.41%. We compare this to the effect of alloying GaN and introducing biaxial strain to shift the effective position of the Mn impurity band on the efficiency.
Online Support and Intervention (OSI) for child anxiety: a case series within routine clinical practice

Abstract Background: Online treatments for child anxiety offer a potentially cost-effective and non-stigmatizing means to widen access to evidence-based treatments and meet the increasing demand on services; however, uptake in routine clinical practice remains a challenge. This study conducted an initial evaluation of the clinical effectiveness, feasibility and acceptability of OSI (Online Support and Intervention for child anxiety) within clinical practice. OSI is a co-designed online therapist-supported, parent-led CBT treatment for pre-adolescent children with anxiety problems. Method: This case series was part of routine service evaluation in a clinic in England where families were offered OSI to treat a primary anxiety difficulty among 7- to 12-year-old children; 24 families were offered OSI, and 23 took it up. Measures of anxiety symptomatology, functional impairment and progress towards therapeutic goals were taken at pre-treatment, post-treatment and 4-week follow-up. Treatment satisfaction and engagement were also measured throughout the intervention. Results: Mean anxiety symptoms significantly improved to below the clinical cut-off post-treatment, with further reduction at follow-up. Functional impairment also significantly improved and significant progress was made towards treatment goals. The majority of children showed reliable change in anxiety symptoms and reliable recovery by follow-up, and were discharged without needing further treatment for anxiety. Uptake, adherence and engagement in OSI were excellent, and parents reported high levels of satisfaction with the treatment. Conclusions: We have provided initial evidence that OSI is feasible, acceptable to families, and appears to be associated with good outcomes within routine clinical practice.
The therapeutic prospect of zinc oxide nanoparticles in experimentally induced diabetic nephropathy

ABSTRACT Diabetic nephropathy (DN) is the most frequent cause of end-stage renal failure. Zinc oxide nanoparticles (ZnO-NPs) are promising antidiabetic agents. Our aim was to evaluate the prospective efficacy of ZnO-NPs in treating DN in streptozotocin-induced diabetic rats. Rats were randomly dispersed into three sets: control group, DN group and DN + ZnO-NPs group. ZnO-NPs were given at a dose of 10 mg/kg/day by oral gavage for 4 weeks. Urine and blood samples were processed for biochemical analyses. Kidney samples were managed for light and electron microscopy studies. Immune histochemical staining of P53, aquaporin11 (AQP11) and mechanistic target of rapamycin (mTOR) were performed. Gene analyses of nephrin, podocin, beclin-1, LC3 and p62 were done. Administration of ZnO-NPs ameliorated the functional and histopathological alterations of the kidney in a rat model of diabetic nephropathy. ZnO-NPs retained the constancy of the glomerular filtration barrier and restored almost normal renal structure. This was confirmed by upregulation of mRNA expression of podocyte markers (nephrin and podocin) and AQP11 immune histochemical expression in the renal tubules. The beneficial outcomes of ZnO-NPs might be attributed to activation of autophagy through inhibiting mTOR signaling pathway. ZnO-NPs enhanced beclin-1 and LC3 mRNA expressions and reduced p62 mRNA expression. ZnO-NPs also exerted anti-apoptotic potential (evidenced by the decrease in p53 immune expression), anti-inflammatory and anti-oxidant effect [endorsed by suppression of serum cyclooxygenase-2 (COX-2) enzyme activity, tissue nuclear factor kappa beta (NF-κB) level and blood hypoxia-inducible factors (HIF-1α) level]. These results may point the way to an effective therapy of DN. Abbreviations: AQP11 Aquaporin11; BUN: Blood urea nitrogen; COX-2: Cyclooxygenase-2; DAB: 3, 3’-diaminobenzidine; DM: Diabetes mellitus; DN: Diabetic nephropathy; ELISA: Enzyme-linked immunosorbent assay; H&E: Hematoxylin & eosin; HIF-1α: Hypoxia-inducible factors; iNOS: inducible nitric oxide synthase; LC3: Microtubule-associated protein 1 light chain 3; mTOR: Mechanistic target of rapamycin; NF-κB: Nuclear factor kappa beta; NPs: Nanoparticles; PAS: Periodic acid Schiff; PCR: Polymerase chain reaction; PGE2: Prostaglandin E2; ROS: Reactive oxygen species; STZ: Streptozotocin; X ± SEM: Mean ± standard error of means; Zn: Zinc; ZnO-NPs: Zinc oxide nanoparticles.