Miracle-dz/UniFAR-FTUs huggingface dataset:
Randomization of vaginal and sublingual misoprostol for cervical ripening and labor induction

Background: Planned induction of labor for various indications has become an established part of modern Obstetric practice. While the efficacy of misoprostol, a prostaglandin E1 analog as a cervical ripening labor induction agent has been established, the appropriate route and dosage are still objected to ongoing research. Objective: This study aims at comparing the efficacy of vaginally administered with sublingual misoprostol for cervical ripening and labor induction. Methodology: One hundred (100) pregnant women at term who fulfill the inclusion criteria were equally randomized into the two arms of the study to receive either 25 μg of misoprostol sublingually or 25μg vaginally. The induction delivery interval and fetal outcomes were compared in the two arms of the study. Results: The vaginal group required more doses of misoprostol than the sublingual group (1.68 ± 0.74 versus 1.26 ± 0.44, P = 0.005). Time from the administration of the first dose of misoprostol to the achievement of a Bishop score of 7 or active phase labor was shorter in the sublingual group than the vaginal route group (5.04 ± 1.77 hours versus 6.32 ± 1.36 hours, P = 0.001). Induction-delivery interval was shorter in the sublingual group than the vaginal route (10.02 ± 2.37 hours versus 11.12 ± 3.97 hours) although the difference was not statistically significant (P = 0.098). The mean Apgar scores at 1 min and 5 min were slightly better in the vaginal group than the sublingual group but the difference did not assume statistical significance (Apgar scores at 1 minute: 7.62 ± 0.83 versus 7.72 ± 0.88, at 5 minutes: 8.94 ± 1.23 versus 9.22 ± 0.46 for the sublingual versus the vaginal group, respectively, P = 0.561). Conclusions: The two routes of sublingual and vaginal administration showed comparable safety and effectiveness for cervical ripening and induction of labor in low-risk pregnancies at term. However, the sublingual route appears to be superior in terms of easy administration and patients' satisfaction.
Mental health outcome and perceived care needs of women treated for a miscarriage in a low-resource setting

Introduction: There have been many advances in the management of miscarriage in recent times including the introduction of expectant and medical management protocols. However, a study of the psychological impact of the condition and its management has not received similar attention. Aim: To determine the psychosocial consequences of miscarriages and perceived needs of the patients compared to the care provided by the hospital. Materials and Method: This was a prospective cohort study conducted between January 15, 2018 and April 30, 2019. Participants were recruited on admission and psychological morbidity was assessed at 1 week after a miscarriage in the gynecological clinics. They were screened for psychological morbidities using DASS 21 (Depression, Anxiety and Stress Scale). Results: Of 140 women that participated in the study, severe depression was reported in 8 (5.7%) whereas 12 (8.5%) participants reported symptoms of extremely severe depression. Moderate to severe anxiety was present in 23.5% while extremely severe anxiety was noted among 21.5% of the women. Stress was reported in over half of respondents and severe to extremely severe stress occurred in 19.9% of the participants. Factors significantly associated with psychological morbidities following miscarriage include age ≥35 years, no living child, subfertility, planned pregnancy, and assisted conception. Healthcare providers not listening to the patient's concern, non-participation in decision making, and dissatisfaction with care were associated with adverse psychological outcomes. Conclusion: Psychological morbidity following a miscarriage is common among participants in our study. The provision of the correct information and psychological debriefing may be useful in enabling women to adjust emotionally following miscarriage.
Serum biomarker CD163 predicts overall survival in patients with pancreatic ductal adenocarcinoma

Supplemental Digital Content is available in the text Abstract The serum soluble CD163 (sCD163) is elevated in patients with inflammatory disease and several types of cancer. However, the prognostic value of serum sCD163 in pancreatic ductal adenocarcinoma (PDAC) has not yet been investigated. In this study, serum level of sCD163 was measured by using the peripheral blood of 54 patients with PDAC, 20 patients with benign tumor of pancreas, and 30 healthy volunteers (healthy controls). The association between serum sCD163 level and overall survival was analyzed. Receiver operating characteristic (ROC) curves were generated, and areas under the curve (AUC) were compared to evaluate the diagnostic accuracy, including CA 19-9, CEA, CA 125, CA 153, and serum sCD163 level. Serum sCD163 level of patients with PDAC was significantly higher than patients with benign tumor (P = .002) and health controls (P < .001). Using ROC curves, we found that the AUC values of serum sCD163 were higher than those of CA 125 and CA 153, but lower than those of CA 19-9 and CEA. Serum sCD163 was negatively correlated with lymphocyte to monocyte ratio (LMR; r = −0.428, P = .001). In addition, the prognosis of PDAC patients with sCD163 ≥ median was worse than sCD163 < median by using univariate analysis (P = .027). Further, multivariate analysis showed that higher level of serum sCD163 was still associated with poorer overall survival (P = .020). In conclusion, the serum sCD163 has the potential as a new promising parameter to predict the prognosis in PDAC patients.
The Impact on Gonadal Development of Precocious Puberty Rats by Guizhen Dihuang Yin

Objective:To observe uterine index,ovarian index,ovarian corpus luteum occurance rate of precocious puberty rats induced by NMA.Methods:60 SD female rats were randomly divided into six groups: the model group,the western medicine group,the high group,the moderate group,the low group and the blank group.Rats were given physiological saline,Leuprorelin,Chinese medicine high dose,moderate dose,low dose and physiological saline,respectively.We investigated the effect of Guizhen Dihuang Yin on uterine index,ovarian index,ovarian corpus luteum occurance rate.Results:The model group rats occurance rules of the sexual cycle,and the length of the sexual cycle had the same as adolescence.The effects of high group and moderate group on uterine index,ovarian index,ovarian corpus luteum occurance rate are better than those of the model group(P0.05). Conclusion:Guizhen Dihuang Yin can decrease uterine index,ovarian index,ovarian corpus luteum occurance rate.
Outcome of a “modified brief intervention” program delivered at work place for a population with hazardous alcohol use

Introduction: At the population level, screening and brief intervention (BI) is the most cost-effective method to reduce the burden of disease due to hazardous alcohol use. In delivering BI at individual level, trained workforce as well as time is a limiting factor. Hence, a study was conducted to assess the outcome of a “modified brief intervention” program delivered at workplace in a group setting for the participants identified with hazardous alcohol use pattern, as a secondary prevention measure. Materials and Methods: Study was a pre- and post-intervention study without a control group. Following an educational lecture, conducted by a mental health team including a psychiatrist, participants were screened using the WHO ASSIST questionnaire, V3.0 version. Those screened positive for hazardous alcohol use were given “modified brief intervention” in a group setting at their workplace which consisted of two semi-structured sessions of 1-h duration each. The sessions were spaced in a month. First session was based on motivation enhancement measures along with gathering of current alcohol use details and second session focused on relapse prevention. Three months later, the outcomes were assessed using a semistructured questionnaire and ASSIST was reapplied. The analysis was done using the R-commander from R-software. Results: No significant difficulty was experienced in conducting the interventions. Fifty (55.6%) participants stayed alcohol abstinent following second session and another 22 (24.44%) had reduced both the quantity and frequency of use. Paired t-tests revealed statistically significant reduction in all secondary outcome parameters (ASSIST scores, usual dose in one sitting, maximum dose, and number of days of use in month). Eighty (88.89%) participants reported the program to be effective. Only 3 months of observation is a limitation. Conclusion: The study provides an efficient secondary prevention model to reduce hazardous drinking at the population level needing less workforce, cost, and time.
Cyclophilin A: a novel biomarker for cardiovascular disease in patients with type 2 diabetes

Background and aims Type 2 diabetes mellitus (DM) is a strong independent risk factor for coronary heart disease. Cyclophilin A (CyPA) is a protein secreted from vascular smooth muscle cells in response to reactive oxygen species. It is suggested that CyPA plays an important role in later stages of atherosclerosis and plaque rupture. It was demonstrated that plasma levels of CyPA are significantly higher in patients with coronary artery disease (CAD) in proportion to severity of disorder. Moreover, several studies have demonstrated a role of CyPA as a biomarker of CADs. Indeed studies revealed significantly higher plasma levels of CyPA in patients with CAD with type 2 DM. Objective To assess the severity of CAD among diabetic and prediabetic patients and predict future cardiovascular events. Patients and methods The study was conducted on 65 patients with CAD diagnosed by coronary angiography, stratified according to GRACE score into low/intermediate/high death risk categories and subdivided into diabetic, prediabetic, and nondiabetic, and 20 age-matched and sex-matched patients, who had normal angiography as a control group. Blood samples were collected for determination of glycated hemoglobin (HbA1c), serum creatinine, cardiac troponin, and CyPA level using double-antibody sandwich enzyme-linked immunosorbent assay technique. Results There were significantly higher levels of CyPA among patient group than control group (P<0.001). Moreover, significantly higher CyPA levels were detected in diabetic group when compared with normal and prediabetic groups (P<0.029). CyPA was positively correlated with HbA1c in all patients and with diabetic patients. HbA1c was negatively correlated with serum creatinine and positively with estimated glomerular filtration rate in prediabetic group and with systolic blood pressure in diabetic group. The number of occluded vessels was positively correlated with both CyPA and HbA1c. The diagnostic sensitivity and specificity of CyPA were 76.92 and 95%, respectively, at a cutoff value of more than 13 ng/ml. Conclusion CyPA can be used as an early predictor of CAD in patients with type 2 DM and also in prediabetic patients.
COVID-19 cardiopulmonary resuscitation: Guidelines and modifications

International societies like the International Liaison Committee on Resuscitation (ILCOR), American Heart Association (AHA), and UK Resuscitation Council have suggested modified guidelines for resuscitation during coronavirus disease (COVID-19) pandemic. Though there is consensus in most of the recommendations there are also disparities. Considering the rapidly evolving COVID-19 pandemic and our better understanding of the spread of the disease, there is an urgent need to suggest modifications to the existing guidelines. These modifications should allay the fear of health care workers regarding their safety and reluctance to provide cardiopulmonary resuscitation (CPR) but should also address the serious concerns where an opportunity is lost to revive patients who may not be COVID positive as suspected.
Discordant Echocardiographic Grading in Low Gradient Aortic Stenosis (DEGAS Study) From the Italian Society of Echocardiography and Cardiovascular Imaging Research Network: Rationale and Study Design

Background: Low-gradient aortic stenosis (LG-AS) is characterized by the combination of an aortic valve area compatible with severe stenosis and a low transvalvular mean gradient with low-flow state (i.e., indexed stroke volume <35 mL/m2) in the presence of reduced (classical low-flow AS) or preserved (paradoxical low-flow AS) ejection fraction. Furthermore, the occurrence of a normal-flow LG-AS is still advocated by many authors. Within this diagnostic complexity, the diagnosis of severe AS remains challenging. Objective: The general objective of the Discordant Echocardiographic Grading in Low-gradient AS (DEGAS Study) study will be to assess the prevalence of true severe AS in this population and validate new parameters to improve the assessment and the clinical decision-making in patients with LG-AS. Methods and Analyses: The DEGAS Study of the Italian Society of Echocardiography and Cardiovascular Imaging is a prospective, multicenter, observational diagnostic study that will enroll consecutively adult patients with LG-AS over 2 years. AS severity will be ideally confirmed by a multimodality approach, but only the quantification of calcium score by multidetector computed tomography will be mandatory. The primary clinical outcome variable will be 12-month all-cause mortality. The secondary outcome variables will be (i) 30-day mortality (for patients treated by Surgical aortic valve replacement or TAVR); (ii) 12-month cardiovascular mortality; (iii) 12-month new major cardiovascular events such as myocardial infarction, stroke, vascular complications, and rehospitalization for heart failure; and (iv) composite endpoint of cardiovascular mortality and hospitalization for heart failure. Data collection will take place through a web platform (REDCap), absolutely secure based on current standards concerning the ethical requirements and data integrity.
Folivory in Fruit-Eating Bats, with New Evidence from Artibeus jamaicensis (Chiroptera: Phyllostomidae)

We review reports of leaf-eating by bats and present new evidence for folivory by leaf fractionation for the neotropical bat Artibeus jamaicensis (Chiroptera: Phyllostomidae). Leaf-eating has been reported for at least 17 species of OldWorld Megachiroptera and four species of New World Microchiroptera. Leaves eaten by bats indude at least 44 species of plants represented by 23 different families. Plant families which account for the greatest species richness (numbers of species given in parentheses) indude the Leguminosae (12), Moraceae (4), and Solanaceae (4). Evidence for folivory by A. jamaicensis is based on captures of bats carrying leaves, and collections of whole and partially chewed leaves and discarded pellets recovered from beneath feeding roosts. Whole leaves carried into caves by A. jamaicensis and partially chewed, but discarded leaves included Erythrina poeppigiana, Ficus sp. , and Calophyllum calaba, in decreasing order of frequency. Bats captured while carrying Erythrina leaves were most often mature males. Erythrina poeppigiana leaves are relatively high in protein (> 19% dry-matter content) and low in fat (1%). Our observations that A. jamaicensis selects and chews leaves high in protein and rejects protein-poor, fibrous pellets, support the hypothesis that these bats extract liquid fractions which contain a reliable source of dietary protein. Although we have no direct evidence that male or female A. jamaicensis transport leaves to feeding roosts located outside of caves, we suggest that liquid fractions derived from leaves may provide females with an important source of protein, especially during periods of pregnancy and lactation. Folivory, once thought to be rare among plantvisiting bats, may in fact be quite common and widespread, especially among species that feed largely on fruits which are low in protein.
The Theory of Composites

Einstein, have contributed to the theory of composite materials. Mathematically, it is the study of partial differential equations with rapid oscillations in their coefficients. Although extensively studied for more than 100 years, an explosion of ideas in the last four decades (and particularly in the last two decades) has dramatically increased our understanding of the relationship between the properties of the constituent materials, the underlying microstructure of a composite, and the overall effective (electrical, thermal, elastic) moduli that govern the macroscopic behavior. This renaissance has been fueled by the technological need for improving our knowledge base of composites, by the advance of the underlying mathematical theory of homogenization, by the discovery of new variational principles, by the recognition of how important the subject is to solving structural optimization problems, and by the realization of the connection with the mathematical problem of quasiconvexification. This book surveys these exciting developments at the frontier of mathematics and presents many new results.
Spin-up from rest in a stratified fluid: boundary flows

We present the results of an integrated experimental, numerical and theoretical examination of spin-up from rest of a stratified fluid. A vertical cylindrical container of radius R and height 2H containing fluid of viscosity ν and characterized by a constant buoyancy frequency N is set impulsively to rotate about its symmetry axis with angular speed Ω = f/2. The characteristic Ekman number E = ν/ΩR2 is small and the Schmidt number S = ν/Ds (where Ds is the diffusivity of salt) is large. The investigation is focused on elucidating the initial stage of spin-up, which is characterized by an axisymmetric circulation driven by nonlinear Ekman layers adjoining the horizontal boundaries. Fluid is drawn by the boundary layers from the stationary, stratified interior and transported into corner regions. It is shown that the corner regions are restricted to a height of approximately 0.3Rf/N from the horizontal boundaries, above which the fluid remains unperturbed apart from that spun up by diffusion of momentum from the sidewall boundary. Two distinct regions thus emerge: rotating corner regions, and a quiescent stratified core. After a time 1.3/(E1/2N), the corner regions cover the bulk of the horizontal boundaries and the boundary layer suction is suppressed. Our study provides a framework for understanding the subsequent evolution of the spin-up process, which may be characterized by axisymmetry-breaking instabilities of the stratified core.
Ecological evaluation on the wild mammalian resources in Wudaoxia Nature Reserve

The wild mammalian resources were investigated in Wudaoxia Nature Reserve in(2004.) The result indicates that there are 59 species,belonging to 8 orders and(25)families respectively.Type of geographical distribution,ecotype of birds and key protected birds are studied.Of them,there are 12 palaearctic species,38 oriental species and 9 cosmopolitan species.42 species and 18 species are protected respectively by nation and province.20 species are listed in the list of CITES(9 species in appendixⅠ,4 species in appendixⅡand 7 species in appendix Ⅲ). 18 species are listed in the list of China Red Data Book of Endangered Animals in which there are 3 endangered species,2 rare species and 13 vulnerable species.The feature of geographical distribution is that the oriental species is dominant,the rare mammals have comparatively greater quantity,and 4 species are typical ones in China.The biodiversity shows seven kinds of ecotype and the least aquatic species.And the comparative research are put up among Wudaoxia Nature Reserve,Shenlongjia National Nature Reserve,Houhe National Nature Reserve and Hupingshan National Nature Reserve.The wild Mammalian Resources are evaluated and the conservation measures are put forward.
Freshwater gobies 30 million years ago: New insights into character evolution and phylogenetic relationships of †Pirskeniidae (Gobioidei, Teleostei)

The modern Gobioidei (Teleostei) comprise eight families, but the extinct †Pirskeniidae from the lower Oligocene of the Czech Republic indicate that further families may have existed in the past. However, the validity of the †Pirskeniidae has been questioned and its single genus †Pirskenius has been assigned to the extant family Eleotridae in previous works. The objective of this study is to clarify the status of the †Pirskeniidae. Whether or not the †Pirskeniidae should be synonymised with the Eleotridae is also interesting from a biogeographical point of view as Eleotridae is not present in Europe or the Mediterranean Sea today. We present new specimens and re-examine the material on which the two known species of †Pirskenius are based (†P. diatomaceus Obrhelová, 1961; †P. radoni Přikryl, 2014). To provide a context for phylogenetically informative characters related to the palatine and the branchiostegal rays, three early-branching gobioids (Rhyacichthys, Protogobius, Perccottus), an eleotrid (Eleotris) and a gobiid (Gobius) were subjected to micro-CT analysis. The new data justify revalidation of the family †Pirskeniidae, and a revised diagnosis is presented for both †Pirskenius and †Pirskeniidae. Moreover, we provide for the first time an attempt to relate a fossil gobioid to extant taxa based on phylogenetic analysis. The results indicate a sister-group relationship of †Pirskeniidae to the Thalasseleotrididae + Gobiidae + Oxudercidae clade. Considering the fossil record, the arrival of gobioids in freshwater habitats in the early Oligocene apparently had generated new lineages that finally were not successful and became extinct shortly after they had diverged. There is currently no evidence that the Eleotridae was present in the European ichthyofauna in the past.
Living on the bare edge: fitness consequences for Cape Gannets Morus capensis at Bird Island, Algoa Bay

Avian breeding colonies often suffer high levels of predation along their margins. Nest predation is a major fitness concern for parents and therefore nests inside of the colony edge might be at a premium. This was tested through studying the colonial breeding seabird, the Cape Gannet Morus capensis, at Bird Island, Algoa Bay, South Africa. We found that breeding success is much lower for nests on the edge. Consequently, we tested whether birds nesting inside the colony had shorter foraging trips and higher nest attendance than birds along the colony edge. Although nest attendance averaged slightly less along the colony edge, the difference was not significant. Nest predation was found to be the likely cause of the higher nest failure along the colony edge. Nest positioning in Cape Gannets clearly has a profound influence on fitness, especially as the Cape Gannet appears to display a high level of nest-site fidelity.