Miracle-dz/UniFAR-FTUs huggingface dataset:
LUX-breast 3: Randomized phase II study of afatinib alone or with vinorelbine versus investigator’s choice of treatment in patients (pts) with HER2-positive breast cancer (BC) with progressive brain metastases (BM) after trastuzumab or lapatinib-based therapy.

TPS647 Background: Approximately 1/3 of pts with HER2-positive, advanced BC will develop BM with a poor prognosis. Efficacy of systemic therapies is limited since few drugs can readily cross the blood-brain barrier. BC BM represents a high unmet medical need for which novel targeted therapies are needed. Afatinib is a small molecule, irreversible ErbB Family Blocker that has shown preclinical activity in trastuzumab-resistant cell lines and HER2-positive tumor xenografts. Its clinical efficacy has been demonstrated in pts with heavily pre-treated, HER2-positive metastatic BC, who progressed after trastuzumab therapy, with partial responses in 10% and clinical benefit in 46% of pts. In a Phase I afatinib trial a sustained PR was observed in a NSCLC pt with BM, and in a phase II trial in NSCLC, pts with or without BM achieved comparable outcome on afatinib. The purpose of this study (NCT01441596) is to investigate whether afatinib alone or in combination with vinorelbine has any effect on HER2-positive BC w.
Hypertension Associated with Atherosclerosis Risk Factors in Patients of Family Health Strategy Highlighting the Framingham Risk Score

The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an underestimated disorder due to non-perceptive symptoms and associated with factors and risk markers of another CVD. Therefore, establishing the risk of progression and aggravation of the SAH, according the Framingham Risk Score (FRS), allows to reducing morbidity and improving preventative measures for DCVs. This observational and transversal study approaches the data collection of patient records at the Health Family Strategy of Senhor do Bonfim, BA, which established differences by descriptive and inferential statistical analysis (correlation and regression). The aspects of hypertension associated with risk factors for atherosclerosis were analyzed, determining the risk of developing cardiovascular events in 10 years by FRS. From 432 families, 746 patients were selected, of which 340 are hypertensive individuals (SAH = 45.57%) and 406 (NSAH = 54.42%) non-hypertensives. Among the SAH the majority (31.17%) was in the age range of 63 - 77, but, in both groups, women were in stronger number. There was greater prevalence in SAH for all the characteristics analyzed, smoking (13.20%), sedentary (29.41%) and cardiovascular accident (22.60%). The SAH group is more susceptive to the CVD progress in 10 years by FRS (P < 0.0001 ANOVA). In the NSAH group, there were significant associations among all the variables analyzed as was expected, without differences between the linear correlation and regression, indicating the physio-metabolic equilibrium of the factors and markers evaluated by FRS. Already in SAH group, despite the correlations have been significant too, the regression analysis revealed that only Total Cholesterol (P = 0.0086); LDL (P < 0.0001), Glucose (P < 0.0006) and Age (P < 0.0001) have significative association with FRS. So, these factors and markers deserve more attention upon the health staff of Health Family Strategy, in the SAH course at studied population, attempt the highest cardiovascular risk by FRS (2.5 to 2.8 times) to SAH. The monitoring of high-risk patients should prioritize the lifestyle changes, employing preventive measures to SAH and CVD and atherosclerosis.
Gynecological lymphoma in a developing community: Case report

Lymphoma of the uterus is rare. Internet search revealed single or few examples from Poland, Spain, Australia, USA, India, China, and UK. Therefore, a case from Nigeria is deemed to be worthy of documentation. Epidemiologically, it differed from the others, whose ages ranged from 23 to 74, by presenting in a 13-year-old girl.
Expanding PVL positive MRSA healthcare-associated infections outbreak in a newborns unit, caused by hospital hygiene shortcomings

Abstract A prolonged outbreak of Healthcare-Associated Infections (HCAIs) evolved since December 2013, in a Newborns Unit from Hospital A, sited in the North-Eastern development region, Romania. A first cluster consisted of 19 cases, of which 18 infections in newborns and 1 labour infectious complication in a mother. Except for five cases declared and treated in the Neonatology Unit as hospital-acquired infections, the other cases were discharged and further required rehospitalisation and treatment. Eight of these innitialy discharged cases were readmitted to the Pediatric Surgery Unit and two others to the Pediatrics Unit of Hospital B, while three others were readmitted to three hospitals: one to the Pediatrics Unit of Hospital C, and other two to Hospital A and Hospital D, respectively. The mother with the labour infectious complication was readmitted to the Gynecology Unit of the Hospital A. A number of fifteen Staphylococcus aureus (S. aureus) strains isolated from the HCAI first episode and 8 strains from 7 HCWs were received by „Cantacuzino” Institute, Nosocomial Infections and Antibiotic Resistance Laboratory from the County Public Health Directorate, for confirmation and molecular typing. After a first round of interventions for infection control, a second episode bursted in Hospital A and our laboratory received six other S. aureus isolates from newborns, hospital environment, and HCWs. Public Health interventions based on epidemiologic data and molecular microbiology results were finally successful. The evolution of all cases was favorable. An important factor favoring the outbreak was the moving of the Birth Unit of Hospital A to an innapropriate location for an 18-month interval, more than innitially estimated, in relation to rehabilitation of the ward. We considered to report this episode taking into account the unusual evolution, the risk of multiresistant bacterial strains spreading, and multiple unwanted consequences caused by shortcomings in providing appropriate hygiene conditions.
Treatment of anxiety disorders with plants and herbs

Anxiety is a natural feeling in people and every person experiences in certain conditions in his/her life. Anxiety refers to an unpleasant and vague feeling accompanied by worry about known and unknown origin. Symptoms of anxiety include heart palpitations, restlessness, fatigue, insomnia, dyspnea, and disturbance in concentration and memory. Fortunately, in these days, there are many ways such as yoga, relaxation, and massage to overcome stress and mental pressures. In addition, there is a completely different, nature-based way to control adverse emotions and anxiety, which is phytotherapy. In this article, the use of medicinal plants in pharmaceutical industry and treatment of anxiety was investigated. To achieve this purpose, the keywords such as medicinal plants, herbal drugs, traditional medicine, and anxiety were used to search for related articles. The databases Scopus, PubMed, ISI, Google Scholar, SID, and Magiran were searched for relevant articles. Based on the results, plants such as Valeriana officinalis, Passiflora incarnata, Rosmarinus officinalis, Lavandula angustifolia, Hypericum perforatum, Mentha piperita, Matricaria chamomilla, Glycyrrhiza glabra, Melissa officinalis, Crataegus aronia, Humulus lupulus, Echium amoenum, Prunus dulcis, and Foeniculum vulgare are some of the flora that, in the references, are recommended to control anxiety.
The mode and mechanism of action of once-weekly glucagon-like peptide-1 receptor agonists in type 2 diabetes

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an efficacious and convenient option for the treatment of type 2 diabetes (T2D). This narrative review assesses the mode and mechanism of action of the GLP-1RA class in general and highlights similarities and differences within the class. Published clinical trials and manuscripts of basic scientific research were collated and critically reviewed for information relating to the mode and mechanism of action of GLP-1RAs. The mode and mechanism of action is consistent across the GLP-1RA class, despite differences in sequence homology, formulation, conjugation and device administration. Within the class there are some differences in efficacy with regard to glycemic control. Crucially, cardiovascular benefit with GLP-1RAs cannot at this time be considered as a class effect. Once-weekly GLP-1RAs are a good therapeutic option for patients with T2D, either as monotherapy or as part of a combination therapy. Differences between these agents in terms of efficacy and safety outcomes, as well as convenience of a particular device and regimen, should be considered as part of individualization of therapy for patients unable to achieve glycemic control with metformin alone.
Histological changes associated with fibroadenoma breast

Introduction: Being the most common benign tumor of the breast, fibroadenoma show considerable histologic changes. It is important to highlight them as some of the changes are associated with increased risk of breast cancer. Aims and Objectives: To study the pattern and histologic changes in fibroadenoma breast. Materials and Methods: Retrospective analysis of histopathology of 55 cases of fibroadenoma breast diagnosed between Jan 2017 to Jun 2018. The pattern, epithelial and stromal changes were examined. Result: Commonest age group involved was in 3rd decade. Pericanalicular pattern was the predominant pattern. Apocrine and cystic change was the commonest change in epithelium. Two cases (3.6%) showed features of complex fibroadenoma. Three (5.5%) cases showed foci of tubular adenoma. Epithelial hyperplasia was seen in 5(9%) of cases of which 2 were mild, 2 were moderate and one was atypical hyperplasia. Inflammatory infiltrate in stroma was frequently observed. Conclusion: Fibroadenoma showed variety of histological changes of which complex fibroadenoma and epithelial hyperplasia are significantly important which requires appropriate management and follow up.
Preventing More “Missing Girls”: A Review of Policies To Tackle Son Preference

In parts of Asia, the South Caucasus, and the Balkans, son preference is strong enough to trigger significant levels of sex selection, resulting in the excess mortality of girls and skewing child sex ratios in favor of boys. Every year, an estimated 1.8 million girls go “missing” because of the widespread use of sex selective practices in these regions. The pervasive use of such practices is reflective of the striking inequities girls face immediately, and it also has possible negative implications for efforts to improve women’s status in the long term. Recognizing this as a public policy concern, governments have employed direct measures such as banning the use of prenatal sex selection technology, and providing financial incentives to families that have girls. This study reviews cross-country experiences to take stock of the direct interventions used and finds no conclusive evidence that they are effective in reducing the higher mortality risk for girls. In fact, bans on the use of sex selection technology may inadvertently worsen the status of the very individuals they intend to protect, and financial incentives to families with girls offer only short-term benefits at most. Instead, what seems to work are policies that indirectly raise the value of daughters. The study also underscores the paucity of causal studies in this literature.
Prediction of the length of the femur from its fragments in a Sri Lankan population

ABSTRACT In many forensic circumstances, the femur is fragmented due to decomposition and mutilation, thus necessitating development and application of regression equations to estimate the length of the femur from its fragments. In this study, regression equations were derived for the prediction of the femoral length, utilizing 11 standard femoral measurements (maximum length of femur, epicondylar breadth, vertical head diameter, transverse head diameter, vertical neck diameter, transverse neck diameter, neck length, subtrochanteric anterior–posterior diameter, subtrochanteric transverse diameter, mid-shaft anterior–posterior diameter and mid-shaft transverse diameter) obtained from 86 femora belonging to a contemporary Sri Lankan population. Univariate regression equations with moderate to high correlations (0.226 to 0.714) were formulated for the estimation of the maximum femoral length from the measurements of fragments of the femur. Of the single variables, the transverse neck diameter emerged as the best predictor (r = 0.714, SEE = 18.6596) of the maximum length of the femur. The multiple regression equations using a combination of variables yielded higher correlations (0.774–0.857) with lower error estimates (14.18–16.96). The regression equations presented in this study can be used to estimate the length of the femur of unknown, mutilated and dismembered human skeletal remains with considerable accuracy.
Efficacy of complex neuroprotection in glaucomatous optic neuropathy

E-mail: olga.v. guzun@gmail.com Background. The problem of glaucomatous optic neuropathy is not solved regardless the fact that intraocular pressure is stabilized. To manage the glaucomatous process, effective neuroprotection of the ganglion cells is required. The purpose of the paper was to study the efficacy of complex neuroprotection in patients with glaucomatous optic neuropathy using sequential laser radiation of the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy. Material and Methods. We followed up 27 patients (43 eyes) with advanced open angle glaucoma, verified glaucomatous optic neuropathy (GON), and stabilized intraocular pressure (IOP). The patients’ age averaged 63.8 (SD; 6.8). A treatment course included 10 every-day sessions of laser stimulation (LS) using a SM-4.3 unit (wavelength, 650 nm; irradiance, 0.4 mW/cm2; treatment timing, 240 s on the papillomacular bundle) and additional directed laser radiation to the optic disc (OD) using a 90 D lens (treatment timing, 60 s). Thereafter, patients received a vitamin supplement with 1 mg resveratrol: one capsule daily for 6 months. Results. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol in patients with glaucomatous optical neuropathy made it possible to increase visual acuity from 0.65 to 0.82 (by 26%), to increase visual system sensitivity with phosphene current threshold decreased from 84.9 μA to 76 μA (by 10%), to improve ocular blood circulation from 2.4 to 2.6‰ (by 8%), to decrease vasospasm from 26.7 to 21.8% (by 18%), significantly increase overall retinal light sensitivity from 1395.0 to 1709.0 dB (by 23%), and to stabilize the glaucomatous process within six months. Analyzing the data obtained after a neuroprotective LS course with a subsequent vitamin antioxidant supplementation therapy with reseratrol (1 mg) revealed an apparent correlation between an increase in overall light sensitivity of the retina and an increase in the blood circulation in the eye (rs=0.71, р<0.01) as well as a decrease in threshold current of visual system sensitivity (rs=-0.84, р<0.01). Conclusions. A combined treatment including LS of the optic nerve and the papillomacular bundle followed by a six-month vitamin and antioxidant supplement therapy with resveratrol (1 mg) in patients with glaucomatous optical neuropathy contributes to: an increase in visual acuity by 26%; an increase in the visual system sensitivity, evidenced by a decrease of phosphene threshold current by 10%; an improvement in ocular blood flow by 8%; a decrease of intraocular vasospasm by 18%; and a significant decrease in overall retinal light sensitivity by 23%. It also supports: an increase in conduction of optic nerve fibers; an improvement of the papillomacular bundle function; and stabilization of the glaucomatous process withing six months.
Development and immune correlates of Zika virus vaccines

Zika virus (ZIKV) was first isolated in 1947 from a sentinel monkey placed in the Zika forest, Uganda. It is an arthropod-borne virus (arbovirus) with the main mosquito vector being Aedes aegypti. The first ZIKV outbreak of public concern was in 2007 in the Yap Islands, followed by rapid spread across Brazil. First considered a relatively benign virus, a new link between ZIKV infection and microcephaly and other congenital malformations –now collectively called congenital Zika syndrome (CZS)– led to the declaration of a Public Health Emergency of International Concern in February 2016, by the World Health Organization (WHO). Described in this thesis is the development of the first vaccines to block ZIKV infection. We established both mouse and non-human primate models to assess efficacy of our vaccines. Correlates of protection were assessed through antibody adoptive transfer and T-cell depletion studies. We concluded that our rhesus adenovirus 52 (RhAd52) based ZIKV vaccine expressing the optimized M-Env antigen led to complete and durable protection of monkeys of at least 1 year, following a single dose immunization. Protection was correlated with neutralizing antibodies. In corroboration, the potent cross-reactive DENV neutralizing antibody B10 effectively halts ZIKV replication following exposure to ZIKV and can be used as a therapeutic treatment. The encouraging data described in this thesis have led to the progression of a human adenovirus 26 (Ad26) ZIKV vaccine expressing M-Env to a phase I clinical trial, which is currently ongoing.
Manual of basic physiotherapeutic exercises for family and caregivers of stroke patients

Received: May 26, 2018; Accepted: June 05, 2018; Published: June 09, 2018 Stroke sequelae need to be addressed early and many can even be prevented. This is when physiotherapy starts a few days after the hospital release (or the admission may even be in the place of hospitalization itself), when there is an effort by the patient to resume functions and when the family or caregiver is engaged in stimulating the same. This facilitates the recovery of simple functions, such as posture changes from dorsal decubitus to sedestation, evolving to independent gait and more elaborate activities such as driving. In addition to increasing the chances of motor improvement, early and disciplined stimulation minimizes shortening and deformities such as those reflected by a spastic pattern (shortening for example of flexors muscles of fingers and wrist, biceps brachii and sural triceps generating deformities in flexion of wrist and fingers, elbow and plantar flexion) or poor limb positioning during the flaccid phase [1,2].
The Effects of WI-FI on College Students' Physical and Mental Health*

Purpose: To understand college students' physical and mental health status and the use of WI-FI, and to explore the relationship between them. Method: A total of 1174 undergraduate students from 5 universities in Guangdong province were selected by stratified random method, and they were investigated by using personal general situation questionnaire (scl-90) and WI-FI questionnaire (WI-FI) compiled by themselves. Result: (1) The overall mental health of college students is good, but there are sub-health problems, mainly manifested as somatization, interpersonal sensitivity, compulsion, depression, anxiety, etc. (2) There are obvious somatic sub-health problems in college students, which are mainly manifested in pain and numbness of neck and lumbar spine, dry eyes, even pain and vision loss. (3) College students lack sufficient knowledge of WI-FI. 80.32% of college students belong to high frequency WI-FI users, and 17.12% are addicted to WI-FI. (4) Multivariate linear regression analysis results show that college students' mental health level (SCL 90 total split) were the major influencing factors of the following aspects: the purpose of understanding of WI-FI, surfing the Internet, on the degree of psychological dependence on WI-FI, whether to install WI-FI software, mobile phone support WI-FI, degree of eyes, neck involvement, the degree of lumbar spine involvement, the places and time of WI-FI use, the WI-FI hours a day on average, and whether to use WI-FI access to the Internet in class time. Conclusion: College students have physical and mental sub-health problems, and the use of WI-FI has a significant impact on their physical and mental health.
Nanofibers in Mucosal Drug and Vaccine Delivery

Successful mucosal administration and delivery of drugs still pose a great challenge. However, the possibility to deliver not only small drug molecules but also macromolecular drugs and nanoparticles via mucosal surfaces represents a great opportunity. Rapid onset of drug action, avoidance of first-pass metabolism, and high immunocompetence of mucosa are some of the important features for mucosal drug and vaccine delivery. The use of mucoadhesive drug delivery systems, systems with fast dissolving properties, and nanomaterials with mucus penetration properties are examples of successful strategies to achieve effective mucosal drug and vaccine delivery. Non-keratinized mucosa of the oral cavity, the nasal and vaginal mucosa represent favorable sites of drug administration. Polymer nanofibers have attracted much attention because of remarkable characteristics such as a large surface area to volume ratio and high porosity. Nanofibers have been extensively used for different biomedical applications including wound dressing, tissue engineering, and drug delivery. Among their fabrication methods, the introduction of electrospinning technique was an important step toward achieving the goal of large scale industrial production of nanofiber-based drug delivery systems used in mucosal applications. This chapter provides an overview on all aspects of mucosal drug and vaccine delivery using nanofibers.
The Effects of Ankle Turner Unit on the Quality of Life of Unilateral Below Knee Amputees

Background: Unilateral below knee amputation is a permanent surgical procedure that can influence the quality of life (QOL) of the person with amputation. The aim of this study was to assess the effects of ankle turner unit on the quality of life of unilateral below knee amputees. Methods: In a cross-sectional study, a total of twenty unilateral below-knee amputee patients were selected by simple random sampling. Quality of life of subjects was assessed with Trinity Amputation and Prosthesis Experience Scales (TAPES) questionnaire baseline and after 30 minute of using the unit. The participants were evaluated by five major criteria including: total TAPES score, conformity of movement restrictions, level of athletic activities, level of daily routine activities, and social activities, which were part of the TAPES survey. Results: In this study, 20 below-knee amputee male patients with average age of 47.7 years participated. Total index of TAPES with P = 0.01, matching of athletic restrictions with P = 0.04, athletic activity level with P = 0.006, and social activity level with P = 0.04 showed a significant difference compared to before using the unit. The difference in the level of daily routine activities, despite 5.15% increase in respect to before using the unit, was not significant (P = 0.2). Conclusions: The results implied that this unit can effectively improve the quality of life in amputees. In a detailed review of the study, it was proven that his unit resulted in an increase of the conformity with restrictions, and reduction of restrictions in athletic and social activities while it did not provide a positive effect on functional restrictions. Keywords: Ankle Turner Prosthesis; Quality of Life; Limb Loss; Below-Knee Prosthesis