Miracle-dz/UniFAR-FTUs huggingface dataset:
Cervical screening in Western Kazakhstan: Liquid-based cytology ‘Cell Scan’ versus azur-eosin staining

Objective To assess the effectiveness of the current cervical cancer screening tools in Western Kazakhstan. Methods Smears taken through (i) conventional cytology using azur-eosin staining and (ii) liquid-based cytology (LBC) ‘Cell Scan’ in the general female population and in women first diagnosed with cervical cancer were collected throughout the region. ROC-analysis with curve construction and weighted Cohen's κ calculation were applied. A total of 494 cytological pairs were collected, including 94 sets with histology findings. Results The conventional (azur-eosin staining) technique contained 0.2% non-informative material and LBC ‘Cell Scan’ had 5.9%. Area under the curve was 0.95 for the conventional technique and 0.92 for ‘Cell Scan’ (p > 0.05). The conventional smears showed κ 0.62, sensitivity 90.4% at specificity 90.0% for CIN2+, while LBC ‘Cell Scan’ smears showed κ 0.47, sensitivity 83.3% at specificity 92.5%. Conclusions In this analysis it was not possible to prove that the LBC ‘Cell Scan’ technique was superior to its predecessor, azur-eosin staining. These findings highlight the need to modify the current screening programme according to updated international scientific evidence on effective screening design, such as the use of HPV DNA testing with Pap smear triage in women aged 30 or older. Further research, and a Health Technology Assessment, are necessary if we wish to establish a national standardized screening programme using the available technology appropriately.
Obesity prevention and the Global Syndemic: Challenges and opportunities for the World Obesity Federation

Global health is currently threatened by three co‐occurring pandemics: undernutrition, obesity, and climate change. Together, these pandemics are described as a “syndemic” coexisting in time and place, interacting with each other, and having common drivers in the underlying systems of food production, land use, urban design, and transport. Developing a comprehensive response to climate change is of high political concern worldwide. Transforming the food supply system globally and nationally has also become a priority on the political agenda, and a lack of government and corporate accountability has become increasingly apparent to the public. This has now been recognized by José Graziano da Silva, Director‐General of the United Nations (UN) Food and Agriculture Organization (FAO), who recently stated “The current food systems do not work; they are designed for something other than guaranteeing good nutrition. Our challenge is to redesign them. ” During the previous month, the UN General Assembly adopted a Resolution urging member states to “Reinforce actions towards the improvement of nutrition, health conditions and living standards of populations around the globe as a key element of strategies for the eradication of all forms of malnutrition and poverty in all its forms and dimensions, as well as the promotion of sustainable development. ” The language of global institutions at a remarkably high level has been reinforced by the recent Lancet Commission on the Global Syndemic, for which several key background papers are published in the present Supplement. The Lancet Commission's report demonstrated the interactive nature of the three crises of undernutrition, with micronutrient deficiencies affecting nearly two billion people,
KUALITAS PELAYANAN FARMASI BERDASARKAN WAKTU PENYELESAIAN RESEP DI RUMAH SAKIT

Based on Standard of Pharmaceutical Quality in Hospitals, there are methods are applied to distribute pharmaceuticals. One outpatient care efforts is to obtain medication prescribed by a doctor in a short time. The quality of outpatient pharmacy services as measured by the time of complete prescription at the pharmacy installation hospitals are based on reliability, responsiveness, assurance, empathy and tangibles. The study use cross-sectional’s method, which is done by January-February in 2015, to analyze pharmacy quality standard and time of complete prescription. The data used in this study are primary data. This study was used sample of 157 respondents for quetioners and 787 outpatients prescriptions. The results showed that the highest satisfaction turn around time is 13 minutes. For the five variables tested showed that the responsiveness had the highest scores of 3.18 and tangibles has the lowest score of 2,53. Conclusion, time of complete prescription less than 13 minutes and supported by quetioners shows the highest variables of responsiveness at 3,29 are agreed that time to wait is not too long.
Knowledge, attitude, and practice regarding breast cancer and its screening methods among nursing staff working in a tertiary-care hospital located in South India -

Background: Role of health personnel in educating the people regarding screening tests of breast cancer is very important to detect cancer at an early stage to prevent the morbidity and mortality. Objective: To assess the knowledge, attitude, and practices (KAP) regarding the breast cancer and its screening methods among staff nurses. Materials and Methods: This cross-sectional study was conducted in a tertiary-care hospital in Puducherry. A total of 198 staff nurses were interviewed using a structured questionnaire, which consisted of questions ascertaining the KAP regarding the epidemiology, diagnosis, and treatment of breast cancer and its screening tests [breast self-examination (BSE), clinical breast examination (CBE), and mammography]. Data analysis was done using SPSS software. Frequency and proportions were calculated. Result: Most of the staff nurses were female subjects (97%) and had less than 5 years of working experience (86.7%). Family history (40.9%), inadequate breast feeding (29.8%), and lifestyle factors (24.7%) were important risk factors of breast cancer as per participants. About 36.9% mentioned biopsy as a diagnostic test; 73.2% mentioned BSE as a screening test; 67.5% were practicing BSE, but only 5.5% were practicing it regularly. Only 11.6% mentioned CBE as a screening test, and 10.8% had undergone CBE only once. About 18.7% mentioned mammography as a screening test. Conclusion: The knowledge and practice of staff nurses regarding screening tests was low. Staff nurses should undergo continuing medical education to revise and update their knowledge; in turn they can educate the community.
Glutathione contributes to efficient post-Golgi trafficking of incoming HPV16 genome

Human papillomavirus (HPV) is the most common sexually transmitted pathogen in the United States, causing 99% of cervical cancers and 5% of all human cancers worldwide. HPV infection requires transport of the viral genome (vDNA) into the nucleus of basal keratinocytes. During this process, minor capsid protein L2 facilitates subcellular retrograde trafficking of the vDNA from endosomes to the Golgi, and accumulation at host chromosomes during mitosis for nuclear retention and localization during interphase. Here we investigated the relationship between cellular glutathione (GSH) and HPV16 infection. siRNA knockdown of GSH biosynthetic enzymes results in a partial decrease of HPV16 infection. Likewise, infection of HPV16 in GSH depleted keratinocytes is inefficient, an effect that was not seen with adenoviral vectors. Analysis of trafficking revealed no defects in cellular binding, entry, furin cleavage of L2, or retrograde trafficking of HPV16, but GSH depletion hindered post-Golgi trafficking and translocation, decreasing nuclear accumulation of vDNA. Although precise mechanisms have yet to be defined, this work suggests that GSH is required for a specific post-Golgi trafficking step in HPV16 infection.
Biomarker-Based Prediction of Progression to Dementia: F-18 FDG-PET in Amnestic MCI

Background: Metabolic patterns on brain F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can predict the decline in amnestic mild cognitive impairment (aMCI) to Alzheimer's disease dementia (AD) or other dementias. Objective: This study was undertaken to evaluate the diagnostic accuracy of baseline F-18 FDG-PET in aMCI for predicting conversion to AD or other dementias on follow-up. Patients and Methods: A total of 87 patients with aMCI were enrolled in the study. Each patient underwent a detailed clinical and neuropsychological examination and FDG-PET at baseline. Each PET scan was visually classified based on predefined dementia patterns. Automated analysis of FDG PET was performed using Cortex ID (GE Healthcare). The mean follow-up duration was 30.4 ± 9.3 months (range: 18–48 months). Diagnosis of dementia at follow-up (obtained using clinical diagnostic criteria) constituted the reference standard, and all the included aMCI patients were divided into two groups: the aMCI converters (MCI-C) and MCI nonconverters (MCI-NC). Diagnostic accuracy of FDG PET was calculated using this reference standard. Results: There were 23 MCI-C and 64 MCI-NC. Of the 23 MCI-C, 19 were diagnosed as probable AD, 1 as frontotemporal demetia (FTD), and 3 as vascular dementia (VD). Of the 64 MCI-NC, 9 had subjective improvement in cognition, and 55 remained stable. The conversion rate for all types of dementia in our series was 26.4% (23/87) and for Alzheimer's type dementia was 21.8% (19/87). The of PET-based visual interpretation was 91.9%. Sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET-based prediction of dementia conversion were 86.9% [confidence interval (CI) 66.4%–97.2%)], 93.7% (CI 84.7%–98.2%), 83.3% (CI 65.6%–92.9%), and 95.2% (CI 87.4%–98.9%), respectively. Kappa for agreement between visual and Cortex ID was 0.94 indicating excellent agreement. In the three aMCI patients progressing to VD, no specific abnormality in metabolic pattern was noted; however, there was marked cortical atrophy on computed tomography. Conclusion: FDG-PET-based visual and cortex ID classification has a good accuracy in predicting progression to dementia including AD in the prodromal aMCI phase. Absence of typical metabolic patterns on FDG-PET can play an important exclusionary role for progression to dementia. Vascular cognitive impairment with cerebral atrophy needs further studies to confirm and uncover potential mechanisms.
Resistance profile and molecular characterization of pyrethroid resistance in a Rhipicephalus microplus strain from Colombia

Intensive use of chemical acaricides for the control of cattle ticks (Rhipicephalus microplus) has led to the development of multiple acaricide resistance in Colombia. The present study aimed to characterize, using toxicological bioassays and molecular biology techniques, the resistance profile of a tick strain isolated from the Arauca state, Northeast Colombia. Commercial acaricides were used in adult immersion tests to determine its in vitro efficacies. Deltamethrin showed very low activity (4–7.3%), a mixture of cypermethrin and chlorpyrifos had intermediate efficacy (64–75.2%), and ethion presented the highest activity (88.5–100%). A colony (Arauquita strain) was established and larval immersion tests confirmed high resistance level to deltamethrin (241‐fold) and susceptibility to ivermectin. A quantitative polymerase chain reaction‐high resolution melt technique was used to identify single nucleotide polymorphisms (SNPs) in the para‐sodium channel gene. All of the genotyped individuals were mutant, presenting one (n = 7), two (n = 7) or three (n = 9) SNPs previously associated with pyrethroid resistance. Sequencing revealed a novel mutation (F712L), that was found for the first time in R. microplus ticks from South America. This is the first description of mutations associated with pyrethroid resistance in R. microplus from Colombia. The acaricide resistance pattern found in the Arauquita strain is similar to other parts of Colombia.
Investigating the Effect of Pharmaceutical Companies’ Gifts on Doctors’ Prescribing Behavior in Jordan

The study aimed at investigating the effect of pharmaceutical companies‘ gifts on doctors‘ prescribing behavior in Jordan. Vacation expenses, gifts of substantial value, lavish meals and entertainment, cash/commissions for prescribing particular brand, money for sponsoring drug trial, free medical samples and Continuing Medical Education funding and honoraria were the main components of pharmaceutical companies‘ gifts in this study. Primary data was collected using a questionnaire from a judgment sample of 335 practicing doctors in the private sector. Multiple regression analysis was used to analyze the data. The findings indicated that there is a high level of acceptance of pharmaceutical companies‘ gifts by doctors, and that there is a statistically significant effect of pharmaceutical companies gifts‘ on doctors‘ prescribing behavior, in which cash commissions for prescribing particular brand was found to have the most influence on doctors‘ prescribing behavior. Number of recommendations was presented to the Jordanian pharmaceutical companies such as: paying more attention to the gifts as part of their promotional mix, competitors' activities, and minimize their expenses on lavish meals and entertainment since they have the lowest effect on doctors‘ prescribing behavior, and to increase their investments on the more influential gifts.
Long-Term Outcomes of StopLoss Jones Tubes for Epiphora in Patients With Early or Multiple Loss of Lester Jones Tubes

Purpose: Extrusion is the most common cause of failure in conventional Lester Jones tubes (LJTs). StopLoss Jones tubes (SLJTs) with distal flange are designed to reduce this complication. This study compared the survival of SLJTs with their prior LJTs and control patients with LJTs-only. Methods: Retrospective review of consecutive LJT or SLJT insertion between January 2014 and December 2016. Results: Twenty-eight eyes of 23 patients had 31 SLJTs. Before their SLJTs, these patients had 116 cumulative failed LJTs. Forty-seven eyes of 34 patients had 59 LJTs only. Fifty-two percent of SLJT group and 18% of LJT-only group had complex medial canthal conditions (p = 0.003). Compared to their previous LJTs, the SLJTs were less likely to extrude (3% SLJT vs. 64% prior LJT, p < 0.0001); there was no statistical difference in rates of sinking in (26% SLJT vs. 13% prior LJT, p = 0.0964). The median survival of LJTs in those who went on to have a SLJT was 3.5 months. SLJT insertion significantly lengthened the median survival to 26 months (p < 0.0001), comparable to the LJT-only group (25.5 months, p = 0.45). While extrusion was also the most common complication in the LJT-only group, this occurred only in 20% of eyes; tube failure from sink-in occurred in 14% of eyes. Conclusions: SLJTs, in patients prone to multiple or early prior LJT losses, can be used to rescue this group and allow them to regain a similar survival curve to the less complicated LJT-only group. Rates of tube extrusion are significantly reduced with the use of SLJT. SLJTs significantly increased the median survival of conjunctivodacryorhinostomy bypass in those with multiple prior LJT losses. The 2-fold increase in sinking-in rate is outweighed by their 20-fold decrease in extrusion rate.
Lack of an Exposure Response and Interaction with HLA-DPβ1 and DRβ1 Polymorphisms in the Development of Beryllium Toxicity in a High Beryllium Exposure Cohort.

OBJECTIVE To evaluate interaction of HLA-DPβ1 and DRβ1 polymorphisms with metrics of beryllium exposure, in the development of beryllium sensitization (BeS) and chronic beryllium disease (CBD). METHODS A matched case-control study of 61 CBD, 41 BeS, and 259 controls from two beryllium-processing facilities. RESULTS BES and CBD were significantly associated with presence of DPβE69. Dose response of exposure was not observed for the development of BES and CBD with/without adjustment for DPβE69 (p > 0.05). The DRβE71 polymorphism was more common in BeS than CBD after adjusting for exposure and maybe a protective factor (aOR 0.4, 95% CI 0.2-0.9) against the progression of BeS to CBD. CONCLUSION No exposure-response association was found, which may reflect that the workers in this high exposure cohort were above a threshold level where an exposure-response could be observed.
Defining a recovery-oriented cascade of care for opioid use disorder: A community-driven, statewide cross-sectional assessment

Background In light of the accelerating and rapidly evolving overdose crisis in the United States (US), new strategies are needed to address the epidemic and to efficiently engage and retain individuals in care for opioid use disorder (OUD). Moreover, there is an increasing need for novel approaches to using health data to identify gaps in the cascade of care for persons with OUD. Methods and findings Between June 2018 and May 2019, we engaged a diverse stakeholder group (including directors of statewide health and social service agencies) to develop a statewide, patient-centered cascade of care for OUD for Rhode Island, a small state in New England, a region highly impacted by the opioid crisis. Through an iterative process, we modified the cascade of care defined by Williams et al. for use in Rhode Island using key national survey data and statewide health claims datasets to create a cross-sectional summary of 5 stages in the cascade. Approximately 47,000 Rhode Islanders (5.2%) were estimated to be at risk for OUD (stage 0) in 2016. At the same time, 26,000 Rhode Islanders had a medical claim related to an OUD diagnosis, accounting for 55% of the population at risk (stage 1); 27% of the stage 0 population, 12,700 people, showed evidence of initiation of medication for OUD (MOUD, stage 2), and 18%, or 8,300 people, had evidence of retention on MOUD (stage 3). Imputation from a national survey estimated that 4,200 Rhode Islanders were in recovery from OUD as of 2016, representing 9% of the total population at risk. Limitations included use of self-report data to arrive at estimates of the number of individuals at risk for OUD and using a national estimate to identify the number of individuals in recovery due to a lack of available state data sources. Conclusions Our findings indicate that cross-sectional summaries of the cascade of care for OUD can be used as a health policy tool to identify gaps in care, inform data-driven policy decisions, set benchmarks for quality, and improve health outcomes for persons with OUD. There exists a significant opportunity to increase engagement prior to the initiation of OUD treatment (i.e., identification of OUD symptoms via routine screening or acute presentation) and improve retention and remission from OUD symptoms through improved community-supported processes of recovery. To do this more precisely, states should work to systematically collect data to populate their own cascade of care as a health policy tool to enhance system-level interventions and maximize engagement in care.
Internalized Homophobia, Depressive Symptoms, and Suicidal Ideation Among Lesbian, Gay, and Bisexual Adults in South Korea: An Age-Stratified Analysis.

Purpose: Little research on internalized homophobia (IHP) and mental health among lesbian, gay, and bisexual (LGB) individuals has been done in South Korea, a context in which LGB populations widely experience societal stigma. This study examined the association between IHP and depressive symptoms and suicidal ideation among Korean LGB adults and investigated whether the association differed by participants' age. Methods: Cross-sectional data from the "Rainbow Connection Project I - Korean Lesbian, Gay, & Bisexual Adults' Health Study" were used for this study (N = 2178). Descriptive analyses were conducted to explore the distribution of IHP, depressive symptoms, and suicidal ideation across all covariates. Multivariate analyses were also used to investigate the overall and age-stratified associations between IHP and depressive symptoms and suicidal ideation. Results: The prevalence of high IHP was greater among older LGB adults, whereas the prevalence of depressive symptoms and suicidal ideation was higher among younger LGB adults. LGB individuals with high IHP levels had significantly greater risk of depressive symptoms than those with low IHP levels. In the age-stratified analyses, the associations between IHP and depressive symptoms were statistically significant only among older LGB adults with high IHP levels. Regarding suicidal ideation, the overall association was statistically significant in the full sample, but not in the age-stratified analyses. Conclusion: These findings suggest that mental health interventions are needed for LGB adults who have high IHP levels, especially among older generations. Furthermore, greater efforts are needed to enact protective legislation for sexual minority individuals in South Korea.
Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta-Analysis.

BACKGROUND The role of donated breast milk and formula feeding in very low birth weight infants (VLBWIs) remains unclear. OBJECTIVE The objective for this study was to evaluate the efficacy and safety of breast milk and formula for feeding VLBWIs. METHODS A comprehensive search of PubMed databases was conducted on November 30, 2018, to identify related randomized controlled trials (RCTs). Pooled odds ratio (OR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using either a fixed or random-effects model. RESULTS Seven RCTs with a total of 876 infants were included. The formula showed more advantages in increasing infant weight (MD = -6.58, 95% CI: -11.19 to -1.98) and length (MD = -0.30, 95% CI: -0.41 to -0.20) than donated breast milk, but formula could also significantly increase the risks of necrotizing enterocolitis (OR = 0.33, 95% CI: 0.18 to 0.59) and length of hospital stay (MD = -3.78, 95% CI: -6.84 to -0.72) when compared with donated breast milk. No significant differences on the head circumference gain (MD = -0.16, 95% CI: -0.33 to 0.01), sepsis (OR = 1.21, 95% CI: 0.84 to 1.75), retinopathy of prematurity (OR = 1.22, 95% CI: 0.73 to 2.05) and mortality (OR = 0.84, 95% CI: 0.47 to 1.52) were found. LINKING EVIDENCE TO ACTION The donated breast milk shows more advantages in reducing the incidence of NEC and length of hospital stay, but also more disadvantages in increasing the weight and length of VLBWIs and ELBWIs when compared with preterm formula feeding. Currently, there is no solid evidence demonstrating a significant advantage of donated breast milk over formula in the feeding of VLBWIs. Larger-scale RCTs with rigorous designs are needed to elucidate the feeding plans of VLBWIs.
Pseudomonas sp. COW3 Produces New Bananamide-Type Cyclic Lipopeptides with Antimicrobial Activity against Pythium myriotylum and Pyricularia oryzae

Pseudomonas species are metabolically robust, with capacity to produce secondary metabolites including cyclic lipopeptides (CLPs). Herein we conducted a chemical analysis of a crude CLP extract from the cocoyam rhizosphere-derived biocontrol strain Pseudomonas sp. COW3. We performed in silico analyses on its whole genome, and conducted in vitro antagonistic assay using the strain and purified CLPs. Via LC-MS and NMR, we elucidated the structures of four novel members of the bananamide group, named bananamides D-G. Besides variability in fatty acid length, bananamides D-G differ from previously described bananamides A-C and MD-0066 by the presence of a serine and aspartic acid at position 6 and 2, respectively. In addition, bananamide G has valine instead of isoleucine at position 8. Kendrick mass defect (KMD) allowed the assignment of molecular formulae to bananamides D and E. We unraveled a non-ribosomal peptide synthetase cluster banA, banB and banC which encodes the novel bananamide derivatives. Furthermore, COW3 displayed antagonistic activity and mycophagy against Pythium myriotylum, while it mainly showed mycophagy on Pyricularia oryzae. Purified bananamides D-G inhibited the growth of P. myriotylum and P. oryzae and caused hyphal distortion. Our study shows the complementarity of chemical analyses and genome mining in the discovery and elucidation of novel CLPs. In addition, structurally diverse bananamides differ in their antimicrobial activity.