Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Increased Skin‐to‐Skin Contact on Breastfeeding Neonates on Exclusive Breastfeeding at 4 and 8 Weeks Postpartum

Paper Presentation Objective To investigate the research question: Is there a relationship between the number of minutes of skin‐to‐skin (STS) contact between mother and infant during hospitalization and the rate of breastfeeding exclusivity at 4 and 8 weeks postpartum? Design Descriptive correlational study. Setting Urban nonprofit hospital with an average of 1,100 births per year. Sample Term pregnant women who had a vaginal delivery of a well newborn with intent to exclusively breastfeed. Sixty‐five women were enrolled into the study. Thirty women were excluded (cesarean delivery, infant admission to level II nursery, incomplete data collection). Thirty‐five women completed the inpatient data collection and follow‐up telephone calls at four and 8 weeks postpartum to assess breastfeeding exclusivity. Methods Subjects were recruited from a midwifery practice during prenatal care. At birth, newborns were placed STS with their mothers. Mothers were educated on how to provide STS for their newborns while in the hospital and maintained a log of the number of minutes of STS while in the hospital. Follow‐up phone calls were made at 4 and 8 weeks postpartum for assessment of exclusive breastfeeding, using the Index of Breastfeeding Status. Results Data were analyzed using correlation and chi‐square. The total length of time of STS in the hospital was not correlated with breastfeeding exclusivity at 4 and 8 weeks. However, STS occurring immediately at birth was positively associated with exclusive breastfeeding at 4 weeks postpartum. Increased times to STS and increased time to first breastfeeding were negatively associated with breastfeeding exclusivity. Additionally, infants with increased length of stay and those who were supplemented with formula were less likely to be exclusively breastfed at 4 and 8 weeks postpartum. Conclusion/Implications for Nursing Practice STS starting at birth was found to be significant for increasing breastfeeding exclusivity. Implications for practice include changing nursing and medical practice at delivery and placing healthy infants STS with their mothers at birth instead of routinely handing infants to the resuscitation team. Weaknesses of this study include recall bias and possible self‐selection bias in recruiting women with intent to exclusively breastfeed.
A METHODOLOGICAL FRAMEWORK FOR DEVELOPING MODELS OF WHOLE DISEASE AREAS TO INFORM RESOURCE ALLOCATION DECISIONS

distributions to patient-level data, two different methods were explored in the modelling of OS beyond the trial duration (55 months) for the novel immunotherapy ipilimumab. In the first approach, the hazard rate from the Kaplan-Meier (KM) curve between 24 and 36 months (before reaching a plateau) was used to extend the curve. In the second approach, different parametric curves were fitted to the period of 18 months onwards. Akaike’s Information Criterion (AIC) was used to determine the best fit curve. RESULTS: When compared to standard OS extrapolation methods, both methods exhibited a better visual fit to the data. Both approaches allow the hazard of the extrapolated tail to be based on a section of the KM curve that is more appropriate in describing the long-term survival of these patients. The hazard rate approach does not allow for a formal comparison with AIC, but allows extrapolation in line with the clinical interpretation. The ‘parametric curves’ approach allows for a statistically better fit with the patient level data using conventional AIC criteria. Both methods are in line with long-term observations of immunotherapy. CONCLUSION: For novel cancer therapies whose KM curves are not well described by standard survival distributions, other methods of extrapolation should be explored in conjunction with an understanding of the clinical rationale. In this case study, two alternatives are presented that describe the OS of immunotherapy patients in a more suitable way.
Mentoring Children of Prisoners: Program Evaluation

This program evaluation explores Seton Youth Shelters, Mentoring Children's Prisoners (MCP) Program. The following questions were research: (a) Where are the children residing, (b) Are mentoring services effective, (c) How are the children faring emotionally and psychologically, and (d) How often and what form of communication do they use. The findings reveal that youth participating in MCP have an increased interest in school, better relationships with their family, and find speaking to someone about everyday issues or problems helpful. Family members report a positive change in the youth attitude, increase interest in school, completion of homework, and greater interest in their well-being.
Papillary Syncytial Metaplasia Associated With Endometrial Breakdown Exhibits an Immunophenotype That Overlaps With Uterine Serous Carcinoma

Uterine serous carcinoma (USC) is an aggressive variant of Type 2 endometrial carcinoma, which in most cases exhibits, at least focally, a papillary architecture. Occasionally, especially in small biopsy specimens, it may be difficult to distinguish between USC and a variety of metaplastic or reactive processes. In particular, papillary syncytial metaplasia (PSM), as a result of endometrial breakdown, may be confused with USC or its precursor serous endometrial intraepithelial carcinoma. In such cases, immunohistochemistry is often undertaken, the panel of markers usually including estrogen receptor (ER), p53, p16, and MIB1. The expected immunoprofile of USC is ER negative, p53 and p16 positive, and a high MIB1 proliferation index, although studies have shown that significant numbers of cases deviate from this immunophenotype. With regard to the aforementioned markers, PSM has not been studied extensively, but intuitively, the expected immunophenotype would be ER positive, p53 and p16 negative, and a low MIB1 proliferation index. After 2 index cases in which breaking down menstrual endometrium with florid PSM was misdiagnosed on an endometrial biopsy as USC or suspected USC, in part due to the observed immunophenotype, we studied the expression of ER, p53, p16, MIB1, and HMGA2 (a recently described useful marker of USC) in 10 further cases of PSM associated with endometrial breakdown. We illustrate that compared with a nonbreaking down endometrium, PSM is characterized by a decreased expression of ER and an increased expression of p53 (although still wild-type staining) and p16, the latter marker typically being diffusely positive. HMGA2 is negative, and there is a low MIB1 proliferation index. In cases of PSM, which are morphologically problematic, the immunophenotype may further heighten the suspicion of serous malignancy and potentially result in a misdiagnosis.
Investigation of Disability Level, Leisure Satisfaction, and Quality of Life in Disabled Employees

The purpose of this study is to investigate the disability level, leisure satisfaction, and quality of life in employees who were disabled. Six hundred twenty-seven employees who were disabled were included in this study and classified according to age, gender and disability level. In quality of life, there was significant difference between genders and age groups (p < .05). There was no significant difference neither in leisure satisfaction nor in disability level between groups (p > .05). In disability assessment, males were better and there was a significant difference in leisure satisfaction (p < .05). Age, gender, and disability level were important factors affecting disability, leisure satisfaction, and quality of life among employees who were disabled.
Process optimization and consumer acceptability of salted ground beef patties cooked and held hot in flavored marinade.

UNLABELLED Food safety is paramount for cooking hamburger. The center must reach 71 °C (or 68 °C for 15 s) to assure destruction of E. coli O157:H7 and other food pathogens. This is difficult to achieve during grilling or frying of thick burgers without overcooking the surface. Thus, the feasibility of partially or completely cooking frozen patties in liquid (93 °C water) together with hot holding in liquid was investigated. Initial studies demonstrated that compared to frying, liquid cooking decreased (P < 0.05) patty diameter (98 compared with 93 mm) and increased (P < 0.05) thickness (18.1 compared with 15.6 mm). Liquid cooked patties had greater weight loss (P < 0.05) immediately after cooking (29 compared with 21%), but reabsorbed moisture and were not different from fried patties after 1 h hot water holding (61 °C). Protein and fat content were not affected by cooking method. However, liquid cooked patties were rated lower (P < 0.05) than fried patties for appearance (5.7 compared with 7.5) and flavor (5.9 compared with 7.5). An 8-member focus group then evaluated methods to improve both appearance and flavor. Salted, grill-marked patties were preferred, and caramel coloring was needed in the marinade to obtain acceptable flavor and color during liquid cooking or hot holding. Patties with 0.75% salt that were grill-marked and then finish-cooked in hot marinade (0.75% salt, 0.3% caramel color) were rated acceptable (P < 0.05) by consumers for up to 4 h hot holding in marinade, with mean hedonic panel ratings > 7.0 (like moderately) for appearance, juiciness, flavor, and texture. PRACTICAL APPLICATION Grill-marked and marinade-cooked ground beef patties reached a safe internal cooking temperature without overcooking the surface. Burgers cooked using this method maintained high consumer acceptability right after cooking and for up to 4 h of hot holding. Consumers and foodservice operations could use this method without specialized equipment, and instead use inexpensive and common equipment such as a soup pot or a restaurant steam table. Use of marinades (salt/caramel color or others) in this cooking and holding method provides a nearly endless culinary flavoring opportunity.
Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology

A significant proportion of the counselling that people receive takes place within informal, situated encounters between service users and practitioners in fields such as nursing, medicine, teaching and social work. However, almost all of the research that has been carried out into the process and outcomes of counselling consists of studies of formal, contracted counselling and psychotherapy based in therapy clinics and offices. The competent and effective delivery of counselling that is embedded in a primary professional role, such as that of nurse, teacher or social worker, presents considerable challenges for practitioners. Research evidence around the process and outcomes of embedded counselling represents a valuable resource that has the potential to enhance the quality of counselling conversations enacted by practitioners in health, education, social work and other professions. An overview is provided of different types of research that has been carried out into informal and embedded counselling, and of the main themes that have emerged from these studies. Suggestions are made for the further development of this field.
IOHEXOL MYELOGRAPHY IN THE DOG

Myelography with iohexol (180 mg iodine/ml, 0.25 ml/kg), a new nonionic radiologic contrast medium, was performed in 100 dogs of 33 different breeds. In 96 of the dogs the iohexol mixed evenly with the cerebrospinal fluid, providing an homogeneous, continuous column of contrast medium within the subarachnoid space, and a radiologic diagnosis of a normal myelogram or disease involving the spinal cord was made. Pooling of iohexol in the dorsal part of the subarachnoid space occurred in four dogs; whether this was related to poor mixing of contrast medium with cerebrospinal fluid or disease of the spinal cord and meninges requires further study. Postmyelographic signs of central nervous system irritation (fasciculations of the temporal muscles and three episodes of seizure activity) were observed in only one dog and were controlled with diazepam. The presenting neurologic signs were aggravated after myelography in four other dogs, two of which were eventually killed. This study provided further evidence of the increased safety of iohexol compared with metrizamide, the first of the nonionic media, as a contrast medium for myelography in the dog.
Interiorização do HIV/AIDS no Brasil: Um Estudo Epidemiológico

Introducao: A Sindrome da Imunodeficiencia Adquirida - aids e uma doenca infecciosa caracterizada por mudancas em sua evolucao. A enfermagem se destaca na assistencia ao portador de HIV/aids pelas acoes efetivas de promocao e recuperacao da saude, em especial as relacionadas ao vinculo necessario para a adesao a terapeutica antirretroviral. Objetivo: caracterizar o perfil epidemiologico dos portadores de HIV/aids em seguimento no servico de atendimento especializado de um municipio mineiro. Metodo: estudo quantitativo, cuja amostra foi de 204 pacientes. A coleta de dados foi realizada entre novembro/2011 a fevereiro/2012 e consistiu na analise das fichas de notificacao do Sistema de Notificacao de Agravos Notificaveis. Utilizou-se estatistica descritiva para analise dos dados. Resultados: 14,7% dos pacientes tinham infeccao pelo virus HIV e 85,3% aids, com media de idade de 39 anos. Houve equivalencia na distribuicao por sexo para os portadores do HIV. 9% dos pacientes sao analfabetos e 37,2% tem menos de 5 anos de estudo. 79,4% contaminaram-se por via sexual e, destes, 66,7% se declararam heterossexuais. Conclusao: pacientes com HIV/aids do municipio estudado possuem a idade, a heterossexualizacao, a feminizacao e a baixa escolaridade como fatores de risco para o HIV/aids.
The interplay between lipid profiles, glucose, BMI and risk of kidney cancer in the Swedish AMORIS study

With exception of cholesterol and total fat intake, associations between lipid biomarkers and kidney cancer have not often been researched. We aimed to assess possible links between lipid profiles and kidney cancer risk in a large prospective cohort study, while also taking into account glucose levels and BMI. A cohort based on 542,924 persons with baseline information on glucose, triglycerides (TGs), total cholesterol (TC) and creatinine was selected from the Swedish Apolipoprotein Mortality Risk study. A subgroup of 85,621 also had baseline measurements of HDL, LDL, apolipoprotein A‐I and apoB. Multivariate Cox proportional hazard models were used to analyze associations between quartiles and dichotomized values of these lipid components and kidney cancer risk. During a mean follow‐up of 13 years, 958 persons developed kidney cancer. TGs were the only lipid component for which a statistically significant association was found with kidney cancer risk when using both quartiles and a clinical cutoff (hazard ratio: 1.25 (95% CI: 0.99–1.60), 1.29 (1.01–1.66) and 1.66 (1.30–2.13) for the 2nd, 3rd and 4th quartile, compared to the 1st, with p‐value for trend: <0.001). The association remained after exclusion of the 95% percentile of TG. Quartiles of glucose were also positively associated with kidney cancer risk, whereas quartiles of TC were negatively associated with kidney cancer risk. This detailed analysis of lipid components only showed a consistent relation between TG levels and kidney cancer risk. Further mechanistic studies are required to assess links between lipid abnormalities and kidney cancer.
αvβ6 integrin expression in diseased and transplanted kidneys

α v β 6 integrin expression in diseased and transplanted kidneys. Background Integrins have been implicated in the pathogenesis of a diverse range of kidney diseases. Herein, we provide the first detailed description of an epithelial restricted integrin, α v β 6 , in kidney biopsies from patients suffering acute and chronic renal diseases and after transplantation. Methods Immunoperoxidase staining for β 6 was performed on 267 selected biopsy specimens from native ( N = 126) and transplanted kidneys ( N = 141) and scored semiquantitatively. The site of β 6 expression in tubules was determined using haematoxylin counterstaining and by colocalization with Tamm-Horsfall protein. Comparisons were made between subcategories of diseases of native kidneys and between "service" and "protocol" biopsies of transplanted kidneys. Results β 6 , when present, is largely confined to the distal tubules and collecting ducts, colocated with Tamm-Horsfall protein. When sparsely present, it was often restricted to the tubular segment associated with the juxtaglomerular apparatus. It was found in tubular cells shed into the urine. β 6 was not expressed in thin membrane nephropathy, or in nonproliferative forms of glomerulonephritis, with the exception of focal and segmental glomerulosclerosis (FSGS). It was diffusely expressed where there was glomerular necrosis or thrombosis and in most forms of acute or chronic tubulointerstitial disease. β 6 was diffusely up-regulated in allografts biopsied for delayed function, in almost all kidneys that have clinical or subclinical rejection episodes and was prominent in chronic allograft nephropathy. Conclusion β 6 integrin is not normally expressed in adult native or transplanted kidneys but is commonly up-regulated in the distal tubule in disease. Our descriptive study suggests that it is a molecule worthy of further study.
Pneumococcal vaccination rates in children with sickle cell disease.

CONTEXT Sickle cell disease (SCD) confers an increased risk of invasive pneumococcal disease, especially among young children. Pneumococcal vaccination decreases this risk, but the completion rate of age-appropriate vaccinations is not well defined in SCD. OBJECTIVE The goal of this study was to assess whether pneumococcal vaccines are administered to high-risk children with SCD according to recommended vaccine schedules. DESIGN A case-control design was used to conduct this study. SETTING Administrative data were obtained on Michigan Medicaid or Children's Special Health Care Services programs enrollees. In addition, Michigan Newborn Screening and Michigan Care Improvement Registry records were used to confirm diagnosis and vaccine administration. PARTICIPANTS This study compared pneumococcal vaccination rates in a cohort of 179 children with SCD with 537 age-matched non-SCD controls (1:3) enrolled in the Michigan Medicaid Program between 2001 and 2008. Study subjects were born in the state of Michigan between 2001 and 2005. MAIN OUTCOME MEASURE The main outcome measure was the proportion of children defined as up to date for pneumococcal vaccines at defined milestone ages. RESULTS Children with SCD had significantly higher vaccination rates than controls, yet these values were much lower than state and national immunization survey rates. CONCLUSION Barriers to completing age-appropriate recommended pneumococcal immunizations should be identified and addressed to further reduce invasive pneumococcal disease in this high-risk patient population.
Boswellic acid inhibits growth and metastasis of human colorectal cancer in orthotopic mouse model by downregulating inflammatory, proliferative, invasive and angiogenic biomarkers

Numerous cancer therapeutics were originally identified from natural products used in traditional medicine. One such agent is acetyl‐11‐keto‐beta‐boswellic acid (AKBA), derived from the gum resin of the Boswellia serrata known as Salai guggal or Indian frankincense. Traditionally, it has been used in Ayurvedic medicine to treat proinflammatory conditions. In this report, we hypothesized that AKBA can affect the growth and metastasis of colorectal cancer (CRC) in orthotopically implanted tumors in nude mice. We found that the oral administration of AKBA (50–200 mg/kg) dose‐dependently inhibited the growth of CRC tumors in mice, resulting in decrease in tumor volumes than those seen in vehicle‐treated mice without significant decreases in body weight. In addition, we observed that AKBA was highly effective in suppressing ascites and distant metastasis to the liver, lungs and spleen in orthotopically implanted tumors in nude mice. When examined for the mechanism, we found that markers of tumor proliferation index Ki‐67 and the microvessel density cluster of differentiation (CD31) were significantly downregulated by AKBA treatment. We also found that AKBA significantly suppressed nuclear factor‐κB (NF‐κB) activation in the tumor tissue and expression of proinflammatory (cyclooxygenase‐2), tumor survival (bcl‐2, bcl‐xL, inhibitor of apoptosis (IAP‐1) and survivin), proliferative (cyclin D1), invasive (intercellular adhesion molecule 1 and matrix metalloproteinase‐9) and angiogenic C‐X‐C (CXC) receptor 4 and vascular endothelial growth factor) biomarkers. When examined for serum and tissue levels of AKBA, a dose‐dependent increase in the levels of the drug was detected, indicating its bioavailability. Thus, our findings suggest that this boswellic acid analog can inhibit the growth and metastasis of human CRC in vivo through downregulation of cancer‐associated biomarkers.
Integrating community health workers within Patient Protection and Affordable Care Act implementation.

CONTEXT The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. OBJECTIVE This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. RESULTS Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. CONCLUSION Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models.