Miracle-dz/UniFAR-FTUs huggingface dataset:
A Qualitative Analysis of Common Concerns about Challenges Facing Pharmacy Experiential Education Programs

Objective. To qualitatively analyze free-text responses gathered as part of a previously published survey in order to systematically identify common concerns facing pharmacy experiential education (EE) programs. Methods. In 2011, EE directors at all 118 accredited pharmacy schools in the US were asked in a survey to describe the most pressing issues facing their programs. Investigators performed qualitative, thematic analysis of responses and compared results against demographic data (institution type, class size, number of practice sites, number and type of EE faculty member/staff). Expert and novice investigators identified common themes via an iterative process. To check validity, additional expert and novice reviewers independently coded responses. The Cohen kappa coefficient was calculated and showed good agreement between investigators and reviewers. Results. Seventy-eight responses were received (66% response rate) representing 75% of publicly funded institutions and 71% of schools with class sizes 51-150. Themes identified as common concerns were site capacity, workload/financial support, quality assurance, preceptor development, preceptor stipends, assessment, onboarding, and support/recognition from administration. Good agreement (mean percent agreement 93%, ƙ range=0.59-0.92) was found between investigators and reviewers. Conclusion. Site capacity for student placements continues to be the foremost concern for many experiential education programs. New concerns about preceptor development and procedures for placing and orienting students at individual practice sites (ie, “onboarding”) have emerged and must be addressed as new accreditation standards are implemented.
Pharmacy Residents’ Pursuit of Academic Positions

Objective. To describe pharmacy residents’ interest in and pursuit of academic positions. Methods. An electronic presurvey and postsurvey were sent to pharmacy residents during the 2011-2012 residency year. The initial survey evaluated residents’ job preferences and interest in academia at the beginning of residency, and the follow-up survey focused on job selection and reasons for pursuing or not pursuing positions in academia. Results. Nine hundred thirty-six residents responded to the initial survey and 630 participated in both the initial and follow-up survey. Forty-eight percent of those responding to both surveys strongly considered a career in academia in the initial survey, 28% applied for an academic position, and 7% accepted a position. Second-year postgraduate residents were more likely than first-year postgraduate residents to apply for and be offered a faculty position. Conclusion. Pharmacy residents are interested in academia. While increasing interest among residents is encouraging for faculty recruitment, the academy should also encourage and develop adequate training experiences to prepare residents to succeed in these positions.
An insight into oral health practices among 1 st year medical students of Karad, India: A questionnaire study

Objectives: The objective was to assess the oral health practices among 1 st year medical students. Methods: This cross‑sectional study was conducted among 180 1 st year medical students of Krishna Institute of Medical Sciences, Karad. The data pertaining to their oral health practices, and demographic variables were recorded in a structured proforma. Subsequently, a clinical oral examination was carried out to record decayed missing filled teeth (DMFT) index and oral hygiene index simplified scores. Data collected were subjected to statistical analysis and results were expressed in means and percentages. A comparison of mean scores between genders with respect to DMFT was carried out using independent sample t‑test. Results: On analyzing responses, it was observed that only 49.4% brushed twice daily, and 61.1% used none of the interdental cleaning aids; 51.7% visited dentist only when they had dental pain. Oral hygiene status score showed 20.6% and 0.6% had fair and poor oral hygiene status, respectively (P = 0.590). Mean number of filled teeth among males and females were 0.22 and 0.94, respectively. This difference was statistically significant (t = 2.332, P = 0.021). Conclusion: From the current study, it can be concluded that the 1st year medical students reflected unfavorable oral health practices. These findings highlight the need to improve the education of medical students about oral health and its relevance through comprehensive educational programs to promote good oral health.
Integrating Medication Therapy Management Education into a Core Pharmacy Curriculum

Objective. To describe the design of a core course directed at improving confidence and competence of students to perform medication therapy management (MTM) services. Design. Using the American Pharmacists Association (APhA) certificate training program framework, a core course was developed to teach MTM concepts to third-year student pharmacists. Using deep learning and authentic assignments, course instructors attempted to improve student confidence and readiness to provide MTM services. Assessment. Student ability to meet course objectives was evaluated by examinations and the APhA MTM program self-assessment. Students had an overall success rate of 93% on all three assessments. Student perceptions of confidence, competence, and importance of performing MTM services were measured using a survey instrument with 56 Likert-type items. Students completing both surveys reported significantly increased confidence and competence. Conclusion. Integrating MTM-specific education into the core curriculum increased student pharmacists’ perceived competence and confidence to perform MTM services.
Insights, Pearls, and Guidance on Successfully Producing and Publishing Educational Research

It is the collaborative responsibility of authors, reviewers, and editors to produce high-quality manuscripts that advance knowledge and educational practice. Experience with manuscript submissions to the American Journal of Pharmaceutical Education reveal several areas for improvement that authors can make to increase their submission success rate during the review process. These improvements include research question justification, improved clarity and details regarding methodology, concise data and results, and a discussion that frames research findings in the context of what is already known. This paper summarizes common flaws we see in submitted manuscripts and makes suggestions on how to address these areas and improve publication success.
Burkholderia cepacia: This Decision Is Overdue

This is the third in a series of seven articles discussing the Recall Root Cause Research project conducted by the Division of Manufacturing and Product Quality, Center for Drug Evaluation and Research. This paper reviews the regulatory and scientific impact of a common and recurring opportunistic pathogen, Burkholderia cepacia. B. cepacia is comprised of closely related species called Burkholderia cepacia complex, which has contaminated many finished pharmaceutical products and environments used to manufacture pharmaceuticals. This review includes a brief perspective as described in several U.S. Food and Drug Administration (FDA) documents, and assesses root cause using product recall reports and FDA Establishment Inspection Reports. We identify several possible points of origin for microbial contamination. This discussion also includes concern with anomalies in test methods that may influence B. cepacia measurement. The issue of objectionable microorganisms and whether B. cepacia can readily be included in a compendial chapter is briefly discussed. Finally, this paper underscores that drugs contaminated with B. cepacia pose a serious threat to susceptible patients, particularly those with cystic fibrosis or who are otherwise immunocompromised. It is therefore important to prevent B. cepacia from contaminating pharmaceutical manufacturing environments, raw materials, and finished products. LAY ABSTRACT: Burkholderia cepacia is a species of bacterium that is commonly found in natural environments such as soil, water, rhizosphere and agriculture products. The species name represents a group of closely related organisms. These bacteria have contaminated many drug products and can create public health concerns. Pharmaceutical products that are contaminated with B. cepacia may pose serious consequences to vulnerable patients (e.g., compromised immune system). Preventing B. cepacia contamination in drugs by addressing the potential sources of this bacteria in a drug manufacturing operation is an important public health goal. This review highlights potential sources of B. cepacia species as they relate to U.S. Food and Drug Administration findings recorded in data from Establishment Inspection Reports and Warning Letters.
Influence of Different Container Closure Systems and Capping Process Parameters on Product Quality and Container Closure Integrity (CCI) in GMP Drug Product Manufacturing

Capping equipment used in good manufacturing practice manufacturing features different designs and a variety of adjustable process parameters. The overall capping result is a complex interplay of the different capping process parameters and is insufficiently described in literature. It remains poorly studied how the different capping equipment designs and capping equipment process parameters (e.g., pre-compression force, capping plate height, turntable rotating speed) contribute to the final residual seal force of a sealed container closure system and its relation to container closure integrity and other drug product quality parameters. Stopper compression measured by computer tomography correlated to residual seal force measurements. In our studies, we used different container closure system configurations from different good manufacturing practice drug product fill & finish facilities to investigate the influence of differences in primary packaging, that is, vial size and rubber stopper design on the capping process and the capped drug product. In addition, we compared two large-scale good manufacturing practice manufacturing capping equipment and different capping equipment settings and their impact on product quality and integrity, as determined by residual seal force. The capping plate to plunger distance had a major influence on the obtained residual seal force values of a sealed vial, whereas the capping pre-compression force and the turntable rotation speed showed only a minor influence on the residual seal force of a sealed vial. Capping process parameters could not easily be transferred from capping equipment of different manufacturers. However, the residual seal force tester did provide a valuable tool to compare capping performance of different capping equipment. No vial showed any leakage greater than 10−8 mbar L/s as measured by a helium mass spectrometry system, suggesting that container closure integrity was warranted in the residual seal force range tested for the tested container closure systems. LAY ABSTRACT: Capping equipment used in good manufacturing practice manufacturing features different designs and a variety of adjustable process parameters. The overall capping result is a complex interplay of the different capping process parameters and is insufficiently described in the literature. It remains poorly studied how the different capping equipment designs and capping equipment process parameters contribute to the final capping result. In this study, we used different container closure system configurations from different good manufacturing process drug product fill & finish facilities to investigate the influence of the vial size and the rubber stopper design on the capping process. In addition, we compared two examples of large-scale good manufacturing process capping equipment and different capping equipment settings and their impact on product quality and integrity, as determined by residual seal force.
Cost-effectiveness and cost-utility analysis of travoprost versus latanoprost and timolol in the treatment of advanced glaucoma in five European countries: Austria, France, Germany, The Netherlands and the United Kingdom

Summary This study compares the cost and effectiveness of timolol, latanoprost and travoprost in Austria, France, Germany, The Netherlands and the UK in patients with advanced glaucoma. A Markov model was constructed to assess the incremental cost-effectiveness ratio. Health states were stable and progressive patients. Transition probabilities were derived from daily intraocular pressure means and variances using two discriminant functions. Costs refer to a specific survey in France, to the General Practice Research Database in the UK, and to expert interviews in the other countries. Utilities were derived from a French survey and from the literature. The time horizon was 5 years (Stewart survey). A payer perspective was adopted. Time without a visual field defect (VFD) was 3.417 years with travoprost, 3.285 years with latanoprost and 2.812 years with timolol. Travoprost economically dominated latanoprost in Austria, Germany, the UK and The Netherlands. The incremental cost-utility ratio of travoprost against both latanoprost and timolol was always less than 50,000 Euro per quality-adjusted life-year. Travoprost is a cost-effective alternative to latanoprost and timolol. A larger prospective study should confirm these findings.
Effects of nuclei ambiguus and dorsal motor nuclei of vagus on gastric H+ and HCO3- secretion in rats

AIM: To determine the effects of electrical stimulation of nucleus ambiguus (NA) and dorsal motor nuclei of vagus (DMV) on gastric acid and bicarbonate secretion in rats. METHODS: NA and DMV in rats were electrically stimulated. Pylorus ligation or esophagus perfusion was used to collect the gastric secretion. The titratable H+ quantum, H+ concentration, HCO3- secretion quantum were measured. RESULTS: Electrical stimulation of NA had no effects on the volume of gastric juice, titratable acidity and acid concentration, but elicited a pronounced increase in the total bicarbonate. However, electrical stimulation of DMV significantly increased the titratable acidity, the volume of gastric juice and the acid concentration. Similarly, electrical stimulation of either NA or DMV decreased the respiratory frequency and sinus bradycardia. CONCLUSION: NA in rats can not control the secretion of gastric acid but the secretion of bicarbonate in gastric juice, while DMV controls the secretion of gastric acid.
HEMORRHAGE FROM PHARYNGEAL AND PERITONSILLAR ABSCESSES: REPORT OF CASES, RÉSUMÉ OF THE LITERATURE AND DISCUSSION OF LIGATION OF THE CAROTID ARTERY

When one for the first time encounters a severe, perhaps fatal, hemorrhage in connection with an abscess in the throat the first reaction is that of surprise or shock, as the occurrence is unforeseen and wholly unexpected. To one who has successfully treated a large number of patients with retropharyngeal and peritonsillar abscesses over a period of years without untoward results, it is a matter of deep concern to be faced with an alarming hemorrhage or a fatality. As a result one turns to the literature for information on the subject, as textbooks in the main make very little reference to this grave complication, and one is rather surprised to discover that the apparently rare complication is really not so infrequent and that the topic has been freely written about, discussed and investigated many times. No doubt every member of this society has at some time or other encountered such
Characterization of Croatian Rape (Brassica sp.) Honey by Pollen Spectrum, Physicochemical Characteristics, and Multielement analysis by ICP-OES.

Rape (Brassica sp.) unifloral honey from Croatia was characterized by certain physicochemical parameters, micro- and macroelement content, and pollen spectrum, as determined in 21 honey samples. The Brassica sp. pollen type was predominant in the analyzed samples and ranged between 60 and 98%, with Trifolium spp. , Robinia pseudoacacia, Rosaceae, Helianthus annuus, Salix spp. , and Taraxacum officinale as the main accompanying pollen types. The electrical conductivity mean value was 0.22 ± 0.05 mS/cm and the glucose/fructose ratio mean value was 1.1 ± 0.07, whereas sucrose was absent in the samples. The most abundant macroelement was potassium (K) (268.49 mg/kg), followed by phosphorus (P) (60.23 mg/kg), calcium (Ca) (54.02 mg/kg), sodium (Na) (22.52 mg/kg), sulfur (S) (15.79 mg/kg), and magnesium (Mg) (12.58 mg/kg). Toxic elements were mainly bellow the LODs; only arsenic (As) concentration was detectable in higher amount (0.233 mg/kg), which may be related to the high arsenic concentration in the soil and groundwater of eastern Croatia. The differences between the two harvesting seasons observed in a large number of elements could be related to climatic and soil conditions and different nectar yields originating from the associated plant species.
Deficits in single-limb stance more than 20 years after ACL injury

Abstract Aim: To investigate the long-term effect on balance during single-limb stance after unilateral anterior cruciate ligament (ACL) injury across two groups who had rehabilitation including ACL reconstruction (ACLR) or a tailored physiotherapy program (ACLTPP), compared with knee-healthy controls. Methods: Single-limb stance was monitored for floor-supports with the contralateral foot. Single-limb stance without floor-supports was assessed with analyses of center of pressure (CoP) for further discrimination. Comparisons were made between ACLR (n = 28) and ACLTPP (n = 28) and with controls (n = 18). The injured and uninjured legs were compared within ACL-injured subjects. Results: Single-limb balance was equally inferior in both ACL-injured groups and on both legs compared with knee-healthy controls. In ACLR and ACLTPP, 39% and 50%, respectively, failed to stand on one leg without floor-supports with the contralateral foot. No contralateral supports occurred in knee-healthy controls. CoP measures for subjects who stood without contralateral floor-supports did not reveal any further differences. Older age and higher body mass index (BMI) correlated with larger migration of CoP. Conclusion: Inability to stand without contralateral supports showed that balance in single-limb stance was inferior in ACL-injured subjects, independently of which initial treatment that was given. Age and BMI need consideration in studies assessing balance in single-limb stance.
Nonintubated Transareolar Endoscopic Thoracic Sympathectomy with a Flexible Endoscope: Experience of 58 Cases.

OBJECTIVE Natural orifice transluminal endoscopic surgery (NOTES) has recently become a hot spot in the field of minimally invasive surgery. But, most of the procedures are still in the early stages of development and limited to animal experiments. Transareolar endoscopic surgery could work as a viable intermediate step before thoracic NOTES. Under intravenous anesthesia without endotracheal intubation, transareolar endoscopic thoracic sympathectomy (ETS) with a flexible endoscope has rarely been attempted. The objective of this study is to evaluate the feasibility and safety of this novel minimally invasive technique in managing primary palmar hyperhidrosis (PPH). METHODS From June 2012 to July 2014, a total of 58 male patients with severe PPH underwent transareolar ETS by use of a flexible endoscope. Under intravenous anesthesia without endotracheal intubation, a flexible endoscope was introduced through the incision on the edge of the areola into the thoracic cavity. The thoracic sympathetic chain was ablated at the level of the fourth rib. RESULTS All procedures were successfully performed with a mean operating time of 33.6 ± 8.3 min. All patients regained consciousness rapidly and none of them complained about sore throat after surgery. There were no operative mortality and conversion to open procedure. The symptoms of all patients disappeared as soon as the sympathetic chain was cut off. Fifty six patients (96.6%) were discharged from the hospital on the first postoperative day. The postoperative complications were minor, and no patients developed Horner's syndrome. At 3 months postoperatively, there was no obvious surgical scar on the chest wall, and none of the patients complained about postoperative pain. Compensatory hyperhidrosis (CH) appeared in 19 patients. No recurrent symptoms were observed in our study. One year follow-up revealed an excellent cosmetic result and degree of satisfaction. CONCLUSION Nonintubated transareolar ETS with a flexible endoscope is a safe, effective and minimally invasive therapeutic procedure, which has the possible advantages of thoracic NOTES and can be performed in routine clinical practice for male PPH patients.
Acquired Cryptorchidism: What Should We Know? The Results of a Systematic Review

Cryptorchidism or undescended testis (UDT) is the most common genital abnormality seen at term in boys (Meij-de Vries A et al 2010, Topari & Kalieva 1999 ). Traditionally UDT was thought to be a congenital disease, with a prevalence of about 0.8-1% by 1 year of age (Berkowitz G Set al 1993). The term acquired UDT was introduced the last few decades, after well documented clinical observations in individuals and groups of patients that many boys continue to be diagnosed and treated later in childhood (Myers NA & Officer CB 1975, Atwell JD 1985, Clarnette TD et al 1977, Schiffer KA et al 1987, Robertson JF & Azmy AF 1988, Wright JE 1989, Fenton EJM et al 1990,Mayr J et al 1995) despite the recommendations for early surgical treatment by orchidopexy (Ritzen M et al 2007). Today, acquired UDT is a recognized separate entity, and after a new clinical classification in 2003, UDT is categorized into two forms: congenital UDT and acquired UDT (Hack WW et al 2003a).
A Prospective Analysis of the Injury Incidence of Young Male Professional Football Players on Artificial Turf

Background: The effects of synthetic surfaces on the risk of injuries is still debated in literature and the majority of published data seems to be contradictory. For such reasons the understanding of injury incidence on such surfaces, especially in youth sport, is fundamental for injury prevention. Objectives: The aim of this study was to prospectively report the epidemiology of injuries in young football players, playing on artificial turfs, during a one sports season. Patients and Methods: 80 young male football players (age 16.1 ± 3.7 years; height 174 ± 6.6 cm; weight 64.2 ± 6.3 kg) were enrolled in a prospective cohort study. The participants were then divided in two groups; the first included players age ranging from 17 to 19 (OP) whereas the second included players age ranging from 13 to 16 (YP). Injury incidence was recorded prospectively, according to the consensus statement for soccer. Results: A total of 107 injuries (35 from the OP and 72 from the YP) were recorded during an exposure time of 83.760 hours (incidence 1.28/1000 per player hours); 22 during matches (incidence 2.84/1000 per player hours, 20.5%) and 85 during training (incidence 1.15/1000 per player hours, 79.5%). Thigh and groin were the most common injury locations (33.6% and 21.5%, respectively) while muscle injuries such as contractures and strains were the most common injury typologies (68.23%). No statistical differences between groups were displayed, except for the rate of severe injuries during matches, with the OP displaying slightly higher rates compared to the YP. Severe injuries accounted for 10.28% of the total injuries reported. The average time lost due to injuries was 14 days. Re-injuries accounted for 4.67% of all injuries sustained during the season. Conclusions: In professional youth soccer injury rates are reasonably low. Muscle injuries are the most common type of injuries while groin and thigh the most common locations. Artificial turf pitches don’t seem to contribute to injury incidence in young football players.