Miracle-dz/UniFAR-FTUs huggingface dataset:
Factors affecting community pharmacist’s service for women with chronic diseases during pregnancy and breastfeeding: application of the Health Belief Model

Abstract Background Pharmacists are known as health care professionals who are responsible for the safety and efficacy of medicine to achieve optimal therapeutic results. Community pharmacists have an opportunity to provide direct services including giving an active medication information service in women during pregnancy and breastfeeding. This study aimed to determine the factors associated with the practice of community pharmacists for actively giving the drug information service for women with chronic diseases during pregnancy and breastfeeding based on the Health Belief Model. Methods About 300 community pharmacists were randomly chosen to participate in the study. All participants were asked to complete questionnaires that were designed based on the theory of the Health Belief Models. The questionnaires measured the community pharmacists’ knowledge, beliefs, cues to action, and practice for actively giving medication information services. Results About 267 pharmacists in the community agreed to participate in this study. Nearly 80% of the participants were female pharmacists (n = 213). The results show that pharmacists’ knowledge had significant influences towards perceived threat (p = 0.009), perceived benefit (p = 0.011), and pharmacists’ self-efficacy (p < 0.001). The self-efficacy factor was the most influential factor in the practice of pharmacists to give medication information service actively (p < 0.001). Conclusions The findings of the study indicate that self-efficacy is the most important factor for pharmacist to be able to provide the medication information services successfully particularly in women during pregnancy and breastfeeding. Providing continuous learning programs through seminars and training related to medication use during pregnancy and breastfeeding to pharmacists is needed to optimise the confidence and the ability of pharmacists in providing the services.
Addressing Challenges and Implications of National Surveillance for Racial/Ethnic Disparities in Diabetes.

Diabetes mellitus is an epidemic in the United States that disproportionately affects racial/ ethnic minorities, with higher prevalence in black, Hispanic, and Asian populations than in the white population. 1 Racial/ethnic minorities with diabetes also have worse outcomes, including higher risks of amputations, end-stage kidney disease, and death. 2 In this issue of JAMA, Cheng and colleagues 3 used 2011–2016 data from the National Health and Nutrition Examination Survey (NHANES) to estimate the race/ethnicity–specific prevalence of diabetes in the United States. In this analysis of cross-sectional survey data and samples from 7575 adults (mean age, 47.5 years; 52% women), there was a higher prevalence of diagnosed diabetes in black (13.6%), Hispanic (10.9%), and Asian (9.9%) groups compared with the white group (9.1%), consistent with prior work. 4 The most novel and important aspects of this study are the nationally representative estimates of both diagnosed and undiagnosed diabetes as well as prediabetes within Hispanic and Asian subgroups. The authors report an almost 2-fold difference in age-and sex-adjusted prevalence of total diabetes within Hispanic and Asian subgroups. The prevalence of undiagnosed diabetes was observed to differ among Hispanic subgroups but not Asian subgroups, although the numbers of individuals in specific ethnic subgroups in these analyses were small. No evident differences in the prevalence of prediabetes were seen within Hispanic or Asian subgroups. The proportion of total diabetes that is undiagnosed is a critical public health metric that can be used to identify gaps in screening. However, the estimates for undiagnosed diabetes reported by Cheng et al 3 —ranging from one-fourth to one-third of total diabetes cases— should be interpreted cautiously. In clinical practice, the diagnosis of diabetes requires confirmatory testing, either with the same or a different test on a different day or a different
Assessing the Measurement Invariance of the Children’s Hope Scale in Chinese and American Adolescents

Abstract Previous studies of the Children’s Hope Scale (CHS) have not compared its factor structure using samples of Chinese early adolescents and American early adolescents. Contrary to expectations, the one-factor model revealed a better fit for the Chinese sample (N = 1184) whereas the two-factor model revealed a better fit for the American sample (N = 1049). Full measurement invariance was not demonstrated for the two-factor model of the CHS with the Chinese adolescents. This finding indicated that researchers should not make mean level comparisons between the two factors of agency and pathways across early adolescents from these two nations. Partial scalar invariance was achieved for the one-factor model, which suggested that researchers may tentatively make comparisons between Chinese and American early adolescents using CHS total scores. Although caution should be exercised in interpreting the mean differences, Chinese adolescents reported a lower total mean level of hope than American adolescents. Differences in the findings are discussed within the collectivism-individualism framework.
MicroRNA-383 suppresses pancreatic carcinoma development via inhibition of GAB1 expression.

OBJECTIVE Pancreatic carcinoma (PC) is a serious malignancy associated with high morbidity and mortality rates. Previous studies have identified various microRNAs (miRNAs) involved in the development of PC; however, the role of miR-383 still remains unclear. This study investigates the role of miR-383 in the malignant transformation of PC. MATERIALS AND METHODS Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to quantify miR-383 and Grb2 associated binding protein 1 (GAB1) RNA levels, and Western blot analysis was performed to measure protein expression. The ability of miR-383 to bind and regulate the expression of GAB1 was assessed using a Luciferase reporter assay. Cell Counting Kit-8 (CCK-8) experiments and flow cytometry analysis were used to assess cell proliferation and apoptosis, respectively. RESULTS Down-regulation of miR-383 was associated with adverse clinical results and poor prognosis in PC patients. Mechanistically, miR-383 inhibited cell proliferation and promoted apoptosis of PANC-1 (human pancreatic cancer cell) cells. Our results show that miR-383 can act directly on GAB1 to inhibit its expression in PC. This downregulation of GAB1 limits cell proliferation and induced apoptosis of PANC-1 cells. CONCLUSIONS MiR-383 suppresses tumor development and progression through the downregulation of GAB1 expression.
Dermal sheath contraction powers stem cell niche relocation during hair cycle regression

Niche relocated by muscle contraction Regulation of adult stem cells by their microenvironment, or niche, is essential for tissue homeostasis and for regeneration after injury and during aging. Normal regression of hair follicles during the hair cycle poses a particular challenge for maintaining a functional proximity of stem cells to their niche, especially the specialized mesenchymal cells of the dermal papilla. Using mice as a model organism, Heitman et al. demonstrate that the follicle dermal sheath is an active smooth muscle that drives tissue remodeling through coordinated cell contraction, enabling renewed contact between the dermal papilla and hair follicle stem cells during hair follicle regression. This biomechanical mechanism of niche relocation may be utilized in other stem cell niche systems. Science, this issue p. 161 In mice, the hair follicle stem cell niche is relocated by the muscle-like contraction of the dermal sheath. Tissue homeostasis requires the balance of growth by cell production and regression through cell loss. In the hair cycle, during follicle regression, the niche traverses the skin through an unknown mechanism to reach the stem cell reservoir and trigger new growth. Here, we identify the dermal sheath that lines the follicle as the key driver of tissue regression and niche relocation through the smooth muscle contractile machinery that generates centripetal constriction force. We reveal that the calcium-calmodulin–myosin light chain kinase pathway controls sheath contraction. When this pathway is blocked, sheath contraction is inhibited, impeding follicle regression and niche relocation. Thus, our study identifies the dermal sheath as smooth muscle that drives follicle regression for reuniting niche and stem cells in order to regenerate tissue structure during homeostasis.
Midbrain morphology in idiopathic normal pressure hydrocephalus: A progressive supranuclear palsy mimic

Various MRI markers have been applied to support the diagnosis of progressive supranuclear palsy (PSP), such as midbrain diameter and surface, superior cerebellar peduncle (SCP) width, midbrain to pons (m/p) diameter and surface ratio and the Magnetic Resonance Parkinsonism Index (MRPI). These markers provide excellent diagnostic accuracy in discriminating Richardson's syndrome from other causes of Parkinsonism. Idiopathic normal pressure hydrocephalus (iNPH) may mimic Richardson's syndrome, particularly in cases of subtle opthalmokinetic abnormalities. The aim of this study was to compare these MRI markers in PSP and iNPH and examine their diagnostic accuracy.
Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 as biomarkers of patients with established acute kidney injury

Background/Aims Urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) have been recently discovered and validated as sensitive biomarkers that can predict stage 2 or 3 acute kidney injury (AKI) development in high-risk patients. We aimed to assess whether these biomarkers could predict adverse outcomes and renal recovery in established AKI patients. Methods This was a single-center study prospectively enrolling 124 patients diagnosed with AKI. TIMP-2, IGFBP7, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule 1 (KIM-1) levels were measured at the time of diagnosis and the predictive performance of short-term outcomes and renal recovery was assessed. Results Patients were divided into 4 quartiles according to the initial urinary TIMP-2/IGFBP7 levels. Stage 3 AKI (odds ratio [OR], 17.86), classified by the Kidney Disease Improving Global Outcomes (KDIGO), as well as the third and fourth quartiles of TIMP-2/IGFBP7 (OR, 5.75 and 44.98, respectively), were found to be independent predictors of renal replacement therapy at the time of AKI diagnosis. In addition, KDIGO stage 3 AKI (OR, 2.468) or the third of fourth quartiles of urinary TIMP-2/IGFBP7 (OR, 1.896 and 3.622, respectively) were also found to be useful in predicting nonrecovery of renal function. In a separate analysis of patients with renal recovery at discharge, initial urinary TIMP-2/IGFBP7 or urinary IGFBP7 at discharge could also predict new-onset or progressive chronic kidney disease (CKD). Conclusions In AKI patients, urine TIMP-2/IGFBP7 could serve as a biomarker for predicting adverse outcomes, renal recovery, or the development and progression of CKD.
Evaluation of a Peer-Led Implementation of a Suicide Prevention Gatekeeper Training Program for College Students.

Background: Research on models of implementation that enable widespread dissemination of suicide prevention to young adults is needed to address the critical public health issue of suicide among young adults. A peer-to-peer implementation approach may increase widespread dissemination of suicide prevention on college campuses. Aims: The current study involved the evaluation of a peer-led implementation of the evidence-based program Question, Persuade, and Refer Gatekeeper Training for Suicide Prevention (QPR). Method: A total of 161 college students attended one of eight QPR implementations conducted by student peer educators certified as QPR trainers. Questionnaires were administered at pretest and posttest to assess knowledge of suicide, likelihood of intervening with someone suicidal, and self-efficacy to intervene with someone suicidal. Results: Results from a series of paired-samples t tests showed significant increases from pretest to posttest on the three outcomes of interest - knowledge of suicide, self-efficacy to intervene with someone suicidal, and likelihood to intervene with someone suicidal. Limitations: The short time frame of the current study is a limitation. Conclusion: Support for a peer-led model of implementation for college students has critical implications in terms of increasing the capacity for widespread dissemination of suicide prevention efforts on college campuses.
Clinical and Molecular Epidemiology of Invasive Haemophilus influenzae Serotype a Infections in Utah Children.

BACKGROUND Following widespread use of the Haemophilus influenzae serotype b (Hib) vaccine, H. influenzae serotype a (Hia) has emerged as an important pathogen in children in some regions. We describe the clinical features and molecular epidemiology of invasive Hia disease in children in Utah over an 11-year period. METHODS We identified cases of invasive Hia disease, defined as detection of Hia from a normally sterile site, in children aged <18 years from Utah between 2007 and 2017. Medical records were reviewed to determine demographic characteristics and clinical outcomes. Available Hia isolates were genotyped using multilocus sequence typing, and phylogenetic division was determined using sodC polymerase chain reaction. Presence of the putative virulence-associated IS1016-bexA duplication-deletion was evaluated. RESULTS We identified 51 children with invasive Hia. The average annual incidence was 1.7 cases per 100 000 children aged <5 years; 4.8 cases per 100 000 children aged <1 year. The median age was 11.3 months. The most common clinical presentation was meningitis (53%), followed by pneumonia (14%) and septic arthritis (14%). Twenty-two children (43%) required admission to an intensive care unit; 1 died. Sequence type (ST) 62, phylogenetic division II isolates caused 75% (21/28) of disease. No isolates contained the virulence-associated IS1016-bexA duplication-deletion. CONCLUSIONS Hia is a significant cause of severe invasive bacterial infection in Utah. The majority of infections were caused by ST62 isolates, a phylogenetic division II Hia type that lacks the IS1016-bexA duplication-deletion. Hia ST62 has not been commonly reported elsewhere, suggesting a unique molecular epidemiology in our population.
Soft tissue sarcoma of the orofacial region: Our experience with 64 cases

Introduction: Soft tissue sarcomas (STSs) are solid malignancies mostly of mesodermal origin whose rarity and variety present formidable challenges in characterization and treatment. According to Pisters and Brennan, STS make up <1% of all oral malignancies. Like other tumors, they can occur at any anatomical site and at any age. The extremities and trunk are favored sites for occurrence and only about 5–10% of STS occur in the head and neck region. STS have varied cell origin, but all STS are considered as a group because of the similarities in their clinical features, natural history, treatment, and disease outcome. Patients and Methods: Medical records of patients with histopathologically diagnosed malignant oral and maxillofacial tumors between January 2003 and December 2013 were retrospectively reviewed at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Results: There were more male than female in a ratio of 1.28:1.The age range from 7 months to 70 years with a mean of 29.3 years and 37.8% being <20 and about 62.2% being above 20 years. Rhabdomyosarcoma was the most common lesion (39%) followed by fibrosarcoma (15.6%), malignant fibrous histiocytoma (7.8%). The most common site was the mandible followed by the cheek, palate, and maxilla. Some patients had both mandible and cheek involved while other had both palate and maxilla involved. The most frequent mode of treatment was surgery followed by radio and chemotherapy. A few patients declined therapy. Conclusion: STS remains a challenge in our center due to late presentation and affordability of treatment by our patients. Another contributing factor is the believe that cancer cannot be treated with orthodox medicine.
Backwashing performance of self-cleaning screen filters in drip irrigation systems

The self-cleaning screen filter is one of the most common types used in drip irrigation systems. Backwashing pressure difference and backwashing time for two screen filters with one geometry and two different screens (178 μm and 124 μm) using two water qualities (tap water and sand–water mixture) were studied in a total of 88 runs (42 runs for tap water, 22 and 24 filtration cycles for sand–water mixture and backwashing, respectively). The backwashing pressure difference and backwashing time were calculated using the experimental data, and the results were largely in the range of measured values. Three constraint conditions (flowrate, sand condition and filtration time) of backwashing pressure difference were analysed, and the optimal values of backwashing pressure difference were given as 60.0 and 70.0 kPa for 178 μm and 124 μm filters, respectively. The backwashing time of the screen filter should be an optimal value that ensures that the pressure difference between the internal and external surfaces of the screen decreased to the initial value, and the sand concentration of the backwashed outlet decreased to a small, stable value. Based on the results of the backwashing experiment and prototype observation, the optimal backwashing time was given as 30 to 45 s for both screen filters.
Co-existence of VIM-2-producing Pseudomonas aeruginosa and KPC-2 and OXA-232-co-producing Klebsiella pneumoniae in the United States

Dear Editor, Infections due to carbapenem-resistant gram-negative bacteria are a major health problem worldwide. Carbapenem resistance in gram-negative bacteria can result from a diversity of mechanisms: carbapenemase production, porin mutations, increased efflux pump activity, or the presence of enzymes other than carbapenemases. Most carbapenem-resistant isolates produce carbapenemase enzymes, which are found on plasmids that can be easily shared with other gram-negative bacteria [1]. The most common carbapenemase types in gram-negative bacteria are Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Verona integron-encoded metalloβ-lactamase (VIM), oxacillinase-48-type carbapenemases (OXA48), and imipenemase (IMP). A blaKPC-producing K. pneumoniae isolate was first recovered from a patient in North Carolina (NC), USA, in 1996 [2]. Since then, many reports of carbapenem-resistant Enterobacteriaceae (CRE) in hospitalized patients, particularly in the northeastern USA have been published. Carbapenem resistance is also an emerging problem among Pseudomonas aeruginosa isolates in many countries worldwide [3]. We report the co-existence of VIM-2-producing P. aeruginosa and KPC-2 and OXA-232 co-producing K. pneumoniae isolates in a patient. To the best of our knowledge, this is the first report of two different species of carbapenemase-producing organisms isolated from the same patient sample in the USA. In addition, while some cases of OXA-232 and NDM co-production have been identified in the USA and subsequently around the world [4], to the best of our knowledge, KPC and OXA-232 (a variant of OXA-48) co-production in a single K. pneumoniae isolate has not been reported worldwide to date. A pediatric patient less than five years old who had received care in India was transferred to a pediatric outpatient clinic at Wake Forest Baptist Health, Winston Salem, NC, in May 2019 with a two-year history of bilateral mucopurulent and malodorous ear discharge. The Institutional Review Board of Wake Forest School of Medicine approved the study for saving the isolate and performing additional testing (IRB approval no. IRB00008691). No informed consent was obtained since CRE is a reportable disease in NC. The patient was diagnosed as having chronic otorrhea through perforated tympanic membranes, and the ear discharge fluid was sent to the clinical microbiology laboratory for bacterial culture. Both K. pneumoniae and P. aeruginosa were recovered from the ear sample, and the organisms were identified to the
Efficacy of PI3K inhibitors in advanced breast cancer

Abstract The phosphoinositide 3 (PI3)-kinase/Akt signaling pathway has always been a focus of interest in breast cancer due to its role in cell growth, cell proliferation, cell migration and deregulated apoptosis. Its activation has been linked to endocrine resistance and worse prognosis in certain subgroups of breast cancer. In addition, deregulation of the PI3K/Akt pathway including PIK3CA activating mutation is frequently present in breast cancer. Multiple efforts have been carried out to target this pathway, initially with pan-PI3K inhibitors with some hint of activity but hampered by their limiting side-effects. A recent large randomized trial in patients with endocrine-resistant PIK3CA-mutant hormone receptor (HR)-positive tumors led to the approval of the first PI3K inhibitor, alpelisib, in combination with fulvestrant. The specificity of alpelisib against the p110α catalytic isoform provided additional efficacy and a better toxicity profile. In this review, we summarize the main research with PI3K inhibitors in breast cancer and we provide some insight of potential future combinations of this treatment in breast cancer patients.
Prevalence of and risk factors for intravenous catheter infection in hospitalized cattle, goats, and sheep

Abstract Background Intravenous catheter (IVC) use in hospitalized ruminants is a common procedure. Limited information is available describing complications associated with IVCs. Hypotheses Prevalence of IVC infections in hospitalized ruminants is >50%. Intravenous catheters maintained for >5 days are more likely to be infected than those maintained for <5 days. Intravenous catheters placed non‐aseptically have a higher risk for infection than those placed aseptically. Animals Thirty‐four cattle, 39 goats, and 33 sheep were hospitalized in a university teaching hospital. Methods Prospective observational study. The IVCs from cattle, goats, and sheep admitted for medical and surgical procedures were randomly selected and submitted for bacteriological culture and susceptibility testing. Results Prevalence values (95% confidence interval) of infected catheters were 61.8 (45.5, 78.1), 51.3 (35.3, 66.7), and 42.4% (25.2, 58.8) in cattle, goats, and sheep, respectively. Coagulase‐negative Staphylococcus spp was the most frequently isolated bacterium. Catheter type/placement technique was a significant (P = .03) predictor of IVC infection in goats but not in cattle (P = .65) and sheep (P = .47). Antibiotic use and reason for catheter placement were not significant predictors of IVC infection in all species. Catheters maintained for >4 days had a higher likelihood of being infected than those maintained for <4 days in all species. Conclusions and Clinical importance Clinicians should consider replacing catheters maintained for >4 days to reduce IVC infection.