Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Pharmacist-Led Interventions on Medication Adherence and Clinical Outcomes in Patients with Hypertension and Hyperlipidemia: A Scoping Review of Published Literature

Background The aim of this study was to provide a scoping review of the impact of pharmacist-led interventions on medication adherence and clinical outcomes in patients with hypertension and hyperlipidemia. Methods A scoping review was conducted using pre-defined search terms in three scientific databases, including Google Scholar, ScienceDirect, and PubMed. A multi-stage screening process that considered relevancy, publication year (2009–2019), English language, and article type (original research) was followed. Review articles, meta-analysis studies, and conference proceedings were excluded. Data charting was done in an iterative process using a study-specific extraction form. Results Of the initially identified 681 studies, 17 studies with 136,026 patients were included in the review. Of these, 16 were randomized controlled trials, while the remaining study was a retrospective cohort study. The majority of pharmacist-led interventions were face-to-face counseling sessions (n=8), followed by remote- or telephone-based interventions (n=5) and multi-faceted interventions (n=4). The majority of the studies (n=7) used self-reported adherence measures and pharmacy refill records (n=8) to measure the rate of adherence to prescribed medications. Eleven of the included studies reported a statistically significant (P<0.05) impact on medication adherence. Overall, twelve studies assessed the effect of the interventions on the clinical outcome measures; of these, only four studies were associated with significant impact. Conclusion Pharmacist-led interventions were associated with improved patients’ adherence to their medications but were less likely to be consistently associated with the attainment of clinical outcomes. Face-to-face counseling was the most commonly used intervention; while, the multi-faceted interventions were more likely to be effective in improving the overall outcome measures. The rigorous design of targeted interventions with more frequent follow-ups, careful consideration of the involved medications, and patients’ characteristics could increase the effectiveness of these interventions.
Novel Insights Into Tissue-Specific Biochemical Alterations in Pediatric Eosinophilic Esophagitis Using Raman Spectroscopy

INTRODUCTION: Elucidating esophageal biochemical composition in eosinophilic esophagitis (EoE) can offer novel insights into its pathogenesis, which remains unclear. Using Raman spectroscopy, we profiled and compared the biochemical composition of esophageal samples obtained from children with active (aEoE) and inactive EoE (iEoE) with non-EoE controls, examined the relationship between spectral markers and validated EoE activity indices. METHODS: In vitro Raman spectra from children with aEoE (n = 8; spectra = 51) and iEoE (n = 6; spectra = 48) and from non-EoE controls (n = 10; spectra = 75) were acquired. Mann-Whitney test was used to assess the differences in their Raman intensities (median [interquartile range]) and identify spectral markers. Spearman correlation was used to evaluate the relationship between spectral markers and endoscopic and histologic activity indices. RESULTS: Raman peaks attributable to glycogen content (936/1,449 cm−1) was lower in children with aEoE (0.20 [0.18–0.21]) compared with that in non-EoE controls (0.24 [0.23–0.29]). Raman intensity of proteins (1,660/1,209 cm−1) was higher in children with aEoE compared with that in non-EoE controls (3.20 [3.07–3.50] vs 2.91 [2.59–3.05]; P = 0.01), whereas that of lipids (1,301/1,260 cm−1) was higher in children with iEoE (1.56 [1.49–1.63]) compared with children with aEoE (1.40 [1.30–1.48]; P = 0.02). Raman peaks attributable to glycogen and lipid inversely correlated with eosinophilic inflammation and basal zone hyperplasia. Raman mapping substantiated our findings. DISCUSSION: This is the first study to identify spectral traits of the esophageal samples related to EoE activity and tissue pathology and to profile tissue-level biochemical composition associated with pediatric EoE. Future research to determine the role of these biochemical alterations in development and clinical course of EoE can advance our understanding of EoE pathobiology.
Volatile molecules for COVID‐19: A possible pharmacological strategy?

COVID‐19 is a novel coronavirus disease with a higher incidence of bilateral pneumonia and pleural effusion. The high pulmonary tropism and contagiousness of the virus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), have stimulated new approaches to combat its widespread diffusion. In developing new pharmacological strategies, the chemical characteristic of volatility can add therapeutic value to the hypothetical drug candidate. Volatile molecules are characterized by a high vapor pressure and are consequently easily exhaled by the lungs after ingestion. This feature could be exploited from a pharmacological point of view, reaching the site of action in an uncommon way but allowing for drug delivery. In this way, a hypothetical molecule for COVID‐19 should have a balance between its lung exhalation characteristics and both antiviral and anti‐inflammatory pharmacological action. Here, the feasibility, advantages, and disadvantages of a therapy based on oral administration of possible volatile drugs for COVID‐19 will be discussed. Both aerosolized antiviral therapy and oral intake of volatile molecules are briefly reviewed, and an evaluation of 1,8‐cineole is provided in view of a possible clinical use and also for asymptomatic COVID‐19.
Side-Information For Steganography Design And Detection

Today, the most secure steganographic schemes for digital images embed secret messages while minimizing a distortion function that describes the local complexity of the content. Distortion functions are heuristically designed to predict the modeling error, or in other words, how difficult it would be to detect a single change to the original image in any given area. This dissertation investigates how both the design and detection of such content-adaptive schemes can be improved with the use of side-information. We distinguish two types of side-information, public and private: Public side-information is available to the sender and at least in part also to anybody else who can observe the communication. Content complexity is a typical example of public side-information. While it is commonly used for steganography, it can also be used for detection. In this work, we propose a modification to the rich-model style feature sets in both spatial and JPEG domain to inform such feature sets of the content complexity. Private side-information is available only to the sender. The previous use of private side-information in steganography was very successful but limited to steganography in JPEG images. Also, the constructions were based on heuristic with little theoretical foundations. This work tries to remedy this deficiency by introducing a scheme that generalizes the previous approach to an arbitrary domain. We also put forward a theoretical investigation of how to incorporate side-information based on a model of images. Third, we propose to use a novel type of side-information in the form of multiple exposures for JPEG steganography.
Evaluation of an Education Strategy versus Usual Care to Implement the STEADI Algorithm in Primary Care Clinics in an Academic Medical Center

Background Although falls are the leading cause of morbidity and mortality in the US in the older adult population, there is little information regarding implementation of evidence-based fall prevention guidelines within primary care settings. The objective of this study was to address this gap in the literature by determining the effectiveness of the use of education and written materials as implementation strategies. Methods Using a prospective, mixed methods, controlled before-and-after study design, we studied the effect of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) education and written materials on knowledge and intention to use in primary care clinics as well as test the screening, assessment, and intervention behaviors. This manuscript details the quantitative findings of the study, using STEADI Knowledge Test, Continuing Professional Development (CPD) Reaction Questionnaire, and EMR Reports. We compared data between the study arms (usual implementation versus education implementation) using descriptive statistics, paired t-tests, and factorial ANOVAs. Results In total, data from 29 primary care staff, including physicians, APRNs, RNs, and medical assistants, were analyzed. Although we found a statistically significant difference within the education arm between immediate pretests and posttests/surveys mean scores, there was no statistically significant difference between the study arms’ knowledge, intent to use STEADI, or use behaviors. The pre/immediate post education mean knowledge score increased by 1.19 (p= 0.02) and the pre/immediate post education intent to use mean increased by 0.64 (p 0.01). There was no statistically significant change between the study arms over time. Conclusion Educational strategies, particularly written materials and an online module, did not increase the long-term use of the STEADI toolkit. Implementation research is needed to identify the strategies that are most effective for promoting the adoption of STEADI in primary care.
Investigating the sexual quality of life and its relationship with general health in older men in Iran

INTRODUCTION: Sexual problems in elder people are considered as a public health concern and can affect their overall health and quality of life. This study aimed to investigate the sexual quality of life and its relationship with general health in older men in the west of Iran. METHODS: This was a cross-sectional study among 362 older men aged 60 years or older attending Comprehensive Health Care Centers in Ilam, Iran. Samples selected through Quota sampling method and simple random sampling. Data were collected using the Sexual Quality of Life Questionnaire-Male and General Health Questionnaire-28. RESULTS: The mean ± standard deviation (SD) of age was 69.9 ± 8.1 years. The mean ± SD score of sexual quality of life and general health of older men was 46.6 ± 14.6 and 19.2 ± 9.7, respectively. A positive and significant association was found between sexual quality of life and general health (P < 0.001, r = −0.41). Moreover, general health, age, sleep problems, and the level of education were the important predictors for sexual quality of life in elder men (P < 0.05). CONCLUSION: According to the results, the sexual quality of life of participants was at a moderate level. Since only some factors influencing the sexual quality of life were ascertained, further studies are required to investigate all factors influencing older men's sexual quality of life.
Development of a Taqman real-time PCR assay for detection of Leifsonia xyli subsp xyli

Leifsonia xyli subsp xyli (Lxx) is the etiological agent of ratoon-stunting disease (RSD), one of the most important diseases that affects productivity of sugarcane crops. The lack of defined external symptoms in most plants is a challenge for the diagnosis of RSD facilitating its spread in production fields. In this study a Taqman® real-time polymerase chain reaction (qPCR) assay was developed for detection of the bacteria in different tissues of the plants and compared to conventional PCR and nested-PCR assays. The bacterial DNA was amplified by the nested-PCR and qPCR assays, indicating that conventional PCR lacks sufficient sensitivity to be used as a diagnostic tool for RSD. On the other hand, qPCR is more advantageous than nested-PCR for processing large amounts of samples since it does not need post processing steps for visualization of results and the level of bacterial infection can be quantified. Therefore by improving the diagnosis of RSD in field plants, it can be applied to monitor losses caused by the disease, as a tool to monitor the efficacy of sanitation procedures and in the development of new sanitizers for Lxx.
The CHRONICLE Study of US Adults with Subspecialist-Treated Severe Asthma: Objectives, Design, and Initial Results

Background Approximately 5–10% of patients with asthma have severe disease. High-quality real-world studies are needed to identify areas for improved management. Objective Aligned with the International Severe Asthma Registry, the CHRONICLE study (ClinicalTrials.gov: NCT03373045) was developed to address this need in the US. Study Design Learnings from prior studies were applied to develop a real-world, prospective, noninterventional study of US patients with confirmed severe asthma who are treated by subspecialist physicians and require biologic or maintenance systemic immunosuppressant therapy or who are uncontrolled by high-dosage inhaled corticosteroids and additional controllers. Target enrollment is 4000 patients, with patient observation for ≥3 years. A geographically diverse sample of allergist/immunologist and pulmonologist sites approach all eligible patients under their care and report patient characteristics, treatment, and health outcomes every 6 months. Patients complete online surveys every 1–6 months. Initial Results From February 2018 to February 2019, 102 sites screened 1428 eligible patients; 936 patients enrolled. Study sites (40% allergist/immunologist, 42% pulmonologist, 18% both) were similar to other US asthma subspecialist samples. Enrolled patients were 67% female with median ages at enrollment and diagnosis of 55 (range: 18–89) and 26 (0–80) years, respectively. Median body mass index was 31 kg/m2; 3% and 29% were current or former smokers, respectively, and >60% reported ≥1 exacerbation in the prior year and suboptimal symptom control. Conclusion CHRONICLE will provide high-quality provider- and patient-reported data from a large, real-world cohort of US adults with subspecialist-treated severe asthma.
Vascular Age as a Cardiovascular Risk Marker in Asymptomatic Patients with Type 2 Diabetes

Aim There is a wide variety of cardiovascular outcomes in patients with type 2 diabetes (T2DM), even in asymptomatic individuals. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and can be considered as a predictor of cardiovascular risk (CVR). The aim of this study was to evaluate the relationship between CIMT-determined vascular age (VA), CVR scores, and thyroid function in asymptomatic patients with T2DM. Patients and Methods Clinical laboratory and CIMT parameters were measured in 154 asymptomatic patients with T2DM. The Framingham risk score (FRS) was performed with chronological age (CA) and with VA. A multinomial logistic regression model was used to analyze variables related to CVR reclassification. Results The use of CIMT-determined VA led to the reclassification of 54 (35.52%) out of 152 asymptomatic T2DM patients, being 20 (37.03%) to a lower categorical risk and 34 (62.96%) to a higher categorical risk according to FRS. The variables that were associated to reclassification to a higher categorical risk were positive family history (FH) of premature coronary artery disease (p=0.046), FH of thyroid disease (p=0.010), use of statins (p=0.027), and free T4 levels (p=0.009). Conclusion VA determined from CIMT allowed the reclassification of the CVR in asymptomatic T2DM patients. FH of premature CAD, FH of known thyroid disease, use of statins, and free T4 levels were associated to a reclassification into a higher risk category. The use of doppler to perform CIMT measure is currently more accessible, especially in a low-middle income country like Brazil. However, further prospective studies must be performed to establish the predictive values of CIMT on atherosclerosis and how thyroid function acts like cardiovascular risk marker on CVR scores.
Evaluation of the Anti-Leishmanial Effect of Recombinant Clostridium α-Toxin

Background Leishmaniasis is an infectious disease common in tropical and subtropical regions caused by the genus Leishmania, which is transmitted by the bite of female sandflies. In this study, we evaluate the anti-leishmanial effect of recombinant Clostridium α-toxin protein alone and the combination with glucantime through in vitro and in vivo. Materials and Methods Production, expression, and purification of recombinant α-toxin were evaluated by SDS-PAGE and Western blotting techniques. The antileishmanial activities of the purified α-toxin plus and without glucantime were examined in vitro and in vivo. Results The results indicated successful expression of α-toxin as a 48 kDa band on SDS-PAGE and Western blot methods. Also, evaluation of α-toxin IC50 showed the strong fatal effect of it, and glucantime on medium proliferated Leishmania promastigotes at lower concentrations compared with glucantime or α-toxin alone. Moreover, in vivo surveys showed that at the end of treatment courses, the mean of lesion size diminished in glucantime plus α-toxin treated mice versus negative control groups (p < 0.001). Also, there was a significant difference in the parasite burden of the spleen and liver of the control versus the test groups (p < 0.001). Conclusion The results showed recombinant α-toxin has synergistic effects with glucantime in destroying Leishmania parasites.
Host Genetic and Gut Microbial Signatures in Familial Inflammatory Bowel Disease

INTRODUCTION: The family history of inflammatory bowel disease (IBD) has been strongly associated with risk of developing IBD. This study aimed to identify the host genetic and gut microbial signatures in familial IBD. METHODS: Genetic analyses using genome-wide single nucleotide polymorphism genotyping and whole exome sequencing were performed to calculate weighted genetic risk scores from known IBD-associated common variants and to identify rare deleterious protein-altering variants specific to patients with familial IBD in 8 Korean families that each included more than 2 affected first-degree relatives (FDRs) and their unaffected FDR(s). In parallel, gut microbial community was analyzed by 16S rRNA sequencing of stools from the sample individuals. RESULTS: The risk of familial IBD was not well explained by the genetic burden from common IBD-risk variants, suggesting the presence of family-shared genetic and environmental disease-risk factors. We identified 17 genes (AC113554.1, ACE, AKAP17A, AKAP9, ANK2, ASB16, ASIC3, DNPH1, DUS3L, FAM200A, FZD10, LAMA5, NUTM2F, PKN1, PRR26, WDR66, and ZC3H4) that each contained rare, potentially deleterious variants transmitted to the affected FDRs in multiple families. In addition, metagenomic analyses revealed significantly different diversity of gut microbiota and identified a number of differentially abundant taxa in affected FDRs, highlighting 22 novel familial disease-associated taxa with large abundance changes and the previously reported gut dysbiosis including low alpha diversity in IBD and 16 known IBD-specific taxa. DISCUSSION: This study identified familial IBD-associated rare deleterious variants and gut microbial dysbiosis in familial IBD.
p300 in Cardiac Development and Accelerated Cardiac Aging

The heart is the first functional organ that develops during embryonic development. While a heartbeat indicates life, cessation of a heartbeat signals the end of life. Heart disease, due either to congenital defects or to acquired dysfunctions in adulthood, remains the leading cause of death worldwide. Epigenetics plays a key role in both embryonic heart development and heart disease in adults. Stress-induced vascular injury activates pathways involved in pathogenesis of accelerated cardiac aging that includes cellular dysfunction, pathological cardiac hypertrophy, diabetic cardiomyopathy, cardiac matrix remodeling, cardiac dysfunction and heart failure. Acetyltransferase p300 (p300), a major epigenetic regulator, plays a pivotal role in heart development during embryogenesis, as deficiency or abnormal expression of p300 leads to embryonic death at early gestation periods due to deformation of the heart and neural tube. Acetyltransferase p300 controls heart development through histone acetylation-mediated chromatin remodeling and transcriptional regulation of genes required for cardiac development. In adult hearts, p300 is differentially expressed in different chambers and epigenetically controls cardiac gene expression. Deregulation of p300, in response to prohypertrophic and profibrogenic stress signals, is associated with increased recruitment of p300 to several genes including transcription factors, increased acetylation of specific lysines in histones and transcription factors, altered chromatin organization, and increased hypertrophic and fibrogenic gene expression. Cardiac hypertrophy and myocardial fibrogenesis are common pathological manifestations of several stress-induced accelerated cardiac aging-related pathologies, including high blood pressure-induced or environmentally induced cardiac hypertrophy, myocardial infarction, diabetes-induced cardiomyopathy, and heart failure. Numerous studies using cellular and animal models clearly indicate that pharmacologic or genetic normalization of p300 activity has the potential to prevent or halt the progression of cardiac aging pathologies. Based on these preclinical studies, development of safe, non-toxic, small molecule inhibitors/epidrugs targeting p300 is an ideal approach to control accelerated cardiac aging-related deaths worldwide.
Physiological resilience of pink salmon to naturally occurring ocean acidification

Abstract Pacific salmon stocks are in decline with climate change named as a contributing factor. The North Pacific coast of British Columbia is characterized by strong temporal and spatial heterogeneity in ocean conditions with upwelling events elevating CO2 levels up to 10-fold those of pre-industrial global averages. Early life stages of pink salmon have been shown to be affected by these CO2 levels, and juveniles naturally migrate through regions of high CO2 during the energetically costly phase of smoltification. To investigate the physiological response of out-migrating wild juvenile pink salmon to these naturally occurring elevated CO2 levels, we captured fish in Georgia Strait, British Columbia and transported them to a marine lab (Hakai Institute, Quadra Island) where fish were exposed to one of three CO2 levels (850, 1500 and 2000 μatm CO2) for 2 weeks. At ½, 1 and 2 weeks of exposure, we measured their weight and length to calculate condition factor (Fulton’s K), as well as haematocrit and plasma [Cl−]. At each of these times, two additional stressors were imposed (hypoxia and temperature) to provide further insight into their physiological condition. Juvenile pink salmon were largely robust to elevated CO2 concentrations up to 2000 μatm CO2, with no mortality or change in condition factor over the 2-week exposure duration. After 1 week of exposure, temperature and hypoxia tolerance were significantly reduced in high CO2, an effect that did not persist to 2 weeks of exposure. Haematocrit was increased by 20% after 2 weeks in the CO2 treatments relative to the initial measurements, while plasma [Cl−] was not significantly different. Taken together, these data indicate that juvenile pink salmon are quite resilient to naturally occurring high CO2 levels during their ocean outmigration.