Miracle-dz/UniFAR-FTUs huggingface dataset:
Barriers to accessing prenatal care in low income rural women

Barriers exist to accessing prenatal care for low income women throughout the United States, such as scheduling appointments, finding childcare, and paying for prenatal care. Women who reside in rural areas experience barriers to accessing prenatal care unique to their geographical locations. Barriers to accessing prenatal care have been associated with less than optimal health outcomes for both women and infants. The purpose of this study was to explore the barriers to accessing prenatal care that are specific to low income rural women. A qualitative approach was used by conducting telephone interviews using open ended questions with low income women from one rural county in Montana. A sample of 6 women was recruited from the Women, Infants, and Children (WIC) nutritional supplement program in a rural county. Patterns were identified from the interview responses and categorized into themes that allowed for identifying common barriers. The results from this study revealed that low income rural women reported an overall lack of providers who offered prenatal care in their area. Difficulty with scheduling transportation to and from appointments was reported in half of the women, as well as distance to the nearest hospital for 2 of the women. These same 2 women also reported that if a complication arose during pregnancy or if a woman were to have a high risk pregnancy, distance to the nearest hospital or provider would be a barrier. There was difficulty recruiting a larger sample population, therefore the sample size of 6 women was a major limiting factor of this study. Implications for practice included a need for recruitment of providers in rural areas, and the potential use of nurse practitioners for providing high-quality, low cost prenatal care for low income rural women. The implementation of group prenatal care in rural locations and investing in rural communities were also implications for future practice. Lastly, the results from this study may help with future practice and research to help focus on the needs of this unique population for gaining improved access to prenatal care.
Effectiveness of pharmacologic therapies on smoking cessation success: Results of three years of smoking cessation clinic

Background:This study aimed to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic. Methods: This retrospective study included 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed one-year follow-up period. All patients were assessed using the Fagerstrom Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients smoking status at one year was learned by telephone interview. Results: The patients were 24.3% female and 75.7% male with a mean age of 38. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients). These groups smoking cessation rates were 32.5%, 23% and 52.8%, respectively, and were statistically significant. The overall success rate was 35%. Further analysis revealed that pharmacologic therapy and gender (p=0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. Lack of determination emerged as the most important factor leading to relapse. Conclusion: Nicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.
Surgical pathology report defects: a College of American Pathologists Q-Probes study of 73 institutions.

CONTEXT The rate of surgical pathology report defects is an indicator of quality and it affects clinician satisfaction. OBJECTIVE To establish benchmarks for defect rates and defect fractions through a large, multi-institutional prospective application of standard taxonomy. DESIGN Participants in a 2011 Q-Probes study of the College of American Pathologists prospectively reviewed all surgical pathology reports that underwent changes to correct defects and reported details regarding the defects. RESULTS Seventy-three institutions reported 1688 report defects discovered in 360,218 accessioned cases, for an aggregate defect rate of 4.7 per 1000 cases. Median institutional defect rate was 5.7 per 1000 (10th to 90th percentile range, 13.5-0.9). Defect rates were higher in institutions with a pathology training program (8.5 versus 5.0 per 1000, P = .01) and when a set percentage of cases were reviewed after sign-out (median, 6.7 versus 3.8 per 1000, P = .10). Defect types were as follows: 14.6% misinterpretations, 13.3% misidentifications, 13.7% specimen defects, and 58.4% other report defects. Overall, defects were most often detected by pathologists (47.4%), followed by clinicians (22.0%). Misinterpretations and specimen defects were most often detected by pathologists (73.5% and 82.7% respectively, P < .001), while misidentifications were most often discovered by clinicians (44.6%, P < .001). Misidentification rates were lower when all malignancies were reviewed by a second pathologist before sign-out (0.0 versus 0.6 per 1000, P < .001), and specimen defect rates were lower when intradepartmental review of difficult cases was conducted after sign-out (0.0 versus 0.4 per 1000, P = .02). CONCLUSION This study provides benchmarking data on report defects and defect fractions using standardized taxonomy.
Interstitial Lung Diseases That Are Difficult to Classify: A Review of Bronchiolocentric Interstitial Lung Disease.

CONTEXT Idiopathic bronchiolocentric interstitial pneumonia, airway-centered interstitial fibrosis, centrilobular fibrosis, and bronchiolitis interstitial pneumonia are increasingly recognized histopathologic variants of idiopathic interstitial pneumonia that are difficult to fit within existing classification schemes. OBJECTIVE To review and analyze the appropriate literature that describes the spectrum of histopathologic changes in these conditions, in an effort to ascertain similarities as well as their differences. In addition, we examined associations with hypersensitivity, cigarette smoking, and survival data. DATA SOURCES Relevant and peer-reviewed literature indexed in PubMed (National Library of Medicine) coupled with experience gained by review of personal cases with appropriate histopathology constitute the basis of this study. CONCLUSIONS As anticipated, the common link among the above-cited conditions is their bronchiolocentricity, with a predominance of either fibrosis or inflammation. Clear-cut associations with hypersensitivity or cigarette smoking are not evident in this study. The airway-centered interstitial fibrosis variant of bronchiolocentric interstitial lung disease appears to have a poor outcome.
Phase I clinical and pharmacokinetic study of PK1 [N-(2-hydroxypropyl)methacrylamide copolymer doxorubicin]: first member of a new class of chemotherapeutic agents-drug-polymer conjugates. Cancer Research Campaign Phase I/II Committee.

PK1 comprises doxorubicin covalently bound to N-(2-hydroxypropyl)methacrylamide copolymer by a peptidyl linker. Following cellular uptake via pinocytosis, the linker is cleaved by lysosomal enzymes, allowing intratumoral drug release. Radically altered plasma and tumor pharmacokinetics, compared to free doxorubicin, and significant activity in animal tumors have been demonstrated preclinically. We aimed to determine the maximum tolerated dose, toxicity profile, and pharmacokinetics of PK1 as an i.v. infusion every 3 weeks to patients with refractory or resistant cancers. Altogether, 100 cycles were administered (range, 20-320 mg/m2 doxorubicin-equivalent) to 36 patients (20 males and 16 females) with a mean age of 58.3 years (age range, 34-72 years). The maximum tolerated dose was 320 mg/m2, and the dose-limiting toxicities were febrile neutropenia and mucositis. No congestive cardiac failure was seen despite individual cumulative doses up to 1680 mg/m2. Other anthracycline-like toxicities were attenuated. Pharmacokinetically, PK1 has a distribution t(1/2) of 1.8 h and an elimination t(1/2) averaging 93 h. 131I-labeled PK1 imaging suggests PK1 is taken up by some tumors. Responses (two partial and two minor responses) were seen in four patients with NSCLC, colorectal cancer, and anthracycline-resistant breast cancer. PK1 demonstrated antitumor activity in refractory cancers, no polymer-related toxicity, and proof of principle that polymer-drug conjugation decreases doxorubicin dose-limiting toxicities. The recommended Phase II dose is 280 mg/m2 every 3 weeks. Studies are planned in colorectal, NSCLC, and breast cancer patients.
Behavioral HIV Harm Reduction Programs for Incarcerated Women: Theory and Practice

The purpose of this article is to provide a theoretical overview of characteristics of successful HIV harm reduction programs that target behavior, and a description of an existing program, AIDS Counseling and Education (ACE) at Bedford Hills Correctional Facility, New York, that promotes HIV harm reduction among incarcerated women through peer education. Successful harm reduction programs are: grounded in theory and past research, tailored for the target group, designed for evaluation, and supported with sufficient resources. Inmate-initiated and facilitated, ACE exemplifies many of these tenets. In addition to providing knowledge about HIV and harm reduction strategies, ACE empowers incarcerated women by cultivating skills critical for utilizing this information to protect themselves from HIV or to care for their illness. Formal evaluation of programs such as ACE would enable its replication, and contribute to the development of theories on which to ground future harm reduction programs for incarcerated women.
Uniform Labeling of Blocks and Slides in Surgical Pathology: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the National Society for Histotechnology.

CONTEXT The labeling of paraffin blocks and microscopic glass slides in the practice of surgical pathology varies from institution to institution and introduces potential risk of preanalytic error. Currently there are no evidence-based guidelines regarding the uniform labeling of these materials. OBJECTIVE To develop recommendations that will address the need for adequate patient identification and provide a consistent method of identifying slides originating from a particular block. DESIGN - The College of American Pathologists Pathology and Laboratory Quality Center and the National Society for Histotechnology convened a panel of pathologists and histotechnologists with expertise in histology laboratory quality practices to develop labeling recommendations. A systematic evidence review was conducted to address 6 main key questions. Recommendations were derived from strength of evidence, open comment feedback, and expert panel consensus. RESULTS Twelve guideline statements were established to assist pathology laboratories in developing standardized block and slide labeling practices. These guidelines call for the use of 2 patient identifiers, 1 of which includes the accession number and case type, on all paraffin blocks and slides. Recommendations were also developed to address the order and format in which identifying elements should appear. CONCLUSIONS Uniform labeling of paraffin blocks and slides derived from patient specimens will provide an important enhancement to patient safety by assuring that all preparations derived from a patient's tissue can be uniquely and unambiguously linked to that patient. Adoption of standardized practices additionally will improve patient care by facilitating interpretation of histologic sections when they are referred in consultation to a second institution.
Efficient Drug Delivery to Alveolar Macrophages and Lung Epithelial Lining Fluid Following Pulmonary Administration of Liposomal Ciprofloxacin in Rats with Pneumonia and Estimation of its Antibacterial Effects

The efficacy of pulmonary administration of liposomal ciprofloxacin (CPFX) in pneumonia was evaluated. In brief, the pharmacokinetics following pulmonary administration of liposomal CPFX (particle size, 1,000 nm; dose, 200 μg/kg) were examined in rats with lipopolysaccharide-induced pneumonia as an experimental pneumonia model. Furthermore, the antibacterial effects of liposomal CPFX against the pneumonic causative organisms were estimated by pharmacokinetic/pharmacodynamic (PK/PD) analysis. The time-courses of the concentration of CPFX in alveolar macrophages (AMs) and lung epithelial lining fluid (ELF) following pulmonary administration of liposomal CPFX to rats with pneumonia were markedly higher than that following the administration of free CPFX (200 μg/kg). The time course of the concentrations of CPFX in plasma following pulmonary administration of liposomal CPFX was markedly lower than that in AMs and ELF. These results indicate that pulmonary administration of liposomal CPFX was more effective in delivering CPFX to AMs and ELF compared with free CPFX, and it avoids distribution of CPFX to the blood. According to PK/PD analysis, the liposomal CPFX exhibited potent antibacterial effects against the causative organisms of pneumonia. This study indicates that pulmonary administration of CPFX could be an effective technique for the treatment of pneumonia.
Schwannoma of the nasal septum: evaluation of unilateral nasal mass

1 Medico (Medico residente de Otorrinolaringologia da UNICAMP). 2 Mestre em medicina (Medico Otorrinolaringologista (fellow em otologia na UNICAMP)). 3 Mestre em ciencias medicas (Medica otorrinolaringologista do Servico de Otorrinolaringologia do Hospital Estadual de Sumare, Disciplina de Otorrinolaringologia, Cabeca e Pescoco, UNICAMP). 4 Doutora em ciencias medicas (Medica otorrinolaringologista, Chefe do Servico de Rinologia, Disciplina de Otorrinolaringologia, Cabeca e Pescoco, UNICAMP). Disciplina de Otorrinolaringologia, Cabeca e Pescoco. Hospital das Clinicas (HC) Faculdade de Ciencias Medicas (FCM) Universidade Estadual de Campinas (UNICAMP) Campinas, Sao Paulo, Brasil. Endereco para correspondencia: Henrique Furlan Pauna. Rua Aldo de Oliveira Barbosa, no 170. Parque das Universidades. Campinas SP. Brasil. CEP: 13086-030. E-mail: h_pauna@hotmail.com Este artigo foi submetido no SGP (Sistema de Gestao de Publicacoes) do BJORL em 21 de abril de 2012. cod. 9165. Artigo aceito em 20 de outubro de 2012. CASE REPORT Braz J Otorhinolaryngol. 2013;79(3):403.
Concise Review: Cell Therapy and Tissue Engineering for Cardiovascular Disease

Cardiovascular disease is a major cause of morbidity and mortality, especially in developed countries. Various therapies for cardiovascular disease are investigated actively and are performed clinically. Recently, cell‐based regenerative medicine using several cell sources has appeared as an alternative therapy for curing cardiovascular diseases. Scaffold‐based or cell sheet‐based tissue engineering is focused as a new generational cell‐based regenerative therapy, and the clinical trials have also been started. Cell‐based regenerative therapies have an enormous potential for treating cardiovascular disease. This review summarizes the recent research of cell sources and cell‐based‐regenerative therapies for cardiovascular diseases.
Concise Review: Adult Mesenchymal Stem Cells, Adult Neural Crest Stem Cells, and Therapy of Neurological Pathologies: A State of Play

Adult stem cells are endowed with in vitro multilineage differentiation abilities and constitute an attractive autologous source of material for cell therapy in neurological disorders. With regard to lately published results, the ability of adult mesenchymal stem cells (MSCs) and neural crest stem cells (NCSCs) to integrate and differentiate into neurons once inside the central nervous system (CNS) is currently questioned. For this review, we collected exhaustive data on MSC/NCSC neural differentiation in vitro. We then analyzed preclinical cell therapy experiments in different models for neurological diseases and concluded that neural differentiation is probably not the leading property of adult MSCs and NCSCs concerning neurological pathology management. A fine analysis of the molecules that are secreted by MSCs and NCSCs would definitely be of significant interest regarding their important contribution to the clinical and pathological recovery after CNS lesions.
The application of the theory of reasoned action to school nurses’ behaviour

The aim of this paper was to ascertain how valuable the Theory of Reasoned Action (TRA) would be in the prediction of the sexual health education behaviour of school nurses. The current government in the United Kingdom has made a commitment to reducing the high rates of teenage conceptions and sexually transmitted infections and emphasise an increased public health role for school nurses. However, there appears to be no research to suggest that school nurses are the most appropriate healthcare professionals to competently assist with sexual health education in schools. In accordance with the TRA, a questionnaire was designed to measure the intention, attitude, subjective norm and behaviour of the group being surveyed. The purpose-designed questionnaire was distributed to all school nurses in a large geographical area in the United Kingdom. All 46 participants who responded were female (as there are currently no male school nurses in the United Kingdom). No demographic data were obtained as it is believed that the components of the model incorporate all information needed. The major components of the model accounted for 43% of the variance in intention and 46% of the variance in behaviour. Results suggest that the model has good predictive utility in this area and could usefully be employed in interventions with school nurses with the aim of modifying their behaviour. This is the first time the TRA has been used in this context, and it has provided some important information regarding school nurse’s intentions to practise in sexual health.
Cancer Stem Cell‐Based Models of Colorectal Cancer Reveal Molecular Determinants of Therapy Resistance

Colorectal cancer (CRC) therapy mainly relies on the use of conventional chemotherapeutic drugs combined, in a subset of patients, with epidermal growth factor receptor [EGFR]‐targeting agents. Although CRC is considered a prototype of a cancer stem cell (CSC)‐driven tumor, the effects of both conventional and targeted therapies on the CSC compartment are largely unknown. We have optimized a protocol for colorectal CSC isolation that allowed us to obtain CSC‐enriched cultures from primary tumor specimens, with high efficiency. CSC isolation was followed by in vitro and in vivo validation, genetic characterization, and drug sensitivity analysis, thus generating panels of CSC lines with defined patterns of genetic mutations and therapy sensitivity. Colorectal CSC lines were polyclonal and maintained intratumor heterogeneity in terms of somatically acquired mutations and differentiation state. Such CSC‐enriched cultures were used to investigate the effects of both conventional and targeted therapies on the CSC compartment in vivo and to generate a proteomic picture of signaling pathways implicated in sensitivity/resistance to anti‐EGFR agents. We propose CSC lines as a sound preclinical framework to test the effects of therapies in vitro and in vivo and to identify novel determinants of therapy resistance.
Hispanic/Latino Concerns about Living Kidney Donation: A Focus Group Study

Context Given the shortage of kidneys for transplant, living kidney donation (LKD) is increasingly used to expand the organ donor pool. Although Hispanics/Latinos need disproportionately more kidney transplants, they receive a smaller proportion of living donor kidney transplants than other ethnic/racial groups. Objective To assess Hispanics' awareness, perceptions, misconceptions, cultural beliefs, and values about and barriers to LKD. Design Nine focus groups were conducted with 76 adult Hispanics in Chicago, Illinois, between January and March 2012. Participants Focus groups included kidney transplant recipients, living kidney donors, dialysis patients, and the general Hispanic public. Results Several themes emerged as perceived barriers to LKD. Many participants identified knowledge deficits about LKD, expressing uncertainty about the differences between LKD and deceased donation, and whether kidney disease simultaneously afflicts both kidneys. Many believed that donors experience dramatically shorter life expectancies, are unable to have children, and are more susceptible to kidney disease after donating. Recipients and donors reported that family members were involved in discussions about the donor's decision to donate, with some family members discouraging donation. Financial barriers cited included fear of becoming unable to work, losing one's job, or being unable to pay household bills while recovering. Participants also identified logistic barriers for undocumented immigrants (eg, the inability to obtain government insurance for transplant candidates and uncertainty about their eligibility to donate). Donors desired information about optimizing self-care to promote their remaining kidney's health. Culturally competent interventions are needed to redress Hispanics' knowledge deficits and misconceptions and reduce LKD disparities among Hispanics.
Validation of one-mile walk equations for the estimation of aerobic fitness in British military personnel under the age of 40 years.

OBJECTIVE To provide an accurate estimate of peak oxygen uptake (VO2 peak) for British Royal Navy Personnel aged between 18 and 39, comparing a gold standard treadmill based maximal exercise test with a submaximal one-mile walk test. METHODS Two hundred military personnel consented to perform a treadmill-based VO2 peak test and two one-mile walk tests round an athletics track. The estimated VO2 peak values from three different one-mile walk equations were compared to directly measured VO2 peak values from the treadmill-based test. One hundred participants formed a validation group from which a new equation was derived and the other 100 participants formed the cross-validation group. RESULTS Existing equations underestimated the VO2 peak values of the fittest personnel and overestimated the VO2 peak of the least aerobically fit by between 2% and 18%. The new equation derived from the validation group has less bias, the highest correlation with the measured values (r = 0.83), and classified the most people correctly according to the Royal Navy's Fitness Test standards, producing the fewest false positives and false negatives combined (9%). CONCLUSION The new equation will provide a more accurate estimate of VO2 peak for a British military population aged 18 to 39.
Coronary Artery Disease May Alter the Spatial Dispersion of the QT Interval at Rest

Background:Increases of QT dispersion (QTd) have been observed in patients with coronary artery‐disease (CAD) under stress. In contrast to ECG, multichannel magnetocardiography (MCG) allows the assessment of the spatial distribution of QTd, which may be altered earlier than standard QTd. The aim of this study was the investigation of repolarization patterns in patients with CAD at rest.