Miracle-dz/UniFAR-FTUs huggingface dataset:
Developing a Medication Self-management Program to Enhance Medication Adherence among Older Adults with Multimorbidity Using Intervention Mapping.

BACKGROUND AND OBJECTIVES Suboptimal medication adherence is prevalent in older adults with multimorbidity. However, intervention programs for enhancing adherence in this population are limited. This study describes the development process of a medication self-management program for older adults with multimorbidity. RESEARCH DESIGN AND METHODS We adopted the first four steps of the Intervention Mapping to develop the program: (1) needs assessment, including a literature review, a systematic review, and a cross-sectional study, (2) development of program outcomes and objectives, (3) selection of theory-based intervention methods and practical applications, and (4) development of the program. RESULTS We conducted a needs assessment to identify factors affecting medication adherence among older adults with multimorbidity and created a logic model of the adherence problem in Step 1. In Step 2, we developed the specific program outcomes and objectives and then selected adherence information, personal motivation, social motivation, behavioral skills, and treatment experiences as modifiable and important targets that needed to change in this program. In Step 3, we chose several theory-based methods and strategies for practical applications. We finally created a nurse-led medication self-management program in Step 4. Feedback from relevant stakeholders refined the intervention protocol and materials. DISCUSSION AND IMPLICATIONS The newly developed medication self-management program incorporated theory and evidence from literature and empirical studies with the engagement of multiple stakeholders, making it a contextually and culturally appropriate intervention. This study provides insights into strategies for geriatrics healthcare professionals to support medication self-management among older adults with multimorbidity.
Vagus nerve stimulated by microbiota‐derived hydrogen sulfide mediates the regulation of berberine on microglia in transient middle cerebral artery occlusion rats

Amelioration of neuroinflammation via modulating microglia is a promising approach for cerebral ischemia therapy. The aim of the present study was to explore gut–brain axis signals in berberine‐modulating microglia polarization following cerebral ischemia. The potential pathway was determined through analyzing the activation of the vagus nerve, hydrogen sulfide (H2S) metabolism, and cysteine persulfides of transient receptor potential vanilloid 1 (TRPV1) receptor. The cerebral microenvironment feature was explored with a metabolomics assay. The data indicated that berberine ameliorated behavioral deficiency in transient middle cerebral artery occlusion rats through modulating microglia polarization and neuroinflammation depending on microbiota. Enhanced vagus nerve activity following berberine treatment was blocked by antibiotic cocktails, capsazepine, or sodium molybdate, respectively. Berberine‐induced H2S production was responsible for vagus nerve stimulation achieved through assimilatory and dissimilatory sulfate reduction with increased synthetic enzymes. Sulfation of the TRPV1 receptor resulted in vagus nerve activation and promoted the c‐fos and ChAT in the nucleus tractus solitaries with berberine. Sphingolipid metabolism is the primary metabolic characteristic with berberine in the cerebral cortex, hippocampus, and cerebral spinal fluid disrupted by antibiotics. Berberine, in conclusion, modulates microglia polarization in a microbiota‐dependent manner. H2S stimulates the vagus nerve through TRPV1 is responsible for the berberine‐induced gut–brain axis signal transmission. Sphingolipid metabolism might mediate the neuroinflammation amelioration following vagus afferent fiber activation.
Enhancing component-specific trust with consumer automated systems through humanness design

Abstract Consumer automation is a suitable venue for studying the efficacy of untested humanness design methods for promoting specific trust in multi-component systems. Subjective (trust, self-confidence) and behavioural (use, manual override) measures were recorded as 82 participants interacted with a four-component automation-bearing system in a simulated smart home task for two experimental blocks. During the first block all components were perfectly reliable (100%). During the second block, one component became unreliable (60%). Participants interacted with a system containing either a single or four simulated voice assistants. In the single-assistant condition, the unreliable component resulted in trust changes for every component. In the four-assistant condition, trust decreased for only the unreliable component. Across agent-number conditions, use decreased between blocks for only the unreliable component. Self-confidence and overrides exhibited ceiling and floor effects, respectively. Our findings provide the first evidence of effectively using humanness design to enhance component-specific trust in consumer systems. Practitioner summary: Participants interacted with simulated smart-home multi-component systems that contained one or four voiced assistants. In the single-voice condition, one component’s decreasing reliability coincided with trust changes for all components. In the four-voice condition, trust decreased for only the decreasingly reliable component. The number of voices did not influence use strategies. Abbreviations: ACC: adaptive cruise control; CST: component-specific trust; SWT: system-wide trust; UAV: unmanned aerial vehicle; CPRS: complacency potential rating scale; MANOVA: multivariate analysis of variance
Estrogenic regulation of reproduction and energy homeostasis by a triumvirate of hypothalamic arcuate neurons

Pregnancy is energetically demanding and therefore, by necessity, reproduction and energy balance are inextricably linked. With insufficient or excessive energy stores a female is liable to suffer complications during pregnancy or produce unhealthy offspring. Gonadotropin‐releasing hormone neurons are responsible for initiating both the pulsatile and subsequent surge release of luteinizing hormone to control ovulation. Meticulous work has identified two hypothalamic populations of kisspeptin (Kiss1) neurons that are critical for this pattern of release. The involvement of the hypothalamus is unsurprising because its quintessential function is to couple the endocrine and nervous systems, coordinating energy balance and reproduction. Estrogens, more specifically 17β‐estradiol (E2), orchestrate the activity of a triumvirate of hypothalamic neurons within the arcuate nucleus (ARH) that govern the physiological underpinnings of these behavioral dynamics. Arising from a common progenitor pool, these cells differentiate into ARH kisspeptin, pro‐opiomelanocortin (POMC), and agouti related peptide/neuropeptide Y (AgRP) neurons. Although the excitability of all these subpopulations is subject to genomic and rapid estrogenic regulation, Kiss1 neurons are the most sensitive, reflecting their integral function in female fertility. Based on the premise that E2 coordinates autonomic functions around reproduction, we review recent findings on how Kiss1 neurons interact with gonadotropin‐releasing hormone, AgRP and POMC neurons, as well as how the rapid membrane‐initiated and intracellular signaling cascades activated by E2 in these neurons are critical for control of homeostatic functions supporting reproduction. In particular, we highlight how Kiss1 and POMC neurons conspire to inhibit AgRP neurons and diminish food motivation in service of reproductive success.
Circulating Tumor DNA as a Biomarker in Patients With Stage III and IV Wilms Tumor: Analysis From a Children's Oncology Group Trial, AREN0533

PURPOSE The utility of circulating tumor DNA (ctDNA) analyses has not been established in the risk stratification of Wilms tumor (WT). We evaluated the detection of ctDNA and selected risk markers in the serum and urine of patients with WT and compared findings with those of matched diagnostic tumor samples. PATIENTS AND METHODS Fifty of 395 children with stage III or IV WT enrolled on Children's Oncology Group trial AREN0533 had banked pretreatment serum, urine, and tumor available. Next-generation sequencing was used to detect ctDNA. Copy-number changes in 1q, 16q, and 1p, and single-nucleotide variants in serum and urine were compared with tumor biopsy data. Event-free survival (EFS) was compared between patients with and without ctDNA detection. RESULTS ctDNA was detected in the serum of 41/50 (82%) and in the urine in 13/50 (26%) patients. Agreement between serum ctDNA detection and tumor sequencing results was as follows: 77% for 1q gain, 88% for 16q deletions, and 70% for 1p deletions, with ĸ-coefficients of 0.56, 0.74, and 0.29, respectively. Sequencing also demonstrated that single-nucleotide variants detected in tumors could be identified in the ctDNA. There was a trend toward worse EFS in patients with ctDNA detected in the serum (4-year EFS 80% v 100%, P = .14). CONCLUSION ctDNA demonstrates promise as an easily accessible prognostic biomarker with potential to detect tumor heterogeneity. The observed trend toward more favorable outcome in patients with undetectable ctDNA requires validation. ctDNA profiling should be further explored as a noninvasive diagnostic and prognostic tool in the risk-adapted treatment of patients with WT.
Ziziphus lotus (L.) Lam. as a Source of Health Promoting Products: Metabolomic Profile, Antioxidant and Tyrosinase Inhibitory Activities

The methanolic extract of the stem bark of a wild species of jujube, Ziziphus lotus (L.) Lam. , growing in Sicily, was chemically and biologically investigated. The chemical profile was defined by UHPLC‐HR‐ESI‐Orbitrap/MS analysis whereas antioxidant and tyrosinase inhibitory activities were investigated by in vitro assays. The extract showed a high total phenolic and flavonoid content (TPC=271.65 GAE/g and TFC=188.11 RE/g extract). Metabolomic analysis revealed a rich phytocomplex characterized by phenols, cyclopeptide alkaloids, and triterpenoid saponins, some of which here detected for the first time. The mushroom tyrosinase inhibition assay displayed that the methanolic extract efficiently inhibits the monophenolase and diphenolase activity. Furthermore, the extract showed a strong ability to scavenge DPPH, a good Fe3+ reducing antioxidant power, in addition to a Fe2+ chelating activity. Taken together, these results suggest possible novel applications of wild jujube stem bark as a source of potential skin‐care agents with several uses in pharmaceutical and cosmetic industries.
Helping Soldiers Leverage Army Knowledge, Skills, and Abilities in Civilian Jobs

Abstract : This report documents one of the primary tasks of a research project titled Facilitating AC-to-RC and AC-to-Civilian Transitions. The overall purpose of the project was to assess the level and importance of the knowledge, skills, and abilities needed to perform in Army military occupational specialties (MOSs) to develop improved crosswalks between military and civilian occupations and to make other recommendations to improve the transition process for soldiers leaving the Regular Army. In this report, we discuss the results of occupation surveys administered to soldiers in ten of the most populous Army MOSs, including the knowledge, skills, and abilities rated most important by soldiers in those MOSs, the best-matching civilian occupations, and comparisons with other military-civilian occupation crosswalks.
Variational Bayes Ensemble Learning Neural Networks With Compressed Feature Space

We consider the problem of nonparametric classification from a high-dimensional input vector (small $n$ large $p$ problem). To handle the high-dimensional feature space, we propose a random projection (RP) of the feature space followed by training of a neural network (NN) on the compressed feature space. Unlike regularization techniques (lasso, ridge, etc.), which train on the full data, NNs based on compressed feature space have significantly lower computation complexity and memory storage requirements. Nonetheless, a random compression-based method is often sensitive to the choice of compression. To address this issue, we adopt a Bayesian model averaging (BMA) approach and leverage the posterior model weights to determine: 1) uncertainty under each compression and 2) intrinsic dimensionality of the feature space (the effective dimension of feature space useful for prediction). The final prediction is improved by averaging models with projected dimensions close to the intrinsic dimensionality. Furthermore, we propose a variational approach to the afore-mentioned BMA to allow for simultaneous estimation of both model weights and model-specific parameters. Since the proposed variational solution is parallelizable across compressions, it preserves the computational gain of frequentist ensemble techniques while providing the full uncertainty quantification of a Bayesian approach. We establish the asymptotic consistency of the proposed algorithm under the suitable characterization of the RPs and the prior parameters. Finally, we provide extensive numerical examples for empirical validation of the proposed method.
Social Environments and Physical Activity Among Active Black Women

Purpose To explore the social context of physical activity (PA) among active Black women, we examine the patterns of PA engagement and the benefits of social support in PA maintenance. Design A cross-sectional study design and descriptive phenomenological approach were used to examine social support and lived experiences of active Black women. Setting The study setting was an online survey of active Black women, ages 21 to 71 years who were recruited from across the United States. Participants This secondary data analysis was conducted among a sample of 187 active Black women who maintained PA for ≥6 months. The mean age was 41 ± 12.3 years, 83.4% completed some college, 37.7% were married, and 30.0% had children. Measures Participants self-reported ‘with whom’ they engaged in PA and provided qualitative responses about their strategies for PA maintenance. Descriptive statistics were used to examine between-group differences among demographic characteristics and PA variables by category of PA engagement using SAS 9.4. Descriptive phenomenology was used to explore social support themes across and within categories of PA engagement. Results On average, the active Black women in this study reported engaging in 57.0 ± 18.9 minutes of moderate intensity leisure-time PA per session. Most engaged in PA alone (n = 87), with a group (n = 72), or with another individual (n = 28). Social context themes within categories included: alone – self-management, groups - motivation and accountability, family – values health, and friends – shared interests in PA. Subthemes across social context categories included: who? - people, what and how? - types of social support, and where? – place of social support. Conclusions Our findings suggest that some Black women may need added social support from others beyond family and friends, while other Black women may prefer additional self-management skills. Nonetheless, this study provides data for developing hypotheses about the mechanisms by which social context may facilitate PA maintenance among Black women. Therefore, intervention studies targeting PA maintenance among Black women should include an in-depth query of social support needs.
Vacuum ultraviolet photoluminescence of NaMgF3:Sm and NaMgF3:Sm,Ce: energy levels of the lanthanides in NaMgF3:Ln compounds

The luminescence properties of NaMgF3:Sm and NaMgF3:Ce,Sm were studied in the vacuum ultraviolet spectral region. Excitation bands corresponding to the charge transfer processes F− → Sm3+, O2− → Sm3+, and O2− → Ce3+, and the energy transfer processes Ce3+ → Sm3+ and O2− → Sm3+, were observed. The energies of the Sm3+ charge transfer transitions and the crystal field split Ce3+ 4f 05d 1 transitions were used to construct a complete host referred binding energy diagram for the series of lanthanide-doped NaMgF3:Ln compounds. We demonstrate that the optical and luminescence properties predicted by the binding energy diagram are in good agreement with those predicted by the binding energy diagram constructed via the alternative impurity-informed method, and all available experimental data regarding the NaMgF3:Ln compounds. We demonstrate that NaMgF3:Ln compounds are model systems for the study of charge trapping phenomena and divalent lanthanide luminescence. Ultimately, we validate that the impurity-informed method can be used to establish the energy levels of lanthanides in fluoride systems.
Development of an Effective Nontoxigenic Clostridioides difficile–Based Oral Vaccine against C. difficile Infection

Clostridioides difficile is an enteric pathogen, and symptoms of C. difficile infection (CDI) are mainly by two exotoxins TcdA and TcdB. Active vaccination is cost-effective approach to prevent CDI and high rates of recurrence. ABSTRACT The symptoms of Clostridioides difficile infection (CDI) are largely attributed to two C. difficile toxins, TcdA and TcdB. Significant efforts have been devoted to developing vaccines targeting both toxins through parenteral immunization routes. Recently, we generated a novel chimeric protein (designated Tcd169), comprised of the glucosyltransferase domain (GT), the cysteine protease domain (CPD), and the receptor binding domain (RBD) of TcdB, and the RBD of TcdA. Parenteral immunizations with Tcd169 provide mice effective protection against infection with a ribotype (RT) 027 C. difficile strain. In this study, we expressed Tcd169 in a nontoxigenic C. difficile CCUG37785 strain (designated NTCD), resulting in strain NTCD_Tcd169 to develop an oral vaccine that can target both C. difficile toxins and colonization/adhesion factors. Oral immunizations with NTCD_Tcd169 spores induced systematic and mucosal antibody responses against, not only both toxins, but also C. difficile flagellins (FliC/FliD). Intriguingly yet importantly, anti-Tcd169 sera raised against Tcd169 protein were significantly cross-reactive with FliC/FliD and two surface layer proteins (SlpA and Cwp2). Oral immunizations with NTCD_Tcd169 spores provided mice effective protection against infection with a hypervirulent RT027 C. difficile strain R20291and significantly reduced R20291spore numbers in feces compared with NTCD or PBS immunized mice. These results imply that the genetically modified, nontoxigenic C. difficile strain expressing Tcd169 may represent a novel mucosal vaccine candidate against CDI. IMPORTANCE Clostridioides difficile is an enteric pathogen, and symptoms of C. difficile infection (CDI) are mainly by two exotoxins TcdA and TcdB. Active vaccination is cost-effective approach to prevent CDI and high rates of recurrence. Ideally, vaccines should target both C. difficile toxins and cell/spore colonization. In this study, we expressed immunodominant fragments of TcdA and TcdB (i.e., Tcd169) in a nontoxigenic C. difficile CCUG37785 strain, generating a promising oral/mucosal vaccine candidate against CDI, by targeting both toxins and colonization of pathogenic C. difficile strains. Importantly, anti-Tcd169 sera raised against Tcd169 protein were significantly cross-reactive with FliC/FliD and two surface layer proteins (SlpA and Cwp2), and all of which are involved in C. difficile adhesion/colonization in vitro and in vivo.
DUSP4 protects BRAF- and NRAS-mutant melanoma from oncogene overdose through modulation of MITF

Our study demonstrates that in BRAF- and NRAS-mutant MITF-proficient melanoma, the DUSP4 MAPK phosphatase restricts MAPK activation and prevents oncogenic overdose through modulation of MITF function. MAPK inhibitors (MAPKi) remain an important component of the standard of care for metastatic melanoma. However, acquired resistance to these drugs limits their therapeutic benefit. Tumor cells can become refractory to MAPKi by reactivation of ERK. When this happens, tumors often become sensitive to drug withdrawal. This drug addiction phenotype results from the hyperactivation of the oncogenic pathway, a phenomenon commonly referred to as oncogene overdose. Several feedback mechanisms are involved in regulating ERK signaling. However, the genes that serve as gatekeepers of oncogene overdose in mutant melanoma remain unknown. Here, we demonstrate that depletion of the ERK phosphatase, DUSP4, leads to toxic levels of MAPK activation in both drug-naive and drug-resistant mutant melanoma cells. Importantly, ERK hyperactivation is associated with down-regulation of lineage-defining genes including MITF. Our results offer an alternative therapeutic strategy to treat mutant melanoma patients with acquired MAPKi resistance and those unable to tolerate MAPKi.
Immediate implant and socket preservation using sticky bone and leukocyte-platelet-rich fibrin in the anterior maxilla: a 3-year case report.

INTRODUCTION Immediate implant in the esthetic area is a challenging procedure. Chronic infection often contributes to extensive bone loss and acute infection often precludes a safe, clean surgery. However, it is quite common to come across failing teeth in the esthetic area, where the patient often demands a faster rehabilitation. CASE PRESENTATION In this clinical case, a fractured upper central incisor was replaced by an immediate implant and the perimetrical area was filled with heterologous bone blended with patient-derived leucocyte- and platelet-rich fibrin (L-PRF) in the form of sticky bone. A Maryland bridge was bonded to the adjacent teeth with the intent to guarantee minimum esthetic to the patient. After 5 months, the implant was connected to a definitive abutment and crown. The facial and interdental soft tissue was maintained with appreciable success after 2 years. The pre- and 2-year-post-treatment computed tomographic (CT) scans revealed marginal bone preservation. CONCLUSION The use of sticky bone and L-PRF in immediate implant sites helps preventing hard and soft tissues collapse and may favor faster and sounder healing. This article is protected by copyright. All rights reserved.
Breast satisfaction in adult women with Turner syndrome—An international survey employing the BREAST‐Q questionnaire

Turner syndrome (TS) is associated with short stature, delayed puberty, primary ovarian insufficiency, and other features. Most girls with TS require oestrogen replacement for pubertal induction. There is paucity of data in adult TS on pubertal outcomes, including breast satisfaction. Here, we assess breast satisfaction in TS with the BREAST‐Q questionnaire, a well‐validated patient‐related outcome measure (PROM).