Miracle-dz/UniFAR-FTUs huggingface dataset:
Early Increase of Abdominal Adiposity in Patients with Spondyloarthritis Receiving Anti-tumor Necrosis Factor-α Treatment

Objective. Patients with spondyloarthritis (SpA) receiving anti-TNF-α treatment have an increase in fat mass. This may be relevant to cardiovascular risk. The aim of this study was to estimate visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) changes by dual-energy x-ray absorptiometry (DEXA) in patients with SpA under anti-TNF-α therapy. Methods. We used an ancillary protocol to an open, prospective 2-year followup study of patients with SpA. Waist circumference (WC), body weight, body mass index, VAT, and SAT were measured at baseline, 6 months, and 1 and 2 years. Univariate and multivariate analyses were performed to assess variables associated with VAT and SAT changes. Results. A total of 85 patients were analyzed. Patients were 39.3 ± 11.4 years old and mean baseline Bath Ankylosing Spondylitis Disease Activity Index was 55.0 ± 20.2. Treatment was effective according to clinical and biological variables, and body weight increased by 0.9 ± 1.7 kg over 2 years. There was a significant gain in VAT after 6 months (13.7 ± 20.6 cm2, p < 0.0001), 1 year (21.0 ± 26.6 cm2, p < 0.0001), and after 2 years (29.1 ± 33.4 cm2, p < 0.0001); and in SAT after 6 months (12.5 ± 27.4 cm2, p < 0.0001), 1 year (27.1 ± 38.2 cm2, p < 0.0001), and after 2 years (31.9 ± 53.2 cm2, p < 0.0001). We could not find any determinant of these changes by multivariate analysis. Conclusion. In patients with SpA receiving anti-TNF-α therapy, there is an early significant increase in abdominal obesity with significant increase in both VAT and SAT after 1 and 2 years of treatment. Prospective studies are required to investigate the relationship between these changes and cardiovascular risk.
Inhibiting Mitochondrial Fission Protects the Heart Against Ischemia/Reperfusion Injury

Background— Whether alterations in mitochondrial morphology affect the susceptibility of the heart to ischemia/reperfusion injury is unknown. We hypothesized that modulating mitochondrial morphology protects the heart against ischemia/reperfusion injury. Methods and Results— In response to ischemia, mitochondria in HL-1 cells (a cardiac-derived cell line) undergo fragmentation, a process that is dependent on the mitochondrial fission protein dynamin-related protein 1 (Drp1). Transfection of HL-1 cells with the mitochondrial fusion proteins mitofusin 1 or 2 or with Drp1K38A, a dominant-negative mutant form of Drp1, increased the percentage of cells containing elongated mitochondria (65±4%, 69±5%, and 63±6%, respectively, versus 46±6% in control: n=80 cells per group; P<0.05), decreased mitochondrial permeability transition pore sensitivity (by 2.4±0.5-, 2.3±0.7-, and 2.4±0.3-fold, respectively; n=80 cells per group; P<0.05), and reduced cell death after simulated ischemia/reperfusion injury (11.6±3.9%, 16.2±3.9%, and 12.1±2.9%, respectively, versus 41.8±4.1% in control: n=320 cells per group; P<0.05). Treatment of HL-1 cells with mitochondrial division inhibitor-1, a pharmacological inhibitor of Drp1, replicated these beneficial effects. Interestingly, elongated interfibrillar mitochondria were identified in the adult rodent heart with confocal and electron microscopy, and in vivo treatment with mitochondrial division inhibitor-1 increased the percentage of elongated mitochondria from 3.6±0.5% to 14.5±2.8% (P=0.023). Finally, treatment of adult murine cardiomyocytes with mitochondrial division inhibitor-1 reduced cell death and inhibited mitochondrial permeability transition pore opening after simulated ischemia/reperfusion injury, and in vivo treatment with mitochondrial division inhibitor-1 reduced myocardial infarct size in mice subject to coronary artery occlusion and reperfusion (21.0±2.2% with mitochondrial division inhibitor-1 versus 48.0±4.5% in control; n=6 animals per group; P<0.05). Conclusion— Inhibiting mitochondrial fission protects the heart against ischemia/reperfusion injury, suggesting a novel pharmacological strategy for cardioprotection.
Sentimentality and Nostalgia in Elderly People in Bulgaria and Greece – Cross-Validity of the Questionnaire SNEP and Cross-Cultural Comparison

Sentimentality and nostalgia are two similar psychological constructs, which play an important role in the emotional lives of elderly people who are usually focused on the past. There are two objectives of this study - making cross-cultural comparison of sentimentality and nostalgia among Bulgarian and Greek elderly people using a questionnaire, and establishing the psychometric properties of this questionnaire among Greek elderly people. Sentimentality and nostalgia in elderly people in Bulgaria and Greece were studied by means of Sentimentality and Nostalgia in Elderly People questionnaire (SNEP), created by Gergov and Stoyanova (2013). For the Greek version, one factor structure without sub-scales is proposed, while for the Bulgarian version of SNEP the factor structure had four sub-scales, besides the total score. Together with some similarities (medium level of nostalgia and sentimentality being widespread), the elderly people in Bulgaria and Greece differed cross-culturally in their sentimentality and nostalgia related to the past in direction of more increased sentimentality and nostalgia in the Bulgarian sample. Some gender and age differences revealed that the oldest male Bulgarians were the most sentimental. The psychometric properties of this questionnaire were examined for the first time in a Greek sample of elders and a trend was found for stability of sentimentality and nostalgia in elderly people that could be studied further in longitudinal studies.
Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine

In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, implant failure, and adjacent segment disease (ASD). This retrospective study examines the records of 70 elderly patients with degenerative changes or instability of the lumbar spine treated between 2002 and 2007 with spondylodesis of more than two segments. Sixty-four patients were included; 5 patients had died and one patient was lost to follow-up. We evaluated complications, clinical/radiological outcomes, and success of fusion. Flexion-extension and standing X-rays in two planes, MRI, and/or CT scans were obtained pre-operatively. Patients were assessed clinically using the Oswestry disability index (ODI) and a Visual Analogue Scale (VAS). Surgery performed was dorsolateral fusion (46.9%) or dorsal fusion with anterior lumbar interbody fusion (ALIF; 53.1%). Additional decompression was carried out in 37.5% of patients. Mean follow-up was 29.4±5.4 months. Average patient age was 64.7±4.3 years. Clinical outcomes were not satisfactory for all patients. VAS scores improved from 8.6±1.3 to 5.6±3.0 pre- to post-operatively, without statistical significance. ODI was also not significantly improved (56.1±22.3 pre- and 45.1±26.4 post-operatively). Successful fusion, defined as adequate bone mass with trabeculation at the facets and transverse processes or in the intervertebral segments, did not correlate with good clinical outcomes. Thirty-five of 64 patients (54%) showed signs of pedicle screw loosening, especially of the screws at S1. However, only 7 of these 35 (20%) complained of corresponding back pain. Revision surgery was required in 24 of 64 patients (38%). Of these, indications were adjacent segment disease (16 cases), pedicle screw loosening (7 cases), and infection (one case). At follow-up of 29.4 months, patients with radiographic ASD had worse ODI scores than patients without (54.7 vs. 36.6; P<0.001). Multilevel fusion for degenerative disease still has a high rate of complications, up to 50%. The problem of adjacent segment disease after fusion surgery has not yet been solved. This study underscores the need for strict indication guidelines to perform lumbar spine fusion of more than two levels.
Compulsive Buying: A Theoretical Framework

For the nearly 18 million Americans suffering from compulsive buying (Bragg, 2009), the process of shopping and buying has caused their lives to go out of control (Magee, 1994; Black, 2007). In an era of social responsibility (Kerin et al., 2011), marketers should understand the negative outcomes of this disease and ensure that marketing practices are not contributing to this social and economic problem. A theoretical framework of compulsive buying is presented, incorporating constructs/data themes from previous research in psychiatry, psychology, sociology, and marketing. Personality antecedents and short and long term consequences describe the addictive consumer disease. Marketing implications and future research directions are discussed.
The Effects of Alteplase 3 to 6 Hours After Stroke in the EPITHET–DEFUSE Combined Dataset: Post Hoc Case–Control Study

Background and Purpose— Two phase 2 studies of alteplase in acute ischemic stroke 3 to 6 hours after onset, Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET; a randomized, controlled, double-blinded trial), and Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution Study (DEFUSE; open-label, treatment only) using MR imaging-based outcomes have been conducted. We have pooled individual patient data from these to assess the response to alteplase. The primary hypothesis was that alteplase would significantly attenuate infarct growth compared with placebo in mismatch-selected patients using coregistration techniques. Methods— The EPITHET–DEFUSE study datasets were pooled while retaining the original inclusion and exclusion criteria. Significant hypoperfusion was defined as a Tmax delay >6 seconds), and coregistration techniques were used to define MR diffusion-weighted imaging/perfusion-weighted imaging mismatch. Neuroimaging, parameters including reperfusion, recanalization, symptomatic intracerebral hemorrhage, and clinical outcomes were assessed. Alteplase and placebo groups were compared for the primary outcome of infarct growth as well for secondary outcome measures. Results— From 165 patients with adequate MR scans in the EPITHET–DEFUSE pooled data, 121 patients (73.3%) were found to have mismatch. For the primary outcome analysis, 60 patients received alteplase and 41 placebo. Mismatch patients receiving alteplase had significantly attenuated infarct growth compared with placebo (P=0.025). The reperfusion rate was also increased (62.7% vs 31.7%; P=0.003). Mortality and clinical outcomes were not different between groups. Conclusions— The data provide further evidence that alteplase significantly attenuates infarct growth and increases reperfusion compared with placebo in the 3- to 6- hour time window in patients selected based on MR penumbral imaging. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT00238537
Pelagic sea snakes dehydrate at sea

Secondarily marine vertebrates are thought to live independently of fresh water. Here, we demonstrate a paradigm shift for the widely distributed pelagic sea snake, Hydrophis (Pelamis) platurus, which dehydrates at sea and spends a significant part of its life in a dehydrated state corresponding to seasonal drought. Snakes that are captured following prolonged periods without rainfall have lower body water content, lower body condition and increased tendencies to drink fresh water than do snakes that are captured following seasonal periods of high rainfall. These animals do not drink seawater and must rehydrate by drinking from a freshwater lens that forms on the ocean surface during heavy precipitation. The new data based on field studies indicate unequivocally that this marine vertebrate dehydrates at sea where individuals may live in a dehydrated state for possibly six to seven months at a time. This information provides new insights for understanding water requirements of sea snakes, reasons for recent declines and extinctions of sea snakes and more accurate prediction for how changing patterns of precipitation might affect these and other secondarily marine vertebrates living in tropical oceans.
Effect of Baseline CD4 Cell Count on the Efficacy and Safety of Peginterferon Alfa-2a (40KD) Plus Ribavirin in Patients With HIV/Hepatitis C Virus Coinfection

Objective:The impact of baseline CD4 status on hepatitis C virus (HCV) treatment response among patients with HIV/HCV coinfection was investigated using data from a randomized study of peginterferon alfa-2a (40KD) + ribavirin (Peg-IFN/RBV). Methods:Of 860 patients treated with conventional interferon alfa-2a + ribavirin (IFN/RBV), peginterferon alfa-2a (40KD) + placebo (Peg-IFN), or Peg-IFN/RBV for 48 weeks, 857 patients had baseline CD4 data available and were included in the analysis. Efficacy and safety were analyzed according to baseline CD4 status as absolute cell count and proportion of total lymphocytes. Results:Sustained virologic response (SVR) rates were highest with Peg-IFN/RBV across all CD4 strata. With Peg-IFN/RBV, SVR rates were independent of baseline CD4 in genotype 2/3 patients, but in genotype 1 patients, they tended to be higher with higher CD4 or CD4%. Frequencies of adverse events (AEs) and serious AEs were similar among treatment arms and CD4 strata. Withdrawal and dose reduction rates attributable to safety were highest with CD4 <200 cells/μL. Conclusions:Peg-IFN/RBV could be effective and well tolerated in HIV/HCV-coinfected individuals with stable HIV. With Peg-IFN/RBV, response tended to increase with higher CD4 counts in genotype 1; however, because of the paucity of patients with CD4 <200 cells/μL, these data require corroboration.
Nurses' communication with families in the intensive care unit – a literature review

AIMS AND OBJECTIVES This review examined the literature across 12 years that explored nurses' perceptions of their role when communicating with families in adult intensive care units (ICUs). The objectives were: (1) to describe how ICU nurses facilitated communication with families; (2) the perceived barriers to that communication; (3) strategies to improve their skills. BACKGROUND Evidence demonstrates that effective communication by health care providers can improve families' understanding of their situation and decrease their psychological burden. The continuous presence of ICU nurses, combined with the use of effective empathic communication skills, can impact on families' ICU experience in a positive way. Nevertheless, research continues to demonstrate that communication with families in ICU is inadequate and of poor quality. SEARCH STRATEGIES AND DESIGN Eight databases were systematically searched to identify peer reviewed studies published in English between 2002 and 2014. The results are presented via a thematic literature review. FINDINGS Four major themes emerged from a synthesis of the review findings: 'Nurses as information and communication facilitators', 'Nurses as family support providers', 'Nurses' non-supportive behaviours' and 'Improving nurses' communication skills'. CONCLUSIONS Most ICU nurses considered communicating with families a vital part of their role, and described supportive behaviours. However, they perceived significant barriers to effective communication; some as a result of active decisions on their part, and some beyond their control. These barriers often resulted in nurses believing that families received suboptimal information and support. Peer support and formal training were identified as key strategies to overcome inadequacies. RELEVANCE TO CLINICAL PRACTICE This review summarizes nurses' perceptions of the means and barriers for communicating with families in ICUs. Intensive care nurses need skills and knowledge in how to communicate effectively with families. This skill can be learnt formally, or acquired from role modelling of more experienced peers.
Using the normality assumption to calculate probability‐based standardized drought indices: selection criteria with emphases on typical events

Enhancing the capability of both standardized precipitation index (SPI) and standardized precipitation evapotranspiration index (SPEI) for quantifying wet and dry events under distinct climate conditions is of paramount importance. The different recommendations of recent studies regarding the best distribution to calculate the SPEI and the lack of studies addressing the effect of different parameters estimation methods on the SPI motivated us to apply and adapt distinct testing methodologies to select candidate models for calculating these standardized drought indices (SDI). The study is based on two data sets. The first represents a tropical–subtropical region of Brazil. The second comprises the same weather stations that were used for developing the original version of the SPEI. The study also emphasized the performance of the models within the range of typical SDI values [−2.0 : 2.0]. Along with goodness‐of‐fit tests, we calculated the mean absolute errors between the indices values estimated from the candidate distributions, and their corresponding theoretical values derived from the standard normal distribution. The two‐parameter gamma and the generalized extreme value distributions are, respectively, recommended for general use in SPI and SPEI algorithms (1–12‐month timescales). The unbiased probability weighted moments are recommended to estimate the distributions parameters. The study also described a trade‐off between choosing the best model for the central part and for the tails of the distributions. This trade‐off suggests that the methodologies used to select models for the SDI algorithms may have to decide which part of the distribution (central or tails) should be emphasized. The behaviour of the errors among different wet/dry categories showed that both indices were only capable of representing drought and floods in a similar probabilistic way within the range [−2.0 : 2.0]. This feature supports our decision to emphasize model performances within such range.
Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia

Objectives Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables. Design Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis. Results The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%–73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas. Conclusions The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia.
etecting overlapped functional clusters in resting state fMRI with Connected terative Scan : A graph theory based clustering algorithm

The brain is a complex neural network with interleaving functional connectivity among anatomical regions. However, current functional parcellation algorithms usually emphasize independence or orthogonality between the spatial components, with the interleaving nature underrepresented. This study investigates a method, Connected Iterative Scan (CIS), for identifying functionally overlapped anatomical groups with resting state fMRI. CIS iteratively optimizes a grouping of vertexes in a weighted graph, using a density metric computed based on the input and output weights of a candidate cluster. In this study, CIS is able to detect the overlapped clusters in a simulated dataset. CIS also detects that the default mode network and the task positive network, which were known as two anti-correlated networks, are raph theory rain network ub overlapped at the posterior cingulate cortex and the lateral parietal cortex. CIS also detects the conventional functional clusters in the whole brain neural network (e.g., the visual cluster, the motor cluster, the frontal cluster, etc.), as well as meaningful overlaps, and also revealed the possible existence of an emotional memory functional cluster. CIS was able to identify several hub regions actively participating in many clusters. With the ability to reveal overlapping functional clusters, CIS is potentially useful in revealing the delicate architecture of the brain neural network.
A supervised strategy for deep kernel machine

This paper presents an alternative to the supervised KPCA based approach for learning a Multilayer Kernel Machine (MKM) (1). In our proposed procedure, the hidden layers are learnt in a supervised fash- ion based on kernel partial least squares regression. The main interest resides in a simplified learning scheme as the obtained hidden features are automatically ranked according to their correlation with the target out- puts. The approach is illustrated on small scale real world applications and shows compelling evidences.
How could pathologists improve the initial diagnosis of colitis? Evidence from an international workshop

Background: The taking of multiple colorectal biopsies is in widespread use although there is little research into their benefit for the pathological diagnosis of inflammatory bowel disease. There is also still debate about appropriate morphological criteria for interpreting these biopsies. Aims: To determine the effect of single versus multiple biopsies on the accuracy of diagnosis and to study the accuracy and reproducibility of the different criteria used in the diagnosis of multiple biopsies by expert and non-expert pathologists. Method: Thirteen expert and 12 non-expert international diagnostic histopathologists attended a workshop. Sixty cases with full follow up were viewed, blinded, in two rounds. Diagnoses were made on rectal biopsies and then full colonoscopic series. Results: Experts correctly identified 24% of Crohn’s disease cases (non-experts, 12%) from the rectal biopsies. This improved to 64% (non-experts, 60%) with the full series. The accuracy of the diagnosis of ulcerative colitis also improved slightly with the full series from 64% to 74% overall. Experts had a similar (moderate) level of agreement and accuracy to non-experts. For Crohn’s disease, the likelihood ratios (LR) for the most important individual features were 12.4 for granulomas and 3.3 for focal or patchy inflammation. Features favouring ulcerative colitis were diffuse crypt architectural irregularity (LR, 3.4), general crypt epithelial polymorphs (LR, 3.7), and reduced crypt numbers (LR, 2.9). Conclusions: A full colonoscopic series gave more accurate diagnosis than a rectal biopsy. Accurate pathologists used the same evidence based criteria for multiple biopsies as for single biopsies.