Miracle-dz/UniFAR-FTUs huggingface dataset:
Collagen scar formation after acute myocardial infarction: relationships to infarct size, left ventricular function, and coronary artery patency.

BACKGROUND Left ventricular function after acute myocardial infarction (AMI) is determined by the expansion of the infarct zone and remodeling of the noninfarcted myocardium. An occluded infarct-related artery (IRA) is an independent risk factor for remodeling. METHODS AND RESULTS Changes in myocardial collagen metabolism were evaluated in 36 patients with suspected AMI. The plasma creatine kinase MB fraction and myoglobin release curves were analyzed for assessment of early reperfusion and infarct size. Collagen scar formation was evaluated by measurement of serum concentrations of the aminoterminal propeptide of type III procollagen (PIIINP), the aminoterminal propeptide of type I procollagen (intact PINP), and the carboxyterminal propeptide of type I procollagen (PICP). Plasma renin activity and urine excretion of cortisol and aldosterone were also measured. Coronary angiography and left ventricular cineangiography were performed during early hospitalization. The serum concentration of PIIINP increased from 3.50+/-0.20 to a maximum of 5.08+/-0.36 microg/L (n=32) in the patients with AMI, whereas the concentrations of intact PINP and PICP tended to decrease. The area under the curve (AUC) of PIIINP during the first 10 postinfarction days was larger in patients with severe heart failure or ejection fractions < or = 40% than in those with no heart failure or with an ejection fraction > 40% (P<.05 and P<.01, respectively), and it was also larger in the patients with TIMI grade 0 to 2 flows than in those with TIMI 3 flows (P<.05), despite similar enzymatically determined infarct sizes. No significant correlations between PIIINP and neurohumoral parameters were observed. The AUC of PIIINP and the change in PIIINP during the first 4 days were significantly correlated with indices of cardiac function. CONCLUSIONS Collagen scar formation after AMI can be quantified by measurement of serum PIIINP concentrations. Scar formation is more prominent in large infarctions causing left ventricular dysfunction and in patients with occluded IRAs.
Beyond LATE with a Discrete Instrument

We show how a discrete instrument can be used to identify the marginal treatment effects under a functional structure that allows for treatment heterogeneity among individuals with the same observed characteristics and self-selection based on the unobserved gain from treatment. Guided by this identification result, we perform a marginal treatment effect analysis of the interaction between the quantity and quality of children. Our estimates reveal that the family size effects vary in magnitude and even sign and that families act as if they possess some knowledge of the idiosyncratic effects in the fertility decision.
A Short Pediatric Crohn’s Disease Activity Index for Quality Improvement and Observational Research

Background— Practical and objective instruments to assess pediatric Crohn’s disease (CD) activity are required for observational research and quality improvement. Objectives— 1) To determine the feasibility of completing the Pediatric Crohn’s Disease Activity Index (PCDAI) and the Abbreviated PCDAI (APCDAI), and 2) To create a short PCDAI by retaining and re-weighting the most practical and informative components. Methods— Physicians in the ImproveCareNow Collaborative for pediatric inflammatory bowel disease (IBD) were asked to record components of the PCDAI and assign a Physician Global Assessment (PGA) of disease severity at each patient encounter. We assessed the feasibility of the PCDAI, the APCDAI, and the individual index components by determining the proportion of visits in which data were recorded. We created a short index by retaining and reweighting components of the PCDAI completed in ≥ 80% of visits. The feasibility of the short PCDAI and its ability to discriminate between PGA categories were evaluated using descriptive statistics. Results— This study population included 1355 subjects with CD (6373
Perindopril-Based Blood Pressure–Lowering Reduces Major Vascular Events in Patients With Atrial Fibrillation and Prior Stroke or Transient Ischemic Attack

Background and Purpose— Patients with atrial fibrillation have a high risk of stroke and other vascular events even if anticoagulated. The primary objective here is to determine whether routine blood pressure–lowering provides additional protection for this high-risk patient group. Methods— This study was a subsidiary analysis of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS)—a randomized, placebo-controlled trial that established the beneficial effects of blood pressure–lowering in a heterogeneous group of patients with cerebrovascular disease. A total of 6105 patients were randomly assigned to either active treatment (2 to 4 mg perindopril for all participants plus 2.0 to 2.5 mg indapamide for those without an indication for or a contraindication to a diuretic) or matching placebo(s). Outcomes are total major vascular events, cause-specific vascular outcomes, and death from any cause. Results— There were 476 patients with atrial fibrillation at baseline, of whom 51% were taking anticoagulants. In these patients, active treatment lowered mean blood pressure by 7.3/3.4 mm Hg and was associated with a 38% (95% confidence interval [CI], 6 to 59) reduction in major vascular events and 34% (95% CI, −13 to 61) reduction in stroke. The benefits of blood pressure–lowering in patients with atrial fibrillation were achieved irrespective of the use of anticoagulant therapy (P homogeneity=0.8) or the presence of hypertension (P homogeneity=0.4). Conclusions— For most patients with atrial fibrillation, routine blood pressure–lowering is likely to provide protection against major vascular events additional to that conferred by anticoagulation.
Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities

BACKGROUND/INTRODUCTION In this study, we investigated intellectual disability support professionals' knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use. METHODS Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate. RESULTS A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training. CONCLUSIONS To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.
ACE-I and ARBs in early diabetic nephropathy

Introduction Antihypertensive treatment of patients with clinical manifestations of diabetic nephropathy, and especially, renin-angiotensin system (RAS) inhibition, slows, but may not fully arrest progression towards end-stage renal disease. Studies using `hard' endpoints such as doubling of serum creatinine, dialysis, or death that are initiated before emergence of any renal functional abnormalities in diabetes, would be of impractical length and size. We therefore undertook a primary prevention study (The Renin-Angiotensin System Study or RASS) to determine if inhibition of the RAS could slow the development of a key diabetic glomerulopathy structural endpoint, increase in mesangial fractional volume (Vv[Mes/glom]). Methods This is a parallel group, double-blind, placebo-controlled trial with 285 patients with Type 1 diabetes mellitus (95 per group) randomised to receive the angiotensin-converting enzyme inhibitor, enalapril, the angiotensin II receptor blocker, losartan, or placebo. All patients are normotensive, normoalbuminuric and have normal or increased glomerular filtration rates at study entry. The study is based on primary endpoint of change in Vv(Mes/glom) from baseline to the five-year renal biopsy, with baseline and interval measures of albumin excretion rate, glomerular filtration rate, blood pressure, and glycaemia. Baseline, mid-point, and five-year retinal fundus photography are also performed. Results One thousand and sixty-five patients were interviewed, 707 refused participation and 73 were excluded. The target of 285 subjects were randomised and their clinical and demographic characteristics are described. Biopsy complications occurred in 17 (6%), only one of which required hospitalisation. There were no permanent biopsy-related sequelae. Conclusions Renal structural variables are reasonable surrogate endpoints for studies of progression of early diabetic nephropathy. Although requiring substantial recruitment effort, diabetic nephropathy primary prevention trials based on change in renal structure are feasible.
THE ARTS AS A VEHICLE TO SCHOOL LITERACY

The intervention described here was based on the use of the arts as a vehicle for learning (i.e., for enhancing literacy across the curriculum) and as a means of increasing school attractiveness. It was an intervention implemented in the framework of the European Union Program “Education of Roma Children in the Regions of Central Macedonia, Western Macedonia, Eastern Macedonia and Thrace” (2010-2015). The intervention was designed primarily to establish collaboration, so that the class could become a learning community engaging all students, Roma and non-Roma, in quality, attractive activities that meant to build on their resources and create cross-cultural interactions for purposeful and meaningful learning. Curricular goals and thematic units were approached through drama, music, environmental education, dance and movement. Activities were created for the whole class and facilitated by the class teacher and the team of artists. These differentiated educational approaches contributed to the improvement of the learning environment. An added benefit was that through their collaboration with the artist facilitators of the activities, classroom teachers were exposed to innovative and effective teaching practices.
BAX protein expression and clinical outcome in epithelial ovarian cancer.

PURPOSE Expression of the pro-apoptotic protein BAX sensitizes ovarian cancer cell lines to paclitaxel in vitro by enhancing the pathway of programmed cell death. The present study was performed to determine the relationship between BAX expression and clinical outcome in 45 patients with newly diagnosed ovarian cancer. METHODS BAX protein expression was analyzed by immunohistochemistry, and its relationship with clinical outcome was determined. Assessment of BAX mRNA transcript levels and mutational analysis of the BAX coding region were also performed. RESULTS BAX protein was expressed at high levels (defined as > or = 50% of tumor cells positive) in tumor tissue from 60% of newly diagnosed patients. All patients whose tumors expressed high levels of BAX achieved a complete response (CR) to first-line chemotherapy that contained paclitaxel plus a platinum analogue, compared with 57% of patients in the low-BAX group (P = .036). After a median follow-up of 1.9 years, the median disease-free survival (DFS) of patients in the high-BAX group has not been reached, compared with a median DFS of 1.1 years for low-BAX expressors (P = .0061). BAX retained independent prognostic significance in multivariate analysis when corrected for stage and histology. BAX mRNA transcripts were easily detected in samples with low BAX protein expression, and no BAX mutations were identified. CONCLUSION The correlation between high BAX levels and improved clinical outcome suggests that an intact apoptotic pathway is an important determinant of chemoresponsiveness in ovarian cancer patients who receive paclitaxel.
Ethyl Glucuronide for Detecting Alcohol Lapses in Patients With an Alcohol Use Disorder

Urine ethyl glucuronide (EtG) was screened in 75 patients during a hospital-based treatment for an alcohol use disorder. During follow-up, EtG was detected in 35 (14.6%) of the 239 urine samples. Positive screens were found in 22 patients (29%), of whom nine were outpatients (39.1% of all outpatients) and 13 inpatients (25.0% of all inpatients). Of the 22 patients with positive EtG, five (22%) also gave a positive breath alcohol test and 10 (45.5%) reported recent alcohol consumption; 12 (54.5%) gave a negative breath alcohol test and declared no alcohol lapse. Ethyl glucuronide has been found useful in detecting covered lapses.
Effectiveness of the VOICES/VOCES Sexually Transmitted Disease/Human Immunodeficiency Virus Prevention Intervention When Administered by Health Department Staff: Does It Work in the “Real World”?

Background: Prevention providers wonder whether benefits achieved in the original, researcher-led, efficacy trials of interventions are replicated when the intervention is delivered in real-world settings by their agency's staff. Methods: A replication study was conducted at 2 public sexually transmitted disease (STD) clinics (New York City and San Juan, PR). Using a controlled trial design, intervention (VOICES/VOCES) and comparison conditions (regular clinic services) were assigned in alternating 4-week blocks. Trained agency staff delivered the intervention. Effectiveness was assessed for incident STDs, redemption of coupons for condoms at neighborhood location after the visit, and improved knowledge and attitudes about STDs and condoms. Results: A total of 3365 patients were recruited, completed the protocol, and followed through STD surveillance systems for an average of 17 months. Of 397 with an incident infection, 226 (13.4%) were among those enrolled during comparison blocks; 171 were among those in the intervention condition (10.2%). Controlling for site and gender, participants enrolled during intervention blocks were significantly less likely to have an incident STD reported to the surveillance system (hazard ratio, 0.78; 95% confidence interval, 0.64–0.96). Intervention block participants scored higher on scales of STD knowledge (4.89 vs. 3.87, P < 0.001) and condom knowledge, attitude, and efficacy (10.98 vs. 9.16, P < 0.001). More of those exposed to VOICES/VOCES redeemed condoms (P < 0.05). Positive effects were more consistent in New York, which may be related to fidelity of implementation. Conclusions: A packaged human immunodeficiency virus prevention intervention can be delivered by agencies, with benefits similar to those achieved in the research setting.
An evaluation of the equilibrium value of the euro, its predecessors and their constituent currencies based on economic fundamentals

ABSTRACT This study presents constructed equilibrium exchange rates (EERs) of the euro and its predecessors the European Unit of Account and the European Currency Unit, as well as the euro’s member states using a relative version of purchasing power parity (PPP) equilibrium. The revealed patterns of over- and undervaluation demonstrate how well suited the northern member states, in contrast to the southern states, were for the monetary union. Moreover, a relative persistent overvaluation for Greece and Portugal suggests that their ambition to join the euro reduced their competitiveness. The constructed EERs of the euro suggest the European Commission was able to set the initial value of the euro with a high degree of accuracy. Furthermore, the EERs indicate a successive strengthening of the fundamental value of the euro versus the U.S. dollar from 1999 to 2015. The analysis shows a close correlation between the deviations from equilibrium and the events of Greece’s sovereign debt crisis. In addition, the presented graphs show strong support for the PPP hypothesis. The results are robust to different constructed EERs and offer a guide to international market participants interested in the general equilibrium path of the euro and its predecessors.
Psychometric properties of the satisfaction with life scale (SWLS) in Iranian infertile women

Background: Infertility is a global public health issue and may adversely affect life satisfaction. One of the most widely instruments used to assess life satisfaction is the Satisfaction with Life Scale (SWLS). Objective: The objective of this study was to examine the psychometric properties of the SWLS in Iranian infertile women. Materials and Methods: In this descriptive cross-sectional study, a total of 125 infertile women referring to Royan Institute in Tehran were selected by convenience sampling method. The participants were administered the SWLS, the Hospital Anxiety and Depression Scale (HADS), and a demographic questionnaire. The psychometric properties of the SWLS were examined: construct validity using confirmatory factor analysis (CFA), reliability using Cronbach’s alpha and convergent validity by examining the relationship with HADS. Result: Results of the CFA indicated that a single-factor model provides a good fit to the data (χ2/df= 1.58; GFI= 0.975; CFI= 0.995; NFI= 0.985; RMSEA= 0.069 and SRMR= 0.027). The Cronbach’s alpha coefficient for SWLS was 0.887. Significant negative correlations were found between SWLS and HADS scores for anxiety (r= -0.410) and depression (r= -0.434), indicating an acceptable convergent validity. Conclusion: The SWLS has adequate psychometric properties for assessing life satisfaction in Iranian infertile women.
Ferroportin gene silencing induces iron retention and enhances ferritin synthesis in human macrophages

Missense mutations in the ferroportin gene (SLC11A3) result in haemochromatosis type 4 [HFE4, Online Mendelian Inheritance in Man (OMIM) reference 606069] or ferroportin disease, an autosomal dominant disorder characterized by predominantly reticuloendothelial iron accumulation. To verify whether HFE4 is caused by defective iron recycling because of loss of functionality of ferroportin, we down‐regulated SLC11A gene expression in human macrophages by using small interfering RNAs (siRNAs). Transfection experiments with ferroportin siRNAs resulted in a marked reduction (about two‐thirds on average) in ferroportin mRNA levels as detected by quantitative real time polymerase chain reaction. When macrophages were grown in medium supplemented with iron, cells transfected with siRNAs displayed three‐ to eightfold increases in staining intensities following Perls reaction. These macrophages also showed significant increases in H‐ferritin content. The observation that ferroportin mRNA down‐regulation to levels compatible with haplo‐insufficiency causes increased iron retention and H‐ferritin synthesis in cultured macrophages has important implications. First, this indicates that ferroportin levels must be finely regulated in order to maintain cellular iron homeostasis, and that both copies of SLC11A3 must function efficiently to prevent iron accumulation. Second, this observation supports the hypothesis that reticuloendothelial iron overload in patients with ferroportin disease is caused by loss‐of‐function mutations in the SLC11A3 gene that mainly impair macrophage iron recycling.
Interprofessional education: the interface of nursing and social work.

AIMS To examine the influence of interdisciplinary seminars on undergraduate nursing and social work students' perceptions of their learning. BACKGROUND Collaboration is considered to be important for health professionals in working towards good patient care, and interdisciplinary education is seen as one way of addressing this need for greater collaboration and team work. Today's health professionals are dealing with an increasing number of older and chronically ill patients. The biopsychosocial dimensions inherent in such chronic illnesses bring about a closer working relationship between the nursing and social work professions to foster good patient care. No local research in Hong Kong, however, has looked specifically at how these two professions can develop their collaborative skills and qualities through interdisciplinary education. DESIGN Mixed methods design. METHOD Data from questionnaires, videotape recordings of the sessions and follow-up phone interviews were used for quantitative and qualitative analyses. RESULTS The findings revealed three themes: an increased awareness of each other's professional values and personal judgement, a recognition of each other's disciplinary knowledge emphases and more, and an appreciation for, and learning about each other's roles for future collaboration. CONCLUSIONS Whilst, it is usual to identify health professionals as non-judgemental, it is also important to recognise the existence of their personal and professional values and beliefs that shape their decision-making. Equally beneficial for students is their reported understanding of the other discipline's emphasis on the physical or social aspects of care, and the interrelationships and complementary values that lead to students' appreciation of each other's roles and the possibility for their future collaboration in the holistic care of patients. RELEVANCE TO CLINICAL PRACTICE The sharing of each other's knowledge and their appreciation of the corresponding roles enhanced students' decision-making capacity and the extension of the holistic approach beyond one profession, which is essential for good patient care.
T cells in organ ischemia reperfusion injury

Purpose of reviewIschemia and reperfusion injuries occur in multiple clinical settings and contribute to organ dysfunction/failures. Despite the innate inflammatory immune nature, T cells that are critically involved in the pathogenesis of ischemia reperfusion injury (IRI), include not only CD4+ T cells, but also CD8+ and &ggr;&dgr;T cells. This review focuses on questions of how putative Ag-specific T cells are involved, which include whether they function in an Ag-dependent manner; how they function, cytokine-mediated or costimulatory molecule-mediated mechanisms; and whether different T-cell subsets, Th1, Th17, regulatory T cell (Treg), are all involved and play distinctive roles? Recent findingsSpecific T-cell populations, such as effector memory CD4 T cells, promote inflammatory immune activation by ischemia reperfusion independent of their adaptive properties, that is Ag-independently. They function by secreting cytokines and expressing costimulatory molecules to either promote or inhibit innate immune activation, or facilitate tissue repair/homeostasis, as exemplified by Th1, Th17 or Th2, Treg cells, respectively. SummaryT-cell-targeted therapies need to be refined with strategies to maximally eliminate the proinflammatory but spare the anti-inflammatory/immune regulatory properties of T cells, for future clinical application to ameliorate IRI.
The impact of interest group diversity on legal implementation in the European Union

ABSTRACT Do interest groups have an impact on transposition of European Union (EU) directives? This paper offers an analysis of interest group communities of member states and links the concept of diversity to legal implementation. In order to accommodate diverse interests, member state governments allow for some deviations when transposing EU legislation into national law. Therefore, successful transposition is hard to achieve in member states with diverse interest group environments. This paper tests this argument by applying a large N study including 19 directives and 15 member states. The results show that correct transposition is likely to be negatively affected by high levels of diversity of national interest groups; however, this effect is conditional on the discretion granted to member states by EU legislation.