Miracle-dz/UniFAR-FTUs huggingface dataset:
Mentholated cigarettes and smoking cessation: findings from COMMIT

Objective: To examine the association between the use of menthol cigarettes and smoking cessation, amount smoked, and time to first cigarette in the morning. Background: The majority of African American smokers smoke mentholated cigarettes. Some evidence suggests that African Americans may be more nicotine dependent than whites. One theory is that menthol in cigarettes is responsible for enhancing the dependence producing capacity of cigarettes; however, few studies have prospectively examined the association between menthol use and indicators of nicotine dependence. Methods: Baseline smokers from the Community Intervention Trial for Smoking Cessation (COMMIT) completed a telephone tobacco use survey in 1988 and were re-interviewed in 1993. Use of mentholated cigarettes was assessed by self report at baseline. Indicators of dependence examined were six month cessation in 1993, amount smoked among continuing smokers in 1993, and time to first cigarette in the morning in 1988. Multivariate regression techniques were used to assess the association of baseline menthol use with these outcomes while controlling for other factors related to dependence. Results: Overall, 24% of the sample smoked a mentholated brand in 1988. No consistent associations were observed for menthol use and indicators of dependence in both overall and race specific analyses. Factors significantly associated with increased menthol use were female sex, age 25–34 years, African American and Asian race/ethnicity, greater education, greater than 60 minutes to the first cigarette in the morning, two or more past quit attempts, and use of premium brand cigarettes. Canadian respondents and those who smoked 15–24 cigarettes per day had lower rates of menthol use. Use of mentholated cigarettes was not associated with quitting, amount smoked, or time to first cigarette in the morning. Conclusion: Future work is needed to clarify the physiological and sociocultural mechanisms involved in mentholated cigarette smoking.
Influence of amino‐acid polymorphism in the core protein on progression of liver disease in patients infected with hepatitis C virus genotype 1b

The substitution of amino acid (aa) 70 of arginine for glutamine and/or that of aa91 of leucine for methionine in the core protein in patients infected with hepatitis C virus (HCV) genotype 1b is associated with a poor response to pegylated interferon and ribavirin. Factors influencing these substitutions were sought in 1,097 patients infected with HCV‐1b who had not received antiviral treatment. HCV variants with Arg70 and Leu91 (wild‐type) decreased, while those with Gln70 and/or Met91 (mutant types) increased with age (P < 0.001). Of the 1,097 patients, 464 (42.3%) were infected with the Gln70 variant and the remaining 633 patients with the Arg70 variant. The proportion of patients with the Gln70 variant increased with the severity of liver disease (P < 0.001), elevated γ‐glutamyl transpeptidase (γ‐GTP) levels (P < 0.001) and a decrease in platelet count (P = 0.008). In univariate analysis patients with hepatocellular carcinoma, elevated aspartate aminotransferase (AST ≥ 58 IU/L) and γ‐GTP (≥61 IU/L), and decreased albumin levels (<3.9 g/dl) were more frequent in the patients with the Gln70 variant than the Arg70 variant (P = 0.003, 0.005, <0.001, and 0.031, respectively). In multivariate analysis HCC (odds ratio 1.829 [95% confidence interval 1.147–2.917]) and γ‐GTP ≥61 IU/L (1.647 [1.268–2.139]) increased the risk for the Gln70 variant. In conclusion, the substitution of amino aa70 of Arg for Gln in patients infected with HCV‐1b increases with age, and it is associated with severe liver disease accompanied by elevated AST and γ‐GTP levels, as well as the development of hepatocellular carinoma. J. Med. Virol. 82:41–48, 2010. © 2009 Wiley‐Liss, Inc.
Scoring the Current Risk Stratification Guidelines in Follow-up Evaluation of Patients After Metal-on-Metal Hip Arthroplasty: A Proposal for a Metal-on-Metal Risk Score Supporting Clinical Decision-Making.

BACKGROUND In the follow-up evaluation of patients with metal-on-metal (MoM) hip replacements, current evidence suggests that orthopaedic surgeons should avoid reliance on any single investigative tool. Current risk stratification guidelines can be difficult to interpret because they do not provide guidance when there are several risk factors in different groups (high and low risk). To improve the clinical utility of risk stratification guidelines, we designed a scoring system to assess the risk of revision. METHODS The study population consisted of 1,709 patients (1,912 hips) enrolled in a multicenter follow-up study of a recalled MoM hip replacement. Eleven scoring criteria were determined on the basis of existing follow-up algorithm recommendations and consisted of patient-related factors, symptoms, clinical status, implant type, metal ion levels, and radiographic imaging results. Forward stepwise logistic regression was conducted to determine the minimum set of predictive variables for the risk of revision and to assign variable weights. The MoM risk score for each hip was then created by averaging the weighted values of each predictive variable. RESULTS Receiver operating characteristic curve analysis yielded good discrimination between all revised and unrevised hips, with an area under the curve of 0.82 (p < 0.001). The odds of revision for the group with a high MoM risk score were increased by 5.8-fold (95% confidence interval [CI], 3.1 to 11.0) relative to the moderate risk group and by 21.8-fold (95% CI, 9.9 to 48.0) compared with the low risk group. CONCLUSIONS Although the use of MoM hip arthroplasty has been limited since 2010, we continue to be faced with the follow-up and risk assessment of thousands of patients who have not had a revision. As more knowledge about risk stratification is gained, the complexity of the algorithms is expected to increase. We propose the use of the MoM risk score as a tool to aid in the clinical decision-making process. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Estradiol’s Salutary Effects on Keratinocytes Following Trauma-Hemorrhage Are Mediated by Estrogen Receptor (ER)-α and ER-β

Although administration of 17β-estradiol (estrogen) following trauma-hemorrhage attenuates the elevation of cytokine production and mitogen-activated protein kinase (MAPK) activation in epidermal keratinocytes, whether the salutary effects of estrogen are mediated by estrogen receptor (ER)-α or ER-β is not known. To determine which estrogen receptor is the mediator, we subjected C3H/HeN male mice to trauma-hemorrhage (2-cm midline laparotomy and bleeding of the animals to a mean blood pressure of 35 mmHg and maintaining that pressure for 90 min) followed by resuscitation with Ringer’s lactate (four times the shed blood volume). At the middle of resuscitation we subcutaneously injected ER-α agonist propyl pyrazole triol (PPT; 5 µg/kg), ER-β agonist diarylpropionitrile (DPN; 5 µg/kg), estrogen (50 µg/kg), or ER antagonist ICI 182,780 (150 µg/kg). Two hours after resuscitation, we isolated keratinocytes, stimulated them with lipopolysaccharide for 24 h (5 µg/mL for maximum cytokine production), and measured the production of interleukin (IL)-6, IL-10, IL-12, and TNF-α and the activation of MAPK. Keratinocyte cytokine production markedly increased and MAPK activation occurred following trauma-hemorrhage but were normalized by administration of estrogen, PPT, and DPN. PPT and DPN administration were equally effective in normalizing the inflammatory response of keratinocytes, indicating that both ER-α and ER-β mediate the salutary effects of estrogen on keratinocytes after trauma-hemorrhage.
De-escalation: A survey of clinical staff in a secure mental health inpatient service.

De-escalation is an important tool for preventing aggression in inpatient settings but definitions vary and there is no clear practice guideline. We aimed to identify how clinical staff define and conceptualize de-escalation, which de-escalation interventions they would use in aggressive scenarios, and their beliefs about the efficacy of de-escalation interventions. A questionnaire survey (n = 72) was conducted using open and closed questions; additionally, clinical vignettes describing conflict events were presented for participants to describe their likely clinical response. Qualitative data were subject to thematic analysis. The major themes that de-escalation encompassed were communication, tactics, de-escalator qualities, assessment and risk, getting help, and containment measures. Different types of aggression were met with different interventions. Half of participants erroneously identified p.r. n. medication as a de-escalation intervention, and 15% wrongly stated that seclusion, restraint, and emergency i.m. medication could be de-escalation interventions. Those interventions seen as most effective were the most commonly used. Clinical staff's views about de-escalation, and their de-escalation practice, may differ from optimal practice. Use of containment measures and p.r. n. medication where de-escalation is more appropriate could have a negative impact; work is needed to promote understanding and use of appropriate de-escalation interventions based on a clear guideline.
Rectal tuberculosis after infliximab therapy despite negative screening for latent tuberculosis in a patient with ulcerative colitis

Tumor necrosis factor-α inhibitors are now considered as standard therapy for patients with severe inflammatory bowel disease who do not respond to corticosteroids, but they carry a definite risk of reactivation of tuberculosis. We present a case in which a patient with inflammatory bowel disease developed a de novo tuberculosis infection after the start of anti-tumor necrosis factor-α treatment despite showing negative results in tuberculosis screening. Although there are many case reports of pleural, lymph nodal and disseminated tuberculosis following infliximab therapy, we present the first case report of rectal tuberculosis following infliximab therapy.
Health issues in the Arab American community. Tobacco use patterns among high school students: do Arab American youth differ?

OBJECTIVE To determine tobacco use rates (cigarette, water pipe smoking [WPS] or narghile) in Arab American compared to non-Arab youth. DESIGN/SETTING A convenience sample of 2,782 14- to 18-year-old high school students from a midwest community completed a 21-item tobacco use history survey. RESULTS Seventy-one percent of the participants were ArA. Grades 9 through 12 were equally represented. Results included 'ever tried cigarettes [narghile]' (20%, 39%); 'smoked cigarettes [narghile] in the past 30 days' (7%, 22%); and 'regular smoking [narghile]' (3%, 15%) for ArA and non-Arab youths, respectively. Each was significantly related to grade and ethnicity. WPS for ArA and non-Arab youths was (38%, 21%); (17%, 11%); and (7%, 5%) for 'ever used,' 'used in the past 30 days,' and 'regular use,' respectively. Grade, ethnicity, and sex were significantly related to WPS. CONCLUSIONS Cigarette smoking rates for non-Arab youth were lower than current national youth smoking rates but significantly higher than ArA youth. Rates for ArA youth were much lower than current national reported data. Rates of WPS for US youth, regardless of race or ethnicity, are not known. Findings from this study indicate that both ArA and non-Arab youth are experimenting and using WPS regularly. These results underscore the importance of assessing novel forms of tobacco use, particularly WPS, a growing phenomenon among US youth.
Determinants of hopelessness and depression among Chinese hospitalized esophageal cancer patients and their family caregivers

It has been well documented that the diagnosis of cancer is psychologically devastating to both the patients and caregivers. The incidence and mortality of esophageal cancer were 20.85 and 16.24 per 100,000 persons and the sixth most commonly diagnosed cancer and the fourth main cause of cancer death in China. We surveyed patients–caregivers dyad and examined the determinants of their depression and hopelessness.
The effect of estrogen vs. combined estrogen‐progestogen therapy on the risk of colorectal cancer

Studies suggest that estrogen therapy (ET) and combined estrogen‐progestogen therapy (EPT) may have different associations with colorectal cancer (CRC) risk, but data are conflicting. Prior meta‐analyses did not distinguish between ET and EPT. We conducted a meta‐analysis to summarize the relative risks (RR) of CRC due to ET versus EPT among peri‐ or postmenopausal women. From a total of 2,661 articles, four randomized controlled trials, eight cohort and eight case‐control studies were included. Variables assessed included study characteristics, duration and recency of menopausal hormone therapy (HT) use, method of assessment of HT use, outcome definition and its ascertainment method. RRs were synthesized by random‐effects models. We found that EPT ever use was associated with a decreased risk of CRC (RR 0.74, 95% CI 0.68‐0.81), and so was ET ever use (RR 0.79, 95% CI 0.69‐0.91). While current use of ET was associated with a significantly reduced risk of CRC (RR 0.70, 95% CI 0.57‐0.85), former use was not (RR 0.86, 95%CI 0.67‐1.11). Recency did not significantly modify the association between EPT and CRC risk. EPT former use was associated with a lower RR of CRC compared to ET former use (p = 0.008) but no such difference was observed between EPT and ET current use (p = 0.12). Overall, we found consistent evidence supporting the association between EPT and CRC risk reduction, regardless of recency. While literature for the association between ET and CRC risk is heterogeneous, our analyses suggest only current use of ET is associated with a decreased CRC risk.
Medical Informatics Training at Stanford University School of Medicine

Abstract: Stanford University School of Medicine has offered graduate degrees in medical informatics since 1982. Located approximately 50 kilometers south of San Francisco near the city of Palo Alto, the university offers both MS and PhD degrees, combining research training with formal course requirements in clinical information sciences, bioinformatics, computer science, decision science, basic biomedicine, health economics, and social and ethical issues. Requirements are adapted to the varying backgrounds of trainees. Graduates of the program work in a variety of capacities, although the majority have sought careers in academia or in industrial research settings.
Trends in HIV testing among pregnant women: United States, 1994-1999.

OBJECTIVES This study evaluated 1995 guidelines for HIV testing of pregnant women. METHODS Analysis focused on Behavioral Risk Factor Surveillance System data for the years 1994 through 1999. Data were aggregated across states. RESULTS Percentages of pregnant women tested for HIV increased from 1995 to 1996 (from 41% to 53%) and again from 1997 (52%) to 1998 (60%). CONCLUSIONS After implementation of the guidelines, the percentage of pregnant women tested for HIV increased, although nearly half had not been tested. More efforts are needed to encourage women to undergo testing for HIV during pregnancy, thus maximizing opportunities for offering antiretroviral therapy.
The hierarchy of work pursuits of public health managers

How public health is managed in various settings is an important but under-examined issue. We examine themes in the management literature, contextualize issues facing public health managers and investigate the relative importance placed on their various work pursuits using a 14-activity management model empirically derived from studies of clinician-managers in hospitals. Ethnographic case studies of 10 managers in nine diverse public health settings were conducted. The case study accounts of managers' activities were content analysed, and substantive words encapsulating their work were categorized using the model. Managerial activities of the nine public health managers were ranked according to the number of words describing each activity. Kendall's coefficient of concordance yielded W = 0.710, P < 0.000, revealing significant similarity between the activity patterns of the public health managers. A rank order correlation between the activity patterns of the average ranks for the public health sample and for the hospital clinician-managers (n = 52) was R = 0.420, P = 0.131, indicating no significant relationship between relative activity priorities of the two groups. Public health managers put less emphasis on pursuits associated with structure, hierarchy and education, and more on external relations and decision-making. The model of hospital clinician-managers' managerial activities is applicable to public health managers while identifying differences in the way the two groups manage. The findings suggest that public health management work is more managerialist than previously thought.
The frequency of the sickle allele in Jamaica has not declined over the last 22 years

The ‘malaria hypothesis’ predicts that the frequency of the sickle allele, which is high in malaria‐endemic African populations, should decline with each generation in populations of African descent living in areas where malaria is no longer endemic. In order to determine whether this has been the case in Jamaica, we compared haemoglobin electrophoresis results from two hospital‐based screening programmes separated by more than 20 years (i.e. approximately one generation). The first comprised 100 000 neonates screened between 1973 and 1981, the second, 104 183 neonates screened between 1995 and 2003. The difference in frequency of the sickle allele was small (5·47% in the first cohort and 5·38% in the second screening cohort) and not significant (Z = 1·23, P = 0·22). The same was true of the sickle trait frequency (10·05% in the first cohort and 9·85% in the second, Z = 1·45, P = 0·15). These differences were smaller than predicted under simple deterministic models based on the malaria hypothesis, and suggest that these models may not capture important determinants of allele and trait frequency decline (or persistence) in contemporary populations. Refining the expectations for allele and trait frequency change for Jamaica and other similar populations is an area for future study.
Treatment of Chronic Hepatitis C in Patients with End-Stage Renal Disease and Hemophilia – The Singapore Experience

Objective: The aim of this study was to determine the response to treatment with interferon-alpha (IFN-α) in patients with chronic hepatitis C who had end-stage renal disease (ESRD) or hemophilia in Singapore. Methods: Treatment-naive hepatitis patients with ESRD or hemophilia were given IFN-α2a 3 million units three times per week for 12 months in an open-label study. Hepatitis C virus RNA was determined before treatment, at the end of treatment and 6 months thereafter. Regular clinical examinations including blood counts and biochemistry were carried out during and after the treatment. Results: Nine consecutive patients with ESRD (8 men and 1 woman) and 6 consecutive male patients with hemophilia, with a mean age of 43 and 40 years, received treatment. Patients in both groups were predominantly infected with hepatitis C virus genotype 1 and had significant cytopenia affecting all three cell lines during the treatment; only 1 patient developed serious neutropenia, temporarily demanding a reduction of his IFN dose. Biochemical and virological responses at the end of treatment were accomplished by 8 of the 9 (89%) patients with ESRD and 4 of the 6 (67%) patients with hemophilia; however, 1 patient with ESRD and 2 with hemophilia relapsed after the treatment. Four of the 7 patients with ESRD who had sustained virological response underwent successful kidney transplantation later on. Conclusion: Monotherapy with IFN-α for 12 months is safe for treatment of the patients with chronic hepatitis C who had ESRD or those with hemophilia. A higher sustained virological response rate was observed in patients with ESRD than in those with hemophilia (78 vs. 33%).
Priming, Replication, and the Hardest Science

Concerns have been raised recently about the replicability of behavioral priming effects, and calls have been issued to identify priming methodologies with effects that can be obtained in any context and with any population. I argue that such expectations are misguided and inconsistent with evolutionary understandings of the brain as a computational organ. Rather, we should expect priming effects to be highly sensitive to variations in experimental features and subject populations. Such variation does not make priming effects frivolous or capricious but instead can be predicted a priori. However, absent theories specifying the precise contingencies that lead to such variation, failures to replicate another researcher’s findings will necessarily be ambiguous with respect to the inferences that can be made. Priming research is not yet at the stage where such theories exist, and therefore failures are uninformative at the current time. Ultimately, priming researchers themselves must provide direct replications of their own effects; researchers have been deficient in meeting this responsibility and have contributed to the current state of confusion. The recommendations issued in this article reflect concerns both with the practice of priming researchers and with the inappropriate expectations of researchers who have failed to replicate others’ priming effects.
Lipid peroxidation and protein modification in a mouse model of chronic iron overload.

Iron-storage diseases are believed to cause organ damage through generation of reactive oxygen species. Using a murine model of iron overload, we found that hepatic iron stores increased logarithmically during 3 weeks of chronic intraperitoneal administration of iron dextran, while hepatic glutathione peroxidase activity declined linearly by approximately 50% during the same period. Plasma concentrations of aliphatic aldehydes increased by 2- to 3-fold, and plasma malondialdehyde (MDA) by 6-fold. Modification of total liver protein by products of lipid peroxidation, including MDA-lysine, 4-hydroxynonenal-lysine, and N(epsilon)-(carboxymethyl)lysine (CML), increased by approximately 3-fold, while levels of the protein oxidation marker, methionine sulfoxide (MetSO), were unchanged. Skin collagen was resistant to modification until the third week, when 2- to 3-fold increases in both CML and MetSO were observed. Our results document that iron overload increases lipid peroxidation, with concomitant increases in reactive aldehydes in plasma and chemical modification of tissue proteins. CML was a sensitive indicator of hepatocellular oxidative stress, compared to MetSO, while extensive modification of extracellular skin collagen was not observed until the late stages of iron overload and oxidative stress. These observations provide direct evidence for the contribution of reactive oxygen species, lipid peroxidation, and reactive carbonyl intermediates to the pathogenesis of iron-overload diseases.
Frontal and Lateral Cephalometry in Patients With Sleep‐Disordered Breathing

Objectives/Hypothesis The traditional lateral‐view cephalometric analysis is limited because it provides only two‐dimensional analysis of the three‐dimensional craniofacial structure. The objectives were to analyze lateral and frontal cephalometric radiographs in a series of normal patients and those with varying degrees of sleep‐disordered breathing and to define the degrees of narrowing or other unfavorable anatomical changes that might differentiate the patients with sleep‐disordered breathing from normal subjects.