Miracle-dz/UniFAR-FTUs huggingface dataset:
The transition to medication adoption in publicly funded substance use disorder treatment programs: organizational structure, culture, and resources.

OBJECTIVE Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. METHOD Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. RESULTS Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. CONCLUSIONS Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.
Hippocampal CRF, NE, and NMDA system interactions in memory processing in the rat

In the present study, we investigated the neural mechanisms of corticotropin‐releasing factor (CRF) and the interactions among CRF, norepinephrine (NE), and N‐methyl‐D‐aspartate (NMDA) systems in the dentate gyrus (DG) of hippocampus in modulating the memory process of rats. One‐way passive avoidance task was adopted. Results indicated that CRF (80 ng), when directly injected into the DG, consistently and significantly enhanced memory retention in rats. The noradrenergic neurotoxin DSP‐4, at a high dose (4 μg), impaired memory. DSP‐4 at a moderate dose (2 μg), which did not affect retention alone, antagonized the memory‐enhancing effect of CRF. Similarly, the ß‐adrenergic antagonist propranolol, at a high dose (8 μg), reduced retention. At a low dose (80 ng), which did not markedly affect retention by itself, propranolol also prevented the memory‐improving effect of CRF. Moreover, direct NE infusions to the DG significantly improved retention performance in a dose‐sensitive manner. Coadministration of CRF and NE did not further enhance retention. These results together suggest that CRF and NE facilitated memory probably through the same instead of independent mechanisms. In contrast, the selective NMDA receptor antagonists 2‐amino‐5‐phosphonopentanoate (AP5) and MK801, at high doses markedly impaired memory retention (0. 8 and 3. 2 μg for AP5, 2 and 10 μg for MK801). At a dose of MK801 that did not significantly alter retention alone (80 ng), it completely blocked the memory‐facilitating effect of CRF. These results indicate that CRF enhanced memory indirectly through NMDA receptor mediation also. Finally, MK801 at 80 ng also successfully antagonized the memory‐facilitating effect of NE in the DG. We have demonstrated that MK801, at the dose chosen for interaction studies, did not markedly alter locomotor activity. These results together suggest that CRF, through a presynaptic facilitation mechanism, possibly facilitates NE release in the DG: increased NE release and stimulation of ß‐adrenergic receptors in the DG result in NMDA receptor activations in the same area. This sequence of events enhance the memory consolidation process in the hippocampus and explained the neural mechanism of CRF in facilitating retention performance in rats. The same neuropeptide/neurotransmitter interactions may have other physiological and neuropathological implications. © 1993 Wiley‐Liss, Inc.
Can aluminum‐based binders be used safely?

hyperparathyroidism.Kidney Int 63:1483–1490, 2003 10. London GM, et al.: Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 18:1731–1740, 2003 11. Kovesdy CP, et al.: Secondary hyperparathyroidism is associated with higher mortality in men with moderate to severe chronic kidney disease. Kidney Int 73:1296–1302, 2008 12. Hagstrom E, et al.: Plasma parathyroid hormone and the risk of cardiovascularmortality in the community. Circulation 119:2765–2771, 2009 13. Wolf M, et al.: Impact of activated vitamin D and race on survival among hemodialysis patients. J AmSocNephrol 19:1379–1388, 2008 14. WolfM, et al.: VitaminD levels and earlymortality among incident hemodialysis patients. Kidney Int 72:1004–1013, 2007
Linguistic and Cognitive Effects of Bilingualism with Regional Minority Languages: A Study of Sardinian–Italian Adult Speakers

This study explores the effects of bilingualism in Sardinian as a regional minority language on the linguistic competence in Italian as the dominant language and on non-linguistic cognitive abilities. Sardinian/Italian adult speakers and monolingual Italian speakers living in the same geographical area of Sardinia were compared in two kinds of tasks: (a) verbal and non-verbal cognitive tasks targeting working memory and attentional control and (b) tasks of linguistic abilities in Italian focused on the comprehension of sentences differing in grammatical complexity. Although no difference was found between bilinguals and monolinguals in the cognitive control of attention, bilinguals performed better on working memory tasks. Bilinguals with lower formal education were found to be faster at comprehension of one type of complex sentence (center embedded object relative clauses). In contrast, bilinguals and monolinguals with higher education showed comparable slower processing of complex sentences. These results show that the effects of bilingualism are modulated by type of language experience and education background: positive effects of active bilingualism on the dominant language are visible in bilinguals with lower education, whereas the effects of higher literacy in Italian obliterate those of active bilingualism in bilinguals and monolinguals with higher education.
The Rorschach Suicide Constellation: Assessing Various Degrees of Lethality

In this article we examine the relation between the Rorschach Comprehensive System's Suicide Constellation (S-CON; Exner, 1993; Exner & Wiley, 1977) and lethality of suicide attempts during the course of patients' hospitalization at the Austen Riggs Center (Stockbridge, MA). Patient records were rated as nonsuicidal (n = 37), parasuicidal (n = 37), or near-lethal (n = 30) based on the presence and lethality of self-destructive acts. Diagnostic efficiency statistics utilizing a cutoff score of 7 or more positive indicators successfully predicted which patients would engage in near-lethal suicidal activity relative to parasuicidal patients (overall correct classification rate [OCC] = .79), nonsuicidal inpatients (OCC = .79), and college students (OCC = .89). Although these predictions were influenced by relatively high base rates in the hospital population (14.5%), base rate estimates were calculated for other hypothetical populations revealing different prediction estimates that should be considered when judging the relative efficacy of the S-CON. Logistic regression analysis revealed that an S-CON score of 7 or more was the sole predictor of near-lethal suicide attempts among 9 psychiatric and demographic variables.
Changing pattern of imported cutaneous leishmaniasis in the Netherlands

Cutaneous leishmaniasis (CL) in western countries seems to be appearing more frequently. Our aim was to determine if there has been a shift in countries where CL is acquired and whether the incidence has changed, and to assess current diagnostic procedures and treatment modalities. In a retrospective study medical records of patients with the diagnosis of CL at the Departments of Tropical Dermatology and Tropical Medicine, Academic Medical Center, Amsterdam, the Netherlands, from 1990 to 2000 were analysed. CL was diagnosed in 78 patients. The majority was acquired in Belize, Surinam, French Guyana and Bolivia. Giemsa stains were positive for the parasite in impression smears from 43% and in biopsies from 71%. Seventy‐eight per cent of cases were culture‐positive and 89% were PCR‐positive. Sixty‐two patients were treated systemically: pentavalent antimony (32), pentamidine isetionate (11), itraconazole (19), and 13 locally, the majority with a combination of cryosurgery and intralesional pentavalent antimony. Imported CL is becoming more frequent, with South and Middle American countries being important sources of infection. Multiple tests, of which PCR is the most sensitive, are required to confirm the diagnosis. Systemic treatment was given to the majority of the patients.
Hybrid Vigor and Transgenerational Epigenetic Effects on Early Mouse Embryo Phenotype1

Abstract Mouse embryos display a strain-dependent propensity for blastomere cytofragmentation at the two-cell stage. The maternal pronucleus exerts a predominant, transcription-dependent effect on this phenotype, with lesser effects of the ooplasm and the paternal pronucleus. A parental origin effect has been observed as an inequality in the cytofragmentation rate of embryos produced through genetic crosses of reciprocal F1 hybrid females. To understand the basis for this, we conducted an extensive series of pronuclear transfer studies employing different combinations of inbred and F1 hybrid maternal and paternal genotypes. We find that the parental origin effect is the result of a transgenerational epigenetic modification, whereby the inherited maternal grandpaternal contribution interacts with the fertilizing paternal genome and the ooplasm. This result indicates that some epigenetic information related to grandparental origins of chromosomes (i.e., imprinting of chromosomes in the mother) is retained through oogenesis and transmitted to progeny, where it affects gene expression from the maternal pronucleus and subsequent embryo phenotype. These results reveal for the first time that mammalian embryonic development can be affected by the epigenotype of at least three individuals. Additionally, we observe a significant suppression of fragmentation by F1 hybrid ooplasm when it is separated from the F1 hybrid maternal pronucleus. This latter effect is a striking example of heterosis in the early mammalian embryo, and it provides a new opportunity for examining the molecular mechanisms of heterosis. These results are relevant to our understanding of the mechanisms of epigenetic effects on development and the possible fertility effects of genetic and epigenetic interactions in reproductive medicine.
Herpes simplex virus infection of cultured human term trophoblast

Mononuclear trophoblast cells were isolated from term placentas of uncomplicated pregnancies, purified to homogeneity by negative immunomagnetic separation using monoclonal antibodies to the major histocompatibility complex, and challenged with herpes simplex virus (HSV). The cultures were highly susceptible to virusinduced cytopathic effect as evidenced by cytopathic alteration and inhibition of human chorionic gonadotropin (hCG) secretion. Both HSV I and II underwent a full replicative cycle in the trophoblast, although the production of progeny virus was 10‐100 times less than that obtained with placental fibroblasts or choriocarcinoma cells. The permissiveness was independent of in vitro syncytial differentiation of the trophoblast. The results suggest that the trophoblast layer may be involved in intrauterine HSV infection.
Veterans Health Administration and Indian Health Service: Healthcare Utilization by Indian Health Service Enrollees

Background:The Veterans Health Administration (VHA) and Indian Health Service (IHS) have executed an agreement to share resources to improve access and health outcomes for American Indian and Alaska Native (AIAN) veterans. Objectives:To describe the extent of dual use, health needs, and utilization patterns for IHS-enrollees served by VHA and IHS. Our objective is to fill those gaps in knowledge to inform strategic planning between these federal agencies. Methods:Secondary data analysis of linked and merged VHA and IHS centralized administrative data from FY02 and FY03. Results:Of 64,746 IHS enrollees who used VHA and/or IHS, 25% accessed care at both healthcare organizations, whereas most used either the VHA (28%) or the IHS (46%). The proportion of dual users varied markedly by state. Like all other VHA users, these AIAN veterans have the same 3 most frequent diagnoses associated with healthcare encounters: posttraumatic stress disorder, hypertension, and diabetes. VHA-IHS dual users were more likely to receive primary care from IHS and to receive diagnostic and behavioral healthcare from VHA. Many dual users who had been diagnosed with diabetes, hypertension, and/or cardiovascular disease received overlapping attention in VHA and IHS. Conclusions:Strategies to improve outcomes for AIAN veterans should target those receiving care in both systems and include information sharing or coordination of clinical care to reduce the potential for duplication and for treatment conflicts. Strategies to improve access may differ regionally.
High culture, black culture: Strategic assimilation and cultural steering in museum philanthropy

This article provides a case study of race and big-gift cultural patronage, a theoretically and empirically understudied phenomenon, by investigating million-dollar donations to the Smithsonian Institution by black patrons. I find that large donations by black supporters are concentrated at one Smithsonian museum – the National Museum of African American History and Culture. To explain this distinctive pattern of cultural consumption, I draw on ethnographic data and archival texts related to patronage at African American museums. Gifts to the National Museum of African American History and Culture can be partly explained by strategic acculturation, or an impulse to articulate and nurture black identity through consuming black culture. However, cultural steering also played a key role. Black donors were identified and cultivated via a robust fundraising infrastructure where market research cast them as key constituents of the National Museum of African American History and Culture and taste-making strategies that constructed the museum as worthy reinforced their attraction to the museum. By conceptually and empirically elaborating cultural steering, this analysis offers a more complete model of black middle- and upper-class consumption of black culture.
A Mechanical Equinometer to Measure the Range of Motion of the Ankle Joint: Interobserver and Intraobserver Reliability

Background: Clinical measurement of passive dorsiflexion of the ankle joint is essential for the diagnosis of various pathologic conditions of the foot and ankle but is of unreliable precision with high interobserver variability in nonweightbearing tests. This work was designed to develop and test a precise, standardized, and reliable technique for measurement of passive and active ankle range of motion. Methods: The proposed measurement tool is composed of two mobile parallelograms, one attached to the tibia, the second one to the plantar surface of the foot. The parallelograms are connected with a hinge with an angular scale to measure the angle between the foot and tibia. Results: Interobserver correlation between clinical measure-ments for maximal passive foot dorsiflexion were 0.03 with knee extension and 0.38 with knee flexion, while for measurements with the proposed tool they reached 0.89 and 0.97, respectively, with a mean measurement error of 0.9 degrees. Intraobserver correlations reached values of r = 0.98 and 0.99. Conclusions: The proposed tool allows measurement of the ankle range of motion with very high precision and reproducibility far superior to clinical measurements. Clinical Relevance: Precise measurement of ankle range of motion is clinically challenging. With the use of the proposed tool, measurement precision and reliability are decisively improved.
A Population-Based Study of All-Terrain Vehicle-Related Head and Spinal Injuries

BACKGROUND:All-terrain vehicles (ATVs) are inherently unstable and their use results in numerous injuries annually in the United States. OBJECTIVE:We evaluated the magnitude of ATV-related head and spinal column injuries in Utah and identified risk factors that might be addressed by preventative measures. METHODS:Four statewide trauma and hospital databases were queried to obtain data on hospital visits by patients with ATV-related neurological injuries in Utah from 2001 to 2005. RESULTS:Seven hundred forty-one patients (median age, 24 years; range, 2-87 years) with ATV-related head and spinal injuries were identified. Five hundred one patients had injuries requiring transport to a hospital, of which 261 required intensive care. Five hundred fifty-nine patients experienced head trauma and 328 patients sustained spinal trauma. The average injury severity score was 12.6 (range, 0-75). Average hospital stay was 4 days (range, 0-34 days). Vehicle rollover was the most common mechanism of injury (28.6%), followed by loss of control and separation of rider and vehicle (20.1%) and collisions with stationary objects (6.1%) or other vehicles (4.1%). Helmet use was inconsistently documented, but patients without helmets were more likely to have a head injury. Injury frequency increased over time, from 116 in 2001 to 174 in 2005. CONCLUSION:The number of ATV-related head and spinal injuries is increasing in Utah. Serious injuries requiring surgery or intensive care are common. Riders under 20 years of age are especially at risk, and helmet use may decrease the likelihood of admission to the intensive care unit, head injuries, and death.
Long-term prognosis of children with Down's syndrome and leukaemia: a 34-year nation-wide experience.

BACKGROUND Although the characteristics of leukaemia in patients with Down's syndrome (DS) have been well documented, little is known about the long-term results of treatment. METHOD Retrospectively from 1968 to 1981 and prospectively from 1982 to 2002, the present authors collected data on every child with DS in Finland who had been diagnosed with leukaemia between 1968 and 1994. RESULTS Forty-one children with DS had acute leukaemia: 28 had acute lymphoblastic leukaemia (ALL); and 13 had acute non-lymphoblastic leukaemia (ANLL). The median age of the subjects at diagnosis was 3.8 years (range = 0-15.9 years). Patients with ANLL were significantly younger (P = 0.001) and all patients under 2 years of age had ANLL. Out of the 28 patients with ALL, 23 (82%) entered primary remission, and of these 23 individuals, 10 remained alive and in continuous remission (CR) after a median of 11.6 years (range = 8.9-20.0 years). Out of the 13 patients with ANLL, five (38%) entered remission and four remained in CR after a median of 16.0 years (range = 9.1-19.2 years). Treatment -related toxicities were common: eight patients with ALL and two with ANLL died of septicaemia. Actuarial, event-free survival rates at 5 years were 53% and 43% for adequately treated subjects with ALL and ANLL, respectively. CONCLUSIONS Standard leukaemia chemotherapy is effective in patients with DS. However, because toxicities are unacceptably frequent, specific anti-leukaemia regimens are needed for subjects with DS design.
A Mouse Model for Observational Fear Learning and the Empathetic Response

Research on observed fear and its relation to human mental disorders has been hampered by the lack of a suitable animal model. The empathetic response, which is impaired in various mental disorders, requires the ability to recognize the emotions and feelings of others. Due to the lack of a robust behavioral assay system, studies of empathy in laboratory animals have been absent from the literature. This unit describes a protocol for assessing social observational fear learning as a precursor of empathy in the mouse. In this assay, the observer animal is conditioned for context‐dependent fear by observing the behavior of the demonstrator animal receiving aversive stimuli. The magnitude of the fear response of the observer is positively influenced by the animal's familiarity with the demonstrator. This indicates that the degree of familiarity, and its relationship to empathy, can be modeled in an animal system by a method relevant to human disease. Curr. Protoc. Neurosci. 57:8.27. 1‐8.27. 9. © 2011 by John Wiley & Sons, Inc.
Diagnosis and management of autoimmune hepatitis

This guideline has been approved by the American Association for the Study of Liver Diseases (AASLD) and represents the position of the Association. 1. Preamble Clinical practice guidelines are defined as ‘‘systematically developed statements to assist practitioner and patient decisions about appropriate heath care for specific clinical circumstances. ’’ 1 (All references are available in the Supporting Information.) These guidelines on autoimmune hepatitis provide a data-supported approach to the diagnosis and management of this disease. They are based on the following: (1) formal review and analysis of the recently-published world lit
Effects of Combined Therapy With a Rho-Kinase Inhibitor and Prostacyclin on Monocrotaline-Induced Pulmonary Hypertension in Rats

Pulmonary hypertension (PH) is a fatal disease characterized by endothelial dysfunction, hypercontraction and proliferation of vascular smooth muscle cells, and migration of inflammatory cells, for which no satisfactory treatment has yet been developed. We have previously demonstrated that long-term inhibition of Rho-kinase, an effector of the small GTPase Rho, ameliorates monocrotaline-induced PH in rats and hypoxia-induced PH in mice. We also have reported that prostacyclin and its oral analogue, beraprost sodium (BPS), may lack direct inhibitory effect on Rho-kinase in vitro, suggesting that combination therapy with a Rho-kinase inhibitor and BPS is effective for the treatment of PH. In this study, we addressed this point in monocrotaline-induced PH model in rats. Male Sprague-Dawley rats were given a subcutaneous injection of monocrotaline (60 mg/kg). They were maintained with or without the treatment with a Rho-kinase inhibitor, fasudil (30 mg/kg/day), BPS (200 μg/kg/day), or a combination of both drugs for 3 weeks. The combination therapy, when compared with each monotherapy, showed significantly more improvement in PH, right ventricular hypertrophy, and pulmonary medial thickness without any adverse effects. Plasma concentrations of fasudil were not affected by BPS. These results suggest that combination therapy with a Rho-kinase inhibitor and prostacyclin exerts further beneficial effects on PH.