Miracle-dz/UniFAR-FTUs huggingface dataset:
The 12-Month Incidence and Predictors of PHQ-9–Screened Depressive Symptoms in Chinese Primary Care Patients

PURPOSE Evidence regarding the onset of depressive symptoms in primary care is rarely available but can help inform policy development, service planning, and clinical decision making. The objective of this study was to estimate the 12-month cumulative incidence and predictors of a positive screen for depressive symptoms on the 9-item Patient Health Questionnare-9 (PHQ-9) among primary care patients with no history of physician-diagnosed depression. METHODS We monitored a cohort of 2,929 adult primary care patients with no past history of physician-diagnosed depression and with baseline PHQ-9 scores of 9 or lower by telephone interview at 3, 6, and 12 months. A generalized linear mixed effects Poisson Model was used to explore factors associated with the incidence of PHQ-positive symptoms. RESULTS The cumulative incidence of positive screening on the PHQ-9 over 12 months was 5.23% (95% CI, 3.83%–6.64%). Positive predictors included being female, coming from a lower-income household, being a smoker, having at least 2 comorbidities, having a family history of depression, and having consulted a physician at least twice in the past 4 weeks. Consulting a physician with qualifications in both family medicine and psychological medicine was a negative predictor. CONCLUSIONS The cumulative incidence of PHQ-9–screened depressive symptoms in this study population was higher than those reported for depressive disorders in earlier systematic reviews. Groups who may warrant greater treatment attention include women, patients with multimorbidity, smokers, patients with recent high rates of medical consultations, and those who are from lower-income households or who have a family history of depression. Greater physician training may have a protective effect.
Measuring disability prevalence

This paper reviews what is meant by disability and puts forth a way of measuring disability suitable for internationally comparable prevalence rates. The basic trend in this regard is to measure functional limitations, rather than disability, and then use different severity thresholds for defining disability based on the purpose of measurement. After explaining this approach, the paper then goes on to summarize recent studies that use this methodology. Overall, as generally defined, disabled people represent a significant proportion of the world's population. Data from developed countries and some recent studies in developing countries over several regions (namely, Brazil, Ecuador, India, Nicaragua, Vietnam, and Zambia) suggest that an estimate of 10-12 percent is not unreasonable. This estimate is in line with the United Nations' often cited figure of 10 percent, which in fact was an informed guess based on data available from developed countries. This paper will argue, however, that a single disability prevalence rate can be highly problematic. Better practice would be to report at least two prevalence rates, one representing a moderate threshold for functional limitations and one with a more severe threshold.
Patients Prefer Pictures to Numbers to Express Cardiovascular Benefit From Treatment

PURPOSE This study aimed to determine which methods of expressing a preventive medication’s benefit encourage patients with known cardiovascular disease to decide to take the medication and which methods patients prefer. METHODS We identified patients in Auckland, New Zealand, family practices located in areas of differing socioeconomic status who had preexisting heart disease (myocardial infarction, angina, or both) and were taking statins. The patients were interviewed about their preference for methods of expressing the benefit of a hypothetical medication. Benefits were expressed numerically (relative risk, absolute risk, number needed to treat, odds ratio, natural frequency) and graphically. Statistical testing was adjusted for practice. RESULTS We interviewed 100 eligible patients, representing a 53% response rate. No matter how the risk was expressed, the majority of patients indicated they would be encouraged to take the medication. Two-thirds (68) of the patients preferred 1 method of expressing benefit over others. Of this group, 57% preferred the information presented graphically. This value was significantly greater (P <.001) than the 19% who chose the next most preferred option, relative risk. Few patients preferred absolute risk (13%) or natural frequencies (9%). Only a single patient (1%) preferred the odds ratio. None preferred number needed to treat. Ninety percent of patients responding to a question about framing preferred positive framing (description of the benefit of treatment) over negative framing (description of the harm of not being treated). CONCLUSIONS Although number needed to treat is a useful tool for communicating risk and benefit to clinicians, this format was the least likely to encourage patients to take medication. As graphical representation of benefit was the method patients preferred most, consideration should be given to developing visual aids to support shared clinical decision making.
Upward Mobility and the African American Accountant: An Analysis of Perceived Discrimination, Perceived Career Advancement Curtailment, and Intent to Remain

Accounting studies related to minority issues have focused mainly on gender and public accountants. As a result, the purpose of this study is to investigate perceptions of discrimination and career advancement among African American accountants, the second largest minority group in accounting today, and reveal any differences between males and females. Although research on African American accountants exists, it does not empirically investigate male/female differences related to perceived discrimination (race and gender), perceived career curtailment, and intent to remain. To address this dearth of research focus, this study analyzes survey results from 553 African American accountants, primarily employed in nonpublic accounting organizations. The results suggest females perceive more race and gender discrimination in private industry and other sectors, than in public accounting, and males perceive race discrimination in all three industry types. Females are less likely to remain with their current employ.
Heme Oxygenase-1 Protects Pancreatic β Cells From Apoptosis Caused by Various Stimuli

Background Several problems can occur after allogeneic islet transplantation: primary nonfunction, rejection, and the recurrence of autoimmune disease, which involve attack by the recipient's cytokines, T cells, natural killer cells, and monocytes on the donor's β cells, which leads to β-cell destruction. Recent studies have revealed that loss of transplanted islets is caused mainly by apoptosis. Heme oxygenase-1 (HO-1) is one of the antiapoptotic genes up-regulated under stress conditions. The aim of this work was to investigate any mechanisms of HO-1-mediated protection of β cells from apoptosis. Methods Apoptosis was assessed by comparison of viable transfected cells with and without apoptotic stimuli, and with and without HO-1 overexpression. Activation and function of p38 mitogen-activated protein kinase were determined using the specific inhibitor SB203580. Results We have shown that HO-1 mediates antiapoptotic effects in β cells. The percentage of apoptotic cells after stimulation with tumor necrosis factor α decreased from 75% without HO-1 to 5% when HO-1 was overexpressed. Our data indicate that HO-1 acts as a signal terminator of tumor necrosis factor α-induced apoptosis by modulation of the p38 mitogen-activated protein kinase pathway. Conclusions Profound cell stress that occurs in islets after transplantation, as well as at the onset of diabetes, results in β-cell loss through apoptosis. Protection of β cells by HO-1 improves their survival in vitro after various proapoptotic stimuli, suggesting that HO-1 suppresses one or several signaling pathways leading to apoptosis. We hypothesize that our in vitro findings can be extrapolated to the in vivo situation, and we propose that expression of HO-1 in islets may illuminate a valuable new approach to improving diabetes treatment.
Prevention of Morphological Changes in Alginate Microcapsules for Islet Xenotransplantation

Background Alginate microcapsule swelling, which occurs as a result of increased hydrophilicity owing to the Ca++ that remains after rapid chelation of the inner alginate core, is a problem in encapsulation. We have previously shown that exchange of the residual divalent Ca++ with the monovalent Na+ through the use of 6 mmol/L Na2SO4 decreases swelling in chelated alginate-polylysine-alginate microcapsules, and this process enhances their durability. The purpose of the present study was to examine the morphology of Na2SO4-treated microcapsules in long-term incubation with the use of serum-supplemented culture medium. Methods Spherical beads of purified alginate (3%) that were gelled with 1.1% CaCl2 were first coated with polylysine, and then with 0.24% alginate. After rapid chelation of the inner alginate core with 55 mmol/L sodium citrate, the capsules were either incubated for 30 minutes in 6 mmol/L Na2SO4 or left untreated (control). Each group of capsules was then placed in a flask containing Ham's culture medium supplemented with 20% porcine serum and incubated at 37°C. Results The diameters of Na2SO4-treated capsules only increased modestly from a mean±SD of 635±22.08 to 684.53±17.86 μm (P <0.0001) by day 7, with no further increases thereafter. In contrast, control capsules showed a steady increase in their mean diameters, which changed from 639.55±21.44 to 735.48±108.85 μm (P<0.0001) by day 66. In addition, whereas treated capsules remained spherical, control capsules showed progressive polymorphism. Conclusion We have developed a new method of making more durable and stable microcapsules that can be used for islet cell xenotransplantation.
Perceptions of hospital admission in patients with cystic fibrosis

Aims and objectives: This paper is a report of a study of experiences of people with Cystic Fibrosis (CF) with their hospital admission. It evaluates how they perceive their treatment and care and the impact on their social life (school or work). Background: In The Netherlands, people with CF are hospitalized in seven CF centers. In general, hospitalization may raise several challenges concerning the patient’s psychosocial well-being, before, during and after the admission. The admission of people with CF is complicated, because of segregated treatment and care that aims to prevent hospital-based cross-infection. Design: This article reports on a qualitative study. Methods: Data were collected during 2009 and 2010. Nineteen people with CF admitted for more than 5 days in one of the seven Dutch CF-centres participated. Results and conclusions: The findings are organized into five contexts with subthemes: Before admission & Arrival (1); Treatment & Care (2); Room & Stay (3); Discharge (4); Social & Societal context (5). The findings show that patients express a need for enhancing the quality of some treatments, like intravenous injections and patients express normative expectations of professionals that directly relate to their psychosocial well-being, e.g. they want to be ‘seen’ and treated as human beings and not solely as patients. They desire segregation policies to be consistent, whilst simultaneously they prefer flexible segregation guidelines. In general, respondents are satisfied with hospital facilities. The study reports on challenges concerning continuation of school and work during the admission. The paper is relevant to every hospital where people are being nursed in isolation.
Evaluation of C-Reactive Protein in Primary and Secondary Prevention

Inflammation is pivotal in atherosclerosis, and C-reactive protein (CRP) is an inflammatory marker that predicts cardiovascular events. Several population-based studies have demonstrated that baseline CRP levels predict future cardiovascular events. CRP testing may thus have a major adjunctive role in the global assessment of cardiovascular risk. Recently, the National Cholesterol Education Program, through the Adult Treatment Panel III guidelines, identified CRP and another marker of inflammation, the fibrinogen, as “emerging risk factors,” suggesting that their measurement may improve the estimations of absolute risk obtained using the traditional cardiovascular risk factors. In terms of clinical application, CRP seems to be a strong predictor of cardiovascular events such as low-density lipoprotein cholesterol and adds prognostic information to all levels of calculated Framingham Risk Score and to the cluster of risk factors of metabolic syndrome. Several pharmacologic agents proven to reduce vascular risk also reduce CRP levels. Among these, all statins lower CRP, with more potent statins having greater effects; on average, median CRP levels decline from 15 to 25% after 6 weeks of starting therapy. Although limitations concerning the inflammatory screening remain, available data suggest that CRP has the potential to play an important role in adding more information for the evaluation of global risk assessment in primary prevention of cardiovascular disease.
An investigation of the boundary layer behaviour on the blading of a single-stage axial-flow compressor.

Observations of the boundary layer behaviour on the blading of a single-stage axial-flow compressor are described : detailed measurements were carried out with hot wire, surface visualisation, and surface pitot tube techniques, and the presence of extensive regions of laminar flow was established. The behaviour of the laminar and turbulent boundary layers, and of separated laminar flow regions are reported. A new correlation is developed to describe the boundary layer transition behaviour, and the effects of pressure gradient, Reynolds number, and free stream turbulence on transition are discussed. A new turbulent skin friction law for conditions of large positive pressure gradient is developed, and the problem of the minimum Reynolds number for turbulent flow under a pressure gradient is re-examined. Various existing methods of calculating the turbulent boundary layer are examined and their success in predicting the boundary layer development on a stationary blade of the research compressor is evaluated. The application of the experimental results to the design and performance analysis of axial-flow turbo-machine blading is discussed. A family of surface velocity distributions giving unseparated flow over the suction surface of an axial-flow compressor blade is derived, and their computed performance is analysed. In conclusion, problems needing further investigation are outlined.
Long-Term Management of Generalized Pustular Psoriasis with Infliximab: Case Series

Background: Infliximab, a tumor necrosis factor α antagonist, has recently been shown to be successful for the short-term treatment of generalized pustular psoriasis (GPP) in multiple case reports. Objective: The goal of this case series was to assess the efficacy of the longer-term management of GPP with infliximab. Methods: Three patients with severe GPP were followed to assess the efficacy of long-term treatment with infliximab. Results: Infliximab therapy was more efficacious with infusion every 6 to 8 weeks in combination with methotrexate. Conclusion: Infliximab may be efficacious for some patients for the long-term management of GPP. Maintaining a strict infliximab infusion schedule and concomitant methotrexate therapy may decrease infusion reactions and increase efficacy.
The Relationship between Body Image and Eating Attitudes of Secondary School Students

AIM: The relationship between body image and eating attitudes of secondary school students Background. Body image can have a wide range of psychological effects and physical effects. Relationship between body image and eating attitude has been reported. Aim of this research is to examine the relationship between secondary school students’ body image and eating attitudes. METHOD: The sample of the research was composed of 485 secondary school students. The research data were collected using a questionnaire, the Body Image Test and the Eating Attitude Test and evaluated with SPSS 17 package program using descriptive statistics, analysis of variance (ANOVA), Kruskal Wallis, independent t test, Mann Whitney U, Pearson Correlation. RESULTS: The average age of the students participating in the study was 16.1±1.1 years. Fourty six percent of the research group were boys. 25.4% of the students Body Mass Index (BMI) were below 18.5 kg/m2 between (underweight), 66,6% were 18.5 and 24.9 kg/m2 (normal) and 8.0% were above 25 kg/m2 (over weighted/obese). 23,9% of the students supposed that they were underweighted and 22.1% over weighted/fat. 17% of the students wanted to put on weight and 40.8% to lose weight. Positive correlation between eating attitude score and body image score was determined. Body image score and eating attitudes score of girls were lower than boys. CONCLUSION: As a result of this research, it was seen that there was a relationship between eating behaviors of secondary school students and body image, students used methods to lose weight because of their low body image and applied these methods being influenced by people who were not experts. People should be informed to achieve healthy and balanced nutrition in their lives instead of being promoted to have diet.
Genome-Wide Comparative Analysis of Chemosensory Gene Families in Five Tsetse Fly Species

For decades, odour-baited traps have been used for control of tsetse flies (Diptera; Glossinidae), vectors of African trypanosomes. However, differential responses to known attractants have been reported in different Glossina species, hindering establishment of a universal vector control tool. Availability of full genome sequences of five Glossina species offers an opportunity to compare their chemosensory repertoire and enhance our understanding of their biology in relation to chemosensation. Here, we identified and annotated the major chemosensory gene families in Glossina. We identified a total of 118, 115, 124, and 123 chemosensory genes in Glossina austeni, G. brevipalpis, G. f. fuscipes, G. pallidipes, respectively, relative to 127 reported in G. m. morsitans. Our results show that tsetse fly genomes have fewer chemosensory genes when compared to other dipterans such as Musca domestica (n>393), Drosophila melanogaster (n = 246) and Anopheles gambiae (n>247). We also found that Glossina chemosensory genes are dispersed across distantly located scaffolds in their respective genomes, in contrast to other insects like D. melanogaster whose genes occur in clusters. Further, Glossina appears to be devoid of sugar receptors and to have expanded CO2 associated receptors, potentially reflecting Glossina's obligate hematophagy and the need to detect hosts that may be out of sight. We also identified, in all species, homologs of Ir84a; a Drosophila-specific ionotropic receptor that promotes male courtship suggesting that this is a conserved trait in tsetse flies. Notably, our selection analysis revealed that a total of four gene loci (Gr21a, GluRIIA, Gr28b, and Obp83a) were under positive selection, which confers fitness advantage to species. These findings provide a platform for studies to further define the language of communication of tsetse with their environment, and influence development of novel approaches for control.
Variability in the pharmacokinetics of mycophenolic acid: Implications for therapeutic drug monitoring

textabstractMycophenolate mofetil (MMF) is an immunosuppressive drug used to prevent rejection following solid organ transplantation. MMF was introduced in 1995 with a recommended fixed-dose regimen of 1 g twice daily. Nowadays, dose individualization using therapeutic drug monitoring (TDM) of the area under the concentration-time curve from 0 to 12 hours postdose (AUC0-12) of the active compound, mycophenolic acid (MPA), is advocated to optimize the treatment. The recommended target range for the MPA AUC0-12 in renal transplant recipients is 30-60 mg*h/L. A practical and suitable manner of determining the MPA AUC0-12 are abbreviated AUC measurements, in which the AUC0-12 is estimated by a limited sampling strategy. In renal transplant recipients, it has been shown that limited sampling strategies estimate MPA AUC0-12 with sufficient accuracy and precision. The aim of this thesis was to further explain the differences in the pharmacokinetics of MMF seen between renal transplant recipients, investigate the validity of these results in other populations, or when different formulations are used, and to describe the effects of these results on individualization of the MMF treatment. In Chapter 1 of this thesis, an overview of the pharmacokinetics of MPA in renal transplant recipients and the added value of TDM are discussed. MPA is a highly protein bounded drug, which binds reversibly to albumin. The free fraction is thought to be responsible for the immunosuppressive effect of MPA. Cyclosporine comedication, low plasma albumin level, and impaired renal function are associated with a decrease in total MPA AUC, but the unbound concentration is hardly affected. The effect of these covariates on total and unbound MPA concentrations is clarified in Chapter 2.1. The effect of MMF dose on the pharmacokinetics of MPA is evaluated in Chapter 2.2. In Chapter 2.3 the differences in the pharmacokinetics of MPA between adult and pediatric renal transplant recipients are examined. Besides solid organ transplantation, MMF is increasingly used to prevent graft-versus-host disease following hematopoietic stem cell transplantation and for treatment of autoimmune diseases. TDM may be a valuable tool to optimize MMF therapy in these patients as well. The differences in the pharmacokinetics of MPA between renal transplant recipients and hematopoietic stem cell transplant patients and patients with autoimmune diseases and the consequences of these differences for TDM are reported in Chapter 3. To prevent gastrointestinal adverse events, which are frequently seen during MMF treatment, enteric-coated mycophenolate sodium (EC-MPS) was developed. EC-MPS and MMF are both prodrugs of MPA, and showed similar efficacy and safety profiles. In Chapter 4, the pharmacokinetic profile of MPA is compared following administration of EC-MPS and MMF.