Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-Term Effects of 4 Popular Diets on Weight Loss and Cardiovascular Risk Factors: A Systematic Review of Randomized Controlled Trials

Background—We conducted a systematic review to examine the efficacy of the Atkins, South Beach, Weight Watchers (WW), and Zone diets, with a particular focus on sustained weight loss at ≥12 months. Methods and Results—We systematically searched MEDLINE, EMBASE, and the Cochrane Library of Clinical Trials to identify randomized controlled trials (RCTs) published in English with follow-up ≥4 weeks that examined the effects of these 4 popular diets on weight loss and cardiovascular risk factors. We identified 12 RCTs (n=2559) with follow-up ≥12 months: 10 versus usual care (5 Atkins, 4 WW, and 1 South Beach) and 2 head-to-head (1 of Atkins, WW, and Zone, and 1 of Atkins, Zone, and control). At 12 months, the 10 RCTs comparing popular diets to usual care revealed that only WW was consistently more efficacious at reducing weight (range of mean changes: −3.5 to −6.0 kg versus −0.8 to −5.4 kg; P<0.05 for 3/4 RCTs). However, the 2 head-to-head RCTs suggest that Atkins (range: −2.1 to −4.7 kg), WW (−3.0 kg), Zone (−1.6 to −3.2 kg), and control (−2.2 kg) all achieved modest long-term weight loss. Twenty-four-month data suggest that weight lost with Atkins or WW is partially regained over time. Conclusions—Head-to-head RCTs, providing the most robust evidence available, demonstrated that Atkins, WW, and Zone achieved modest and similar long-term weight loss. Despite millions of dollars spent on popular commercial diets, data are conflicting and insufficient to identify one popular diet as being more beneficial than the others.
Endothelial Junctional Adhesion Molecule-A Guides Monocytes Into Flow-Dependent Predilection Sites of Atherosclerosis

Background— Junctional adhesion molecule (JAM)-A expressed in endothelial, epithelial, and blood cells can regulate permeability and leukocyte extravasation. Atherosclerosis develops at sites of disturbed flow in large arteries, but the mechanisms guiding inflammatory cells into these predilection sites remain unknown. Methods and Results— To characterize cell-specific functions of JAM-A in atherosclerosis, we used apolipoprotein E–deficient mice with a somatic or endothelium-specific deficiency in JAM-A and bone marrow chimeras with JAM-A–deficient leukocytes. We show that impaired JAM-A expression in endothelial cells reduced mononuclear cell recruitment into the arterial wall and limited atherosclerotic lesion formation in hyperlipidemic mice. In contrast, JAM-A deficiency in bone marrow cells impeded monocyte de-adhesion, thereby increasing vascular permeability and lesion formation, whereas somatic JAM-A deletion revealed no significant effects. Regions with disturbed flow displayed a focal enrichment and luminal redistribution of endothelial JAM-A and were preferentially protected by its deficiency. The functional expression and redistribution of endothelial JAM-A was increased by oxidized low-density lipoprotein, but confined by atheroprotective laminar flow through an upregulation of microRNA (miR)-145, which repressed JAM-A. Conclusions— Our data identify endothelial JAM-A as an important effector molecule integrating atherogenic conditions to direct inflammatory cell entry at predilection sites of atherosclerosis.
Helping Patients Adopt Healthier Behaviors

A ssisting patients to improve health-related behaviors is an important responsibility of caregivers, including physicians, nurses, health educators, and counselors. From 1992 to 2000, diet and physical activity counseling took place in < 45 and 30%, respectively, of primary care physician visits by adults with coronary heart disease risk factors.1 Physicians in primary care seldom have time to engage in such discussions and may be unsure how to discuss behavior change with their patients;1-3 nonphysicians are generally the appropriate caregivers to assist patients in adopting healthy behaviors. This article describes a goal-setting method for discussing behavior change with patients in the primary care setting and provides a training guide for clinicians and nonprofessional practice staff. To address the barrier of insufficient time, each primary care practice needs to decide which caregivers—clinicians, nursing personnel, medical assistants, health educators, community health workers, or other patients—can realistically engage patients in goal-setting discussions and whether the activity is best conducted with patients individually or in groups. Goal setting is a collaborative process in which patients choose a behavior-change goal. Goal setting takes place after the clinician has assessed the patient's problem, provided necessary information, and engaged the patient in decision making regarding medical or surgical management of the patient's condition. Most patients with chronic conditions or adverse risk factors would benefit from behavior change to implement an evidence-based management plan. Goal setting is a technique to assist patients in working toward healthier behaviors. One excellent way to initiate a goalsetting discussion is to ask the question used by Stanford Medical School's Dr. Kate Lorig, an international leader in helping patients cope with chronic disease: “Is there anything you would like to do this week to improve your health? ” This question allows patients to choose which behavior they are motivated to …
Timing of pollen release and stigma receptivity period of Piper vicosanum: New insights into sexual reproduction of the genus.

PREMISE OF THE STUDY Dichogamy is a common characteristic among angiosperms, including Piper species. In this genus, the tiny flowers are morphologically similar and have an asynchronous stamen development. However, there is no information on the duration of stigma receptivity and whether it overlaps with pollen release. To better understand mechanisms of floral function in Piper vicosanum, we provide a detailed characterization of the timing of pollen release from the four stamens and the period of stigma receptivity and exposure mode of the receptive areas. METHODS We investigated plants of a natural population in a semideciduous seasonal forest (Viçosa, Minas Gerais State, southeastern Brazil), based on chemical tests, light microscopy, and scanning electron microscopy analyses. KEY RESULTS Incomplete protogyny-a mechanism that favors outcrossing-was recorded. The period of stigma receptivity was long (14 d), and the sequential exposure and senescence of stigmatic papillae occurred gradually and in a basipetal direction. Pollen release began 2-6 d after the beginning of the pistillate phase, with an average pollen viability of 87.7%, during the bisexual flower phase. Pollen was released for up to 6 d and occurred in one stamen at a time. The fruit set observed in tests of self-pollination indicated self-compatibility. CONCLUSIONS The gradual and sequential exposure of stigmatic papillae in P. vicosanum flowers is described here as the mechanism for the long duration of receptivity. Anther development and pollen release were also sequential. These findings are yet unreported reproductive characteristics of the genus and offer new perspectives for future studies on the floral biology of other Piper species.
Health outcomes, program completion, and criminal recidivism among participants in the Rural Alcohol Diversion program, Australia

Introduction: Alcohol use and dependence are common among people involved in the criminal justice system but there have been few efforts to assess the utility of diversionary programs for defendants whose offending is related to alcohol use. Method: This paper analyses program completion, health outcomes and recidivism among 202 participants in the Rural Alcohol Diversion (RAD) program, Australia. Logistic regression was used to identify predictors of program completion. Paired t-tests were used to assess changes in alcohol use, general health and mental health from program entry to exit. Recidivism was assessed using Cox proportional hazards modelling. Results: Being male was associated with increased odds of program completion at p = . 05. Among participants who completed the program, there were reductions in alcohol use and psychological distress, and improvements in general and mental health. The only predictor of re-offending was number of prior convictions. Conclusions: These findings are suggestive of improved health for RAD participants but do not indicate that completion of RAD is associated with reduced offending. Further research employing a control group is needed to determine if the changes noted in this study are a direct effect of the RAD program.
Factors Influencing Nurses' Smoking Cessation Assessment and Counseling Practices

&NA; Nurses are in a strategic position to influence their patients to stop smoking, but factors affecting their likelihood of assessing and counseling are unknown. The purpose of this cross‐sectional survey study was to identify predictors of tobacco use assessment and smoking cessation intervention by office‐based nurses employed in private physician practices in Kansas. A 43‐item questionnaire was mailed to all family practice, internal medicine, and pediatric private practice offices located throughout the state of Kansas with a final sample of 415 completed surveys. Logistic regression was performed to identify predictors of three dependent variables: (1) tobacco use assessment, (2) patient interest in smoking cessation, and (3) delivering smoking cessation counseling. Nurses were more likely to assess patient tobacco use, assess patient interest in tobacco cessation, and provide tobacco cessation counseling if they believed they had the skills, and had attended tobacco‐related continuing education in the previous year. Advanced practice nursing and more years of experience were predictors of assessment activities, but not cessation counseling. Nurses with a bachelor (BSN) degree or higher did provide smoking cessation advice more consistently than non‐BSN prepared nurses. Nurses must believe they are sufficiently skilled to overcome perceived barriers to assess tobacco use. Continuing education, skills development and improved understanding of tobacco cessation facts may increase self‐efficacy.
Clinical and Radiographic Findings of Pulmonary Tuberculosis in Infants

literature. Objectives: This study defines the clinical and radiological features of tuberculosis in infants less than one year of age. Materials and Methods: The medical records were reviewed for all infants aging 12 months or less with diagnosis of tuberculosis at TB wards of National Research Institute of Tuberculosis and Lung Disease (N.R.I.T.L.D.) in Tehran, Iran between 2006 - 2012 retrospectively. Results: Nine infants with a median age of eight months were identified, all of whom had endothoracic Tuberculosis. The cause of medical evaluation was the unset of symptom in five infants and close contact with infected patients in four. Common symptoms and signs included cough in four, Night sweat in three and Crackles in two patients. Chest X-ray showed consolidation in three, nodular lesions in three, consolidation and ground glass in one, mediastinal bulging in one. Chest CT scan revealed consolidation in three, disseminated pulmonary nodules in one, tiny nodules in two, ground glass lesion in two, right Para-tracheal and subcarinal lymphadenopathies in two, pre-bronchial thickening in one and bronchiectasis in one. Culture was obtained from all of the patients and was positive in one. All infants promptly responded to the treatment. No complications and deaths occurred. Conclusions: Pulmonary tuberculosis predominates in infants. Prompt diagnosis and treatment seem to reduce morbidity and mortality in this age group. Chest CT may be supportive in the diagnosis of infants with characteristic lymphadenopathy.
Natural history of Chiari malformation Type I following decision for conservative treatment.

OBJECT The natural history of the Chiari malformation Type I (CM-I) is incompletely understood. The authors report on the outcome of a large group of patients with CM-I that were initially selected for nonsurgical management. METHODS The authors identified 147 patients in whom CM-I was diagnosed on MR imaging, who were not offered surgery at the time of diagnosis, and in whom at least 1 year of clinical and MR imaging follow-up was available after the initial CM-I diagnosis. These patients were included in an outcome analysis. RESULTS Patients were followed clinically and by MR imaging for a mean duration of 4.6 and 3.8 years, respectively. Of the 147 patients, 9 had new symptoms attributed to the CM-I during the follow-up interval. During this time, development of a spinal cord syrinx occurred in 8 patients; 5 of these patients had a prior diagnosis of a presyrinx state or a dilated central canal. Spontaneous resolution of a syrinx occurred in 3 patients. Multiple CSF flow studies were obtained in 74 patients. Of these patients, 23 had improvement in CSF flow, 39 had no change, and 12 showed worsening CSF flow at the foramen magnum. There was no significant change in the mean amount of cerebellar tonsillar herniation over the follow-up period. Fourteen patients underwent surgical treatment for CM-I. There were no differences in initial cerebellar tonsillar herniation or CSF flow at the foramen magnum in those who ultimately underwent surgery compared with those who did not. CONCLUSIONS In patients with CM-Is that are selected for nonsurgical management, the natural history is usually benign, although spontaneous improvement and worsening are occasionally seen.
Estimating Basin‐Scale Water Budgets With SMAP Soil Moisture Data

Soil Moisture Active Passive (SMAP) Level‐2 soil moisture retrievals collected during 2015–2017 are used in isolation to estimate 10‐day warm season precipitation and streamflow totals within 145 medium‐sized (2,000–10,000 km2) unregulated watersheds in the conterminous United States. The precipitation estimation algorithm, derived from a well‐documented approach, includes a locally calibrated loss function component that significantly improves its performance. For the basin‐scale water budget analysis, the precipitation and streamflow algorithms are calibrated with 2 years of SMAP retrievals in conjunction with observed precipitation and streamflow data and are then applied to SMAP retrievals alone during a third year. While estimation accuracy (as measured by the square of the correlation coefficient, r2, between estimates and observations) varies by basin, the average r2 for the basins is 0.53 for precipitation and 0.22 for streamflow. For the subset of 22 basins that calibrate particularly well, the r2 increases to 0.63 for precipitation and to 0.51 for streamflow. The magnitudes of the estimated variables are also accurate, with sample pairs generally clustered about the 1:1 line. The chief limitation to the estimation involves large biases induced during periods of high rainfall; the accuracy of the estimates (in terms of r2 and root‐mean‐square error) increases significantly when periods of higher rainfall are not considered. The potential for transferability is also demonstrated by calibrating the streamflow estimation equation in one basin and then applying the equation in another. Overall, the study demonstrates that SMAP retrievals contain, all by themselves, information that can be used to estimate large‐scale water budgets.
Synaptonemal Complexes in the Hybridogenetic Squalius alburnoides Fish Complex: New Insights on the Gametogenesis of Allopolyploids

In the Squalius alburnoides fish complex, allotriploid females (3n = 75) reproduce mostly by meiotic hybridogenesis, producing haploid gametes by means of the elimination of the heterospecific chromosome set and recombination between the 2 homospecific genomes. A synaptonemal complexes (SCs) analysis was performed in specimens from a confined southern population (Quarteira, Portugal) to understand chromosome dynamics during gametogenesis. The comparative study between hybrid females with QAA genome composition and the parental bisexual species Squalius aradensis (2n = 50, QQ genome) evidenced: (i) that allotriploid meiocytes comprise the complete chromosome set (75 chromosomes) in prophase I, proving the heterospecific genome (Q) is only excluded after pachytene stage, and (ii) a 2-phase synaptic process where initially, exclusively homologous SCs form and the unmatched univalents remain in a bouquet conformation, followed by the establishment of extensive non-homologous SCs with multivalent associations among the later. These findings disagree with most literature concerning the meiotic process in allotriploid vertebrates, since the most accountable mechanisms (premeiotic exclusion of the unmatched chromosome set and whole genome endoduplication) were not observed.
Hydrogel versus Bare Platinum Coils in Patients with Large or Recurrent Aneurysms Prone to Recurrence after Endovascular Treatment: A Randomized Controlled Trial

This Level 1 expedited report was a pragmatic, multicenter, parallel, randomized (1:1) trial evaluating patients who were at high risk of aneurysm recurrence after endovascular treatment, including patients with large aneurysms (Patients Prone to Recurrence After Endovascular Treatment PRET-1) or with aneurysms that had previously recurred after coiling (PRET-2). The trial was stopped once 250 patients in PRET-1 and 197 in PRET-2 had been recruited because of slow accrual. A poor primary outcome occurred in 44.4% of those in PRET-1 allocated to platinum compared with 52.5% of patients allocated to hydrogel and in 49.0% in PRET-2 allocated to platinum compared with 42.1% allocated to hydrogel. Adverse events and morbidity were similar. The authors conclude that coiling of large and recurrent aneurysms is safe but often poorly effective according to angiographic results. Hydrogel coiling was not shown to be better than platinum. BACKGROUND AND PURPOSE: Some patients are at high risk of aneurysm recurrence after endovascular treatment: patients with large aneurysms (Patients Prone to Recurrence After Endovascular Treatment PRET-1) or with aneurysms that have previously recurred after coiling (PRET-2). We aimed to establish whether the use of hydrogel coils improved efficacy outcomes compared with bare platinum coils. MATERIALS AND METHODS: PRET was an investigator-led, pragmatic, multicenter, parallel, randomized (1:1) trial. Randomized allocation was performed separately for patients in PRET-1 and PRET-2, by using a Web-based platform ensuring concealed allocation. The primary outcome was a composite of a residual/recurrent aneurysm, adjudicated by a blinded core laboratory, or retreatment, intracranial bleeding, or mass effect during the 18-month follow-up. Secondary outcomes included adverse events, mortality, and morbidity (mRS > 2). The hypothesis was that hydrogel would decrease the primary outcome from 50% to 30% at 18 months, necessitating 125 patients per group (500 for PRET-1 and PRET-2). RESULTS: The trial was stopped once 250 patients in PRET-1 and 197 in PRET-2 had been recruited because of slow accrual. A poor primary outcome occurred in 44.4% (95% CI, 35.5%–53.2%) of those in PRET-1 allocated to platinum compared with 52.5% (95% CI, 43.4%–61.6%) of patients allocated to hydrogel (OR, 1.387; 95% CI, 0.838–2.295; P = .20) and in 49.0% (95% CI, 38.8%–59.1%) in PRET-2 allocated to platinum compared with 42.1% (95% CI, 32.0%–52.2%) allocated to hydrogel (OR, 0.959; 95% CI, 0.428–1.342; P = .34). Adverse events and morbidity were similar. There were 3.6% deaths (1.4% platinum, 5.9% hydrogel; P = .011). CONCLUSIONS: Coiling of large and recurrent aneurysms is safe but often poorly effective according to angiographic results. Hydrogel coiling was not shown to be better than platinum.
Doctors’ Orders: Specialists’ Day to Day Work and their jurisdictional Claims in Dutch Hospitals

textabstractThis study analyses the nature and organisation of specialists' day to day work in general hospitals in the Netherlands and the claims for jurisdiction specialists make in their work. It is of interest because it presents a picture of specialist work from within. Most studies about the organisation of specialist work address management structures or policy processes in hospital. Not many researchers study the real work of physicians in day to day patient care by observing it directly. The information 12 1.1 collected in this study was obtained from day to day work as much as possible. The title, Doctors’ orders, is related to two aspects of this subject. In the . rst place it re.ects an element of physicians’ jurisdiction: the right to give orders to patients, nurses, and other people and parties surrounding them in hospital. In the second place, more important in this thesis, the title re.ects the ‘social orders’ doctors take part in, together with people and parties surrounding them. In hospitals these orders are kept in balance by continuous small and large negotiations. The social orders doctors work in are ‘negotiated orders’. Specialists do not form a homo­geneous group with respect to their work and jurisdictional claims. Several characteristics, for instance age, sex, family life, size of hospital, size of peer group, being self-employed or salaried, speciality, and teaching status, distribute specialists over many potential subgroups. Since this thesis is about work, it takes the speciality as one of the most important characteristics in distinguishing subgroups. The speciality de.nes the working processes in day to day life. Three categories of specialities will be used throughout this thesis: ‘medical’, ‘surgical’ and ‘supporting’. They will be de.ned in Chapter 2. It is important to know that the term ‘medical specialities’ refers to ‘non­surgical’ specialities. Throughout this thesis ‘medical’ sometimes refers to the total . eld of physicians, for instance the ‘medical profession’, and sometimes to the speci.c . eld of ‘medical’ physicians (for instance internists and cardiologists) that distinguish themselves from surgical physicians and supporting physicians. The context of the phrases will usually specify their meaning. Besides the speciality, other criteria will be used to de.ne subgroups of specialists as well, for instance men and women, and self-employed or salaried specialists. Summarising, this thesis is about specialists’ day to day work in Dutch general hospitals and about the negotiations specialists take part in when maintaining the negotiated order in their day to day work.
Hypergastrinemia in Long-Term Use of Proton Pump Inhibitors

Background/Aim: The use of proton pump inhibitors (PPIs) is known to lead to hypergastrinemia; however, the data in patients with atrophic gastritis is still lacking. The aim of this study was to investigate the effects of long-term PPIs use on the gastrin levels in patients with atrophic gastritis and to determine factors affecting hypergastrinemia in long-term users of PPIs. Methods: Serum Helicobacter pylori IgG, gastrin and pepsinogen levels were measured. Atrophic gastritis was assessed by upper gastrointestinal endoscopies based on the Kimura-Takemoto classification and pepsinogen levels. CYP2C19 polymorphisms were assessed using DNA extracted from peripheral blood. Results: A total number of 382 patients (275 men and 107 women) were enrolled. Median serum gastrin levels were higher in PPI users than in non- users (234 vs. 113 pg/mL, p < 0.001) and in women than in men (252 vs. 155 pg/mL, p = 0.006). Gastrin levels were significantly associated with corpus atrophy only in the subgroup of non-users of PPIs. Multivariate analysis revealed that hypergastrinemia (over 150 pg/mL) was significantly associated with PPI use (OR 5.30; 95% CI 3.32–8.47), women (OR 2.22; 95% CI 1.33–3.72) and corpus atrophy (OR 1.82; 95% CI 1.14–2.90). Conclusion: PPI use, women and corpus atrophy were risk factors for hypergastrinemia. Gender, but not corpus atrophy, affected the gastrin levels in long-term users of PPIs.