Miracle-dz/UniFAR-FTUs huggingface dataset:
Performance of magnetic resonance elastography and diffusion‐weighted imaging for the staging of hepatic fibrosis: A meta‐analysis

A meta‐analysis was performed to assess and compare the accuracies of magnetic resonance elastography (MRE) and diffusion‐weighted imaging (DWI) for the staging of hepatic fibrosis. Online journal databases and a manual search from January 2000 to May 2011 were used. We identified 41 studies, but only 14 met the criteria to perform a meta‐analysis assessing MRE (five trials) or DWI (10 trials). Fibrosis was categorized by redistribution into five stages according to histopathological description. A bivariate binomial model was used to combine the sensitivity and specificity and their 95% confidence intervals (CIs), from which diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and summary receiver operating characteristic (sROC) were derived to indicate the diagnostic accuracy of imaging modalities. With MRE, the sensitivity, specificity, DOR, PLR, NLR, and area under sROC curve (with 95% CIs) for staging F0 ∼ F1 versus F2 ∼ F4 and F0 ∼ F2 versus F3 ∼ F4 were 0.94 (0.81‐0.98), 0.95 (0.87‐0.98), 20 (7‐57), 0.06 (0.02‐0.22), 317 (55‐1,796), 0.98 (0.97‐0.99) and 0.92 (0.85‐0.96), 0.96 (0.91‐0.98), 21 (10‐45), 0.08 (0.04‐0.16), 251 (103‐609), and 0.98 (0.96‐0.99), respectively; and with DWI, these values were 0.77 (0.71‐0.82), 0.78 (0.69‐0.85), 3 (2‐5), 0.30 (0.22‐0.40), 12 (6‐21), 0.83 (0.79‐0.86) and 0.72 (0.60‐0.81), 0.84 (0.77‐0.89), 5 (3‐7), 0.34 (0.23‐0.50), 13 (6‐29), and 0.86 (0.83‐0.89), respectively. A z test demonstrated that MRE had a significantly higher accuracy than DWI in those indicators (P < 0.05). Conclusion: MRE is more reliable for staging hepatic fibrosis, compared with DWI, with a high combination of sensitivity, specificity, likelihood ratios, DOR, and area under sROC curve. (HEPATOLOGY 2012;56:239–247)
Child Safety in Vehicles: Validation of a Mathematical Model and Development of Restraint System Design Guidelines for 3-Year-Olds through Mathematical Simulations

Objective: The objectives of this study are to validate a mathematical simulation model of the Q3 ATD in an integrated forward-facing booster-type restraint in the rear seat and to evaluate restraint parameters to further develop design guidelines for this type of restraint system for forward-facing children corresponding to the size of the Q3. Only frontal impact was considered. Methods: The software MADYMO was used to create and run the model of the restraint system and model of the child. The restraint system consisted of a seat and a safety belt. The child dummy model was the Q3. The complete model was validated to sled tests on 12 response signals: displacements of the dummy model, safety belt forces, and dummy model accelerations. The method used in the evaluation of the restraint parameters was a factorial design of experiments (DOE). The study included a total of 9 parameters: 6 related to the safety belt, such as pretensioner, load limiter, and belt anchor positions; two parameters related to the seat (stiffness and pitch angle); and one related to the foot support. The parameters were evaluated based on their effect on a number of dummy model responses. Results: The validation study showed that the mathematical model predicted the ATD's kinematics and measurements. Furthermore, the parameters that had the greatest effect on the dummy model responses were the lap belt angle, the D-ring x and y positions (upper belt anchor), the retractor pretensioner, and the retractor load limiter. The lap belt angle had the greatest effects of all parameters. The resulting head x displacement was 7.8 cm shorter with a lap belt angle of 24 degrees to the horizontal, compared to a 73 degrees to the horizontal belt angle; it also resulted in a reduction of the head resultant acceleration by 9.8 g. Conclusions: In order to decrease the Q3 ATD head, chest, and pelvis accelerations and to limit the Q3 ATD head displacement, the following practices are recommended: first, position the D-ring rearward of the ATD so that the belt encloses the ATD's shoulder; second, position the lap belt anchors to make the lap belt angle 24 degrees to the horizontal, but make sure submarining is not induced; and finally, use a safety belt with pretensioner and load limiter functions. However, these recommendations need to be balanced with the recommendations for other occupant sizes, and any specific settings have to be evaluated further before introduction into vehicles.
Identification of carbonic anhydrase 9 as a contributor to pingyangmycin‐induced drug resistance in human tongue cancer cells

Drug resistance is the major obstacle to successful cancer treatment. To understand the mechanisms responsible for drug resistance in tongue cancer, Tca8113 cells derived from moderately differentiated human tongue squamous cell carcinoma were exposed to stepwise escalated concentrations of pingyangmycin (PYM) to develop the resistant cell line called Tca8113/PYM, which showed over 18.78‐fold increased resistance to PYM as compared with Tca8113 cells, and cross‐resistance to cisplatin, pirarubicin, paclitaxel, adriamycin, and mitomycin. We found that the resistance was not associated with multidrug resistance transporter 1 (p170, p‐gp), multidrug resistance‐associated protein 1 and breast cancer resistance protein overexpression, so we hypothesized that Tca8113/PYM cells must have some other resistance mechanism selected by PYM. To test this hypothesis, the global gene expression profiles between Tca8113 and Tca8113/PYM cells were compared by cDNA microarray. Eighty‐nine genes and thirteen expressed sequence tags with differential expression levels between the two cell lines were identified. Some differential expression levels were validated with real‐time PCR and western blot. Furthermore, the functional validation showed that both carbonic anhydrase (CA) inhibitor acetazolamide application and CA9 silencing with CA9 antisense oligonucleotides contribute to the medium pH increase of Tca8113/PYM cells and enhanced PYM chemosensitivity. Moreover, both acetazolamide and CA9 antisense oligonucleotides significantly increased PYM‐induced caspase 3 activation in Tca8113/PYM cells. Thus, our study suggests that the resistance of Tca8113/PYM cells is probably associated with CA9 and other differential expression molecules, and that CA9 may be an important marker for prediction of PYM responsiveness in tongue cancer chemotherapy.
Episodic Crises in the Provision of Care to Elderly Relatives

An extensive body of research explores caring for older relatives. However, relatively little is known about crisis episodes in the provision of care to older adults. The purpose of this research is to explore the nature of crises in employed caregivers' lives by examining the type, frequency, and impact associated with crises. Data come from the Canadian Aging Research Network's (CARNET) survey of 5,496 employed Canadians. The analyses focus on open- and close-ended data collected from 250 respondents (108 men and 142 women) with caregiving responsibilities. Nearly half the participants (47%) reported a crisis in the previous 6 months. Crises are predictable and unpredictable events in the lives of the caregiver and the older person receiving care. They are primarily health related but could also be social, emotional, financial, and idiosyncratic to a family. Findings from this research contribute to a more comprehensive understanding of the trajectories in caregiving.
Religious Involvement and DSM-IV 12-Month and Lifetime Major Depressive Disorder Among African Americans

Abstract This study explores relationships between lifetime and 12-month DSM-IV major depressive disorder and religious involvement within a nationally representative sample of African American adults (n = 3,570). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview. Multivariate findings indicate that reading religious materials were positively associated with 12-month (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.001–1.29) and lifetime (OR, 1.12; 95% CI, 1.03–1.21) MDD, religious service attendance was inversely associated with 12-month and lifetime MDD, and religious coping was inversely associated with 12-month MDD (OR, 0.75, 95% CI, 0.57–0.99). Findings are discussed in relation to the role of religion for African American mental health, prior research on the effects of religious involvement on physical and mental health, and theoretical and conceptual models of religion-health connections that specify multiple and often divergent pathways (e.g., prevention and resource mobilization) by which diverse forms of religious involvement impact mental health.
Dysregulation of innate immunity in hepatitis C virus genotype 1 IL28B‐unfavorable genotype patients: Impaired viral kinetics and therapeutic response

Recent studies have shown that a single‐nucleotide polymorphism upstream of the interleukin‐28B (IL28B) gene plays a major role in predicting therapeutic response in hepatitis C virus (HCV)‐infected patients treated with pegylated interferon (PEG‐IFN)/ribavirin. We sought to investigate the mechanism of the IL28B polymorphism, specifically as it relates to early HCV viral kinetics, IFN pharmacokinetics, IFN pharmacodynamics, and gene expression profiles. Two prospective cohorts (human immunodeficiency virus [HIV]/HCV‐coinfected and HCV‐monoinfected) completing treatment with IFN/ribavirin were enrolled. Patients were genotyped at the polymorphic site rs12979860. In the HIV/HCV cohort, frequent serum sampling was completed for HCV RNA and IFN levels. DNA microarray of peripheral blood mononuclear cells and individual expression of IFN‐stimulated genes (ISGs) were quantified on IFN therapy. The IL28B‐favorable (CC) genotype was associated with improved therapeutic response compared with unfavorable (CT or TT) genotypes. Patients with a favorable genotype had greater first‐ and second‐phase viral kinetics (P = 0.004 and P = 0.036, respectively), IFN maximum antiviral efficiency (P = 0.007) and infected cell death loss (P = 0.009) compared with unfavorable genotypes. Functional annotation analysis of DNA microarray data was consistent with depressed innate immune function, particularly of natural killer cells, from patients with unfavorable genotypes (P <0.004). Induction of innate immunity genes was also lower in unfavorable genotypes. ISG expression at baseline and induction with IFN was independent of IL28B genotype. Conclusion: Carriers of the IL28B‐favorable genotype were more likely to have superior innate immune response to IFN therapy compared with unfavorable genotypes, suggesting that the unfavorable genotype has aberrant baseline induction of innate immune response pathways resulting in impaired virologic response. IL28B genotype is associated with more rapid viral kinetics and improved treatment response outcomes independent of ISG expression. (HEPATOLOGY 2012)
A Randomized Comparison of Two Synthetic Mid-Urethral Tension-Free Slings

MeThOdS: between January 2004 and September 2005, 96 women with stress urinary incontinence were consecutively assigned to Gynecare TVT® or boston Scientific Lynx® mid-urethral slings (n=48 in each group) at the University of Nebraska Medical Center. both groups were similar in mean age, parity, weight, preoperative post-void residual, cystometric capacity, flow rate, and urethral closure pressures. Postmenopausal status and previous incontinence surgery rates were also comparable. Intraoperative complications, ease of trocar placement, postoperative voiding difficulties, subjective and objective cure rates, and postoperative interventions were assessed. during statistical analysis, p<0.05 was used as cut-off for significance.
The Social Context of Motorcycle Riding and the Key Determinants Influencing Rider Behavior: A Qualitative Investigation

Objective: Given the increasing popularity of motorcycle riding and heightened risk of injury or death associated with being a rider, this study explored rider behavior as a determinant of rider safety and, in particular, key beliefs and motivations that influence such behavior. To enhance the effectiveness of future education and training interventions, it is important to understand riders’ own views about what influences how they ride. Specifically, this study sought to identify key determinants of riders’ behaviors in relation to the social context of riding, including social and identity-related influences relating to the group (group norms and group identity) as well as the self (moral/personal norm and self-identity). Method: Qualitative research was undertaken via group discussions with motorcycle riders (n = 41). Results: The findings revealed that those in the group with which one rides represent an important source of social influence. Also, the motorcyclist (group) identity was associated with a range of beliefs, expectations, and behaviors considered to be normative. Exploration of the construct of personal norm revealed that riders were most cognizant of the “wrong things to do” when riding; among those issues raised was the importance of protective clothing (albeit for the protection of others and, in particular, pillion passengers). Finally, self-identity as a motorcyclist appeared to be important to a rider's self-concept and was likely to influence on-road behavior. Conclusion: Overall, the insight provided by the current study may facilitate the development of interventions including rider training as well as public education and mass media messages. The findings suggest that these interventions should incorporate factors associated with the social nature of riding in order to best align it with some of the key beliefs and motivations underpinning riders’ on-road behaviors.
No Association Between Cumulative Traumatic Experiences and Sex in Risk for Posttraumatic Stress Disorder Among Human Immunodeficiency Virus–Positive Adults

Abstract This study examined the association between the type and number of traumatic experiences and the conditional risk for posttraumatic stress disorder (PTSD), stratified by sex, in human immunodeficiency virus (HIV). We evaluated 465 (114 male and 350 female) HIV-positive adults attending HIV clinics in Cape Town, South Africa. Demographic and clinical data were collected, and the participants were screened for current PTSD and traumatic event exposure using the Mini-International Neuropsychiatric Interview and the Life Events Checklist, respectively. The highest attributable risk for PTSD was derived from sexual assault (17.4%) and transport accidents (16.9%). Only sexual assault was significantly (p = 0.002) associated with current PTSD. Although sex had no effect on the prediction of current PTSD, HIV-infected men tended to experience more lifetime traumas than HIV-infected women, with the men having significantly higher rates of exposure than women to physical assault (p = 0.018) and assault with a weapon (p = 0.001). These data highlight the importance of considering trauma type in contributing to the burden of PTSD in HIV-infected adults.
Fatal Crashes of 16- to 17-Year-Old Drivers Involving Alcohol, Nighttime Driving, and Passengers

Objective: The objective of this study was to provide a contemporary analysis of the alcohol-impaired driving problem among 16- to 17-year-olds and to consider the potential role of night and passenger restrictions in dealing with the alcohol problem by determining how many of the alcohol-related crashes take place at night or with passengers. Methods: The data were derived from the Fatality Analysis Reporting System for 16- to 17-year-old passenger vehicle drivers in fatal crashes during 2005–2009. Results: During the 5-year period, 15 percent of the 8664 16- to 17-year-old drivers in fatal crashes had positive blood alcohol concentrations, most of which were 0.08 percent or greater. Drivers in alcohol-related crashes were more likely than those in non-alcohol-related crashes to be male, unbelted, in single vehicles, and speeding, and their crashes were more likely to occur on Saturday or Sunday, at night, and when passengers were present. Of the alcohol-related crashes, 88 percent took place at night or with passengers present or both, as did 67 percent of the non-alcohol-related crashes. Conclusions: Stronger night and passenger restrictions with increased compliance and greater application of alcohol-specific policies would likely be effective in reducing the alcohol-related and non-alcohol-related crashes of 16- to 17-year-olds. Increasing the licensing age beyond age 16 would supplement the effectiveness of these actions.
Disruption of hemochromatosis protein and transferrin receptor 2 causes iron‐induced liver injury in mice

Mutations in hemochromatosis protein (HFE) or transferrin receptor 2 (TFR2) cause hereditary hemochromatosis (HH) by impeding production of the liver iron‐regulatory hormone, hepcidin (HAMP). This study examined the effects of disruption of Hfe or Tfr2, either alone or together, on liver iron loading and injury in mouse models of HH. Iron status was determined in Hfe knockout (Hfe−/−), Tfr2 Y245X mutant (Tfr2mut), and double‐mutant (Hfe−/−×Tfr2mut) mice by measuring plasma and liver iron levels. Plasma alanine transaminase (ALT) activity, liver histology, and collagen deposition were evaluated to assess liver injury. Hepatic oxidative stress was assessed by measuring superoxide dismutase (SOD) activity and F2‐isoprostane levels. Gene expression was measured by real‐time polymerase chain reaction. Hfe−/−×Tfr2mut mice had elevated hepatic iron with a periportal distribution and increased plasma iron, transferrin saturation, and non‐transferrin‐bound iron, compared with Hfe−/−, Tfr2mut, and wild‐type (WT) mice. Hamp1 expression was reduced to 40% (Hfe−/− and Tfr2mut) and 1% (Hfe−/−×Tfr2mut) of WT values. Hfe−/− ×Tfr2mut mice had elevated plasma ALT activity and mild hepatic inflammation with scattered aggregates of infiltrating inflammatory cluster of differentiation 45 (CD45)–positive cells. Increased hepatic hydoxyproline levels as well as Sirius red and Masson's Trichrome staining demonstrated advanced portal collagen deposition. Hfe−/− and Tfr2mut mice had less hepatic inflammation and collagen deposition. Liver F2‐isoprostane levels were elevated, and copper/zinc and manganese SOD activities decreased in Hfe−/−×Tfr2mut, Tfr2mut, and Hfe−/− mice, compared with WT mice. Conclusion: Disruption of both Hfe and Tfr2 caused more severe hepatic iron overload with more advanced lipid peroxidation, inflammation, and portal fibrosis than was observed with the disruption of either gene alone. The Hfe−/−×Tfr2mut mouse model of iron‐induced liver injury reflects the liver injury phenotype observed in human HH. (HEPATOLOGY 2012)
An Empirical Analysis of Nurse Retention: What Keeps RNs in Nursing?

OBJECTIVE: This study investigates the effects of stress, economic factors, altruism, and value congruence on intentions to leave jobs and the nursing profession. BACKGROUND: Retaining nurses will be critical for healthcare organizations as the demand for nurses increases. Regulation and cost pressures are changing the nursing work environment. METHODS: We surveyed 861 RNs in the southeastern United States. Structural equation modeling was used to analyze the survey. RESULTS: Results confirm the importance of stress and salaries and underscore the impact of both value congruence and altruism. Evidence shows a correlation between altruistic desires and intentions to leave the profession. CONCLUSIONS: Efforts to retain nurses should include matching nurse and organizational values. Initiatives need to be undertaken to increase professional autonomy and provide opportunities for the expression of altruism. Further research is indicated to investigate the unexpected result that highly altruistic nurses are leaving the profession.
Immediate intraportal transplantation of human bone marrow mesenchymal stem cells prevents death from fulminant hepatic failure in pigs

The effectiveness of human bone marrow mesenchymal stem cell (hBMSC) transplantation to treat acute and chronic liver injury has been demonstrated in animal models and in a few nonrandomized clinical trials. However, no studies have investigated hBMSC transplantation in the treatment of fulminant hepatic failure (FHF), especially in large animal (pig) models. The aim of this study was to demonstrate the safety, effectiveness, and underlying mechanism of hBMSC transplantation for treating FHF in pigs through the intraportal route. Human BMSCs (3 × 107) were transplanted into pigs with FHF via the intraportal route or peripheral vein immediately after D‐galactosamine injection, and a sham group underwent intraportal transplantation (IPT) without cells (IPT, peripheral vein transplantation [PVT], and control groups, respectively, n = 15 per group). All of the animals in the PVT and control groups died of FHF within 96 hours. In contrast, 13 of 15 animals in the IPT group achieved long‐term survival (>6 months). Immunohistochemistry demonstrated that transplanted hBMSC‐derived hepatocytes in surviving animals were widely distributed in the hepatic lobules and the liver parenchyma from weeks 2 to 10. Thirty percent of the hepatocytes were hBMSC‐derived. However, the number of transplanted cells decreased significantly at week 15. Only a few single cells were scattered in the regenerated liver lobules at week 20, and the liver tissues exhibited a nearly normal structure. Conclusion: Immediate IPT of hBMSCs is a safe and effective treatment for FHF. The transplanted hBMSCs may quickly participate in liver regeneration via proliferation and transdifferentiation into hepatocytes during the initial stage of FHF. This method can possibly be used in future clinical therapy. (HEPATOLOGY 2012;56:1044–1052)
Employment Outcomes of Gerontology Certificate Graduates

Students desiring specialized skills and knowledge in working with older adults frequently pursue gerontology certificates. This paper reports the results of a study of gerontology certificate graduates which examined their educational backgrounds, their employment status, the predictive factors which led to aging-related jobs, and their recommendations for improvement to the certificate program. Certificate graduates came from varying educational backgrounds. Most were able to use their gerontology training, usually by being employed in aging-related work or else by utilizing their skills in other professional capacities. Implications for job placement and curriculum development are discussed.
An Assessment of Commercial Motor Vehicle Driver Distraction Using Naturalistic Driving Data

Objective: This study analyzed naturalistic driving data from commercial trucks (3-axle and tractor-trailer/tanker) and buses (transit and motorcoach) during a 3-month period. Methods: The data set contained 183 commercial truck and bus fleets comprising 13,306 vehicles and included 1085 crashes, 8375 near crashes, 30,661 crash-relevant conflicts, and 211,171 baseline events. Study results documented the prevalence of tertiary tasks and the risks associated with performing these tasks while driving. Results: Results indicated the odds of involvement in a safety-critical event differed as a function of performing different cell phone–related subtasks while driving. Although the odds ratio for talking/listening on a cell phone while driving was found to not significantly increase the likelihood of involvement in a safety-critical event, other cell phone subtasks (e.g., texting, dialing, reaching) were found to significantly increase the odds of involvement in a safety-critical event. Conclusions: The results suggest that cell phone use while driving should not be considered a simple dichotomous task (yes/no). Consideration should instead be made for a set of discrete cell phone subtasks that are each associated with varying levels of risk. Several hypotheses are presented to explain why cell phone use while driving was found to not increase the likelihood of involvement in a safety-critical event.