Miracle-dz/UniFAR-FTUs huggingface dataset:
Exploring the Potential of Technology-Based Mental Health Services for Homeless Youth: A Qualitative Study

Homelessness has serious consequences for youth that heighten the need for mental health services; however, these individuals face significant barriers to access. New models of intervention delivery are required to improve the dissemination of mental health interventions that tailor these services to the unique challenges faced by homeless youth. The purpose of this study was to better understand homeless youths’ use of technology, mental health experiences and needs, and willingness to engage with technology-supported mental health interventions to help guide the development of future youth-facing technology-supported interventions. Five focus groups were conducted with 24 homeless youth (62.5% female) in an urban shelter. Youth were 18- to 20-years-old with current periods of homelessness ranging from 6 days to 4 years. Transcripts of these focus groups were coded to identify themes. Homeless youth reported using mobile phones frequently for communication, music, and social media. They indicated a lack of trust and a history of poor relationships with mental health providers despite recognizing the need for general support as well as help for specific mental health problems. Although initial feelings toward technology that share information with a provider were mixed, they reported an acceptance of tracking and sharing information under certain circumstances. Based on these results, we provide recommendations for the development of mental health interventions for this population focusing on technology-based treatment options.
The impact of HIV/AIDS on education and institutionalizing preventive education

The objective of this book on The Impact of HIV/AIDS on Education and Institutionalizing Preventive Education is to provide a compilation of various research findings on the impact of HIV/AIDS on education in countries south of the Sahara which is the world’s most infected region. It also presents different options available to the education ministries and government decision-makers with regard to the use of education as an instrument to mitigate the effect of HIV/AIDS as well as a tool for its prevention. (excerpt)
Cystatin C and aging success.

BACKGROUND To our knowledge, the effect of kidney function on successful aging has not been examined. METHODS We evaluated the relationship between cystatin C and aging success during a 6-year follow-up in the Cardiovascular Health Study, a community-based cohort of older adults (aged >or= 65 years). Successful aging was defined as remaining free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease and having intact physical and cognitive functioning. In adjusted analysis, an accelerated failure time model was used to evaluate the percentage reduction in successful years by level of cystatin C. A separate Cox proportional hazards model evaluated whether cystatin C was related to incident physical and cognitive disability. RESULTS A total of 2140 participants had cystatin C measured and were free of the previously mentioned conditions at baseline. Their mean age was 74 years. The mean cystatin C level, creatinine level, and estimated glomerular filtration rate were 1.06 mg/L, 0.93 mg/dL, and 78 mL/min/1.73 m(2), respectively (to convert cystatin C to nanomoles per liter, multiply by 75; and to convert creatinine to micromoles per liter, multiply by 88.4). A total of 873 participants reached a first event in follow-up, 138 because of cognitive disability, 238 because of physical disability, 34 because of chronic obstructive pulmonary disease, 146 because of cancer, and 317 because of cardiovascular disease. The adjusted percentage reduction in successful life years in the highest vs the lowest quartile of cystatin C was 27% (95% confidence interval, 11%-39%). The highest vs lowest quartile of cystatin C also was independently associated with incident cognitive or physical disability (hazard ratio, 1.39; 95% confidence interval, 1.00-1.98). CONCLUSION A higher cystatin C level, even within a range of relatively normal kidney function, was associated with unsuccessful aging.
HYPERTENSION IN HEMODIALYSIS PATIENTS: Noncardiac Consequences of Hypertension in Hemodialysis Patients

The incidence of cerebrovascular events and peripheral vascular disease is higher in dialysis patients compared to the general population. Although normotensive dialysis patients have an elevated risk of stroke, hypertension remains an important risk factor for symptomatic cerebrovascular accidents. The risk of stroke increases in a linear fashion with blood pressure (BP) level. Furthermore, hypertension is also an important risk factor for silent cerebral infarction in dialysis patients. With regard to peripheral vascular disease, the association with hypertension is less clear. The spectrum of cerebrovascular accidents differs from the general population, as the relative incidence of cerebral hemorrhage to cerebral infarction is much higher. The prognosis of cerebral hemorrhage is poor and depends on the size and location of the hemorrhage. In order to prevent noncardiac complications, strict control of hypertension is of major importance in dialysis patients.
Vitamin C intake and the risk of gout in men: a prospective study.

BACKGROUND Several metabolic studies and a recent double-blind, placebo-controlled, randomized trial have shown that higher vitamin C intake significantly reduces serum uric acid levels. Yet the relation with risk of gout is unknown. METHODS We prospectively examined, from 1986 through 2006, the relation between vitamin C intake and risk of incident gout in 46 994 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout. Vitamin C intake was assessed every 4 years through validated questionnaires. RESULTS During the 20 years of follow-up, we documented 1317 confirmed incident cases of gout. Compared with men with vitamin C intake less than 250 mg/d, the multivariate relative risk (RR) of gout was 0.83 (95% confidence interval [CI], 0.71-0.97) for total vitamin C intake of 500 to 999 mg/d, 0.66 (0.52-0.86) for 1000 to 1499 mg/d, and 0.55 (0.38-0.80) for 1500 mg/d or greater (P < .001 for trend). The multivariate RR per 500-mg increase in total daily vitamin C intake was 0.83 (95% CI, 0.77-0.90). Compared with men who did not use supplemental vitamin C, the multivariate RR of gout was 0.66 (95% CI, 0.49-0.88) for supplemental vitamin C intake of 1000 to 1499 mg/d and 0.55 (0.36-0.86) for 1500 mg/d or greater (P < .001 for trend). CONCLUSIONS Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout.
Essential Epidemiology: An Introduction for Students and Health Professionals

This is an accessible, easily readable, and modern introduction to epidemiology for students of medicine and public health. It combines a strong public health perspective and rationale with modern methodological insights in a coherent and straight forward way. It emphasises the fundamental principles common to all areas of epidemiology and, unlike many other texts, integrates both public health and clinical epidemiology and the study of infectious and chronic diseases. It aims to give health professionals a good understanding of the methods and potential problems underlying epidemiological data and reports but also provides a thorough introduction for would-be epidemiologists. The 'nuts and bolts' of epidemiology are embedded in the wider health perspective and the concluding chapter explores future possibilities and emphasises the integration of the various strands of the discipline. The basic messages are reinforced through numerous examples and questions, with answers provided.
Suboptimal nutritional intake for hypertension control in 4 ethnic groups.

BACKGROUND This study compared intake of specific nutrients based on the Dietary Approaches to Stop Hypertension (DASH) guidelines for hypertension management among multiethnic middle-aged and older adults. METHODS We conducted quantitative analysis using baseline data of a prospective cohort study of 5972 adults aged 45 to 84 years recruited between July 2000 and August 2002 who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). Diet information was collected using a 120-item food frequency questionnaire. Bivariate and multivariate methods were used to evaluate associations between DASH-accordant intake of each nutrient (fat, saturated fat, cholesterol, protein, fiber, calcium, magnesium, and potassium) with ethnicity and hypertension status. RESULTS Less than 30% of MESA participants met any DASH nutrient target. DASH accordance was lowest in saturated fat intake and highest in cholesterol intake (5.3% and 29.5% of the participants, respectively). Multivariate analyses showed significant ethnic differences in DASH accordance in all nutrients but saturated fat. Compared with white participants, Chinese American participants had greater DASH accordance in cholesterol (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.13-1.67) and protein intake (2.32; 1.55-3.49) but less in total fat (0.47; 0.30-0.74), magnesium (0.58; 0.51-0.67), and potassium intake (0.40; 0.20-0.81); African Americans and Hispanics had greater DASH accordance in fiber intake (1.36; 1.13-1.62; and 2.23; 1.53-3.23, respectively) but less in calcium intake (0.44; 0.37-0.52; and 0.79; 0.68-0.91, respectively). Diagnosed and uncontrolled hypertension was associated with less DASH accordance in saturated fat (OR, 0.80; 95% CI, 0.70-0.91) and magnesium (0.80; 0.71-0.91). DASH accordance differed significantly with and without inclusion of dietary supplements in the analysis. CONCLUSIONS There is significant variation in DASH goal attainment among different ethnic groups. Assessments of nutrient intake that exclude dietary supplements may be underestimating DASH accordance.
Dramatic reduction in infective endocarditis-related mortality with a management-based approach.

BACKGROUND Despite improvements in medical and surgical therapy, infective endocarditis (IE) is still associated with a severe prognosis and remains a therapeutic challenge. We aimed to evaluate the impact of a standardized diagnostic and therapeutic protocol on mortality and to correlate the outcome with compliance with our management-based protocol. METHODS We conducted an observational before-after study that included 333 consecutive patients treated for IE at a referral center from 1991 to 2006, which was divided into 2 periods: period 1 (1991-2001), before implementation of our therapeutic protocol (n = 173), and period 2 (2002-2006), after implementation of our protocol (n = 160). Our protocol was created by a multidisciplinary task force including a sampling of biological specimens, the use of only 4 antimicrobial agents, a standardized duration of treatment, standardized surgical indications, and 1 year of close follow-up. Because our protocol was based on a local consensus by physicians and surgeons, it was not possible to randomize the study. RESULTS The 1-year mortality significantly decreased from 18.5% during period 1 to 8.2% during period 2 (hazard ratio, 0.41; 95% confidence interval, 0.21-0.79 [P = .008]). After multivariable analysis, the management during period 2 remained a strong protective factor (adjusted hazard ratio, 0.26; 95% confidence interval, 0.09-0.76 [P = .01]). During period 2, we observed a statistically significantly better compliance in antimicrobial therapy and fewer cases of renal failure. Deaths by embolic events and multiple organ failure syndrome also significantly decreased during period 2. CONCLUSION A dramatic reduction in mortality was observed during this study, suggesting that a management-based approach has a significant impact on IE outcome.
Maternal Posttraumatic Stress Disorder and Infant Developmental Outcomes in a South African Birth Cohort Study

Objective: To investigate the association between maternal posttraumatic stress disorder (PTSD) and infant development in a South African birth cohort. Method: Data from the Drakenstein Child Health Study were analyzed. Maternal psychopathology was assessed using self-report and clinician-administered interviews; and 6-month infant development using the Bayley III Scales of Infant Development. Linear regression analyses explored associations between predictor and outcome variables. Results: Data from 111 mothers and 112 infants (1 set of twins) were included. Most mothers (72%) reported lifetime trauma exposure; the lifetime prevalence of PTSD was 20%. Maternal PTSD was significantly associated with poorer fine motor and adaptive behavior – motor development; the latter remaining significant when adjusted for site, alcohol dependence, and infant head-circumference-for-age z score at birth. Conclusion: Maternal PTSD may be associated with impaired infant neurodevelopment. Further work in low- and middle-income populations may improve early childhood development in this context.
Pitavastatin decreases the expression of endothelial lipase both in vitro and in vivo.

AIMS In addition to their cholesterol-lowering effect, statins increase high-density lipoprotein cholesterol (HDL-C) levels. Endothelial lipase (EL) is a regulator of plasma HDL-C levels. In the present study, the effects of statins on EL expression were investigated. METHODS AND RESULTS The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pitavastatin suppressed basal and cytokine-treated EL expression in endothelial cells. Concomitant treatment with mevalonate or geranylgeranyl pyrophosphate completely reversed the inhibitory effect of pitavastatin, suggesting that geranylgeranylated proteins are involved in the inhibition of EL expression by statins. Inhibition of RhoA activity by overexpression of a dominant-negative mutant of RhoA or a Rho kinase inhibitor decreased EL levels. Pitavastatin reduced phospholipase activities of endothelial cells, and concomitant treatment with mevalonate reversed its inhibitory effect. Pitavastatin reduced RhoA activity and EL expression in mouse tissues. Furthermore, plasma EL concentrations in human subjects were measured by enzyme-linked immunosorbent assays. Plasma EL levels were negatively associated with plasma HDL levels in 237 patients with cardiovascular diseases, and pitavastatin treatment reduced plasma EL levels and increased HDL-C levels in 48 patients with hypercholesterolaemia. CONCLUSION These findings suggest that statins can reduce EL expression in vitro and in vivo via inhibition of RhoA activity. The inhibition of EL expression in the vessel wall may contribute to the anti-atherogenic effects of statins.
ADAM15 regulates endothelial permeability and neutrophil migration via Src/ERK1/2 signalling.

AIMS Endothelial barrier dysfunction is a key event in the pathogenesis of vascular diseases associated with inflammation. ADAM (a disintegrin and metalloprotease) 15 has been shown to contribute to the development of vascular inflammation. However, its role in regulating endothelial barrier function is unknown. The aim of this study was to examine the effect of ADAM15 on endothelial permeability and its underlying mechanisms. METHODS AND RESULTS By measuring albumin transendothelial flux and transendothelial electric resistance in cultured human umbilical vein endothelial cell monolayers, we found that depletion of ADAM15 expression via siRNA decreased endothelial permeability and attenuated thrombin-induced barrier dysfunction. In contrast, endothelial cells overexpressing either wild-type or catalytically dead mutant ADAM15 displayed a higher basal permeability and augmented hyperpermeability in response to thrombin. In addition, ADAM15 knockdown inhibited whereas ADAM15 overexpression promoted neutrophil transendothelial migration. Further molecular assays revealed that ADAM15 did not cleave vascular endothelial-cadherin or cause its degradation. However, overexpression of ADAM15 promoted extracellular signal-regulated kinase (ERK)1/2 phosphorylation in both non-stimulated and thrombin-stimulated endothelial cells in a protease activity-independent manner. Pharmacological inhibition of Src kinase or ERK activation reversed ADAM15-induced hyperpermeability and neutrophil transmigration. CONCLUSION The data provide evidence for a novel function of ADAM15 in regulating endothelial barrier properties. The mechanisms of ADAM15-induced hyperpermeability involve Src/ERK1/2 signalling independent of junction molecule shedding.
Controlling immune response and demyelination using highly potent bifunctional peptide inhibitors in the suppression of experimental autoimmune encephalomyelitis

In this study, we investigated the efficacy of new bifunctional peptide inhibitors (BPIs) in suppressing experimental autoimmune encephalomyelitis (EAE) in an animal model. BPI [e.g. proteolipid protein–cyclo(1,8)‐CPRGGSVC‐NH2 (PLP‐cIBR)] is a conjugate between the PLP139–151 peptide derived from proteolipid protein (PLP) and the cIBR7 peptide derived from domain‐1 (D1) of intercellular adhesion molecule‐1 (ICAM‐1). PLP–cIBR is designed to bind to major histocompatibility complex (MHC)‐II and leucocyte function‐associated antigen‐1 (LFA‐1) simultaneously to inhibit the formation of the immunological synapse and alter the differentiation and activation of a subpopulation of T cells, thus inducing immunotolerance. The results show that PLP–cIBR is highly potent in ameliorating EAE, even at low concentrations and less frequent injections. Mice treated with PLP–cIBR had a higher secretion of cytokines related to regulatory and/or suppressor cells compared to phosphate‐buffered saline (PBS)‐treated mice. In contrast, T helper type 1 (Th1) cytokines were higher in mice treated with PBS compared to PLP–cIBR, suggesting that it suppressed Th1 proliferation. Also, we observed significantly less demyelination in PLP‐cIBR‐treated mice compared to the control, further indicating that PLP–cIBR promoted protection against demyelination.
Conceptual Structure and the Procedural Affordances of Rational Numbers : Relational Reasoning With Fractions and Decimals

The standard number system includes several distinct types of notations, which differ conceptually and afford different procedures. Among notations for rational numbers, the bipartite format o f fractions (a/b) enables them to represent 2-dimensional relations between sets o f discrete (i.e., countable) elements (e.g., red marbles/all marbles). In contrast, the format o f decimals is inherently 1-dimensional, expressing a continuous-valued magnitude (i.e., proportion) but not a 2-dimensional relation between sets of countable elements. Experiment 1 showed that college students indeed view these 2-number notations as concep­ tually distinct. In a task that did not involve mathematical calculations, participants showed a strong preference to represent partitioned displays o f discrete objects with fractions and partitioned displays of continuous masses with decimals. Experiment 2 provided evidence that people are better able to identify and evaluate ratio relationships using fractions than decimals, especially for discrete (or discretized) quantities. Experiments 3 and 4 found a similar pattern o f performance for a more complex analogical reasoning task. W hen solving relational reasoning problems based on discrete or discretized quantities, fractions yielded greater accuracy than decimals; in contrast, when quantities were continuous, accuracy was lower for both symbolic notations. Whereas previous research has established that decimals are more effective than fractions in supporting magnitude comparisons, the present study reveals that fractions are relatively advantageous in supporting relational reasoning with discrete (or discretized) concepts. These findings provide an explanation for the effectiveness of natural frequency formats in supporting some types of reasoning, and have implications for teaching of rational numbers.
Paediatric Crohn disease patients with stricturing behaviour exhibit ileal granulocyte–macrophage colony‐stimulating factor (GM‐CSF) autoantibody production and reduced neutrophil bacterial killing and GM‐CSF bioactivity

Granulocyte–macrophage colony‐stimulating factor (GM‐CSF) autoantibodies are associated with stricturing behaviour in Crohn disease (CD). We hypothesized that CD ileal lamina propria mononuclear cells (LPMC) would produce GM‐CSF autoantibodies and peripheral blood (PB) samples would contain GM‐CSF neutralizing capacity (NC). Paediatric CD and control PBMC and ileal biopsies or LPMC were isolated and cultured and GM‐CSF, immunoglobulin (Ig)G and GM‐CSF autoantibodies production were measured by enzyme‐linked immunosorbent assay (ELISA). Basal and GM‐CSF‐primed neutrophil bacterial killing and signal transducer and activator of transcription 5 (STAT5) tyrosine phosphorylation (pSTAT5) were measured by flow cytometry. GM‐CSF autoantibodies were enriched within total IgG for LPMC isolated from CD ileal strictures and proximal margins compared to control ileum. Neutrophil bacterial killing was reduced in CD patients compared to controls. Within CD, neutrophil GM‐CSF‐dependent STAT5 activation and bacterial killing were reduced as GM‐CSF autoantibodies increased. GM‐CSF stimulation of pSTAT5 did not vary between controls and CD patients in washed PB granulocytes in which serum was removed. However, GM‐CSF stimulation of pSTAT5 was reduced in whole PB samples from CD patients. These data were used to calculate the GM‐CSF NC. CD patients with GM‐CSF NC greater than 25% exhibited a fourfold higher rate of stricturing behaviour and surgery. The likelihood ratio (95% confidence interval) for stricturing behaviour for patients with elevation in both GM‐CSF autoantibodies and GM‐CSF NC was equal to 5 (2, 11). GM‐CSF autoantibodies are produced by LPMC isolated from CD ileal resection specimens and are associated with reduced neutrophil bacterial killing. CD peripheral blood contains GM‐CSF NC, which is associated with increased rates of stricturing behaviour.
Subcutaneous immunoglobulin (16 or 20%) therapy in obese patients with primary immunodeficiency: a retrospective analysis of administration by infusion pump or subcutaneous rapid push

A retrospective chart review was conducted at a single centre, capturing data on 173 primary immunodeficiency disease (PIDD) patients, including 40 obese patients, using subcutaneous administration of immunoglobulin (Ig) (SCIG) (16 or 20%) delivered by infusion pump or subcutaneous (s.c.) rapid push. Patients previously using Ig administered as intravenous (i.v.) infusions (IVIG) were converted to SCIG dosing on a 1:1 basis. In both obese and non‐obese patients, mean serum Ig levels were higher during SCIG administration (steady state) compared with IVIG administration (trough values). Similar SCIG dose : serum IgG level relationships were observed between obese and non‐obese patients, suggesting the consistent bioavailability of SCIG regardless of body mass index (BMI). The mean SCIG volume per dosing site and the mean number of dosing days per week were greater with s.c. rapid push compared with infusion pump in this cohort, but the mean number of sites per infusion session was lower with s.c. rapid push. Both methods were well tolerated. The use of 20 versus 16% SCIG in obese patients improved dosing efficiency, resulting in smaller weekly volumes (54·7 versus 74·5 ml/week) and dosing on fewer days per week (2·3 versus 3·4 days). These data do not suggest a need for SCIG dosing adjustments in obese individuals relative to non‐obese patients. The administration of SCIG using either infusion pump or s.c. rapid push is a practical and well‐tolerated alternative to IVIG in obese patients. Offering various administration techniques provides a greater opportunity for treatment satisfaction and patient empowerment, which may support high levels of patient compliance.