Miracle-dz/UniFAR-FTUs huggingface dataset:
Perspectives on Tiered Older Driver Assessment in Primary Care Settings.

PURPOSE OF THE STUDY Widespread screening of older drivers, with in-depth evaluation only of those who screen positive ("tiered assessment"), might efficiently balance driver safety and mobility. To inform program development, we sought to examine the perspectives of older drivers and clinicians on the concept of tiered assessment in primary care settings. DESIGN AND METHODS Iterative focus groups and interviews with 33 community-dwelling current drivers aged ≥65 years and 8 primary care providers. We used inductive and deductive theme analysis to explore driver and clinician perspectives and to identify barriers and facilitators to establishing a tiered older driver assessment program in primary care settings. RESULTS Four dominant themes emerged. Two themes addressed the overall concept: (a) support for the concept of tiered older driver assessment and (b) concerns about the consequences of older driver assessment and how these could affect program viability. Two themes addressed screening: (c) tension inherent in using a generalized approach to the highly individualized issue of driving and (d) logistical considerations for screening in primary care settings. IMPLICATIONS Standardized older driver screening and referral might improve clinician-driver communication, but screening should occur in a context that includes personalized mobility counseling.
Association between Genetic Variation in Transforming Growth Factors β1 and β3 and Renal Dysfunction in Non-Diabetic Chinese

Genetic variants of transforming growth factor (TGF) β1 have been reported to be associated with diabetic nephropathy. Few studies investigated polymorphisms in the TGF-β1 and TGF-β3 genes in relation to renal dysfunction in non-diabetic subjects. In all, 601 non-diabetic Chinese were genotyped for the TGF-β1 T869C and TGF-β3 IVS3-98G>A polymorphisms by PCR-restriction fragment length polymorphism and real-time allele-specific PCR, respectively. Renal dysfunction was defined as a predicted glomerular filtration rate (GFR) of 60mL/min/1.73m2 or less. 24-hour urinary albumin excretion was measured by an immunonephelometric assay in 352 hypertensive subjects. Our study sample included 184 (30.6%) women, 396 (65.9%) hypertensive patients (65.9%), and 94 (15.6%) patients with renal dysfunction. In men but not women, the TGF-β1 TC genotype was significantly (p = 0.0005) overrepresented in patients with renal dysfunction (52.2% vs 36.8% in subjects with normal renal function). Accordingly, in men, with adjustment for age, body mass index, and systolic and diastolic blood pressure, serum creatinine concentration was significantly (p ≤ 0.03) higher in the TC heterozygotes than TT and CC homozygotes. Furthermore, in 231 male hypertensive patients, with similar adjustments applied, 24-hour urinary albumin excretion was significantly (p = 0.02) higher in the IVS3-98 AA homozygotes than G allele carriers. In further multivariate regression analysis, only in men, TGF-β1 and TGF-β3 genotypes as independent predictors had statistically significant effect on serum creatinine (p = 0.007) and urinary albumin excretion (p = 0.022), respectively. Our study demonstrated the associations of genetic variants in the TGF-β genes with renal dysfunction and albuminuria in non-diabetic Han Chinese men but not women.
Calcitonin, carcinoembryonic antigen and neuron‐specific enolase in medullary thyroid carcinoma. An immunohistochemical study

Calcitonin, carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) were studied in the thyroid glands of patients with multiple endocrine neoplasia (MEN) type 2a, 2b, and with sporadic thyroid carcinomas (MTC). Calcitonin, CEA and NSE were localized in normal C‐cells, hyperplastic C‐cells, and in MTC. While the distribution of calcitonin and CEA was quite similar in most cases, a smaller proportion of cases were positive for NSE. C‐cell hyperplasia was identified in all nine patients with MEN 2a and in four of six patients with MEN 2b. None of the four patients with sporadic MTC had C‐cell hyperplasia. These results indicate that C‐cell hyperplasia is present in patients with MEN 2a and 2b and that NSE in addition to calcitonin and CEA is a useful marker for the thyroid C‐cells.
Association between single nucleotide polymorphisms in prospective genes and susceptibility to ankylosing spondylitis and inflammatory bowel disease in a single centre in Turkey.

BACKGROUND/AIMS To establish the prevalence of the single nucleotide polymorphisms (SNPs) of endoplasmic reticulum aminopeptidase 1 (ERAP1), IL-23 receptor (IL-23R), signal transducer and activator of transcription 3 (STAT-3) and Janus kinase 2 (JAK-2) in ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) in a Turkish population. MATERIALS AND METHODS A total of 562 subjects who presented at the Ankara University internal medicine departments of rheumatology and gastroenterology outpatient clinics were recruited in this study, including 365 patients with AS, 197 patients with IBD and 230 healthy controls. ERAP1, IL-23R, STAT-3 and JAK-2) were genotyped in competitive allele-specific polymerase chain reactions. RESULTS The ERAP1 (rs26653) polymorphism was found to increase the disease risk in patients with AS and IBD compared with the control group (p=0.02 and p=0.01, respectively). In addition, this polymorphism revealed a significant relationship with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI) in patients with AS (r=0.829, p < 0.001 and r=0.731, p < 0.001, respectively). CONCLUSION The ERAP1 gene polymorphism might be a risk factor in the pathogenesis of AS and IBD. In contrast, IL-23R gene polymorphisms may serve a protective role in AS and IBD.
KIN AND NON-KIN MARRIAGES AND FAMILY STRUCTURE IN A RICH TRIBAL SOCIETY

Summary Human consanguinity is often attributed to poverty, lack of education and social insecurity. Nevertheless, kin unions continue to be arranged in socioeconomically transformed societies. This study examined the structure of families and marriages in the rich tribal society of the United Arab Emirates, which has had a high gross domestic product for the last two generations and currently has one of the highest in the world. The respondents were 217 national medical students whose families are proportionally distributed to the population of the country emirates. The rate of parental consanguinity (defined as a union of any two cousins) was 36%. The social status and mean size of consanguineous and non-consanguineous families were not significantly different. In non-consanguineous families, polygamy was more common and the number of half-siblings per family was higher. The extended families were on average 7% larger among non-consanguineous families. In contrast, for the extended families of the participants’ grandparents, non-consanguineous families were smaller than their consanguineous counterparts. Participants from consanguineous families indicated that marriage of either a son or daughter was more difficult to arrange than did participants from non-consanguineous families. Though consanguineous parents had their offspring marry consanguineously more often than non-consanguineous parents, the numbers of married offspring in the two groups of families were not different. Consanguineous parents have more difficulty than non-consanguineous parents in finding spouses for themselves and for their offspring, and they arranged kin marriages for their children more often.
Characterization of B and plasma cells in blood, bone marrow, and secondary lymphoid organs of rhesus macaques by multicolor flow cytometry

B cells, as an important part of the humoral immune response, are generated in the BM, migrate to secondary lymphoid organs, and upon activation, differentiate into antibody‐producing memory B cells or plasma cells. Despite the pivotal roles that they play in different diseases, a comprehensive characterization in healthy rhesus macaques, which serve as valuable models for a variety of human diseases, is still missing. With the use of multiparameter flow cytometry, we analyzed B cells in BM collected from two locations, i.e., the iliac crest (BMca) and the femur (BMfem), PB, as well as secondary lymphoid organs of healthy rhesus macaques. We assessed the frequencies of immature and mature B cells, as well as CD19+ CD20– CD38+/++ CD138+/++ plasmablasts/plasma cells. Furthermore, we found site‐specific differences in the expression of markers for B cell activation and proliferation, chemokine receptors and Igs, as well as the distribution of memory B cell subpopulations. As secondary lymphoid organs harbor the highest frequencies of naive B cells, expression of CD80, CD95, and Ki67 was lower compared with B cells in the periphery and BM, whereas expression of IgD, CXCR4 (CD184), and CCR7 (CD197) was higher. Interestingly, BMca differed from BMfem regarding frequencies of B cells, their expression of CD80 and CXCR4, T cells, and plasma cells. In summary, these data identify baseline values for the above‐mentioned parameters and provide the foundation for future studies on B and plasma cells in different diseases.
Creating sustainable value in the hospitality industry: a (critical) multi-stakeholder study in the Dominican Republic

ABSTRACT This paper identifies sustainable initiatives reported by “sustainability-champion” hotels in the Dominican Republic, while contrasting them against the views of key stakeholders. We adapt and apply Hart and Milstein's Sustainable Value Framework, and complement it with a Critical Management Studies approach. Our analysis relies on a mixed-methods approach (non-hierarchical k-means cluster analysis, as well as thematic and content analysis). Findings indicate that most hotels are engaging more actively in present-oriented strategies such as pollution prevention (especially, the international hotels) and in product/service stewardship. However, in the future-oriented strategies, hotels owned by local investors show higher commitment to both clean technology and innovation, and to the sustainability vision (as the firm's growth path). In addition, although the views of multiple stakeholders show a clear acknowledgment of the hospitality industry's sustainability efforts (particularly regarding education and environmental protection), they also offer differing views about the ultimate impact and value of those efforts for them and for the broader society. Our study offers a new theoretical lens to explore multi-stakeholder approaches and offers practical implications for the Dominican Republic's National Strategy for Development 2010–2030, as well as implications that may be of use for other tourism-dependent countries.
GENETIC, ENVIRONMENTAL, AND CONDITION‐DEPENDENT EFFECTS ON FEMALE AND MALE ORNAMENTATION IN THE BARN OWL TYTO ALBA

Secondary sexual characters are thought to indicate individual quality. Expression of sex‐limited traits in an extravagant state may require both the underlying genes and the available nutrient resources. The assessment of the relative contribution of genes, environment, and body condition is relevant for understanding to that extent the extravagant trait may signal genotypic or phenotypic quality of the individual. In birds, usually only the males are ornamented. In the barn owl, Tyto alba, both females and males display sex‐limited plumage traits. Males are commonly lighter colored and females spottier. In an experiment with combined cross‐fostering and brood size manipulation we determined the relative contribution of genes, environment, and body condition to the variation in plumage coloration and plumage spottiness. The partial cross‐fostering experiment tested the relative importance of shared genes and a shared environment for the resemblance of related birds. Siblings raised in different nests converged toward similar trait values, offspring resembled the true but not the foster parents, and plumage traits of unrelated nestlings sharing the same nest were not correlated. Results were not inflated by maternal effects detectable in the mother's phenotype, because middaughter to mother resemblance was not higher than midson to father resemblance. This suggests that plumage coloration and spottiness are largely genetically inherited traits, and that the rearing environment does not have a strong impact on the expression of these traits. To further investigate whether the two sex‐limited traits are condition dependent, brood sizes were manipulated. Enlargement or reduction of broods by two nestlings resulted in lower and higher body mass of nestlings, respectively. However, nestlings raised in enlarged or reduced broods did not show either a significantly darker or lighter or a more or less spotted plumage. We did not detect any genotype‐by‐environment interaction. In conclusion, simultaneous cross‐fostering and brood size manipulation demonstrate that additive genetic variance for plumage coloration and spottiness is maintained and that both the rearing environment and body condition do not account for a large proportion of the phenotypic variance in female and male ornamentations.
Follicular psoriasis: an under‐reported entity. A report of five cases

Follicular psoriasis is not rare in dermatological practice, although only a few cases have been reported. We describe five patients with follicular psoriasis, one man and four women. The patients ranged in age from 23 to 73 years. Lesions consisted of erythematous scaly follicular papules located on the trunk and extremities. Two patients had associated plaque‐type psoriasis of the scalp. None had nail involvement at the time of diagnosis. Histological examination of several biopsy specimens revealed the changes of psoriasis in the follicular epithelium.
Autografting followed by nonmyeloablative immunosuppressive chemotherapy and allogeneic peripheral-blood hematopoietic stem-cell transplantation as treatment of resistant Hodgkin's disease and non-Hodgkin's lymphoma.

PURPOSE To investigate the use of a nonmyeloablative fludarabine-based immunosuppressive regimen to allow engraftment of HLA-sibling donors' mobilized stem cells and induction of a graft-versus-lymphoma effect for patients with advanced resistant Hodgkin's disease and non-Hodgkin's lymphoma. PATIENTS AND METHODS Fifteen patients with Hodgkin's disease (n = 10) and non-Hodgkin's lymphoma (n = 5) were studied. All patients received cyclophosphamide and granulocyte colony-stimulating factor to mobilize autologous hematopoietic stem cells (HSCs). Subsequently, they received high-dose therapy with carmustine, etoposide, cytarabine, and melphalan and reinfusion of HSCs. At a median of 61 days after engraftment, patients were given fludarabine 30 mg/m(2) with cyclophosphamide 300 mg/m(2) daily for 3 days. Donor-mobilized HSC collections were prepared for fresh infusion and were not T-cell depleted. Methotrexate and cyclosporine were used to prevent graft rejection and as graft-versus-host disease (GVHD) prophylaxis. RESULTS Combined treatment was well tolerated. After mini-allografting, hematologic recovery was prompt. Thirteen patients had 100% donor cell engraftment. Eleven patients achieved complete remission (CR) after the combined procedure. Nine patients, who were in partial remission after autografting, achieved CR after mini-allografting. Seven patients developed >/= grade 2 acute GVHD (aGVHD) and two developed extensive chronic GVHD (cGVHD). Three patients who received the highest number of donor lymphocyte infusions (DLIs) developed grade 3 GVHD (two patients) and extensive cGVHD (one patient). Ten patients are currently alive, and five are in continuous CR. Seven patients received DLI, with five CRs. Five patients died: one of progressive disease, two of progressive disease combined with aGVHD or cGVHD, one of extensive cGVHD, and one of infection. CONCLUSION Fludarabine/cyclophosphamide was well tolerated and allowed consistent engraftment in lymphoma allografted patients. Response rates were high in this group of refractory and heavily pretreated patients. This dual procedure seems to be most promising in patients with end-stage malignant lymphomas.
Overexpression of the csk gene suppresses tumor metastasis in vivo

The non‐receptor tyrosine kinase c‐Src has been implicated in the development of numerous human cancers. c‐Src is activated in colon cancers, particularly in highly metastatic cells, and its overexpression strongly correlates with tumor progression. C‐terminal Src kinase (Csk) has been demonstrated to negatively regulate Src family tyrosine kinases through tyrosine phosphorylation at the C‐terminal regulatory site (Tyr‐527). We report herein that down‐regulation of Src kinase activity by adenovirus‐mediated csk gene transfer abrogated the highly metastatic phenotype of colon cancer cells. Overexpression of Csk decreased Src tyrosine kinase activity in NL‐17 cells, the highly metastatic clone of mouse colon adenocarcinoma 26. Importantly, Csk overexpression in NL‐17 cells resulted in significant suppression of in vivo metastasis, without affecting its tumorgenicity. Csk overexpression decreased the invasiveness of NL‐17 cells through Matrigel, in vitro reconstituted basement membrane. Gelatin zymography confirmed the decreased protein levels of MMP‐2 (gelatinase A) in the supernatants of Csk‐overexpressed NL‐17 cells. These results provide a therapeutic basis for interfering with metastasis of colon cancer by csk gene‐mediated down‐regulation of Src kinase activity. Int. J. Cancer 88:384–391, 2000. © 2000 Wiley‐Liss, Inc.
Genetic variation, phenotypic stability, and repeatability of drought response in European larch throughout 50 years in a common garden experiment

Abstract Assessing intra-specific variation in drought stress response is required to mitigate the consequences of climate change on forest ecosystems. Previous studies suggest that European larch (Larix decidua Mill.), an important European conifer in mountainous and alpine forests, is highly vulnerable to drought. In light of this, we estimated the genetic variation in drought sensitivity and its degree of genetic determination in a 50-year-old common garden experiment in the drought-prone northeastern Austria. Tree ring data from larch provenances originating from across the species' natural range were used to estimate the drought reaction in four consecutive drought events (1977, 1981, 1990–1994, and 2003) with extremely low standardized precipitation- and evapotranspiration-index values that affected growth in all provenances. We found significant differences among provenances across the four drought periods for the trees’ capacity to withstand drought (resistance) and for their capacity to reach pre-drought growth levels after drought (resilience). Provenances from the species' northern distribution limit in the Polish lowlands were found to be more drought resistant and showed higher stability across all drought periods than provenances from mountainous habitats at the southern fringe. The degree of genetic determination, as estimated by the repeatability, ranged up to 0.39, but significantly differed among provenances, indicating varying degrees of natural selection at the provenance origin. Generally, the relationship between the provenances’ source climate and drought behavior was weak, suggesting that the contrasting patterns of drought response are a result of both genetic divergence out of different refugial lineages and local adaptation to summer or winter drought conditions. Our analysis suggests that European larch posseses high genetic variation among and within provenances that can be used for assisted migration and breeding programs.
Endotracheal intubation without muscle relaxants in children using remifentanil and propofol: Comparative study

Introduction: Endotracheal intubation is essential during general anesthesia and muscle relaxant drugs provide ideal conditions for this purpose. The objective of this study was to evaluate the intubating condition of remifentanil combined with propofol without muscle relaxant. Materials and Methods: In this prospective randomized study, 60 children aged 3-12 years, American Society of Anesthesiologists physical status I and II were included. All the children were premedicated with 0.05 mg/kg midazolam and 1.5 mg/kg lidocaine 5 min before the induction of anesthesia with 3 mg/kg propofol. Then, they were allocated randomly to receive either 2 μg/kg remifentanil (group R) or 1.5 mg/kg succinylcholine (group S). Tracheal intubation was attempted 90 s after the administration of propofol. The quality of intubation was assessed by using Copenhagen score based on jaw relaxation, ease of laryngoscopy, position of vocal cord, coughing and limb movement. Heart rate and blood pressure were recorded before and after induction, and 1, 3, 5 min after intubation. Results: There was no significant difference in intubating condition between the two groups (P = 0.11). Intubation condition was excellent in 26 of 30 (86.7%) patients in the group R compared with 30 (100%) patients in the group S. We observed significant difference in heart rate and systolic blood pressure over time between two groups (P = 0.02, P = 0.03 respectively). After intubation, we had higher heart rate and systolic blood pressure with a significant difference in group S compared with group R (P = 0.006, P = 0.018). None of the children had a chest rigidity, laryngospasm, and hypoxia. Conclusions: In premedicated children, propofol-remifentanil combination provides adequate conditions for tracheal intubation that is comparable with succinylcholine. Hemodynamic response to laryngoscopy and tracheal intubation was controlled better in group R.
Comparison of 10-mg Doses of 4-Aminopyridine and 3,4-Diaminopyridine for the Treatment of Downbeat Nystagmus

Objective Animal experiments have demonstrated that aminopyridines increase Purkinje cell excitability, and in clinical studies, 4-aminopyridine (4-AP) and 3,4-diaminopyridine (3,4-DAP) improved downbeat nystagmus. In this double-blind, prospective, crossover study, the effects of equivalent doses of 4-AP and 3,4-DAP on the slow-phase velocity (SPV) of downbeat nystagmus were compared. Methods Eight patients with downbeat nystagmus due to different etiologies (cerebellar degeneration [n = 1], bilateral vestibulopathy [n = 1], bilateral vestibulopathy and cerebellar degeneration [n = 1], Arnold-Chiari I malformation and cerebellar ataxia [n = 1], cryptogenic cerebellar ataxia [n = 4]) were included. They were randomly assigned to receiving a single capsule of 10 mg of 3,4-DAP or 4-AP followed by 6 days with no medication. One week later, the treatment was switched, that is, 1 single capsule (10 mg) of the other agent. Recordings with 3-dimensional video-oculography were performed before and 45 and 90 minutes after drug administration. Results Both medications had a significant effect throughout time (pre vs post 45 vs post 90) (F(2,14) = 8.876; P < 0.01). Following the administration of 3,4-DAP, mean slow velocity decreased from −5.68°/s (pre) to −3.29°/s (post 45) to −2.96°/s (post 90) (pre vs post 45/post 90 P < 0.01). In 4-AP, the mean SPV decreased from −6.04°/s (pre) to −1.58°/s (post 45) to −1.21°/s (post 90) (pre vs post 45/post 90 P < 0.00001). Both after 45 and after 90, the mean SPVs were significantly lower for 4-AP than for 3,4-DAP (P < 0.05). None of the patients reported serious side effects. Conclusion Based on these results, 10-mg doses of 4-AP lead to a more pronounced decrease of the SPV of downbeat nystagmus than do equivalent doses of 3,4-DAP.