Miracle-dz/UniFAR-FTUs huggingface dataset:
Transesophageal echocardiography in diagnosis of infective endocarditis.

STUDY OBJECTIVE To determine whether transesophageal echocardiography (TEE) was superior to transthoracic echocardiography (TTE) in defining valvular vegetations and diagnosing clinical infective endocarditis (IE) in patients suspected of having this infection. PATIENTS AND METHODS Between April 1989 and May 1991, 64 febrile patients with clinical and/or microbiologic risk factors for IE were prospectively enrolled. Patients underwent both TEE and TTE, which were interpreted in a blinded fashion as to the patient's clinical status. Clinical criteria for the diagnosis of IE were compared with TEE and TTE findings to delineate the ability of the two echocardiographic techniques to define valvular vegetations and to establish the clinical diagnosis of vegetative IE. RESULTS Thirty-four valves had typical valvular vegetations demonstrated by either TEE or TTE. Transesophageal echocardiography was more sensitive than TTE in identifying valvular vegetations (33/34 vs 23/34 instances, respectively; p = 0.004). Also, TEE was better at identifying smaller vegetations (< 1 cm) than TTE; 12 patients with such vegetations were identified by TEE as compared with only 5 of 12 identified by TTE (p = 0.02). Of the 64 patients enrolled, 30 (47 percent) were classified as having "definite" or "probable" IE by modified von Reyn criteria. Among these 30 patients, TEE was significantly more sensitive than TTE at documenting vegetative valvular lesions (26/30 [87 percent] vs 18/30 [60 percent], respectively) (p < 0.01). Both TEE and TTE were highly specific (91 percent) in delineating valvular vegetations in this patient population; two of the three false-positive TEE studies for valvular vegetations occurred in patients with a history of IE. All nine periannular complications of IE were identified by TEE, as compared with only two being defined by TTE (p = 0.001). CONCLUSIONS Transesophageal echocardiography is significantly more sensitive than TTE and highly specific in both confirming the clinical diagnosis of IE, as well as in identifying valvular vegetations in patients at risk for this infection. Our data also support the concept that TEE is the echocardiographic method of choice for defining small vegetations and periannular complications in IE.
Homelessness in Lithuania: policy and research

> > Abstract_ This paper reviews developments in social policy and services related to homelessness in Lithuania over the last 20 years. Using the form of a descriptive case study, it provides an overview of how homelessness is conceptualised, the organisation of homelessness services, the development of social policy related to homelessness, and the support services available within the provision and maintenance of housing, as well as a review of relevant research on homelessness in Lithuania. The paper draws on secondary analyses of legislation, both published and unpublished research results and other sources. It discusses two parallel policies administrated by dif ferent departments of the Lithuanian government: tackling homelessness and increasing housing quality, and using social housing to alleviate housing poverty. Finally, findings on the problem of homelessness and its relationship to housing policy in the Lithuanian context are discussed.
A simple and effective method for cancer immunotherapy by inactivated allogeneic leukocytes infusion

Allogeneic mixed leukocytes reaction has been reported to activate vast numbers of T lymphocytes and produce large amounts of type 1 cytokines that are linked to an initiation of antitumor immunity. Using poor immunogeneic B16‐F10 and Lewis lung carcinoma (LLC) tumor model, we evaluated the effects of inactivated allogeneic leukocytes infusion (ALI) on the generation of antitumor immune response, as well as its effect on the primary and metastatic tumor. Allogeneic response promoted the generation of both specific and nonspecific antitumor immunity in an in vitro mixed lymphocytes‐tumor cell culture system. Introveinous infusion of mitotically inactivated allogeneic leukocytes resulted in increased type‐1 cytokines (including IL‐2 and IFN‐γ) release, proliferation of various lymphocyte subsets, and generation of both specific and nonspecific antitumor immune response. As a result of such immune response, ALI caused a delayed tumor growth and a prolonged survival in established B16‐F10 melanoma model. In LLC pulmonary spontaneous metastases model, ALI treatment significantly reduced postoperative tumor metastasis as the lung weights were far smaller than control group (0.16 vs. 0.34 g). Furthermore, after primary tumor resection and ALI treatment, 62.5% mice obtained long‐term survival (>120 days) and there were no tumor growths in these mice when they were rechallenged with the same tumor. These experiments demonstrate that inactivated ALI could activate innate and adoptive antitumor immune response. It would be a simple, effective and secured method for cancer immunotherapy. © 2008 Wiley‐Liss, Inc.
A novel microscopic assay for oral malodor-related microorganisms

Previous research has shown that the production of volatile sulfide compounds (VSC) by oral bacteria is associated with oral malodor. In the present study, we report a novel technique (microscopic sulfide assay (MSA)) for the quantification of VSC-producing oral microorganisms. The MSA was performed by overnight incubation of saliva samples in the presence of ferrous sulfate and sodium thiosulfate, followed by digital analysis of cells stained black due to cell-associated precipitation of ferric sulfide. This method was found to correlate significantly with oral malodor parameters, including mean odor judge scores (two judges, r = 0.48 and p = 0.001) and Halimeter® readings (r = 0.53 and p < 0.001), in a group of 42 subjects. As compared with odor judge scores as the gold standard, the new MSA technique yielded a diagnostic accuracy of 0.7 (ROC, p = 0.023). Results indicate that the MSA may serve as a diagnostic technique for assessing oral malodor levels and aid in identifying the particular bacteria involved in this condition.
Factors affecting gay and bisexual men's decisions and intentions to seek HIV testing.

OBJECTIVES This paper describes the relationships of sociodemographic, attitudinal, and behavioral variables to (1) decision to be tested, (2) expressed intention to be tested, and (3) reasons for not being tested for the human immunodeficiency virus (HIV) antibody. METHODS A sample of 1295 men completed an anonymous questionnaire in gay-identified venues. Factor analysis was used to group reasons for not being tested and logistic and multiple linear regression were used to model the dependent variables. RESULTS Fifty-three percent of the respondents had been tested, of whom 26% tested positive. Metropolitan residence and anal intercourse most strongly correlated with previous test-seeking. Previous test experience correlated most strongly with intention to be tested. Reasons for not being tested fell into three groups: (1) desire for anonymity, (2) self-perceived health, and (3) no benefit and denial. The odds were lower for gay men than bisexuals and men who did not participate in anal intercourse to express a desire for anonymity. CONCLUSIONS Public health agencies should be prepared to individualize testing policies and education to deal with specific concerns and fears. Improving access to the test by removing some of the current psychological and physical barriers will enhance its medical and public health value.
Twice daily versus four times daily insulin dose regimens for diabetes in pregnancy: randomised controlled trial.

OBJECTIVE To compare perinatal outcome and glycaemic control in two groups of pregnant diabetic patients receiving two insulin regimens. DESIGN Randomised controlled open label study. SETTING University affiliated hospital, Israel. PARTICIPANTS 138 patients with gestational diabetes mellitus and 58 patients with pregestational diabetes mellitus received insulin four times daily, and 136 patients with gestational diabetes and 60 patients with pregestational diabetes received insulin twice daily. INTERVENTION Three doses of regular insulin before meals and an intermediate insulin dose before bedtime (four times daily regimen), and a combination of regular and intermediate insulin in the morning and evening (twice daily regimen). MAIN OUTCOME MEASURES Maternal glycaemic control and perinatal outcome. RESULTS Mean daily insulin concentration before birth was higher in the women receiving insulin four times daily compared with twice daily: by 22 units (95% confidence interval 12 to 32) in patients with gestational diabetes and by 28 units (15 to 41) in patients with pregestational diabetes. Glycaemic control was better with the four times daily regimen than with the twice daily regimen: in patients with gestational diabetes mean blood glucose concentrations decreased by 0.19 mmol/l (0.13 to 0.25), HbA(1c) by 0.3% (0.2% to 0.4%), and fructosamine by 41 micromol/l (37 to 45), and adequate glycaemic control (mean blood glucose concentration <5.8 mmol/l) was achieved in 17% (8% to 26%) more women; in patients with pregestational diabetes mean blood glucose concentration decreased by 0.44 mmol/l (0.28 to 0.60), HbA(1c) by 0.5% (0.2% to 0.8%), and fructosamine by 51 micromol/l (45 to 57), and adequate glycaemic control was achieved in 31% (15% to 47%) more women. Maternal severe hypoglycaemic events, caesarean section, preterm birth, macrosomia, and low Apgar scores were similar in both dose groups. In women with gestational diabetes the four times daily regimen resulted in a lower rate of overall neonatal morbidity than the twice daily regimen (relative risk 0.59, 0.38 to 0.92), and the relative risk for hyperbilirubinaemia and hypoglycaemia was lower (0.51, 0.29 to 0.91 and 0.12, 0.02 to 0.97 respectively). The relative risk of hypoglycaemia in newborn infants to mothers with pregestational diabetes was 0.17 (0.04 to 0.74). CONCLUSIONS Giving insulin four times rather than twice daily in pregnancy improved glycaemic control and perinatal outcome without further risking the mother.
Normal left ventricular diastolic compliance after regression of hypertrophy.

We wished to determine whether (a) left ventricular (LV) diastolic chamber compliance and tissue elastic modulus were decreased with hypertrophy and improved after reversal of hypertension and regression of hypertrophy and whether collagen concentration was a major determinant of LV chamber compliance during hypertrophy or aging. Spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY), aged 8 months at time of study, were used for the hypertension-regression experiments. The aging study was based on 14- and 24-month-old Fischer-344 rats. LV chamber compliance was measured in isolated perfused hearts arrested in diastole. Length-tension curves (tissue elastic modulus) were obtained from ventricular strips, and hydroxyproline assays were used to estimate LV collagen content. Captopril and hydrochlorothizide were given for an 8-week period to both normotensive and hypertensive rats. Treatment normalized arterial pressure and caused regression of LV hypertrophy in SHR. LV diastolic compliance was less (pressure-volume curve steeper) in SHR than in WKY, but stiffness was similar in the two groups, as indicated by similar slopes when volume was adjusted for heart mass. Treatment significantly decreased ventricular stiffness in both SHR and WKY. Length-tension curves were almost identical in SHR and WKY, but treated SHR demonstrated less tension per given length. These changes occurred although collagen did not decrease in parallel to the decrease in LV mass. Aging was associated with 66 and 60% increases in collagen content and concentration, respectively, but did not alter LV chamber compliance significantly. (ABSTRACT TRUNCATED AT 250 WORDS)
Comparative cellular distribution of GABAA and GABAB receptors in the human basal ganglia: Immunohistochemical colocalization of the α1 subunit of the GABAA receptor, and the GABABR1 and GABABR2 receptor subunits

The GABAB receptor is a G‐protein linked metabotropic receptor that is comprised of two major subunits, GABABR1 and GABABR2. In this study, the cellular distribution of the GABABR1 and GABABR2 subunits was investigated in the normal human basal ganglia using single and double immunohistochemical labeling techniques on fixed human brain tissue. The results showed that the GABAB receptor subunits GABABR1 and GABABR2 were both found on the same neurons and followed the same distribution patterns. In the striatum, these subunits were found on the five major types of interneurons based on morphology and neurochemical labeling (types 1, 2, 3, 5, 6) and showed weak labeling on the projection neurons (type 4). In the globus pallidus, intense GABABR1 and GABABR2 subunit labeling was found in large pallidal neurons, and in the substantia nigra, both pars compacta and pars reticulata neurons were labeled for both receptor subunits. Studies investigating the colocalization of the GABAA α1 subunit and GABAB receptor subunits showed that the GABAA receptor α1 subunit and the GABABR1 subunit were found together on GABAergic striatal interneurons (type 1 parvalbumin, type 2 calretinin, and type 3 GAD neurons) and on neurons in the globus pallidus and substantia nigra pars reticulata. GABABR1 and GABABR2 were found on substantia nigra pars compacta neurons but the GABAA receptor α1 subunit was absent from these neurons. The results of this study provide the morphological basis for GABAergic transmission within the human basal ganglia and provides evidence that GABA acts through both GABAA and GABAB receptors. That is, GABA acts through GABAB receptors, which are located on most of the cell types of the striatum, globus pallidus, and substantia nigra. GABA also acts through GABAA receptors containing the α1 subunit on specific striatal GABAergic interneurons and on output neurons of the globus pallidus and substantia nigra pars reticulata. J. Comp. Neurol. 470:339–356, 2004. © 2004 Wiley‐Liss, Inc.
Role of the planar cell polarity gene Protein tyrosine kinase 7 in neural tube defects in humans.

BACKGROUND Neural tube defects (NTDs) are among the most common congenital defects affecting approximately 1 in 1000 live births in North America. Their etiology is complex including environmental and genetic factors. Defects in the planar cell polarity (PCP) signaling pathway have been strongly associated with NTDs in animal models and human cohorts. Protein tyrosine kinase 7 (Ptk7) was shown to cause a very severe form of NTDs called craniorachischisis in a mouse model and genetically interacts with a core PCP member Vangl2 where double heterozygotes suffer from spina bifida. In this study, we examined the role of PTK7 in human NTDs to determine whether variants at this gene predispose to these defects. METHODS We sequenced the coding region and the exon-intron junctions of PTK7 in a cohort of 473 patients affected with various forms of open and closed NTDs. Novel and rare variants(<1%) were genotyped in a cohort of 473 individuals. Their pathogenic effect was predicted in silico and functionally in an overexpression assay in a well-established zebrafish model. RESULTS We identified in our cohort 6 rare variants, 3 of which were absent in public databases. One variant, p.Gly348Ser, acted as a hypermorph when overexpressed in the zebrafish model. CONCLUSION We detected potentially pathogenic PTK7 variants in 1.1% of our NTD cohort. Our findings implicate PTK7 as a risk factor for NTDs and provide additional evidence for a pathogenic role of PCP signaling in these malformations.
Panton–Valentine leukocidin‐positive methicillin‐resistant Staphylococcus aureus infections in children with cancer

New strains of methicillin‐resistant Staphylococcus aureus (MRSA) which frequently carry the Panton–Valentine leukocidin (PVL) genes have been recognized to cause invasive infections in otherwise healthy children and adults. However, the epidemiology of PVL‐positive MRSA infections has not been described in children or adults with cancer.
Are there early features of autism in infants and preschool children?

Abstract: Autism is characterized by impairments in three areas: (i) reciprocal social interaction; (ii) communication; and (iii) repetitive and stereotyped patterns of interest and behaviour. Despite the finding that parents notice abnormalities and problems with their child's development at a very early age, research shows that diagnoses are often made at an age beyond that recommended for the commencement of early intervention. This paper reviews the range of studies that have sought to elucidate the early features of autism in young, preschool children. Impairments in the capacity for reciprocal social interaction involving preverbal, verbal and non‐verbal communication, and play and symbolic behaviour are the key features indicative of autism in infants and preschool children.
Health status and the return to work after traffic accidents.

OBJECTIVE to compare the health status of traffic accident victims, at hospital discharge and after six months, and to analyze the predictive variables of their health status and return to work. METHOD observational, longitudinal study. Data were collected through interviews and medical records of 102 patients with a mean age of 33 years; with the majority being men and victims of motorcycle accidents. The variables were analyzed by means of validated tools, student's t-test, multiple linear regression, and logistic regression. RESULTS there was an improvement of perception in the patients' health status six months after hospital discharge and functional capacity. The individuals who returned to work showed better health-related quality of life evaluation. CONCLUSION improvement of the perceived health status six months after hospital discharge was found. Factors that influenced the patients' return to work were not identified.
Combining bevacizumab with temozolomide increases the antitumor efficacy of temozolomide in a human glioblastoma orthotopic xenograft model.

PURPOSE The aims of the present work were to investigate the in vitro and in vivo antiangiogenic effects of chronic temozolomide treatment on various glioma models and to demonstrate whether bevacizumab (Avastin) increased the therapeutic benefits contributed by temozolomide in glioma. EXPERIMENTAL DESIGN The expression levels of various antiangiogenic factors in four glioma cell lines were evaluated after chronic in vitro treatment with temozolomide by Western blot. Proliferation and migration assays were performed on human endothelial cells incubated with supernatants of glioma cells treated with and without temozolomide. Orthotopic glioma models were used to evaluate the antiangiogenic effects of temozolomide in vivo and the therapeutic benefits of different temozolomide treatment schedules used alone or in combination with bevacizumab. RESULTS Temozolomide, a proautophagic and proapoptotic drug, decreased the expression levels of HIF-1alpha, ID-1, ID-2, and cMyc in the glioma models investigated, all of which playing major roles in angiogenesis and the switch to hypoxic metabolism. These changes could be, at least partly, responsible for the impairment of angiogenesis observed in vitro and in vivo. Moreover, combining bevacizumab with temozolomide increased the survival of glioma-bearing mice in comparison to each compound administered alone. CONCLUSIONS In addition to the numerous mechanisms of action already identified for temozolomide, we report here that it also exerts antitumor effects by impairing angiogenic processes. We further emphasize that bevacizumab, which is an antiangiogenic drug with a different mechanism of action, could be useful in combination with temozolomide to increase the latter's therapeutic benefit in glioma patients.
Determinants of Rural-Urban Inequality in Vietnam: Detailed Decomposition Analyses Based on Unconditional Quantile Regressions

Abstract This study examines determinants of the rural-urban gap of household welfare in Vietnam during 2008–2012 using national household data. We have used unconditional quantile regressions (UQR) to carry out quantile decomposition analyses to identify underlying causes for the rural-urban disparity across the entire distribution. Our analyses have overcome the limitations of Oaxaca-Blinder decomposition, namely, (i) decomposition is made only at mean and (ii) a dependent variable has a linear and parametric relationship with covariates. For these purposes, we have carried out detailed decomposition analyses and the UQR decomposition (N) combined with the reweighting technique. Our results show that basic education is beneficial to the rural poor and ethnic minorities in improving their living standards. Remittances generally improve rural welfare, but do not reduce within or between-inequality. Public policy should ensure easier access to education for the rural poor and support the self-employed to raise and stabilise income.
Family Policies and the Macroeconomy

This dissertation investigates the macroeconomic effects of family policies. For the case of Germany, it can be shown that family policies have a positive impact on fertility, welfare and the government budget. The welfare ranking of family policies depends on the way the government uses the budgetary surplus. It is shown that family policies can also be used to stabilize the public pay-as-you-go pension system. Given an external financial shock that hits the pension system re-adjusting the system with family policies is welfare superior to reforms of the pension system itself. Finally, it can be shown that the effect on fertility remains when introducing altruism in the model while the effects on welfare and budget depend more strongly on the model parameterization.
Up-Regulation of Vascular Endothelial Growth Factor (VEGF) in Small-for-Size Liver Grafts Enhances Macrophage Activities through VEGF Receptor 2-Dependent Pathway1

This study aims to investigate the potential role of vascular endothelial growth factor (VEGF) and VEGF-R2 (fetal liver kinase (Flk)-1) in mediating macrophage activities in small-for-size liver transplantation. A rat orthotopic liver transplantation model was performed using either whole, 50, or 30% liver grafts (both 50 and 30% were regarded as small-for-size) in syngeneic or allogeneic combinations, respectively. Firstly, the mRNA and protein levels of VEGF and Flk-1 in liver grafts were detected by RT-PCR and Western blot, and the number of Flk-1+ macrophages (labeled by ED1) was determined by flow cytometry. It was found that the small-for-size isografts and allografts presented higher levels of VEGF and Flk-1 expression than the whole isograft and allograft. In addition, a higher number of Flk-1+ED1+ cells were detected in the small-for-size isografts and allografts than the whole isograft and allograft. Secondly, our study revealed that macrophage cell lines did not initially express detectable Flk-1, but could be induced by VEGF, and the inducible expression of Flk-1 in macrophages was related to their migration and proliferation activities. Finally, our study demonstrated that the induction of Flk-1 expression on macrophages by VEGF was associated with the expression of NF-κB and heat shock protein 90. In conclusion, the present study showed that the up-regulated expression of VEGF and its interaction with Flk-1 in small-for-size liver grafts might facilitate the activities of macrophages.