Miracle-dz/UniFAR-FTUs huggingface dataset:
Nationwide survey of the role of travel medicine in primary care in Germany.

BACKGROUND With more persons traveling to (sub)tropical destinations, travel medicine is an increasing challenge for the health care system in many countries. This study investigated the role and scope of travel medicine provided by general practitioners (GPs) in primary health care, assessed the determinants of specific prophylactic recommendations, and identified the needs of GPs regarding training and cooperation in travel medicine. METHODS A national survey was conducted among randomly selected GPs in Germany. Information on the type and extent of activities in travel medicine, the number and characteristics of patients, the use of specific information systems, and training and cooperation, was obtained with a standardized postal questionnaire. Representativeness was assessed by a computer-assisted telephone survey among nonrespondents. Univariate and multivariate statistical analysis was performed. RESULTS Of all GPs (n=1,320), 95% provided medical pretravel advice or post-travel counseling (13.2 patients/month). The most common topics in pretravel consultation were immunizations (95%), malaria chemoprophylaxis (94%), advice on exposure prophylaxis (41%), and advice on protection from sexually transmitted infections (STIs) (43%). GPs frequently advised certain patient groups (e.g., cardiovascular patients 68%, pregnant women 20%). Travelers' diarrhea was the most common topic in post-travel consultation (89%), followed by fever (38%). Of the GPs, 25% cooperated regularly with institutions with special expertise in travel medicine or tropical diseases. Sixty-four percent had received some training in travel medicine, and 86% stated a need for additional training. In the multivariate analysis, independent determinants for advice on exposure prophylaxis and STI risks included special training in travel medicine, use of country-specific information sources, and location of the practice in the former West Germany and urban areas. CONCLUSIONS Travel medicine is of importance in primary health care in Germany. There is a need for improved counseling on exposure and STI prophylaxis. GPs' training in travel medicine and cooperation with institutions such as institutes, clinics and laboratories for tropical medicine should be improved.
PHYSICAL AND BIOCHEMICAL PREDICTORS OF DEATH IN AN AUSTRALIAN ABORIGINAL COHORT

1. Predictors of natural and cardiovascular death were examined in a cohort from a remote Australian Aboriginal community with high mortality rates. The cohort was marked by high prevalences of diabetes (17%), hypertension (19% diastolic blood pressure (BP) > 90 mmHg), obesity (16% body mass index (BMI) > 30), albuminuria (26% albumin/creatinine ratio (ACR) ≥ 34 g/mol) and renal failure (26% calculated glomerular filtration rate < 80 mL/min).
Ambulatory Blood Pressure Thresholds for Diagnosis of Hypertension in Patients With and Without Type 2 Diabetes Based on Cardiovascular Outcomes

Currently recommended ambulatory blood pressure (BP) monitoring (ABPM) thresholds for diagnosis of hypertension do not differentiate, as international guidelines do for clinic BP, uncomplicated persons at low risk from those at higher risk, e.g., patients with diabetes, for target injury and cardiovascular disease (CVD) risk. We aimed to derive diagnostic thresholds for the awake and asleep systolic (SBP) and diastolic (DBP) BP means based upon CVD outcomes (death from all causes, myocardial infarction, angina pectoris, coronary revascularization, heart failure, acute arterial occlusion of the lower extremities, thrombotic occlusion of the retinal artery, hemorrhagic stroke, ischemic stroke, and transient ischemic attack) for patients with and without diabetes. We prospectively studied 3344 subjects (1718 men/1626 women), 52.6 ± 14.5 (mean ± SD) yrs of age, 607 with type 2 diabetes, during a median follow-up of 5.6 yrs. Those with hypertension at baseline were randomized to ingest all their prescribed hypertension medications upon awakening or the entire daily dose of ≥1 of them at bedtime. At baseline, BP was measured at 20-min intervals from 07:00 to 23:00 h and at 30-min intervals at night for 48 h, and physical activity was simultaneously monitored every minute by wrist actigraphy to accurately derive the awake and asleep BP means. Identical assessment was scheduled annually and more frequently (quarterly) if treatment adjustment was required. Cox regression analysis was used to derive outcome-based reference thresholds for ABPM in subjects with and without diabetes. CVD risk was consistently greater in patients with than without diabetes for awake SBP/DBP means ≥130/75 mm Hg and asleep means ≥110/65 mm Hg. Derived outcome-based reference thresholds for persons without diabetes were 135/85 mm Hg for the awake and 120/70 mm Hg for the asleep SBP/DBP means. In terms of CVD outcome, the equivalent cutoff threshold values for patients with diabetes were 120/75 mm Hg for the awake and 105/60 mm Hg for the asleep SBP/DBP means. Outcome-based reference thresholds for the diagnosis of hypertension were 15/10 mm Hg lower for ambulatory SBP/DBP in patients with than without diabetes. This marked difference indicates the need for revision of current guidelines that propose diagnostic thresholds for ambulatory BP without differentiation between the presence/absence of diabetes. (Author correspondence: rhermida@uvigo.es)
Enhanced Nitrosative and Oxidative Stress with Decreased Total Antioxidant Capacity in Patients with Oral Precancer and Oral Squamous Cell Carcinoma

Objective: Interaction between reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a crucial determinant in the etiology of oral squamous cell carcinoma (OSCC), and antioxidants protect against cellular and molecular damage caused by these. This study aims to evaluate ROS and RNS, together with the total antioxidant capacity (TAC), in serum and tissues of OSCC patients. Method: Total nitric oxide (TNO), malondialdehyde (MDA), and TAC were evaluated using a UV visible spectrophotometer in the serum of 30 controls, 30 precancer and 30 OSCC patients and in tissues of 10 controls and 30 OSCC patients. Results: MDA and TNO were significantly elevated with concomitant depletion of TAC in serum and tissues of OSCC patients when compared to controls. A significant positive correlation (p = 0.01), at different levels between TNO and MDA in OSCC patients, was found, which increased with the grade of OSCC. Conclusion: An increase in the levels of TNO, NO-mediated lipid peroxidation, resulting in an increase in MDA levels, the positive TNO-MDA correlation with a deranged antioxidant defense system as demonstrated by significantly low levels of TAC; when all these facts are taken together, we can conjecture that oxidative DNA damage, a vital phenomenon for carcinogenesis, occurs due to the interplay of ROS, RNS and TAC.
Are Patient Falls and Pressure Ulcers Sensitive to Nurse Staffing?

Research has demonstrated an association between more nurses and more qualified nursing staff in hospitals and better patient outcomes. Patient falls and pressure ulcers have been advanced as nursing-sensitive outcomes. This article evaluates the state of the science linking nurse staffing to falls and pressure ulcers. Studies that employed multivariate analysis to discern the effect of nurse staffing on patient falls and pressure ulcers in hospitals were evaluated. Eleven studies that met inclusion criteria were contrasted on their data sources and measures, data analysis, risk adjustment, and results. The evidence of an effect of nursing hours or skill mix on patient falls and pressure ulcers is equivocal. Substantial differences in research methods across studies may account for the mixed findings. Two study types were identified based on the level at which nurse staffing was measured, hospital or nursing unit, which exhibited systematic differences in measures and methods. Improvements in measurement and methods are suggested.
Cannabinoid-induced enhanced interaction and protein levels of serotonin 5-HT2A and dopamine D2 receptors in rat prefrontal cortex

Recent evidence suggests that non-selective cannabinoid receptor agonists may regulate serotonin 2A (5-HT2A) receptor neurotransmission in brain. The molecular mechanisms of this regulation are unknown, but could involve cannabinoid-induced enhanced interaction between 5-HT2A and dopamine D2 (D2) receptors. Here, we present experimental evidence that Sprague-Dawley rats treated with a non-selective cannabinoid receptor agonist (CP55,940, 50 µg/kg, 7 days, i.p.) showed enhanced co-immunoprecipitation of 5-HT2A and D2 receptors and enhanced membrane-associated expression of D2 and 5-HT2A receptors in prefrontal cortex (PFCx). Furthermore, 5-HT2A receptor mRNA levels were increased in PFCx, suggesting a cannabinoid-induced upregulation of 5-HT2A receptors. To date, two cannabinoids receptors have been found in brain, CB1 and CB2 receptors. We used selective cannabinoid agonists in a neuronal cell line to study mechanisms that could mediate this 5-HT2A receptor upregulation. We found that selective CB2 receptor agonists upregulate 5-HT2A receptors by a mechanism that seems to involve activation of Gai G-proteins, ERK1/2, and AP-1 transcription factor. We hypothesize that the enhanced cannabinoid-induced interaction between 5-HT2A and D2 receptors and in 5-HT2A and D2 receptors protein levels in the PFCx might provide a molecular mechanism by which activation of cannabinoid receptors might be contribute to the pathophysiology of some cognitive and mood disorders.
Effect of age and sex on N-methyl-D-aspartate antagonist-induced neuronal necrosis in rats.

BACKGROUND AND PURPOSE Although N-methyl-D-aspartate (NMDA) antagonism may be a useful therapeutic approach in stroke treatment, it has been found that these pharmacological agents cause neuronal necrosis in restricted cortical regions of the rodent brain. METHODS To test the hypothesis that age and sex influence NMDA antagonist-induced neuronal necrosis, male and female rats were studied at 2 months (young), 12 months (middle-aged), and 24 months (old) of age. A dose of 5 mg/kg MK-801 was administered, followed by quantitation of neuronal necrosis at nine coronal levels in the cingulate and retrosplenial cortex at 1 week of survival. RESULTS Mortality was dependent on age but not sex and was higher in the old rats (P<.01). The number of necrotic neurons per hemisphere was greater in female than in male rats at all ages (P<.0001). Female rats also showed increasing neuronal necrosis with age (P<.05). CONCLUSIONS The results indicate a major sex difference in neuronal cytotoxicity caused by NMDA antagonists and a minor increase in susceptibility with increasing age in females. The findings may be relevant to development of drugs with NMDA antagonist properties for use in human stroke.
Do Gonadotropins Influence Serum Lipoprotein(a) Concentrations? Observations on Children, Adolescents and Adults

Data from 7045 subjects were examined. The main groups consisted of the following in- and outpatients: 1414 neonates, 2554 children and adolescents (1336 males, 1218 females), 1209 women directly postpartum, 786 non-pregnant women and 1090 men aged between 18 and 100 years of age. Unless otherwise stated, persons were under medical observation or therapy. The results were obtained over a three-year period using an in-house immunoluminometric assay specific for apolipoprotein(a) using two polyclonal antibodies and single lot of reagents to allow for comparability of results. Girls aged between 10 and 12 years of age had significantly higher serum lipoprotein(a) (median 124 mg/l) levels than boys (median 88 mg/l) of the same age (p < 0.05-Mann-Whitney U-test). Post-pubertal lipoprotein(a) concentrations were not significantly different from pre-pubertal levels. Between the ages of 0-9 and 13-17 years there were no statistically significant sex-linked differences in serum lipoprotein(a). In adults, lipoprotein(a) serum levels were significantly higher in women (median 163 mg/l) aged between 50 and 59 years, when compared with men (median 128 mg/l) of the same age group (p = 0.05-Kruskal-Wallis one way ANOVA followed by the Nemenyi test). There was no significant difference in serum lipoprotein(a) concentrations between healthy women (median 91 mg/l), women direct postpartum (median 116 mg/l) and in-patient women (median 117 mg/l) aged between 18 and 41 years of age (p = 0.11-0.96). There was no correlation between maternal lipoprotein(a) and birth weight in mature newborns (r = -0.028-0.085). The results may indicate a direct influence of gonadotropins at puberty and during the menopause which cause an increase in serum lipoprotein(a) concentrations.
On the Meaning of Masculinities and Its Implication to Advancing Men’s Health

Men’s health research is dominated by biomedical research, and those working within biomedicine are often unaware of discourses on the topic of men’s health within the field of masculinities studies. We argue that incorporating social sciences in biomedical research would greatly benefit men’s health, but these fields have differing worldviews that isolate them from one another. There are many factors that contribute to this separation of the disciplines, including the use of language. Here, we focus specifically on the term masculinities, which emerged in the sociological literature in 1992. Classic scientific disciplines are based upon identifiable and diagnosable entities, and agreed upon criteria for distinguishing one entity from another. We argue, however, that there are no established criteria for distinguishing one masculinity from another and that, in turn, parks masculinities studies outside the sciences as viewed from the perspective of biomedicine. We argue that research in masculinities does not incorporate the realities of the body, such as hormones, in ways that would be relevant for health research. Lastly, we argue that substantive advances in men’s health will require a multidisciplinary approach, which first and foremost requires commonly agreed upon language. We use the example of andropause, to demonstrate the need for the disciples of biomedicine and masculinities studies to understand each other’s language, methodologies, and goals as a step toward advancing men’s health.
Longitudinal Analysis of Severe Anxiety Symptoms in the Last Year of Life Among Patients With Advanced Cancer: Relationships With Proximity to Death, Burden, and Social Support.

BACKGROUND Temporal changes in the prevalence of anxiety disorders/symptoms for patients with cancer at the end of life (EOL) remain unclear. This study was undertaken to describe changes in the prevalence of severe anxiety symptoms and to identify its correlates in the last year of life for patients with cancer. METHODS A convenience sample of 325 patients with cancer was followed until death. Severe anxiety symptoms were identified as anxiety subscale scores of 11 or greater on the Hospital Anxiety and Depression Scale. Longitudinal changes in and correlates of severe anxiety symptoms were examined from demographics, disease-related characteristics, disease burden, perceived burden to others, and social support using multivariate logistic regression modeling with generalized estimating equations. RESULTS The prevalence of severe anxiety symptoms increased as death approached (18.6%, 21.9%, 26.7%, and 33.4% at 181-365, 91-180, 31-90, and 1-30 days before death, respectively). However, after controlling for covariates, this temporal increase was not significant. The prevalence of severe anxiety symptoms was not associated with fixed demographics and disease-related characteristics, except for diagnosis and metastatic status, but was significantly higher in patients with cancer with high physical symptom distress, severe depressive symptoms, high perceived burden to others, and strong perceived social support. CONCLUSIONS Severe anxiety symptoms were not associated with time proximity to death per se but were related to factors modifiable by high-quality EOL care. Clinicians may decrease the likelihood of severe anxiety symptoms at EOL by adequately managing physical and depressive symptoms and lightening perceived burden to others for patients strongly connected with their social network to improve their psychological well-being.
EVIDENCE FOR ASSORTATIVE MATING ON DIGIT RATIO (2D:4D), A BIOMARKER FOR PRENATAL ANDROGEN EXPOSURE

Summary The second-to-fourth digit ratio (2D:4D) presents an anatomical sex difference in humans. On average, men tend to have lower 2D:4D compared with women. There is fairly strong evidence for a role of the 2D:4D ratio as a biomarker for the organizational (permanent) effects of prenatal testosterone on the brain and behaviour. Recently, an accumulating research programme has shown 2D:4D to be related to a multitude of sex-dependent, hormonally influenced biosocial traits and phenotypes which reach into the domains of ability, behaviour, fertility, health, personality and sexuality. This study investigated the degree of assortative mating (spousal similarity) in a sample of 239 native Austrian couples of parental or grandparental age, all of them having reproduced. Results included: (i) significant spousal correlations of +0·19 and +0·18 for right-hand and left-hand 2D:4D, respectively, and +0·24 for average 2D:4D; (ii) no assortative mating effect on the right-minus-left difference in 2D:4D; (iii) indications consistent with a possible generational decrease of spousal similarity in 2D:4D; (iv) a prevalence of couples with a lower right-hand 2D:4D observed in the husband compared with his wife; and (v) relations of spousal 2D:4D patterns to spousal age differences, such that matings of men with more male-typical trait expressions (namely, a generally low right-hand 2D:4D or showing a lower right-minus-left 2D:4D difference than their wives) implicated larger male-minus-female age differences, i.e. younger wives. It is argued that assortative mating on 2D:4D operates indirectly and may be mediated through the assortment on other, more perceptible, physical traits and psychological phenotypes that entertain associations with 2D:4D and are relevant for courtship and mate choice.
In‐vitro metabolism of glycyrrhetinic acid by human and rat liver microsomes and its interactions with six CYP substrates

Objectives Glycyrrhetinic acid is the main metabolite of glycyrrhizin and the main active component of Licorice root. This study was designed to investigate the in‐vitro metabolism of glycyrrhetinic acid by liver microsomes and to examine possible metabolic interactions that glycyrrhetinic acid may have with other cytochrome P450 (CYP) substrates.
Global identification of alternative splicing via comparative analysis of SMRT‐ and Illumina‐based RNA‐seq in strawberry

Alternative splicing (AS) is a key post-transcriptional regulatory mechanism, yet little information is known about its roles in fruit crops. Here, AS was globally analyzed in the wild strawberry Fragaria vesca genome with RNA-seq data derived from different stages of fruit development. The AS landscape was characterized and compared between the single-molecule, real-time (SMRT) and Illumina RNA-seq platform. While SMRT has a lower sequencing depth, it identifies more genes undergoing AS (57.67% of detected multiexon genes) when it is compared with Illumina (33.48%), illustrating the efficacy of SMRT in AS identification. We investigated different modes of AS in the context of fruit development; the percentage of intron retention (IR) is markedly reduced whereas that of alternative acceptor sites (AA) is significantly increased post-fertilization when compared with pre-fertilization. When all the identified transcripts were combined, a total of 66.43% detected multiexon genes in strawberry undergo AS, some of which lead to a gain or loss of conserved domains in the gene products. The work demonstrates that SMRT sequencing is highly powerful in AS discovery and provides a rich data resource for later functional studies of different isoforms. Further, shifting AS modes may contribute to rapid changes of gene expression during fruit set.
Fault location for DC marine power systems

Modern marine vessels look to employ integrated full electric propulsion systems. This, together with the proposed increase in use of power electronic converters can offer reduced fuel consumption and maintenance plus increased operational flexibility and availability. Some of the issues concerning continuity of power, power quality and system stability are now being addressed. This paper considers the area of fault location - particularly important for the concept of ldquoself-healingrdquo systems. Three technologies are described which may offer potential benefits to future marine power systems, and their application to DC distribution systems is also discussed.
Mapping the affective domain in young adolescents.

Four widely used instruments in the affective domain measuring self-esteem, locus of control, achievement motivation, and moral development were administered to 885 middle school youngsters in an effort to "map" the affective domain. Interest centered on sex differences, developmental trends, relationships between the instruments, and the relationship between the affective and cognitive domains, the latter being assessed by achievement test scores. As predicted, sex and age effects varied considerably from trait to trait. Females evidenced greater stability in affective behavior than males. Two explanations for this finding were discussed: one credits females with greater emotional maturity than males, the other regards early adolescence as a less stressful time for females than males. In recent years there has been an increasing interest on the part of educators in the affective domain. The number of books and articles devoted to noncognitive variables appears to be on the increase and many make the same point: "Unless
Per se performance of cluster bearing, glossy purple Brinjal (Solanum melongena L.) hybrids for economic traits

An investigation was carried out in brinjal (Solanum melongena L.) to develop F1 hybrids with cluster bearing and glossy purple fruits. A total number of eight genotypes viz., Poiyur Purple, Ujala, Yendhal, Pusa Purple Cluster, PLR 1, Hybrid Derivative 1, Hybrid Derivative 2 and Hybrid Derivative 3 were chosen as parents and they were crossed in a ‘Full diallel mating design’ to get fifty six cross combinations. All the fifty six F1 hybrids and the eight parents were evaluated for thirteen characters. Based on the per se performance, the parent HD 3 was found to be the best for plant height, number of branches per plant, earliness, number of fruiting clusters per plant, number of fruits per plant, fruit yield per plant, whereas PPC followed by HD 1 and HD 2 excelled for number of flowers per cluster, number of fruits per cluster and fruit length. Among the hybrids, the hybrid PLR 1 x HD 3 registered the maximum per se for plant height, number of branches per plant, earliness, fruiting clusters per plant, fruit yield per plant and number of solitary fruits per plant followed by the hybrid PPC x HD 3 which had the highest number of flowers per cluster, number of fruits per cluster and solasodine content and HD 1 x HD 3 recorded the maximum number of fruits per plant. The hybrids PPC x HD 2 and Yendhal x HD 3, also showed favourable performance for yield and economic traits.