Miracle-dz/UniFAR-FTUs huggingface dataset:
Career preferences of medical students: influence of a new four-week attachment in general practice.

BACKGROUND It is not clear why medical students choose one specialty over another. Experiences at medical school are extremely strong determinants of attitudes to the medical specialties, and attitude is the most important factor in determining choice. AIM This study sought to describe the factors influencing career choices of final year medical students, the effect of a new four-week attachment in general practice on career choices, and changes in career choices towards or away from general practice between the final year and the end of the preregistration house officer year. METHOD Career preferences, and influences on them, were assessed by questionnaires administered to 206 medical students undergoing their final clinical attachment at the University of Glasgow immediately before and immediately after a four-week attachment in general practice. These were followed up by a postal questionnaire at the end of the preregistration house officer year. RESULTS One hundred and thirty-one students returned all three questionnaires. Before the attachment, students born outside the UK, and those who had a previous or intercalated degree were significantly less likely to put general practice as a career preference; female students were more likely to put it as their first career choice. After the attachment, the number stating that it was 'likely' or 'very likely' that they would choose general practice as a career increased from 60 to 72--mainly through male students changing their preference--but after the preregistration house officer year it had fallen back to 56. Seventeen of the preregistration house officers were planning to complete posts which would qualify for GP training. Reasons for changing preference towards general practice were mainly to do with a dislike of and disillusionment with hospital medicine and with the perceived lifestyle advantages of general practice. Reasons for changing preference away from general practice were mainly to do with positive feelings about hospital medicine and a dislike of the management aspects of general practice. CONCLUSION The general practice attachment influenced students, especially males, towards a career in general practice, but this effect was transient. This cohort of doctors should be followed up in order to discover their ultimate career choices.
Daily support in couples coping with early stage breast cancer: maintaining intimacy during adversity.

OBJECTIVE Recent work has identified intimacy as a potentially important determinant of psychological adjustment in couples coping with cancer. Little work has examined specific social support processes within the context of the everyday life of couples' cancer experience. Specifically, we examined the links between breast cancer patient reports of receiving support from one's spouse/partner (support receipt) and spouse reports of providing support to the patient (support provision) with daily intimacy outcomes. We hypothesized that both patient and spouse would benefit from support receipt and support provision. METHOD Forty-five women with early stage breast cancer and their spouses independently completed an Internet-based electronic diary assessing support receipt, support provision, and relationship intimacy for seven consecutive evenings shortly after surgery. Study outcomes consisted of daily relationship intimacy reported by each partner. RESULTS As hypothesized, when controlling for patient report of support receipt, spouse report of support provision was uniquely associated with a significant additional increase in feelings of relationship intimacy for patients. Moreover, the independent effects of support receipt and support provision were also found to be beneficial for nonpatient spouses' daily feelings of intimacy. CONCLUSION Findings highlight the use of dyadic diary methods and corresponding modeling to uncover the unique benefits of support provision that may sometimes occur outside the awareness of the recipient. Results are discussed in terms of conceptualizing the cancer experience in a shared interpersonal context, whereby patients and their spouses can both benefit from support as they adjust to cancer together.
Attenuation by Fibrates of Plasminogen Activator Inhibitor Type-1 Expression in Human Arterial Smooth Muscle Cells

Summary Human atherosclerotic lesions exhibit increased expression of plasminogen activator inhibitor type-1 (PAI-1) that has been implicated in atherogenesis. Although vascular smooth muscle cells are a predominant source of PAI-1 expression potentially favorable modulation of PAI-1 expression by fibrates has not yet been characterized in these cells. Human aortic smooth muscle cells were exposed to selected growth factors. PAI-1 expression was stimulated most powerfully by TGF-β (EC50 = 0.2 ng/ml, up to 12-fold increase). Gemfibrozil inhibited basal PAI-1 expression by 23% (p = ns) and TGF-β -induced PAI-1 expression by 52% (p = 0.017) whereas t-PA and total protein synthesis was not affected. Changes in PAI-1 protein accumulation reflected PAI-1 gene expression attributable to modulation of half-life of PAI-1 mRNA by gemfibrozil. Inhibition by other fibrates was less. Gemfibrozil specifically attenuates TGF-β -induced PAI-1 expression in human arterial smooth muscle cells. Thus, fibrates are promising agents for normalizing increased PAI-1 expression in arterial walls in patients in whom PAI-1 expression is increased.
Fused protein domains inhibit DNA binding by LexA

Many studies of transcription activation employ fusions of activation domains to DNA binding domains derived from the bacterial repressor LexA and the yeast activator GAL4. Such studies often implicitly assume that DNA binding by the chimeric proteins is equivalent to that of the protein donating the DNA binding moiety. To directly investigate this issue, we compared operator binding by a series of LexA-derivative proteins to operator binding by native LexA, by using both in vivo and in vitro assays. We show that operator binding by many proteins such as LexA-Myc, LexA-Fos, and LexA-Bicoid is severely impaired, while binding of other LexA-derivative proteins, such as those that carry bacterially encoded acidic sequences ("acid blobs"), is not. Our results also show that DNA binding by LexA derivatives that contain the LexA carboxy-terminal dimerization domain (amino acids 88 to 202) is considerably stronger than binding by fusions that lack it and that heterologous dimerization motifs cannot substitute for the LexA88-202 function. These results suggest the need to reevaluate some previous studies of activation that employed LexA derivatives and modifications to recent experimental approaches that use LexA and GAL4 derivatives to detect and study protein-protein interactions.
Living with a venous leg ulcer: a descriptive study of patients' experiences.

This study aimed to describe the experience of living with a venous leg ulcer from the patient's perspective, to answer the question 'What is it like to live with a venous leg ulcer? ' Investigating the experience of illness is important in understanding how disease processes affect people, how they understand and cope with these processes, and how care may be given most effectively. Little research was identified which examined these areas with reference to people with leg ulceration. A qualitative approach was taken in the following study, using phenomenological methods to describe the experience of venous leg ulceration. Informal unstructured interviews were conducted with 13 informants, guided by their descriptive priorities. Tape recordings were then transcribed and analysed for recurrent themes and their meanings. It was found that certain symptoms of ulceration, principally pain, were the overwhelming feature of the experience. These symptoms caused significant restrictions in people's lives, particularly in their ability to walk and go out. Treatment was not described as being efficacious in ameliorating these symptoms, but nevertheless great confidence and trust was placed in the expertise of nurses. People coped with the experience mainly by a process of normalizing its components. It is concluded that if treatment is to meet the needs of those suffering venous leg ulceration, then symptom control must be the highest priority.
Prevalence and severity of asthma among Indian school children aged between 6 and 14 years: associations with parental smoking and traffic pollution

Abstract Objective: Phase three of the International Study of Asthma and Allergy in Children (ISAAC) was carried out at various sites in India. The prevalence of asthma symptoms in school children and the effect of environmental tobacco smoke and traffic pollution on the occurrence of asthma were analysed. Methods: Two groups of school children, aged 6–7 yr and 13–14 yr, participated according to the ISAAC protocol. Schools were randomly selected and responses to the ISAAC questionnaire were recorded. Results: The prevalence of asthma was 5.35% in the 6–7 yr age group and 6.05% in the 13–14 yr age group. The odds ratios (ORs) for the risk of asthma in children with exposure to mild, moderate and heavy traffic pollution compared with minimal traffic pollution were 1.63 (95% CI: 1.43, 1.85), 1.71 (95% CI: 1.49, 1.96) and 1.53 (95% CI: 1.31, 1.78), respectively, in the younger group. Similarly, in the older group, they were 1.19 (95% CI: 1.04, 1.36), 1.51 (95% CI: 1.31, 1.75) and 1.51 (95% CI: 1.29, 1.76). Asthma was associated with maternal smoking [6–7 yr group: OR = 2.72 (2.05, 3.6); 13–14 yr group: OR = 2.14 (1.72, 2.66)] and paternal smoking [6–7 yr group: OR = 1.9 (1.70, 2.11); 13–14 yr group: OR = 1.21 (1.09, 1.34)]. Conclusions: The prevalence of asthma was lower in the 6–7 than the 13–14 yr age group. Environmental tobacco smoke and traffic pollution were the factors most strongly associated with asthma in Indian children.
The effect of Aspergillus fumigatus infection on vitamin D receptor expression in cystic fibrosis.

RATIONALE Aspergillus fumigatus (A. fumigatus) in cystic fibrosis (CF) is increasingly recognized. Although allergic bronchopulmonary aspergillosis (ABPA) leads to deterioration of pulmonary function, the effect of A. fumigatus colonization in the absence of ABPA remains unclear. OBJECTIVES To address this, we examined individuals with CF with A. fumigatus who were ABPA negative to identify the effects of itraconazole therapy on Aspergillus-induced lung inflammation. METHODS The effect of A. fumigatus on nuclear vitamin D receptor (VDR) expression was investigated using qRT-PCR and Western blotting. IL-5 and IL-13 levels were quantified by ELISA. The effect of itraconazole was assessed by a combination of high-resolution computed tomography, lung function test, and microbiological analysis. MEASUREMENTS AND MAIN RESULTS We demonstrate that A. fumigatus down-regulates VDR in macrophages and airway epithelial cells and that the fungal metabolite gliotoxin (Gt) is the main causative agent. Gt overcame the positive effect of 1,25-OH vitamin D(3) on VDR expression in vitro, resulting in increased IL-5 and IL-13 production. In vivo, A. fumigatus positivity was associated with increased Gt in CF bronchoalveolar lavage fluid and increased bronchoalveolar lavage fluid levels of IL-5 and IL-13. After airway eradication of A. fumigatus with itraconazole, we observed decreased Gt, IL-5 and IL-13, improved respiratory symptoms, and diminished high-resolution computed tomography mosaic pattern consistent with sustained pulmonary function. CONCLUSIONS This study provides a rationale for the therapeutic effect of itraconazole and implied that the therapeutic potential of vitamin D supplementation in preventing ABPA is only feasible with concurrent elimination of A. fumigatus to permit VDR expression and its positive functional consequences.
OESTROGEN‐GONADOTROPHIN FEEDBACK MECHANISMS IN THE PUERPERIUM

The effect of oestradiol benzoate on serum gonadotrophin concentrations before and after LHRH administration was studied in lactating and non‐lactating women at 3 and 6 weeks post‐partum. Except in the non‐lactating women at 6 weeks, basal serum FSH concentrations were suppressed by oestrogen. There were no significant changes in basal concentrations of LH after oestrogen in the lactating women in either the 3‐ or 6‐week studies. Individual increases in the basal LH concentrations in two out of six non‐lactating subjects in the 6‐week study occurred but overall there were no significant changes.
UK consensus guidelines for the use of the protease inhibitors boceprevir and telaprevir in genotype 1 chronic hepatitis C infected patients

The nonstructural 3 serine protease inhibitors (PIs), boceprevir and telaprevir, represent the first in a new generation of directly acting antivirals against genotype 1 hepatitis C (HCV) infection. When used in combination with pegylated interferon and ribavirin, these drugs greatly improve sustained virological response rates in both treatment‐naïve patients and patients who have had previous virological failure on treatment. However, the addition of these new agents will increase the complexity of therapeutic regimens, the rates of side‐effects and costs.
Application of alternative medicine in gastrointestinal cancer patients.

BACKGROUND/AIM [corrected] Alternative medicine is a set of therapeutic procedures which are no part of official practice. At present, the use of alternative medicine among cancer patients is significant and the purpose of this study was to get more information on the methods and products of alternative medicine. Thus, the aim of the study was to determine the frequency of the use of alternative medicine among gastrointestinal cancer patients. METHODS The research was conducted using an anonymous questionnaire in writing. We included 205 patients with the diagnosis of gastrointestinal malignancy in the study but the questionnaire was fulfilled by 193 patients and the presented data were based on their answers. The questions were about the sociodemographic characteristics of the patients, the reasons for their use of alternative medicine, and their information sources about alternative medicine. We divided existing alternative therapies into 6 categories: herbal therapy, special diets, psychotherapy, body-mind therapy, spiritual therapy, and other supplements. RESULTS A total of 48 (24.9%) patients did not use any type of alternative therapy; 145 (75.1%) patients used at least one product and 124 (64.25%) patients used herbal preparations (beetroot juice was consumed by 110 [56.99%] patients); 136 (70.5%) patients were informed about alternative therapies by other patients; 145 (75.1%) used alternative medicine to increase the chances for cure; 88 (45.6%) of interviewed patients would like to participate in future research in this field. CONCLUSION The use of alternative medicine is evidently significant among cancer patients. Further research should be conducted in order to find out interactions of these products with other drugs and potential advantages and disadvantages of this form of treatment.
High carbohydrate fat-free diet modulates epitope expression of LDL-apoB-100 and interaction of LDL with human fibroblasts.

High carbohydrate diets are known to increase the concentration of very low density lipoprotein (VLDL) and to lower the concentrations of low density lipoprotein (LDL) and high density lipoprotein (HDL) in plasma. Such diets also alter lipoprotein compositions and metabolism. The aims of the present study were to assess in detail the effects of a virtually fat-free high carbohydrate (CHO) diet (CHO greater than 85% and fat less than 1% of calories) on various aspects of LDL. Thirteen healthy normolipidemic volunteers ate a basal "American" diet and the CHO diet for 7 days each in a forward or reverse sequence. Fasting blood samples were drawn at the ends of each study period and analyzed for lipoprotein lipid and apolipoprotein concentrations. Compositions of LDL particles isolated by ultracentrifugation were characterized chemically, LDL sizes were assessed by nondenaturing gradient electrophoresis on 2-16% gels, and association and degradation of LDL with normal human skin fibroblasts were quantified in cell cultures. Immunoreactivities of apoB in LDL were tested in solid phase competitive binding radioimmunoassays using five monoclonal anti-LDL antibodies that reacted with defined epitopes of apoB-100. The study diet produced consistent decreases of LDL cholesterol and apoB concentrations by 25% and 17%, respectively. LDL compositions were altered. Mean LDL triglycerides increased 3% to 4% of total LDL mass (P less than 0.004), and LDL particle sizes decreased (P less than 0.01). In radioimmunoassays that contained monoclonal antibody B1B3, an antibody that inhibits binding of LDL to the LDL receptor, the mean ED50 value for LDL protein was reduced from 3.75 to 2.66 micrograms (P less than 0.001). (ABSTRACT TRUNCATED AT 250 WORDS)
Reexamination of the assessment criteria for rheumatoid arthritis disease activity based on comparison of the Disease Activity Score 28 with other simpler assessment methods

ObjectiveTo explore simpler and possibly more appropriate tools than the conventional Disease Activity Score 28 (DAS28) for assessing rheumatoid arthritis (RA) and to derive more reliable DAS28-based criteria.MethodsThe capabilities of assessing disease activities in 250 RA patients were compared between DAS28 and other methods, including the Simplified DA Index (SDAI), Clinical DA Index (CDAI), and Routine Assessment of Patient Index Data-3 (RAPID-3). ResultsSDAI and CDAI showed a good correlation and consistency with DAS28, whereas RAPID-3 yielded inferior results. In terms of remission criteria, DAS28 was less stringent than SDAI or CDAI; when RA remission was reexamined based on more stringent SDAI or CDAI criteria, cut-off values for DAS28-C-reactive protein of <1.72 were considered to be appropriate. The conventional DAS28 was considered to be appropriate for assessing low, middle and high disease activities because it provides criteria similar to or more stringent than those of other methods, while SDAI and CDAI were considered to be simpler and more appropriate criteria for assessing remission.ConclusionFor assessing remission, DAS28-CRP provides the most appropriate criterion of the methods compared when the currently used cut-off value of 2.3 is lowered to a new value of 1.72.
Treatment responsiveness in CIDP patients with diabetes is associated with unique electrophysiological characteristics, and not with common criteria for CIDP

Objectives: Characterize treatment responsiveness in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients with diabetes mellitus (DM). Methods: We performed a retrospective chart review of CIDP subjects assessed between 1997 and 2013 and compared treatment response rates in those with and without DM, using different sets of criteria. Results: 99 CIDP patients were included, 34 CIDP+DM and 65 CIDP−DM patients, both having similar treatment response rates. CIDP patients fulfilling European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria had higher treatment response rates. Responders fulfilled a higher number of American Academy of Neurology (AAN) and EFNS/PNS criteria and had a higher number of demyelinating features in the total cohort and in CIDP−DM but not in CIDP+DM patients. CIDP+DM responders, however, had unique electrophysiologic characteristics. Conclusion: Fulfilling EFNS/PNS and AAN criteria, and higher number of demyelinating features, are associated with higher treatment response rates in CIDP−DM but not in CIDP+DM patients, implying the need for adjusting current criteria to predict treatment response rates in CIDP−DM patients.
T Cell Regulation of p62 dok (Dok1) Association with Crk-L*

In addition to engagement of the T cell receptor-CD3 complex, T lymphocytes can be activated by a variety of cell surface molecules including the ∼50-kDa surface receptor CD2. While the majority of biochemical signaling elements are triggered by either CD2 or TcR-CD3 receptors, a small number of proteins are engaged by only one receptor. Recently, p62 dok (Dok1), a member of the Dok family of adapter molecules, has been reported to be activated by CD2 and not by CD3 engagement. Here we have examined the role of p62 dok in CD2-dependent signaling in Jurkat T cells. As previously reported, we find that ligation of the CD2 molecule by mitogenic pairs of anti-CD2 mAbs led to phosphorylation of p62 dok . While CD2-induced p62 dok tyrosine phosphorylation was independent of both the p36/38 membrane adapter protein linker of activated T cells (LAT) and the ZAP70/Syk family of kinases, it was dependent upon the Src family of kinases including Lck and Fyn. We find further that CD2 engagement induced the association of tyrosine-phosphorylated p62 dok to Crk-L. The CD2-dependent association of p62 dok to Crk-L was independent of expression of the ZAP70/Syk family of kinases. Of note, while T cell receptor-CD3 engagement did not induce either p62 dok phosphorylation or Crk-L association in Jurkat T cells, it did inhibit CD2-dependent p62 dok -Crk-L complexes; this TcR-CD3-mediated regulation was dependent upon ZAP70 kinase activity. Our data suggest that phosphorylation of p62 dok and its interaction with other signaling proteins may depend upon integrated signals emanating from the CD2 receptor, utilizing a ZAP70/LAT-independent pathway, and the TcR-CD3 receptor, which is ZAP70/Syk-dependent.