Miracle-dz/UniFAR-FTUs huggingface dataset:
A phase II trial of pegylated interferon alpha-2b therapy for polycythemia vera and essential thrombocythemia: feasibility, clinical and biologic effects, and impact on quality of life.

BACKGROUND Conventional interferon-alpha (IFN) is an effective treatment for patients with myeloproliferative disorders. However, many patients discontinue therapy because of side effects. METHODS In this 24-month, Phase II feasibility study of pegylated interferon alpha-2b (PEG-IFN) treatment, a starting dose of 0.5 microg/kg per week was received by 21 patients with polycythemia vera (PV) and 21 patients with essential thrombocythemia (ET). The treatment objective, a complete platelet response (CR), was a platelet count<400x10(9)/L in symptomatic patients and <600 in asymptomatic patients. Neutrophil polycythemia rubra vera-1 (PRV-1) messenger RNA expression was analyzed prior to and during therapy. Quality of life (QoL) was investigated by using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. RESULTS At 6 months, 29 of 42 patients (69%) had achieved a CR after a median of 83 days. The CR rate was not related to diagnosis, gender, or previous therapy. Nineteen patients completed the planned 2-year treatment in CR. No thromboembolic or bleeding complications were observed. Phlebotomy requirements were reduced in the majority of patients with PV. Five of 14 patients (36%) who initially were positive for PRV-1 achieved normalized PRV-1 expression under PEG-IFN treatment. Side effects were the cause of therapy failure in 16 of 23 patients. However, only 8 of 19 patients reported any side effects at 2 years. The QLQ-C30 revealed clinically significant impairments in several aspects of QoL at 6 months; however, at 2 years, QoL measurements were not different from baseline. CONCLUSIONS PEG-IFN effectively reduced platelet counts in 29 of 42 patients, but only 19 patients maintained a CR at 2 years. The reversal of PRV-1 positivity noted in a subset of patients suggested that PEG-IFN may have an effect on the malignant clone. PEG-IFN is a valuable therapeutic alternative for patients who tolerate its initial side effects.
In utero exposure to Civil Conflict: Nicaraguan War and its long-term effects on socioeconomic outcomes

We examine the Nicaraguan Civil conflict in the seventies that ended up with the overthrown of the Somoza dictatorship and the start of the Sandinista Revolution. Nicaragua between 1977 and 1979 experienced high rates of war confrontation. After the announcement of the Sandinista National Liberation Front (FSLN, by its acronym in Spanish) in November of 1977, the country had undergone a civil war which ended up with a range of 30,000-50,000 casualties. The escalated confrontation allows us to examine the long-term effects of the war-related conflict on the subsequent generation’s socioeconomic outcomes. In particular, this paper aims to identify whether in-utero exposure to the civil conflict in Nicaragua has a negative impact on individual’s labor and marriage market outcomes. We exploit the variation in timing of and geographical exposure to the civil conflict during the last year of the dictatorship. We construct novel data which combine full population information of the 2005 Nicaraguan National Census, the World Health Organization historical mortality data, and the Correlates of War. Exploiting differences across regions and across cohorts, our preliminary findings indicate that the civil conflict negatively affected those exposed to the conflict in utero. In particular, the long-term consequences of the war decreased educational attainment, formal employability, and thus reducing lifetime earnings, especially for females. The exposure to the civil conflict also seems to decrease marriage probability. JEL Codes: I10, J24, N35.
Should Depressive Syndromes Be Reclassified as "Metabolic Syndrome Type II"?

BACKGROUND A nascent explanatory theory regarding the pathophysiology of major depressive disorder posits that alterations in metabolic networks (e.g., insulin and glucocorticoid signaling) mediate allostasis. METHOD We conducted a PubMed search of all English-language articles published between January 1966 and September 2006. The search terms were: neurobiology, cognition, neuroprotection, inflammation, oxidative stress, glucocorticoids, metabolic syndrome, diabetes mellitus, insulin, and antidiabetic agents, cross-referenced with the individual names of DSM-III-R/IV/-TR-defined mood disorders. The search was augmented with a manual review of article reference lists; articles selected for review were determined by author consensus. RESULTS Disturbances in metabolic networks: e.g., insulin-glucose homeostasis, immuno-inflammatory processes, adipokine synthesis and secretion, intra-cellular signaling cascades, and mitochondrial respiration are implicated in the pathophysiology, brain volumetric changes, symptomatic expression (e.g., neurocognitive decline), and medical comorbidity in depressive disorders. The central nervous system, like the pancreas, is a critical modulator of the metabolic milieu and is endangered by chronic abnormalities in metabolic processes. We propose the notion of "metabolic syndrome type II" as a neuropsychiatric syndrome in which alterations in metabolic networks are a defining pathophysiological component. CONCLUSION A comprehensive management approach for depressive disorders should routinely include opportunistic screening and primary prevention strategies targeting metabolically mediated comorbidity (e.g., cardiovascular disease). Innovative treatments for mood disorders, which primarily target aberrant metabolic networks, may constitute potentially novel, and disease-modifying, treatment avenues.
Planned relaparotomy vs relaparotomy on demand in the treatment of intra-abdominal infections. The Peritonitis Study Group of the Surgical Infection Society-Europe.

OBJECTIVE To define the role of planned relaparotomy (PR) in the treatment of intraperitoneal infection, compared with that of relaparotomy on demand (RD). DESIGN Case-control study on the basis of a prospective multicenter cohort analytic study. Statistical evaluation was done by the McNemar test for qualitative data and the Wilcoxon matched-pairs signed rank test for qualitative data. SETTING Eighteen hospitals of different care levels in Austria, Germany, and Switzerland. PATIENTS Thirty-eight of 42 patients with intra-abdominal infections who underwent PR were matched for APACHE II (Acute Physiology and Chronic Health Evaluation II) score, age, cause of infection, site of origin of peritonitis, and the ability of the surgeon to securely eliminate the source of infection with 38 patients taken from a cohort of 278 undergoing RD. INTERVENTIONS Planned relaparotomy was defined as at least one relaparotomy decided on at the time of the first surgical intervention; RD, relaparotomy indicated by clinical findings. MAIN OUTCOME MEASURES Mortality and incidence of postoperative multiple organ failure and infectious complications. RESULTS There was no significant difference in mortality between patients treated with PR (21%) or RD (13%). Postoperative multiple organ failure as defined by a Goris score of more than 5 was more frequent in the group of patients undergoing PR (50%), compared with the group undergoing RD (24%) (P = .01), as were infectious complications (68% vs 39% [P = .01]). Infectious complications were due to more frequent suture leaks (16% vs 0% [P = .05]), recurrent intra-abdominal sepsis (16% vs 0% [P = .05]), and septecemia (45% vs 18% [P = .05]) in the PR vs the RD groups. The incidence of other complications was not different in the two groups. CONCLUSIONS Until larger prospective studies are available, the indication for PR should be evaluated with caution.
Infusing Infographics into the Business Curriculum: A Study of Infographic Interpretations in China, New Zealand, and the United States

The present study sought to identify whether infographics should be infused into business curriculum as a tool for improving the efficiency of cross-cultural business communication. Students from the United States, New Zealand, and China were presented with a series of 10 infographics with all text in French, a language not spoken by any of the student participants. Of the infographics, eight were designed with traditional visual relationships, one was designed based upon metaphor, and one relied upon visual relationships and incorporated metaphor. The majority of students in both samples were able to successfully interpret the information in each infographic except for the infographic that relied upon a combination of visual relationships and metaphor. Additionally, the New Zealand students struggled with the Venn Diagram. As such, it is concluded that infographics should be taught as a business communication tool, but instructors should exercise caution in training students to use color metaphor or Venn Diagrams.
Assessment of regional longitudinal myocardial strain rate derived from doppler myocardial imaging indexes in normal and infarcted myocardium.

Myocardial deformation properties may be characterized by regional strain rates (SRs) calculated from Doppler myocardial velocity data. In 10 control subjects and 12 patients with established transmural infarcts, longitudinal median segmental SR, strain, and myocardial velocity were analyzed and compared with the corresponding wall motion score. All segments in control subjects and normal segments in infarct patients showed no significant difference in either systolic or diastolic SR (systolic: -1.27+/-0.39 s(-1) versus -1.23+/-0.24 s(-1), not significant [NS]; and isovolumic relaxation [IVR]: 1.23+/-0.38 s(-1) versus 1.95+/-0.62 s(-1), NS; respectively) and strain (-0.21+/-0.06 versus -0.19+/-0.06, NS). In infarcted segments, peak systolic SR, systolic strain, and early diastolic SR showed the most pronounced reduction (hypokinetic and akinetic) or even inversion (dyskinetic segments: 0.10+/-0.26 s(-1), 0.00+/-0.03, and -1.78+/-0.67 s(-1), respectively; P<. 001). In this study, new myocardial deformation indexes were shown to quantitatively describe the function of normal and chronically infarcted regions.
Network activity-independent coordinated gene expression program for synapse assembly

Global biological datasets generated by genomics, transcriptomics, and proteomics provide new approaches to understanding the relationship between the genome and the synapse. Combined transcriptome analysis and multielectrode recordings of neuronal network activity were used in mouse embryonic primary neuronal cultures to examine synapse formation and activity-dependent gene regulation. Evidence for a coordinated gene expression program for assembly of synapses was observed in the expression of 642 genes encoding postsynaptic and plasticity proteins. This synaptogenesis gene expression program preceded protein expression of synapse markers and onset of spiking activity. Continued expression was followed by maturation of morphology and electrical neuronal networks, which was then followed by the expression of activity-dependent genes. Thus, two distinct sequentially active gene expression programs underlie the genomic programs of synapse function.
Pupil dilatation after single and triple doses of mydriatic agent in preterm infants.

OBJECTIVE To compare the pupillary response to a single drop and three drops of a combination of eye drops (0.2% cyclopentolate and 1.0% phenylephrine) in preterm infants. DESIGN Prospective comparative study. MATERIAL AND METHOD Preterm infants scheduled to undergo their first retinopathy of prematurity (ROP) screening in the Neonatal Intensive Care Unit, Songklanagarind Hospital, between 1 August 2007 and 30 August 2008, were enrolled in the present study. An eyelid speculum was placed after the topical anesthetic, 0.5% tetracaine, application to measure the baseline horizontal pupil diameter with a Vernier caliper. Then each eye was randomized to either receive a drop of mixture of 0.2% cyclopentolate and 1.0% phenylephrine single dose for group A, or triple doses of 10-minute interval for group B. The pupil diameter was measured at 45 and 60 minutes after instillation and a fundus examination was performed afterward. RESULTS Seventy preterm infants, 45 males and 25 females, were included in the present study. The mean gestational age was 30.49 +/- 2.34 weeks (range of 24-36 weeks) and the mean birth weight was 1,368.00 +/- 438.99 grams (range of 640-2,850 grams). At baseline, the mean pupil diameter was 2.18 +/- 0.44 mm in group A and 2.19 +/- 0.44 mm in group B (p = 0.90). The mean pupil diameter at 45 minutes after instillation was 5.50 +/- 0.80 mm in group A and 6.02 +/- 0.56 mm in group B (p < 0.01). At 60 minutes after instillation, the mean pupil diameter was 6.13 +/- 0.82 mm in group A and 6.77 +/- 0.41 mm in group B (p < 0.01). CONCLUSION The pupil size of preterm infants was significantly larger after three drops of the eye drop mixture (0.2% cyclopentolate and 1.0% phenylephrine) than after a single drop. However, a dilated pupil diameter > or = 6 mm was adequate for the peripheral retina examination.
Kinetic and Product Distribution Analysis of Human Eosinophil Cationic Protein Indicates a Subsite Arrangement That Favors Exonuclease-type Activity*

With the use of a high yield prokaryotic expression system, large amounts of human eosinophil cationic protein (ECP) have been obtained. This has allowed a thorough kinetic study of the ribonuclease activity of this protein. The catalytic efficiencies for oligouridylic acids of the type (Up) n U>p, mononucleotides U>p and C>p, and dinucleoside monophosphates CpA, UpA, and UpG have been interpreted by the specific subsites distribution in ECP. The distribution of products derived from digestion of high molecular mass substrates, such as poly(U) and poly(C), by ECP was compared with that of RNase A. The characteristic cleavage pattern of polynucleotides by ECP suggests that an exonuclease-like mechanism is predominantly favored in comparison to the endonuclease catalytic mechanism of RNase A. Comparative molecular modeling with bovine pancreatic RNase A-substrate analog crystal complexes revealed important differences in the subsite structure, whereas the secondary phosphate-binding site (p2) is lacking, the secondary base subsite (B2) is severely impaired, and there are new interactions at the po, Bo, and p-1sites, located upstream of the P-O-5′ cleavable phosphodiester bond, that are not found in RNase A. The differences in the multisubsites structure could explain the reduced catalytic efficiency of ECP and the shift from an endonuclease to an exonuclease-type mechanism.
Physical Activity Dose for Hemodialysis Patients: Where to Begin? Results from a Prospective Cohort Study.

OBJECTIVE Greater physical activity is associated with lower risk of mortality in persons with kidney disease; however, little is known about the appropriate dose of physical activity among hemodialysis patients. Here detected the minimum level of habitual physical activity to help inform interventions aimed at improving outcomes in the dialysis population. DESIGN The design was prospective cohort study. SUBJECTS Clinically stable outpatients in a hemodialysis unit from October 2002 to March 2014 were assessed for their eligibility to be included in this 7-year prospective cohort study. We used the Youden index to determine the optimal cutoff points for physical activity. The prognostic effect of physical activity on survival was estimated by Cox proportional hazards regression analysis. The number of steps per nondialysis day was recorded by accelerometer at study entry. MAIN OUTCOME MEASURE The main outcome measure was all-cause mortality. RESULTS There were 282 participants who had a mean age of 65 ± 11 years and 45% were female. A total of 56 deaths occurred during the follow-up period (56 months [interquartile range: 29-84 months]). The cutoff value for the physical activity discriminating those at high risk of mortality was 3,752 steps. After adjustment for the effect of confounders, the hazard ratio in the group of <4,000 steps was 2.37 (95% confidence interval: 1.22-4.60, P = .01) compared with the others. CONCLUSIONS Engaging in physical activity is associated with decreased mortality risk among hemodialysis patients. Our findings of a substantial mortality benefit among those who engage in at least 4,000 steps provide a basis for as a minimum initial recommendation kidney health providers can provide for mobility disability-free hemodialysis patients.
Intravenous high‐dose gammaglobulins for intractable childhood epilepsy

Immunological mechanisms have been implicated in the pathogenesis of epileptic seizures in some patients and in experimental animal models of epilepsy. A beneficial effect of high dose intravenous gammaglobulin (IVIG) has been demonstrated for some children with intractable epilepsy. In this study we treated 9 children ages 1.1–9.2 years (mean 5.0 years) with intractable epilepsy not responsive to conventional antiepileptic drugs (AEDs) and steroid therapy. Eight children and Lennox‐Gastaut syndrome and 1 had complex partial seizures with secondary generalization. Each child received 3 doses of IVIG (200 mg/kg of polyvalent immunoglobulin) on Days 1, 15 and 36. Concomitant AEDs were not changed. Four children had complete remission, 3 had partial response with a more than 50% reduction in seizure frequency and 2 had no response. Onset of response varied from immediate to 7 months after the last injection. No toxicity was noted. Duration of remission was 9 months in 1 case. The other 3 cases have remained in remission to date with a follow up period of 22–26 months. We conclude that IVIG is a safe therapy which appears to be effective in some children with intractable seizures. Children with shorter duration of their seizure disorder (<1 year) and relatively preserved cognitive function (IQ> 70) appear to have a more favorable response. Larger scale controlled trials are needed to determine the optimal timing and dosage, as well as to identify specific subgroups which may benefit most from IVIG treatment.
Assessing approaches to appraisal : a comparison of performance appraisal practices and consequences for hospital nurses in the Czech Republic and Germany

I Acknowledgements . II List of Tables & Figures . VII Glossary of terms/ acronyms . IX Chapter 1: Introduction . 1 1.1 Background . 1 1.2 Aim of the thesis. 4 1.3 Research contribution . 7 1.4 Summary of findings . 8 1.5 Outline of the thesis . 10 Chapter 2: Literature review: Performance Appraisal . 12 2. Introduction . 12 2.1 The meaning of Performance Appraisal (PA): definition . 13 2.2 Main themes within the PA literature . 14 2.2.1 Traditional PA literature . 15 2.2.2 ‘Radical’ perspective . 19 2.2.3 Research gap . 21 2.3. Approaches to performance appraisal: Framework for comparison . 24 2.3.1 The ‘Why’: Main purposes of appraisal . 27 2.3.2 The ‘How’: how PA is conducted . 33 2.3.3 Consequences (Nurses experiences & reactions). 37 2.4 Conclusion . 44 Chapter 3: The convergence-divergence debate and institutional perspective . 46 3. Introduction . 46 3.1. Universalist view: convergence across and within countries . 47 3.1.1 Cross-national pressures for performance . 49 3.1.2 Nursing Profession . 56 3.2. Divergence: The Contextual perspective and institutionalism . 63 3.2.1 Varieties of capitalism . 66 3.3. National institutional factors . 70 3.3.1 Healthcare Systems . 71 3.3.2 Employment Relations . 76 3.4. Conclusion . 80 Chapter 4: Research Methods . 81
The limits of skill-selective immigration policies: Welfare states and the commodification of labour immigrants

Why do some countries have more skill-selective labour immigration policies than others? Despite general agreement that high-skilled immigrants are economically and socially desirable, some countries extensively select high-skilled from low-skilled labour immigrants, while others do not. While most political economy accounts indicate an explicit connection between relative skill selectivity and welfare states, two different hypotheses emerge regarding the direction of this relationship. The fiscal cost hypothesis puts forward that the tension between welfare state generosity and immigration motivates greater selectivity as states try to reconcile fiscal pressures for closure with continuing needs for immigration. The decommodification hypothesis, in contrast, holds that the capabilities of generous welfare states to decommodify their citizens also decrease rationales to be more skill-selective towards labour immigrants. Developing an original measure of skill selectivity in labour immigration policies for 20 developed democracies from 2000 to 2010, we test these two hypotheses. Our results indicate that differences in decommodification levels appear to be substantively and negatively associated with differences in skill selectivity levels, while changes in welfare spending over time, particularly among high-spending countries, rather than differences in spending levels, seem to be positively associated with increasing skill selectivity. This suggests potential tensions between the political responses to economic and demographic changes in the form of immigration policy adjustments and the underlying social logic of modern welfare states. The findings contribute not only to the study of high-skilled immigration, but also advance the current research on the tension between immigration and the welfare state.
The Association Between Crowding and Mortality in Admitted Pediatric Patients From Mixed Adult-Pediatric Emergency Departments in Korea

Objective We aimed to investigate the effect of crowding on the hospital mortality of pediatric patients from adult-pediatric mixed emergency departments (EDs). Methods We used the National Emergency Department Information System database, which included demographic, clinical, diagnostic, and procedural information with all emergency patients visiting to 116 EDs from Korea since 2004. We enrolled EDs with mean length of stay of more than 6 hours. Study period was from January 2006 to December 2008. Pediatric patients younger than 15 years admitted from these EDs were study targets. We calculated the mean patient volume (mean number of patients in the ED) over 8-hour shift for each hospital. When the volume reached the highest quartile, the period was considered as crowded. Patients who came during the overcrowded period were defined as the crowded group. We performed a Kaplan-Meier analysis, and hazard ratio and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model. Results A total of 34 EDs and 125,031 admitted pediatric patients were included; 74,152 (59.3%) were male, and the mean age was 3.84 (95% CI, 3.82–3.86) years; 35,924 (28.7%) were determined as the crowded group. The 30-day mortality rates were 0.4% and 0.3% (P = 0.063) for the crowded group and for the noncrowded group, respectively. The hazard ratio for hospital mortality of the crowded group was 1.230 (95% CI, 1.019–1.558). Conclusions The ED crowding was associated with increased hazard for hospital mortality for pediatric patients in mixed EDs.