Miracle-dz/UniFAR-FTUs huggingface dataset:
Inflammatory bowel disease and risk of mortality in COPD

Patients with chronic obstructive pulmonary disease (COPD) have higher incidence and prevalence of other chronic inflammatory diseases, including inflammatory bowel disease (IBD). We assessed whether IBD onset increases mortality risk in patients with COPD or asthma-associated COPD. Two population-based cohorts of COPD and asthma-COPD subjects were identified using the administrative health databases in Québec, Canada, 1990–2007. Death records were retrieved from the death certificate registry. Cox proportional hazards models were used to assess the impact of newly developed IBD on mortality risk. The COPD and asthma-COPD cohorts included 273 208 and 26 575 patients, respectively, of which 697 and 119 developed IBD. IBD increased the risk of all-cause mortality in both COPD (hazard ratio 1.23, 95% CI 1.09–1.4) and asthma-COPD (hazard ratio 1.65, 95% CI 1.23–2.22). In asthma-COPD patients, IBD increased the risk of mortality from respiratory conditions (hazard ratio 2.18, 95% CI 1.31–3.64); in COPD patients, IBD increased the risk of death from digestive conditions (hazard ratio 4.45, 95% CI 2.39–8.30). IBD is a risk factor for mortality in patients with pre-existing COPD or asthma-COPD. IBD increased mortality by respiratory and digestive conditions in patients with asthma-COPD and COPD, respectively. IBD is a risk factor for mortality in patients with pre-existing COPD or asthma-associated COPD http://ow.ly/X6PaY
The Clostridium difficile Exosporium Cysteine (CdeC)-Rich Protein Is Required for Exosporium Morphogenesis and Coat Assembly

ABSTRACT Clostridium difficile is an important nosocomial pathogen that has become a major cause of antibiotic-associated diarrhea. There is a general consensus that C. difficile spores play an important role in C. difficile pathogenesis, contributing to infection, persistence, and transmission. Evidence has demonstrated that C. difficile spores have an outermost layer, termed the exosporium, that plays some role in adherence to intestinal epithelial cells. Recently, the protein encoded by CD1067 was shown to be present in trypsin-exosporium extracts of C. difficile 630 spores. In this study, we renamed the CD1067 protein Clostridium difficile exosporium cysteine-rich protein (CdeC) and characterized its role in the structure and properties of C. difficile spores. CdeC is expressed under sporulation conditions and localizes to the C. difficile spore. Through the construction of an ΔcdeC isogenic knockout mutant derivative of C. difficile strain R20291, we demonstrated that (i) the distinctive nap layer is largely missing in ΔcdeC spores; (ii) CdeC is localized in the exosporium-like layer and is accessible to IgGs; (iii) ΔcdeC spores were more sensitive to lysozyme, ethanol, and heat treatment than wild-type spores; and (iv) despite the almost complete absence of the exosporium layer, ΔcdeC spores adhered at higher levels than wild-type spores to intestinal epithelium cell lines (i.e., HT-29 and Caco-2 cells). Collectively, these results indicate that CdeC is essential for exosporium morphogenesis and the correct assembly of the spore coat of C. difficile.
Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

Context Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria.
Simultaneous QPSK-to- \(2\times \) BPSK Wavelength and Modulation Format Conversion in PPLN

Phase-sensitive cascaded second-harmonic generation and difference-frequency generation in a periodically poled lithium niobate waveguide allow converting two orthogonal quadratures of an optical field to different wavelengths, thus enabling simultaneous quadrature phase-shift keying-to-2× binary phase-shift keying modulation format and wavelength conversions. Static phase-sensitive extinction ratios above 20 dB are obtained for both quadratures, resulting in error-free dynamic operation with low penalty (BER 10-9) at 10 Gbaud.
Highly Potent, Selective, and Low Cost Bis-tetrahydroaminacrine Inhibitors of Acetylcholinesterase

We report highly potent, selective, and low cost bifunctional acetylcholinesterase (AChE) inhibitors developed by our two-step prototype optimization strategy utilizing computer modeling of ligand docking with target proteins: 1) identify low affinity sites normally missed by x-ray crystallography; and 2) design bifunctional analogs capable of simultaneous binding at the computer-determined low affinity site and the x-ray-identified high affinity site. Applying this strategy to 9-amino-1,2,3,4-tetrahydroacridine (THA), a drug for Alzheimer's disease, we obtained alkylene linked bis-THA analogs. These analogs were up to 10,000-fold more selective and 1,000-fold more potent than THA in inhibiting rat AChE and yet required one simple reaction to synthesize. Additionally, alkylene linked benzyl-THA analogs were developed to examine the specificity of the docking-derived low affinity THA peripheral site in AChE. The present work and our previous computational studies strongly suggest that a low affinity THA peripheral site exists in AChE. This peripheral site provides a structural basis for design of improved cholinesterase ligands for treating Alzheimer's disease and for other health-related purposes.
Gefitinib versus placebo in completely resected non-small-cell lung cancer: results of the NCIC CTG BR19 study.

PURPOSE Survival of patients with completely resected non-small-cell lung cancer (NSCLC) is unsatisfactory, and in 2002, the benefit of adjuvant chemotherapy was not established. This phase III study assessed the impact of postoperative adjuvant gefitinib on overall survival (OS). PATIENTS AND METHODS Patients with completely resected (stage IB, II, or IIIA) NSCLC stratified by stage, histology, sex, postoperative radiotherapy, and chemotherapy were randomly assigned (1:1) to receive gefitinib 250 mg per day or placebo for 2 years. Study end points were OS, disease-free survival (DFS), and toxicity. RESULTS As a result of early closure, 503 of 1,242 planned patients were randomly assigned (251 to gefitinib and 252 to placebo). Baseline factors were balanced between the arms. With a median of 4.7 years of follow-up (range, 0.1 to 6.3 years), there was no difference in OS (hazard ratio [HR], 1.24; 95% CI, 0.94 to 1.64; P = .14) or DFS (HR, 1.22; 95% CI, 0.93 to 1.61; P = .15) between the arms. Exploratory analyses demonstrated no DFS (HR, 1.28; 95% CI, 0.92 to 1.76; P = .14) or OS benefit (HR, 1.24; 95% CI, 0.90 to 1.71; P = .18) from gefitinib for 344 patients with epidermal growth factor receptor (EGFR) wild-type tumors. Similarly, there was no DFS (HR, 1.84; 95% CI, 0.44 to 7.73; P = .395) or OS benefit (HR, 3.16; 95% CI, 0.61 to 16.45; P = .15) from gefitinib for the 15 patients with EGFR mutation-positive tumors. Adverse events were those expected with an EGFR inhibitor. Serious adverse events occurred in ≤ 5% of patients, except infection, fatigue, and pain. One patient in each arm had fatal pneumonitis. CONCLUSION Although the trial closed prematurely and definitive statements regarding the efficacy of adjuvant gefitinib cannot be made, these results indicate that it is unlikely to be of benefit.
Foxp3+IL‐17+ T cells promote development of cancer‐initiating cells in colorectal cancer

The pathogenesis of CRC remains to be further understood. This study was designed to elucidate the role of Foxp3+IL‐17+ T cells in the pathogenesis of CRC. Surgically removed CRC tissue was collected from 12 patients with CRC. The frequency and cytokine profile of Foxp3+IL‐17+ T cells in CRC were examined by flow cytometry. Chemokine CXCL11 was examined in CRC tissue by Western blotting. Treg chemotaxis was examined in a transwell system. The effect of Foxp3+IL‐17+ T cells on induction of cancer‐initiating cells was examined; the latterˈs Akt and MAPK activities and colony formation were examined afterward. Abundant Foxp3+IL‐17+ T cells were detected in CRC tissue that expresses high levels of TGF‐β, CXCR3, CCR6, and RORγt. High levels of CXCL11 were detected in CRC tissue‐derived CD68+ cells, which had a strong chemotactic effect on Foxp3+ Tregs. Hypoxia induced the expression of IL‐17 in Foxp3+ Tregs; Foxp3+IL‐17+ T cells were capable of inducing CRC‐associated cell markers in BMMo and drove the cells to be cancer‐initiating cells. High levels of phosphorylated Akt and MAPK were detected in the induced cancer‐initiation cells; the latter has the capability to form a colony. CRC tissue‐derived Foxp3+IL‐17+ cells have the capacity to induce cancer‐initiating cells.
Defining the Importance of Daily Glycemic Control and Implications for Type 2 Diabetes Management

Abstract Glycemic control remains an elusive goal for most patients with type 2 diabetes. Questions concerning glucose targets that have emerged from recent outcomes studies further complicate glucose control strategies. Navigating through these challenges requires an understanding of the relationship between hyperglycemia, glycemic variability, and risk, as well as how to combine antidiabetic agents safely and effectively to minimize complications. Relevant data were selected from recently published major outcomes studies and peer-reviewed articles discussing glycemic variability, incretins, and dipeptidyl peptidase-4 inhibition. Incretin hormones play a premier role in maintaining normal glucose homeostasis. In type 2 diabetes, however, incretin functioning is impaired and glucose homeostasis is disturbed, contributing to hyperglycemia and both acute and chronic glucose fluctuations. Glycemic control efforts should involve quarterly glycated hemoglobin assessments, routine monitoring of daily blood glucose values, and combination therapy that targets both fasting and postprandial hyperglycemia. Dipeptidyl peptidase-4 inhibitors, which enhance endogenous incretin function, are well suited for combination with other agents to promote daily glycemic control without increasing the risk of hypoglycemia or weight gain. Results of recent outcomes studies suggest that a lifetime strategy for diabetes management might involve aggressive efforts to control glycemia daily and early in type 2 diabetes, with less stringent glucose targets and avoidance of hypoglycemia as patients acquire comorbidities, such as advanced cardiovascular disease. Dipeptidyl peptidase-4 inhibitors have the potential to play a vital role in diabetes management at all stages of the disease.
Dietary intake of Austrian diabetic children 10 to 14 years of age.

BACKGROUND The dietary intake of 63 children with insulin-dependent diabetes mellitus (IDDM; age 10 to 14 years) was weighed by dietitians for 2 days during a summer camp for youth with diabetes. Data were analyzed for the content of macronutrients with the help of a computer database program. METHODS The dietary intake of children with diabetes was compared with that of healthy Austrian school children and with the current nutritional recommendations for children with IDDM. RESULTS The mean intake of carbohydrate did not meet the recommended level, whereas sucrose, fiber, and protein intake approximated the recommendations. The total consumption of fat and cholesterol, however, exceeded the recommended values. The nutritional intake of Austrian children with IDDM was similar to that of healthy children of the same age and thus reflected regional dietary habits. CONCLUSION Dietary educational measures on a national basis are needed to change harmful local eating patterns.
Immediate loading of mandibular overdentures supported by unsplinted direct laser metal-forming implants: results from a 1-year prospective study.

BACKGROUND At present, only some studies have dealt with immediate loading of unsplinted implants supporting mandibular overdentures. The aim of this prospective study is to evaluate treatment outcomes of mandibular overdentures supported by four one-piece, unsplinted, immediately loaded, direct laser metal-forming (DLMF) implants by assessing implant survival rate, implant success, marginal bone loss, and prosthetic complications. METHODS A total of 96 one-piece DLMF implants were inserted in the edentulous mandible of 24 patients. Four implants were placed in each edentulous mandible. Immediately after implant placement, a mandibular overdenture was connected to the implants. At 1-year follow-up, clinical, radiographic, and prosthetic parameters were assessed. Success criteria included absence of pain, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact <1.5 mm. RESULTS After a 1-year loading time, the overall implant survival rate was 98.9%, with only one implant lost. Among the surviving 95 implants, two did not fulfill the success criteria; therefore, the implant success rate was 97.8%. The mean distance between the implant shoulder and the first visible bone contact was 0.28 ± 0.30 mm (95% confidence interval, 0.24 to 0.32). Some prosthetic complications were reported. CONCLUSION Based on the present results and within the limits of this study, the immediate loading of four unsplinted DLMF implants by means of ball attachment-supported mandibular overdentures seems to represent a safe and successful procedure.
Low Childhood IQ and Early Adult Mortality: The Role of Explanatory Factors in the 1958 British Birth Cohort

OBJECTIVE: To examine whether the association between childhood IQ and later mortality risk was explained by early developmental advantages or mediated by adult sociodemographic factors and health behaviors. PARTICIPANTS AND METHODS: Participants were 10 620 men and women from the 1958 British Birth Cohort Study whose IQ was assessed at the age of 11 years and who were followed up to age 46. Childhood covariates included birth weight, childhood height at 11 years of age, problem behaviors, father's occupational class, parents' interest in child's education, family size, and family difficulties. Adult risk factors were assessed at ages 23, 33, and 42 years, and they included education, occupational class, marital status, smoking, BMI, alcohol use, and psychosomatic symptoms. RESULTS: Between ages 23 and 46 years, 192 participants died. Higher childhood IQ was related to lower mortality risk (standardized odds ratio [OR]: 0.80 [95% confidence interval (CI): 0.69–0.93]) with no gender differences (OR: 0.81 [95% CI: 0.67–0.98] [men] and 0.79 [95% CI: 0.63–0.98] [women]). Adjusting for parents' interest in child's education attenuated the IQ-mortality association by 15% to 20%, and adult education and psychosomatic symptoms both attenuated the association by 25%. Other covariates were less influential. CONCLUSIONS: In a cohort of British men and women, the most important explanatory factors for the lower mortality rate among individuals with high IQ were parental interest in child's education, high adult educational level, and low prevalence of psychosomatic symptoms. However, common sociodemographic risk factors and health behaviors may not be sufficient to explain the association between IQ and early mortality completely.
GABRA2 genotype, impulsivity, and body mass.

BACKGROUND The goal of this study was to test a hypothesis associating impulsivity with an elevated body mass index (BMI). METHODS To this end, we examined associations of BMI with putative genetic, neurophysiological, psychiatric, and psychological indicators of impulsivity in 78 women and 74 men formerly dependent on alcohol or drugs. A second analysis was designed to test the replicability of the genetic findings in an independent sample of 109 women and 111 men with a similar history of substance dependence. RESULTS The results of the first analysis showed that BMI was positively correlated with Total and Nonplanning Scale Scores on the Barratt Impulsiveness Scale and the number of childhood symptoms of Attention-Deficit/Hyperactivity Disorder in women. It was also positively correlated, in women, with a GABRA2 variant previously implicated as a risk factor for substance dependence and an objective electroencephalographic feature previously associated with GABRA2 and relapse risk. The second analysis confirmed that the correlation between BMI and the substance-dependence-associated GABRA2 genotype was reliable and sex-specific. CONCLUSIONS We conclude that an elevated BMI is associated with genetic, neurophysiological, psychiatric, and psychological indicators of impulsivity. The sex difference may be explained by greater opportunities to eat and overeat, a preference for higher calorie foods, a longer duration of alcohol/drug abstinence, or previous pregnancies in women.
Insecure Adult Attachment and Child Maltreatment: A Meta-Analysis

Extant evidence has shown that insecure adult attachment is related to dysfunctional parenting styles that heighten parents’ risk of child maltreatment. However, there is a lack of studies appraising the evidence for the association between insecure adult attachment and child maltreatment. This meta-analytic study examined the relationship between parents’ adult attachment and child maltreatment perpetration/child abuse potential. Studies examining the relationship between parents’ adult attachment and child maltreatment/child abuse potential published before February 2017 were identified through a systematic search of online databases. In total, 16 studies (N = 1,830) were selected. Meta-analysis based on random-effects models shows a significant positive association between insecure attachment and child maltreatment (pooled effect size: odds ratio [OR] = 2.93, p = .000). Subgroup analyses show insecure attachment was more strongly associated with failure to thrive (OR = 8.04, p = .000) and filicide (OR = 5.00, p < .05). Medium effect sizes were found for subgroup analyses on insecure romantic attachment (OR = 3.76, p = .000), general attachment (OR = 3.38, p = .000), attachment to own child (OR = 3.13, p = .001), and to own parents (OR = 2.63, p = .000) in relation to child maltreatment.
Interferon‐β affects the tryptophan metabolism in multiple sclerosis patients

Tryptophan and its metabolites are of great interest in understanding the pathogenesis of multiple sclerosis (MS). The total levels of tryptophan and its metabolites, kynurenine and kynurenic acid were determined in plasma by capillary liquid chromatography electrospray ionisation tandem mass spectrometry. This is the first report of the plasma levels of these analytes in healthy controls and relapsing–remitting MS patients receiving long‐term and acute interferon‐β (IFN‐β) treatment. Twenty‐four hours post‐administration increased kynurenine levels (first IFN MS versus healthy, P = 0.042) and kynurenine/tryptophan ratio (K/T; first IFN MS versus healthy, P =0.027; first IFN MS versus long‐term IFN MS, P = 0.036) were found. The long‐term IFN MS group had higher K/T ratios at 4 and 12 h post‐administration (P = 0.015 and 0.009, respectively). The increase of K/T ratio in the first IFN MS group indicate an induction of the enzyme indolamine‐2,3‐dioxygenase (IDO), as reported earlier in experimental allergic encephalomyelitis. As IDO is participating in both inflammatory and neurodegenerative processes, further knowledge of its involvement in the pathogenesis of MS is of great importance.
The Impact of Therapeutic Case Management on Participation in Adolescent Substance Abuse Treatment

Establishing the efficacy of case management in substance abuse treatment has been confounded by the lack of attention given to assessing the fidelity of case management implementation. The current study measured the fidelity of case management implementation and used fidelity information to examine the impact of therapeutic case management on attrition in an adolescent, outpatient, group, substance abuse treatment program. Ninety adolescent women enrolled in substance abuse treatment were randomly assigned to receive or to not receive case management. Treatment fidelity was measured using the Case Management Quality Inventory. Cox regression analyses revealed that higher fidelity of case management implementation predicted a decreased risk of dropping out of the substance abuse treatment program (RR = −11.21, p < 0.02). Higher proportions of total case management time spent on case management core functions predicted a decreased risk of dropping out of treatment (RR = 4.32, p < 0.03). This study confirms that programs need to first demonstrate that the case management model has been implemented faithfully before its efficacy in reducing attrition in the substance abuse treatment program can be fairly evaluated. It also suggests that core case management functions may have a greater influence on attrition in substance abuse treatment than does intensity.
The relationship between gross motor function and participation restriction in children with cerebral palsy: an exploratory analysis.

BACKGROUND Children with cerebral palsy (CP) experience a variety of functional limitations depending on the severity of their condition that impact on their participation in day-to-day activities. METHODS The gross motor function and participation restrictions experienced by 60 ambulant children with CP (mean age 11.04 years) were assessed using the Gross Motor Function Measure (GMFM-88) and the Lifestyle Assessment Questionnaire - Cerebral Palsy (LAQ-CP). RESULTS A significant negative correlation existed between the GMFM-88 and the LAQ-CP (r = -0.52, P < 0.001). Significant relationships were also identified between the GMFM-88 and the physical independence, mobility, economic burden and social integration domains of the LAQ-CP. CONCLUSION In ambulatory children with CP, better physical function is associated with a lesser impact of disability; however, the relationship between function and participation is complex. Measures of participation restriction may assist with goal setting appropriate to the specific needs of the child and family.
Alexithymia, emotional empathy, and self-regulation in anorexia nervosa.

BACKGROUND Individuals with anorexia nervosa (AN) who are starved have poor awareness (alexithymia), reduced understanding of others' mental states (cognitive empathy), and difficulty regulating personal emotions (self-regulation). Despite its important role in social interaction, sympathy for others (emotional empathy) has not been measured in AN. Furthermore, it is unknown how restoring weight affects the relationship among alexithymia, empathy, and self-regulation in AN. METHODS Women with AN were tested longitudinally during their starvation period (N = 26) and after weight was restored (N = 20) and compared with 16 age-matched healthy women. Alexithymia, empathy, and self-regulation were assessed with the Toronto Alexithymia Scale, the Interpersonal Reactivity Index, and items measuring self-regulation from the Minnesota Multiphasic Personality Inventory-2, respectively. RESULTS Relative to comparison participants, individuals with AN during both starvation and weight restoration reported greater alexithymia and emotional empathy in one domain, personal distress (vicarious negative arousal to others' suffering). Among AN participants, personal distress was positively correlated with alexithymia and negatively correlated with self-regulation, when accounting for depression. CONCLUSIONS High levels of alexithymia and personal distress may be persistent features of AN because they do not resolve upon weight restoration. Greater personal distress in AN may be a function of poor emotional awareness and regulation.