Miracle-dz/UniFAR-FTUs huggingface dataset:
Acceptance, well-being and goals in adolescents with chronic illness: a daily process analysis

Objective: The main aim of this study was to investigate the relationship between acceptance and well-being in adolescents with chronic illness from a daily process perspective. Furthermore, we explored the role of daily experienced interference and facilitation of life goals by treatment goals as mediating mechanisms. Methods: Thirty-eight adolescents with cystic fibrosis (CF) or diabetes completed questionnaires assessing acceptance, negative life events and goal-related self-efficacy. Furthermore, an online diary assessing daily mood, daily experienced interference and facilitation of life goals by treatment goals was completed during three consecutive weeks. Results: Acceptance of illness was positively related to daily well-being, but unrelated to daily goal interference and facilitation. Furthermore, daily goal interference and facilitation were unrelated to same-day and next-day well-being. Conclusion: This study suggests that acceptance of illness plays an important role in the daily mood of adolescents with CF and diabetes. This relationship, however, was not mediated by daily experienced interference and facilitation of life goals by treatment goals. Further research is needed to determine whether interventions promoting acceptance are beneficial for adolescents with CF and diabetes.
Outbreak of Atypical Pertussis Detected by Polymerase Chain Reaction in Immunized Preschool-Aged Children

Background: From October 2005 to March 2006, a laboratory-confirmed outbreak of pertussis occurred in preschool-aged children (1–4 years) in Toronto, Canada. A case-control study in children was done to identify the risk factors for being positive for Bordetella pertussis by polymerase chain reaction (PCR). Methods: A case was defined as an individual 0 to 18 years of age who tested positive for B. pertussis by PCR in Toronto from October 2005 to March 2006. Each case was matched to 2 controls (negative for B. pertussis by PCR) by: (1) age, (2) geographic region of testing, and (3) date of testing. Results: One hundred eighty-nine cases and 296 controls were enrolled. Only 42% of cases (vs. 25% controls, P < 0.0001) met a clinical definition of pertussis, 3 cases (4 controls) were hospitalized, and the secondary household attack rate was 8%. One-third of cases were positive for another respiratory pathogen and >90% of cases and controls were up-to-date with pertussis immunization. Children attending school (matched odds ratio [ORm] = 5.2; 95% confidence intervals [CI]: 1.4–19.0), day care (ORm = 2.2; 95% CI: 1.2–4.0), visiting a doctor's office (ORm = 1.6; 95% CI: 1.0–2.5), or exposed to a household member (median age: 4–5 years) with a pertussis-like cough (ORm = 1.9; 95% CI: 1.0–3.6) were significantly more likely to have a positive PCR test for B. pertussis. Conclusions: The main risk factors for PCR positivity for B. pertussis were school or day care attendance. Atypical symptoms were likely moderated by high immunization rates or may have been caused by other respiratory pathogens. In some cases, a positive PCR result might simply have reflected transient nasopharyngeal carriage of B. pertussis.
The effect of cataract surgery on neuropsychological test performance: A randomized controlled trial

Recent cross-sectional studies have reported strong associations between visual and cognitive function, and longitudinal studies have shown relationships between visual and cognitive decline in late life. Improvement in cognitive performance after cataract surgery has been reported in patients with Mild Cognitive Impairment. We investigated whether improving visual function with cataract surgery would improve neuropsychological performance in healthy older adults. A randomized clinical trial of cataract surgery performed at acute hospitals was conducted on 56 patients (mean age 73) with bilateral cataract, after excluding a total of 54 patients at the screening stage, of whom 53 did not meet visual acuity criteria and one did not have cataract. In-home assessments included visual and neuropsychological function, computerized cognitive testing and health questionnaires. Results showed no cognitive benefits of cataract surgery in cognitively normal adults. We conclude that visual improvement following cataract surgery is not strongly associated with an improvement in neuropsychological test performance in otherwise healthy adults. Joint associations between visual and cognitive function in late life are likely to be due to central factors, and unlikely to be strongly related to eye disease. Short-term increased neural stimulation from improved visual function does not appear to affect cognitive performance. (JINS, 2006, 12, 632–639.)
Role of Omega-3 Fatty Acids on Lipid Profile in Diabetic Dyslipidaemia: Single Blind, Randomised Clinical Trial.

INTRODUCTION Diabetic dyslipidaemia is characterised by hypertriglyceridaemia, low High Density Lipoprotein (HDL), postprandial lipimea, small and dense LDL particles is considered to be a major predisposing factor for various macrovascular complications. Omega-3 fatty acids are fish oil derivative introduced in the market for dyslipidaemia associated with increased triglyceride level. AIM To study the effect of omega-3 fatty acids on lipid profile in Type II diabetes patients. MATERIALS AND METHODS This study was prospective, single blind, randomized comparative trial. Hundred patients were randomized into three groups. Group I received metformin 500 mg twice daily and placebo, Group II received metformin 500 mg twice daily and omega-3 fatty acids (1 gram) once daily and the Group III received metformin 500 mg twice daily and omega-3 fatty acids (1 gram) twice daily. ANOVA test was applied for analysis. RESULTS Group II was effective in reducing the triglyceride level from 144.59±14.18 mg/dl to 101±13.31 mg/dl which was significant as compared to Group I from 147.67±18.57 mg/dl to 145.8±19.86 mg/dl respectively. Group III containing 1 g of omega-3 fatty acids twice daily showed decrease from 144.83±22.17 mg/dl to 86±17.46 mg/dl and was more effective in reducing triglyceride levels than Group II containing 1 gram of omega-3 fatty acids once daily. CONCLUSION Omega-3 fatty acids can be given in conjunction with metformin to reduce triglyceride levels in diabetic dyslipidaemia without any adverse drug reactions or any drug interaction. Omega-3 fatty acids were effective in reducing the triglyceride level significantly as compared to placebo. Two grams of omega-3 fatty acids were more effective than 1 gram of omega-3 fatty acids in reducing triglyceride levels.
[Effects of education on knowledge and practice of caregivers of the stroke patient].

PURPOSE This study was conducted to evaluate the effects of stroke patient care education on the knowledge and practice of caregivers of stroke patients. METHOD Data was collected from December 15, 2004 to March 30, 2005. The research design was a non-equivalent control group non-synchronized design. The subjects were forty primary caregivers of stroke patients who were hospitalized in a neurology unit of a university hospital. Forty caregivers, twenty in the experimental group and twenty in the control group were assigned. The experimental group participated 2 times in an education class given by the researcher. Data analysis included -test, and t-test using the SPSS program. RESULT Knowledge(t=5.87, p=o.oo) and practice(t=5.53, p=0.00) of the experimental group were significantly different from the control group. CONCLUSION The stroke patient care education developed in this study shows a significant promotion of knowledge and practice of caregivers. Thus this program can be recommanded as an intervention model for stroke patients and caregivers.
Porcine cytomegalovirus and coagulopathy in pig-to-primate xenotransplantation1

Background. A rapidly progressive disorder termed consumptive coagulopathy (CC) has been observed frequently in pig-to-baboon renal xenotransplantation. CC may be initiated by endothelial activation and induction of procoagulant factors after immunologic injury or infection, or by molecular incompatibilities between porcine coagulation proteins and primate clotting factors. The activation of porcine (P) cytomegalovirus (PCMV) and baboon (B) CMV infections has been documented in pig-to-primate xenotransplantation. The purpose of this study was to determine the contribution of PCMV and BCMV to CC. Methods. Endothelial activation was assessed by means of measurement of porcine tissue factor (pTF) in a functional assay in primary porcine aortic endothelial cells (PAEC) in vitro. Renal xenografts and native kidneys were studied by immunohistochemistry in immunosuppressed swine and baboons. BCMV and PCMV DNA was measured by quantitative molecular assays using real-time polymerase chain reaction. Results. In vitro, infection of PAEC with PCMV resulted in a significant increase of pTF expression. In vivo, pTF increase occurred without the activation of PCMV in two xenografts, and in four grafts no pTF was detected despite PCMV activation. All animals with graft pTF increase developed CC. BCMV activation in the baboon xenograft recipients did not correlate with CC or pTF increase. Control pigs and baboons had activation of PCMV and BCMV, respectively, but without coagulation abnormalities. Conclusions. PCMV induces endothelial cell activation in vitro with procoagulant expression. However, in vivo, CC and pTF induction has an uncertain relationship to increased replication of PCMV within a xenograft. Although the data do not exclude a contributory role of PCMV in CC, other mechanisms are also likely to contribute to coagulopathies observed in pig-to-primate xenotransplantation.
Latissimus dorsi flaps oriented on the lateral intercostal artery perforators: Anatomical study and application in autologous breast reconstruction

Abstract Autologous breast reconstruction with the latissimus dorsi (LD) musculocutaneous flap has several problems including scarcity of tissue and postoperative atrophy of muscles. We report a modification of the flap based on a re-evaluation of the intramuscular and perforating vascular anatomy focused on the intercostal vascular system. Our anatomical study confirmed the following technical improvements: splitting of the muscle oriented along the 10th posterior intercostal artery; siting the axis of the flap on the centre of the 10th lateral intercostal artery perforator to obtain ample subcutaneous fat cranial to the iliac crest; and enclosing the dermoadipofascial flap around the split muscular pedicle. These flaps were used in 12 patients who required reconstruction without implants. The results showed a consistent volume of tissue and shape, and less donor site morbidity. Our modifications can be used to improve the three-dimensional potential of the LD flap in autologous breast reconstruction.
Dorsal periaqueductal gray-amygdala pathway conveys both innate and learned fear responses in rats

The periaqueductal gray (PAG) and amygdala are known to be important for defensive responses, and many contemporary fear-conditioning models present the PAG as downstream of the amygdala, directing the appropriate behavior (i.e., freezing or fleeing). However, empirical studies of this circuitry are inconsistent and warrant further examination. Hence, the present study investigated the functional relationship between the PAG and amygdala in two different settings, fear conditioning and naturalistic foraging, in rats. In fear conditioning, electrical stimulation of the dorsal PAG (dPAG) produced unconditional responses (URs) composed of brief activity bursts followed by freezing and 22-kHz ultrasonic vocalization. In contrast, stimulation of ventral PAG and the basolateral amygdalar complex (BLA) evoked freezing and/or ultrasonic vocalization. Whereas dPAG stimulation served as an effective unconditional stimulus for fear conditioning to tone and context conditional stimuli, neither ventral PAG nor BLA stimulation supported fear conditioning. The conditioning effect of dPAG, however, was abolished by inactivation of the BLA. In a foraging task, dPAG and BLA stimulation evoked only fleeing toward the nest. Amygdalar lesion/inactivation blocked the UR of dPAG stimulation, but dPAG lesions did not block the UR of BLA stimulation. Furthermore, in vivo recordings demonstrated that electrical priming of the dPAG can modulate plasticity of subiculum–BLA synapses, providing additional evidence that the amygdala is downstream of the dPAG. These results suggest that the dPAG conveys unconditional stimulus information to the BLA, which directs both innate and learned fear responses, and that brain stimulation-evoked behaviors are modulated by context.
Entrepreneurship, Small Businesses, and Urban Growth

Entrepreneurship is widely believed to be a main source of economic growth. This paper’s objective is threefold: (1) to estimate the impact of entrepreneurship measured by the birth of businesses on urban employment and income growth; (2) to examine how entrepreneurship supported by government guaranteed loans compares with market entrepreneurship regarding its impact on urban growth; and (3) to examine whether market and government-backed entrepreneurship are complements or substitutes. The study of entrepreneurship and urban growth is hampered by the joint determination of the two. I use the variation in entrepreneurship generated by the homestead exemption levels in state bankruptcy laws in 1975 to examine urban growth between 1993 and 2002. I find that a ten percent increase in the birth of small businesses increases MSA employment by 1 to 1.5% and income by 2.5 to 3.5% after ten years. I next examine whether the federal Small Business Loan program that guarantees loans to entrepreneurs that were unable to finance through the market generates urban growth. I find no growth impact from government-backed entrepreneurship and further find that government-backed entrepreneurship crowds out market entrepreneurship one for one. Nonetheless, a complete assessment of government-backed entrepreneurship requires further examination of equity concerns, such as potential discrimination in small business lending.
Impact of late pregnancy haemoglobin A1c at 29–30 weeks’ gestation on adverse pregnancy outcomes among women with pre-existing diabetes: a retrospective analysis

Abstract This study was to assess the relationship between late pregnancy haemoglobin A1C (HbA1C) at 29–30 weeks of gestation and adverse pregnancy outcomes (APOs) in 272 pregnant women with pre-existing diabetes. HbA1C ≥6.1% was associated with significantly increased risk of preterm delivery, Caesarean section, large for gestational age (LGA), neonatal respiratory distress, neonatal hypoglycaemia, and composite adverse neonatal outcome (p < .05). The risk of pre-eclampsia increased significantly at the lower HbA1C cut-off of > 5.6% (p = .039). Reduction of HbA1C cut-off from 6.1% to 5.6% improved the sensitivity but reduced the specificity for prediction of APOs. Overall, the receiver operating characteristic (ROC) curves demonstrated the moderate predictive value of late pregnancy HbA1C for APOs. In conclusion, elevated late pregnancy HbA1C levels at 29–30 gestational weeks had a negative impact on APOs in pregnant women with pre-existing diabetes. However, HbA1C cut-off levels of neither ≥6.1% nor >5.6% were ideal for predicting APOs. Impact statement What is already known on this subject: Poorly controlled diabetes is associated with adverse pregnancy outcomes (APOs). Periconceptual haemoglobin A1C (HbA1C) correlates well with the risk of foetal anomaly but is not predictive of APOs at time of delivery. New evidence suggested that late pregnancy HbA1C is predictive of APOs but the definitions of a late pregnancy gestational week and target HbA1C cutpoint remain in doubt. What the results of this study add: This study investigated the relationship between late pregnancy HbA1C levels at 29–30 weeks of gestation and the APOs among pregnant women with pre-existing diabetes. Late pregnancy HbA1C ≥ 6.1% correlated with the risk of APOs but the increased risk of pre-eclampsia only became significant at the lower cut-off of >5.6%. Reducing HbA1C cut-off from 6.1% to 5.6% improved the sensitivity but reduced the specificity for prediction of APOs. Overall, late pregnancy HbA1C had a moderate predictive value for APOs. What the implications are of these findings for clinical practice and/or further research: HbA1C cut-off levels of neither ≥6.1% nor >5.6% were ideal in predicting APOs among pregnant women with pre-existing diabetes. As HbA1C levels tend to drop in pregnancy, caution should be taken when interpreting HbA1C in pregnancy. More multi-centred studies are required to explore the respective glycaemic target for each APO and to determine the ideal timing for late pregnancy HbA1C measurement.
Evolution de l'assurance en France et cyclicité des résultats en assurances de dommages

Underwriting cycles in property-liability insurance are a well-known phenomenon in the United States, but even if some newspapers talk about them in France, no research has been undertaken into the causes of this phenomenon. The French insurance industry plays a pivotal role in economic and social advances, and has developed beyond recognition since 1945. Our research will first review and study its practices, its economic and financial role and the changes which have occured within it, in order to find some explanations for these underwriting cycles. In property-liability insurance, net income is approximately equal to the difference between, on one hand, premiums and net investment income and, on the other hand, losses (claims) and (acquisition and administrative) expenses. Three of these fluctuate.
Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial.

IMPORTANCE Short-term outcome studies of antipsychotic dose-reduction/discontinuation strategies in patients with remitted first-episode psychosis (FEP) showed higher relapse rates but no other disadvantages compared with maintenance treatment; however, long-term effects on recovery have not been studied before. OBJECTIVE To compare rates of recovery in patients with remitted FEP after 7 years of follow-up of a dose reduction/discontinuation (DR) vs maintenance treatment (MT) trial. DESIGN Seven-year follow-up of a 2-year open randomized clinical trial comparing MT and DR. SETTING One hundred twenty-eight patients participating in the original trial were recruited from 257 patients with FEP referred from October 2001 to December 2002 to 7 mental health care services in a 3.2 million-population catchment area. Of these, 111 patients refused to participate and 18 patients did not experience remission. PARTICIPANTS After 7 years, 103 patients (80.5%) of 128 patients who were included in the original trial were located and consented to follow-up assessment. INTERVENTION After 6 months of remission, patients were randomly assigned to DR strategy or MT for 18 months. After the trial, treatment was at the discretion of the clinician. MAIN OUTCOMES AND MEASURES Primary outcome was rate of recovery, defined as meeting the criteria of symptomatic and functional remission. Determinants of recovery were examined using logistic regression analysis; the treatment strategy (MT or DR) was controlled for baseline parameters. RESULTS The DR patients experienced twice the recovery rate of the MT patients (40.4% vs 17.6%). Logistic regression showed an odds ratio of 3.49 (P = .01). Better DR recovery rates were related to higher functional remission rates in the DR group but were not related to symptomatic remission rates. CONCLUSIONS AND RELEVANCE Dose reduction/discontinuation of antipsychotics during the early stages of remitted FEP shows superior long-term recovery rates compared with the rates achieved with MT. To our knowledge, this is the first study showing long-term gains of an early-course DR strategy in patients with remitted FEP. Additional studies are necessary before these results are incorporated into general practice. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN16228411.
Cell growth rate regulates expression of group B Streptococcus type III capsular polysaccharide

The capsular polysaccharide (CPS) of group B streptococci (GBS) is an important virulence factor that also serves to protect cells from nonspecific host defense mechanisms. Expression of CPS by GBS, as with other encapsulated bacterial pathogens, is not constitutive but varies during growth in vitro and in primary cultures isolated from different sites of infection. Despite this understanding, little is known about regulation of this surface-expressed carbohydrate antigen in GBS. Here we report that expression of type III CPS by GBS strain M781 grown in continuous culture with a modified chemically defined medium is regulated by growth rate. Cells in steady state at mass doubling times (tds) of 0.8, 1.4, and 1.6 h expressed an average of sixfold more cell-associated CPS than did cells held at tds of 2.3 and 11 h. Strain M781 grown at a td of 1.4 h repeatedly produced more type III CPS than those held at a td of 11.0 h, even when limited for glucose, pyridoxamine, or thiamine. In our studies, > or = 93% of the total CPS expressed by strain M781 was cell associated. Strain M781 grown at a td of 11.0 h (i.e., lowered CPS expression) was susceptible to in vitro complement-mediated opsonophagocytosis and killing by human peripheral blood leukocytes, whereas cells grown at a td of 1.4 h (i.e., higher CPS expression) were not killed unless type III CPS-specific antibody was present. Factors that allow GBS to asymptomatically colonize women yet cause invasive infection to both mother and infant are poorly understood. Our results shed new light on parameters that regulate the pathogenic potential of GBS and may also serve as a way to discern more fully the genetics and biochemistry of GBS capsule synthesis.
Dysthymia among the community‐dwelling elderly

There are few data on the clinical features of dysthymia among the community‐dwelling elderly. Forty elderly individuals with dysthymic disorder were identified following screening in the community with GMS–AGECAT. A detailed clinical history was obtained and DSM‐IV checklists and standardized scales were used, at a second interview. Comparisons were made with a group of 630 non‐depressed elderly from the same community. Dysthymia was predominately of late onset (93%) and associated with a major stressor in 65% of cases. Comorbid axis 1 disorders were present in 15% of dysthymics and an axis 2 disorder in 10%. The dysthymic group had significantly higher degrees of physical impairment than the non‐depressed elderly. The symptom profile demonstrated prominent anxiety and functional features. Eighty‐three per cent of the elderly with dysthymia had presented to their GP with anxiety/depressive symptoms at some stage during the dysthymic disorder. The presentation of dysthymia in older people differs from that in earlier life. Late life dysthymia is less associated with axes 1 and 2 comorbidity but is associated with significant degrees of physical impairment. Dysthymia in older people presents to primary care, rather than specialist services, and interventions must be delivered at this level. Copyright © 1999 John Wiley & Sons, Ltd.