Miracle-dz/UniFAR-FTUs huggingface dataset:
Autonomy and integrity: upholding older adult patients' dignity.

AIM The aim of this study was to deepen understanding of the relationship between autonomy and integrity in interactions between patients and individual health care workers in real-life care situations. METHOD The data reported here are from a 6- and 12-month follow-up of the teaching of ethics to health care professionals working with older people. The data collection method used was participant observation. Health professionals' caring behaviour in everyday situations was observed from the point of view of patients' autonomy and integrity. Theoretical frameworks relating to autonomy and integrity were used to analyse the data. FINDINGS The structural framework was useful for identifying the two concepts and their relationship in everyday situations. The data suggest that the two concepts are ethically complex. Autonomy is grounded in respect for patients' ability to choose, decide and take responsibility for their own lives. Autonomy varies within and between individuals and is dependent on context and on those involved. It stresses the intrinsic value of patients, which marks their worth independently of others. Integrity, however, is bound to patients' very existence, no matter what their physical and mental conditions, and must be respected regardless of their ability to act autonomously. CONCLUSION The concepts of autonomy and integrity appear to presuppose one another and to be indivisible if older adult patients' dignity is to be maintained. This implies that when patients' autonomy is supported their integrity is protected and, consequently, their dignity upheld.
LRH-1 expression patterns in breast cancer tissues are associated with tumour aggressiveness

The significance and regulation of liver receptor homologue 1 (LRH-1, NR5A2), a tumour-promoting transcription factor in breast cancer cell lines, is unknown in clinical breast cancers. This study aims to determine LRH-1/NR5A2 expression in breast cancers and relationship with DNA methylation and tumour characteristics. In The Cancer Genome Atlas breast cancer cohort NR5A2 expression was positively associated with intragenic CpG island methylation (1.4-fold expression for fully methylated versus not fully methylated, p=0.01) and inversely associated with promoter CpG island methylation (0.6-fold expression for fully methylated versus not fully methylated, p=0.036). LRH-1 immunohistochemistry of 329 invasive carcinomas and ductal carcinoma in situ (DCIS) was performed. Densely punctate/coarsely granular nuclear reactivity was significantly associated with high tumour grade (p<0.005, p=0.033 in invasive carcinomas and DCIS respectively), negative estrogen receptor status (p=0.008, p=0.038 in overall cohort and invasive carcinomas, respectively), negative progesterone receptor status (p=0.003, p=0.013 in overall cohort and invasive carcinomas, respectively), HER2 amplification (overall cohort p=0.034) and non-luminal intrinsic subtype (p=0.018, p=0.038 in overall cohort and invasive carcinomas, respectively). These significant associations of LRH-1 protein expression with tumour phenotype suggest that LRH-1 is an important indicator of tumour biology in breast cancers and may be useful in risk stratification.
Multiple WW Domains, but Not the C2 Domain, Are Required for Inhibition of the Epithelial Na+ Channel by Human Nedd4*

The epithelial Na+ channel (ENaC) absorbs Na+ across the apical membrane of epithelia. The activity of ENaC is controlled by its interaction with Nedd4; mutations that disrupt this interaction increase Na+absorption, causing an inherited form of hypertension (Liddle's syndrome). Nedd4 contains an N-terminal C2 domain, a C-terminal ubiquitin ligase domain, and multiple WW domains. The C2 domain is thought to be involved in the Ca2+-dependent localization of Nedd4 at the cell surface. However, we found that the C2 domain was not required for human Nedd4 (hNedd4) to inhibit ENaC in both Xenopus oocytes and Fischer rat thyroid epithelia. Rather, hNedd4 lacking the C2 domain inhibited ENaC more potently than wild-type hNedd4. Earlier work indicated that the WW domains bind to PY motifs in the C terminus of ENaC. However, it is not known which WW domains mediate this interaction. GlutathioneS-transferase-fusion proteins of WW domains 2–4 each bound to α, β, and γENaC in vitro. The interactions were abolished by mutation of two residues. WW domain 3 (but not the other WW domains) was both necessary and sufficient for the binding of hNedd4 to αENaC. WW domain 3 was also required for the inhibition of ENaC by hNedd4; inhibition was nearly abolished when WW domain 3 was mutated. However, the interaction between ENaC and WW domain 3 alone was not sufficient for inhibition. Moreover, inhibition was decreased by mutation of WW domain 2 or WW domain 4. Thus, WW domains 2–4 each participate in the functional interaction between hNedd4 and ENaC in intact cells.
Clinical risk factors and timing of recurrent venous thromboembolism during the initial 3 months of anticoagulant therapy.

BACKGROUND In patients with venous thromboembolism (VTE), identifying clinical risk factors for recurrence during the initial 3 months of anticoagulant therapy and knowledge of the time course of recurrence may help clinicians decide about the frequency of clinical surveillance and the appropriateness of outpatient treatment. METHODS Analysis of a randomized controlled trial database involving 1021 patients with VTE (750 with deep vein thrombosis [DVT] and 271 with pulmonary embolism [PE]) who were followed up for 3 months after the start of anticoagulant therapy. All patients received initial treatment with unfractionated heparin or a low-molecular-weight heparin (reviparin) and a coumarin derivative starting the first or second day of treatment, with a target international normalized ratio of 2.0 to 3.0. RESULTS Four independent clinical risk factors for recurrent VTE were identified: (1) cancer (odds ratio [OR], 2.72; 95% confidence interval [CI], 1. 39-5.32), (2) chronic cardiovascular disease (OR, 2.27; 95% CI, 1. 08-4.97), (3) chronic respiratory disease (OR, 1.91; 95% CI, 0.85-4. 26), and (4) other clinically significant medical disease (OR, 1.79; 95% CI, 1.00-3.21). Older age was associated with a decreased risk for recurrent VTE (OR, 0.76; 95% CI, 0.64-0.92). Previous VTE, sex, and idiopathic VTE were not risk factors for recurrence. In patients with DVT or PE, there was no significant difference in the rates of recurrent nonfatal VTE (4.8% vs 4.1%; P =.62), major bleeding (2.9% vs 2.2%; P =.53), and non-VTE death (6.4% vs 7.8%; P =.45), but recurrent fatal PE was more frequent in patients with PE than DVT (2. 2% vs 0%; P<.01). There was a clustering of recurrent VTE episodes during the initial 2 to 3 weeks after the start of treatment. CONCLUSIONS During the initial 3 months of anticoagulant therapy, recurrent VTE is more likely to occur in patients with cancer, chronic cardiovascular disease, chronic respiratory disease, or other clinically significant medical disease. Patients with PE are as likely to develop recurrent VTE as those with DVT; however, recurrence is more likely to be fatal in patients who initially present with PE. Arch Intern Med. 2000;160:3431-3436.
The Clustering of Premature Deaths in Families

Background: Infant deaths cluster in families, but beyond infancy, little is known about familial aggregation of premature deaths. We hypothesized that an individual's risk of premature death would be influenced by prior premature deaths of any age in family members. Methods: For all Danish residents registered in the Civil Registration System, 1968–2005, information was linked to the Causes of Death Register and the Danish Family Relation Database, yielding a cohort of 4,870,821 persons linked to one or more relatives (93 million persons-years and 73,278 deaths). We used log-linear Poisson regression to estimate mortality rate ratios (relative risks) for premature death (before age 40 years) in persons with a family history of premature death, compared with persons without such a history. Results: Persons with a family history of premature death were 46% more likely themselves to die prematurely than persons without such a family history (relative risk [RR] = 1.46 [95% confidence interval = 1.42–1.50]). Relative risks were higher for concordant age at death, a close kinship relation, and similar causes of death. As expected, certain natural causes clustered among first-degree relatives (RRs ranged from 1.81–618), but unnatural causes of death, such as nonsimultaneous motor vehicle injuries, other injuries, and suicides, also clustered (RRs = 1.80, 3.53, and 4.23, respectively). Previous family history of premature death in a first-degree relative also increased the risk of dying from another cause (overall RR = 2.08 in infancy and 1.33 between ages 1 and 39). Conclusion: Premature deaths cluster in families, for both similar and dissimilar causes.
Awareness and Assessment of Work-related Hearing Impairment among Dental Professionals in Kano-Nigeria.

Background: Dentist and allied professionals are undoubtedly among professional groups at risk of noiseinduced hearing impairment in the workplace. There has been speculation about the relationship between hearing loss and the use of high-speed dental drills among dental professionals. In resource-poor settings, dental instruments may be old and worn out with the attendant risks of hearing impairment following their use. Aim: To report the awareness and assessment of work-related hearing impairment among dental professionals in Kano State. Original Research Article Ahmed et al.; BJMMR, 13(2): 1-9, 2016; Article no.BJMMR. 23347 2 Methods: The study was a cross-sectional self-administered questionnaire-based survey among Dentists and dental allied staff in Kano State. Participants were given questionnaires containing detailed information about the survey to fill after consenting. Each questionnaire was examined to ensure they were properly filled and the consent form duly signed. Results: A total of 138 respondents fulfilled the inclusion criteria with a response rate of 86%. The highest respondents were Dental surgeon assistants and dental hygienist under 35 years (85.5%) of age and had worked for at least 5years. Sixty two respondents (44.9%) worked more than 8 hours / day while 76(55.1%) worked less than 8hours/day. Out of 99(71.7%) respondents who use Ultrasonic scaler about 43(43.0%) reported that the Ultrasonic scaler was at least 5 years old while out of 84 respondents who use dental turbines, 36(42.9%) of them reported that the turbines were at least 5years old. Loud power generators were an additional source of exposure to loud noise 42(31.6%) contributing to hearing impairment. Conclusion: It is recommended that periodic hearing evaluation and use of hearing protective devices and appropriate content workshops/seminar about work related noise exposure made a mandatory part of continuous professional development for dental professionals.
The prognostic significance of APC gene mutation and miR‐21 expression in advanced‐stage colorectal cancer

Colorectal cancer (CRC) is the second commonest cause of cancer death in Taiwan. Although numerous genes have been associated with tumorigenesis in colorectal cancer, only a few have been validated and used as biomarkers for predicting clinical outcome. The aim of this study was to analyse the association of APC gene mutation and miR‐21 expression with clinical outcome in CRC patients.
Analysis of TLR7, SOCS1 and ISG15 immune genes expression in the peripheral blood of responder and non-responder patients with chronic Hepatitis C

Aim: To evaluate the baseline expression of the immune genes in PBMCs of responder and non-responder patients with chronic Hepatitis C. Background: Although the contribution of peripheral blood mononuclear cell (PBMC) gene expression in treatment outcome of hepatitis C virus (HCV) infection is supposed, it has remained to be distinctly delineated. The baseline expression of the immune genes inside PBMCs may reflect the responsiveness status following IFN treatment. Methods: Totally, 22 chronic HCV encompasses 10 responders and 12 non-responsive cases enrolled randomly regarding medical records. The PBMCs from the peripheral blood samples were isolated and then incubated for 6 hours in the culture media. The baseline expression of TLR7, SOCS1 and ISG15 was measured by Real time PCR. Results: The gene expression pattern in PBMCs of both groups showed a similar trend. The expression of SOCS1 and TLR7 genes showed higher levels in non-responder group (P>0.05). The result of ISG15 showed a higher but non-significant expression in the responder group (P>0.05). Conclusion: The similar pattern of TLR7, SOCS1 and ISG15 expression in the responder and non-responder patients indicated their poor discriminating and predictive value in PBMCs sample.
AIDS-related Kaposi's sarcoma patients with visceral manifestations. Response to human chorionic gonadotropin preparations.

OBJECTIVE In vitro cell culture studies and a murine model for human Kaposi's sarcoma (KS) have shown that human chorionic gonadotropin (hCG)-associated factor (HAF) isolated from commercial hCG preparations has antiproliferative and cell killing effects on neoplastic KS cells, without toxic effects on normal endothelial cells and lymphocytes. These findings prompted preliminary study of hCG preparations for patients with early-stage KS with skin lesions only and no known visceral involvement. Complete or partial regression of the skin lesions occurred after intralesional injections of hCG (hCG-Pregnyl, hCG-APL). The current study sought to extend these early observations to evaluation of the safety of hCG in acquired immunodeficiency syndrome (AIDS) KS patients with aggressive disease and visceral involvement. These patients present in a more advanced stage of the disease that is coupled with serious immunodeficiency. They commonly respond poorly to conventional chemotherapy and have a reduced median life expectancy of only 4 to 9 months. STUDY DESIGN/METHODS After approval by the local institutional review boards, 13 patients with advanced AIDS-KS gave informed consent and were treated with hCG preparations. These hCG preparations are known to have antiproliferative activity in laboratory tests. Patients were monitored for tumor size by clinical evaluation, ultrasonography, radiography, respiratory functions, and endoscopic examination. Histologic examinations of biopsied tissues were used for studies of apoptosis using in situ hybridization techniques. The patients were also monitored for CD4+ T-cell numbers and human immunodeficiency virus type 1 (HIV-1) plasma viral load according to common clinical practice. RESULTS Thirteen patients with advanced AIDS-KS and visceral KS were treated with hCG. Five of 13 (38%) patients had dramatic responses to therapy, and overall tolerance to the drug was excellent for all patients. Some hCG preparations also showed beneficial effects against HIV-associated markers. An accompanying decrease in viral load (plasma HIV-1 RNA) was observed in one patient, a dramatic increase in CD4+ cells occurred in another, and significant weight gain was seen in seven patients. CONCLUSIONS These clinical observations suggest that patients with aggressive visceral forms of KS, usually indicative of an extremely poor prognosis and poor response to combined chemotherapy, can benefit from this new therapeutic approach. In some patients, these preparations also induce several other beneficial effects, such as weight gain, reduction in HIV-1 RNA load, or increase in the CD4+ T-cell count. Additional controlled clinical trials comparing this new therapeutic option with standard cytotoxic chemotherapy are needed. These trials should be extended to patients with KS not related to HIV-1 infection. Because we showed elsewhere that pure hCG had no effect on KS, identification and subsequent clinical use of the active molecules in hCG preparations is urgently needed.
Late versus Prophylactic Chorioretinectomy for the Prevention of Trauma-Related Proliferative Vitreoretinopathy

Introduction: Certain injuries, especially those with a deep-impact (involving the choroid and even the sclera) intraocular foreign body (IOFB), have a high risk for developing either full-blown proliferative vitreoretinopathy (PVR) or full-thickness retinal folds. Although less severe than the former, this so-called ‘stage 0 PVR’ can severely impact vision, and effective treatment for these folds has not existed heretofore. Patients and Methods: Four eyes of 4 patients sustained an IOFB injury with deep impact. All eyes underwent vitrectomy and IOFB removal soon after the injury, and all eyes showed substantial visual improvement postoperatively. However, in a few months the visual acuity dropped again, due to the development of full-thickness retinal folds radiating from the scar. All four eyes then underwent a second vitrectomy with (late rather than prophylactic) chorioretinectomy by creating a 1-mm-wide ring of bare sclera around the scar. The highest setting of the diathermy machine was used as the endodiathermy probe evaporated both the retina and the choroid to create the ring. Laser retinopexy to surround the ring was used only if the lesion was not in the posterior pole. Results: Within a few days, the retinal folds completely disappeared in each eye, and the visual acuity reached the highest earlier value seen after the initial surgery. All patients have long-term follow-up (mean, 22 months) with no postoperative complications. Conclusions: Chorioretinectomy, although it is ideally used as a prophylaxis against PVR formation and the development of retinal fold formation, also proved equally effective as a late treatment option in the presence of such folds. Such late chorioretinectomy, however, is applicable only for eyes with deep-impact IOFB injuries, not for eyes with a perforating injury or rupture.
Planning health behaviour change: comparing the behavioural influence of two types of self-regulatory planning.

OBJECTIVES Recent efforts in health psychology to bridge the gap between individuals' intentions and behaviour have centered on the influence of planning strategies. This study investigated the impact of two commonly used types of self-regulatory planning in the prediction of health promoting behaviour. DESIGN This study employed a prospective longitudinal design. Three measurements were implemented in order to assess associations between various socio-cognitive determinants, planning, and health behaviour. METHODS Structural equation modelling (N = 572) was used to compare the value of preparatory planning, i.e. the planning of strategies and preparatory actions towards a goal behaviour, and implemental planning, i.e. the planning of when, where, and how to perform a goal behaviour, in the prediction of fruit consumption. RESULTS Both preparatory planning (ss = 0.21; p <.001) and implemental planning (ss = 0.13; p <.01) were significant predictors of fruit consumption, over and above the influence of motivational factors. Comparison of differences in explained variance (DeltaR(2)) indicated that the contribution of preparatory planning was larger than that of implemental planning (z = 2.19; p <.05). Implemental planning did not contribute to the prediction of fruit consumption over and above the influence of preparatory planning when tested simultaneously. CONCLUSIONS The results provide a first indication that the planning of strategic preparatory actions may be more influential in predicting health behaviour than implemental planning, focusing on when, where, and how to enact goal-directed behaviour. Implications of the results and suggestions for future research are outlined.
Isolation and characterization of motile Aeromonas from human, food and environmental specimens

SUMMARY From July 1985 to March 1987, the occurrence of motile Aeromonas sp. in stool, food and environmental specimens was investigated to assess their pathogenic significance and to determine sources and routes of infection. A total of 9366 stool specimens were examined; Aeromonas was isolated from 11.1% of diarrhoeal stools and 2.2% of normal stools (P 0.001). Aeromonas counts in food specimens, which included minced beef, pork and chicken, seafood and various vegetables and their products, were unexpectedly high suggesting that infection might be food–borne rather than water–borne. About 70% of the isolates from meat products were A. hydrophila and A. sobria, while A. Caviae was the most common in sea–fish, vegetables and their products. Most A. hydrophila and A. sobria strains produced haemolysin, but haemagglutinin was found more frequently in A. Sobria.
Spatial genetic structure in four understory Psychotria species (Rubiaceae) and implications for tropical forest diversity.

• Premise of the study: Tropical forests are the most species-rich terrestrial communities on Earth, and understory trees and shrubs comprise a large fraction of their plant species diversity, especially at high rainfalls. The mechanisms responsible for generating such high levels of diversity remain unknown. One hypothesis is that fleshy-fruited understory species should have limited seed dispersal due to the sedentary nature of their avian dispersers, resulting in restricted gene flow, population differentiation at small spatial scales, and ultimately, high rates of allopatric speciation. • Methods: We sampled four species of the hyperdiverse tropical shrub genus Psychotria (Rubiaceae) on Barro Colorado Island (BCI) and two nearby sites in Panama. We genotyped each species with AFLPs, assessed genetic differentiation among populations, and determined patterns of fine-scale spatial genetic structure in the BCI population. Measures of spatial autocorrelation and population density were used to estimate the dispersal distance parameter σ. • Key results: Regionally, ΦPT values ranged from 0.13 to 0.28, reflecting local population differentiation and suggesting that Lake Gatun/Rio Chagres has posed a relatively strong barrier to gene flow. Fine-scale spatial genetic structure on BCI was stronger than in most canopy trees, and estimated distances of gene flow were unusually low for endozoochorous tropical woody plants, with dispersal distance σ = 9-113 m. • Conclusions: These results demonstrate comparatively limited gene flow in bird-dispersed understory species, supporting a hypothesized mechanism for generating high levels of plant species diversity in tropical rain forests, in one of the largest genera of flowering plants on Earth.
Improvement of Glucose Tolerance in NIDDM by Clofibrate Randomized Double-Blind Study

A randomized double-blind study was performed to examine the effect of clofibrate on glucose tolerance in subjects with non-insulin-dependent diabetes mellitus (NIDDM). Clofibrate (1.5 g/day) or placebo was administered to 70 patients and an oral glucose tolerance test (OGTT) was performed before and 12 wk after treatment. Blood glucose levels were significantly improved in clofibrate-treated groups at all time points during OGTT, whereas there was no change in insulin levels. Improvement of fasting glucose levels required 8 wk of clofibrate treatment. Insulin binding to erythrocytes demonstrated no significant change in the clofibrate-treated subjects.A randomized double-blind study was performed to examine the effect of clofibrate on glucose tolerance in subjects with non-insulin-dependent diabetes mellitus (NIDDM). Clofibrate (1.5 g/day) or placebo was administered to 70 patients and an oral glucose tolerance test (OGTT) was performed before and 12 wk after treatment. Blood glucose levels were significantly improved in clofibrate-treated groups at all time points during OGTT, whereas there was no change in insulin levels. Improvement of fasting glucose levels required 8 wk of clofibrate treatment. Insulin binding to erythrocytes demonstrated no significant change in the clofibrate-treated subjects. These results suggest that clofibrate improves glucose tolerance in NIDDM subjects without a change in insulin receptors and that clofibrate increases insulin sensitivity through an unknown postreceptor mechanism.