Miracle-dz/UniFAR-FTUs huggingface dataset:
Words without action? The production, dissemination, and impact of consensus recommendations.

When existing evaluations find little or no evidence of consensus recommendations leading to action, one can justifiably ask why so much of this review was dedicated to analyzing alternative ways of producing such "words without action. " There are, however, at least two reasons why consensus recommendations should be produced with care and attention to validity. First, recommendations do sometimes have an impact on behavior as a consequence of mere dissemination activity--the Dutch program, for instance, was more successful than most. This success may occur when the target audience is already particularly receptive to change and the message is timely and delivered by a credible source in a clinically relevant way. Thus, although "such a conjunction of favorable conditions is probably the exception rather than the rule for consensus topics" (46, 240) it does happen. Second, the output from consensus processes is increasingly a potential input to other processes. Consensus recommendations can be used as the criteria for evaluation and appraisal aimed at changing practice behavior, making administrative decisions on resource allocation, or defining research protocols. For instance, quality assurance activities, such as peer assessment, practitioner certification, or utilization review, are actively seeking criteria with which to make judgments and elicit changes in practice to improve the quality of care. Funding agencies are looking for information to help make reimbursement, capital expenditure, or fee-for-service decisions on cessation of insurance for particular procedures or approaches. These uses of the consensus criteria are potentially major and controversial. Therefore, even if dissemination rarely leads to action, consensus processes should still be done carefully and with valid techniques. The use of their recommendations embedded within other activities may well lead to (forced) changes in behavior. On ethical grounds alone, we should be as sure as possible that the behavior changes being implied and encouraged are indeed advisable. For these reasons, the review describes the decision points in the production process for consensus recommendations as a start on the development of a set of recognized standards. The review offers a critical appraisal of the various methodological choices available at each decision point. The seven decision points are selecting a topic, picking the consensus group, providing background preparation, identifying information inputs, choosing a group judgment process, defining the criteria for recommendations, and choosing a report preparation procedure and format. At least two important points emerged from this review. First, the research is often not well enough developed to give clear indications for many of the choices on what is the "best" alternative. (ABSTRACT TRUNCATED AT 400 WORDS)
Precatheterization Use of P2Y12 Inhibitors in Non‐ST‐Elevation Myocardial Infarction Patients Undergoing Early Cardiac Catheterization and In‐Hospital Coronary Artery Bypass Grafting: Insights From the National Cardiovascular Data Registry®

Background Current guidelines recommend early P2Y12 inhibitor administration in non‐ST‐elevation myocardial infarction, but it is unclear if precatheterization use is associated with longer delays to coronary artery bypass grafting (CABG) or higher risk of post‐CABG bleeding and transfusion. This study examines the patterns and outcomes of precatheterization P2Y12 inhibitor use in non‐ST‐elevation myocardial infarction patients who undergo CABG. Methods and Results Retrospective analysis was done of 20 304 non‐ST‐elevation myocardial infarction patients in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry (2009–2014) who underwent catheterization within 24 hours of admission and CABG during the index hospitalization. Using inverse probability‐weighted propensity adjustment, we compared time from catheterization to CABG, post‐CABG bleeding, and transfusion rates between patients who did and did not receive precatheterization P2Y12 inhibitors. Among study patients, 32.9% received a precatheterization P2Y12 inhibitor (of these, 2.2% were given ticagrelor and 3.7% prasugrel). Time from catheterization to CABG was longer among patients who received precatheterization P2Y12 inhibitor (median 69.9 hours [25th, 75th percentiles 28.2, 115.8] versus 43.5 hours [21.0, 71.8], P<0.0001), longer for patients treated with prasugrel (median 114.4 hours [66.5, 155.5]) or ticagrelor (90.4 hours [48.7, 124.5]) compared with clopidogrel (69.3 [27.5, 114.6], P<0.0001). Precatheterization P2Y12 inhibitor use was associated with a higher risk of post‐CABG major bleeding (75.7% versus 73.4%, adjusted odds ratio 1.33, 95% confidence interval 1.22‐1.45, P<0.0001) and transfusion (47.6% versus 35.7%, adjusted odds ratio 1.51, 95% confidence interval 1.41‐1.62, P<0001); these relationships did not differ among patients treated with clopidogrel, prasugrel, or ticagrelor. Conclusions Precatheterization P2Y12 inhibitor use occurs commonly among non‐ST‐elevation myocardial infarction patients who undergo early catheterization and in‐hospital CABG. Despite longer delays to surgery, the majority of pretreated patients proceed to CABG <3 days postcatheterization. Precatheterization P2Y12 inhibitor use is associated with higher risks of postoperative bleeding and transfusion.
Coarticulatory Aggression and Direction of Coarticulation: An Ultrasound Study

Coarticulatory pattern can be varied based on the articulatory dynamics of the sound produced. The present study aims to analyze some of the coarticulatory patterns such as coarticulatory aggression and direction of coarticulation based on ultrasound imaging technique. Ten adult Kannada speakers participated as subjects. The stimuli consisted of V1CV2 sequences, with C corresponding to voiced/voiceless counterparts of dental stops (/t/, /d/) or retroflex stops (/ʈ/, /ɖ/) or velar stops (/k/, /g/), in the context of vowels /a, i, u/. Measurements of coarticulation resistance of consonants were carried out based on Root Mean Square (RMS) distance between the tongue contours of consonant and vowel. Results showed that there was a clear pattern of minimum extent of coarticulation from intervocalic consonant to following vowel in VCV syllable structure. Significant coarticulatory aggressive was noticed in high front vowel /i/ at all three places of articulation considered. Anticipatory coarticulation was evident across dental, retroflex, and velar stop consonants. Overall, the study agreed that the pattern of coarticulation explained using Degree of Articulatory Constriction (DAC) model and the duration of phoneme planning varied as a property of articulatory dynamics.
An automated two-phase system for hydrogel microbead production

Polymeric beads have been used for protection and delivery of bioactive materials, such as drugs and cells, for different biomedical applications. Here, we present a generic two-phase system for the production of polymeric microbeads of gellan gum or alginate, based on a combination of in situ polymerization and phase separation. Polymer droplets, dispensed using a syringe pump, formed polymeric microbeads while passing through a hydrophobic phase. These were then crosslinked, and thus stabilized, in a hydrophilic phase as they crossed through the hydrophobic–hydrophilic interface. The system can be adapted to different applications by replacing the bioactive material and the hydrophobic and/or the hydrophilic phases. The size of the microbeads was dependent on the system parameters, such as needle size and solution flow rate. The size and morphology of the microbeads produced by the proposed system were uniform, when parameters were kept constant. This system was successfully used for generating polymeric microbeads with encapsulated fluorescent beads, cell suspensions and cell aggregates proving its ability for generating bioactive carriers that can potentially be used for drug delivery and cell therapy.
Quantitative Trait Loci Associated with Drought Tolerance in Common Bean

Drought stress is the major limitation of common bean (Phaseolus vulgaris L.) grown in subsistence farming systems worldwide. The objective of this study was to use single nucleotide polymorphism (SNP) markers from the BARCBean6K_3 Beadchip to identify quantitative trait loci (QTL) associated with traits related to drought tolerance in common bean. An intergene pool recombinant inbred line (RIL) population from a cross of drought tolerant line SEA5 and CAL96 cultivar was evaluated in Rwanda for 3 yr under drought stress and nonstress and in Colombia for 1 yr under drought stress. Traits evaluated included the numbers of days to flower, maturity, and seed fill; harvest index and pod harvest index; yield and yield components including number of pods per plant, seeds per pod, 100 seed weight (SW), and seed yield per day. Harvest indices, and SW were stable regardless of water treatment while number of pods per plant, seeds per pod, and yield were significantly reduced by drought. A linkage map of the RIL population spanning 1351 cM was constructed using 2122 SNP markers. The map covered all eleven bean chromosomes with an average distance of 0.64 cM between markers. A total of 14 QTL for performance under drought were consistently identified in different environments. Quantitative trait loci associated with phenology and SW traits mapped near previously reported QTL. Linkage between SW and yield QTL SY3.3SC was observed on Pv03 and could be used to simultaneously select for seed yield and size in intergene pool crosses of common bean.
Spondyloarthropathies in Japan: nationwide questionnaire survey performed by the Japan Ankylosing Spondylitis Society.

OBJECTIVE The Japan Ankylosing Spondylitis Society conducted a nationwide questionnaire survey of spondyloarthropathies (SpA) in 1990 and 1997, (1) to estimate the prevalence and incidence, and (2) to validate the criteria of Amor and the European Spondylarthropathy Study Group (ESSG) in Japan. METHODS Japan was divided into 9 districts, to each of which a survey supervisor was assigned. According to unified criteria, each supervisor selected all the clinics and hospitals with potential for SpA patients in the district. The study population consisted of all patients with SpA seen at these institutes during a 5 year period (1985-89) for the 1st survey and a 7 year period (1990-96) for the 2nd survey. RESULTS The 1st survey recruited 426 and the 2nd survey 638 cases, 74 of which were registered in both studies. The total number of patients with SpA identified 1985-96 was 990 (760 men, 227 women). They consisted of patients with ankylosing spondylitis (68.3%), psoriatic arthritis (12.7%), reactive arthritis (4.0%), undifferentiated SpA (5.4%), inflammatory bowel disease (2.2%), pustulosis palmaris et plantaris (4.7%), and others (polyenthesitis, etc.) (0.8%). The maximum onset number per year was 49. With the assumption that at least one-tenth of the Japanese population with SpA was recruited, incidence and prevalence were estimated not to exceed 0.48/100,000 and 9.5/100,000 person-years, respectively. The sensitivity was 84.0% for Amor criteria and 84.6 for ESSG criteria. CONCLUSION The incidence and prevalence of SpA in Japanese were estimated to be less than 1/10 and 1/200, respectively, of those among Caucasians. The adaptability of the Amor and ESSG criteria was validated for the Japanese population.
Y4 Receptors Mediate the Inhibitory Responses of Pancreatic Polypeptide in Human and Mouse Colon Mucosa

The antisecretory effects of several Y agonists, including pancreatic polypeptide (PP), indicate the presence of Y1, Y2, and Y4 receptors in mouse and human (h) colon mucosae. Here, we used preparations from human and from wild-type (WT), Y4, and Y1 receptor knockout (-/-) mice, alongside Y4 receptor-transfected cells to define the relative functional contribution of the Y4 receptor. First, rat (r) PP antisecretory responses were lost in murine Y4-/- preparations, but hPP and Pro34 peptide YY (PYY) costimulated Y4 and Y1 receptors in WT mucosa. The Y1 antagonist/Y4 agonist GR231118 [(Ile,Glu,Pro,Dpr,Tyr,Arg,Leu,Arg,Try-NH2)-2-cyclic(2,4′),(2′,4)-diamide] elicited small Y4-mediated antisecretory responses in human tissues pretreated with the Y1 antagonist, BIBO3304 [(R)-N-[[4-(aminocarbonylaminomethyl)-phenyl]methyl]-N2-(diphenylacetyl)-argininamide trifluoroacetate)], and attenuated Y4-mediated hPP responses in mouse and human mucosa. GR231118 and rPP were also antisecretory in hY4-transfected epithelial monolayers but were partial agonists compared with hPP at this receptor. In Y4-transfected human embryonic kidney (HEK) 293 cells, Y4 ligands displaced [125I]hPP binding with orders of affinity (pKi) at human (hPP = rPP > GR231118 > Pro34PYY = PYY) and mouse (rPP = hPP > GR231118 > Pro34PYY > PYY) Y4 receptors. GR231118- and rPP-stimulated guanosine 5′-3-O-(thio)triphosphate binding through hY4 receptors with significantly lower efficacy than hPP. GR231118 marginally increased basal but abolished further PP-induced hY4 internalization to recycling (transferrin-labeled) pathways in HEK293 cells. Taken together, these findings show that Y4 receptors play a definitive role in attenuating colonic anion transport and may be useful targets for novel antidiarrheal agents due to their limited peripheral expression.
A POSSIBLE CASE OF MIMICRY IN LARGER MAMMALS

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Ethics of qualitative research: are there special issues for health services research?

BACKGROUND An increasing volume of qualitative research and articles about qualitative methods has been published recently in medical journals. However, compared with the extensive debate in social sciences literature, there has been little consideration in medical journals of the ethical issues surrounding qualitative research. A possible explanation for this lack of discussion is that it is assumed commonly that qualitative research is unlikely to cause significant harm to participants. There are no agreed guidelines for judging the ethics of qualitative research proposals and there is some evidence that medical research ethics committees have difficulty making these judgements. OBJECTIVES Our aim was to consider the ethical issues which arise when planning and carrying out qualitative research into health and health care, and to offer a framework within which health services researchers can consider these issues. RESULTS Four potential risks to research participants are discussed: anxiety and distress; exploitation; misrepresentation; and identification of the participant in published papers, by themselves or others. Recommended strategies for reducing the risk of harm include ensuring scientific soundness, organizing follow-up care where appropriate, considering obtaining consent as a process, ensuring confidentiality and taking a reflexive stance towards analysis. CONCLUSIONS While recognizing the reservations held about strict ethical guidelines for qualitative research, we argue for further debate of these issues so that the health services research community can move towards the adoption of agreed standards of good practice. In addition, we suggest that empirical research is desirable in order to quantify the actual risks to participants in qualitative studies.
Periodic omission of dairy cow milkings: II. Effect on the composition and processing properties of herd milk

Summary Forty-five Friesian cows were assigned to one of 3 milking management treatments: (1) cows milked 14 times weekly, (2) cows milked 13 times weekly (Wednesday morning milking omitted) and (3) cows milked 12 times weekly (Tuesday evening and Wednesday morning milkings omitted). The trial continued for 12 months. Milking omission led to compositional changes in herd milk similar to those described for subclinical mastitis, including increases in pH, chloride level and cell count. Alterations in processing properties consistent with these changes were encountered. Heat stability and curd firmness were affected by extending the milking interval, but the magnitude and direction of the effects varied. Where only one milking was omitted weekly, herd milk arriving at cheese or powdered-milk factories would not be expected to cause any serious technical difficulties. Omission of 2 consecutive milkings a week would cause processing difficulties where milk was to be condensed or dried, since the maximum heat stability obtained by pH adjustment was reduced.
The importance of surgical margins in gastric cancer

Interpretation and management of the surgical margin is paramount to the treatment of gastric adenocarcinoma. Although in early‐stage disease, a microscopically positive margin may be associated with poor outcomes, in later stages, it does not persist as an independent poor prognostic factor but rather is likely a marker of other adverse pathologic characteristics that ultimately determine outcomes. Thus, the decision to extend a resection to achieve a negative margin should be deliberate and individualized. J. Surg. Oncol. 2016;113:277–282. © 2015 Wiley Periodicals, Inc.
Treatment of vaginal prolapse in cows and buffaloes

SIR, – Vaginal prolapse is a commonly encountered problem in pregnant dairy animals, particularly during the last quarter of gestation. Its incidence is higher in buffaloes than in cows. [Dhillon and Singh (2006)][1], after screening several indigenous drugs, found seeds of Argyreia speciosa (
Spatial ability mediates the gender difference in middle school students' science performance.

Prior research has demonstrated a male advantage in spatial skills and science achievement. The present research integrated these findings by testing the potential role of spatial skills in gender differences in the science performance of eighth-grade students (13-15 years old). In (N = 113), the findings showed that mental rotation ability mediated gender differences in physical science and technology/engineering test scores. In (N = 73,245), science performance was examined in a state population of eighth-grade students. As in , the results revealed larger gender differences on items that showed higher correlations with mental rotation. These findings underscore the importance of considering spatial training interventions aimed at reducing gender differences in the science performance of school-aged children.
Evaluation of separate role of intestine and liver in first pass metabolism of budesonide in rat

Abstract 1. Budesonide, a potent topical corticosteroid, reported to have low oral bioavailability in mice, rat, dog and human due to rapid first pass metabolism. However, there is insufficient information available in literature regarding the role of intestine and or liver responsible for the first pass metabolism of budesonide. 2. Current study in rats investigates the role of intestine and liver in first pass metabolism of budesonide using two in vivo models. Additionally, budesonide was also evaluated in in vitro assays such as thermodynamic solubility, permeability in Caco-2 cells and stability in simulated gastric (SGF), intestinal fluids (SIF) to understand the underlaying cause for low oral bioavailability. 3. Budesonide showed low oral, intra-duodenal and high intra-portal bioavailability in rat. In a dual vein cannulated rat model, intestinal and hepatic extraction ratios calculated based upon intestinal availability (Fa·Fg) and hepatic availability (Fh), suggests hepatic extraction of budesonide is minimal compared to intestinal. 4. In vitro results suggest, solubility and permeability may not be a barrier for the observed low oral bioavailability in rats. 5. Correlating the in vitro and in vivo data together, it can be concluded that, intestine might be playing major role in first pass metabolism of budesonide.