Miracle-dz/UniFAR-FTUs huggingface dataset:
Selection design phase II trial of high dosages of tamoxifen and creatine in amyotrophic lateral sclerosis

Abstract Objective: To conduct a phase-II trial using a ranking and selection paradigm where multiple treatments are compared with limited sample size and the best is chosen for a subsequent efficacy trial versus placebo. This strategy can find an effective treatment faster than traditional strategy of conducting larger trials against placebo. Methods: Sixty amyotrophic lateral sclerosis (ALS) participants were randomized 1:1:1 to creatine 30 g/day (CRE), tamoxifen 40 mg/day (T40), or tamoxifen 80 mg/day (T80), with matching placebo. The primary outcome was 38-week change in ALS Functional Rating Scale-Revised (ALSFRS-R), analyzed in a repeated-measures ANOVA. Secondary outcomes included slow vital capacity (SVC), quantitative muscle strength, early drug discontinuation (EDD), adverse events (AEs), and survival. Results: CRE participants experienced higher rates of drug-related AEs (82% vs. 43% T40, 47% T80) and EDD (50% vs. 24% T40, 29% T80). T80 participants experienced slower adjusted mean decline in ALSFRS-R in points/month (–0.80 vs. –0.84 T40, –0.85 CRE) and quantitative muscle strength but not in SVC and higher rates of mortality. Conclusion: Efficacy of T80 ranked numerically superior to CRE and T40 with respect to ALSFRS-R decline. Following the selection paradigm, T80 would be chosen to test against placebo. The approach was not designed to distinguish among treatments that are nearly equally effective or ineffective. If treatments are equivalent, then under the paradigm, it does not matter which treatment is selected. Newer approaches for increasing trial efficiency, including an adaptive platform trial design, may mitigate limitations of the selection design.
Lifelong Physical Activity Determines Vascular Function in Late Postmenopausal Women.

INTRODUCTION The study evaluated the role of life-long physical activity for leg vascular function in post-menopausal women (61±1 years). METHOD The study design was cross-sectional with 3 different groups based on their self-reported physical activity level with regard to intensity and volume over the past decade: Inactive (n=14); Moderately active (n=12) and; Very active (n=15). Endothelial dependent and smooth muscle dependent leg vascular function were assessed by ultrasound doppler measurements of the femoral artery during infusion of acetylcholine, the nitric oxide (NO) donor sodium nitroprusside and the prostacyclin analog epoprostenol. Thigh muscle biopsies and venous plasma samples were obtained for assessment of vasodilator systems. RESULTS The very active group was found to have ~ 76% greater responsiveness to acetylcholine compared to the sedentary group accompanied by a ~200% higher prostacyclin synthesis during ach infusion. Smooth muscle cell responsiveness to sodium nitroprusside and epoprostenol was not different between groups. The protein amount of endothelial nitric oxide synthase and endogenous antioxidant enzymes in muscle tissue was higher in the very active than the inactive group. The moderately active group had a similar endothelial and smooth muscle cell responsiveness as the inactive group. A secondary comparison with a smaller group (n=5) of habitually active young (24±2 yrs) women indicated that smooth muscle cell responsiveness and endothelial responsiveness is affected by age per se. CONCLUSION This study shows that leg vascular function, and a greater potential to form prostacyclin and NO in late post-menopausal women, is influenced by the extent of life-long physical activity.
The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease

Abstract Objective: To analyse the effect of general and specific self-efficacy on the adherence to a gluten free diet (GFD) in patients with celiac disease along with the effect of other relevant variables. Design: 271 patients with celiac disease participated in this transversal descriptive study and completed a series of questionnaires regarding adherence (CDAT), general self-efficacy (GSES) and specific self-efficacy (Celiac-SE) and quality of life (CD-Qol), among others. Main Outcome Measures: Dependent variable was adherence to the Gluten Free Diet (GFD). Main independent variables were general self-efficacy, specific self-efficacy and quality of life. Model tests were conducted using regression analysis. Results: 71.9% of patients show an excellent or good adherence to the diet. Higher levels of adherence are positively associated to a high expectancy of specific self-efficacy, to the perceived adoption of recommended behaviours, risk perception and better quality of life (these variables accounted for 36.4% of the variance in the adherence to a GFD, p < .001). Conclusions: Specific self-efficacy rather than general has a predictive value in adherence to a GFD. Therefore, we need to develop and transculturally adapt new instruments to assess specific self-efficacy. Celiac-SE has proved to be a useful scale for this objective.
Making ‘us’ better: High-quality athlete leadership relates to health and burnout in professional Australian football teams

Abstract Overtraining, exhaustion, and burnout are widely recognized problems amongst elite athletes. The present research addresses this issue by exploring the extent to which high-quality athlete leadership is associated with elite athletes’ health and burnout. Participants (120 male athletes from three top-division Australian football teams) were asked to rate the quality of each of their teammates in four different leadership roles (i.e. as task and motivational leaders on the field and as social and external leaders off the field), and also to indicate their identification with their team as well as their self-reported health and burnout. Findings indicated that (a) being seen to be a good athlete leader by other members of the team and (b) having a good athlete leader on the team were both positively associated with better team member health and lower burnout. This relationship was mediated by athletes’ identification with their team, suggesting that leaders enhance athletes’ health and reduce athlete burnout by creating and maintaining a sense of shared identity in their team. This, in turn, suggests that coaches can foster an optimal team environment by developing the leadership potential of their athlete leaders – in particular, their skills that foster a sense of shared team identification. This is in the interests not only of team performance but also of team members’ health and burnout.
Sleep and fatigue in newly graduated nurses - experiences and strategies for handling shiftwork.

AIMS AND OBJECTIVES This study explores newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed in order to understand what supportshould be provided. BACKGROUND For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management, and at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk. DESIGN AND METHODS Semi-structured interviews were conducted with nurses (N=11) from four different Swedish hospitals and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board inStockholm. The COREQ checklist was followed. RESULTS Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and non-executive cognitive function. CONCLUSION The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance in order to improve wellbeing among nurses and increase patient safety. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of addressing sleep and fatigue issues in nursing education andwork introduction programmesin order to increase patient safety and improve wellbeing among nurses.
Screening Instruments for Developmental and Behavioral Concerns in Pediatric Hispanic Populations in the United States: A Systematic Literature Review.

BACKGROUND Racial and ethnic disparities in the identification of developmental and behavioral concerns in children are public health problems in the United States. Early identification of developmental delay using validated screening instruments provides a pathway to prevention and intervention in pediatric health care settings. However, the validity of Spanish-language screening instruments, used in clinical settings in the United States, has not been systematically examined. OBJECTIVE This study aims to review the literature of clinically administered developmental and behavioral instruments with Hispanic caregivers to investigate implementation variation due to language and cultural factors. METHODS A systematic literature review using PubMed and PsycINFO was conducted of articles published from January 1, 2006 to December 12, 2017. Abstract, full-text, and critical appraisal resulted in 11 studies that met criteria for inclusion. RESULTS Five different instruments were used to screen Hispanic or Spanish-speaking caregivers of children younger than 6 years. None of the instruments established validity and reliability apart from Spanish translation. Two studies identified differences in screening results with Spanish-speaking caregivers due to language and 6 described cultural differences that impacted screening implementation. Two studies reported differential item functioning in Spanish-translated instruments. CONCLUSIONS Language and cultural considerations are critical to the administration of valid and reliable screening in pediatric health care settings. Available developmental and behavioral Spanish-language-screening instruments function differently because of both language and culture, suggesting the tools are not as psychometrically valid when administered to Spanish-speaking families. Validation of translated screening instruments is essential to eliminate the possibility of detection bias or misidentification of developmental risk, improving early access to clinical services for Hispanic and Spanish-speaking families.
How to Improve the YLS/CMI? Exploring a Particularly Predictive Combination of Items

Recidivism risk assessment is central to addressing criminogenic needs among youth offenders. To accomplish this, the Youth Level of Service/Case Management Inventory (YLS/CMI) is worldwide used, but it is long and has limited predictive validity for minority populations. This study presents a particularly predictive combination of seven items that overcomes these limitations. A sample of 430 Spanish youth offenders participated in this study. The YLS/CMI long version was filled out and reconvictions were collected over a 2-year period. Results show that this combination of seven items reduced more than 80% of the inventory and improved the predictive validity, globally and for minorities. The items that were included were related to psychopathic traits and the lack of protective role models. Therefore, this specific combination of YLS/CMI items has considerable higher predictive validity across gender and culture, and may be useful to practitioners in this field.
Silencing of GAS5 alleviates glaucoma in rat models by reducing retinal ganglion cell apoptosis.

OBJECTIVE Retinal ganglion cells (RGCs) play a key role in the pathogenesis and development of glaucoma. The present study aims to investigate the underlying mechanism of long non-coding RNA (lncRNA) GAS5 in glaucoma development through regulating the apoptosis of RGCs. METHODS Rat models of chronic glaucoma were successfully established by translimbal laser photocoagulation. Retinal tissues were collected to determine the density of RGCs via Toluidine blue staining. The overexpression vector or short hairpin RNA for GAS5 or enhancer of zeste homolog 2 (EZH2) were transfected into RGCs after in vitro pressurization culture to exam the function of GAS5 in RGC apoptosis. The involvement of EZH2 and ATP-binding cassette transporter A1 (ABCA1) was further identified. Cell apoptosis after laser treatment and transfection was assessed by flow cytometry. RESULTS We found abundant GAS5 expression and a reduction in RGC density in the retinal tissues of glaucoma rats. Silencing of GAS5 led to increased EZH2 expression and decreased ABCA1 expression in RGCs. In addition, up-regulation of EZH2 promoted trimethylation of lysine 27 on histone H3, therefore suppressing ABCA1 expression, eventually leading to the inhibition of RGC apoptosis. CONCLUSION These findings provide further understanding of the function of GAS5 in RGC apoptosis. We conclude that down-regulation of GAS5 could help relieve glaucoma symptoms. GAS5 is therefore a promising target for developing novel therapeutic approaches for treating patients with glaucoma.
Novel long-range inhibitory nNOS-expressing hippocampal cells

The hippocampus, a brain region that is important for spatial navigation and episodic memory, benefits from a rich diversity of neuronal cell-types. Through the use of an intersectional genetic viral vector approach in mice, we report novel hippocampal neurons which we refer to as LINCs, as they are long-range inhibitory neuronal nitric oxide synthase (nNOS)-expressing cells. LINCs project to several extrahippocampal regions including the tenia tecta, diagonal band, and retromammillary nucleus, but also broadly target local CA1 cells. LINCs are thus both interneurons and projection neurons. LINCs display regular spiking non-pyramidal firing patterns, are primarily located in the stratum oriens or pyramidale, have sparsely spiny dendrites, and do not typically express somatostatin, VIP, or the muscarinic acetylcholine receptor M2. We further demonstrate that LINCs can strongly influence hippocampal function and oscillations, including interregional coherence. The identification and characterization of these novel cells advances our basic understanding of both hippocampal circuitry and neuronal diversity.
Plasma cell leukemia with plasmablastic morphology in a dog

A 5-y-old female Golden Retriever was presented with a 2-wk history of hyporexia, vomiting, diarrhea, lethargy, weight loss, polyuria, and polydipsia. Clinical examination and ultrasonography revealed multiple organ enlargement with gallbladder and kidney nodules suggestive of disseminated neoplasia. Hematologic and biochemical analyses revealed pancytopenia, hypercalcemia, and monoclonal IgA gammopathy suspicious for a plasma cell neoplasm. Bone marrow and blood smear examination revealed neoplastic atypical cells highly suggestive of lymphoid origin. Autopsy confirmed the presence of homogeneous white masses and multifocal pale infiltrates in the spleen, kidney, small intestine, gallbladder, and urinary tract. Histologic features were consistent with a multicentric atypical plasma cell tumor. Tumor cells were negative for CD204, IBA-1, E-cadherin, CD3, CD5, CD79a, CD20, and PAX5, and positive for MUM1, consistent with plasma cell origin. The presence of > 20% of circulating blastic plasma cells was consistent with primary plasma cell leukemia with plasmablastic morphology, a disease rarely described in veterinary medicine.
Effectiveness of residential treatment for anorexia nervosa 1 Effectiveness of treatment for adolescents and adults with anorexia nervosa in a routine residential setting

Residential treatment is a necessary element of treatment in some cases of anorexia nervosa, where it is used prior to transitioning to complete the treatment in a less intensive setting. This study tests how effective residential treatment is at helping adolescent and adult patients to reduce their eating pathology to levels that can be managed in outpatient settings. Ninety-eight patients with anorexia nervosa started treatment in a routine residential setting (83 completers). The adolescent and adult groups showed comparable levels of benefit, showing gains in weight and reductions in eating pathology, compatible with transitioning to less intensive treatment. Change was particularly substantial over the first six weeks. This effectiveness study has shown that an appropriate period of residential treatment can be used to prepare patients to be able to benefit from a less intensive treatment, regardless of age group.
Evaluation of the effects of hemoglobinopathies on the mandible with fractal dimension analysis

Aims: The aim of this study was to evaluate the mandibular bone changes on panoramic radiographs of thalassemia and sickle cell anemia (SCA) patients using fractal dimension (FD) analysis and to compare the findings obtained from healthy individuals. Materials and Methods: A total of 90 panoramic radiographs (from 30 patients with thalassemia, 30 patients with SCA and 30 healthy individuals) were assessed to measure FD, mandibular cortical width (MCW), panoramic mandibular index (PMI) in the mandible. Three region of interests (ROI) of angulus, corpus, and interdental bone were created. FD was calculated using ImageJ program. Results: In thalassemia group, the mean value of FD was 1.11, 1.03, and 1.02 in interdental bone, corpus, and angulus, respectively. In SCA group, the mean value of FD was 1.10, 1.05, and 1 in interdental bone, corpus, and angulus, respectively. In control group, the mean value of FD was 1.09, 1.04, and 1 in interdental bone, corpus, and angulus, respectively. FD value of interdental bone are significantly higher in thalassemia group than control group. FD values of corpus and angulus values did not show a significant difference between the groups. Conclusions: Fractal analysis may be used and recommended for evaluation of the bone changes induced by hemoglobinopathies.
Lipoprotein receptor‐related protein 6 is required to maintain intercalated disk integrity

The intercalated disk (ID), a highly organized adhesion structure connecting neighboring cardiomyocytes, fulfills mechanical and electrical signaling communication to ensure normal heart function. Lipoprotein receptor‐related protein 6 (LRP6) is a co‐receptor inducing canonical Wnt/β‐catenin signaling. It was recently reported that LRP6 deficiency in cardiomyocytes predisposes to arrhythmia independent of Wnt signaling. However, whether LRP6 directly regulates the structure of IDs requires further investigation. The aim of the present study was to explore the role of LRP6 in IDs and the potential underlying mechanisms by inducible cardiac‐specific LRP6 knockout mice. The results revealed that LRP6 was predominately expressed in the cell membrane, including the IDs of cardiomyocytes. Tamoxifen‐inducible cardiac‐specific LRP6 knockout mice displayed overt cardiac dysfunction and disruption of ID structure. Further analysis revealed that cardiac LRP6 deficiency induced the imbalance of ID component proteins, characterized by the sharply decreased expression of connexin 43 (Cx43) and the significantly increased expression of N‐cadherin, desmoplakin and γ‐catenin in tissue lysates or membrane fraction from the left ventricle. STRING database analysis indicated that β‐catenin, but no other ID‐associated proteins, interacted with LRP6. Our immunoprecipitation analysis demonstrated that LRP6 strongly interacted with Cx43, N‐cadherin and γ‐catenin, and weakly interacted with β‐catenin, whereas there was no association with desmoplakin. In response to LRP6 deficiency, the recruitment of β‐ or γ‐catenin to N‐cadherin was increased, but they displayed little interaction with Cx43. In conclusion, LRP6 is required to maintain the integrity of ID structure and the balance of ID proteins, and the interaction between LRP6 and Cx43, N‐cadherin and γ‐catenin may be involved in this process.
Dietary Energy Density is Associated with Body Mass Index and Fat Mass in Early Adulthood

A cross-sectional study was conducted to investigate the association between body composition parameters as well as body mass index (BMI), and dietary energy density in a population of 538 young adults. Fat mass, fat mass percent, fat-free mass, and visceral fat were measured using a body composition analyzer. Daily energy intake was assessed using a 72-hr diet recall, and dietary energy density was calculated. Significant differences in dietary energy density among underweight, normal-weight and overweight/obesity young adults were identified (M = 1.42, SD = 0.26 vs. M = 1.52, SD = 0.46 vs. M = 1.66, SD = 0.53, p = .002). Dietary energy density was associated with BMI (β = .961; CI 95% = 0.335, 1.586; p = .0030), fat mass percent (β = 1.921; CI 95% = 0.707, 3.135; p = .002), and fat mass (β = 2.146; CI 95% = 0.827, 3.466; p = .001). Dietary energy density might be considered as an important aspect in the obesity nutritional education programs in young people.
Survival rate of colon and rectum cancer in Iran: A systematic review and meta-analysis.

Colorectal cancer is one of the deadliest cancers worldwide. Effective screening, surveillance, and prevention can decrease its incidence, mortality and burden. This meta-analysis aims to provide a pooled estimation of 5-year survival rate for colorectal cancer based on topography codes and treatment in Iranian population. A systematic search for literature was done in international and national databases up to July 2018. Twenty-seven studies from 4929 articles met the eligible criteria. The overall pooled 5-year survival rate of colorectal cancer, colon, rectal and sigmoid were estimated 56% (95% CI: 49, 63), 53% (95% CI: 41, 65), 52% (95% CI: 41, 62), and 38% (95% CI: 22, 55), respectively. In addition, 5-year survival rate of colorectal cancer after surgery was estimated: 64% (95%CI: 50, 78). Subgroup analysis by type of data source showed significantly higher rate of survival in oncology center (29%) than hospital-based (P = 0.005). As a conclusion, low survival rate of colorectal cancer in Iran necessitates effective screening and surveillance strategies to find precancerous polyps and detect early-stage cases with lower stage risk of cancer.