Miracle-dz/UniFAR-FTUs huggingface dataset:
The Impact of Child Sexual Abuse Discovery on Caregivers and Families: A Qualitative Study

In this qualitative study with nonoffending caregivers of suspected child sexual abuse victims, we aimed to explore the perceived impact of sexual abuse discovery on caregivers and their families, and caregivers’ attitudes about mental health services for themselves. We conducted semistructured, in-person interviews with 22 nonoffending caregivers of suspected sexual abuse victims <13 years old seen at a child advocacy center in Philadelphia. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment continued until thematic saturation was reached. We found that caregivers experienced significant emotional and psychological distress, characterized by anger, depressed mood, and guilt, after learning that their child may have been sexually abused. We identified four specific sources of caregiver distress: concerns about their child, negative beliefs about their parenting abilities, family members’ actions and behaviors, and memories of their own past maltreatment experiences. Some caregivers described worsening family relationships after discovery of their child’s sexual abuse, while others reported increased family cohesion. Finally, we found that most caregivers in this study believed that mental health services for themselves were necessary or beneficial to help them cope with the impact of their child’s sexual abuse. These results highlight the need for professionals working with families affected by sexual abuse to assess the emotional and psychological needs of nonoffending caregivers and offer mental health services. Helping caregivers link to mental health services, tailored to their unique needs after sexual abuse discovery, may be an acceptable strategy to improve caregiver and child outcomes after sexual abuse.
Ethylene Biosynthesis Is Promoted by Very-Long-Chain Fatty Acids during Lysigenous Aerenchyma Formation in Rice Roots1

Long-chain fatty acids enhance the expression of an ethylene biosynthesis gene, production of ethylene, and promote ethylene-induced aerenchyma formation. In rice (Oryza sativa) roots, lysigenous aerenchyma, which is created by programmed cell death and lysis of cortical cells, is constitutively formed under aerobic conditions, and its formation is further induced under oxygen-deficient conditions. Ethylene is involved in the induction of aerenchyma formation. reduced culm number1 (rcn1) is a rice mutant in which the gene encoding the ATP-binding cassette transporter RCN1/OsABCG5 is defective. Here, we report that the induction of aerenchyma formation was reduced in roots of rcn1 grown in stagnant deoxygenated nutrient solution (i.e. under stagnant conditions, which mimic oxygen-deficient conditions in waterlogged soils). 1-Aminocyclopropane-1-carboxylic acid synthase (ACS) is a key enzyme in ethylene biosynthesis. Stagnant conditions hardly induced the expression of ACS1 in rcn1 roots, resulting in low ethylene production in the roots. Accumulation of saturated very-long-chain fatty acids (VLCFAs) of 24, 26, and 28 carbons was reduced in rcn1 roots. Exogenously supplied VLCFA (26 carbons) increased the expression level of ACS1 and induced aerenchyma formation in rcn1 roots. Moreover, in rice lines in which the gene encoding a fatty acid elongase, CUT1-LIKE (CUT1L; a homolog of the gene encoding Arabidopsis CUT1, which is required for cuticular wax production), was silenced, both ACS1 expression and aerenchyma formation were reduced. Interestingly, the expression of ACS1, CUT1L, and RCN1/OsABCG5 was induced predominantly in the outer part of roots under stagnant conditions. These results suggest that, in rice under oxygen-deficient conditions, VLCFAs increase ethylene production by promoting 1-aminocyclopropane-1-carboxylic acid biosynthesis in the outer part of roots, which, in turn, induces aerenchyma formation in the root cortex.
Specificity of Radionuclide Brain Blood Flow Testing in Brain Death: Case Report and Review

Brain blood flow tests with diffusible radiopharmaceuticals are often done as an ancillary test in brain death (BD). We report a case of an infant with absent brain blood flow on an anterior planar image despite persistent breathing and extensor posturing. We reviewed the literature from 1980 to 2008 using MEDLINE and PubMed to determine the sensitivity and specificity of these tests in the diagnosis of BD. Search terms were any combination of: brain death; and single photon emission computed tomography (SPECT), radiopharmaceuticals, technetium Tc 99m exametazime, or organotechnetium compounds. The sensitivity of absent brain blood flow on planar imaging for clinically confirmed BD is 119/153 = 77.8% [95% CI 70.5%—83.7%]; and the specificity is 41/41 (100%) [95% CI 92.6%—100%]. For clinically confirmed BD, the sensitivity of SPECT is 107/121 (88.4%) [95% CI 81.4%—93.1%], and specificity is 12/12 (100%) [95% CI 78.4%—100%]. For contrast angiography confirmed BD, the sensitivity of SPECT is 34/34 (100%) [95% CI 91.2%—100%]; the specificity could not be estimated as there were no patients without clinical BD having both tests. Case reports emphasized the possibility of isolated posterior-fossa blood flow, which would not be detectable using non-diffusible radiopharmaceuticals, or without a lateral view using diffusible agents. We conclude that patients having an ancillary radiopharmaceutical brain blood flow test for BD should have anterior and lateral views without exception. Larger numbers of patients both with and without BD (but with severe brain injury) must be studied to determine the sensitivity and specificity of these tests.
Comparison between ultrasound and noncontrast helical computed tomography for identification of acute ureterolithiasis in a teaching hospital setting.

CONTEXT AND OBJECTIVE Recent studies have shown noncontrast computed tomography (NCT) to be more effective than ultrasound (US) for imaging acute ureterolithiasis. However, to our knowledge, there are few studies directly comparing these techniques in an emergency teaching hospital setting. The objectives of this study were to compare the diagnostic accuracy of US and NCT performed by senior radiology residents for diagnosing acute ureterolithiasis; and to assess interobserver agreement on tomography interpretations by residents and experienced abdominal radiologists. DESIGN AND SETTING Prospective study of 52 consecutive patients, who underwent both US and NCT within an interval of eight hours, at Hospital São Paulo. METHODS US scans were performed by senior residents and read by experienced radiologists. NCT scan images were read by senior residents, and subsequently by three abdominal radiologists. The interobserver variability was assessed using the kappa statistic. RESULTS Ureteral calculi were found in 40 out of 52 patients (77%). US presented sensitivity of 22% and specificity of 100%. When collecting system dilatation was associated, US demonstrated 73% sensitivity, 82% specificity. The interobserver agreement in NCT analysis was very high with regard to identification of calculi, collecting system dilatation and stranding of perinephric fat. CONCLUSIONS US has limited value for identifying ureteral calculi in comparison with NCT, even when collecting system dilatation is present. Residents and abdominal radiologists demonstrated excellent agreement rates for ureteral calculi, identification of collecting system dilatation and stranding of perinephric fat on NCT.
Can lean save lives?

PURPOSE The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. DESIGN/METHODOLOGY/APPROACH This paper is a viewpoint. FINDINGS One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. ORIGINALITY/VALUE Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.
Insulinoma‐released exosomes activate autoreactive marginal zone‐like B cells that expand endogenously in prediabetic NOD mice

Exosomes (EXOs) are nano‐sized secreted microvesicles that can function as potent endogenous carriers of adjuvant and antigens. To examine a possible role in autoimmunity for EXOs, we studied EXO‐induced immune responses in nonobese diabetic (NOD) mice, an autoimmune‐prone strain with tissue‐specific targeting at insulin‐secreting beta cells. EXOs released by insulinoma cells can activate various antigen‐presenting cells to secrete several proinflammatory cytokines and chemokines. A subset of B cells responded to EXO stimulation in culture by proliferation, and expressed surface markers representing marginal zone B cells, which was independent of T helper cells. Importantly, splenic B cells from prediabetic NOD mice, but not diabetic‐resistant mice, exhibited increased reactivity to EXOs, which was correlated with a high level of serum EXOs. We found that MyD88‐mediated innate TLR signals were essential for the B‐cell response; transgenic B cells expressing surface immunoglobulin specific for insulin reacted to EXO stimulation, and addition of a calcineurin inhibitor FK506 abrogated the EXO‐induced B‐cell response, suggesting that both innate and antigen‐specific signals may be involved. Thus, EXOs may contribute to the development of autoimmunity and type 1 diabetes in NOD mice, partially via activating autoreactive marginal zone‐like B cells.
Impaired Uterine Arterial Blood Flow in Pregnant Women With Recurrent Pregnancy Loss

Objective. This study was undertaken to evaluate uterine perfusion, which regulates uterine receptivity, in women with recurrent pregnancy loss. Methods. We evaluated the blood flow resistance in the uterine arteries of 104 pregnant women at 4 to 5 weeks' gestation by transvaginal pulsed Doppler ultrasonography (control group, n = 52; and recurrent pregnancy loss group, n = 52). Blood tests for antinuclear and antiphospholipid antibodies were also performed. Results. The uterine arterial pulsatility index in the recurrent pregnancy loss group was significantly higher than that in the control group. Women with antinuclear or antiphospholipid antibodies had an elevated pulsatility index in the uterine artery, which is prominent in women with recurrent pregnancy loss. Coagulopathy and vascular dysfunction caused by autoantibodies may impair uterine perfusion. However, the uterine arterial pulsatility index in the recurrent pregnancy loss group was significantly higher than that in the control group even among women without antinuclear antibodies or among women without antiphospholipid antibodies. This observation strongly suggests that the uterine artery pulsatility index may be an independent index for recurrent pregnancy loss. Conclusions. The introduction of pulsed Doppler ultrasonography has provided the means for noninvasive evaluation of uterine impedance and may identify patients with recurrent pregnancy loss associated with impaired uterine perfusion.
Chemoprevention of Cigarette Smoke–Induced Alterations of MicroRNA Expression in Rat Lungs

We previously showed that exposure to environmental cigarette smoke (ECS) for 28 days causes extensive downregulation of microRNA expression in the lungs of rats, resulting in the overexpression of multiple genes and proteins. In the present study, we evaluated by microarray the expression of 484 microRNAs in the lungs of either ECS-free or ECS-exposed rats treated with the orally administered chemopreventive agents N-acetylcysteine, oltipraz, indole-3-carbinol, 5,6-benzoflavone, and phenethyl isothiocyanate (as single agents or in combinations). This is the first study of microRNA modulation by chemopreventive agents in nonmalignant tissues. Scatterplot, hierarchical cluster, and principal component analyses of microarray and quantitative PCR data showed that none of the above chemopreventive regimens appreciably affected the baseline microRNA expression, indicating potential safety. On the other hand, all of them attenuated ECS-induced alterations but to a variable extent and with different patterns, indicating potential preventive efficacy. The main ECS-altered functions that were modulated by chemopreventive agents included cell proliferation, apoptosis, differentiation, Ras activation, P53 functions, NF-κB pathway, transforming growth factor–related stress response, and angiogenesis. Some microRNAs known to be polymorphic in humans were downregulated by ECS and were protected by chemopreventive agents. This study provides proof-of-concept and validation of technology that we are further refining to screen and prioritize potential agents for continued development and to help elucidate their biological effects and mechanisms. Therefore, microRNA analysis may provide a new tool for predicting at early carcinogenesis stages both the potential safety and efficacy of cancer chemopreventive agents. Cancer Prev Res; 3(1); 62–72
Organ-cultured, prestripped donor tissue for DMEK surgery: clinical outcomes

Aim To determine whether clinical performance is negatively affected by prestripping Descemet membrane endothelial keratoplasty (DMEK) grafts from organ-cultured corneas. Methods We reviewed clinical records of all patients who underwent DMEK surgery for Fuchs endothelial dystrophy between 28 October 2014 and 11 August 2015. Grafts had been prepared from organ-cultured corneoscleral buttons 24 hours prior to surgery or during surgery. We included only patients for which at least one follow-up examination was available at a minimum of 2 months postoperatively. Main outcome measures: best-corrected visual acuity (BCVA), central corneal thickness, endothelial cell count and rebubbling rates. Results Data given are mean±SD. No statistically significant differences were recorded at baseline between the partially stripped group (n=65) and the control group (n=72) with regard to donor age (70±9 vs 69±8 years; p=0.49), donor cornea endothelial cell density (2586±604 vs 2522±186 cells/mm2; p=0.6), BCVA (before DMEK: 0.77±0.5 vs 0.63±0.3 logMAR; p=0.27; before triple-DMEK: 0.56±0.2 vs 0.52±0.2 logMAR; p=0.33) or central corneal thickness (621±72 vs 607±53 μm; p=0.49). Mean follow-up was 149±83 versus 148±77 days; p=0.79. No statistically significant differences were observed between the two groups postoperatively with regard to BCVA (after DMEK: 0.25±0.2 vs 0.21±0.2 logMAR; p=0.59; after triple-DMEK: 0.22±0.2 vs 0.2±0.1 logMAR; p=0.98), central corneal thickness (502±42 vs 508±41 μm; p=0.47), endothelial cell count (1537±245 vs 1551±287 cells/mm2; p=0.65) and number of graft detachments requiring rebubbling (4.6% vs 9.7%; p=0.33). Conclusions We found no evidence that the use of prestripped DMEK grafts is inferior to same-day preparation in organ-cultured corneas within the given follow-up.
Orthosteric and allosteric potentiation of heteromeric neuronal nicotinic acetylcholine receptors

Heteromeric nicotinic ACh receptors (nAChRs) were thought to have two orthodox agonist‐binding sites at two α/β subunit interfaces. Highly selective ligands are hard to develop by targeting orthodox agonist sites because of high sequence similarity of this binding pocket among different subunits. Recently, unorthodox ACh‐binding sites have been discovered at some α/α and β/α subunit interfaces, such as α4/α4, α5/α4 and β3/α4. Targeting unorthodox sites may yield subtype‐selective ligands, such as those for (α4β2)2α5, (α4β2)2β3 and (α6β2)2β3 nAChRs. The unorthodox sites have unique pharmacology. Agonist binding at one unorthodox site is not sufficient to activate nAChRs, but it increases activation from the orthodox sites. NS9283, a selective agonist for the unorthodox α4/α4 site, was initially thought to be a positive allosteric modulator (PAM). NS9283 activates nAChRs with three engineered α4/α4 sites. PAMs, on the other hand, act at allosteric sites where ACh cannot bind. Known PAM sites include the ACh‐homologous non‐canonical site (e.g. morantel at β/α), the C‐terminus (e.g. Br‐PBTC and 17β‐estradiol), a transmembrane domain (e.g. LY2087101) or extracellular and transmembrane domain interfaces (e.g. NS206). Some of these PAMs, such as Br‐PBTC and 17β‐estradiol, require only one subunit to potentiate activation of nAChRs. In this review, we will discuss differences between activation from orthosteric and allosteric sites, their selective ligands and clinical implications. These studies have advanced understanding of the structure, assembly and pharmacology of heteromeric neuronal nAChRs.
Dual-Kidney Transplantation with Organs from Expanded Criteria Donors: A Long-Term Follow-Up

Background. Since 1995, dual-kidney transplantation using organs from marginal donors has been used at our center to expand the organ donor pool and decrease the waiting time for deceased donor kidney transplantation. This approach has allowed for a shorter waiting period without compromising outcome in the early posttransplant period. We now have 8-year follow-up in the first recipients. Older individuals were offered this option preferentially, because we reasoned that they would stand to benefit most from the shorter waiting period. Methods. Patients aged 55 years or more who underwent either dual-kidney transplantation with expanded criteria donors or single-kidney transplantation with standard donors were included in this study. All expanded criteria donor organs were those that were refused by all other local transplant centers. The primary endpoints were recipient death and graft failure. Results. Waiting time for dual-kidney transplantation was 440±38 days versus 664±51 days for single-kidney transplantation (P<0.01). The 8-year actuarial patient survivals for the single- and dual-kidney transplants were 74.1% and 82.1%, respectively. The 8-year actuarial graft survivals for the single- and dual-kidney transplants were 59.4% and 69.7%, respectively. Conclusions. Eight-year actuarial patient and graft survivals in older individuals who underwent dual-kidney transplantation are equivalent to those who underwent standard single-kidney transplantation. With the continuing organ shortage and increasing waiting times for cadaver kidney transplantation, dual-kidney transplantation using organs that would otherwise be discarded offers a good option for older individuals who may not withstand a long waiting period.
Effects of behavioural family management on family communication and patient outcomes in schizophrenia

Background Family interventions for schizophrenia have proved to be highly effective in preventing relapse, but it is not clear how they work or how they should be structured. Aims To examine the effects of a behavioural family intervention and a family support programme on communication, problem solving and outcome in order to determine the impact of structured communication training. Method Patients and family members participating in the Treatment Strategies in Schizophrenia study were videotaped engaging in 10-minute problem-solving conversations at baseline and after the conclusion of the family intervention. Tapes were subsequently evaluated for changes in communication patterns. Results The intensive behavioural intervention did not produce differential improvement in communication, and change in communication was unrelated to patient outcomes. Conclusions The data suggest that intensive behavioural family interventions may not be cost efficient, and that change in family communication patterns may only be important for a subset of families.
Learning and Recall of Story Content and Spatial Location After Unilateral Temporal-Lobe Excision in Children and Adolescents

The present study examined verbal and spatial learning and memory in children and adolescents who had undergone unilateral temporal lobectomy versus controls. All participants were trained to criterion before a delay to assess learning efficiency. There were no significant differences between the groups in rate of learning the verbal task. The right temporal-lobe group, but not the left, had difficulty learning spatial information. These findings indicate a specific effect of early right temporal-lobe lesions on spatial learning. As material-specificity is more often found in adults for verbal information, the present results highlight the unique role of the temporal-lobe in development.
Ecomorphology of the External Flight Apparatus of Blackcaps (Sylvia atricapilla) with Different Migration Behavior

Abstract: An analysis of the external flight apparatus of 700 blackcaps from eight different populations (sedentary to long‐distance migrators) is presented. With increasing migration distances of populations, (1) wing length, aspect ratio, and wing pointedness increase; (2) wing load decreases; (3) slots on the wing tips become relatively shorter; (4) the alula tends to be shorter in relation to wing length; and (5) the tail is shorter in relation to wing length. Although body mass increases from southern to northern populations, changes in wing length and wing area are two to three times larger than expected for simple isometric relationships. Regarding the aerodynamic background of these changes, it can be stated that traits for energy‐effective flight are more strongly developed and traits for maneuverability are less developed in birds traveling longer distances, presumably as a consequence of trade‐offs. Nonmigratory blackcaps from Madeira and the Cape Verde islands do not always show the traits we would expect in view of their sedentary behavior. This can be seen as a result of recent colonization of these islands by migrants or of selection by factors other than migration behavior. In migratory populations, changes between the first and the second set of primaries during first complete molt show almost the same pattern as the changes from nonmigratory to migratory populations. During molt of the primaries, blackcaps of nonmigratory populations do not show these changes. Hybrids between migrating and nonmigrating blackcap populations (Moscow and Madeira) showed intermediate values between parent populations in wing length, wing shape, and wing area; in the other variables they resembled either parent population.