Miracle-dz/UniFAR-FTUs huggingface dataset:
Ethical Principles Applied to Complementary Healing

With the public and professional shift to an interest in alternative/complementary therapies and holistic health, existing assumptions about the relationship between providers and clients are being challenged. This study explores the ethical approaches and underlying principles in the expectations of three organizations espousing holistic health and touch therapies. An analytic technique using a qualitative approach was applied to the documents of written ethical codes and standards from these organizations and was augmented by field exposure from previous work with each of the groups of healers. The emphasis on and approach to the principles of paternalism and autonomy from the groups provided contrasts with general biomedical approaches. All groups gave attention to the constructs of nonmaleficence, beneficence, and autonomy, with a strong emphasis on virtue ethics. The shift in the expression of the principles of paternalism and client agency allowed the healers to employ the therapeutic effects of placebo, suggestion, optimism, hope, and surrender with the avoidance of noicebo effects.
Prevalence of Anemia in Inflammatory Bowel Diseases in European Countries: A Systematic Review and Individual Patient Data Meta-analysis

Background:The main objective is to determine the overall prevalence of anemia in inflammatory bowel diseases (IBD) in Europe. Methods:A systematic literature search in PubMed and Embase was performed for studies published between January 2007 and May 2012. Eligible studies were included if they were original full-paper publications originated from Europe and if the authors agreed to provide their data. An overall prevalence of anemia in IBD, disease specific, and age–gender stratified basis prevalences were estimated. The influence of disease entity (Crohn's disease/ulcerative colitis), gender, age, disease activity (remission/active disease), and IBD-specific treatment strategies on the prevalence of anemia was analyzed by a mixed logistic regression model. Thereby, the factor country of origin was included as a random effect. Results:Data were available for 2192 patients, mainly treated in tertiary referral centers. The overall prevalence of anemia in IBD patients was 24% (95% confidence interval, 18–31). Age–gender stratified prevalences were estimated for the age strata 18 to 29, 30 to 39, 40 to 49, 50 to 64, 65 to 74, >74 years and ranged from 18% to 35%. Patients receiving IBD-specific medication (P = 0.0002, odds ratio 1.54), and patients with active disease status (P < 0.0001, odds ratio 2.72) were significantly more likely to have anemia compared with patients not receiving IBD-specific medication or being in remission. Patients with ulcerative colitis tended to have anemia less likely than patients with Crohn's disease (P = 0.01, odds ratio 0.77). Conclusions:The overall prevalence of anemia in patients with Crohn's disease was 27% (95% confidence interval, 19–35) and 21% (95% confidence interval, 15–27) in patients with ulcerative colitis. Thereby, 57% of the anemic patients were iron deficient.
Cerebrospinal fluid levels of MMP‐2, 7, and 9 are elevated in association with human immunodeficiency virus dementia

Pathological evidence suggests that alterations of the blood–brain barrier (BBB) may occur in association with human immunodeficiency virus (HIV) dementia (HIVD). Increased BBB permeability could contribute to the development of dementia by facilitating the entry of activated and infected monocytes, as well as potentially toxic serum proteins, into the central nervous system. One mechanism by which BBB permeability may be altered is through increased activity of select matrix metalloproteinases (MMPs). In the present study, we examined the possibility that MMPs that target critical BBB proteins, including laminin, entactin, and collagen type IV, are elevated in the cerebrospinal fluid (CSF) of patients with HIVD. We also examined the possibility that such MMPs could be produced by brain‐derived cells, and that MMP production by these cells might be increased by tumor necrosis factor‐α, an inflammatory cytokine that is produced by HIV‐infected monocytes/microglia and is elevated in HIVD. By using western blot and enzyme‐linked immunosorbent assay, we observed that CSF levels of pro–MMP‐2 and pro–MMP‐7 were increased in association with HIVD. In addition, through the use of gelatin substrate zymography, a sensitive functional assay for MMP‐2 and MMP‐9, we observed that MMP‐2 or pro–MMP‐9 activity was more frequently detectable in the CSF of individuals with HIV dementia (9/16) than in the CSF from either nondemented seropositive (2/11) or seronegative (0/11) controls. Although the presence of MMPs in the serum could contribute to elevated levels in the CSF, we also show that brain‐derived cells release MMP‐2, 7, and 9, and that such release is increased after their stimulation with tumor necrosis factor‐α. Together, these results suggest that elevated CSF levels of select MMPs may reflect immune activation within the central nervous system. They also suggest that further studies may be warranted to determine whether these proteins may play a role in the development of symptomatic neurological disease.
Inferring the evolutionary history of Indian Plasmodium vivax from population genetic analyses of multilocus nuclear DNA fragments

The human malaria parasite Plasmodium vivax is globally widespread, causing high malaria morbidity. As P. vivax is highly endemic to India, and previous reports indicate genetic homogeneity in population samples, we tested the hypothesis of no genetic structuring in Indian P. vivax. Further, based on the reports of increasing incidence of Plasmodium falciparum infection in comparison with P. vivax in recent years in India, it was important to understand whether reduction in population size has resulted in decrease in P. vivax infection rate in India. For this, we utilized recently developed putatively neutral markers from chromosome 13 of P. vivax to score single nucleotide polymorphisms in 126 P. vivax isolates collected from 10 different places in India. The overall results indicated that Indian P. vivax bears high nucleotide diversity within population samples but moderate amount of genetic differentiation between population samples. STRUCTURE analysis grouped 10 population samples into three clusters based on the proportion of the genetic ancestries in each population. However, the pattern of clustering does not correlate with sampling locations in India. Furthermore, analyses of past demographic events indicated reduction in population size in majority of population samples, but when isolates from all the 10 samples were considered as a single population, the data fit to the demographic equilibrium model. All these observations clearly indicate that Indian P. vivax presents complex evolutionary history but possesses several features of being a part of ancestral distribution range of this species.
Geographic Differences in the Risk of Insulin-dependent Diabetes Mellitus: The Importance of Registries

There are marked geographic differences in the incidence of insulin-dependent diabetes mellitus (IDDM); for example, children in countries such as Finland are over 35 times more likely to develop IDDM than children in Japan. An understanding of the reasons for the geographic differences is likely to be important for understanding and, hopefully, preventing IDDM. There are problems, however, because of the lack of registries with adequate standardization. The major needs for the future studies include (1) to clarify the definition of IDDM for epidemiologic study, (2) to establish a standardized approach for IDDM registries, (3) to use registries to evaluate viral, immunologic, and genetic differences in order to explain differential risks across populations, and (4) to encourage the development of new population-based registries worldwide.
Yet the Poorest, Relatively Speaking: Italian Poverty Rates in International Perspective

Few works more than Esping-Andersens Three Worlds of Welfare Capitalism have drawn researchers attention on institutional features that characterize the diverse typologies of welfare regimes; yet the impact of the different institutional settings on income distribution has mostly been taken for granted. This paper uses cross nationally comparable data from the Luxembourg Income Study (LIS) to assess the performance of Italian Welfare against that of other countries of the "conservative" cluster (Germany, France and the Netherlands), as well as countries of the "liberal" (United Kingdom) and "social-democratic" (Sweden) regime. The results reveal that the institutional setting is strongly correlated with the antipoverty efficiency of social transfers (indeed in the direction one would expect), with the significant exception of Italy, whose performance approaches that of the United Kingdom. The reason for such performance must be found within the structure of social transfers. Italys extremely generous pension system has in fact crowded out any form of support directed to younger families, both in child support or means-tested assistance. While two-earners-households find a good hedge against poverty risks in market income, one earner household shaped around the "single male breadwinner model" face considerable poverty risks, which increase linearly by a factor of 10% according to the number of children in the household. As a consequence of the greater diffusion of such family model in Italy, child poverty rates tend to be double and almost ten times higher than the Swedish ones, approaching the British standard (almost 20%). Evidence also shows that what prevents a greater diffusion of the double income household is probably not as much related to cultural inheritance as to concrete difficulties encountered by women in young households combining parental and working responsibilities. In higher quintiles of disposable income, where services to families may be easily acquired on the market, female employment rate tend to be almost 3 times the average rate, approaching the Swedish rate. With respect to the foreseen tendencies towards higher wage dispersion (concentrated in the bottom part of the distribution), Italian welfare system (with its strong bias on old age pensions and the total lack of services to families) appear particularly unstable, as increased wage flexibility may only be acquired at the cost of falling deeper in the "fertility trap", a problem shared by most Europes continental countries, but which has taken a dramatic relevance in the case of Italy.
Feasibility of a transition intervention aimed at adolescents with chronic illness

Abstract Background: International guidelines recommend planned and structured transition programmes for adolescents with chronic illness because inadequate transition may lead to poor disease control and risk of lacking outpatient follow-up. Objective: To investigate the feasibility of a transition intervention aimed at adolescents with chronic illness focusing on declines, drop-outs, no-shows and advantages and disadvantages of participating. Methods: We invited 236 adolescents (12–20 years) with juvenile idiopathic arthritis (JIA) to participate in a randomised controlled trial (RCT) transition intervention. Reasons for decline and drop-outs were calculated. Adolescents’ experiences of advantages and disadvantages of participating and reasons for no-shows were investigated through focus groups and telephone interviews, which were analysed using thematic analysis. Results: One hundred and twenty of the 236 eligible patients declined to participate in the intervention and 20% dropped out during the intervention. Unspecified declines and practical issues were the most common reason to decline, and ‘do not wish to continue’ was the most common reason to drop-out. Reasons for no-shows were forgetting and being too busy. Advantages of participating were stated as ‘participating without parents’, ‘trust and confidentiality’, ‘being able to set the agenda’ and ‘responsiveness’. Disadvantages were ‘unclear aim of the study’, ‘meeting others with JIA’, ‘too few conversations’ and ‘transport issues’. Conclusions: Many adolescents had difficulties understanding the aim of the intervention. However, most participants appreciated the conversations about identity as well as the trust and confidentiality in the communication. In the future, adolescents should be offered more individually organised programmes according to their preferences and needs in cooperation with parents and health care providers.
Surgery in the Treatment of Acute Pancreatitis — Open Pancreatic Necrosectomy

Management of acute necrotizing pancreatitis has changed significantly over the past years. Early management is non-surgically and solely supportive. Today, more patients survive the early phase of severe pancreatitis due to improvements of intensive-care-medicine. Pancreatic infection is the major risk factor with regard to morbidity and mortality in the late phase of severe acute pancreatitis. Whereas early surgery and surgery for sterile necrosis can only be recommended in selected cases, pancreatic infection is a well accepted indication for surgical treatment. Surgery should ideally be postponed until four weeks after the onset of symptoms as necrosis is well demarcated at that time. Four surgical techniques can be performed with comparable results regarding mortality: necrosectomy combined with (1) open packing, (2) planned staged relaparotomies with repeated lavage, (3) closed continuous lavage of the retroperitoneum, and (4) closed packing. However, closed continuous lavage of the retroperitoneum, and closed packing seem to be associated with a lower morbidity compared to the other two approaches. Advances in radiologic imaging, new developments of interventional radiology and other minimal access interventions have revolutionized the management of many surgical conditions over the past decades. However, minimal invasive surgery and interventional therapy for infected necrosis should be limited to specific indications in patients who are critically ill and otherwise unfit for conventional surgery. Open surgical debridement is the “gold standard” for treatment of infected pancreatic and peripancreatic necrosis.
Memory for Animal Tracks: A Possible Cognitive Artifact of Human Evolution

Abstract Although many human behaviors are held to have adaptive significance, specific examples of behaviors that represent direct holdovers from the ancient world have been few, particularly in the cognitive realm. In the present research, the authors tested the hypothesis that such cognitive examples might in fact exist and be experimentally verifiable. They suggested that human predispositions to learn basic aspects of hunting with relative ease might be “left over” from human evolution in the pre-agricultural past. This hypothesis was tested in 3 experiments with reference to the learning and recall of animal tracks, an activity of probable high adaptive significance within the area of visual memory. Undergraduate students selected at random learned and recalled animal tracks with significantly greater ease than they recalled other animate and inanimate items. A single exception lay in relatively unfamiliar kitchen implements, which were recalled with greater facility than were animal tracks, consistent with current theoretical considerations. Results indicate that direct behavioral holdovers from the ancient world may exist in the cognitive realm and that these may be accessed experimentally and predictably under appropriate conditions.
LytF, a Novel Competence-Regulated Murein Hydrolase in the Genus Streptococcus

ABSTRACT Streptococcus pneumoniae and probably most other members of the genus Streptococcus are competent for natural genetic transformation. During the competent state, S. pneumoniae produces a murein hydrolase, CbpD, that kills and lyses noncompetent pneumococci and closely related species. Previous studies have shown that CbpD is essential for efficient transfer of genomic DNA from noncompetent to competent cells in vitro. Consequently, it has been proposed that CbpD together with the cognate immunity protein ComM constitutes a DNA acquisition mechanism that enables competent pneumococci to capture homologous DNA from closely related streptococci sharing the same habitat. Although genes encoding CbpD homologs or CbpD-related proteins are present in many different streptococcal species, the genomes of a number of streptococci do not encode CbpD-type proteins. In the present study we show that the genomes of nearly all species lacking CbpD encode an unrelated competence-regulated murein hydrolase termed LytF. Using Streptococcus gordonii as a model system, we obtained evidence indicating that LytF is a functional analogue of CbpD. In sum, our results show that a murein hydrolase gene is part of the competence regulon of most or all streptococcal species, demonstrating that these muralytic enzymes constitute an essential part of the streptococcal natural transformation system.
Treatment of advanced renal cell carcinoma with the combination bevacizumab/erlotinib/imatinib: a phase I/II trial.

PURPOSE The aim of this study was to evaluate the efficacy and toxicity of imatinib, a platelet-derived growth factor-beta receptor antagonist, when added to the combination bevacizumab/erlotinib in the treatment of patients with advanced clear cell renal carcinoma. PATIENTS AND METHODS Ninety-four patients with metastatic clear cell renal carcinoma were treated with bevacizumab 10 mg/kg intravenously every 2 weeks, erlotinib 150 mg orally daily, and imatinib 400 mg orally daily. Patients were reevaluated after 8 weeks of treatment; patients with objective response or stable disease (SD) continued to receive treatment until they experienced tumor progression. RESULTS Fifteen of 88 evaluable patients (17%; 95% confidence interval, 10%-26%) had partial responses, whereas an additional 54 patients (61%) had SD. The median progression-free and overall survival for all patients was 8.9 months and 17.2 months, respectively. The addition of imatinib markedly increased toxicity compared with the bevacizumab/erlotinib regimen; the most common grade 3/4 toxicities were diarrhea, rash, and fatigue. CONCLUSION Bevacizumab/erlotinib/imatinib was unacceptably toxic in this group of patients. Inhibition of the PDGF receptor (PDGFR) with imatinib did not appear to improve efficacy compared retrospectively with the results of treatment with bevacizumab/erlotinib. The importance of PDGFR inhibition in the treatment of advanced clear cell renal carcinoma remains unclear. Further development of this particular combination is not planned or recommended.
Spermatic cord torsion: loss of spermatogenesis despite return of blood flow.

Previous work in animal models has recapitulated and refined the clinical observation that longer periods of testicular torsion are associated within increased damage to the testis. Minimum times of damage-inducing torsion have not been established, however, nor has it been established to what degree blood flow returns to the testis on examination several hours or days after the torsion repair. Adult male rats were subjected to 0.5-h or 1.0-h 720 degrees torsion and examined for effects on testis weight, histology, and daily sperm production (DSP). None of the parameters examined were affected by 0.5-h, but all were affected by 1.0-h torsion. In a subsequent experiment, adult rats were subjected to unilateral, 1-h, 720 degrees torsion, and bilateral testicular blood flow as measured by radiolabeled microsphere distribution was determined during torsion and 4 h, 24 h, 2 days, 7 days, 15 days, and 30 days after repair of torsion. Ipsilateral testicular blood flow was reduced 94% during torsion. Blood flow was not significantly different from control or contralateral values by 4 or 24 h after repair of torsion. In spite of this return of blood flow, testis weights were significantly reduced by half by 7 days after torsion repair and spermatogenesis was clearly disrupted upon histological examination 30 days after torsion repair. Increasing the time of torsion to 2 or 4 h did not inhibit return of blood flow to the testis as measured 48 h after torsion repair. Unless the testis is infarcted, testicular blood flow in the rat model returns to normal after torsion repair. (ABSTRACT TRUNCATED AT 250 WORDS)
Ixodes ricinus as a vector of Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti in urban and suburban forests.

In the suburban and urban forests in the cities of Gdansk, Sopot and Gdynia (northern Poland), Ixodes ricinus ticks should be considered as the vector of pathogenic microorganisms that may cause significant diseases in wild and domestic animals and humans. These microorganisms include etiologic agents of Lyme disease, human anaplasmosis (HA) and babesiosis: Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti, respectively. DNA extracts from 701 ticks collected in 15 localities were examined by PCR for the simultaneous detection of these 3 pathogens. Overall, 14 % were infected with A. phagocytophilum followed by 12.4 % with B. burgdorferi s.l. and 2.3 % with B. microti. In total, the percentage of infected females (32.9 %) was 2.4 times higher than in males (13.7 %) and 3.2 times higher than in nymphs (10.3 %). Among adult ticks (n = 303), 8.3 % were dually infected with A. phagocytophilum and B. burgdorferi s.l. , 2.0 % with the agent of human anaplasmosis and B. microti and 0.3 % with borreliae and B. microti.
Asymmetries in the Firm's Use of Debt to Changing Market Values

Using a large sample of U.S. firms over the period, 1984 to 2013, this study examines the relation between market and book leverage ratios. Unlike Welch (2004) who contends that changes in market leverage do not induce adjustments in book leverage, we find an asymmetric effect. That is, firms adjust their book leverage relative to market leverage only when the changes in market leverage are due to increases in the value of the firm's equity. No adjustment is observed when firm equity values decrease. We observe a number of interesting differences between those firms that make large and small capital structure adjustments in response to changing equity prices. Our results are consistent with Barclay, Morellec and Smith (2006) who argue that the optimal level of debt decreases in the presence of corporate growth options.