Miracle-dz/UniFAR-FTUs huggingface dataset:
CLINICAL PRACTICE Irritable bowel syndrome: Diagnosis and pathogenesis

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastroscopy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifacto-rial, with the following factors playing a central role in the pathogenesis of IBS: heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following: genetic factors, dietary intake, intestinal flora, or low-grade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI- and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.
Cerebrospinal fluid biomarkers and rate of cognitive decline in very mild dementia of the Alzheimer type.

BACKGROUND Cerebrospinal fluid (CSF) levels of Abeta peptide 1-42 (Abeta 42), tau, and phosphorylated tau (ptau) are potential biomarkers of Alzheimer disease. OBJECTIVE To determine whether Abeta 42, tau, and ptau predict the rate of cognitive change in individuals with very mild dementia of the Alzheimer type (DAT). DESIGN Retrospective analysis of CSF biomarkers and clinical data. SETTING An academic Alzheimer disease research center. PARTICIPANTS Research volunteers in a longitudinal study of aging and cognition. Participants (n = 49) had a clinical diagnosis of very mild DAT with a Clinical Dementia Rating (CDR) of 0.5 at the time of lumbar puncture. All the participants had at least 1 follow-up assessment (mean [SD] follow-up, 3.5 [1.8] years). MAIN OUTCOME MEASURES Baseline CSF levels of Abeta 42, Abeta 40, tau, and ptau at threonine 181 (ptau181) and the rate of dementia progression as measured using the CDR sum of boxes (CDR-SB) score and psychometric performance. RESULTS The rate of dementia progression was significantly more rapid in individuals with lower baseline CSF Abeta 42 levels, higher tau or ptau181 levels, or high tau: Abeta 42 ratios. For example, the annual change in the CDR-SB score was 1.1 for the lowest 2 tertiles of Abeta 42 values and 0.3 for the highest tertile of Abeta 42 values. CONCLUSIONS In individuals with very mild DAT, lower CSF Abeta 42 levels, high tau or ptau181 levels, or high tau:Abeta 42 ratios quantitatively predict more rapid progression of cognitive deficits and dementia. Biomarkers of CSF may be useful prognostically and to identify individuals who are more likely to progress for participation in therapeutic clinical trials.
Multisite study of an evidence-based practice to reduce seclusion and restraint in psychiatric inpatient facilities.

OBJECTIVE This federally funded study examined implementation and outcomes of the Six Core Strategies for Reduction of Seclusion and Restraint (6CS) in 43 inpatient psychiatric facilities. METHODS A prototype Inventory of Seclusion and Restraint Reduction Interventions (ISRRI) tracked fidelity over time. Outcome measures--seclusion and restraint events as percentages of total inpatient population and seclusion and restraint hours as percentages of total inpatient hours--conformed to licensed Behavioral Health Performance Measurement System specifications. Independent variables were facility and patient characteristics. Facilities were classified into five implementation types based on ISRRI scores: stabilized (N=28), continued (N=7), decreased (N=5), discontinued (N=1), or never implemented (N=2). For the stabilized group, linear modeling and random-effects meta-analysis compared the contribution of individual facilities to an overall effect. Subgroup analyses explored relationships between facility characteristics and outcomes. Dose-effect analysis tested the hypothesis that the stabilized group would have more positive outcomes. RESULTS Overall, the stabilized group reduced the percentage secluded by 17% (p=.002), seclusion hours by 19% (p=.001), and proportion restrained by 30% (p=.03). The reduction in restraint hours was 55% but nonsignificant (p=.08). Individual facility effect sizes varied; some rates increased for some facilities. The dose-effect hypothesis was supported for two outcomes, seclusion hours and percentage restrained. The order of implementation group effects in relation to each outcome varied unpredictably. CONCLUSIONS The 6CS was feasible to implement and effective in diverse facility types. Fidelity over time was nonlinear and varied among facilities. Further research on relationships between facility characteristics, fidelity patterns, and outcomes is needed.
Reasons for lapse: the case of face-to-face donors

Face-to-face fundraising is attracting increasingly hostile media coverage in the United Kingdom in the run up to the publication of the Charities Act in 2004. Despite the antipathy comparatively little is known about how donors view this technique and why they might elect to terminate their support having been recruited by this medium. This paper reports the results of a survey of 4,800 face-to-face recruits, comparing the attitudes and profiles of both active and lapsed supporters. The results suggest that donors exhibit high levels of satisfaction with the recruitment process and lapse primarily because of a change in their financial circumstances rather than feelings of having being pressurised to offer their support. Copyright © 2004 Henry Stewart Publications
Labour Market Slack in the UK

Given the recent unexpectedly rapid fall in the unemployment rate, the extent of labour market slack in the UK economy is an important issue for policymakers, particularly the Bank of England’s Monetary Policy Committee (MPC). However, in our view, the MPC is arbitrarily reducing its estimate of the impact of two important components of labour market slack, risking damaging mistakes in the formulation of monetary policy. The first is long-term unemployment and the second is underemployment. In each case the MPC has explained these adjustments in a box in its May 2014 Inflation Report called ‘Assessing the degree of spare capacity’. The purpose of this article is to explain why we think the MPC’s approach is incorrect.
Roles of transmembrane domain 2 and the first intracellular loop in human noradrenaline transporter function: pharmacological and SCAM analysis

The aim was to investigate the roles of transmembrane domain 2 and the adjacent region of the first intracellular loop in determining human noradrenaline transporter (hNET) function by pharmacological and substituted‐cysteine accessibility method (SCAM) analyses. It was first necessary to establish a suitable background NET for SCAM. Alanine mutants of endogenous hNET cysteines, hC86A, hC131A and hC339A, were examined and showed no marked effects on expression or function. hNET and the mutants were also resistant to methanethiosulfonate (MTS), ethylammonium (MTSEA) and MTStrimethylammonium (MTSET). Hence, wild‐type hNET is an appropriate background for production of cysteine mutants for SCAM. Pharmacological investigation showed that all mutants except hT99C and hL109C showed reduced cell‐surface expression, while all except hM107C showed a reduction in functional activity. The mutations did not markedly affect the apparent affinities of substrates, but apparent affinities of cocaine were decreased 7‐fold for hP97C and 10‐fold for hF101C and increased 12‐fold for hY98C. [3H]Nisoxetine binding affinities were decreased 13‐fold for hP97C and 5‐fold for hF101C. SCAM analysis revealed that only hL102C was sensitive to 1.25 mm MTSEA, and this sensitivity was protected by noradrenaline, nisoxetine and cocaine. The results suggest that this region of hNET is important for interactions with antidepressants and cocaine, but it is probably not involved in substrate translocation mechanisms.
Periodontal disease decreases insulin sensitivity and insulin signaling.

BACKGROUND The purpose of this study is to investigate whether local inflammatory events, such as periodontal disease, are able to increase tumor necrosis factor-alpha (TNF-α) plasmatic concentration and decrease insulin sensitivity and insulin signaling in non-diabetic rats. METHODS Forty-eight male Wistar rats (2 months old) were divided into two groups, with either ligature-induced periodontal disease (LPD) or control conditions (CN). Experiments were performed in both groups 28 days after ligature placement. Plasmatic concentration of glycemia and TNF-α (n = 10) were analyzed by the glucose oxidase and enzyme-linked immunosorbent assay method, respectively. Insulin sensitivity (n = 7) was measured using the insulin tolerance test. Insulin signal transduction (n = 7) was measured by pp185 tyrosine phosphorylation status in insulin-sensitive tissues using the Western blotting method. RESULTS The LPD group showed decreased insulin sensitivity (P <0.05), although no glycemic alterations were noted (P >0.05). TNF-α plasmatic concentration was higher in LPD rats compared to CN rats. In addition, a decrease in the pp185 tyrosine phosphorylation status was observed after insulin stimulus in both white adipose and skeletal muscle tissues of the LPD group compared with the CN group. CONCLUSIONS LPD is able to cause alterations to both insulin signaling and insulin sensitivity, probably because of the elevation of TNF-α plasmatic concentration. Thus, the present results emphasize the importance of the prevention of local inflammatory diseases, such as periodontitis, to prevent diabetes mellitus.
Feasibility and effects of a home-care rehabilitation program in patients with chronic obstructive pulmonary disease.

PURPOSE Pulmonary rehabilitation programs often show beneficial effects in patients with chronic obstructive pulmonary disease (COPD). These programs are usually hospital-based. This study assesses the feasibility and application of a 12-week Home-Care Rehabilitation Program (HCRP), carried out by general practitioners, physiotherapists, and home-care nurses. METHODS Effects of the HCRP are assessed in 15 COPD patients with moderate to severe airflow limitation (inspiratory vital capacity [IVC]: mean, 75.4 [SD, 13.7] percent predicted, mean FEV1: 45.5 [6.9] percent predicted) and are compared with a stratified and randomized control group (n = 15). RESULTS All participating disciplines judged the program to be useful and feasible. Patient compliance with the rehabilitation exercises was high. No major problems concerning the rehabilitation program were reported. After the HCRP, 4-minute walking distance improved significantly from 274 m [61] to 301 m [72] and maximal work load (W max), as measured during an incremental cycle test, increased from 75.3 W [24] to 85.3 W [28]. At equal work levels (W submax) during the cycle test both Borg dyspnea and leg effort scores decreased significantly after the HCRP (6.7 [1.3] versus 4.9 [1.7] and 4.2 [2.0] versus 1.7 [2.5], respectively). Changes in walking distance, dyspnea, and leg effort scores at W submax were significantly different between the two groups. IVC and FEV1 did not change significantly. In the control group, no significant changes in any parameter were observed. CONCLUSION It was possible to design and perform successfully a home-care rehabilitation program, providing both objective and subjective improvements in a group of patients with COPD. A home-care rehabilitation program appears to be a valuable component in the management of COPD patients with a moderate to severe airflow limitation.
Psychosocial differences between whites and African Americans living with HIV/AIDS in rural areas of 13 US states.

CONTEXT Acquired immunodeficiency syndrome (AIDS) prevalence rates are increasing rapidly in rural areas of the United States. As rural African Americans are increasingly affected by human immunodeficiency virus (HIV), it is important to identify psychosocial factors unique to this group so that AIDS mental health interventions can be culturally contextualized to meet their unique needs. PURPOSE The current study characterized psychosocial functioning in 43 rural African Americans living with HIV/AIDS and compared their levels of functioning to those of 196 HIV-infected rural white persons. METHODS All participants were recruited through AIDS service organizations in 13 US states. Surveys were completed as part of a preintervention phase of a randomized clinical trial evaluating 2 mental health interventions for HIV-infected rural persons. FINDINGS Compared to their white counterparts, fewer African Americans had progressed to AIDS. African American participants also reported higher levels of coping self-efficacy, more support from family members, and marginally fewer depressive symptoms, and they engaged in more active coping. African Americans who had greater HIV disease severity also received less support from family members and experienced more loneliness. CONCLUSIONS Study findings caution that rural African Americans and whites living with HIV disease should not be considered a homogeneous group.
Interobserver Variability for the WHO Classification of Pulmonary Carcinoids

Pulmonary carcinoids are neuroendocrine tumors histopathologically subclassified into typical (TC; no necrosis, <2 mitoses per 2 mm2) and atypical (AC; necrosis or 2 to 10 mitoses per 2 mm2). The reproducibility of lung carcinoid classification, however, has not been extensively studied and may be hampered by the presence of pyknotic apoptosis mimicking mitotic figures. Furthermore, prediction of prognosis based on histopathology varies, especially for ACs. We examined the presence of interobserver variation between 5 experienced pulmonary pathologists who reviewed 123 originally diagnosed pulmonary carcinoid cases. The tumors were subsequently redistributed over 3 groups: unanimously classified cases, consensus cases (4/5 pathologists rendered identical diagnosis), and disagreement cases (divergent diagnosis by ≥2 assessors). &kgr;-values were calculated, and results were correlated with clinical follow-up and molecular data. When focusing on the 114/123 cases unanimously classified as pulmonary carcinoids, the interobserver agreement was only fair (&kgr;=0.32). Of these 114 cases, 55% were unanimously classified, 25% reached consensus classification, and for 19% there was no consensus. ACs were significantly more often in the latter category (P=0.00038). The designation of TCs and ACs by ≥3 assessors was not associated with prognosis (P=0.11). However, when disagreement cases were allocated on the basis of Ki-67 proliferative index (<5%; ≥5%) or nuclear orthopedia homeobox immunostaining (+; −), correlation with prognosis improved significantly (P=0.00040 and 0.0024, respectively). In conclusion, there is a considerable interobserver variation in the histopathologic classification of lung carcinoids, in particular concerning ACs. Additional immunomarkers such as Ki-67 or orthopedia homeobox may improve classification and prediction of prognosis.
Antimicrobial Resistance among Respiratory Pathogens in Spain: Latest Data and Changes over 11 Years (1996-1997 to 2006-2007)

ABSTRACT A nationwide multicenter susceptibility surveillance study (Susceptibility to the Antimicrobials Used in the Community in España [SAUCE] project), SAUCE-4, including 2,559 Streptococcus pneumoniae, 2,287 Streptococcus pyogenes, and 2,736 Haemophilus influenzae isolates was carried out from May 2006 to June 2007 in 34 Spanish hospitals. Then, the results from SAUCE-4 were compared to those from all three previous SAUCE studies carried out in 1996-1997, 1998-1999, and 2001-2002 to assess the temporal trends in resistance and the phenotypes of resistance over the 11-year period. In SAUCE-4, on the basis of the CLSI breakpoints, penicillin (parenteral, nonmeningitis breakpoint) and cefotaxime were the antimicrobials that were the most active against S. pneumoniae (99.8% and 99.6%, respectively). Only 0.9% of isolates had a penicillin MIC of ≥2 μg/ml. In S. pyogenes, nonsusceptibility to erythromycin was observed in 19.4% of isolates. Among the H. influenzae isolates, a β-lactamase-positive prevalence of 15.7% was found. A statistically significant temporal decreasing trend over the 11-year period was observed for nonsusceptibility (from 60.0% to 22.9%) and resistance (from 36.5% to 0.9%) to penicillin and for the proportion of erythromycin-resistant isolates of S. pneumoniae of the macrolide-lincosamide-streptogramin B (MLSB) phenotype (from 98.4% to 81.3%). A similar trend was observed for the prevalence of ampicillin resistance (from 37.6% to 16.1%), β-lactamase production (from 25.7% to 15.7%), and β-lactamase-negative ampicillin resistance (BLNAR) in H. influenzae (from 13.5% to 0.7%). Among erythromycin-resistant isolates of S. pyogenes, a significant increasing trend in the prevalence of MLSB was observed (from 7.0% to 35.5%). SAUCE-4 confirms a generalized decline in the resistance of the main respiratory pathogens to the antimicrobials as well as a shift in their resistance phenotypes.
Three essays on corporate control

This paper explores whether ownership matters in a fundamental sense by comparing the performance of stockholder-owned firms to the much less analyzed nonprofit firms. No stakeholder has residual cash flow rights in nonprofit firms, and the control rights are held by customers, employees, and the community. Accounting for differences in size and risk and only comparing firms within the same industry, we find that stockholder-owned firms do not outperform nonprofits. This result is consistent with the notion that the governance function of residual claimants may be successfully replaced by other mechanisms. We find evidence that product market competition plays this role as a substitute disciplining device.
Untangling the Knot in Diabetic Nephropathy: The Unanticipated Role of Glycocalyx in the Antiproteinuric Effect of Endothelin Receptor Antagonists

Diabetes is a devastating disease that is imposing itself as one of the largest health emergencies of the 21st century, and high blood glucose is the third-highest risk factor for premature mortality (1). In 2015, almost 5 million people aged 20–79 years died from diabetes and its related complications, which accounted for almost 15% of the overall causes of mortality among people in this age-group (1). With no effective prevention and management programs, the incidence of diabetes and its complications is dramatically increasing worldwide, imposing a substantial impact on the economy. Diabetic nephropathy (DN) affects 30–40% of patients with diabetes (2) and induces a progressive deterioration of renal function. Albuminuria independently associates with increased vascular mortality and morbidity in patients with diabetes (3), in patients with hypertension (4), and in the general population (5), and therefore is not only a sign of renal impairment and a key pathogenic element of renal disease progression but also a marker of more generalized vascular damage. Many studies have linked albuminuria with cardiovascular disease (CVD). A linear relationship was observed between albumin excretion and CVD risk (6), but the exact significance and mechanism of such a relationship are not yet understood. Microalbuminuria not only denotes renal capillary damage but also represents an early biological marker of vascular injury (7). Endothelial dysfunction has been implicated …
Prevalence of Tuberculin Reactivity Among Healthcare Workers from a Mexican Hospital

Abstract: The prevalence of tuberculosis (TB) infection in healthcare workers (HCWs) is completely unknown in Mexico. To evaluate the frequency of TB infection in our hospital, we performed a prevalence study of tuberculin reactivity among a random sample of asymptomatic HCWs. Our results showed an extremely high prevalence of PPD reactivity (70%) among 175 HCWs, probably related to the high incidence of active TB in the general population and to the absence of preventive programs.
GATA-6 Activates Transcription of Surfactant Protein A*

Surfactant protein A (SP-A) is a member of the collectin family of innate host defense molecules expressed primarily in respiratory epithelial cells of the lung. SP-A concentrations are influenced by both cell-specific and ubiquitous nuclear proteins that regulate SP-A gene transcription in a cell-selective and temporally regulated manner. In this work, a consensus GATA-binding site (GBS) was identified at positions −69 to −64 of the mouse SP-A gene. The transcriptional activity of wild-type SP-A reporter constructs in HeLa cells was increased 5–10-fold when cotransfected with a GATA-6 expression plasmid. Deletion of the GBS completely blocked transactivation by GATA-6. Transfection of a construct expressing GATA-6-engrailed fusion protein inhibited basal expression of the SP-A/chloramphenicol acetyltransferase construct in MLE-15 cells. Nuclear extract proteins from MLE-15 cells bound to the GBS in the mouse SP-A gene, and a supershifted band was detected with a GATA-6-specific antibody. Transactivation of the wild-type SP-A constructs by GATA-6 increased transcriptional activity 7–10-fold, whereas thyroid transcription factor-1 (TTF-1) increased the activity of these constructs 12–18-fold. The effects of cotransactivating with both GATA-6 and TTF-1 expression constructs were additive. However, mutation of the TTF-1-binding sites alone or in combination decreased GATA-6 transactivation. Likewise, mutation of the GBS blocked TTF-1 activation of the SP-A promoter. In situ hybridization demonstrated GATA-6 mRNA in the peripheral epithelial cells of fetal mouse lung, consistent with the sites of SP-A expression. GATA-6 is expressed in respiratory epithelial cells and binds to acis-acting element in the SP-A gene promoter, activating the transcriptional activity of the gene.
Roles of Different Sources of Social Support on Caries Experience and Caries Increment in Adolescents of East London

Evidence on the contribution of social support to oral health is scarce. We first explored the association of social support with caries experience and the relative roles of support from family, friends and a special person on caries experience in 15–16-year-old adolescents. We then explored whether social support at 11–12 years of age predicts caries increment in second permanent molars over 4 years and the relative roles of different sources of support on 4-year caries increment. Data from phases 1 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents in East London, were used for cross-sectional (phase 3) and longitudinal analyses (phases 1 and 3). Data were collected by questionnaires including the same questions on demographic characteristics, socioeconomic measures and the Multidimensional Scale of Perceived Social Support at phases 1 and 3. A questionnaire section on dental behaviours and an oral clinical examination were also included in phase 3. Social support was negatively related to both caries experience and increment independently of demographic characteristics, socioeconomic measures and dental behaviours. Furthermore, only support from a special person was significantly related to caries experience and increment in unadjusted and adjusted regression models. In conclusion, adolescents who perceived higher levels of social support had lower caries experience and increment. However, support from a special person was more relevant for these adolescents than support from family and peers.