Miracle-dz/UniFAR-FTUs huggingface dataset:
Pleiotropic Effects With Equivalent Low-density Lipoprotein Cholesterol Reduction: Comparative Study Between Simvastatin and Simvastatin/Ezetimibe Coadministration

Background: Coadministration of any statin with ezetimibe is as effective as using high doses of the same statin in the reduction of low-density lipoprotein cholesterol (LDL-c). There may be other effects called pleiotropics. Objective: To compare the effectiveness of 2 different treatments that obtain equivalent LDL-c reductions (80 mg of simvastatin, once a day and coadministration of 10 mg of simvastatin and 10 mg of ezetimibe, once a day) over endothelial function and inflammation. Methods: Twenty-three randomized patients with hypercholesterolemia in a 2 × 2 crossover protocol were studied. Endothelial function was analyzed by ultrasound assessment of endothelial dependent flow-mediated vasodilation of the brachial artery, and inflammation was estimated by high-sensitivity C-reactive protein (hs-CRP). Results: LDL-c reduction was similar between the 2 treatments with simvastatin/ezetimibe and with simvastatin (P < 0.001); no difference between treatments was found (P = 0.968). Both treatments improved significantly the endothelial function [3.61% with simvastatin/ezetimibe (P = 0.003) and 5.08% with simvastatin (P < 0.001)]; no difference was found between the 2 treatments (P = 0.291). hs-CRP had a 23% reduction with simvastatin/ezetimibe (P = 0.004) and a 30% reduction with simvastatin alone (P = 0.01), with no significant difference between the 2 treatments (P = 0.380). Conclusion: The 2 forms of treatment presented similar pleiotropic effects: improvement in endothelial function and decrease in hs-CRP levels.
Parasites, democratization, and the liberalization of values across contemporary countries

The countries of the world vary in their position along the autocracy–democracy continuum of values. Traditionally, scholars explain this variation as based on resource distribution and disparity among nations. We provide a different framework for understanding the autocracy–democracy dimension and related value dimensions, one that is complementary (not alternative) to the research tradition, but more encompassing, involving both evolutionary (ultimate) and proximate causation of the values. We hypothesize that the variation in values pertaining to autocracy–democracy arises fundamentally out of human (Homo sapiens) species‐typical psychological adaptation that manifests contingently, producing values and associated behaviours that functioned adaptively in human evolutionary history to cope with local levels of infectious diseases. We test this parasite hypothesis of democratization using publicly available data measuring democratization, collectivism–individualism, gender egalitarianism, property rights, sexual restrictiveness, and parasite prevalence across many countries of the world. Parasite prevalence across countries is based on a validated index of the severity of 22 important human diseases. We show that, as the hypothesis predicts, collectivism (hence, conservatism), autocracy, women’s subordination relative to men’s status, and women’s sexual restrictiveness are values that positively covary, and that correspond with high prevalence of infectious disease. Apparently, the psychology of xenophobia and ethnocentrism links these values to avoidance and management of parasites. Also as predicted, we show that the antipoles of each of the above values—individualism (hence, liberalism), democracy, and women’s rights, freedom and increased participation in casual sex—are a positively covarying set of values in countries with relatively low parasite stress.
Consumptive emasculation: the ecological and evolutionary consequences of pollen theft

Many of the diverse animals that consume floral rewards act as efficient pollinators; however, others ‘steal’ rewards without ‘paying’ for them by pollinating. In contrast to the extensive studies of the ecological and evolutionary consequences of nectar theft, pollen theft and its implications remain largely neglected, even though it affects plant reproduction more directly. Here we review existing studies of pollen theft and find that: (1) most pollen thieves pollinate other plant species, suggesting that theft generally arises from a mismatch between the flower and thief that precludes pollen deposition, (2) bees are the most commonly documented pollen thieves, and (3) the floral traits that typically facilitate pollen theft involve either spatial or temporal separation of sex function within flowers (herkogamy and dichogamy, respectively). Given that herkogamy and dichogamy occur commonly and that bees are globally the most important floral visitors, pollen theft is likely a greatly under‐appreciated component of floral ecology and influence on floral evolution. We identify the mechanisms by which pollen theft can affect plant fitness, and review the evidence for theft‐induced ecological effects, including pollen limitation. We then explore the consequences of pollen theft for the evolution of floral traits and sexual systems, and conclude by identifying key directions for future research.
Preconditioning by Subinotropic Doses of Ouabain in the Langendorff perfused Rabbit Heart

Short exposure to low concentrations of digitalis drugs like ouabain protects the rat heart against ischemia/reperfusion injury through the activation of the Na/K-adenosine triphosphatase (ATPase)/Src receptor complex and subsequent stimulation of key intracellular cardioprotective signals. Rat Na/K-ATPase, however, is relatively insensitive to digitalis, and it is not known if similar results could be obtained in species with higher sensitivity. Thus, to determine whether ouabain pretreatment protects against ischemic injury and activates the Na/K-ATPase signaling cascade in a species with cardiac glycoside sensitivity comparable to humans, the present study was conducted in the rabbit model. In Langendorff perfused rabbit hearts, 20-minute exposure to 500-nM ouabain resulted in positive inotropy as evidenced by a significant increase in +dP/dt, and this increase was accompanied by the activation of several well-characterized downstream mediators of the cardiac Na/K-ATPase receptor pathway, including Src, Akt, ERK1/2, and protein kinase Cϵ. A short (4 minutes) administration of a subinotropic dose of ouabain (100 nM) followed by an 8-minute washout before 30 minutes of global ischemia and 120 minutes of reperfusion resulted in protection against cell death, as evidenced by a significant decrease in infarct size. These data indicate that ouabain administration activates the Na/K-ATPase signaling cascade and protects against ischemic injury in a species with high cardiac Na/K-ATPase sensitivity.
Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R 2 = 0.21) and intention (adjusted R 2 = 0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.
Caudal Epidural Steroid Application at Chronic Low Back and Leg Pain: Experience of Fifty Cases and the Analysis of Pain and Satisfaction of the Cases

Background: In this article, we present the results of 50 patients whom we treated with epidural steroid injection, and our experience on the subject. Methods: Fifty patients who were followed in our clinic between January 2011 and August 2011 were assessed retrospectively. These were the patients who had chronic low back and leg pain due to lomber spinal degeneration and for whom operation was not recommended and lomber caudal epidural steroid was applied. Results: In our study, 50 patients having low back pain or leg pain or low back and leg pain together were assessed, and regression at rVAS score of 86% of the patients was detected for a short period after the intervention. VAS scores of 14% of the patients were not different. On long-term follow-up rVAS score analysis of the patients showed regression at 74% of the cases. Conclusion: Caudal steroid injection is a safe and efficient treatment method for the patients who have radicular pain, who do not respond to conservative treatment and for whom surgery is not recommended. Randomized double blind studies are needed to assess its superiority to other conservative methods. J Neurol Res. 2013;3(6):173-178 doi: http://dx.doi. org/10.4021/jnr212w
Reference change values may need some improvement but are invaluable tools in laboratory medicine

We thank Fuentes-Arderiu and colleagues for their thoughtful critique (1) of our strong advocacy of the use of reference change values (RCV) in a recent Mini Review (2) and accompanying Editorial (3) . They are right that the Mini Review has only one paragraph specifi cally devoted to the potential disadvantages of RCV, but the material following did address many of these concerns. Some additional concerns that they have regarding the value of RCV were listed (1) and will be addressed in this response.
Applying stable isotopes to examine food‐web structure: an overview of analytical tools

Stable isotope analysis has emerged as one of the primary means for examining the structure and dynamics of food webs, and numerous analytical approaches are now commonly used in the field. Techniques range from simple, qualitative inferences based on the isotopic niche, to Bayesian mixing models that can be used to characterize food‐web structure at multiple hierarchical levels. We provide a comprehensive review of these techniques, and thus a single reference source to help identify the most useful approaches to apply to a given data set. We structure the review around four general questions: (1) what is the trophic position of an organism in a food web? ; (2) which resource pools support consumers? ; (3) what additional information does relative position of consumers in isotopic space reveal about food‐web structure? ; and (4) what is the degree of trophic variability at the intrapopulation level? For each general question, we detail different approaches that have been applied, discussing the strengths and weaknesses of each. We conclude with a set of suggestions that transcend individual analytical approaches, and provide guidance for future applications in the field.
The structural characteristics of the heart ventricle of the African lungfish Protopterus dolloi: freshwater and aestivation

This paper reports on the structure and ultrastructure of the ventricular myocardium of the African lungfish Protopterus dolloi in freshwater (FW), in aestivation (AE), and after the AE period. The myocardium shows a conventional myofibrillar structure. All the myocytes contain large intracytoplasmic spaces occupied by a pale material that could contain glycosaminoglycans and/or glycogen, which may be used as food and water reservoirs. In FW, the myocytes in the trabeculae associated with the free ventricular wall show structural signs of low transcriptional and metabolic activity (heterochromatin, mitochondria of the dense type). These signs are partially reversed during the AE period (euchromatin, mitochondria with a light matrix), with a return to the FW appearance after arousal. The myocytes in the septum show, in FW conditions, nuclear polymorphism (heterochromatin, euchromatin), and two types (colliquative and coagulative) of necrosis. In AE, all the septal myocytes show euchromatin, and the number of necrotic cells increases greatly. Cell necrosis appears to be related to the septal architecture. After arousal, the septal myocytes exhibit a heterochromatin pattern, the number of necrotic cells decreases, cell debris accumulates under the endocardium, and phagocytosis takes place. Despite being a morphologic continuum, the trabeculae associated with the free ventricular wall appear to constitute a different compartment from that formed by the trabeculae in the ventricular septum. Paradoxically, AE appears to trigger an increase in transcriptional and synthetic myocardial activities, especially at the level of the ventricular septum. This activity may be involved in mechanisms of autocrine/paracrine regulation. Aestivation cannot be regarded as the result of a general depression of all cellular and organic activities. Rather, it is a much more complex state in which the interplay between upregulation and downregulation of diverse cell activities appears to play a fundamental role.
Effects of a prevention program for divorced families on youth cortisol reactivity 15 years later

Objective: We examined whether an empirically based, randomised controlled trial of a preventive intervention for divorced mothers and children had a long-term impact on offspring cortisol regulation. Design: Divorced mothers and children (age 9–12) were randomly assigned to a literature control condition or the 11-week New Beginnings Program, a family-focused group preventive intervention for mothers and children in newly divorced families. Main Outcome Measures: Fifteen years after the trial, offspring salivary cortisol (n = 161) was measured before and after a social stress task. Results: Multilevel mixed models were used to predict cortisol from internalizing symptoms, externalizing symptoms, group assignment and potential moderators of intervention effects. Across the sample, higher externalizing symptoms were associated with lower cortisol reactivity. There was a significant group-by-age interaction such that older offspring in the control group had higher reactivity relative to the intervention group, and younger offspring in the control group exhibited a decline across the task relative to younger offspring in the intervention group. Conclusions: Preventive interventions for youth from divorced families may have a long-term impact on cortisol reactivity to stress. Results highlight the importance of examining moderators of program effects.
Is There a Relationship Between Fibromyalgia Syndrome and Work Conditions?

Objectives: This study examines the initial course of the fibromyalgia syndrome [FMS] and the influence of physical and psychosocial workplace factors on developing FMS. Methods: Patients with FMS were recruited to participate in a structured interview about pain and physical and psychosocial load. In addition, they participated in a clinical examination. Physical load in occupational life was assessed by two validated indices relevant for risk evaluation of pain in the upper extremities and the neck. Results: Of the 116 female FMS patients [25–45 years] recruited, 64 agreed to participate. Seventy percent of the participants noted that their pain started out as localized pain. The neck [52 percent], the shoulders [45 percent], and the low back [28 percent] were the regions most frequently engaged. The localized pain worsened to widespread pain [median six years after start of pain]. For the 71 percent of the participants who were working at the onset of pain, the onset occurred after eight occupationally active years. They scored relatively high on the validated measures of physical load for the employment period, including the time for onset of pain. To a higher degree, the FMS patients had heavy and light repetitive work compared to the age-matched women from the same geographic area. The odds ratio affected by FMS when occupied in heavy or light repetitive work was 5.1 [95 percent CI: 3.4–7.7] compared to subjects occupied in administration, computer work, or medium heavy variable work-tasks. Conclusions: Job strain and strenuous events were more common in the FMS group than in the control group. The majority of FMS patients had been exposed to a substantially risky physical workload. Hence, we consider physical workload as an important risk factor for localized pain and for FMS. Occurrence of job strain probably enhances the risk for the development of FMS. The frequently reported strenuous events might have contributed to spreading localized pain.
Facial asymmetry in young healthy subjects evaluated by statistical shape analysis

Statistical shape analysis, a relatively a new method for biological research, compares body forms by using specific landmarks determined by anatomical prominences. In this study, we aimed to identify normal facial asymmetry between the right and the left sides of the face. Facial landmark data were collected from two‐dimensional digital images of 321 young healthy subjects (150 males and 171 females). These data were analysed using Euclidean distance matrix analysis. The number of significantly asymmetric linear distances between the two halves of the face was greater in females than in males. We found that the left side of the face was most commonly dominant in both males and females. Such data may be useful in establishing a database for future similar studies.
Predicting sun-protective intentions and behaviours using the theory of planned behaviour: a systematic review and meta-analysis

Objective: To synthesise theory of planned behaviour (TPB) relationships, using meta-analysis, and test the predictive utility of the model for sun protection behaviour. Design: Thirty-eight samples were identified via database/manual searches and academic society posts based on the criteria: measuring sun-protective intentions and/or prospective behaviour; using the TPB/theory of reasoned action as a basis of measurement; and providing bivariate correlations for at least one relevant TPB association. Main outcome measures: Sun-protective intentions and behaviours. Results: The sample-weighted average effects were moderate-to-strong with attitudes showing the strongest association with intention (r+ = 0.494), followed by perceived behavioural control (PBC; r+ = 0.451), and subjective norm (r+ = 0.419). Intentions showed a stronger association with prospective behaviour (r+ = 0.486) compared to PBC (r+ = 0.314). A total of 39% of variance in intentions and 25% of variance in behaviour were explained. Publication bias was not evident. Moderator analyses showed that TPB associations were stronger when measures specified the Target, Action, Context and Time; in non-student samples; and when follow-up exceeded two weeks. Conclusion: Despite recent criticism, this review shows that the TPB explains a large amount of variance in sun protection and that TPB associations are robust across different populations.
Flecainide-Induced Proarrhythmia Is Attributed to Abnormal Changes in Repolarization and Refractoriness in Perfused Guinea-Pig Heart

Abstract: Flecainide is nonselective Na+ channel blocker which may also inhibit IKr, the rapid component of the delayed rectifier. This study was designed to explore if proarrhythmic responses to flecainide noted in cardiac patients may be partly attributed to abnormal changes in repolarization and refractoriness. Monophasic action potential duration (APD) and effective refractory periods (ERP) were assessed at distinct epicardial and endocardial sites along with volume-conducted ECG recordings in isolated perfused guinea-pig heart preparations. Flecainide was found to prolong ventricular repolarization, with effect being greater at the left ventricular compared with the right ventricular epicardium. This change translated to reversal of the normal right ventricular-to-left ventricular transepicardial APD difference determined before drug infusion. An inverse correlation between local epicardial APD and corresponding activation time values seen at baseline was eliminated in flecainide-treated hearts, indicating the activation-to-repolarization uncoupling. Over transmural plane, flecainide produced a greater ERP lengthening at endocardium than epicardium, thus markedly increasing ERP dispersion across ventricular wall. Spontaneous short-lasting episodes of monomorphic ventricular tachycardia were observed in 45% of heart preparations upon flecainide infusion. In conclusion, in nonischemic guinea-pig heart, flecainide-induced proarrhythmia may be partly attributed to abnormal spatial gradients in repolarization and refractoriness and impaired transepicardial activation-to-repolarization coupling.
A discourse of silence: professional carers reasoning about death and dying in nursing homes

ABSTRACT Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.
Clark, et al, reply

To the Editor: We read with interest Dr. Carp’s comments regarding the HepASA trial. The questions he raises about our inclusion criteria and conclusions are those that have surrounded therapeutic trials for recurrent pregnancy loss (RPL) with or without antiphospholipid antibodies (aPL) for decades. Dr. Carp suggests that stratification for this patient population should include age and number of previous losses. The issue of evaluating and treating women with a history of 2 versus 3 losses continues to be debated, and evidence supporting both contentions is available and used by investigators according to their convictions. As noted, we and others have observed that causes of RPL are similar in women with 2 or 3 losses1,2. Brigham, et al , in a longitudinal study of 325 patients with idiopathic RPL, found that women with a history of 2 versus 3 previous losses had the same chances of success in a subsequent pregnancy (76% vs 79%)3. Intuitively, therefore, if, in … Address correspondence to C. Clark; E-mail: cclarksolo{at}aol.com