Miracle-dz/UniFAR-FTUs huggingface dataset:
Cognitive Emotion Regulation Strategies in Chinese Adolescents with Overweight and Obesity.

BACKGROUND The relationship between psychological factors and obesity has become a hot topic in psychosomatic research. The aim of this study was to examine the characteristics of cognitive emotion regulation (CER) strategies in Chinese adolescents with different weight status. METHODS Using stratified random cluster sampling, 700 and 321 adolescents were defined as adolescents with overweight status and obese status, respectively. One thousand and twenty-one adolescents with normal-weight status were also selected. All participants completed a general questionnaire and Chinese version of the Cognitive Emotion Regulation Questionnaire. RESULTS Adolescents in the obesity group obtained the highest scores on self-blame and rumination in three groups, and those from the obesity group obtained lower scores on acceptance, positive refocusing, and positive reappraisal than those from normal group (ps < 0.05). Cognitive emotion regulation strategies had a significant impact on BMI, accounting for 32.0% variance (p < 0.001). Higher scores on self-blame and rumination were associated with higher BMI, but greater acceptance and positive refocusing were associated with lower BMI (ps < 0.05). CONCLUSION Self-blame, rumination, acceptance, and positive refocusing have considerable effects on BMI in Chinese adolescents. The causal relationship of CER strategies and BMI should be explained more accurately and thoroughly to prevent and intervene in cases of adolescent obesity.
Preliminary analysis of mortality associated with rituximab use in autoimmune diseases

Abstract Normal antibodies and pathogenic autoantibodies are produced by B-cells and plasma cells. Rituximab is a chimeric monoclonal antibody that targets the CD20 molecule on cells that express them on their surface and kills them. Rituximab has been increasingly used to treat several autoimmune diseases. Studies on fatal outcomes associated with rituximab therapy are lacking. A comprehensive and detailed analysis in which the multiple factors that could contribute to a fatal outcome in all the autoimmune diseases in which rituximab has been used would be cumbersome, lack uniformity and would prove difficult in making certain definitive conclusions and comparisons, but more importantly it would not allow to provide specific precautions and recommendations to prevent mortality. Hence, autoimmune mucocutaneous blistering diseases (AMBD) were used as model to study fatal outcomes in patients treated with rituximab between 2000 and 2013, using uniform 13 criteria. Fatal outcomes were found in 14 patients with autoimmune blistering diseases out of 134 patients (10.4%). Patients died due to infections (75%), gastrointestinal (17%) and cardiac events (8%). Causes of death were reported in 101 patients with other autoimmune diseases out of 4320 with a mortality rate of 2.4%. Among them, 44 patients (43.6%) died from infections. A statistical analysis of the data demonstrated that a statistically significant higher mortality rate was observed in patients with AMBD compared to patients with other autoimmune diseases. Similarly, a statistically significant higher rate of death due to infections was reported in patients with AMBD compared to patients with other autoimmune diseases. Use of systemic corticosteroids and immunosuppressive agents as concomitant therapy with rituximab enhanced immunosuppression. In many patients, B-cells were depleted for prolonged periods, even after clinical recovery was observed. Although its main action is depletion of B-cells, rituximab has a significant impact on the immune and inflammatory systems, directly and indirectly and thus enhances susceptibility to infection. These preliminary data suggests that physicians using rituximab to treat autoimmune diseases should monitor their patients closely, especially their B-cell levels until they return to normal, be vigilant for possible sources of infection, and be aware of potential fatal outcomes.
Polimedicación en pacientes adultos con dolencias crónicas en un centro de salud

OBJETIVOS: Conocer la cuantia de la polimedicacion (toma de 5 o mas medicaciones diferentes diariamente) en nuestra poblacion y como identifican los farmacos, recuerdan su posologia, a que patologia estan destinados y quien inicio la prescripcion. DISENO: Transversal descriptivo PARTICIPANTES: El criterio de inclusion era ser adulto y seguir medicacion de forma cronica (>1mes), excluidos pacientes con medicaciones para procesos agudos, inyectables y si los cuidadores eran profesionales sanitarios. Encuestas realizadas en el primer semestre 2007. MEDICIONES PRINCIPALES: Edad, sexo, nivel de estudios, autoadministracion, prevalencia de polimedicacion, ? que medicamentos tomaba? , ? como los identificaba? , ? sabia para que enfermedad eran? , ? como recordaban su posologia? , y ? quien se lo habia prescrito? RESULTADOS: Edad media de 58,9 +/-14,9 anos y mediana 70 anos. Se auto-administraba la medicacion el 83,9%. La polimedicacion era del 38,8%, siendo del 49,5% en =65anos y del 20,5% en el resto (p<0,001). La identificacion de farmaco con la enfermedad destinada era 86,4%; 94,1% en <65 anos y 81,5% en =65 (p=0,041). La posologia la recordaban de memoria el 79%. El 52,6% de las prescripciones fueron iniciadas en atencion especializada. CONCLUSIONES: La polimedicacion en nuestra poblacion es alta. Los =65 anos y los pacientes de bajo nivel instructivo son los que mas usan medidas de apoyo para el control del uso de la medicacion. Deberiamos reforzar su educacion sanitaria, aprovechando para esta la labor de otros profesionales sanitarios.
Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: the Postoperative Radiation Therapy in Endometrial Carcinoma Trial.

PURPOSE Stage IC, grade 3 endometrial cancer is regarded as a high-risk category. Stage IC, grade 3 patients were not eligible for the randomized Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial, but were registered and received postoperative radiotherapy. PATIENTS AND METHODS The PORTEC trial included 715 patients with stage IC, grade 1 or 2, and stage IB, grade 2 or 3 endometrial cancer. Patients were randomly assigned after surgery to receive pelvic radiotherapy (RT) or no further treatment. A total of 104 patients with stage IC, grade 3 endometrial cancer were registered, of whom 99 could be evaluated. Patterns of relapse and survival were compared with PORTEC patients receiving RT. Median follow-up was 83 months. RESULTS The actuarial 5-year rates of locoregional relapse were 1% to 3% for PORTEC patients who received RT, compared with 14% for stage IC, grade 3 patients. Five-year distant metastases rates were 3% to 8% for grade 1 and 2 tumors; 20% for stage IB, grade 3 tumors; and 31% for stage IC, grade 3 tumors. Overall survival rates were 83% to 85% for grades 1 and 2; 74% for stage IB, grade 3; and 58% for stage IC, grade 3 patients (P <.001). In multivariate analysis grade 3 was the most important adverse prognostic factor for relapse and death as a result of endometrial cancer (hazard ratios, 5.4 and 5.5; P <.0001). CONCLUSION Patients with stage IC, grade 3 endometrial carcinoma are at high risk of early distant spread and endometrial carcinoma-related death. Novel strategies for adjuvant therapy should be explored to improve survival for this patient group.
Dominant, non‐MHC genetic control of food allergy in an adjuvant‐free mouse model

Food allergy is a potentially fatal immune‐mediated disorder with incompletely understood mechanisms. We studied the genetic control of food allergy using major histocompatibility complex‐identical mice (H2s) and an adjuvant‐free method of sensitization. Whereas, transdermal exposure to hazelnut — a model allergenic food, elicited robust IgG1 response in both strains, an IgE response was evident only in A.SW mice. Following oral challenge, only A.SW but not SJL mice exhibited signs of systemic anaphylaxis and hypothermia. In addition, (A.SW × SJL) F1 hybrids exhibited IgE responsiveness, systemic anaphylaxis and hypothermia similar to A.SW, indicating dominant inheritance of these traits. Furthermore, whereas A.SW and F1 mice but not SJL elicited robust interleukin (IL)‐4 response, all three strains elicited IL‐5 and IL‐13 responses by spleen cells. These data demonstrate for the first time, dominant non‐MHC genetic control of food allergy and a critical role of IL‐4 but not IL‐5 or IL‐13 in this model.
Head and Neck Squamous Cell Carcinoma Cell Line-Induced Suppression of in vitro Lymphocyte Proliferative Responses

Tumour-infiltrating lymphocytes (TILS) are often difficult to expand in vitro. In some cases this has been attributable to immunosuppression mediated by the elaboration of prostaglandins by either tumor cells or tumor-infiltrating monocytes. In this laboratory, freshly prepared TILs containing single-cell suspensions of head and neck tumors displayed both poor proliferation as well as minimal responsiveness to indomethacin-mediated reversal of immunosuppression. In order to investigate tumor-mediated immunosuppression further, a system was developed whereby a new cell line of head and neck squamous cell carcinoma was used to suppress allogeneic peripheral blood mononuclear cell proliferation in response to phytohemagglutinin (PHA) and interieukin-2 (IL-2). Tumor cells were able to suppress peripheral blood mononuclear cell (PBMNC) proliferation up to 95%. This suppressive effect was dependent on tumor cell number and was reversible by the use of higher concentrations of PHA, but not by increased concentrations of IL-2. Suppression was immediate when IL-2 was used as the stimulus for proliferation, but required extended lymphocyte/tumor cell contact when PHA was used. Flow cytometric analysis of tumor-exposed and PHA-stimulated PBMNCs revealed a decrease in both the number of cells expressing IL-2 receptors as well as the density of IL-2 receptors per cell. This pattern of suppression, as well as the reversibility of suppression by indomethacin, implicates prostaglandins in the mechanisms by which these tumor cells mediate immunosuppression.
Objective low-frequency audiometry by distortion-product acoustic emissions.

The aim of this study was to measure distortion-product otoacoustic emissions (DPOEs) in a clinical setting. First, DPOE input-output functions were automatically realized to determine the ratio of the pure tones (primaries) f2 and f1 that would elicit the most significant DPOE input-output function. The DPOE input-output functions presented two separate portions for the f2/f1 ratio, ranging from 1.18 to 1.26: (1) below 60-dB sound pressure level (SPL), a saturating portion with a DPOE detection threshold at 36-dB SPL; and (2) above 66-dB SPL, a linear portion. For other f2/f1 ratios, DPOE input-output functions had a more linear behavior. The DPOEs generated by primary intensities below 60-dB SPL, which show saturating behavior, probably have their origin in the properties of outer hair cells. This indicates that DPOE measurements in a clinical setting must be realized with precise stimulus values: (1) f2/f1 ratio near 1.22, and (2) primary intensities below 60-dB SPL. Second, DPOE input-output functions were realized for DPOEs varying from 707.5 to 342 Hz. No more saturating plateau could be observed with DPOEs below 512.5 Hz, suggesting that active mechanisms are absent below 725 Hz within the human cochlea. These data permit us to establish the bases of an objective low-frequency audiometric test.
Implementation and Operational Research: A Time–Motion Analysis of HIV Transmission Prevention Counseling and Antiretroviral Adherence Messages in Western Kenya

Background:Shortages of health workers and large number of HIV-infected persons in Africa mean that time to provide antiretroviral therapy (ART) adherence and other messages to patients is limited. Methods:Using time–motion methodology, we documented the intensity and nature of counseling delivered to patients. The study was conducted at a rural and an urban HIV clinic in western Kenya. We recorded all activities of 190 adult patients on ART during their return clinic visits to assess type, frequency, and duration of counseling messages. Results:Mean visit length for patients at the rural clinic was 44.5 (SD = 27.9) minutes and at urban clinic was 78.2 (SD = 42.1) minutes. Median time spent receiving any counseling during a visit was 4.07 minutes [interquartile range (IQR), 1.57–7.33] at rural and 3.99 (IQR, 2.87–6.25) minutes at urban, representing 11% and 8% of total mean visit time, respectively. Median time patients received ART adherence counseling was 1.29 (IQR, 0.77–2.83) minutes at rural and 1.76 (IQR, 1.23–2.83) minutes at urban (P = 0.001 for difference). Patients received a median time of 0.18 (0–0.72) minutes at rural and 0.28 (IQR, 0–0.67) minutes at urban clinic of counseling regarding contraception and pregnancy. Most patients in the study did not receive any counseling regarding alcohol/substance use, emerging risks for ongoing HIV transmission. Conclusions:Although ART adherence was discussed with most patients, time was limited. Reproductive counseling was provided to only half of the patients, and “positive prevention” messaging was minimal. There are strategic opportunities to enhance counseling and information received by clients within HIV programs in resource-limited settings.
Influenza Virus Infection in Infants Less Than Three Months of Age

Objective: We evaluated the presentation, outcomes, and the risk of serious bacterial infection (SBI) in infants <3 months old with influenza virus infection. Patients and Methods: We identified demographic, hospitalization, and microbiologic data from computerized medical records for all infants and children <24 months of age, with laboratory confirmed influenza infection cared for at a tertiary care children's hospital during 4 winter seasons (2004–2008). We compared those <3 months of age with older groups. Results: We identified 833 children <24 months of age with laboratory-confirmed influenza. Of those, 218 were <3 months old. Influenza accounted for 3.6% of all evaluations of febrile infants and 12% of febrile infant encounters during winter. Infants <3 months of age were less likely to have a high risk chronic medical condition, but were more likely to be hospitalized than children 3 to <24 months old (P < 0.005). Infants <3 months with influenza had fewer prolonged hospital stays than those 3 to <6 months old [P = 0.056; OR: 0.5 (0.24–1.0)] and 6 to <12 months old [P = 0.011; OR: 0.43 (0.24–0.83)]. Five (2.3%) infants <3 months old had SBI. Conclusions: Infants <3 months of age with influenza virus infection often present with fever alone. Although they are more likely to be hospitalized than those 3 to <24 months old, hospital stays are short and outcomes generally good. Infants with influenza virus infection have a low risk of concomitant SBI.
Looking good or doing better? Patterns of decoupling in the implementation of clinical directorates.

BACKGROUND The interest toward hospital restructuring has risen significantly in recent years. In spite of its potential benefits, often organizational restructuring in health care produces unexpected consequences. Extant research suggests that institutional theory provides a powerful theoretical lens through which hospital restructuring can be described and explained. According to this perspective, the effectiveness of change is strongly related to the extent to which innovative arrangements, tools, or practices are adopted and implemented within hospitals. Whenever these new arrangements require a substantial modification of internal processes and practices, resistance to implementation emerges and organizational change is likely to become neutralized. PURPOSE This study analyzes how hospital organizations engage in decoupling by adopting but not implementing a new organizational model named clinical directorate. METHODOLOGY We collected primary data on the diffusion of the clinical directorate model, which was mandated by law in the Italian National Health Service to improve hospital services. We surveyed the adoption and implementation of the clinical directorate model by monitoring the presence of clinical governance tools (measures for the quality improvement of hospital services) within single directorates. In particular, we compared hospitals that adopted the model before (early adopters) or after (later adopters) the mandate was introduced. FINDINGS Hospitals were engaged in decoupling by adopting the new arrangement but not implementing internal practices and tools for quality improvement. The introduction of the law significantly affected the decoupling, with late-adopter hospitals being less likely to implement the adopted model. PRACTICE IMPLICATIONS The present research shows that changes in quality improvement processes may vary in relation to policy makers' interventions aimed at boosting the adoption of new hospital arrangements. Hospital administrators need to be aware and identify the institutional changes that might be driven by law to be able to react consistently with expectations of policymakers.
Factors associated with "do not resuscitate" orders and rates of withdrawal from hemodialysis in the international DOPPS.

BACKGROUND Worldwide statistics on practice patterns regarding "do not resuscitate" (DNR) orders and patient withdrawal from hemodialysis have not been uniformly collected or analyzed. METHODS Using data concerning adult hemodialysis patients randomly selected from 308 representative dialysis facilities in France, Germany, Italy, Japan, Spain, the United Kingdom, and the United States participating in the Dialysis Outcomes and Practice Patterns Study, DNR orders were tabulated at study entry from a prevalent cross-section of patients (N = 8615), using multivariate logistic regression to investigate characteristics associated with DNR status, Cox models to identify risk factors for withdrawal from hemodialysis, and scores from the mental component summary (MCS) and physical component summary (PCS) of the SF-36 to assess health-related quality of life. RESULTS The United States had the highest prevalence of DNR orders (7.5%) and rate of withdrawal from hemodialysis (3.5 per 100 patient-years). Significant and independent associations with higher odds ratio (OR) of DNR were observed for older age (OR 1.16 per 10 years higher, P = 0.03) and nursing home residence (OR 2.34, P = 0.003), and with higher relative risk (RR) of withdrawal from dialysis (RR 2.38, P < 0.001). Patients who withdrew from hemodialysis died within a mean of 7.8 days and a median of 6.0 days. CONCLUSION The higher prevalence of DNR and rate of withdrawal from hemodialysis in the United States are consistent with its greater legal and cultural emphasis on patient autonomy. By showing characteristics associated with these outcomes, this study contributes to our understanding of why hemodialysis patients request DNR or withdraw from treatment.
Tissue characterisation of atherosclerotic plaque in coronary artery bifurcations: an intravascular ultrasound radiofrequency data analysis in humans.

AIMS To investigate tissue characteristics of atherosclerotic plaques in coronary artery bifurcations. METHODS AND RESULTS Using a global virtual histology registry, geometric and compositional characteristics of plaque in three segments (proximal, distal, and at the bifurcation) of coronary bifurcation sites were analysed with intravascular ultrasound radiofrequency data (RFD) analysis. A total of 256 bifurcation sites were analysed: left main (LM)-left anterior descending artery (LAD), 41; LAD-diagonal artery, 128; left circumflex artery-obtuse marginal artery, 34; and right coronary artery-acute marginal artery, 53. The plaque+media (P+M) burden was larger in the distal segments of LM-LAD bifurcation sites than in the proximal and at the bifurcation segments (46.55±12.08% vs. 40.40±11.76%, 41.15±11.01%, p<0.001). The % necrotic core (NC) and % dense calcium (DC) at the bifurcation and distal segments of LM-LAD bifurcation sites was significantly greater than in the proximal segments (6.75±5.09%, 7.36±6.01% vs. 4.89±4.78%, p<0.05, and 3.31±2.87%, 3.73±3.28% vs. 1.89±2.10%, p<0.001). In contrast, P+M burden, % NC and % DC in the proximal segments of non-LM bifurcation sites was significantly greater than at the bifurcation and distal segments (49.41±12.12% vs. 45.34±11.21%, 46.80±10.68% / 8.08±6.21% vs. 6.47±5.11%, 6.28±5.05% / 4.57±4.67% vs. 3.38±3.44%, 3.55±3.74%, all p<0.001). CONCLUSIONS The results demonstrate that heterogeneous nature of coronary atherosclerosis at coronary bifurcations according to their segments and anatomical locations (LM-LAD vs. non-LM bifurcations). The further investigation for the clinical efficacy of the RFD analysis on bifurcation sites are warranted.
Acute inflammatory responses to mechanical lesions in the CNS: differences between brain and spinal cord

Lesion‐induced inflammatory responses in both brain and spinal cord have recently become a topic of active investigation. Using C57BL/6J mice, we compared the tissue reaction in these two central nervous system (CNS) compartments with mechanical lesions of similar size involving both grey and white matter. This evaluation included the quantitative assessment of neutrophils, lymphocytes and activated macrophages/microglia, as well as astrocyte activation, upregulation of vascular cell adhesion molecules (ICAM‐1, VCAM‐1, PECAM) and the extent of blood–brain barrier (BBB) breakdown. Time points analysed post‐lesioning included 1, 2, 4 and 7 days (as well as 10 and 14 days for the BBB). We found clear evidence that the acute inflammatory response to traumatic injury is significantly greater in the spinal cord than in the cerebral cortex. The numbers of both neutrophils and macrophages recruited to the lesion site were significantly higher in the spinal cord than in the brain, and the recruitment of these cells into the surrounding parenchyma was also more widespread in the cord. The area of BBB breakdown was substantially larger in the spinal cord and vascular damage persisted for a longer period. In the brain, as in spinal cord, the area to which neutrophils were recruited correlated well with the area of BBB breakdown. It will be of interest to determine the extent to which the infiltration of inflammatory cells contributes, either directly or indirectly, to the vascular permeability and secondary tissue damage or, conversely, to local tissue repair in the brain and the spinal cord.
Towards the development of a standardized performance evaluation framework for eye gaze estimation systems in consumer platforms

There is a need to standardize the performance of eye gaze estimation (EGE) methods in various platforms for human computer interaction (HCI). Because of lack of consistent schemes or protocols for summative evaluation of EGE systems, performance results in this field can neither be compared nor reproduced with any consistency. In contemporary literature, gaze tracking accuracy is measured under non-identical sets of conditions, with variable metrics and most results do not report the impact of system meta-parameters that significantly affect tracking performances. In this work, the diverse nature of these research outcomes and system parameters which affect gaze tracking in different platforms is investigated and their error contributions are estimated quantitatively. Then the concept and development of a performance evaluation framework is proposed- that can define design criteria and benchmark quality measures for the eye gaze research community.