Miracle-dz/UniFAR-FTUs huggingface dataset:
Family Skills Labs: Facilitating the Development of Family Nursing Skills in the Undergraduate Curriculum

This article describes the implementation offamily nursing skills labs with undergraduate nursing students at the University of Calgary. The intent of the family nursing skills labs is to facilitate the development of family interviewing skills of students and to apply these skills to a variety ofclinical settings. The incorporation of demonstration interviews, role playing, and practice interviews provides students with simulated situations to implementfamily interviewing skills. Students who participate in thefamily skills labs are invited to consider therapeutic conversations as interventions and are offered a preferred relational stance for working with families. Specific strategies for implementing the family skills labs are proposed.
Heart Rate Reduction by Ivabradine Reduces Oxidative Stress, Improves Endothelial Function, and Prevents Atherosclerosis in Apolipoprotein E–Deficient Mice

Background— Elevated heart rate is associated with increased cardiovascular morbidity. We hypothesized that selective heart rate reduction may influence endothelial function and atherogenesis and tested the effects of the I(f) current inhibitor ivabradine in apolipoprotein E–deficient mice. Methods and Results— Male apolipoprotein E–deficient mice fed a high-cholesterol diet were treated with ivabradine (10 mg · kg−1 · d−1) or vehicle for 6 weeks (n=10 per group). Ivabradine reduced heart rate by 13.4% (472±9 versus 545±11 bpm; P<0.01) but did not alter blood pressure or lipid levels. Endothelium-dependent relaxation of aortic rings was significantly improved in ivabradine-fed animals (P<0.01). Ivabradine decreased atherosclerotic plaque size in the aortic root by >40% and in the ascending aorta by >70% (P<0.05). Heart rate reduction by ivabradine had no effect on the number of endothelial progenitor cells and did not alter aortic endothelial nitric oxide synthase, phosphorylated Akt, vascular cell adhesion molecule-1, or intercellular adhesion molecule-1 expression but decreased monocyte chemotactic protein-1 mRNA and exerted potent antioxidative effects. Ivabradine reduced vascular NADPH oxidase activity to 48±6% and decreased markers of superoxide production and lipid peroxidation in the aortic wall (P<0.05). The in vivo effects of ivabradine were absent at a dose that did not lower heart rate, in aortic rings treated ex vivo, and in cultured vascular cells. In contrast to ivabradine, treatment with hydralazine (25 mg · kg−1 · d−1 for 6 weeks) reduced blood pressure (−15%) but increased heart rate (37%) and did not improve endothelial function, atherosclerosis, or oxidative stress. Conclusions— Selective heart rate reduction with ivabradine decreases markers of vascular oxidative stress, improves endothelial function, and reduces atherosclerotic plaque formation in apolipoprotein E–deficient mice.
Long-term incidence and risk factors for development of spinal deformity following resection of pediatric intramedullary spinal cord tumors.

OBJECT Spinal deformity in pediatric patients with intramedullary spinal cord tumors (IMSCTs) may be either due to neurogenic disability or due to secondary effects of spinal decompression. It is associated with functional decline and impairment in health-related quality-of-life measures. The authors sought to identify the long-term incidence of spinal deformity in individuals who had undergone surgery for IMSCTs as pediatric patients and the risk factors and overall outcomes in this population. METHODS Treatment records for pediatric patients (age < 21 years) who underwent surgical treatment for histology-proven primary IMSCTs between 1975 and 2010 were reviewed. All patients were evaluated in consultation with the pediatric orthopedics service. Clinical records were reviewed for baseline and follow-up imaging studies, surgical fusion treatment, and long-term skeletal and disease outcomes. RESULTS The authors identified 55 patients (30 males and 25 females) who were treated for pediatric IMSCTs between January 1975 and January 2010. The mean duration of follow-up (± SEM) was 11.4 ± 1.3 years (median 9.3 years, range 0.2-37.2 years). Preoperative skeletal deformity was diagnosed in 11 (20%) of the 55 patients, and new-onset postoperative deformity was noted in 9 (16%). Conservative management with observation or external bracing was sufficient in 8 (40%) of these 20 cases. Surgical fusion was necessary in 11 (55%). Posterior surgical fusion was sufficient in 6 (55%) of these 11 cases, while combined anterior and posterior fusion was undertaken in 5 (45%). Univariate and multivariate analysis of clinical and surgical treatment variables indicated that preoperative kyphoscoliosis (p = 0.0032) and laminectomy/laminoplasty at more than 4 levels (p = 0.05) were independently associated with development of spinal deformity that necessitated surgical fusion. Functional scores and 10-year disease survival outcomes were similar between the 2 groups. CONCLUSIONS Long-term follow-up is essential to monitor for delayed development of spinal deformity, and regular surveillance imaging is recommended for patients with underlying deformity. The authors' extended follow-up highlights the risk factors associated with development of spinal deformity in patients treated for pediatric IMSCTs. Surgical fusion allows patients who develop progressive deformity to achieve long-term functional and survival outcomes comparable to those of patients who do not develop progressive deformity.
Fighting to eat healthfully: measurements of the military food environment

Purpose – The purpose of this paper is to report on a quantitative study of the food environment designed to measure aspects of support for healthy eating. Design/methodology/approach – An ecological view of eating behaviour was taken by examining the food environment that surrounded a military population of interest. Food outlets (n = 34) were assessed using the Nutrition Environment Measures Survey in store (NEMS-S), Nutrition Environment Measures Study in restaurants (NEMS-R) and military Nutrition Environment Assessment Tool (mNEAT) instruments to determine how well food outlets supported healthy eating. Findings – Despite better-than-average provision of healthy options on-base, the total environment surrounding the military base barely supports healthy eating. Average support to healthy eating was 45 per cent (NEMS) or 27 per cent (mNEAT) of support that could be measured. Individuals accessing this food environment would find few healthy alternatives, little information directing them to healthy ch.
L'Herceptin ® : un nouveau standard du traitement du cancer de l'estomac ?

Auteur(s) : Frederique Maire Hopital Beaujon, Service de gastroenterologie-pancreatologie, 100, boulevard du General-Leclerc, 92110 Clichy, France La survie des patients ayant un cancer de l'estomac inoperable ne depasse pas 20 % a cinq ans. Des essais de phases 2 et 3 ont montre qu'une polychimiotherapie a base de 5-FU et de platine permettait d'allonger la survie de ces patients, comparativement a des soins de confort ou a une monochimiotherapie. Des resultats [. ]
Socio-Cultural, Organizational, and Community Level Influences on Physical Activity Levels of Latino Preschool-Age Children: A Qualitative Study

Objectives : As more children grow up in families with immigrant parents of Latino origin, there is a need to understand key influences on physical activity behaviors of young Latino children to prevent obesity in this high-risk group. Design : We conducted six focus groups with low-income Latina mothers (N = 33) whose preschool-aged children (2-5 years) were enrolled in the Supplemental Nutrition Program for Women, Infants and Children (WIC) program in Rhode Island . Data was analyzed using content analysis to identify recurrent themes. Results : Despite understanding the importance of physical activity for overall health, physical activity was not a top priority for the Latino mothers participating in the focus groups. Mothers reported facing numerous barriers to establishing and maintaining healthful physical activity habits for their preschool-aged children and themselves, particularly financial and socio-cultural barriers. Analyses revealed that Latina mothers perceive the WIC as a program focused on the development and maintenance of healthy eating habits and nutritional status of children and not physical activity. Conclusions : Recognizing the importance of socioeconomic position and the influence of cultural factors on physical activity is essential if effective prevention and intervention programs for Latino families and their children are to be designed. Study findings emphasize the importance of the family as a central unit of change and suggest that successful interventions to promote physical activity of low-income Latino preschool children must take into account the needs and constraints of the family unit as a whole. The WIC program has the potential to be a venue for promoting awareness of and educating low-income Latino parents about the importance of helping their children develop and maintain early healthful physical activity habits. The WIC program can also play an important role in facilitating access and creating programs and services that provide increased opportunities for physical activity of young children and their families.
Risk of Rupture of an Intracranial Aneurysm Based on Patient Characteristics: A Case–Control Study

Background and Purpose— Knowledge about risk factors contributes to understanding the pathophysiological mechanisms that cause intracranial aneurysm rupture and helps to develop possible treatment strategies. We aimed to study lifestyle and personal characteristics as risk factors for the rupture of intracranial aneurysms. Methods— We performed a case–control study with 250 patients with an aneurysmal subarachnoid hemorrhage and 206 patients with an unruptured intracranial aneurysm. All patients with an aneurysmal subarachnoid hemorrhage and patients with a unruptured intracranial aneurysm were asked to fill in a structured questionnaire about their lifestyle and medical history. For patients with an unruptured intracranial aneurysm, we also collected data on the indication for imaging. With logistic regression analysis, we identified independent risk factors for aneurysmal rupture. Results— Reasons for imaging in patients with an unruptured intracranial aneurysm were atherosclerotic disease (23%), positive family history (18%), headache (8%), preventive screening (3%), and other (46%). Factors that increased risk for aneurysmal rupture were smoking (odds ratio, 1.9; 95% confidence interval, 1.2–3.0) and migraine (2.4; 1.1–5.1); hypercholesterolemia decreased this risk (0.4; 0.2–1.0), whereas a history of hypertension did not independently influence the risk. Conclusions— Smoking, migraine and, inversely, hypercholesterolemia are independent risk factors for aneurysmal rupture. Data from the questionnaire are insufficient to conclude whether hypercholesterolemia or its treatment with statins exerts a risk-reducing effect. The pathophysiological mechanisms through which smoking and migraine increase the risk of aneurysmal rupture should be investigated in further studies. Although a history of hypertension does not increase risk of rupture, a sudden rise in blood pressure might still trigger aneurysmal rupture.
The Support Feature Machine: Classification with the Least Number of Features and Application to Neuroimaging Data

By minimizing the zero-norm of the separating hyperplane, the support feature machine (SFM) finds the smallest subspace (the least number of features) of a data set such that within this subspace, two classes are linearly separable without error. This way, the dimensionality of the data is more efficiently reduced than with support vector–based feature selection, which can be shown both theoretically and empirically. In this letter, we first provide a new formulation of the previously introduced concept of the SFM. With this new formulation, classification of unbalanced and nonseparable data is straightforward, which allows using the SFM for feature selection and classification in a large variety of different scenarios. To illustrate how the SFM can be used to identify both the smallest subset of discriminative features and the total number of informative features in biological data sets we apply repetitive feature selection based on the SFM to a functional magnetic resonance imaging data set. We suggest that these capabilities qualify the SFM as a universal method for feature selection, especially for high-dimensional small-sample-size data sets that often occur in biological and medical applications.
Ximelagatran zur Therapie thromboembolischer Erkrankungen

Zusammenfassung Die initiale Therapie thromboembolischer Erkrankungen wird heute vorzugsweise mit niedermolekularem Heparin subkutan mit überlappender oraler Antikoagulation durchgeführt. Die Dauer der Rezidivprophylaxe mit oraler Antikoagulation beträgt 6 Monate bei Patienten mit proximaler Beinvenenthrombose oder symptomatischer, hämodynamisch stabiler Lungenembolie. Die wesentliche Einschränkung der Therapie stellt die Blutungskomplikation dar. Ximelagatran als oral verfügbarer direkter Thrombininhibitor hat sich zur Therapie der akuten tiefen Beinvenenthrombose im Vergleich zu niedermolekularem Heparin subkutan und überlappender oraler Antikoagulation über insgesamt 4 Wochen als gleich effektiv erwiesen. Ein Therapiezeitraum über 6 Monate wird zurzeit gegen Warfarin doppelblind und double dummy (mit verblindeten INR-Werten) geprüft. Nach der 6-monatigen oralen Antikoagulation wegen tiefer Beinvenenthrombose kann es bei 25% der Patienten über einen Zeitraum von 2 Jahren zu thromboembolischen Rezidiven kommen. Daher wird Ximelagatran gegen Plazebo über einen Zeitraum von 18 Monaten auf die Inzidenz thromboembolischer Rezidive geprüft.
Bone Morphogenetic Protein 9 Reduces Cardiac Fibrosis and Improves Cardiac Function in Heart Failure

Background: Heart failure is a growing cause of morbidity and mortality worldwide. Transforming growth factor beta (TGF-&bgr;1) promotes cardiac fibrosis, but also activates counterregulatory pathways that serve to regulate TGF-&bgr;1 activity in heart failure. Bone morphogenetic protein 9 (BMP9) is a member of the TGF&bgr; family of cytokines and signals via the downstream effector protein Smad1. Endoglin is a TGF&bgr; coreceptor that promotes TGF-&bgr;1 signaling via Smad3 and binds BMP9 with high affinity. We hypothesized that BMP9 limits cardiac fibrosis by activating Smad1 and attenuating Smad3, and, furthermore, that neutralizing endoglin activity promotes BMP9 activity. Methods: We examined BMP9 expression and signaling in human cardiac fibroblasts and human subjects with heart failure. We used the transverse aortic constriction–induced model of heart failure to evaluate the functional effect of BMP9 signaling on cardiac remodeling. Results: BMP9 expression is increased in the circulation and left ventricle (LV) of human subjects with heart failure and is expressed by cardiac fibroblasts. Next, we observed that BMP9 attenuates type I collagen synthesis in human cardiac fibroblasts using recombinant human BMP9 and a small interfering RNA approach. In BMP9–/– mice subjected to transverse aortic constriction, loss of BMP9 activity promotes cardiac fibrosis, impairs LV function, and increases LV levels of phosphorylated Smad3 (pSmad3), not pSmad1. In contrast, treatment of wild-type mice subjected to transverse aortic constriction with recombinant BMP9 limits progression of cardiac fibrosis, improves LV function, enhances myocardial capillary density, and increases LV levels of pSmad1, not pSmad3 in comparison with vehicle-treated controls. Because endoglin binds BMP9 with high affinity, we explored the effect of reduced endoglin activity on BMP9 activity. Neutralizing endoglin activity in human cardiac fibroblasts or in wild-type mice subjected to transverse aortic constriction–induced heart failure limits collagen production, increases BMP9 protein levels, and increases levels of pSmad1, not pSmad3. Conclusions: Our results identify a novel functional role for BMP9 as an endogenous inhibitor of cardiac fibrosis attributable to LV pressure overload and further show that treatment with either recombinant BMP9 or disruption of endoglin activity promotes BMP9 activity and limits cardiac fibrosis in heart failure, thereby providing potentially novel therapeutic approaches for patients with heart failure.
Nonsteroidal Anti-Inflammatory Drugs and the Heart

Aspirin has been on the market for 115 years. Beginning with the marketing of indomethacin for the treatment of rheumatoid arthritis in 1963, at least 20 other nonsteroidal anti-inflammatory drugs (NSAIDs) with aspirin-like actions have been developed over the past 50 years,1 culminating with the introduction of a new class of selective inhibitors of cyclooxygenase (COX)-2, the coxibs, approximately 15 years ago.2 The NSAIDs represent the single most crowded family of drugs sharing the same therapeutic activities and mechanism of action, perhaps reflecting the unmet therapeutic need in the area of pain management and the large interindividual variability in response to these agents. NSAIDs provide symptomatic relief of pain and inflammation associated with a variety of human disorders, including the rheumatic diseases. Their shared therapeutic actions (ie, analgesic, anti-inflammatory, and antipyretic) are usually accompanied by mechanism-based adverse effects that can, at least in part, be attenuated as a function of individual pharmacokinetic or pharmacodynamic properties.1 Nuances in the tolerability of different NSAIDs had been described in the precoxib era on the basis of clinical trials of a few hundred patients treated for up to a few months with soft end points. More recently, however, important differences in safety have been demonstrated in head-to-head randomized comparisons of individual coxibs and 1 or more traditional NSAIDs that involved tens of thousands of patients treated for up to a few years with hard end points. Even more significantly, the interpretation of the effects of NSAIDs has been greatly enhanced by the availability, for the first time, of large, placebo-controlled trials that aimed to assess the potential for chemoprevention of colorectal cancer by rofecoxib or celecoxib. As a result of these developments, the whole field of NSAIDs has been illuminated during the past 15 years. Although epidemiological studies had previously associated …
Radiation-induced Pulmonary Toxicity and Related Risk Factors in Breast Cancer

Purpose: This study was designed to assess the incidence of pulmonary toxicity (PT) and related risk factors in breast cancer patients treated with postoperative adjuvant radiotherapy (RT) with or without the use of chemotherapy. Methods: The whole breast or chest wall was irradiated with two tangential photon fields to a total dose of 50.4 Gy in 261 patients. A single anterior oblique photon field for a supraclavicular (SCL) node included if indicated. All patients underwent threedimensional RT planning (3D RTP), and the calculation of dose volume histogram (DVH) parameters (i.e., ipsilateral lung volume that received ≥15 Gy [V15], V20, V30, and mean lung dose [MLD]). The relationship of symptomatic radiation pneumonitis (SRP) and pulmonary toxicity as discerned by radiographic features (radiographic pulmonary toxicity or RPT) with the clinical and DVH parameters were evaluated. In addition, the relationship of severity of RPT with the DVH parameters was assessed. Results: SRP and RPT developed in 1.9% (5/261) and 22.6% (59/261) of patients, respectively. Age (p=0.008), inclusion of an SCL field (p<0.0001), use of chemotherapy (p<0.0001), use of taxane (p<0.0001), and all DVH parameters (p<0.0001) were associated with RPT in univariate analysis. Based on the results of multivariate analysis, V 30 (p<0.001), age (p=0.001) and use of taxane (p=0.036) were significant risk factors in the development of RPT. None of the DVH parameters was associated with the severity of RPT. Conclusion: The incidence rate of SRP was very low and there was no correlation between any clinical factor or DVH parameters and SRP. Age, the use of taxane-based chemotherapy and V 30 were correlated with the development of RPT.
The Impact of Parameterization on the Interpretation of the Main-Effect Term in the Presence of an Interaction

This paper examines the meaning of the so-called main-effect term in a logistic model that contains an interaction term involving the main-effect factor. The interpretation of the main-effect term is given in conjunction with the parameterization used to formulate the model for identification purposes. It occurred to the authors, through a consulting project, that many applied statisticians were not aware of the impact of parameterization on the inferential conclusions concerning the main-effect term in the presence of an interaction. It was thus decided to bring this fact to the attention of a wider audience. The motivating project is included.
Estudio del D-004 sobre la defensa antioxidante endógena en ratas con hiperplasia prostática inducida por inyección de testosterona

Benign prostatic hyperplasia, a common disease in men aged over 50 is characterized by uncontrolled growth of prostatic gland and the presence of low urinary tract symptoms. The oxidative stress has been recently associated with the disease cause. The D-004, a lipid extract from Roystonea regia, reduces the prostatic hyperplasia induced by testosterone in rodents and to produce in vitro and in vivo antioxidant effects nut its effects on endogenous antioxidant4e system enzymes haven't been studied. Present paper researched the effects of D-004 oral treatment over 14 days on dismutase and catalase superoxide enzymes in rats with prostatic hyperplasia induced by testosterone. Animals were randomized distributed into 4 groups: a negative control ant three-testosterone injected: one treated with the vehicle (positive control) and two with D-004 (400 and 800 mg/kg, respectively). The plasma total antioxidant ability was determined as well as the activity of catalase and dismutase superoxide enzymes in lysed erythrocyte and plasma, respectively. D-004 (400 and 800 mg/kg) oral treatment markedly and significantly prevented the prostate enlargement induced with testosterone in rats and increased very much the plasma antioxidant activity and of catalase, without modify the superoxide dismutase. These results suggest that D-004 antioxidant activity is partially related to stimulation of some enzymes of the endogenous antioxidant system.
Students' test anxiety, motivation for examinations and science achievement in junior secondary schools in Ogun State, Nigeria

This study investigated the relative and combined influences of test anxiety and motivation for examinations on science achievement of selected Junior Secondary School students in Ogun State, Nigeria. Twelve secondary schools were randomly selected from the list of secondary schools in all the four divisions of Ogun State. A sample of three hundred and sixty students selected from twelve schools participated in the study. Three instruments were used to collect data. Test anxiety and motivation for examinations accounted for 14.6% of the total variance in science achievement. (R square = 0.146, p < 0.05). This percentage is statistically significant. There is negative significant relationship between test anxiety and science achievement (r = -0.228, p < 0.05) and positive significant relationship between motivation for examinations and science achievement (r = +0.333, p < 0.05). Teachers and counselors should motivate students for examinations by providing necessary materials and equipping them with techniques of tackling questions. Key words: Test anxiety, examinations, motivation, science achievement, junior secondary school, Ogun State, Nigeria.