Miracle-dz/UniFAR-FTUs huggingface dataset:
What Do We Need at the End of Life? Competence, but not Autonomy, Predicts Intraindividual Fluctuations in Subjective Well-Being in Very Old Age

Objectives Self-determination theory (SDT) suggests that fulfillment of the universal psychological needs for autonomy, competence, and relatedness is essential for well-being of all humans. However, it is not clear whether this prediction also holds in advanced old age. The present study aims to test SDT for the two less researched needs in advanced old age: the needs for competence and autonomy. Method A total of 111 very old adults (age range at first measurement occasion 87-97 years) were assessed up to 6 times over the course of about 4 years. Results Competence, but not autonomy, predicted subjective well-being at the within-person level of analysis. At the between-person level, only negative affect was predicted by autonomy and competence, whereas positive affect and life satisfaction were predicted by competence only. Discussion Results challenge the life-span universality of the needs for competence and autonomy postulated by SDT in very old adults and suggest that the high vulnerability in this life phase may change the importance of these needs for well-being.
On the Validity of Beer–Lambert Law and its Significance for Sunscreens

The sun protection factor (SPF) is the most important quantity to characterize the performance of sunscreens. As the standard method for its determination is based on clinical trials involving irradiation of human volunteers, calculations of sunscreen performance have become quite popular to reduce the number of in vivo studies. Such simulations imply the calculation of UV transmittance of the sunscreen film using the amounts and spectroscopic properties of the UV absorbers employed, and presuppose the validity of the Beer–Lambert law. As sunscreen films on human skin can contain considerable concentrations of UV absorbers, it is questioned whether the Beer–Lambert law is still valid for these systems. The results of this work show that the validity of the Beer–Lambert law is still given at the high concentrations at which UV absorbers occur in sunscreen films on human skin.
Effect of pain on autonomic nervous system indices derived from photoplethysmography in healthy volunteers.

BACKGROUND Photoplethysmographic pulse wave amplitude (PPGA) and heart rate (HR) can be used to measure cold, nociception-induced autonomic responses, or both. The aim of our study was to correlate the intensity of experimental pain to changes in physiological variables reflecting the autonomic nervous system response to pain. METHODS PPGA, HR, and subjective measurements of pain intensity were measured in 29 healthy male volunteers during two heat stimuli (43°C and 48°C) and the cold pressor test (CPT). Surgical pleth index (SPI), autonomic nervous system state (ANSS), and ANSS index (ANSSi) were calculated using PPGA and HR. RESULTS Pain intensity scores increased on the average by 1.6, 3.5, and 8.1 for the 43°C, 48°C, and CPT stimuli, respectively. The pain intensity scores for all three stimuli groups were significantly different from each other (P<0.001). All three stimuli changed HR, PPGA, SPI, ANSS, and ANSSi values significantly from their respective baseline values (P<0.001 for all). Heat stimuli-induced pain intensity did not correlate with the magnitude of the respective changes in HR, PPGA, SPI, ANSS, and ANSSi. CPT-induced pain intensity correlated with the magnitude of the respective changes in HR, PPGA, SPI, ANSS, and ANSSi. PPGA, ANSSi, ANSS, and SPI differentiated between heat and cold stimuli-induced pain. CONCLUSIONS All three thermal stimuli produced a significant change in photoplethysmograph-derived parameters. All photoplethysmograph-derived parameters appear to be suitable to study autonomic nervous system activation.
Inhibition by fibrates of plasminogen activator inhibitor type-1 expression in human adipocytes and preadipocytes

Summary Plasminogen activator inhibitor type-1 (PAI-1), an established marker and mediator of cardiovascular risk, is produced extensively in adipose tissue. Fibrates are hypolipidemic peroxisome proliferator activated receptor-alpha (PPARα) agonists. Recent laboratory and clinical observations indicate that they are also anti-atherosclerotic. Mechanisms responsible, however, remain to be fully understood. The present study was designed to elucidate modulation of PAI-1 expression in adipose cells by fibrates as a potential mechanism. Expression of PPARα was verified by PCR, immunohistochemistry, and Western blotting. In cultured preadipocytes and adipocytes gemfibrozil and fenofibrate significantly reduced PAI-1 protein expression by up to 55 ± 5% and 34 ± 4% under basal conditions and up to 56 ± 6% and 31 ± 6% under conditions of stimulation of the cells with 40 pM trans-Keywords forming growth factor (TGF)β, respectively. Quantification of mRNA showed that the gemfibrozil-induced effect was at least in part regulated at the transcriptional level. Incubations with non-fibrate PPARα agonists showed similar reductions in PAI-1 expression. The decrease in PAI-1 expression induced by gemfibrozil was inhibited by MK886, a PPARα inhibitor. Furthermore, preadipocytes isolated from PPARα-deficient mice produced significantly more PAI-1 than those from wild-type mice upon stimulation with TGFβ. Finally, fenofibrate reduced PAI-1 expression both in plasma and adipose tissue of hyperlipidemic mice. Our data support the view that PPARα activation down-regulates PAI-expression in adipose cells that may contribute in part to the reduction in cardiovascular mortality seen with fibrates in clinical trials.
Discordant Genotypic Sex and Phenotype Variations in Two Spanish Siblings with 17α-Hydroxylase/17,20-Lyase Deficiency Carrying the Most Prevalent Mutated CYP17A1 Alleles of Brazilian Patients

17α-hydroxylase/17,20-lyase deficiency is a rare form of congenital adrenal hyperplasia caused by mutations in CYP17A1. Two phenotypic female sisters, aged 17 and 15 years and with 46,XY and 46,XX karyotypes, respectively, presented with primary amenorrhea and absent secondary sexual characteristics. The elder sib also presented with high blood pressure. Both patients had elevated levels of ACTH, gonadotropins, progesterone, corticosterone, and deoxycorticosterone, and reduced levels of estradiol, testosterone, androstenedione, 17-OH-P, DHEA-S, cortisol, aldosterone, and renin activity. The CYP17A1 gene was sequenced, and polymorphic haplotypes were further analyzed in the Spanish family and in Brazilian patients. The 2 sisters were compound heterozygous for p.Arg362Cys and p.Trp406Arg mutations, previously described as the most prevalent mutations in Brazilian families of Spanish (p.Trp406Arg) or Portuguese (p.Arg362Cys) origin. Analysis of polymorphisms in CYP17A1 suggested that the paternal allele with p.Arg362Cys may share a common origin with the Brazilian carriers, while the maternal allele with p.Trp406Arg did not. Hydrocortisone and sex hormone replacement therapy was initiated in both patients. In conclusion, one CYP17A1 mutation (p.Arg362Cys) may share a common ancestry in Brazilian and our present Spanish patients, while p.Trp406Arg may have arisen separately. The elder patient (46,XY) developed a more severe phenotype and a poorer response to estradiol replacement therapy.
Diabetic Patients’ Knowledge of Therapeutic Goals in Kuwait

Objective: This study was conducted to analyze patients’ knowledge about therapeutic goals for diabetic patients and factors associated with good knowledge. Methods: A total of 266 diabetic patients were randomly selected from 6 diabetes clinics in Kuwait to be included in a cross-sectional patient survey. Data were collected via face-to-face structured interviews using a pretested questionnaire. Descriptive and logistic regression analysis was used in data analysis. Results: The response rate was 93% (n = 247). The percentages [95% confidence interval (CI)] of patients who reported knowing their recent levels of low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and glycosylated hemoglobin (HbA1c) were 5% (2–8), 54% (48–60), and 8% (5–11), respectively. The percentages (95% CI) of patients who admitted knowing the target goals for LDL-C, BP, HbA1c, fasting, and postprandial blood glucose levels were 3% (1–6), 49% (43–55), 6% (3–9), 62% (56–68) and 55% (49–61), respectively. Correct target goals for LDL-C, BP, HbA1c, fasting, and postprandial blood glucose levels were reported by 2% (1–4), 43% (37–49), 5% (2–8), 60% (54–66), and 47% (41–53), respectively. Those with a high education (OR = 4.76; 95% CI 2.34–9.68) and those with a family history of diabetes (OR = 3.05; 95% CI 1.50–6.19) had good knowledge about correct targets. Conclusion: The current findings revealed that lack of knowledge about recent levels of BP, LDL-C and HbA1c and therapeutic goals was alarmingly high, which highlights the need for the implementation of an effective multidisciplinary team approach to encourage patient education and self-care.
Child Sexual Abuse and Depression in Late Life for Men: A Population-Based, Longitudinal Analysis.

OBJECTIVE Research investigating long-term effects of childhood sexual abuse (CSA) on mental health for men is vastly underdeveloped. This study strengthened the knowledge base by examining: (a) long-term trajectories of depressive symptoms for men with and without a history of CSA, and (b) moderating effects of social support over time. METHOD We analyzed multiple waves of data from the Wisconsin Longitudinal Study. The sample (N = 2,451) consisted of men with histories of CSA and a stratified, randomly sampled comparison group. Growth curve modeling was employed for analyses. RESULTS After controlling for demographic, parental, and health factors, men with CSA histories had greater depressive symptoms than those with no history of CSA. For both groups, depressive symptoms decreased over time; slope patterns did not differ. We found a significant moderating effect of social support on the relationship between CSA and depressive symptoms. DISCUSSION This innovative, population-based, longitudinal study demonstrated that CSA can undermine mental health for men across the life span and into old age. Social support appears to mitigate these deleterious effects. In early, middle, and late adulthood, practitioners should assess for CSA and strengthen support resources for male survivors.
Long‐term effects of intralymphatic immunotherapy (ILIT) on canine atopic dermatitis

BACKGROUND Subcutaneous allergen immunotherapy (SCIT) is an established and efficacious therapy for canine atopic dermatitis (AD). In humans, intralymphatic immunotherapy (ILIT) was reported to be associated with fewer and less severe adverse effects than subcutaneous allergen immunotherapy and to be efficacious for several years after three intralymphatic injections. OBJECTIVE To evaluate safety and effects of ILIT in a case series of dogs with (AD). ANIMALS Fifty one privately owned dogs with AD. METHODS Dogs received injections of 0.2 mL alum-precipitated allergen extract into the popliteal lymph nodes at monthly intervals for 3-5 months. Lesion scores, pruritus and medication scores were determined before and at three and 12 months after beginning immunotherapy, and compared in a per protocol analysis (PP) and an intention-to-treat analysis (ITT). RESULTS Twenty two dogs completed the study and 29 dogs did not fulfil study completion criteria due to lack of a final study visit (21 of 29) or due to insufficient improvement (14 of 29). All scores improved during the study with both analyses. For pruritus and Quality of Life scores this improvement was significant with both analyses; for Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03 values and medication scores only with PP. The only rare adverse effects observed included mild swelling of the lymph node post-injection and increased pruritus. CONCLUSION AND CLINICAL RELEVANCE ILIT is safe and feasible, and provides long-lasting relief in some atopic dogs with a limited number of injections.
Face Age and Eye Gaze Influence Older Adults’ Emotion Recognition

Objectives Eye gaze has been shown to influence emotion recognition. In addition, older adults (over 65 years) are not as influenced by gaze direction cues as young adults (18-30 years). Nevertheless, these differences might stem from the use of young to middle-aged faces in emotion recognition research because older adults have an attention bias toward old-age faces. Therefore, using older face stimuli might allow older adults to process gaze direction cues to influence emotion recognition. Method To investigate this idea, young and older adults completed an emotion recognition task with young and older face stimuli displaying direct and averted gaze, assessing labeling accuracy for angry, disgusted, fearful, happy, and sad faces. Results Direct gaze rather than averted gaze improved young adults' recognition of emotions in young and older faces, but for older adults this was true only for older faces. Discussion The current study highlights the impact of stimulus face age and gaze direction on emotion recognition in young and older adults. The use of young face stimuli with direct gaze in most research might contribute to age-related emotion recognition differences.
Measuring strain at extreme temperatures with a Fabry-Perot optical fiber sensor

In this work, a Fabry-Perot optical fiber sensor for the measurement of strain at extreme temperatures is proposed. The cavity is formed by splicing a short section of a silica tube between two sections of single mode fiber. The tube, with a cladding ~14 μm thick and a hollow core, presents four small rods, of ~20 μm in diameter each, positioned in in diametrically opposite positions. This design ensures higher mechanical stability of the tube. Strain measurements are performed over a wide range of temperatures, until 900 °C. Some of the annealing effects are addressed in this study.
A severe, relapsing case of myelin oligodendrocyte glycoprotein IgG-associated CNS inflammation.

A 55-year-old man presented in October 2004 with general unease, vomiting, and gait disturbance. Initially diagnosed with an inner ear infection, the patient's symptoms did not improve and he was evaluated further. MRI revealed a cerebellar lesion, which led to the suspicion of a posterior circulation stroke, and he was started on antiplatelet drugs. However, an angiogram suggested no vascular pathology. In March 2011, he had another episode of ataxia and MRI showed a right brainstem lesion. Cryptogenic stroke was reconsidered. In March 2013, the patient developed paraparesis with urinary and bowel symptoms. MRI revealed myelitis of the midthoracic spinal cord. Oligoclonal bands were present in both serum and CSF and steroids were begun. In February 2014, he was admitted with expressive aphasia and right hemiparesis. MRI (figure 1) confirmed a new T2-hyperintense lesion in the left frontal lobe and he was given IV methylprednisolone and subsequently underwent plasma exchange. Aquaporin 4 (AQP4) IgG was negative. The working diagnosis was tumefactive multiple sclerosis. He was started on glatiramer acetate in August 2014. A few months later, he developed right-sided weakness, left optic neuritis (ON), and confusion. MRI (figure 2) showed left occipital and left parietal cortical and subcortical white matter lesion spreading across the corpus callosum to the opposite side. There were changes bilaterally in the cerebellum, cerebral peduncles, and along the corticospinal tracts on the left side. Further scans showed swelling of the splenium of the corpus callosum. He was put back on prednisolone 60 mg. Markers for systemic inflammation (erythrocyte sedimentation rate, C-reactive protein) were normal and autoantibody testing (antinuclear antibodies, extractable nuclear antigen, paraneoplastic antineuronal antibodies) was negative. The diagnosis of fulminant seronegative NMO was re-entertained but AQP4 antibodies were negative. However, MOG antibodies returned positive (October 2014, live cell-based assay, John Radcliffe Hospital, Oxford, UK). Azathioprine 125 mg was begun in February 2015.
Five-year Outcomes of Ranibizumab in Neovascular Age-related Macular Degeneration: Real Life Clinical Experience

Purpose To evaluate the outcomes of 5-year ranibizumab treatment in neovascular age-related macular degeneration (nAMD) in a single center and real life clinical setting. Methods The records of nAMD patients who were treated with ranibizumab between January 2010 and June 2011 were retrospectively reviewed. Patients who completed 5 years of follow-up were included. Main outcome measures were change in best-corrected visual acuity, central retinal thickness, and visit and injection numbers. Results Forty-four eyes of 37 patients were included. Mean best-corrected visual acuity decreased from 0.82 ± 0.69 to 1.11 ± 0.65 logarithm of minimal angle of resolution after 5 years. Twenty-four eyes (54.5%) had visual acuity loss ≥3 lines, and 20 eyes (45.5%) had stable or improved vision (loss <3 lines, remained stable, or gained ≥1 line) at month 60. The mean total number of visits was 25.3 ± 5.8 (range, 14 to 42), and the mean total number of injections was 12.6 ± 6.4 (range, 3 to 26) at month 60. Conclusions Half of the ranibizumab-treated nAMD patients maintained their vision during the 5 years of follow-up. Visit and injection numbers were found to be lower than in prospective studies, reflecting a real world clinical practice.
Acute Occlusions of Dual-Layer Carotid Stents After Endovascular Emergency Treatment of Tandem Lesions

Background and Purpose— A new generation of carotid artery stents that uses a second micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. The purpose of this study was to compare acute occlusion rates of these new dual-layer stents with those of single-layer stents in the setting of emergency carotid artery stenting with intracranial mechanical thrombectomy in acute ischemic stroke. Methods— Consecutive patients with acute tandem (intra- and extracranial) lesions of the anterior circulation who were endovascularly treated at our institution were identified from our registry of neuroendovascular interventions. Clinical, angiographic, and neuroimaging data were analyzed. End points included acute occlusions of the carotid stents (within 72 hours after stenting) and symptomatic intracerebral hemorrhage. Results— Forty-seven patients were included. Dual-layer stents (n=20) had a significantly higher rate of acute occlusions than single-layer stents (n=27; 45% versus 3.7%; P=0.001; odds ratio, 21.3; 95% confidence interval, 2.4–188.4). There were no significant differences in the rates of patients who had any antiplatelet or dual antiplatelet medication before admission, in the rates of postinterventional symptomatic intracerebral hemorrhage, the mean National Institutes of Health Stroke Scale scores at admission, or the modified Rankin Scale scores at discharge. Conclusions— The recently introduced dual-layer stents have a higher risk of acute occlusion compared with single-layer stents in the treatment of acute stroke.
Trends in Hospitalizations Related to Invasive Aspergillosis and Mucormycosis in the United States, 2000–2013

Abstract Background. Invasive aspergillosis (IA) and mucormycosis contribute to substantial mortality, especially among immunocompromised persons, including those with hematopoietic stem cell transplant (HSCT), hematologic malignancy (HM), and solid organ transplant (SOT). Methods. Using International Classification of Diseases, Ninth Revision codes available in the National Inpatient Sample, a hospital discharge database, we estimated IA-related hospitalizations (IA-RH), mucormycosis-RH (M-RH), HSCT-RH, HM-RH, and SOT-RH during 2000–2013. United States census data were used to calculate overall M-RH and IA-RH rates and present trends; estimated annual numbers of HSCT-RH, HM-RH, and SOT-RH served as denominators to calculate M-RH and IA-RH rates occurring with these conditions. Weighted least-squares technique was used to test for linear trends and calculate average annual percentage change (APC). Results. There were an estimated 169 110 IA-RH and 9966 M-RH during 2000–2013. Overall, IA-RH and M-RH rates per million persons rose from 32.8 to 46.0 (APC = +2.9; P < .001) and 1.7 to 3.4 (APC = +5.2%; P < .001), respectively, from 2000 to 2013. Among HSCT-RH, there was no significant change in M-RH rate, but a significant decline occurred in IA-RH rate (APC = −4.6%; P = .004). Among HM-RH, the rate of M-RH increased (APC = +7.0%; P < .001), but the IA-RH rate did not change significantly (APC = +1.2%; P = .073). Among SOT-RH, M-RH (APC = +6.3%; P = .038) and IA-RH rates (APC = +4.1%; P < .001) both increased. Conclusions. Overall IA-RH and M-RH rates increased during 2000–2013, with a doubling of M-RH. Mucormycosis-related hospitalization occurring in conjunction with certain comorbidities increased, whereas IA-RH rates among patients with the comorbidities, decreased, remained stable, or increased to a lesser extent than M-RH.
A Novel Ligand of Toll-like Receptor 4 From the Sheath of Wuchereria bancrofti Microfilaria Induces Proinflammatory Response in Macrophages

Background Lymphatic filariasis, frequently caused from Wuchereria bancrofti infection, is endemic in several parts of the globe and responsible for human health problems and socioeconomic loss to a large extent. Inflammatory consequences originating from host-parasite interaction play a major role in the disease pathology and allied complications. The identity of the key mediator of this process is yet unknown in filarial research. Methods Microfilarial protein (MfP) was isolated from the sheath of W. bancrofti microfilariae through ultrafiltration, followed by chromatographic separation. Expression of signaling molecules was studied by enzyme-linked immunosorbent assay and immunoblotting. Binding of MfP to Toll-like receptor 4 (TLR4) was determined by co-immunoprecipitation, fluorescein isothiocyanate-probing, and surface plasmon resonance analysis. Results We found that MfP (approximately 70 kDa) binds to macrophage-TLR4 and triggers nuclear factor kappa beta activation that upregulates secretion of proinflammatory cytokines. Microfilarial protein failed to induce inflammation in either TLRKO macrophage or macrophage treated with TLR4 inhibitor, indicating that MfP acts through TLR4. We have also detected phenotypic transformation of macrophages from anti-inflammatory (M2) to proinflammatory (M1) subtype after incubation with MfP. Conclusions Microfilarial protein appears to be a new ligand of TLR4 from W. bancrofti. Determination of its functional attributions in the host-parasite relationship, especially immunopathogenesis of filarial infection, may improve our understanding.