Miracle-dz/UniFAR-FTUs huggingface dataset:
Insight and danger in Alzheimer's disease

To determine the frequency, and demographic and clinical correlates of dangerous behaviours in Alzheimer's disease (AD). We assessed a consecutive series of 278 patients with AD and 45 age‐comparable healthy controls with a comprehensive psychiatric and neuropsychological evaluation. Caregivers rated the frequency of patients’ exposure to dangerous situations or commission of dangerous behaviours. The frequency of dangerous behaviours was 16% in the AD group and 2% in the healthy control group. The presence of anosognosia was associated with a threefold increase in the risk of dangerous behaviours, but there was no significant association between dangerous behaviours and patients’ age, years of education, diagnosis of major or minor depression and presence of suicide ideation. Sixteen per cent of a consecutive series of patients with AD had dangerous behaviours during the month preceding the clinical evaluation. Anosognosia was the main clinical correlate of dangerous behaviours in this population.
Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995-1998: Opportunities for prevention in the conjugate vaccine era.

CONTEXT Pneumococcal polysaccharide vaccine is recommended for elderly persons and adults with certain chronic illnesses. Additionally, a recently licensed pneumococcal 7-valent conjugate vaccine has been recommended for use in young children and could dramatically change the epidemiology of pneumococcal disease. OBJECTIVES To assess pneumococcal disease burden in the United States, estimate the potential impact of new vaccines, and identify gaps in vaccine recommendations. DESIGN AND SETTING Analysis of data from the Active Bacterial Core Surveillance (ABCs)/Emerging Infections Program Network, an active, population-based system in 9 states. PATIENTS A total of 15 860 cases of invasive pneumococcal disease occurring between January 1, 1995, and December 31, 1998. MAIN OUTCOME MEASURES Age- and race-specific pneumoccocal disease incidence rates per 100 000 persons, case-fatality rates, and vaccine preventability. RESULTS In 1998, overall incidence was 23.2 cases per 100 000, corresponding to an estimated 62 840 cases in the United States. Incidence was highest among children younger than 2 years (166.9) and adults aged 65 years or older (59.7). Incidence among blacks was 2.6 times higher than among whites (95% confidence interval [CI], 2.4-2.8). Overall, 28.6% of case-patients were at least 65 years old and 85.9% of cases in this age group were due to serotypes included in the 23-valent polysaccharide vaccine; 19.3% of case-patients were younger than 2 years and 82.2% of cases in this age group were due to serotypes included in the 7-valent conjugate vaccine. Among patients aged 2 to 64 years, 50.6% had a vaccine indication as defined by the Advisory Committee on Immunization Practices (ACIP). The case-fatality rate among patients aged 18 to 64 years with an ACIP indication was 12.1% compared with 5.4% for those without an indication (relative risk, 2.2; 95% CI, 1.7-2.9). CONCLUSIONS Young children, elderly persons, and black persons of all ages are disproportionately affected by invasive pneumococcal disease. Current ACIP recommendations do not address a subset of persons aged 18 to 64 years but do include those at highest risk for death from invasive pneumococcal disease.
Carotid chemoreceptor control of muscle sympathetic nerve activity in hypobaric hypoxia

What is the central question of this study? High‐altitude hypoxia increases muscle sympathetic nerve activity (MSNA), but whether intravenous infusion of dopamine, to blunt the responsiveness of the carotid chemoreceptors, reduces MSNA at high altitude is not known. What is the main finding and its importance? Muscle sympathetic nerve activity was elevated after 15–17 days of high‐altitude hypoxia (3454 m) compared with values at ‘sea level’ (432 m). However, intravenous dopamine infusion to blunt the responsiveness of the carotid chemoreceptors did not significantly decrease MSNA either at sea level or at high altitude, suggesting that high‐altitude sympathoexcitation arises via a different mechanism.
Cloning and embryonic expression of Hrsna, a snail family gene of the ascidian Halocynthia roretzi: Implication in the origins of mechanisms for mesoderm specification and body axis formation in chordates

snail family genes encode a transcription factor with specific zinc finger motifs. In vertebrates, they are expressed in the entire mesoderm in early embryogenesis and later in the paraxial mesoderm and the tail‐bud, suggesting roles in specification and morphogenesis of the paraxial mesoderm. In the present study, a snail family gene Hrsna from a member of the chordates, an ascidian (Halocynthia roretzi), was cloned to obtain an insight into the origin of the mechanisms of mesoderm specification and body axis formation as observed in vertebrates. Expression of Hrsna during ascidian embryogenesis was found to be quite similar to that of vertebrate snail genes. First, before gastrulation, Hrsna was initially expressed in most precursors of mesodermal tissues including the notochord where As‐T, the ascidian homolog of brachyury, was expressed. Hrsna expression persisted in the paraxial mesoderm, the mesenchyme and muscle, but not in the notochord precursors. Also, just as vertebrate snail family genes are expressed in the border of the neural plate that develops into dorsal neural tube and neural crest cells, so Hrsna expression was detected in the precursors of lateral and dorsal regions of the neural tube. However, Hrsna expression was not detected in the tip of the tail, unlike in vertebrate counterparts. In the light of the present findings, similarity and dissimilarity of mechanisms governing mesoderm specification and body axis formation between ascidians and vertebrates are discussed.
Suicide: A Four‐pathway Clinical‐Biochemical Model

Abstract This chapter, based on a review of recent research as well as data presented in this report, proposes four hypothetical pathways leading to suicide in clinical depression: (1) an acute pathway involving severe anxiety/agitation associated with high brain corticotrophin‐releasing factor (CRF or CRH) levels, (2) trait baseline and reactivity hopelessness, (3) severe anhedonia, and (4) trait impulsiveness associated with low brain serotonin turnover and low total cholesterol as a possible peripheral correlate.
Human osteoarthritic chondrocytes possess an increased number of insulin-like growth factor 1 binding sites but are unresponsive to its stimulation. Possible role of IGF-1-binding proteins.

OBJECTIVE To characterize the insulin-like growth factor 1 (IGF-1) receptor in human osteoarthritic (OA) and normal adult chondrocytes. The biologic response of chondrocytes to IGF-1 stimulation was examined, as was the presence and synthesis of IGF binding proteins (IGFBP) in these cells. METHODS Binding studies, Northern blot, immunohistochemical analysis, and affinity cross-linking experiments were performed for characterization of the IGF receptor, and the latter method was also used for IGFBP determination. The biologic response was estimated via the incorporation of radiolabeled proline into a newly synthesized protein. RESULTS Binding experiments revealed a single class of binding sites. The mean +/- SEM affinity (Kd) of normal chondrocytes was 1.4 +/- 0.4 nM, with 26.8 +/- 5.5 x 10(3) binding sites/cell. OA chondrocytes had a lower affinity (Kd 15.4 +/- 4.7 nM) and a higher density (1,178.3 +/- 299.5 x 10(3) binding sites/cell) compared with normal cells (P < 0.004 and P < 0.001, respectively). Immunohistochemical studies with a monoclonal antibody (MAb) against the type 1 IGF receptor (alpha IR3) showed increased staining in OA cartilage compared with normal tissue. Biologic responses of chondrocytes after IGF-1 stimulation revealed that OA chondrocytes were unresponsive, whereas a 2.5-fold increase in new protein synthesis was observed in normal cells. Competition studies in normal chondrocytes revealed that both IGF-1 and IGF-2 displaced radiolabeled IGF-1 in a comparable manner; however, insulin at high concentration weakly competes. Moreover, MAb alpha IR3 effectively blocked specific binding in normal chondrocytes (77%), but not in OA chondrocytes (26%). Northern blot and covalent cross-linking analyses revealed the specific band characteristic of type 1 receptor. With the latter technique, other bands corresponding to the IGFBPs were also detected. Comparison between normal and OA chondrocytes showed increased intensity of the IGFBP bands, particularly those corresponding to the IGFBP-3 doublet. CONCLUSION It is shown that type 1 IGF receptor is expressed in human articular cartilage and that the level of binding sites is significantly increased in OA chondrocytes. Interestingly, despite the higher level of binding sites in OA cells, no response to IGF-1 stimulation was found in these cells. Our data suggest that this increase in specific binding may involve not only the type 1 IGF receptor but also IGFBP on the cell surface. The latter, by binding the IGF-1, will diminish the bioavailability of IGF-1 and thus prevent its anabolic action.
Term perinatal mortality and morbidity in monochorionic and dichorionic twin pregnancies: A retrospective study

Aim. Perinatal mortality and morbidity in monochorionic (MC) twins appears to be increasing compared to dichorionic (DC) twins. The aim of our study was to determine the difference in perinatal mortality and morbidity in MC and DC twins born after 37 weeks’ gestation. Design. A retrospective, cross‐sectional study of medical records. Setting. Large tertiary care centre in the Netherlands. Population. All twins delivered ≥37 gestational weeks at the Leiden University Medical Centre between 1988 and 2004 were included in the study. Methods. Perinatal outcome was assessed in all term twins. Differentiation between a MC study group and a DC control group was made based on gender, intertwin membrane histology, or first trimester ultrasound. Main outcome measures. Perinatal mortality and morbidity was assessed. Morbidity was defined as admission to the neonatal nursery. Results. We included 383 DC and 74 MC twin pregnancies. Three fetuses died in utero in two MC pregnancies at 38 gestational weeks. One surviving MC co‐twin had a right‐sided hemiparesis due to a large parenchymal defect in the left cerebral hemisphere. Perinatal mortality was 2% (3/148) in MC and 0% (0/766) in DC twins (p = 0.004). The admission rate to the neonatal nursery was 27% in MC and 19% in DC twins (p = 0.031). Conclusions. At term, MC twins have a higher risk for perinatal mortality and a higher admission rate to the neonatal nursery compared to DC twins. Given the increased mortality, a prospective study is needed to determine the effects of elective delivery in uncomplicated MC twin pregnancies at around 37 weeks’ gestation.
Central venous lines in neonates: a study of 2186 catheters

Objective: To describe the use of percutaneously inserted silicone central venous lines (CVLs) in neonates at the Royal Brisbane and Women’s Hospital, Australia. Design: Data for all infants admitted from 1 January 1984 until 31 December 2002 who had a CVL were examined in the neonatal database, completed from paper records and patient charts where necessary. Autopsy reports of all babies who died with a catheter in place were reviewed. Results: There were 18 761 admissions, 2186 catheters in 1862 babies for a total of 35 159 days (median 14 days, range 1–99 days). The tip was in the right atrium for 1282 (58.6%) of the catheters. A total of 142 babies (7.6%) died with a CVL in place, 89 (4.8%) with the catheter tip in the right atrium. Thirty two of these 89 babies had an autopsy. No autopsies reported tension in the pericardium or milky fluid resembling intralipid. One case (0.05% of catheters) of non-lethal pericardial effusion occurred in a baby whose catheter was inappropriately left coiled in the right atrium. There were no cases of pleural effusion related to CVL use. Most (1523, 69.7%) were removed electively. Septicaemia occurred during the life of 116 catheters (5.3%). Conclusion: This is the largest series of percutaneously inserted silicone central venous catheters reported. It illustrates the safety of these catheters in this context. It highlights the value of keeping prospective records on such catheters. Catheters with their tips in the right atrium and not coiled did not cause pericardial effusion. Strict insertion and management principles for CVLs should be adhered to.
A QoS-aware downlink packet scheduler using token bucket algorithm for LTE systems

LTE is one of the leading technologies to meet the requirements of 4G telecommunication systems. Important design parameters intended to achieve this goal include high data rate, low latency and efficient network bandwidth requirements. Scheduling in LTE is one of the most important functions of the eNodeB due to the existence of different subcarriers in OFDMA modulation and the frequency diversity of the channel. However, the scheduling algorithms are not defined by the Third Generation Partnership Project (3GPP) and are left open for designers and manufacturers. In this paper, we propose a novel QoS-Aware scheduling algorithm in which a Token Bucket algorithm is used in order to limit the access to the resources used by the real time traffic. Simulation results show that the Token Bucket algorithm, by limiting the amount of resources allocated to real time and high priority traffic streams, causes other type of traffic not to be starved. This feature of the scheduling algorithm not only increases the efficiency of the frequency utilization, but also causes the QoS requirements of various traffic classes to be satisfied.
Minimized cardiopulmonary bypass combined with a smart suction device: the future of cardiopulmonary bypass?

OBJECTIVE The standard heart-lung machine is a major trigger of systemic inflammatory response and the morbidity attributed to conventional extracorporeal circulation (CECC) is still significant. Reduction of blood-artificial surface contact and reduction of priming volume are principal aims in minimized extracorporeal circulation (MECC) cardiopulmonary bypass systems. The aim of this paper is to give an overview of the literature and to present our experience with the MECC-smart suction system. METHODS AND RESULTS At our institution, 1799 patients underwent isolated coronary artery bypass grafting (CABG) surgery, 1372 with a MECC-smart suction system and 427 with CECC. All in-hospital data were assessed and the results were compared between the 2 groups. Patient characteristics and the distribution of EuroSCORE risk profile in our collective were similar between both groups. Average age in the MECC collective was 67.5 +/- 11.4 years and average EuroSCORE was 5.0 +/- 1.5. Average number of distal anastomoses was similar to the average number encountered in patients undergoing CABG surgery with CECC (3.3 +/- 1.0 for MECC versus 3.2 +/- 1.1 for CECC; P = ns). Myocardial protection is superior in MECC patients with lower postoperative maximal cTnI values (11.0 +/- 10.8 micromol/L for MECC versus 24.7 +/- 25.3 micromol/L for CECC; P < .05). Postoperative recovery was faster in patients operated on with the MECC-smart suction system and discharge from the hospital was earlier than for CECC patients (7.4 +/- 1.9 days for MECC versus 8.8 +/- 3.8 days for CECC; P < .05). CONCLUSIONS The MECC-smart suction system is a safe perfusion technique for CABG surgery. In patients operated on with this system, the clinical outcome seems to be better than in patients operated on with CECC. This promising and less damaging perfusion technology has the potential to replace CECC systems in CABG surgery.
Polymorphisms of tumor necrosis factor-alpha and interleukin-6 gene and C-reactive protein profiles in patients with idiopathic dilated cardiomyopathy

BACKGROUND AND OBJECTIVES The tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6 gene polymorphism has a controversial role in the pathogenesis of cardiovascular disease among different populations. The effect of the cytokine’s gene polymorphism on idiopathic dilated cardiomyopathy (IDCM) is still unresolved. The current study aimed to evaluate the association of the TNF-α −308 G/A and IL-6 −174 G/C polymorphism with IDCM in a Pakistani population. DESIGN AND SETTINGS Blood samples for this case-control study were collected from the cardiology outpatient department of multiple cardiology centers of Rawalpindi/Islamabad, Pakistan, between July 2012 and December 2012. PATIENTS AND METHODS IDCM cases (number [n]=250) and healthy controls (n=300) were genotyped using polymerase chain reaction and restriction fragment length polymorphism. RESULTS The TNF-α −308 variant genotypes GA and AA were more prevalent in patients compared with the control group (P<.0001). Similarly, the IL-6 −174 variant genotypes GC and CC showed a high prevalence in patients with IDCM compared with healthy controls (P=.0019). IDCM cases had a higher prevalence of the TNF-α–308A (P<.0001) and the IL-6 −174C (P=.0008) mutant alleles than did the control group. The IDCM cases bearing the TNF-α−308 and IL-6 variant genotypes revealed elevated levels of high-sensitivity C-reactive protein (hs-CRP) when compared with the corresponding controls (P<.05). CONCLUSION The TNF-α −308 G/A and IL-6 −174 G/C gene polymorphisms and high levels of hs-CRP may be associated with the pathogenesis of IDCM in the study population.
Association of metabolic syndrome and its components with hyperuricemia in a Mediterranean population.

Several studies have found an association between hyperuricemia and metabolic syndrome (MS), although there are discrepancies as to which MS components play a pivotal role in this association. We aimed to investigate the association between serum uric acid (SUA) levels and MS in a Mediterranean population (eastern Spain). We performed a case-control study of 71 patients with MS and 122 healthy controls. MS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III modified criteria. Hyperuricemia was defined as SUA levels >6.55 mg/dL. We determined biochemical, lipidic and inflammatory parameters along with uric acid. Patients with MS showed a higher risk of hyperuricemia than those without MS (OR: 2.87 95% CI: 1.48- 5.55; p = 0.002). In turn, the unadjusted logistic regression analysis showed that hyperuricemia is associated with a higher risk of presenting all the MS components, except hypertension; i.e., hypertriglyceridemia, low HDL-cholesterol, abdominal obesity and glucose intolerance were predictors for hyperuricemia (OR: 3.15, 95% CI: 1.61- 6.15, p = 0.001; OR: 4.07, 95% CI: 1.77- 9.33, p = 0.001; OR: 2.81, 95% CI: 1.41- 5.58, p = 0.003 and OR: 2.82, 95% CI: 1.46- 5.45, p = 0.002 respectively). The adjusted logistic regression analysis revealed that only low HDL-cholesterol and glucose intolerance were independent predictors for hyperuricemia (OR: 2.71, 95% CI 1.06- 6.97, p = 0.038; OR: 2.14, 95% CI 1.01- 4.56, p = 0.049, respectively). In our geographical area, the patients with MS showed a nearly 3-fold risk of hyperuricemia than those without. Among all the MS components, low-HDL-cholesterol and high glucose independently increased more than twice the risk of hyperuricemia, and are the pivotal components involved in hyperuricemia.
Qualitative Examination of Adolescent Health-Related Quality of Life at 1 Year Postconcussion.

CONTEXT Moderate to severe traumatic brain injuries can negatively influence health-related quality of life (HRQOL) in adolescent patients. The effect of sport-related concussion on adolescent HRQOL remains unclear. OBJECTIVE To investigate the perceptions of adolescent student-athletes and their parents regarding the adolescents' HRQOL 1 year after sport-related concussion. DESIGN Qualitative study. SETTING Secondary school. PATIENTS OR OTHER PARTICIPANTS Seven adolescent student-athletes (age range, 12-16 years) who sustained a sport-related concussion at least 1 year (15.3 ± 2.8 months) before the study participated along with their primary care-giving parents (n = 7). DATA COLLECTION AND ANALYSIS Fourteen semistructured face-to-face interviews (7 adolescents, 7 parents) were completed. Interviews were transcribed and inductively analyzed by a team of 3 athletic trainers with 32 combined years of professional experience. Themes were negotiated through a consensual review process. Participant checks were completed to ensure trustworthiness of the results. RESULTS Four major themes emerged from the interviews: (1) significant effect of symptoms, (2) feelings of frustration, (3) influence on school attendance and activities, and (4) nature of interpersonal and team relationships. Participants indicated that the physical symptoms of the concussion substantially affected their emotional and academic function. The influence of the concussion on social interactions seemed to depend on the nature of interpersonal relationships. CONCLUSIONS Sport-related concussion can negatively influence physical and emotional function, academics, and interpersonal interactions as perceived by adolescent student-athletes and their parents. Education of parents and their children, school professionals, coaches, and teammates remains critical to effectively recognize and manage sport-related concussion. Secondary school districts also play a critical role in the concussion-management process by establishing and implementing accommodation policies that alleviate student concerns about falling behind while ensuring a healthy return to normal school routines. Furthermore, adolescent support systems must be considered throughout the recovery process.
Long-Distance Trust-Free Quantum Key Distribution

The feasibility of trust-free long-haul quantum key distribution (QKD) is addressed. We combine measurement-device-independent QKD, as an access technology, with a quantum repeater setup, at the core of future quantum communication networks. This will provide a quantum link none of whose intermediary nodes need to be trusted, or, in our terminology, a trust-free QKD link. As the main figure of merit, we calculate the secret key generation rate when a particular probabilistic quantum repeater protocol is in use. We assume the users are equipped with imperfect single photon sources, which can possibly emit two single photons, or laser sources to implement decoy-state techniques. We consider apparatus imperfection, such as quantum efficiency and dark count of photodetectors, path loss of the channel, and writing and reading efficiencies of quantum memories. By optimizing different system parameters, we estimate the maximum distance over which users can share secret keys when a finite number of memories are employed in the repeater setup.