Miracle-dz/UniFAR-FTUs huggingface dataset:
Incidence and cumulative recurrence rates of venous thromboembolism in the Taiwanese population

Summary. Background: Little information is available on the epidemiology of venous thromboembolism (VTE) in Asian populations. Objectives: To investigate VTE incidence, VTE cumulative recurrence rates and risk factors for VTE recurrence among the adult Taiwanese population. Methods: This population‐based cohort study used the Taiwanese National Health Insurance claims databases to identify 5347 adult patients (2463 men, 46.1%) with VTE diagnosed in 2001 and 2002. We calculated the crude incidence of VTE and its recurrence. We also conducted a nested case–control study (n = 3576) among this population to estimate the association between VTE recurrence and exposure to potential VTE risk factors by conditional logistic regression. Results: The crude incidence of VTE was 15.9 per 100 000 person‐years, and its recurrence rate was 5.1% per person‐year. During 11 566 person‐years of follow‐up, the cumulative rates of VTE recurrence at 6, 12, 24, 36 and 47 months were 6.7%, 9.4%, 12.4%, 13.9%, and 14.4%, respectively. By conditional logistic regression, histories of VTE [adjusted odds ratio (OR) 1.71, 95% confidence interval (CI) 1.32–2.16] or malignant neoplasm (adjusted OR 1.64, 95% CI 1.26–1.99), major extremity trauma (adjusted OR 2.76, 95% CI 1.82–4.52), serious neurologic diseases (adjusted OR 1.43, 95% CI 1.12–1.84) or undergoing major surgery (adjusted OR 4.57, 95% CI 1.72–12.50) were associated with higher risks of VTE recurrence. Conclusions: The incidence of VTE is lower in the Taiwanese population than in Caucasians. Most VTE recurrences occur within 12 months, but they continue to occur beyond 1 year. The VTE recurrences are associated with malignancy, history of VTE, and major surgery after a previous VTE.
OMIP‐003: Phenotypic analysis of human memory B cells

This panel was developed to characterize the phenotypic diversity of human memory B cells, with an emphasis on discriminating cell subsets within both the conventional memory population (CD27+) and the more recently described isotype switched (IgD−) population lacking expression of CD27 (1). It has been tested on fresh and cryopreserved peripheral blood mononuclear cells (PBMC), as well as bone marrow aspirates and tonsillar cells. The multicolor panel described herein has been used extensively to analyze large numbers of PBMC samples obtained from healthy controls in steady state and in response to infection (HIV, influenza, RSV) and vaccination (influenza, tetanus) as well as in hundreds of patients with autoimmune diseases (Systemic Lupus Erythematosus, Rheumatoid Arthritis, Sjogren’s syndrome, Psoriatic Arthritis and Type 1 Diabetes) and conditions characterized by allogeneic immune responses (renal transplantion and chronic graft versus host disease). This panel is also being applied in a longitudinal study in which 150 SLE patients are to be followed quarterly for a period of two years.
Type 2 diabetes mellitus impairs the maturation of endothelial progenitor cells and increases the number of circulating endothelial cells in peripheral blood

Type 2 diabetes mellitus (T2DM) is associated with endothelial dysfunction, which leads to vascular complications. Endothelial progenitor cells (EPCs) are thought to be a subset of cells derived from the bone marrow that play a crucial role in the neovascularization of ischemic tissue and in the maintenance of endothelial cell integrity. In contrast, circulating endothelial cells (CECs) are of endothelial origin and become detached from the intima of blood vessels in response to pathological stimuli. The study investigated the effects of T2DM on subpopulations of EPCs and CECs in peripheral blood, as compared with the effects on unacylated (UAG) and acylated (AG) ghrelin levels, which have been shown recently to play an important role in endothelial dysfunction associated with diabetes. Using the high‐performance flow cytometer FACSCanto, and UAG/AG ghrelin enzyme immunoassay kits, we analyzed whole peripheral blood samples from: (i) diabetic patients with a history of disease of less than 1 year and no clinical evidence of angiopathy, (ii) diabetic patients with long‐standing disease with vascular complications, and (iii) healthy donors. We found that T2DM did not affect bone‐marrow mobilization, but it altered the UAG/AG profile and decreased the number of highly differentiated EPCs (late EPCs) greatly. In addition, T2DM increased the number of CECs, together with the number of activated CECs. Our results suggest that: (i) the endothelial damage could be due mainly to altered maturation/commitment of EPCs, rather than a simple decrease in their production in the bone marrow; and (ii) EPC subpopulations and ghrelin levels could be useful markers to assess endothelial damage in diabetes. © 2012 International Society for Advancement of Cytometry
Medium-term carbohydrate tolerance improves and then deteriorates with advancing pregnancy in urban Nigerian women

Background: It has been reported that carbohydrate metabolism does not deteriorate in pregnancy in the African, an observation at variance with general teaching. Objective: To determine the effect of pregnancy on medium term carbohydrate metabolism Methods: Medium term carbohydrate metabolism was evaluated in pregnant and non-pregnant Nigerian women using changes in Glycoted Plasma Proteins (GPP) as a surrogate for medium-term carbohydrate metabolism. Study subjects included women in all three trimesters of pregnancy, a group of non-pregnant women with normal carbohydrate metabolism and another group of women with confirmed diabetes already on treatment but not pregnant. Fasting plasma glucose was determined by the glucose oxidase method while GPP was determined using a modification of the thiobarbituric method with correction for levels of total plasma proteins (TPP). Average values are presented as mean (SD) while relationship between variables were determined using Pearson product moment correlation coefficients. Significance of p values of determinations is set at p Keywords: Pregnancy, Carbohydrate intolerance, Glycated plasma proteins, Fructosamine, Fasting plasma glucose, Nigeria.
Anesthesia and Neurosurgery

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The plasma membrane calcium ATPase modulates calcium homeostasis, intracellular signaling events and function in platelets

Summary. Background: The plasma membrane calcium ATPase (PMCA) regulates localized signaling events in a variety of cell types, although its functional role in platelets remains undefined. Objectives: To investigate the role of PMCA in determining platelet intracellular calcium concentration ([Ca2+]i) at rest and following agonist stimulation, and to define the corresponding effects upon different stages of platelet activation. Methods: [Ca2+]i was continuously measured in Fura‐2‐loaded platelets and in vitro and in vivo functional analyses performed in the presence of the PMCA inhibitor carboxyeosin (CE). Results: Concentrations of CE that selectively inhibited Ca2+ extrusion through PMCA were established in human platelets. [Ca2+]i was elevated by CE in resting platelets, although collagen‐stimulated Ca2+ release was reduced. Impaired Ca2+ mobilization upon agonist stimulation was accompanied by reduced dense granule secretion and impaired platelet aggregation. Platelet aggregation responses were also reduced in PMCA4−/− mice and in an in vivo mouse model of platelet thromboembolism. Conversely, inhibition of PMCA promoted the early and later stages of platelet activation, observed as enhanced adhesion to fibrinogen, and accelerated clot retraction. Investigations into the signaling mechanisms underlying CE‐mediated inhibition of platelet aggregation implicated cGMP‐independent vasodilator‐stimulated phosphoprotein phosphorylation. Conclusions: Disruption of PMCA activity perturbs platelet Ca2+ homeostasis and function in a time‐dependent manner, demonstrating that PMCA differentially regulates Ca2+‐dependent signaling events, and hence function, throughout the platelet activation process.
HIV‐1 Tat‐induced platelet activation and release of CD154 contribute to HIV‐1‐associated autoimmune thrombocytopenia

Summary. Background: Enhanced platelet activation in human immunodeficiency virus (HIV)‐1‐infected patients has been reported and shown to strongly correlate with plasma viral load. Activated platelets are known to express and to release a variety of proteins that can modulate the immune system. Specifically, platelet‐derived CD154 has been shown to be directly involved in the development of autoimmune thrombocytopenia (ITP). The mechanism by which HIV‐1 infection leads to platelet activation and the effect of this activation on the development of HIV‐1 ITP, however, is not fully understood. Objective: We have investigated the effect of HIV‐1 Trans activating factor (Tat) on platelet activation. Results: We report that HIV‐1 Tat directly interacts with platelets and induces platelet activation resulting in platelet micro‐particle release. This activation by Tat requires the chemokine receptor CCR3 and β3‐integrin expression on platelets, as well as calcium flux. Tat‐induced activation of platelets releases platelet CD154, an immune modulator. Enhanced B‐cell activity is found in mouse spleen B cells co‐cultured with platelets treated with Tat in vitro. An early antibody response against adenovirus is found in Tat‐injected mouse immunized with adenovirus, suggesting an enhanced immune response in vivo. Conclusions: We have described a role of Tat‐induced platelet activation in the modulation of the immune system, with implications for the development of HIV‐1‐associated thrombocytopenia.
Validity of Methods Used for the Assessment of Body Components in Children: Pros and Cons of Modern versus Old Technology

There is increasing interest in measuring muscle mass in paediatric research and clinical practice. The simplest approach is to measure lean mass and predict muscle mass as a proportion of it, but individuals and groups vary in this ratio. Calculation of arm muscle area from anthropometry has been shown to have poor accuracy in individuals; segmental impedance analysis, however, may perform better as a simple predictive method for limb composition, and merits further development. Biochemical techniques (e.g. urinary creatinine measurement) are cumbersome in children and their data are confounded by variability in maturation, diet and activity level. The best tools are radiographic imaging techniques that attempt direct measurement of muscle mass. The most widely available is dual-energy X-ray absorptiometry, which is capable of detecting the direction of differences or changes, but is less reliable regarding their magnitude because of error that varies with gender, size and fatness. Magnetic resonance imaging is currently the best technique available, as computed tomography has too high a radiation dose to justify its use in younger age groups. Regardless of which technique is used, reference data are required to aid interpretation of results, and are a current research priority.
An Alternative to the Balance Error Scoring System: Using a Low-Cost Balance Board to Improve the Validity/Reliability of Sports-Related Concussion Balance Testing

Objective:Recent guidelines advocate sports medicine professionals to use balance tests to assess sensorimotor status in the management of concussions. The present study sought to determine whether a low-cost balance board could provide a valid, reliable, and objective means of performing this balance testing. Design:Criterion validity testing relative to a gold standard and 7 day test-retest reliability. Setting:University biomechanics laboratory. Participants:Thirty healthy young adults. Assessment of Risk Factors:Balance ability was assessed on 2 days separated by 1 week using (1) a gold standard measure (ie, scientific grade force plate), (2) a low-cost Nintendo Wii Balance Board (WBB), and (3) the Balance Error Scoring System (BESS). Main Outcome Measures:Validity of the WBB center of pressure path length and BESS scores were determined relative to the force plate data. Test-retest reliability was established based on intraclass correlation coefficients. Results:Composite scores for the WBB had excellent validity (r = 0.99) and test-retest reliability (R = 0.88). Both the validity (r = 0.10–0.52) and test-retest reliability (r = 0.61–0.78) were lower for the BESS. Conclusions:These findings demonstrate that a low-cost balance board can provide improved balance testing accuracy/reliability compared with the BESS. Clinical Relevance:This approach provides a potentially more valid/reliable, yet affordable, means of assessing sports-related concussion compared with current methods.
Ketamine use: minimising problems and maximising pleasure

In January 2006 ketamine shifted from medical regulation through the Medicines Act to a Class C drug through an amendment to the Misuse of Drugs Act. In the debate surrounding this criminalisation, interest has grown in prevalence and patterns of ketamine consumption. Such information is scarce however, particularly given that ketamine has yet to be included in the British Crime Survey or most other surveys of youth and young adult drug use. Here Karenza Moore and Fiona Measham reveal the true extent of ketamine use, who is using it and how.
Psychiatry and politicians: the ‘hubris syndrome’

Lord Owen has alerted us to the dangers of ill health in heads of government, especially if they strive to keep their illnesses secret. The description of the hubris syndrome is still at an early stage but Owen has provided psychiatrists and other physicians with useful guidance on how to recognise its appearance in persons who hold positions of power. He has also provided advice to doctors caring for such persons.
Correlates of Disordered Eating Attitudes Among Male and Female Young Talented Dancers: Findings From the UK Centres for Advanced Training

Correlates of disordered eating attitudes were examined with a mixed-sex sample of 347 young talented dancers aged 10–18 years from all UK Centres for Advanced Training. Equal proportions of females (7.3%) and males (7.6%) were symptomatic for disordered eating but correlates differed: for females, self-evaluative perfectionism, waking up > twice/night and hours of non-dance physical activity were predictive while for males, only the combination of self-evaluative and conscientious perfectionism was significant. Differences between menstrual status groups were evident, with young dancers (pre-menarcheal/within first year of menarche) reporting the least disordered eating attitudes and those with dysfunctional menses reporting the most.
Social Information-Processing and Coping in Adolescent Females Diagnosed With an Eating Disorder: Toward a Greater Understanding of Control

The objective of this study was to examine differences in social information-processing and coping strategies between adolescent females in treatment for an eating disorder and asymptomatic peers. Adolescent females in treatment for an eating disorder (n = 50) were compared to asymptomatic control participants (n = 59) on a measure of social information-processing. Participants were presented with 4 hypothetical, ambiguous social dilemmas in which the intent of a peer provocateur was unclear. Questions followed each dilemma assessing intent attributions, the participant's emotional reaction, the intensity of the emotion, and coping strategies. The participants in treatment for an eating disorder were significantly more likely to perceive hostile intent from a peer provocateur, reported a greater intensity of negative emotions, and identified a significantly greater number of avoidant coping strategies. Specifically, the eating disorder group identified significantly more intrapunitive avoidant coping strategies that reflect maladaptive and self-destructive means of coping with distressing events. Results indicate social cognitive processing biases and maladaptive coping strategies may be instrumental in perceived loss of control and influence the development/maintenance of eating disorders.
Characteristics of Pediatric and Adolescent Concussion Clinic Patients With Postconcussion Amnesia

Objective:The current study examines the demographics, injury characteristics, and outcomes associated with the presence of postconcussion amnesia in young concussion clinic patients. Design:Cross-sectional, retrospective clinical cohort. Setting:Concussion services clinic. Patients:Pediatric and adolescent concussion services program patients, presenting within 10 days postinjury, aged 10-18 years, with the goal of returning to sport (n = 245). Assessment of Risk Factors:Age, gender, race, head trauma history, injury mechanism, loss of consciousness (LOC), injury-related visit to an emergency department, cognitive and balance scores, symptoms, and management recommendations. Main Outcome Measures:Univariate and multivariate analyses determined adjusted odds ratios for reported presence of any postconcussion amnesia (anterograde or retrograde). Results:Factors associated with amnesia (univariate, P < 0.10) and included in the multivariate model were race, head trauma history, mechanism of injury, LOC, injury-related visit to an emergency department, management recommendations and time of injury and initial visit symptom severity. Age and gender were also included in the model due to biological significance. Of the 245 patients, 181 had data for all model variables. Of the 181 patients, 58 reported amnesia. History of head trauma [odds ratio (OR), 2.7; 95% confidence interval (CI), 1.3-5.7]; time of injury (TOI) symptom severity >75th percentile (OR, 2.6; 95% CI, 1.2-5.3) and LOC (OR, 2.2; 95% CI, 1.1-4.6) were found to have significant and independent relationships with amnesia in the multivariate model. Conclusions:This study illustrates that patients presenting with postconcussion amnesia are more likely to have a history of head trauma, LOC, and greater symptom severity. Future research is needed to better understand amnesia following concussion. Clinical Relevance:Amnesia presence, previous head trauma, LOC, and increased symptom severity may aid in identifying patients with a greater initial injury burden who warrant closer observation and more conservative management.
Potential Benefits of Glitazones for Cancer and Vascular Disease

Glitazones were introduced into clinical use to offer type II diabetic patients an alternative to oral hypoglycae- mic agents. Unlike traditional agents based on � -pancreatic overstimulation, glitazones raise peripheral insulin sensitivity allowing the patient to efficiently use his own insulin. Although glitazones are only approved for the treatment of diabetes, their beneficial effects extend to every symptom of the so-called metabolic syndrome: they protect against atherosclerosis, inhibit blood coagulation, decrease hypertension and improve vascular endothelial function. Moreover, glitazones coun- teract activation of macrophages and brain microglia, attenuate the expression of pro-inflammatory genes, and inhibit various signalling events involved in inflammation. In addition, glitazones are able to induce cell differentiation and apop- tosis in several cancer cells, suggesting possible use of these drugs for the treatment of gliomas and other tumors. The mo- lecular basis of such a vast array of glitazone actions is necessarily complex. Glitazone effects were originally attributed to activation of peroxisome proliferator activated receptor-� (PPAR� ). However, several properties of glitazones are unre- lated to PPAR� . We review here the emerging actions of glitazones focusing on their antihypertensive and anti-tumoral ef- fects, PPAR�-dependent and -independent, and also emphasizing the contribution of mitochondria and reactive oxygen and nitrogen species to these actions.
Efficient purification of CD4+ lymphocytes from peripheral blood progenitor cell products using affinity bead acoustophoresis

Processing of peripheral blood progenitor cells (PBPC) for clinical transplantation or research applications aims to effectively isolate or deplete specific cell populations, utilizing primarily magnetic or fluorescence activated sorting methods. Here, we investigated the performance of microfluidic acoustophoresis for the separation of lymphocyte subsets from PBPC, and present a novel method for affinity‐bead‐mediated acoustic separation of cells which can otherwise not be acoustically discriminated. As the acoustic force on a particle depends on particle size, density and compressibility, targeting of cells by affinity specific beads will generate cell‐bead complexes that exhibit distinct acoustic properties relative to nontargeted cells and are, thus, possible to isolate. To demonstrate this, PBPC samples (n = 22) were obtained from patients and healthy donors. Following density gradient centrifugation, cells were labeled with anti‐CD4‐coated magnetic beads (Dynal) and isolated by acoustophoresis and, for comparison, standard magnetic cell sorting technique in parallel. Targeted CD4+ lymphocytes were acoustically isolated with a mean (±SD) purity of 87 ± 12%, compared with 96 ± 3% for control magnetic sorting. Viability of sorted cells was 95 ± 4% (acoustic) and 97 ± 3% (magnetic), respectively. The mean acoustic separation efficiency of CD4+ lymphocytes to the target fraction was 65 ± 22%, compared with a mean CD4+ lymphocyte recovery of 56 ± 15% for magnetic sorting. Functional testing of targeted CD4+ lymphocytes demonstrated unimpaired mitogen‐mediated proliferation capacity and cytokine production. Hematopoietic progenitor cell assays revealed a preserved colony forming ability of nontarget cells post sorting. We conclude that the acoustophoresis platform can be utilized to efficiently isolate bead‐labeled CD4+ lymphocytes from PBPC samples in a continuous flow format, with preserved functional capacity of both target and nontarget cells. These results open up for simultaneous affinity‐bead‐mediated separation of multiple cell populations, something which is not possible with current standard magnetic cell separation technology. © 2014 International Society for Advancement of Cytometry
Combative Sports Injuries: An Edmonton Retrospective

Objective:Mixed martial arts (MMA) is an increasingly popular combative sport involving aggressive techniques that present substantial injury risk. We examined the incidence and types of injuries sustained in MMA fights and compared this with injuries sustained in boxing matches. Design:Consecutive Case Series. Setting:We used data from post-fight medical examinations on all bouts in Edmonton, Canada, between 2000 and 2013. Participants:The participants were 1181 MMA competitors and 550 boxers. Main Outcome Measures:The attending physician conducted a mandatory post-fight examination of all fighters and documented the nature of injuries sustained. Results:Boxers were significantly more likely not to experience injury (49.8% vs 59.4%, P < 0.001), whereas MMA fighters were significantly more likely to experience 1 injury (typically contusion/bruising, P < 0.001). Boxers were more likely to experience loss of consciousness (7.1% vs 4.2%, P = 0.01) and serious eye injury (1.1% vs 0.3%, P = 0.02). Conclusions:The overall injury incidence in MMA competitors appears slightly higher than for boxers, but MMA fighters experience more minor contusion/bruising injuries. Boxers are more likely to experience serious injury such as concussion/head trauma involving loss of consciousness or eye injury such as retinal detachment.