Miracle-dz/UniFAR-FTUs huggingface dataset:
Radiosurgery for low-grade intracranial arteriovenous malformations.

OBJECT Low-grade, or Spetzler-Martin (SM) Grades I and II, arteriovenous malformations (AVMs) are associated with lower surgical morbidity rates than higher-grade lesions. While radiosurgery is now widely accepted as an effective treatment approach for AVMs, the risks and benefits of the procedure for low-grade AVMs, as compared with microsurgery, remain poorly understood. The authors of this study present the outcomes for a large cohort of low-grade AVMs treated with radiosurgery. METHODS From an institutional radiosurgery database comprising approximately 1450 AVM cases, all patients with SM Grade I and II lesions were identified. Patients with less than 2 years of radiological follow-up, except those with complete AVM obliteration, were excluded from analysis. Univariate and multivariate Cox proportional-hazards and logistic regression analyses were used to determine factors associated with obliteration, radiation-induced changes (RICs), and hemorrhage following radiosurgery. RESULTS Five hundred two patients harboring low-grade AVMs were eligible for analysis. The median age was 35 years, 50% of patients were male, and the most common presentation was hemorrhage (47%). The median AVM volume and prescription dose were 2.4 cm(3) and 23 Gy, respectively. The median radiological and clinical follow-up intervals were 48 and 62 months, respectively. The cumulative obliteration rate was 76%. The median time to obliteration was 40 months, and the actuarial obliteration rates were 66% and 80% at 5 and 10 years, respectively. Independent predictors of obliteration were no preradiosurgery embolization (p < 0.001), decreased AVM volume (p = 0.005), single draining vein (p = 0.013), lower radiosurgery-based AVM scale score (p = 0.016), and lower Virginia Radiosurgery AVM Scale (Virginia RAS) score (p = 0.001). The annual postradiosurgery hemorrhage rate was 1.4% with increased AVM volume (p = 0.034) and lower prescription dose (p = 0.006) as independent predictors. Symptomatic and permanent RICs were observed in 8.2% and 1.4% of patients, respectively. No preradiosurgery hemorrhage (p = 0.011), a decreased prescription dose (p = 0.038), and a higher Virginia RAS score (p = 0.001) were independently associated with postradiosurgery RICs. CONCLUSIONS Spetzler-Martin Grade I and II AVMs are very amenable to successful treatment with stereotactic radiosurgery. While patient, physician, and institutional preferences frequently dictate the final course of treatment, radiosurgery offers a favorable risk-to-benefit profile for the management of low-grade AVMs.
Eph/ephrin expression in the adult rat visual system following localized retinal lesions: localized and transneuronal up‐regulation in the retina and superior colliculus

Following unilateral optic nerve section in adult PVG hooded rat, the axon guidance cue ephrin‐A2 is up‐regulated in caudal but not rostral superior colliculus (SC) and the EphA5 receptor is down‐regulated in axotomised retinal ganglion cells (RGCs). Changes occur bilaterally despite the retino‐collicular projection being mostly crossed. Here we investigate the dynamics of Eph/ephrin expression using in situ hybridization and semi‐quantitative immunohistochemistry after localized retinal lesions. Unilateral krypton laser lesions to dorso‐nasal retina ablated contralaterally projecting RGCs (DN group); ventro‐temporal lesions ablated contralaterally and ipsilaterally projecting RGCs (VT group). Lesions of the entire retina served as controls (Total group). Results are compared to normal animals in which tectal ephrin‐A2 and retinal EphA5 are expressed, respectively, as shallow ascending rostro‐caudal and naso‐temporal gradients. In both SCs of DN and Total groups, tectal ephrin‐A2 was up‐regulated caudally; in the VT group, expression remained normal bilaterally. Unilateral collicular ablation indicated that bilateral changes in ephrin‐A2 expression are mediated via intercollicular pathways. EphA5 expression in the VT group was elevated in the intact nasal region of experimental retinae. For each experimental group, EphA5 expression was also elevated in nasal retina of the opposite eye, resulting in uniform expression across the naso‐temporal axis. Up‐regulation of ephrin‐A2 in caudal, but not rostral, SC suggests the enhancement of developmental positional information as a result of injury. Bilateral increases in retinal EphA5 expression demonstrate that signals for up‐regulation operate interocularly. The study demonstrates that signals regulating guidance cue expression are both localized and relayed transneuronally.
Renal cell carcinoma: relevance of angiogenetic factors.

Angiogenesis is essential for tumour growth. Mostly hypervasculariced renal cell carcinoma (RCC) usually express angiogenic factors, e.g. basic fibroblast factor (bFGF), vascular endothelial growth factor, and angiogenin (ag). This study was designed to evaluate the improvement of serological angiogenesis-factors, their prognostic relevance and correlation to tumour-grade, -stage and -volume. Measurement of bFGF, vEGF and ag was done with ELISA (Quantikine), R and D-Systems Europe Abbington, United Kingdom. The control group comprised 39 healthy blood donors, RCC-group were 35 patients with different RCC. Survival dates were presented with Kaplan-Meyer-curves, significance was tested with students-t-test. For all angiogenic factors a highly significant difference between the healthy and RCC-group was found. A strong correlation between angiogenic factors and tumor grade, -stage and -volume, was not found, but a trend for each of the angiogenic factors to correlate with grade was seen. No survival benefit was seen between patients with normal angiogenic factor over those with elevated angiogenic levels.
Nasopharyngeal carriage of Streptococcus pneumoniae shortly before vaccination with a pneumococcal conjugate vaccine causes serotype-specific hyporesponsiveness in early infancy.

BACKGROUND The antibody response to pneumococcal conjugate vaccines (PCVs) in infants is variable. Factors responsible for this variability have not been fully elucidated. The objective of this study was to investigate whether pneumococcal carriage around the time of the first dose of 7-valent PCV (PCV7) affects serotype-specific immunologic response. METHODS Healthy 2-month old infants were randomized to receive 2 (at the ages of 4 and 6 months) or 3 (at the ages of 2, 4, and 6 months) PCV7 doses and a booster dose (at the age of 12 months). Nasopharyngeal or oropharyngeal specimens were obtained for culture shortly before the first PCV7 dose. Serotype-specific immunoglobulin (Ig) G levels were measured at ages 2, 7, and 13 months. RESULTS Of 545 children studied, 332 received a booster dose. The most common serotypes carried around the time of the first PCV7 dose were 6B (n = 37), 19F (n = 22), and 23F (n = 14). In carriers before the first dose, the IgG response to the carried serotype after 2 or 3 doses was significantly lower than in noncarriers. In contrast, response to the noncarried serotypes was not affected. Although all children responded to the booster dose, the response to the originally carried serotype was generally lower. CONCLUSIONS Serotype-specific hyporesponsiveness to PCV7 after pneumococcal carriage in infants is demonstrated for the first time. This phenomenon was common, lasted for at least several months, and was only partially overcome by the 12-month booster. TRIAL REGISTRATION isrctn.org identifier: ISRCTN28445844.
The Contribution of Human Capital to China's Economic Growth

Based on literature review on human capital and economic growth,the paper calculates stock of human capital and material capital stock in our country via economic and education data in Chinese statistical yearbook,and estimates the contribution of human capital to China' s economic growth by means of effective labor model and human capital externality model.The paper finds that the role of material capital stock is more important and the externality of stock of human capital to economic growth is significant during China's economic growth.
Early childhood caries: Current evidence for aetiology and prevention

Background: Despite the fact that it is largely preventable, dental caries (decay) remains one of the most common chronic diseases of early childhood. Dental decay in young children frequently leads to pain and infection necessitating hospitalization for dental extractions under general anaesthesia. Dental problems in early childhood have been shown to be predictive of not only future dental problems but also on growth and cognitive development by interfering with comfort nutrition, concentration and school participation.
Fatal pulmonary arterial hypertension associated with phenylpropanolamine exposure

Exogenous substances such as the appetite suppressant fenfluramine are known to be causally related to the development of pulmonary arterial hypertension (PAH). In these cases, the clinical course as well as the pulmonary vascular disease pathologically is indistinguishable from idiopathic PAH. Other exogenous substances, such as amphetamines, cocaine, and meta-amphetamines, have been considered to be potential risk factors for inducing PAH. SOPHIA (the study of pulmonary hypertension in America), in addition to confirming previous reports of a causal association between the appetite suppressant fenfluramine and PAH, unexpectedly found a significantly increased risk for the development of PAH with exposure to over-the-counter antiobesity agents containing phenylpropanolamine. The first case is reported of fatal PAH in a child heavily treated with cold remedies containing phenylpropanolamine, which, in addition to the results of SOPHIA, strengthens the hypothesis that phenylpropanolamine is a risk factor for the development of PAH.
Function, ontogeny and canalization of shape variance in the primate scapula

Primates have shoulders adapted to a wide range of locomotor functions from terrestrial pronograde quadrupedalism to highly arboreal suspensory behaviours. The shape of the scapula tightly follows these functional differences. Previous analyses of primate postcrania, including the scapula, indicate that quadrupedal monkeys are less variable than non‐quadrupeds. It was previously suggested that this difference was due to a relationship between the strength of stabilizing selection and the functional demands of the upper limb. Here it is shown that intraspecific scapular shape variance is highly correlated with the degree of committed quadrupedalism. Primates that engage in frequent suspensory behaviours (e.g. apes and ateline monkeys) average twice the amount of shape variance as quadrupeds (e.g. Old World monkeys and Saimiri). Because this difference in intraspecific shape variance is apparent in infants and does not increase or decrease appreciably over ontogeny, it is not likely that differences in postnatal growth, neuromuscular control or environmental factors such as habitat structure/composition are the primary contributors to differences in adult shape variance. Instead variance in embryonic factors that affect the shape/size of the scapula or epigenetic factors associated with muscle attachments are more likely candidates. In particular, the heterogeneous functional demands of the non‐quadrupedal shoulder probably reduce the stringency of stabilizing selection, resulting in the persistence into adulthood of increased amounts of embryonically generated scapular shape variance.
Collective Autonomy and Absenteeism Within Work Teams: A Team Motivation Approach

ABSTRACT This study investigates the role of collective autonomy in regard to team absenteeism by considering team potency as a motivational mediator and task routineness as a moderator. The sample consists of 90 work teams (327 members and 90 immediate superiors) drawn from a public safety organization. Results of structural equation modeling indicate that the relationships between collective autonomy and two indicators of team absenteeism (i.e., absence frequency and time lost) are mediated by team potency. Specifically, collective autonomy is positively related to team potency which in turn is negatively related to team absenteeism. Furthermore, results of hierarchical regression analyses show that task routineness moderates the relationships between collective autonomy and the two indicators of team absenteeism such that these relationships are stronger when the level of task routineness is low. On the whole, this study points out that collective autonomy may exercise a motivational effect on attendance at work within teams, but this effect is contingent on task routineness.
Morbidity among farm workers in a desert country in relation to long-term exposure to pesticides.

OBJECTIVES Farm workers chronically exposed to low levels of pesticides seldom show signs and symptoms of clinical significance. This study investigates subclinical morbidity patterns among male farm workers in a desert country. METHODS Migrant-established farm workers (N=226) were compared with referents (N=226) and with new farm workers (N=92) who had just entered the country to work on farms. Acetylcholinesterase activity was measured, the aiming test and digit symbol test were applied, and a morbidity profile was collected with a questionnaire. RESULTS The erythrocyte acetylcholinesterase activity and hemoglobin-adjusted erythrocyte acetylcholinesterase activity were significantly depleted in the established farm workers. The results of the aiming and digit symbol tests were also significantly lower for the established farm workers. For the morbidity profile, irritated conjunctiva (47.3%), watery eyes (52.2%), blurred vision (63.3%), dizziness (55.2%), headache (63.7%), muscular pain (61.1%), and weakness (76.6%) were reported by established farm workers in statistically significantly higher numbers than by the referents and new farm workers. CONCLUSIONS Morbidity patterns, such as the health complaints and objective parameters suggested in this study, would be suitable as criteria for identifying farm workers most at risk from pesticide toxicity and as criteria for initiating measures to control and reduce exposure.
Repeated local administration of noradrenaline or saline inhibits thermal hyperalgesia in pain-sensitized human skin.

AIMS Noradrenaline increases thermal hyperalgesia in skin sensitized to heat by the topical application of capsaicin. The aim of this study was to determine whether desensitization to the hyperalgesic effects of noradrenaline would develop after repeated local administrations of noradrenaline in the skin of the forearm. METHODS Noradrenaline and saline were administered to the forearm by iontophoresis (200 microA, 2 min, over a surface area of 3.1 cm(2)) two times per day for 4-10 days in 19 healthy subjects. The adequacy of the desensitization procedure was evaluated by measuring noradrenaline-induced vasoconstriction with laser Doppler fluxmetry. Thresholds and pain ratings to heat were then investigated at treated and control sites before and after the topical application of capsaicin, and after the iontophoresis of noradrenaline. RESULTS At previously untreated sites blood flow was 49 +/- 14% (+/- 95% confidence intervals) lower than flow at reference sites after the iontophoresis of noradrenaline. Vascular signs of adrenergic desensitization developed after 4-5 days of repeated local administration of noradrenaline in the majority of subjects. In those whose vessels constricted after the acute administration of noradrenaline, the adrenergic response averaged 23 +/- 15% at the desensitized site compared with 61 +/- 9% at previously untreated sites (P < 0.001). However, similar signs developed after repeated iontophoreses of saline (adrenergic response 7 +/- 16% compared with 58 +/- 15% at previously untreated sites, P < 0.001). Both the noradrenaline and saline treatments inhibited thermal hyperalgesia after the topical application of capsaicin. Heat-pain thresholds averaged 43.2 +/- 2.5 degrees C and 43.0 +/- 2.3 degrees C at the noradrenaline and saline pretreated sites compared with 41.4 +/- 2.7 degrees C at the control site (P < 0.05 and P < 0.06, respectively). On a 0-10 scale, heat-pain ratings to a 7 s, 45 degrees C stimulus averaged 3.8 +/- 1.6 and 3.5 +/- 1.7 at the noradrenaline and saline pretreated sites compared with 5.3 +/- 1.6 at the control site (P < 0.05). After the iontophoresis of noradrenaline heat-pain ratings increased 1.6 +/- 1.4 at the site pretreated with saline (P < 0.05) compared with only 0.4 +/- 1.0 at the site pretreated with noradrenaline (not significant), consistent with local adrenergic desensitization. CONCLUSIONS We conclude that repeated iontophoreses of noradrenaline or saline inhibit vasoconstriction to noradrenaline, and also inhibit increases in thermal hyperalgesia evoked by capsaicin. The release of endogenous stores of noradrenaline by iontophoretic currents might contribute to these effects.
Evaluation of gingival crevicular fluid adrenomedullin and human neutrophil peptide 1-3 levels of patients with different periodontal diseases.

BACKGROUND Antimicrobial peptides participating in the innate host response are important contributors for maintaining the balance between health and disease. The aim of the present study is to investigate the levels of gingival crevicular fluid (GCF) adrenomedullin and human neutrophil peptides 1 through 3 (HNP1-3) in patients with different periodontal diseases. METHODS A total of 77 subjects, including 20 patients with chronic periodontitis, 18 patients with generalized aggressive periodontitis, 20 patients with gingivitis, and 19 healthy subjects, were included in the present study. The probing depth, clinical attachment level, plaque index, and papilla bleeding index were assessed in all study subjects. GCF samples were analyzed for evaluating adrenomedullin and HNP1-3 levels by enzyme-linked immunosorbent assay. RESULTS The present study demonstrated that the periodontitis groups had a significantly higher total amount of GCF adrenomedullin compared to the gingivitis and healthy control groups after adjusting for age and gender (P <0.05). Additionally, GCF adrenomedullin levels were positively correlated with clinical periodontal parameters of sampling sites (P <0.05). The total amount of GCF HNP1-3 was not different among the study groups, and there was no correlation between the total amount of GCF HNP1-3 and clinical periodontal parameters (P >0.05). CONCLUSIONS Our results suggest a defensive role for adrenomedullin during the host response in periodontal disease. Additionally, the lack of the HNP1-3 antimicrobial peptide might point to the deficiency of one of the protective mechanisms for periodontal tissues.
Structure of the autism symptom phenotype: A proposed multidimensional model.

BACKGROUND The main objective of this study was to develop a comprehensive, empirical model that will allow the reorganization of the structure of the pervasive developmental disorder symptom phenotype through factor analysis into more homogeneous dimensions. METHOD The sample consisted of 209 children with pervasive developmental disorder referred for genetic studies. The 12 subdomains of the Autism Diagnostic Interview-Revised were used in a factor analysis, and the emerged factors were then correlated with independent variables (measures of cognition, adaptive function, and diagnostic subtype). Intraclass correlation coefficients were calculated to investigate any familial relationships between sibling pairs on the derived factors. RESULTS The autism symptom phenotype is indeed made up of three factors or domains that are somewhat different than those used in DSM-IV. Rather, domains include social-communication, inflexible language and behavior, and repetitive sensory and motor behavior. For the three factors, only a small amount of variance was accounted for by cognitive and adaptive functioning. Only inflexible language and behavior showed familial correlation between siblings. CONCLUSIONS The pervasive developmental disorder symptom phenotype is composed of three domains or factors: social-communication, inflexible language and behavior, and repetitive sensory and motor behavior. Each child with pervasive developmental disorder can be characterized by these dimensions, which give an informative picture of the clinical presentation and a quantitative estimate of the severity of the disability.
Teaching and assessing clinical skills: a competency‐based programme in China

The objective of this study was to develop a compentency‐based clinical skills teaching and assessment programme in China utilizing modern teaching techniques. Medical teachers from three schools agreed on items for inclusion in the complete physical examination of an asymptomatic adult, an outline for an adult and paediatric history, and important interviewing skills. Lesson plans, performance checklists, and written and videotape training materials were developed. Standardized patients were trained at one school to assist with the teaching at that school and with the assessment at all three schools. A national, a provincial, and a local medical school in China were used. Before beginning the new curriculum for students in their first year of clinical training, baseline data were collected on skills of students at various levels of training in the previous curriculum at all three schools. Although in the previous curriculum there was some improvement in clinical skills among advanced compared to more junior students, performance was lower than expected by staff. One year after implementation of the new curriculum, students were evaluated. These students significantly outperformed their counterparts as well as the more senior level students tested the previous year. This project has established a competency‐based teaching and assessment programme in China that allows for rapid improvement in the clinical skills of students. Within a short time, a sophisticated group of medical educators has been formed, who now function as consultants to other educators in their own country. Many aspects of this programme are being adapted throughout China and are applicable to medical schools throughout the world.
Cardiac Autonomic Response to Active Standing in Adults With Vasovagal Syncope

Purpose: Little is known about the autonomic response to active standing in vasovagal syncope, and most works have focused on children or adolescents. The aim of this work was to study the changes in cardiac autonomic modulation in adult patients with vasovagal syncope through heart rate variability analysis with linear and short-term complexity (alpha-1) indexes during supine position and active standing, in patients with positive or negative head-up tilt test (HUTT). Methods: Twenty-five patients with vasovagal syncope were included. Heart rate variability linear and short-term complexity (alpha-1) indexes were recorded during an active standing test (15 minutes in each position) and compared among patients grouped by HUTT outcome and between positions. Results: During supine position, positive HUTT (+HUTT) patients had longer mean RR (1016 [850–1051] milliseconds), higher pNN50 (17.7 [9.2–26.2]), lower sympathovagal balance (1.3 [0.5–1.7]), and alpha-1 (0.9 [0.8–1.0]) than negative HUTT (−HUTT) patients (871 [776–969] milliseconds, 8.8 [2.1–14.5], 2.9 [1.3–3.9], and 1.2 [1.0–1.1], respectively). During active standing, heart rate and alpha-1 increased in both groups; in +HUTT patients, pNN50 decreased, whereas sympathovagal balance increased. The magnitude of change between positions of sympathovagal balance and alpha-1 was 6.1 and 4.8 times larger in +HUTT than −HUTT patients, respectively. Conclusions: The underlying cardiac autonomic mechanism in vasovagal syncope may involve different autonomic patterns in subjects with a history of recurrent syncope and +HUTT or −HUTT.