Miracle-dz/UniFAR-FTUs huggingface dataset:
High prevalence of myocardial ischemia and vasoconstrictive hormonal release in hypertension during chronic renal failure.

OBJECTIVE Indexes of myocardial ischemia and vasoconstrictive hormonal release were evaluated in order to investigate the difference between essential hypertension and hypertension during chronic renal failure. BACKGROUND Arterial hypertension induces several cardiovascular alterations that reflect themselves either on the heart and/or on the coronary blood flow enhancing the cardiovascular risk. Since chronic renal failure can influence the neuroendocrine response, various mechanisms involved in hypertension during chronic renal failure are still unclear. High endothelin 1 (ET-1) levels have been found both in arterial hypertension and during chronic renal failure. Interestingly, either ET-1 or catecholamines seem also to be implied in the pathogenesis of myocardial ischemia. METHODS 20 hypertensive uremic and 20 essentially hypertensive patients underwent echocardiographic wall motion and wall thickening analysis performed at baseline and immediately after the end of exercise. Simultaneously, myocardial perfusion was evaluated by 99mTc-MIBI-SPECT. In addition, plasma norepinephrine and ET-1 concentrations were measured at baseline and at peak exercise. RESULTS The segmental radionuclide analysis showed a greater ischemic degree in hypertensive uremic patients. Yet, we were able to identify one or more regions of the left ventricle in which both systolic thickening measurements and wall motion after exercise were impaired. After exercise, wall thickening impairment was correlated with both wall motion abnormalities (r = 0.72, p < 0.01) and MIBI ischemic grade (r = 0.82, p < 0.001). Basal and after-exercise plasmatic norepinephrine and endothelin levels were higher in hypertensive uremic than in essentially hypertensive patients. Moreover, there was a significant correlation between increments in norepinephrine concentration and MIBI perfusion defects, and between the increment in ET-1 concentration and both MIBI perfusion defects, or kinetic alterations assessed by wall motion as well as by wall thickening. CONCLUSIONS This is the first cross-sectional study in which a higher degree of myocardial ischemia has been observed in hypertensive uremic patients combined with an enhanced plasma release of both norepinephrine and ET-1. This phenomenon may contribute to enhance the cardiovascular risk of these patients.
Cricopharyngeal function or dysfunction: what's the deal?

Purpose of reviewThe purpose of the review is to examine current research focused on upper oesophageal sphincter (UES) and cricopharyngeus muscle function, and how better understanding UES physiology will translate to improved management. Recent findingsAlthough much is known about UES function, new information describing the dynamics of the UES and cricopharyngeus is being identified through manometry, combined fluoromanometry, and anatomic study. Response of the UES to injury, reflux, and surgical interventions is reported. Direct surgical treatment of cricopharyngeus noncompliance with or without diverticuli continues to show benefit and long-term results support a sustained improvement in three-quarters of patients. SummaryUES and cricopharyngeus function is complex and dynamic. It is affected by internal signals such as posture and constitution of refluxate, aging, and interventions particularly radiation and surgery. Clear understanding of the triggers and responses of the UES will enable clinicians to choose the correct therapy for their dysphagic patients.
Managing High‐Cost Healthcare Users: The International Search for Effective Evidence‐Supported Strategies

High‐cost healthcare users (HCUs) are a small proportion of the population who use a disproportionate amount of healthcare resources. Although the phenomenon occurs across the entire age spectrum, older adults represent the majority of HCUs. HCUs have drawn increasing attention internationally from clinicians, health policy‐makers, and government administrators. Many experts have suggested that the short‐ and long‐term sustainability of the healthcare system is threatened unless current approaches to the care and healthcare costs of this population are modified. Complex case management and care coordination models are being implemented internationally to address HCUs despite a lack of strong evidence to support their effectiveness in improving clinical outcomes or savings in costs of care. We review what is known about HCUs and the available evidence for the effectiveness of interventions designed to manage their high and costly healthcare use.
Apoptosis of Tubular Epithelial Cells in Familial Juvenile Gouty Nephropathy

Two patients, a 47-year-old woman suffering from chronic renal failure, hyper- uricemia and gout, and her 26-year-old son with hyperuricemia and chronic renal failure, are described. The father and two siblings of the woman had died of chronic renal failure. Both patients had a markedly reduced fractional excretion of urate, which was significantly increased by both benzbromarone and probenecid. A renal biopsy of the son revealed an unspecific chronic tubulointerstitial nephropathy. By light microscopy, many proximal tubular epithelial cells showed signs of apoptosis, which was confirmed with the specific TUNEL assay. We propose a hypothesis based on a gain-of-function mutation of the luminal anion exchanger of the proximal tubulus to explain reduced uric acid excretion, dominant inheritance and apoptosis of tubular epithelial cells in this rare disease. Treatment with a combination of allopurinol to reduce the renal urate load and benzbromarone to block the tubular anion exchanger and normalize fractional uric acid excretion is suggested.
Progression to tuberculosis disease increases with multiple exposures

During a single year, a Canadian village had 34 individuals with microbiologically confirmed tuberculosis (TB) among 169 people with a new infection (20%). A contact investigation revealed multiple exposures for each person. We investigated whether the intensity of exposure might contribute to this extraordinary risk of disease. We carried out a case–control study using a public health database. Among those with a new infection, 34 had culture-confirmed TB (cases) and 118 did not progress to disease (controls). 17 patients with probable disease were excluded. Contact investigation data were utilised to tabulate the number of potential sources (total exposures). Generalised estimating equations with a logit link were used to identify associations between exposures and progression, and to investigate other potential risk factors. The median (interquartile range) number of total exposures was 15 (3–23) for cases and 3 (2–12) for controls (p=0.001). The adjusted OR for disease was 1.11 (95% CI 1.06–1.16) per additional exposure, corresponding to an OR of 3.4 for disease when comparing the medians of 15 versus 3 total exposures. This association increased when restricting to tuberculin skin test conversions. Increased exposure could be a marker of greater risk of progression to TB disease. Therefore, this risk may not be transportable across epidemiologic settings with variable exposure intensities. Increased exposure could not only be associated with risk of infection, but also risk of progression to TB disease http://ow.ly/aPCX302XC9j
Immunohistochemical characteristics of neurons in the ganglia of the greater splanchnic nerve of the pig.

INTRODUCTION Greater splanchnic nerve (GSN) is by far the largest of the splanchnic nerves and connects the paravertebral and prevertebral ganglia to transmit the majority of nociceptive information from the viscera. Despite its importance, the immunohistochemical features of the porcine GSN neurons have not yet been examined. Therefore, the aim of the study was to investigate the neurochemistry of the porcine GSN neurons and to compare their neurochemical coding with those of the paravertebral and prevertebral ganglia. MATERIAL AND METHODS Four gilts of Large White Polish breed were examined in this study. Antibodies to tyrosine hydroxylase (TH), dopamine b-hydroxylase (DBH), choline acetyltransferase (ChAT), neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), somatostatin (SOM), galanin (GAL), methionine-enkephalin (MET), calcitonin gene-related peptide (CGRP), and substance P (SP) were used for immunohistochemical detection of classical neurotransmitters marker enzymes and neuropeptides in neuronal cell bodies of the GSN. RESULTS Double-labeling immunofluorescence revealed that virtually all GSN neurons exhibited the presence of catecholamine-synthesizing enzymes (TH/DBH-positive) and subpopulations of neurons contained immunoreactivity to NPY, VIP, SOM, GAL and MET. However, CGRP and SP-immunoreactivity were not observed in neuronal somata. CONCLUSIONS Our data strongly suggest that the general immunohistochemical characterization of ganglion cells in the porcine greater splanchnic nerve is similar to that of the prevertebral ganglia (e.g. celiacomesenteric ganglion).
Multicohort Analysis of Whole-Blood Gene Expression Data Does Not Form a Robust Diagnostic for Acute Respiratory Distress Syndrome

Objectives: To identify a novel, generalizable diagnostic for acute respiratory distress syndrome using whole-blood gene expression arrays from multiple acute respiratory distress syndrome cohorts of varying etiologies. Data Sources: We performed a systematic search for human whole-blood gene expression arrays of acute respiratory distress syndrome in National Institutes of Health Gene Expression Omnibus and ArrayExpress. We also included the Glue Grant gene expression cohorts. Study Selection: We included investigator-defined acute respiratory distress syndrome within 48 hours of diagnosis and compared these with relevant critically ill controls. Data Extraction: We used multicohort analysis of gene expression to identify genes significantly associated with acute respiratory distress syndrome, both with and without adjustment for clinical severity score. We performed gene ontology enrichment using Database for Annotation, Visualization and Integrated Discovery and cell type enrichment tests for both immune cells and pneumocyte gene expression. Finally, we selected a gene set optimized for diagnostic power across the datasets and used leave-one-dataset-out cross validation to assess robustness of the model. Data Synthesis: We identified datasets from three adult cohorts with sepsis, one pediatric cohort with acute respiratory failure, and two datasets of adult patients with trauma and burns, for a total of 148 acute respiratory distress syndrome cases and 268 critically ill controls. We identified 30 genes that were significantly associated with acute respiratory distress syndrome (false discovery rate < 20% and effect size >1.3), many of which had been previously associated with sepsis. When metaregression was used to adjust for clinical severity scores, none of these genes remained significant. Cell type enrichment was notable for bands and neutrophils, suggesting that the gene expression signature is one of acute inflammation rather than lung injury per se. Finally, an attempt to develop a generalizable diagnostic gene set for acute respiratory distress syndrome showed a mean area under the receiver-operating characteristic curve of only 0.63 on leave-one-dataset-out cross validation. Conclusions: The whole-blood gene expression signature across a wide clinical spectrum of acute respiratory distress syndrome is likely confounded by systemic inflammation, limiting the utility of whole-blood gene expression studies for uncovering a generalizable diagnostic gene signature.
A cloud platform for big IoT data analytics by combining batch and stream processing technologies

The Internet of things is a current major developing technology, which is a network of everyday physical objects that enhances the quality of lifestyle. Application of the internet of things encounters dealing with huge amount of data. One of the directions of big data is this huge amount of data with respect to the internet of things. As the name implies, big data refers to the data that cannot be analyzed by a traditional data processing software. The key challenge of this phenomenon is to use a proper way to analyse, which can provide useful features from the data absorbed by the perception layer of the internet of things in order to provide feedback to end users, which helps them in better decision making and improves the performance of the corresponding internet of things network. Analysis of big data in the internet of things is obviously a hard task. Data storages are distributed and there should be parallel data processing. Transmission of the data across the network can slow down because of the massive amount of data. In this regard, this paper focuses on how to analyze the massive and heterogeneous data of the internet of things in a proper way. At first, the internet of things and the big data are discussed separately with architectures, applications, challenges etc. Since these two technologies are interrelated, data analysis in the internet of things is discussed with various methodologies and challenges-Finally, the study discusses a proper framework that can analyze the big data in the internet of things in an efficient way.
Reduction of Radiation Exposure to Patients and Professionals by Reducing the Administered Activity of 18F-Fluorodeoxyglucose in a Positron-emission Tomography/Computed Tomography Study

Aim: With increased clinical indications for positron-emission tomography/computed tomography (PET/CT) and repeated PET/CT scans, there is a need to reduce the radiation burden to the patient, professionals as well as public. This requires a redefining of the workflow and the 18-F-fluorodeoxyglucose (18F-FDG) administered activity. The objective of our study is to observe the impact of strike out reduction of administered activity on the radiation exposure to personnel and public, as well as the absorbed dose to the patient with no compromise on image quality by increasing the image acquisition time. Materials and Methods: Nineteen patients evaluated in this study (11 males, 8 females) were put into two groups, namely, A and B. Patients in Group A (n = 10) were administered with 18F-FDG equivalent to the recommended dose (7–8 MBq/kg body weight) whereas patients in Group B (n = 9) were administered with 18F-FDG equivalent to half the recommended dose (3–4MBq/kg body weight). The exposure rates from the patients at the body surface and 100 cm distance were measured immediately and 1 h postinjection. Results: The average surface dose rate and 100 cm dose rate of the adult patients immediately postinjection for patients of Group A were 0.94 ± 0.19 mSv/h and 0.057 ± 0.007 mSv/h, and for Group B were 0.34 ± 0.24 mSv/h and 0.031 ± 0.01 mSv/h. Conclusion: This study suggests that reduction in injected 18F-FDG activity reduces the radiation exposure rate from the patient, absorbed dose to the patient with reportable image quality.
Graphene oxide regulates cox2 in human embryonic kidney 293T cells via epigenetic mechanisms: dynamic chromosomal interactions

Abstract To extend the applications of engineered nanomaterials, such as graphene oxide (GO), it is necessary to minimize cytotoxicity. However, the mechanisms underlying this cytotoxicity are unclear. Dynamic chromosomal interactions have been used to illustrate the molecular bases of gene expression, which offers a more sensitive and cutting-edge technology to elucidate complex biological processes associated with epigenetic regulations. In this study, the role of GO-triggered chromatin interactions in the activation of cox2, a hallmark of inflammation, was investigated in normal human cells. Using chromosome conformation capture technology, we showed that GO triggers physical interactions between the downstream enhancer and the cox2 promoter in human embryonic kidney 293T (293T) via p65 and p300 complex-mediated dynamic chromatin looping, which was required for high cox2 expression. Moreover, tumor necrosis factor-α (TNF-α), located upstream of the p65 signaling pathway, contributed to the regulation of cox2 activation through dynamic chromatin architecture. Compared with pristine GO and aminated GO (GO-NH2), poly (acrylic acid)-functionalized GO (GO-PAA) induced a weaker inflammatory response and a weaker effect on chromatin architecture. Our results mechanistically link GO-mediated chromatin interactions with the regulation of cox2 and suggest that GO derivatives may minimize toxicity in practical applications.
Performance and Ratings Based Measures of Executive Function in School-Aged Children with Down Syndrome

ABSTRACT We examined performance-based laboratory tasks and ratings-based assessments of executive function (EF) in school-aged children with Down syndrome and mental-age matched peers along with adaptive functioning. Methods. A battery of assessments including EF laboratory tasks was collected. Results. The DS group performed both working memory/inhibition and planning laboratory tasks with significant challenges. Moderate correlations were evident only between some laboratory tasks and ratings-based EF domains. However, ratings-based EF better predicted adaptive function than performance on an EF laboratory-based task. Conclusions. Findings underscore the need to address early and targeted EF intervention in children with DS.
Multi-GPU configuration of 4D intensity modulated radiation therapy inverse planning using global optimization

We report on the design, implementation and characterization of a multi-graphic processing unit (GPU) computational platform for higher-order optimization in radiotherapy treatment planning. In collaboration with a commercial vendor (Varian Medical Systems, Palo Alto, CA), a research prototype GPU-enabled Eclipse (V13.6) workstation was configured. The hardware consisted of dual 8-core Xeon processors, 256 GB RAM and four NVIDIA Tesla K80 general purpose GPUs. We demonstrate the utility of this platform for large radiotherapy optimization problems through the development and characterization of a parallelized particle swarm optimization (PSO) four dimensional (4D) intensity modulated radiation therapy (IMRT) technique. The PSO engine was coupled to the Eclipse treatment planning system via a vendor-provided scripting interface. Specific challenges addressed in this implementation were (i) data management and (ii) non-uniform memory access (NUMA). For the former, we alternated between parameters over which the computation process was parallelized. For the latter, we reduced the amount of data required to be transferred over the NUMA bridge. The datasets examined in this study were approximately 300 GB in size, including 4D computed tomography images, anatomical structure contours and dose deposition matrices. For evaluation, we created a 4D-IMRT treatment plan for one lung cancer patient and analyzed computation speed while varying several parameters (number of respiratory phases, GPUs, PSO particles, and data matrix sizes). The optimized 4D-IMRT plan enhanced sparing of organs at risk by an average reduction of 26% in maximum dose, compared to the clinical optimized IMRT plan, where the internal target volume was used. We validated our computation time analyses in two additional cases. The computation speed in our implementation did not monotonically increase with the number of GPUs. The optimal number of GPUs (five, in our study) is directly related to the hardware specifications. The optimization process took 35 min using 50 PSO particles, 25 iterations and 5 GPUs.
Fitting motivational content and process: A systematic investigation of fit between value framing and self-regulation.

OBJECTIVE Values are often phrased as ideals that people seek to approach, but they can also be conceptualized as counter-ideals that people seek to avoid. We aimed to test whether individuals endorse more strongly values that are framed in line with their predominant self-regulatory motivation, using individual difference scales in promotion/prevention (Higgins, 1997) and in behavioral approach/inhibition (Carver & White, 1994). To address this systematically, we developed approach- and avoidance-framed versions of the Portrait Value Questionnaire-RR (PVQ-RR; Schwartz et al., 2012). METHOD Participants completed approach- and avoidance-framed PVQ-RR versions in two studies measuring regulatory focus or motivational orientation (together 414 U.S. adults, 48% female, ages 18-69) and one study manipulating motivational orientation (39 UK high school students, 79% female, ages 16-19). RESULTS Value framing consistently interacted with both self-regulation variables. However, a fit between self-regulation and value framing resulted in greater value endorsement only for promotion-focused and approach-oriented (not prevention-focused and avoidance-oriented) participants. This may be because values are more naturally understood as ideal states that people seek to approach. CONCLUSIONS Our findings provide first insights into the psychological process of person-value framing fit affecting value endorsement. We discuss implications for cross-cultural value research and research on value-congruent behavior.
Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers

Purpose This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. Methods The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. Results Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P < 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min·d−1 of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P < 0.001 to P = 0.046). Conclusion Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength.