Miracle-dz/UniFAR-FTUs huggingface dataset:
A longitudinal evaluation of diffusion kurtosis imaging in patients with mild traumatic brain injury

Abstract Primary objective: To investigate longitudinal diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) changes in white and grey matter in patients with mild traumatic brain injury (mTBI). Research design: A prospective case-control study. Methods and procedures: DKI data was obtained from 24 patients with mTBI along with cognitive assessments within 10 days, 1 month and 6 months post-injury and compared with age-matched control (n = 24). Fractional anisotropy (FA), mean diffusivity (MD), radial diffusion (λr), mean kurtosis (MK) and radial kurtosis (Kr) were extracted from the thalamus, internal capsule and corpus callosum. Main outcomes and results: Results demonstrate reduced Kr and MK in the anterior internal capsule in patients with mTBI across the three visits, and reduced MK in the posterior internal capsule during the 10 day time point. Correlations were observed between the change in MK or Kr between 1–6 months and the improvements in cognition between the 1 and 6 month visits in the thalamus, internal capsule and corpus callosum. Conclusions: These data demonstrate that DKI may be sensitive in tracking pathophysiological changes associated with mTBI and may provide additional information to conventional DTI parameters in evaluating longitudinal changes following TBI.
Presence of leukaemia inhibitory factor (LIF) and LIF-receptor chain (gp190) in osteoclast-like cells cultured from human giant cell tumour of bone. Ultrastructural distribution.

The behaviour of multinucleated giant cells (MNC) obtained from a giant cell tumour of the tibia and cultured on glass coverslips or on devitalized dentin slices was investigated using light and electron microscopy. Cells were studied in the presence or absence of LIF a cytokine known to be involved in bone turnover and to act as a growth factor in some solid tumours. The direct effect of LIF on MNC was examined by a post-embedding colloidal gold immunocytochemistry process using human anti-LIF and anti-LIF-receptor (chain gp190) antibodies. After 7 days of culture, the MNC obtained displayed osteoclast immunocytochemical features. Moreover, these MNC were able to resorb large amounts of dentin and presented typical features of active osteoclasts. Immunolocalization of LIF and LIF-receptor revealed the presence of this cytokine and its receptor within the cytoplasm and nucleus of active resorbing MNC. LIF upmodulated MNC number and nucleation but decreased their ability to resorb dentin. The present study suggests that MNC obtained from human GCT, currently considered as osteoclast-like cells, are targets for LIF and may be a source of LIF production in this pathological condition.
Daily Serial Hemodynamic Data During Pregnancy and Seasonal Variation: The BOSHI Study

Although there are some reports that low plasma volume or increased cardiac output is associated with developing preeclampsia, there are few reports of daily serial hemodynamic data during pregnancy. A total of 37 092 home blood pressure (BP) and heart rate (HR) measurements were obtained from 425 normal pregnant women. Heart rate and shock index (SI) gradually increased by gestational week 32 and then decreased, whereas double product (DP) increased linearly during pregnancy. Although systolic BP and DP were consistently and negatively correlated with daily minimum outside temperature, HR and SI were positively correlated with minimum outside temperature in summer.
Locus of Control and Sex Offenders With an Intellectual Disability

Locus of control has been implicated as an important construct that is related to treatment outcome for several groups of offenders, including sexual offenders. However, little attention has been paid to how this construct is related to sexual offending by people with intellectual disabilities. Given this, 41 participants with intellectual disabilities were recruited into three groups: sex offenders who had undergone psychological treatment, sex offenders who had no history of treatment, and nonoffenders. All participants completed measures of locus of control and distorted cognitions. There was a significant difference between those who had and had not completed treatment in terms of cognitive distortions relating to sexual offending. There was no significant difference between the three groups on the measure of locus of control, with all three groups endorsing an external locus of control. Three possible explanations for how locus of control relates to sexual offending by people with intellectual disabilities is explored and discussed.
Comparative effectiveness of two doses versus three doses of hepatitis A vaccine in human immunodeficiency virus–infected and ‐uninfected men who have sex with men

The purpose of this prospective cohort study was to compare the serologic response between human immunodeficiency virus (HIV)‐infected men who have sex with men (MSM) receiving two and three doses of hepatitis A virus (HAV) vaccine and HIV‐uninfected MSM receiving two doses of HAV vaccine. Between June 2009 and December 2010, 582 MSM aged 18 to 40 years who were seronegative for HAV were enrolled in the study. HIV‐infected MSM received either two doses of HAV vaccine (1,440 enzyme‐linked immunosorbent assay units) (n = 140) with the second dose given at week 24 or three doses (n = 225) with the second and third dose given at weeks 4 and 24, respectively, while HIV‐uninfected MSM (n = 217) received two doses. The primary endpoint was seroconversion at week 48. The geometric mean concentration (GMC) of anti‐HAV antibody was determined at weeks 48 and 72. At week 48, the seroconversion rate was 75.7%, 77.8%, and 88.5% in intention‐to‐treat analysis for two‐dose HIV‐infected, three‐dose HIV‐infected, and two‐dose HIV‐uninfected MSM, respectively. The GMC of anti‐HAV antibody at week 48 for three‐dose HIV‐infected MSM (2.29 ± 0.73 log10 mIU/mL) was significantly higher than that for two‐dose HIV‐infected MSM (1.94 ± 0.66; P < 0.01), but was lower than HIV‐uninfected MSM (2.49 ± 0.42; P < 0.01). Multivariate analysis revealed higher CD4 counts (adjusted odds ratio [AOR] for per 50 cells/μL increase, 1.13; 95% confidence interval [CI], 1.05‐1.21) and undetectable plasma HIV RNA load (AOR, 1.90; 95% CI, 1.10‐3.28) before HAV vaccination were predictive of seroconversion in HIV‐infected patients. Conclusion: Serologic response rate to three and two doses of HAV vaccine was similar in HIV‐infected MSM, which was lower than that in HIV‐uninfected MSM receiving two doses. HAV vaccination in HIV‐infected patients with a higher CD4 count and suppression of HIV replication increased the seroconversion rate. (HEPATOLOGY 2013)
Evidence for neuroinflammatory and microglial changes in the cerebral response to sleep loss.

STUDY OBJECTIVES Sleep loss has pro-inflammatory effects, but the roles of specific cell populations in mediating these effects have not been delineated. We assessed the modulation of the electroencephalographic and molecular responses to sleep deprivation (S-DEP) by minocycline, a compound that attenuates microglial activation occurring in association with neuroinflammatory events. DESIGN Laboratory rodents were subjected to assessment of sleep and wake in baseline and sleep deprived conditions. PARTICIPANTS Adult male CD-1 mice (30-35 g) subjected to telemetric electroencephalography. INTERVENTIONS Minocycline was administered daily. Mice were subjected to baseline data collection on the first day of minocycline administration and, on subsequent days, 2 S-DEP sessions, 1 and 3 h in duration, followed by recovery sleep. Following EEG studies, mice were euthanized either at the end of a 3 h S-DEP or as time-of day controls for sampling of brain messenger RNAs. Gene expression was measured by real-time polymerase chain reaction. MEASUREMENTS AND RESULTS Minocycline-treated mice exhibited a reduction in time spent asleep, relative to saline-treated mice, in the 3-h interval immediately after administration. S-DEP resulted in an increase in EEG slow wave activity relative to baseline in saline-treated mice. This response to S-DEP was abolished in animals subjected to chronic minocycline administration. S-DEP suppressed the expression of the microglial-specific transcript cd11b and the neuroinflammation marker peripheral benzodiazepine receptor, in the brain at the mRNA level. Minocycline attenuated the elevation of c-fos expression by S-DEP. Brain levels of pro-inflammatory cytokine mRNAs interleukin-1β (il-1β), interleukin-6 (il-6), and tumor necrosis factor-α (tnfα) were unaffected by S-DEP, but were elevated in minocycline-treated mice relative to saline-treated mice. CONCLUSIONS The anti-neuroinflammatory agent minocycline prevents either the buildup or expression of sleep need in rodents. The molecular mechanism underlying this effect is not known, but it is not mediated by suppression of il-1β, il-6, and tnfα at the transcript level.
Heterogeneous mixing in epidemic models

We extend the relation between the basic reproduction number and the initial exponential growth rate of an epidemic to models with heterogeneous mixing, and show that an epidemic with heterogeneity of mixing may have a quite different epidemic size than an epidemic with homogeneous mixing and the same reproduction number and initial exponential growth rate. Determination of the final size of an epidemic if there is heterogeneous mixing requires additional data from the initial exponential growth stage of the epidemic.
Real-world replication of randomized controlled trial results for carotid endarterectomy.

BACKGROUND The efficacy of carotid endarterectomy (CE) has been shown in randomized clinical trials (RCTs), but doubts remain about whether the results can be replicated in routine clinical practice, especially in asymptomatic patients for whom the absolute risk reduction shown in the trials is small. In particular, a low rate of short-term adverse events is required for the long-term benefits of CE to accrue over time. OBJECTIVE To determine whether the incidence of short-term adverse events after CE met the standards established by the major RCTs and those recommended by major clinical practice guidelines. Design, Setting, and Patients We used clinically detailed data derived from a comprehensive medical record review to measure the short-term adverse outcomes of CE, focusing on in-hospital death and stroke, in 3283 cases in western Canada in 2000 and 2001, and compared the results with those from the RCTs. RESULTS For symptomatic patients, the in-hospital ischemic stroke or death rate was 3.9%; for asymptomatic patients, the rate was 2.6%. Extrapolating our in-hospital results to the 30-day post-CE results of the RCTs gave stroke or death rates of 4.9% for cases involving symptomatic patients and 4.1% for cases involving asymptomatic patients. These results are comparable to or better than those of the major RCTs for symptomatic patients but slightly worse for asymptomatic patients. About 45% of hospitals had adverse event rates higher than those recommended by authoritative clinical practice guidelines. CONCLUSIONS This large population-based study shows that the RCT results for CE can be achieved in the real world. However, the finding that some hospitals exceeded the maximum suggested rates of adverse events highlights the need for continuous outcome monitoring and associated quality improvement efforts to ensure that all providers and institutions involved achieve desired outcomes.
‘This is mine, this is for me’: preexposure prophylaxis as a source of resilience among women in Eswatini

Objective: To understand the relationship between HIV preexposure prophylaxis (PrEP) and resilience among Emaswati women. Design: A qualitative study using semistructured in-depth interviews. Methods: We interviewed 24 women who recently initiated PrEP at one of six public-sector primary-care clinics participating in a government demonstration project for PrEP for the general population, as well as 30 PrEP stakeholders from HIV policy, implementation and donor sectors. Results: PrEP clients and stakeholders described an environment marked by high HIV risk. In this context, clients felt PrEP enhanced their resilience through feelings of protection, control over HIV acquisition, choice in relation to when to take PrEP, sexual pleasure and relief from the fear and consequences of HIV infection. Those in serodiscordant relationships described improved partner communication and a shared sense of responsibility for HIV prevention. Both PrEP clients and stakeholders asserted that PrEP marketing and communication should be Emaswati-led and community-owned. Conclusion: PrEP helps women in Eswatini envision longer, healthier and more fulfilled lives. PrEP enhances resilience through several pathways, including self-efficacy, choice, control over HIV infection and relief from the fear of HIV infection. Social marketing and information campaigns should not only focus on PrEP as an HIV-prevention method but also emphasize how PrEP has expanded choice, enhanced control and facilitated sexual enjoyment among PrEP clients.
URINARY EXCRETION OF FOLLICLE-STIMULATING AND LUTEINIZING HORMONES.

A study was made of the urinary excretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in normal men, young women and postmenopausal women, and in certain patients who had increased gonadotropin titers. It was found that, in men, the mean urinary excretion of FSH and LH was 0.34 mg equivalent of NIH-FSH-S1 and 0.25 mg equivalent of NIH-LH-S1 per 24 hr, respectively, an FSH/LH ratio of 1.3. In young women, the urinary excretion of FSH and LH during different phases of the menstrual cycle was of a similar order of magnitude. The excretion of FSH did not vary greatly during the cycle, but it was higher in the first half than in the second. LH excretion was increased during the middle portion of the cycle. Therefore, the FSH /LH ratio was high in the follicular phase, due to the increased FSH excretion and low LH excretion; decreased during the middle of the cycle, due to the slight decrease in FSH excretion and peak excretion of LH;and also decreased in the last third of the cycle, due .
The floating hip: complications and outcomes.

BACKGROUND To perform a descriptive study of the course, treatment decisions, complications, and outcome of patients suffering simultaneous ipsilateral fractures of the femur and pelvis. METHODS Medical records and radiographs of 57 patients were reviewed retrospectively. RESULTS The average follow-up was 28 months. Fifteen patients (26%) had an acetabular fracture, 17 (30%) had a pelvic ring fracture, and 25 (44%) had both fractures concomitant with the ipsilateral femoral fracture. Eighty percent of acetabular fractures and 55% of pelvic ring fractures were treated surgically. Femur fractures underwent operation in 94% of cases. When multiple operative settings were used, the femur fracture was always fixed at the first operation. Complications included deep venous thrombosis (DVT) (12%), heterotopic ossification (HO) (34%), femoral head avascular necrosis (AVN) (2%), osteoarthritis (OA) (16%), and traumatic sciatic nerve palsy (33%). At least partial nerve palsy resolution occurred in 53% of patients. CONCLUSIONS Ipsilateral injuries to the femur and the pelvis or acetabulum ("floating hip") are severe injuries usually caused by high-energy trauma. The acetabulum and pelvic ring are more commonly fractured together than either alone. The femur fracture will most commonly be addressed first, as in 65% of our cases in which both components were addressed at the same setting, and 100% of cases in which they were addressed in separate settings. Delays of surgery were common because of severity of systemic trauma. Surgeons should be aware of the high incidence of sciatic nerve palsy as well as treatment options and potential complications associated with this devastating combination of injuries.
Recurrence of primary biliary cholangitis after liver transplantation: A Japanese perspective

Primary biliary cholangitis (PBC) is a chronic cholestatic disease characterized by granulomatous destruction of intrahepatic bile ducts. The precise pathogenic mechanisms of developing PBC are still poorly understood, and the development of disease is believed to result from a combination of multiple genetic factors interacting with environmental triggers. Although relatively rare, up to 10% of patients listed for liver transplant (LT) in North America and Europe have a diagnosis of PBC. The outcome after LT for patients with PBC is generally good, with 1-year and 5year patient survival rates reported between 93%-94% and 82%-90%, respectively. However, recurrent PBC (rPBC) is common, and the risk of recurrence increases with time following LT (Table 1). In the majority of studies, rPBC has been linked to the more potent immunosuppression regimens, especially with the initial use of tacrolimus following LT. This observation may appear counterintuitive as increased risk with immunosuppression is usually associated with infectious rather than autoimmune disease processes. However, it is notable that specific immunosuppressive treatments are not routinely used for patients with PBC due to lack of efficacy and undue side effects. Following LT, initial tacrolimus therapy is associated with both earlier and more severe recurrence, whereas cyclosporine has been shown to be protective against rPBC in Europe and North America (Table 1). The reasons for this observation are not clear and could include issues concerning alloreactivity, hastening any infectious process linked with PBC, immune reconstitution with immunosuppression withdrawal, and even off-target effects of different regimens. In this regard, it is notable that cyclosporine is known to have broad antiviral effects and has been shown to block the replication of a betaretrovirus that has been linked with PBC. In this issue of Hepatology Communications, Kogiso et al. present a large, retrospective, multicenter study of patients with PBC who survived for more than 1year after receiving a living donor liver transplantation. Approximately 15% of patients developed rPBC (median, approximately 5 years), and this was associated with a younger age at time of LT, preserved liver function status manifested with lower Child-Pugh and Model for End-Stage Liver Disease scores, high serum immunoglobulin (Ig)M level, sex mismatch, human leukocyte antigen B60 and D-related 8, and initial treatment with cyclosporine. These findings are consistent with other Japanese studies reporting an association of rPBC with high IgM, sex mismatch, and initial immunosuppression with cyclosporine. As discussed, the increased risk of rPBC with initial use of cyclosporine in Japan is contrary to observations from the majority of the LT series from North America and Europe reporting a protective effect of this calcineurin inhibitor (Table 1). Of note, the Abbreviations: Ig, immunoglobulin; LT, liver transplant; PBC, primary biliary cholangitis; rPBC, recurrent PBC; UDCA, ursodeoxycholic acid.
The relationship between tooth loss and psychological factors.

OBJECTIVES Limited evidence is available regarding mutual interactions between psychological factors and tooth loss. This study aimed to investigate the association between these two issues. METHOD In this 2011 cross-sectional study we obtained data from 4,585 adults who had completed information in 20 counties across Isfahan province, Iran, regarding tooth loss and psychological factors (depression, anxiety and stress level). To analyse the data ANOVA and multiple ordinal regression were applied. RESULTS After adjusting socio demographic factors, the association between depression (OR 1.23; 95% CI = 1.01,1.49), anxiety (OR 1.19; 95% CI = 1.03,1.38), and high stress level (OR 95% CI = 1.19; 1.01,1.39) remained significant. CONCLUSION We confirm the interaction between psychological factors and tooth loss, but recommend further studies on a national Iranian population.
Survey of prescriptions for peptic ulcer drugs (ACT class AOB2) in Iceland.

BACKGROUND The consumption of peptic ulcer drugs in Iceland is 20 DDD/1000/day, which is two to three times higher than in other Scandinavian countries. This study was done to register the pattern of use and possibly to find reasons for the high consumption. METHODS Prescriptions for peptic ulcer drugs (ACT class AO2B) were surveyed in Iceland during 1 month in 1991. All pharmacies in Iceland participated in the study, and information was obtained on about 90% of peptic ulcer drugs used outside hospitals. The pharmacists registered all prescriptions of peptic ulcer drugs with regard to the age and sex of the patient, speciality of the prescribing physician, and name, dose, and quantity of the drug. RESULTS A total of 2021 prescriptions were registered, accounting for 15.4 DDD/1000/day. The prevalence of peptic ulcer drug use was 1.52%, but female use was 52.5%. The maximal use, 2.91% was in the age group 70-79 years. H2 blockers accounted for 79%, omeprazole for 17%, and other drugs for 4%. General practitioners prescribed 65% of the drugs, gastroenterologists 15%, and other specialists 14%. If the patient himself collected the drug, he was asked to fill out a questionnaire with regard to the reason for the prescription, previous prescriptions, and investigations. A total of 1131 (56%) of patient questionnaires were received. Only 1% of the patients did not know the reason for the prescription. The patients registered that 30% of the prescriptions were for peptic ulcer, 29% for heartburn, 21% for gastritis, 9% for dyspepsia, and 7% for prevention of side effects of other drugs. It was estimated from the data that about 40% of the prescriptions were for non-ulcer dyspepsia. Investigations were done in 67% of the patients, but 33% received the prescription only after an appointment with a physician. CONCLUSIONS The results of the survey suggest that the extensive use of peptic ulcer drugs in Iceland is mostly due to excessive use in non-ulcer dyspepsia.
A novel concept in mucosal adjuvanticity: The CTA1‐DD adjuvant is a B cell‐targeted fusion protein that incorporates the enzymatically active cholera toxin A1 subunit

A promising novel concept in mucosal adjuvant research is demonstrated here. The adjuvant and toxic effects of the cholera toxin (CT) have been successfully separated in a gene fusion protein, CTA1‐DD. This protein consists of the ADP‐ribosylating A1 subunit of CT linked to a synthetic analogue of protein A. The CTA1‐DD protein was found to exert comparable adjuvant activity to that of CT after systemic as well as mucosal immunizations with soluble protein antigens, such as KLH or ovalbumin (OVA). However, contrary to CT it was completely non‐toxic. The CTA1‐DD approach to the construction of a potential vaccine adjuvant is unique and highly promising. Conceptually, the CTA1‐DD fusion protein demonstrates that: (i) contrary to CT the CTA1‐DD is a highly targeted adjuvant, directed to B cells and possibly other antigen‐presenting cells; (ii) it is possible to introduce ADP‐ribosyltransferase activity into cells via an alternative pathway to the GM1 receptor pathway used by CTB; (iii) the adjuvant effect of CTA1‐DD, and possibly also of CT, depend on the enzymatic activity; and (iv) one possible mechanism, shared by CT, that may explain the adjuvant effect of CTA1‐DD is its ability to induce expression of the costimulatory molecule CD86 on B cells.