Miracle-dz/UniFAR-FTUs huggingface dataset:
Patients with Posttraumatic Stress Disorder Show Decreased Cognitive Control: Evidence from Dichotic Listening

Abstract The influence of posttraumatic stress disorder (PTSD) on cognitive control and auditory attention modulation was examined with the use of a dichotic-listening (DL) task. The participants were 45 war-exposed refugees. The PTSD group comprised 22 participants meeting the DSM-IV criteria for PTSD, and the Control group comprised 23 war-exposed participants without PTSD. Both groups were tested with a consonant–vowel syllables DL task under three different attentional instructions. The two groups did not differ in the non-forced and forced-right conditions and showed, as expected, right-ear advantages. The Control group showed, as expected, a left-ear advantage in the forced-left (FL) condition. However, the PTSD group continued to show a right-ear advantage - and only minor modulation of the performance during the FL condition. This finding suggests that PTSD is associated with a reduced capacity for top-down attentional control of a bottom-up or stimulus-driven effect. The result shows that participants with PTSD have impaired cognitive control functions when tested on information processing of neutral stimuli. (JINS, 2011, 17, 344–353)
Urinary alkaline phosphatase and 7‐glutamyl transferase as indicators of acute renal damage in dogs

Urinary alkaline phosphatase (AP) and 7-glutamyl transferase (GGT) levels were measured in normal dogs, dogs with chronic renal failure, and dogs with acute renal failure, as confirmed by renal histology. The median values for urinary AP were 5–8 iu/litre/mmol creatinine for normal dogs, 6–7 for dogs with chronic renal failure and 49-4 for dogs with acute renal failure. The median values for urinary GGT were 3–4 iu/litre/mmol creatinine for normal dogs, 4–9 for dogs with chronic renal failure and 9-6 for dogs with acute renal failure. The results suggest that urinary AP can be used as an indicator of acute renal damage in the dog. GGT was shown to be less useful. No clear correlations were found between urinary enzyme levels and the extent of morphological kidney damage.
The Relative Benefits of Tamoxifen in Older Women with T1 Early‐Stage Breast Cancer Treated with Breast‐Conserving Surgery and Radiation Therapy

Small, hormone receptor‐positive breast carcinomas in older women are associated with low local recurrence rates. The relative benefits of adjuvant hormonal therapy remain unclear in elderly women with small, node‐negative breast cancer after breast‐conserving surgery and adjuvant radiation therapy. From our institutional data base, 224 patients ≥65 years of age with T1N0M0 breast cancer treated with BCS+RT were identified. Of these, 102 patients (45.5%) received tamoxifen (TAM) and 122 patients (54.5%) did not (no‐TAM). The median follow‐up time was 62.6 months. The 10‐year local relapse‐free survival (LRFS) was 98% in both the TAM and no‐TAM cohorts (p = 0.58); the 10‐year DMFS was 83% TAM vs. 89% no‐TAM (p = 0.91). There was no difference in 10‐year contralateral breast relapse or overall survival (OS) between the two cohorts. In univariate and multivariate analysis, use of TAM was not associated with LRFS, distant metastases‐free survival (DMFS), OS, or a reduction in contralateral breast cancers when compared with the no‐TAM cohort. In this large cohort of T1N0 elderly breast cancer patients treated with CS+RT, the use of TAM did not appear to decrease ipsilateral breast relapse, contralateral breast relapse, distant metastasis, or OS.
Commercial Insurance Triples Chances of Breast Cancer Survival in a Public Hospital

Breast cancer survival is affected both by endogenous factors and exogenous factors such as socioeconomic status. This study explored the relationship between insurance status and overall survival of 987 female breast cancer patients in a population served by a public hospital. All patients were offered the same level of care regardless of ability to pay. Of the 987 breast cancer patients investigated, 54.6% were African‐American. 54.1% of patients were insured (commercial insurance or Medicare), 27.1% with Medicaid, and 18.8% who were uninsured. Overall median survival was 15.5 years and was not statistically significant between Caucasian and African‐American women. Median survival times were 15.8, 11.3, and 8.2 years for insured, Medicaid, and uninsured groups, respectively. Uninsured patients had worse overall survival rates compared with insured patients (p < 0.05). Adjusting for other factors (e.g., stage, age, race, body mass index, and income), insurance was a significant factor affecting survival with hazard ratios of 2.24 and 3.22 for Medicaid and uninsured patients, respectively, compared with insured patients. Even in a public hospital, after adjusting for potential risk factors, insurance status still proved to be an important factor in the survival of breast cancer patients. Further research is necessary to identify causal factors related to the survival disparities associated with insurance status.
Predictors of Nipple Ischemia after Nipple Sparing Mastectomy

Nipple sparing mastectomy (NSM) has become an accepted approach in selected cases of breast cancer and prophylactic mastectomy. Various surgical techniques have been described and nipple ischemia has been a common complication. Potential risk factors for nipple ischemia after NSM are examined. To examine predisposing factors for nipple ischemia after NSM. Prospective evaluation of 71 consecutive NSM in 45 patients from 2009 to 2011 was performed. There were 40 mastectomies for cancer (56.3%), and 31 (43.7%) prophylactic mastectomies. In cases of cancer, the ducts were excised from the undersurface of the nipple. Reconstructive methods included: expander 58, latissimus flap/expander 2, implant 10, and free TRAM flap 1. Various patient and technical factors were examined for impact on nipple ischemia. Partial nipple necrosis occurred in 20 cases (28.2%). Nineteen cases healed uneventfully and one required secondary nipple reconstruction. Operations for cancer (OR 10.54, CI 1.88–59.04, p = 0.007) and periareolar incisions (OR 9.69, CI 1.57–59.77, p = 0.014) predisposed to nipple ischemia. Periareolar incisions and dissection of the nipple ducts for cancer have a higher risk of nipple necrosis after NSM.
AIDS and itch

The complaint of itch is common in patients with AIDS and HIV infection. Inspection of the skin often reveals a dermatosis, but precise diagnosis is not always easy which makes it difficult for effective treatment. In HIV‐positive patients with itch, as well as common dermatoses, one often has to deal with atypical and even new skin diseases. Many of these are papular, papulo‐vesicular or papulo‐pustular. This article is a protocol for the diagnosis and treatment of itch in these patients.
Role of Frontotemporal Fiber Tract Integrity in Task-Switching Performance of Healthy Controls and Patients with Temporal Lobe Epilepsy

Abstract The objective of this study is to investigate the relationships among frontotemporal fiber tract compromise and task-switching performance in healthy controls and patients with temporal lobe epilepsy (TLE). We performed diffusion tensor imaging (DTI) on 30 controls and 32 patients with TLE (15 left TLE). Fractional anisotropy (FA) was calculated for four fiber tracts [uncinate fasciculus (UncF), arcuate fasciculus (ArcF), dorsal cingulum (CING), and inferior fronto-occipital fasciculus (IFOF)]. Participants completed the Trail Making Test-B (TMT-B) and Verbal Fluency Category Switching (VFCS) test. Multivariate analyses of variances (MANOVAs) were performed to investigate group differences in fiber FA and set-shifting performances. Canonical correlations were used to examine the overall patterns of structural-cognitive relationships and were followed by within-group bivariate correlations. We found a significant canonical correlation between fiber FA and task-switching performance. In controls, TMT-B correlated with left IFOF, whereas VFCS correlated with FA of left ArcF and left UncF. These correlations were not significant in patients with TLE. We report significant correlations between frontotemporal fiber tract integrity and set-shifting performance in healthy controls that appear to be absent or attenuated in patients with TLE. These findings suggest a breakdown of typical structure-function relationships in TLE that may reflect aberrant developmental or degenerative processes. (JINS, 2012, 18, 57–67)
Altered Brain Activation in Military Personnel with One or More Traumatic Brain Injuries Following Blast

Abstract Explosive blast is a frequent cause of traumatic brain injury (TBI) among personnel deployed to Afghanistan and Iraq. Functional magnetic resonance imaging (fMRI) with an event-related stimulus-response compatibility task was used to compare 15 subjects with mild, chronic blast-related TBI with 15 subjects who had not experienced a TBI or blast exposure during deployment. Six TBI subjects reported multiple injuries. Relative to the control group, TBI subjects had slightly slower responses during fMRI and increased somatic complaints and symptoms of post-traumatic stress disorder (PTSD) and depression. A between-group analysis indicated greater activation during stimulus-response incompatibility in TBI subjects within the anterior cingulate gyrus, medial frontal cortex, and posterior cerebral areas involved in visual and visual-spatial functions. This activation pattern was more extensive after statistically controlling for reaction time and symptoms of PTSD and depression. There was also a negative relationship between symptoms of PTSD and activation within posterior brain regions. These results provide evidence for increased task-related activation following mild, blast-related TBI and additional changes associated with emotional symptoms. Limitations of this study include no matching for combat exposure and different recruitment strategies so that the control group was largely a community-based sample, while many TBI subjects were seeking services. (JINS, 2012, 18, 89–100)
Validity of Affect Measurements in Evaluating Symptom Reporting in Athletes

Abstract Identifying factors that improve the assessment of athletes’ psychological functioning is imperative to make proper return-to-play decisions following concussion. Prior research indicates that an individual's affect is related to symptom reporting. The present study examines two novel methods of affect assessment in college athletes at baseline participating in a sports-concussion management program. A total of 256 athletes completed a neuropsychological baseline battery with measurements of psychological symptoms (BDI-Fast Screen, Post-Concussion Symptom Scale, and ImPact Total Symptom Score) and a measure of affective memory bias (the Affective Verbal Learning Test; AVLT). Examiners completed an observation-based rating of affect. Multivariate analysis of variance and χ2 analyses were conducted to examine the effect of affect on symptom reports. Examiners’ Affect Ratings were predictive of broad symptom reporting, while the performance based index of affect (Affective Verbal Learning Test, AVLT) was more predictive of depressive symptoms. These findings suggest that performance on the AVLT may be a useful indicator of self-reported depression in a collegiate athlete sample. Additionally, these results demonstrate that examiners’ behavioral assessments of affect are important in the assessment of psychological functioning in athletes. Continued work should focus on developing objective measures that are sensitive and valid for the evaluation of outcomes from concussion. (JINS, 2012, 18, 101–107)
Specific Measures of Executive Function Predict Cognitive Decline in Older Adults

Abstract Decline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia. (JINS, 2012, 18, 118–127)
Hypofractionated Radiation Therapy for Early Stage Breast Cancer: Outcomes, Toxicities, and Cost Analysis

A French prospective randomized trial comparing whole breast radiotherapy with 45 Gy in 25 fractions versus 23 Gy in four fractions demonstrated equivalent 5‐year local control and survival. On the basis of this data, we offer the hypofractionated regimen to women who refuse to undergo standard radiotherapy. We report our outcomes and a cost analysis. Between 2000 and 2012, 84 patients participated in this IRB‐approved study and underwent whole breast radiation to 23 Gy in four fractions. Local control and survival were analyzed using the Kaplan–Meier method. Acute toxicities and overall long‐term cosmetic results were assessed. Costs were estimated from 2012 Medicare reimbursement data and compared to costs from standard courses of 25 and 16 fractions. All 84 patients are included in this report. Median age was 83 (range 42–98). Most patients had stage I (80%), hormone receptor positive (90%) breast cancer. Fifty‐eight patients (69%) were treated prone and 26 (31%) supine. At a median follow‐up of 3 years, one local recurrence has occurred, of ductal carcinoma in situ histology. Among the 13 patients deceased, two died of metastatic breast cancer. Five‐year actuarial local control is 99%, breast cancer‐specific survival is 98%, and overall survival is 79%. Toxicities were limited to grade 1 dermatitis in 32 patients (38%) and grade 2 fatigue in three (4%). Sixty‐three patients (75%) reported good or excellent cosmetic outcome at their last follow‐up. Collected Medicare reimbursement was $4,798 for the hypofractionated course. Compared to the projected reimbursement of standard regimens, $10,372 for 25 fractions and $8,382 for 16 fractions, it resulted in a difference of $5,574 and $3,584, respectively. At a follow‐up of 3 years, this hypofractionated regimen appears to be a promising approach, primarily for elderly women who are unable to undergo longer treatment courses but have indications for whole breast radiotherapy.
Keeping Children with a Disability Safely in their Families

With the trend towards keeping children with a disability in their families, intervention practices are seeking to ensure child safety. A research project in New South Wales, Australia, aimed to discover whether particular support programme(s) for children with a disability and their families significantly and positively influenced outcomes for the child and family, and if significant positive change did occur, which programme elements, strategies and/or techniques significantly contributed to positive client outcomes. Families in crisis and their support workers participated in the research and were followed and interviewed using quantitative and qualitative methods, at instigation of intervention, immediately post-intervention, at six and at twelve months post-intervention. Measurements of empowerment, emotional support, parent–child involvement, abuse potential, family functioning, symptom reduction, hope, happiness and worker–client alliance were used to gather data, as were qualitative interviews. Analyses indicated that the interventions improved families' levels of well-being and functioning and were significantly successful in reducing child abuse potential. Specific worker strategies and programme elements were found to be associated with these improvements and are discussed in detail. Safety of children with disabilities can be improved significantly using the family-centred interventions that were a distinctive feature of the programmes studied.
Socioeconomic and Geographic Differences in Immediate Reconstruction after Mastectomy in the United States

Disparities are evident in breast cancer diagnosis, treatment, and outcomes. This study examines multiple socioeconomic and geographic regions across the US to determine if disparities exist in the type of reconstruction obtained after mastectomy. This is a retrospective study evaluating socioeconomic and geographic variables of 14,764 women who underwent mastectomy in 2008 using the Nationwide Inpatient Sample (NIS). Statistical analysis was performed on three groups of women: patients without reconstruction (NR), patients who underwent breast implant/tissue expander reconstruction (TE), and patients with autologous reconstruction such as free or pedicled flaps (FLAP). The majority of patients (63.9%) had NR, while 23.9% had TE and 12.2% underwent FLAP. Compared to patients with NR, women with TE or FLAP were younger (64.9 years versus 51.3 and 51.1 years, p < 0.001), had fewer chronic conditions (2.60 and 2.54 chronic conditions for TE and FLAP respectively versus 3.85 for NR, p < 0.001) and higher mean hospital charges ($42,850 TE and $48,680 FLAP versus $22,300 NR, p < 0.001). Both Medicare and Medicaid insurance carriers had a higher proportion of women that did not get reconstructed compared to other insurance types (p < 0.001). Compared to NR, reconstructed women more often lived in urban areas and zip codes with higher average incomes (p < 0.001). This is the first national study analyzing insurance type and geographic variations to show statistically significant disparities in rate and type of immediate reconstruction after mastectomy. These inequalities need to be addressed to extend immediate reconstruction options to all women undergoing mastectomy.
Neurocognitive Speed and Inconsistency in Parkinson's Disease with and without Incipient Dementia: An 18-Month Prospective Cohort Study

Abstract We examined two-wave longitudinal changes in two indicators of neurocognitive speed (i.e., mean rate, intraindividual variability) using one simple and three complex reaction time tasks. Participants included idiopathic Parkinson's disease (PD) patients, with and without incipient dementia, and normal controls. At baseline, there were 45 patients (26 men, 19 women) with idiopathic PD who ranged from 65 to 84 years (M = 71.3; SD = 4.5) and 47 matched controls (27 men, 20 women) who ranged from 65 to 84 years (M = 71.4; SD = 4.9). The 18-month longitudinal sample comprised of 74 returning participants (43 controls; 31 PD patients) who had no cognitive impairment or dementia at both waves. Ten of the 31 PD patients returning for Time 3 had dementia or cognitive impairment. These constituted the PD with incipient dementia (PDID) group. Repeated measures analyses of variance showed that the PD and PDID groups were slower over time on the reaction time tasks, whereas the controls improved their performance over time on all tasks. Inconsistency distinguished the two clinical groups (i.e., the PDID group but not the PD group became more inconsistent over time). Changes in neurocognitive speed and inconsistency may be valid clinical markers of PDID. (JINS, 2012, 18, 1–9)
Loco‐regional Control After Neo‐adjuvant Chemotherapy and Conservative Treatment for Locally Advanced Breast Cancer Patients

Breast‐conserving treatment (BCT) has been validated for breast cancer patients receiving adjuvant chemotherapy. Our objective was to evaluate the difference in loco‐regional recurrence (LRR) rates between BCT and mastectomy in patients receiving radiation therapy after neo‐adjuvant chemotherapy (NCT). A retrospective data base was used to identify all patients with breast cancer undergoing NCT from 2002 to 2007. Patients with initial metastatic disease were excluded from this analysis. LRR was compared between those undergoing BCT and mastectomy. Individual variables associated with LRR were evaluated. Two hundred eighty‐four patients were included, 111 (39%) underwent BCT and 173 (61%) mastectomy. Almost all patients (99%) in both groups received postoperative radiation. Pathologic complete response was seen in 37 patients, of which 28 underwent BCT (p < 0.001). Patients receiving mastectomy had more invasive lobular carcinoma (p = 0.007) and a higher American Joint Committee on Cancer (AJCC) stage (p < 0.001) at diagnosis than those with BCT. At a median follow‐up of 6.3 years, the loco‐regional control rate was 91% (95% CI: 86–94%). The 10‐year LRR rate was similar in the BCT group (9.2% [95% CI: 4.9–16.7%]) and in the mastectomy group (10.7% [95% CI: 5.9–15.2%]; p = 0.8). Ten‐year overall survival (OS) rates (63% [95% CI: 46–79%] in the BCT group; 60% [95% CI: 47–73%] in the mastectomy group, p = 0.8) were not statistically different between the two patient populations. Multivariate analysis showed that AJCC stage ≥ III (HR: 2.6; 95% CI: 1.2–5.8; p = 0.02), negative PR (HR: 6; 95% CI: 1.2–30.6, p = 0.03), and number of positive lymph nodes ≥3 (HR: 2.5; 95% CI: 1.1–5.9; p = 0.03) were independent predictors of LRR. Ten‐year OS was similar in the BCT and in the mastectomy group (p = 0.1). The rate of LRR was low and did not significantly differ between the BCT and the mastectomy group after NCT. Randomized trials assessing whether mastectomy can be safely omitted in selected breast cancer patients (nonstage III tumors or those which do not require adjuvant hormone suppression) which respond to NCT are required.