Miracle-dz/UniFAR-FTUs huggingface dataset:
Active surveillance and risk factors for leptospirosis in Hawaii.

A clinic-hospital-based leptospirosis surveillance program was conducted to determine the morbidity and risk factors in nonepidemic settings. The study was conducted on two islands, Kauai and Hawaii (Big Island), in the state of Hawaii for one year during 1988 and 1989. An active, more comprehensive case detection system was used on the Big Island that enabled us to determine the incidence of clinical disease. Subjects from both islands were used to conduct a case-control study for risk factors. One hundred seventy-two subjects from the Big Island (who presented with any two of the following symptoms: fever, headache, myalgia, or nausea/vomiting) were enrolled in the study. Twenty cases were diagnosed by culture, serology, or fluorescent antibody tissue staining at autopsy. Six cases required hospitalization and two succumbed to fatal infections. We estimated that these cases represented an annual incidence rate of 128 per 100,000 person-years in our target population. For 33 cases, 77 controls were matched for island, age, sex, and time of onset of illness. Interviews were conducted retrospectively in a double-blinded fashion with cases and controls and evaluated approximately 30 risk factors. Factors that were associated most strongly with development of leptospirosis were household use of rainwater catchment systems (P = 0.003), presence of skin cuts during the incubation period (P = 0.008), contact with cattle or the urine of cattle (P = 0.05 and P = 0.03, respectively), and handling of animal tissues (P = 0.005). (ABSTRACT TRUNCATED AT 250 WORDS)
Three‐dimensional hemodynamics in intracranial aneurysms: influence of size and morphology

To use four‐dimensional (4D)‐flow MRI for the comprehensive in vivo analysis of hemodynamics and its relationship to size and morphology of different intracranial aneurysms (IA). We hypothesize that different IA groups, defined by size and morphology, exhibit different velocity fields, wall shear stress, and vorticity.
Activity of the liver enzyme ornithine carbamoyltransferase (OTC) in blood: LC-MS/MS assay for non-invasive diagnosis of ornithine carbamoyltransferase deficiency

Abstract Background: Liver enzymes are released from hepatocytes into circulation and their activity can be measured in the blood. We examined whether the plasma activity of the liver enzyme ornithine carbamoyltransferase, determined by a novel liquid chromatography-mass spectrometry (LC-MS/MS) assay, could be utilized for the detection of OTC deficiency (OTCD), an X-linked inborn error of the urea cycle. Methods: The plasma ornithine carbamoyltransferase (OTC) activity was assayed in the reverse reaction using isotopically labeled citrulline-d4 as a substrate and by determination of the product, ornithine-d4, by LC-MS/MS analysis. Results: The plasma OTC activity in the controls was in the range of 111–658 pkat/L (n=49, median 272 pkat/L), and the activity increased linearly with serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in patients with hepatopathy. The OTC activity was subsequently determined in 32 individuals carrying mutations in the OTC gene, and OTC/ALT and OTC/AST ratios were calculated to account for the degree of hepatopathy, which is a common finding in OTCD. The OTC/ALT ratio enabled clear differentiation of OTCD hemizygotes (n=11, range 0–69×10−6) from controls (504–3440×10−6). This ratio also enabled the detection of 11 of 12 symptomatic heterozygotes (range 38–794×10−6), while this marker did not allow for reliable differentiation of asymptomatic heterozygotes (n=9) from controls. Conclusions: LC-MS/MS assay of plasma OTC activity enabled the detection of all hemizygous and the majority of symptomatic heterozygous OTCD patients in the tested cohort. This study demonstrates that non-invasive assay of enzymes expressed predominantly in the liver could be used as an alternative approach for diagnosing inborn errors of metabolism.
Kidney dysfunction and cognitive decline in women.

BACKGROUND AND OBJECTIVES ESRD is associated with substantial cognitive deficits but whether earlier kidney dysfunction predicts cognitive decline is less well defined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS More than 1700 women aged ≥70 years in the Nurses' Health Study had plasma creatinine and urinary albumin/creatinine ratios (ACRs) measured in 2000, within 12 months of their initial cognitive testing. These participants had repeated assessments of cognition administered by phone every 2 years, including tests for general cognition, verbal memory, verbal fluency, and working memory for up to 6 years of follow-up. Mixed-effects regression analysis was applied to calculate mean differences in the rate of cognitive decline between women with an estimated GFR <60 ml/min per 1.73 m(2) or an ACR ≥5 mg/g versus referent levels. RESULTS The median age was 74 years at initial cognitive testing, 99% of women were Caucasian, median plasma creatinine was 0.8 mg/dl, and 25% had an ACR ≥5 mg/g. The difference in cognitive decline with a baseline ACR ≥5 mg/g versus an ACR <5 mg/g was equivalent to the difference observed with 2-7 years of aging; that is, a higher ACR was associated with 2-7 times faster decline in all four cognitive domains assessed (all P values <0.05) than that attributed to each 1 year of aging alone. No associations were observed between an eGFR <60 ml/min per 1.73 m(2) and cognitive decline. CONCLUSIONS A baseline urinary ACR ≥5 mg/g, a level not traditionally considered clinically significant, is independently associated with faster decline in cognitive function.
The role of imaging in the pathophysiology and diagnosis of headache

Purpose of reviewFunctional neuroimaging in headache patients has revolutionized our understanding of these syndromes and provided unique insights into some of the most common maladies in humans, suggesting that at least migraine and cluster headache are driven primarily from the brain. This review highlights new studies and recent advances in studying headache using neuroimaging. Recent findingsConcerning the diagnostics of headache, an EFNS Task Force evaluated recently the usefulness of imaging procedures in non-acute headache patients on the basis of evidence from the literature and defined guidelines on when to use magnetic resonance imaging or computed tomography. Regarding the pathophysiology of primary headache syndromes, repeated and independent findings reinforce the crucial role for the brainstem in acute and probably also in chronic migraine, and the hypothalamic grey in several trigemino-autonomic headaches. If further studies confirm these findings, a better understanding will be gained of where and how acute and preventive therapy can be targeted. SummaryGiven the rapid advances in functional neuroimaging, in particular newer techniques such as voxel-based morphometry and magnetic resonance spectrometry, functional imaging continues to play a significant role and opens new avenues in targeting the neural substrates in individual primary headache syndromes.
RHETORIC, ORGANIZATIONAL CATEGORY DYNAMICS AND INSTITUTIONAL CHANGE: A STUDY OF THE UK WELFARE STATE

Accounts of institutional change and categorization conventionally assume that high-status change agents can impose change, even to stable category systems, which lower-status actors accommodate in order to ensure social approval and material resources. By exploring the UK Conservative-Liberal Coalition's rhetorical efforts to reform the welfare state, how welfare providers are categorized and the subsequent response of implicated category members, we offer instead an account of institutional change that exposes the agentic limitations of high-status actors. Whilst governments may well be in a position to impose changes in the formal rules of the game through manipulation of material resources (fiscal contraction, privatization, open markets, deregulation), we find that they cannot necessarily monopolize symbolic resources (identities/cultural features). We also find that deviation from cultural expectations is not only available to large, high-status organizations, low-status actors too have discretion over their responses to institutional pressures regarding how they are categorized and subsequently judged.
Ultrasonographic evaluation of gallbladder volume in diabetics.

AIMS AND OBJECTIVE Ultrasonographic determination of gallbladder volume in diabetics [both type I and type 2], it's comparison with a control group, and correlation of gallbladder volume in diabetics with parameters such as age, sex, body mass index, parity, hyperlipidaemia, and autonomic neuropathy. MATERIALS AND METHOD Ninety one cases of diabetes mellitus and 40 healthy controls were recruited for the study. A detailed history and physical examination were recorded. Laboratory investigations done were--fasting and postprandial blood sugar, glycosylated haemoglobin, microalbuminuria, and serum lipid profile. Autonomic neuropathy was determined by using simple non-invasive bedside tests. Fasting gallbladder volume was measured by ultrasonography (calculated by ellipsoid formula). RESULTS The mean fasting gallbladder volume was 18.20 +/- 2.54 ml in type I diabetics and 25.87 +/- 13.90 ml in type 2 diabetics, with a minimum value of 9.30 ml and maximum value of 88 ml. When type 2 diabetics were subgrouped according to the presence of autonomic neuropathy, higher gallbladder volumes were seen in patients with autonomic neuropathy. CONCLUSIONS Cholecystomegaly, to a significant degree, was found in type 2 diabetics in the present study. It was significantly correlated with age, body mass index, and the severity of autonomic neuropathy. In male type 2 diabetics, gallbladder volume was significantly correlated with LDL cholesterol levels. In female type 2 diabetics, gallbladder volume was significantly correlated with waist-hip ratio. Gallbladder volume also had significant correlation with proliferative diabetic retinopathy, but not with glycaemic control, microalbuminuria, hypertension, or the duration of diabetes.
Alcohol misuse.

INTRODUCTION Alcohol use is a leading cause of mortality and morbidity internationally, and is ranked by the World Health Organization (WHO) as one of the top 5 risk factors for disease burden. Without treatment, approximately 16% of hazardous or harmful alcohol users will progress to more dependent patterns of alcohol consumption. This review covers interventions in hazardous or harmful, but not dependent, alcohol users. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions in hazardous or harmful drinkers in the primary-care setting? What are the effects of interventions in hazardous or harmful drinkers in the emergency-department setting? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS In this systematic review, we present information relating to the effectiveness and safety of the following interventions in primary care and in emergency departments: brief intervention (single or multiple session), universal screening plus brief interventions, and targeted screening plus brief interventions.
Geopolitics, Ethnic Conflicts along the Border, and Chinese Foreign Policy Changes toward Myanmar

ABSTRACT Ever since Myanmar reoriented its foreign policy as a result of its transition to democratic rule in 2010, it has significantly improved its relations with the West, particularly the United States. Amid heightened geostrategic competition between the U.S. and China, how can we understand the Chinese government’s changing approaches to Myanmar, where China’s strategic and economic interests face unprecedented pressure? This article examines those changes in the context of the Chinese government’s response to three militarized ethnic conflicts along its border with Myanmar before and after Myanmar’s foreign policy reorientation. Drawing evidence from Chinese Ministry of Foreign Affairs statements and Chinese media coverage of the 2009 and 2015 Kokang conflicts and the 2011-2013 Kachin conflict, the article argues that combined geopolitical changes and domestic nationalist signaling explain the variations of China’s foreign policy approaches to Myanmar. The article thus contributes to ongoing interest in China’s foreign policy approaches to Southeast Asia in the wake of geostrategic competition between China and the United States.
The sensitivity and spectral identity of the cones driving the b-wave of the rat electroretinogram

In the retina of rat, cones make up ∼0.85% of the photoreceptor population: 93% of these cones contain a midwave-sensitive pigment, the rest expresses a short-wave-sensitive pigment (Szel & Rohlich, 1992). We used normal adult Long Evans rats to determine the spectral sensitivity of the cone-driven electroretinogram (ERG) b-wave and its absolute sensitivity at λmax of the cone pigments. ERGs were recorded at the cornea of anesthetized animals under dark- and light-adapted conditions. Rod responses were suppressed by steady rod-saturating orange backgrounds and/or by a flashed “white” background. Cone-driven b-waves were evoked by “white” or narrowband full-field stimuli of varying intensity. The action spectrum for the cone b-wave indicates the presence of an absorbance peak at 510 nm; a second, twofold lower, peak was found at 360 nm (after correction for transmittance by the lens). Chromatic adaptation experiments strongly suggest that retinal responses to midwave and UV stimuli are mediated by a single cone type. On a background producing ∼17,000 R* rod−1 s−1, which completely suppressed the saturated a-wave, the absolute sensitivity of the cone b-wave was 18 nV photon−1 μm2 at 510 nm and 4 nV photon−1 μm2 at 360 nm which is 20–30 times higher than for the mouse. It is suggested that the relatively large number of on-cone bipolar cells in the retina of rat is responsible for the remarkable sensitivity of the cone b-wave.
Early indicators of autism spectrum disorders at 12 and 24 months of age: A prospective, longitudinal comparative study

Prospective questionnaire data from a longitudinal population sample on children with autism spectrum disorders (ASD), developmental delay, specific language impairment, or typical development (TD), were collected at ages eight, 12 and 24 months, via the Communication and Symbolic Behavior Scale Developmental Profile (CSBS) – Infant Toddler Checklist, and the Actions and Gesture section of the MacArthur-Bates Communicative Development Inventory (CDI):Words and Gestures. The four groups were compared at four years of age to identify whether any early behaviours differentiated the groups. While children with ASD differed from TD children on most social communicative measures by 12 months of age, the only social communication characteristic which could differentiate the children with ASD from the other groups were gesture scores on the CDI at 12 months and the CSBS at 24 months. Significant markers of ASD were identifiable in this community sample at an early age, although discrimination between clinical groups was rarely evident.
Functional role of charybdotoxin-sensitive K+ channels in the resting state of cerebral, coronary and mesenteric arteries of the dog.

To determine the possible role of Ca(++)-activated K+ (KCa) channels in the regulation of resting tone of arteries, the effects of agents that interact with these channels on tension and 86Rb efflux were examined in endothelium-denuded strips of cerebral (middle cerebral, posterior cerebral and basilar), coronary and mesenteric arteries of the dog. Strips of cerebral arteries maintained a myogenic tone; i.e., the resting tone decreased when either the Krebs' solution was replaced with a Ca(++)-free solution or nifedipine was added. The addition of charybdotoxin, a blocker of large conductance KCa channels, to the resting strips (strips at a resting state) caused a concentration-dependent contraction in the cerebral arteries but not in the coronary or mesenteric artery. In resting strips preloaded with 86Rb, the basal 86Rb efflux rate constant was significantly greater in the cerebral arteries than in the coronary and mesenteric arteries. The addition of nifedipine to the resting strips decreased the basal 86Rb efflux rate constant in the cerebral and coronary arteries. Effects of nifedipine on tension and 86Rb efflux in 20.9 mM K(+)-contracted strips of the mesenteric artery were comparable to the effects of this blocker in the resting strips of the middle cerebral artery. The 86Rb efflux rate constant during the stimulation with 65.9 mM K+ was similar for the middle cerebral and mesenteric arteries. Studies using 1- or 5-min pulse labeling with 45Ca demonstrated increased basal 45Ca influx in the resting state of cerebral arteries compared with the coronary and mesenteric arteries. (ABSTRACT TRUNCATED AT 250 WORDS)
Randomized Trial of a Peer Resistance Skill-Building Game for Hispanic Early Adolescent Girls

Background:Adolescents can use peer resistance skills to avoid being pressured into risky behavior, such as early sexual behavior. Avatar-based virtual reality technology offers a novel way to help build these skills. Objectives:The aims of this study were to evaluate the feasibility of an avatar-based virtual reality peer resistance skill building game (DRAMA-RAMA), to explore the impact of game play on peer resistance self-efficacy, and to assess how positively the game was perceived. Methods:Forty-four low-income early adolescent Hispanic girls were assigned randomly to either the intervention (DRAMA-RAMA) or attention control game (Wii Dancing With the Stars) condition. All participants were offered a five-session curriculum that included peer resistance skill content before playing their respective game for 15 minutes, once a week, for 2 weeks. Participants completed electronic surveys at baseline, after game play, and at 2 months to assess demographics, peer resistance self-efficacy, and sexual behavior. They also completed a paper–pencil game experience questionnaire immediately after game play. Data were analyzed using descriptive statistics, t test, chi-square, and analyses of covariance. Results:Separate analyses of covariance showed a significant game effect at posttest for the peer resistance self-efficacy measure (F = 4.21, p < .05), but not at follow-up (F = 0.01, p = .92). DRAMA-RAMA was rated as positively as the Wii Dancing With the Stars (p > .26). Discussion:This randomized control trial provides preliminary support for the hypothesis that playing an avatar-based virtual reality technology game can strengthen peer resistance skills, and early adolescent Hispanic girls will have a positive response to this game.
Primary Renal Lymphoma Presenting with Chronic Low-Grade Fever

Primary renal lymphoma (PRL) is a rare form of extranodal non-Hodgkin’s lymphoma often diagnosed and treated by oncologists and urologists. Pathophysiological and clinical data on PRL are sparse, but the limited reported experience suggests the disease usually has an ominous outcome. As in other renal tumors, comprehensive radiological investigations have a central role in the recognition and final diagnosis of PRL. We describe the presenting features and clinical course of an elderly woman who was found to have PRL after evaluation for persistent low-grade fever. Diagnostic and therapeutic caveats are discussed on the basis of a critical literature review of case reports and descriptions of small series of patients.
Growth factors regulate the expression profile of their syndecan co-receptors and the differentiation of mesothelioma cells.

BACKGROUND Diffuse malignant pleural mesotheliomas are locally aggressive and highly lethal tumors that are becoming more common. The tumor derives from pluripotential mesothelial stem cells, which differentiate into epithelial or mesenchymal elements. Tumors with a predominantly epithelial growth pattern have a better prognosis than the sarcomatous and mixed types, the phenotype being important for the biology of the tumor. We have previously shown that mesotheliomas express a wide range of cell surface heparan sulfate proteoglycans (HSPGs), particularly syndecans, which interact with growth factors and matrix components. MATERIALS AND METHODS This study was undertaken to examine the epithelial-mesenchymal transition of mesothelioma cells by exposing epithelially-differentiated cells to an array of growth factors. Following substitution with TGF-beta 2, EGF, FGF-2, IGF-I and PDGF-BB, the expression levels of syndecans-1, -2 and -4 were monitored at selected times (30 minutes, 6 hours and 18 hours) by semi-quantitative RT-PCR and FACS analysis. The morphological appearance and proliferation rate of the treated cells was correlated to the PG profile obtained and to the subcellular compartmentalization of PGs. RESULTS An early response was obtained only for syndecan-4. Changes in the differentiation pattern appeared later. Exposure to EGF and IGF-I induced a fibroblast-like morphology, simultaneously with a reduced expression of syndecans-1 and 2. TGF-beta 2 enhanced the focal contacts and showed a marked up-regulation of syndecan-4 and down-regulation of syndecan-1. Interestingly, TGF-beta 2 delayed the nuclear transport of syndecan-1 concomitantly with an antiproliferative effect. CONCLUSION Growth factor signalling seems to be delicately controlled by an autoregulatory loop involving the syndecan expression levels and amounts of soluble HS chains shed into the medium.
Intact Intestinal mRNAs and Intestinal Epithelial Cell Esterase, But Not Cryptosporidium parvum, Reach Mesenteric Lymph Nodes of Infected Mice1

Dendritic cells from the mesenteric lymph nodes (MLN) contain dense esterase-positive inclusions that may originate in effete intestinal epithelial cells and reach MLN without degradation. The MLN esterases have the electrophoretic mobilities of both intestinal and mononuclear cells. Cryptosporidium parvum (CP)-infected mice have CP Ag-positive cells in MLN and also increased numbers of dense esterase-positive cells, but the CP Ag-positive cells do not stain for esterase. To characterize the handling of epithelial cell products by dendritic cells, we analyzed mRNAs in the MLN of control and CP-infected recombination-activating gene−/−DO11.10 mice by oligoarrays. mRNAs for 115 proteins were increased in MLN after CP infection, of which the principal increases in trypsin and chymotrypsin approximated to 250-fold. Colipase, reg-1, C-reactive protein-ductin, and amyloid were also up-regulated >10-fold and all returned to baseline by 28 days after infection. mRNAs for the same proteins were detected in intestinal epithelial cells of infected mice by oligoarrays and RT-PCR after infection. mRNA for CP β-tubulin was detectable in intestinal epithelial cells between 5 and 18 days after infection but was not detected in the MLN throughout the observation period. It appears that host response to CP infection includes expression of mRNA for some pancreatic enzymes by intestinal epithelial cells and their subsequent transport to the MLN. The esterase and trypsin, and mRNAs for chymotrypsin, colipase, and others that may derive from uninfected epithelial cells, appear to be transported to the MLN intact, while mRNA for CP β-tubulin that is derived from infected cells is degraded.