Miracle-dz/UniFAR-FTUs huggingface dataset:
The growth hormone deficiency syndrome in adults

The effects of growth hormone (GH) deficiency in childhood are well recognized. These include shortness of stature with normal proportions, slow linear growth rate, delayed bone age with reduced bone density, excess adiposity with a predominantly truncal distribution, reduced lean tissue mass, and fasting hypoglycaemia (Collip et al., 1973; Hopwood et al., 1975; Tanner et al., 1977; Milner et al., 1979; Parra et al., 1979, Shore et al., 1980). These effects reflect the known metabolic actions of GH (Davidson, 1987; Press, 1988); GH promotes anabolism and lipolysis, and has complex actions on carbohydrate metabolism which can be summarized as insulinotrophic and insulin antagonistic. The effects of GH deficiency in adults have been appreciated only recently. There may be several reasons for this. Firstly, adults who developed panhypopituitarism from mass effects of a pituitary tumour or the treatment of the tumour survived, often returning to reasonably functional lives with conventional pituitary hormone replacement therapy. Secondly, GH treatment of such patients was not possible due to limited supplies of human pituitary-derived GH. The introduction of recombinant DNA technology has resulted in the production of authentic sequence human GH (rhGH) in potentially unlimited supplies, allowing treatment of conditions other than short stature. The aims of this review are to summarize the recent studies of GH treatment in adults with GH deficiency, thereby defining the syndrome of GH deficiency in adults, and to highlight areas for future investigation.
Colorectal neoplasia screening with CT colonography in average-risk asymptomatic subjects: community-based study.

PURPOSE To evaluate computed tomographic (CT) colonography as a screening tool for average-risk asymptomatic subjects with regard to participation, acceptability, and safety. MATERIALS AND METHODS CT colonography for colorectal neoplasia screening was offered to 2,000 subjects aged 50-54 and 65-69 years. Only asymptomatic subjects at average risk of colorectal neoplasia were enrolled. Participants underwent CT colonography followed by colonoscopy if CT colonography findings showed any polyps. Acceptability was measured with a 100-point (0, most favorable; 100, least favorable) visual analogue scale (VAS). Chi2 statistic was used to compare participation rates among subgroups. Safety of CT colonography was evaluated by recording all important adverse events. RESULTS A total of 1,452 subjects were eligible for screening. The adjusted participation rate was 28.4%. Participation was higher in younger subjects and in those from a high socioeconomic region. Major reasons for nonparticipation were insufficient time and perceived good health. Median VAS scores for pain, general satisfaction, embarrassment, and willingness to repeat screening were 13, 6, 8, and 5, respectively. Most subjects found CT colonography better than (60%) or same as (32%) expected. Ninety-three (27.4%) of 340 subjects were referred for colonoscopy, with polyps found in 67 (positive predictive value, 0.73). By adopting criteria that a positive finding at CT colonography is that of a single polyp larger than 5 mm or multiple polyps larger than 2 mm, 14% of CT examinations would have led to colonoscopy; 5.7% of CT findings were false-positive, with no significant impairment in large polyp detection. There were no important adverse events related to CT colonography, although four subjects had syncope or presyncope related to bowel preparation. CONCLUSION Community-based colorectal neoplasia screening with CT colonography was accompanied by a participation rate that compares favorably with that of similar screening programs. CT colonography was highly acceptable to participants.
Narrow focus realization in the monosyllabic lexical pitch contrast in East Norwegian

The Trøndersk dialect of East Norwegian is rather unusual typologically in that it exhibits a tonal contrast (unmarked vs. circumflex) on monosyllabic words [7, 1, 20]. The goal of the current study was to examine this contrast and how it is impacted by sentential focus. Ten speakers of the Trøndersk dialect were recorded reading target monosyllabic words with these accents embedded in sentences with broad and narrow focus. In broad focus, words with the unmarked accent have an L tone and words with the circumflex accent have a HL contour with a higher F0 maximum and vowel onset than the unmarked contour. In narrow focus, both accents have a wider pitch range and later low tone alignment. Phonologically long vowels were lengthened under narrow focus. This study adds to the literature on the realization of focus in pitch accent languages, and the interaction between prosodically marked focus and lexical accents.
Autoimmune rheumatic diseases and the risk of Parkinson disease: a nationwide population-based cohort study in Taiwan

Abstract Backgrounds: In autoimmune rheumatic diseases (ARDs), the levels of inflammatory mediators are increased and microglia may be activated, resulting in an inflammatory state and the degeneration of dopaminergic neurons. We investigated the association between ARDs and Parkinson disease (PD). Methods: We identified ARD patients through the Taiwan National Health Insurance Research Database from 2001 to 2012. From the general population, we randomly selected a comparison cohort that was frequency-matched by age (in 5-year increments), sex and index year. We analysed the risk of PD, stratified by sex, age and comorbidities, by using a Cox regression model. Results: The risk of PD was 1.37 times greater in ARD patients than in controls after adjustment for age, sex, and comorbidities. ARD subgroups, such as the rheumatoid arthritis and Sjogren syndrome (SS) cohorts, were associated with a significantly higher risk of PD (adjusted hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.03–1.2 and adjusted HR, 1.56; 95% CI, 1.35–1.79, respectively). Furthermore, primary and secondary SS patients had significantly higher risks of PD (adjusted HR, 1.58; 95% CI, 1.32–1.88 and adjusted HR, 1.53, 95% CI, 1.23–1.90, respectively). Conclusions: The risk of PD was significantly higher in the ARD patients. Prospective studies are needed to confirm whether ARDs indeed increase the risk of PD.
Quantitative residual properties of Γ-limit groups

Let Gamma be a fixed hyperbolic group. The Gamma-limit groups of Sela are exactly the finitely generated, fully residually Gamma groups. We give a new invariant of Gamma-limit groups called Gamma-discriminating complexity and show that the Gamma-discriminating complexity of any Gamma-limit group is asymptotically dominated by a polynomial. Our proof relies on an embedding theorem of Kharlampovich-Myasnikov which states that a Gamma-limit group embeds in an iterated extension of centralizers over Gamma. The result then follows from our proof that if G is an iterated extension of centralizers over Gamma, the G-discriminating complexity of a rank n extension of a cyclic centralizer of G is asymptotically dominated by a polynomial of degree n.
Training primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes?

Background. We developed a comprehensive, 20-hour training programme for primary-care physicians, that sought to improve their ability to detect, diagnose and manage depression. We evaluated the effects of physician training on patient outcomes, using a pre-post design. Methods. In the pre-training phase of the study, we sampled 1834 consecutive patients of 17 primary-care physicians and evaluated 518 of these patients for the presence of depression. We measured outcomes of all patients with depression at 3 months and 1 year. The outcome measures were: severity of psychopathology; duration of depressive episode; and level of daily functioning. After the 17 physicians completed the training, we drew a new sample from their practices (498 of 1785 consecutive patients were evaluated for depression) and measured outcomes for the depressed patients. Results. We found an effect of the training on short-term outcome, particularly for patients with a recent-onset depression. At 3-month follow-up depressed patients whose physicians had received training had less severe psychopathology and patients with recent-onset depression also showed higher levels of daily functioning than patients of the same physicians prior to the training. The patients with a recent-onset depression that was recognized by trained physicians had shorter depressive episodes, but this was not statistically significant. At 1-year follow-up, all training effects had faded away. Conclusions. Training primary-care physicians to recognize, diagnose and manage depression can improve short-term patient outcomes, especially for patients with a recent onset of depression. Patients suffering from a recurrent or chronic depression may need more specific interventions, both for acute treatment and long-term management.
A Dominant Negative Heterozygous G87R Mutation in the Zinc Transporter, ZnT-2 (SLC30A2), Results in Transient Neonatal Zinc Deficiency

Background: Infants of mothers carrying the H54R mutation in ZnT-2 develop transient neonatal zinc deficiency (TNZD). Results: Transfection of a novel heterozygous G87R mutant ZnT-2 resulted in its mislocalization, impaired zinc transport, and negative dominance. Conclusion: G87R is an inactivating mutation inflicting a dominant negative effect via homodimer formation. Significance: This study significantly advances our understanding regarding the molecular mechanism underlying TNZD. Zinc is an essential mineral, and infants are particularly vulnerable to zinc deficiency as they require large amounts of zinc for their normal growth and development. We have recently described the first loss-of-function mutation (H54R) in the zinc transporter ZnT-2 (SLC30A2) in mothers with infants harboring transient neonatal zinc deficiency (TNZD). Here we identified and characterized a novel heterozygous G87R ZnT-2 mutation in two unrelated Ashkenazi Jewish mothers with infants displaying TNZD. Transient transfection of G87R ZnT-2 resulted in endoplasmic reticulum-Golgi retention, whereas the WT transporter properly localized to intracellular secretory vesicles in HC11 and MCF-7 cells. Consequently, G87R ZnT-2 showed decreased stability compared with WT ZnT-2 as revealed by Western blot analysis. Three-dimensional homology modeling based on the crystal structure of YiiP, a close zinc transporter homologue from Escherichia coli, revealed that the basic arginine residue of the mutant G87R points toward the membrane lipid core, suggesting misfolding and possible loss-of-function. Indeed, functional assays including vesicular zinc accumulation, zinc secretion, and cytoplasmic zinc pool assessment revealed markedly impaired zinc transport in G87R ZnT-2 transfectants. Moreover, co-transfection experiments with both mutant and WT transporters revealed a dominant negative effect of G87R ZnT-2 over the WT ZnT-2; this was associated with mislocalization, decreased stability, and loss of zinc transport activity of the WT ZnT-2 due to homodimerization observed upon immunoprecipitation experiments. These findings establish that inactivating ZnT-2 mutations are an underlying basis of TNZD and provide the first evidence for the dominant inheritance of heterozygous ZnT-2 mutations via negative dominance due to homodimer formation.
Lipid-lowering and Antiatherosclerotic Effect of NK-104, a Potent 3-Hydroxy-3-methylglutaryl Coenzyme A Reductase Inhibitor, in Watanabe Heritable Hyperlipidemic Rabbits

Summary NK-104 ((+)-monocalcium bis{(3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)-3-quinolyl]-3,5-dihydroxy-6-heptenoate}, CAS 147526-32-7) an inhibitor of 3-hydroxy-3-metylglutaryl coenzyme A reductase, was administered in drinking water (0.5 mg/kg equivalent) to Watanabe heritable hyperlipidemic (WHHL) rabbits for 26 weeks. It lowered plasma total cholesterol (TC,7-20 %) and triglyceride (TG, 16-39 %) levels throughout the experimental period due to a significant reduction of very low density lipoprotein cholesterol (VLDL-C, 61-62 %, p < 0.05), intermediate density lipoprotein cholesterol (IDL-C, 49-60 %, p < 0.05), VLDL-TG (40-53 %,p=0.06-0.08) and IDL-TG (29-59 %,p=0.06-0.14); low density lipoprotein cholesterol (LDL-C) was not affected. The pattern of the lipoprotein reduction along with a decrease in liver cholesteryl ester (CE, 33.1 %, p < 0.01) suggests an intense reduction of VLDL secretion and a marginal induction of LDL-receptor. Enhanced expression of LDL receptor-related protein (LRP) in the liver was observed at mRNA levels (49.5 % increase, P=0.13), which might play a role in the lipoprotein reduction. Histological analyses of aorta revealed that aortic arch showed the most advanced lesions with larger lesion area (70.0 vs 41.3 %) and much greater CE content (more than 2 fold) with less macrophages than thoracic aorta. NK-104 decreased the surface lesion area at the arch (23.1 %, p=0.054) and reduced the degeneration of media in the thoracic aorta (69.9 % increase in medial smooth muscle cells, p < 0.01). Thus NK-104 preferentially reduced TG-rich lipoproteins (VLDL and IDL) without affecting LDL-C levels and prevented progression of atherosclerosis in WHHL rabbits.
Pre-vaccine circulating group a rotavirus strains in under 5 years children with acute diarrhea during 1999–2013 in Cameroon

The aim of this review was to assess all the studies on rotavirus G and P characterization during the pre-vaccine period (1999–2013) in Cameroon to have a better basis for post-vaccine introduction evaluations. A retrospective study was done through a comprehensive review of published (PubMed, Google Scholar) and accessible unpublished data on rotavirus G and P genotypes circulating in five regions of Cameroon. Descriptive data were expressed as frequencies tables and proportions. A total of 1844 rotavirus positive cases were analyzed. In all, 1534 strains were characterized for the P (VP4) specificity. Six different VP4 genotypes were observed, including P [4], P [6], P [8], P [9], P [10] and P [14]. The most predominant P genotypes were P [8] at 42.6%, and P [6] at 37.9%. Mixed infections were observed at 5.3%, whereas 4.1% of the strains were P non-typeable. A total of 1518 rotavirus strains were characterized for the G (VP7) specificity. VP7 genotypes G1, G2, G3, G4, G5, G6, G8, G9, G10 and G12 were observed. G1 (35.3%), G3 (19.5%), G2 (14.9%) and G12 (10.1%) were the predominant G genotypes while G5 and G10 were least prevalent at 0.06% each. Approximately 5.1% of all strains were G non-typeable whereas 5.3% were mixed G genotypes. A total of 1472 strains were characterized for both G and P genes, from which 38 different G–P combinations were observed. Overall, G1P [8] (22%) was identified as the predominant rotavirus strain circulating in Cameroon followed by G3P [6] (15%). In conclusion, we observed that the genotypes identified in Cameroon during 1999–2013 were partially covered by the two WHO recommended rotavirus vaccines. This review provides comprehensive up-to-date information on rotavirus strain surveillance in Cameroon during the pre-vaccination era.
The Adaptive Significance of Coloration in Mammals

Abstract Coloration is a diagnostic tool for identifying mammals, but inquiry into its function has lain dormant for almost a century. Recently, the topic has been revived and modern phylogenetic methods have been applied to large data sets, allowing researchers to assess, for the first time, the relative importance of three classic hypotheses for the function of coloration in mammals: concealment, communication, and regulation of physiological processes. Camouflage appears to be the single most important evolutionary force in explaining overall coloration in mammals, whereas patches of colored fur are used for intraspecific signaling. Sexual selection is associated with flamboyant ornamentation in a minority of primates and other restricted mammalian taxa, but to a far lesser extent than in birds. Interspecific signaling among mammals includes aposematic coloration, exaggeration of signals to deter pursuit, and lures for misdirecting predatory attack. Physiological causes of coloration, including melanism, are evident but poorly researched. The relative importance of evolutionary forces responsible for external coloration varies greatly between vertebrate taxa, but the reasons for this variation are not yet understood.
Stirling's Series Revisited

1. INTRODUCTION. We present a concise and elementary derivation of the complete asymptotic expansion for the factorial function n! , which we will refer to as Stirling’s series. While there have been numerous published proofs of Stirling’s series and of its classical dominant term given by Stirling’s formula lim n→∞ n! e n n n √ 2πn = 1
The Role of Pirani Scoring System in the Management and Outcome of Idiopathic Club Foot by Ponseti Method

Background: Clubfoot is not an embryonic malformation. A normally developing foot turns into a clubfoot during the second trimester of pregnancy. Therefore, like developmental hip dysplasia and idiopathic scoliosis, clubfoot is a developmental deformation. Understanding the pathomechanics and treating successfully clubfoot has always been unsolved mystery for modern medicine. Clubfoot is usually diagnosed immediately after birth simply by looking at the foot. Most Orthopaedic surgeons have agreed that the initial treatment of a clubfoot should be nonsurgical and start as soon as possible after birth. Pirani et al has developed a reliable and valid method of clinically assessing the amount of deformity present in an unoperated congenital clubfoot less than 2 years of age. It allows the treating practitioner to know how patient is responding to treatment, to know when tenotomy is indicated, and to reassure parents regarding progress. Material and method: The subjects included in the study were consecutive patients presenting with Idiopathic CTEV attending Orthopaedic OPD from December 2014 to December 2015. Results: In total there were 25 children (38 feet) presented with idiopathic clubfoot deformity, treated by Ponseti technique. Most of the children were below 6 week of age. When mobility of feet was analysed with respect to different Pirani Score groups, It was also found that mean Pirani Score of supple and rigid feet were 4.76 and 5.5 respectively. The more severe the initial deformity higher Pirani Score, the more casts were required to obtain correction. Conclusion: The study clearly showed that age at initial presentation, quality (mobility) of foot and Pirani Score at presentation, has a direct bearing on final results.
Microalbuminuria in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study

Objectives Left ventricular hypertrophy and albuminuria have both been shown to predict increased cardiovascular morbidity and mortality. However, the relationship between these markers of cardiac and renal glomerular damage has not been evaluated in a large hypertensive population with target organ damage. The present study was undertaken to determine whether albuminuria is associated with persistent electrocardiographic (ECG) left ventricular hypertrophy, independent of established risk factors for cardiac hypertrophy, in a large hypertensive population with left ventricular hypertrophy who were free of overt renal failure. Methods Patients with stage II–III hypertension were enrolled in the study if they had left ventricular hypertrophy on a screening ECG by Cornell voltage-duration product and/or Sokolow–Lyon voltage criteria, and clinic blood pressures between 160 and 200/95–115 mmHg and plasma creatinine < 160 mmol/l. A second ECG and morning spot urine were obtained after 14 days of placebo treatment. Renal glomerular permeability was evaluated by urine albumin/creatinine (UACR, mg/mmol). Microalbuminuria was present if UACR > 3.5 mg/mmol and macroalbuminuria if UACR > 35 mg/mmol. Results The mean age of the 8029 patients was 66 years, 54% were women. Microalbuminuria was found in 23% and macroalbuminuria in 4% of patients. Microalbuminuria was more prevalent in patients of African American (35%), Hispanic (37%) and Asian (36%) ethnicity, heavy smokers (32%), diabetics (36%) and in patients with ECG left ventricular hypertrophy by both ECG-criteria (29%). Urine albumin/creatinine was positively related to Sokolow–Lyon voltage criteria and Cornell voltage-duration product criteria. In multiple regression analysis, higher UACR was independently associated with older age, diabetes, higher blood pressure, serum creatinine, smoking and left ventricular hypertrophy. Patients smoking > 20 cigarettes/day had a 1.6-fold higher prevalence of microalbuminuria and a 3.7-fold higher prevalence of macroalbuminuria than never-smokers. ECG left ventricular hypertrophy by Cornell voltage-duration product or Sokolow–Lyon criteria was associated with a 1.6-fold increased prevalence of microalbuminuria and a 2.6-fold increase risk of macroalbuminuria compared to no left ventricular hypertrophy on the second ECG. Conclusions In patients with moderately severe hypertension, left ventricular hypertrophy on two consecutive ECGs is associated with increased prevalences of micro- and macroalbuminuria compared to patients without persistent ECG left ventricular hypertrophy. High albumin excretion was related to left ventricular hypertrophy independent of age, blood pressure, diabetes, race, serum creatinine or smoking, suggesting parallel cardiac damage and albuminuria.
The Radon Transform over Cones with Vertices on the Sphere and Orthogonal Axes

Recovering a function from its integrals over circular cones recently gained significance because of its relevance to novel medical imaging technologies such emission tomography using Compton cameras. In this paper we investigate the case where the vertices of the cones of integration are restricted to a sphere in $n$-dimensional space and symmetry axes are orthogonal to the sphere. We show invertibility of the considered transform and develop an inversion method based on series expansion and reduction to a system of one-dimensional integral equations of generalized Abel type. Because the arising kernels do not satisfy standard assumptions, we also develop a uniqueness result for generalized Abel equations where the kernel has zeros on the diagonal. Finally, we demonstrate how to numerically implement our inversion method and present numerical results.
Longer Tenure, Greater Seniority, or Both? Evidence from Open-End Equity Mutual Fund Managers in Taiwan

In this paper, we investigate the relationship between a fund manager's characteristics and performance, focusing on the interrelationships among fund managers' tenure, seniority and performance in the Taiwan open-end equity mutual fund market. To our knowledge, this is the first study to look into the joint impact of tenure and seniority. By sorting managers both by tenure and seniority, we are able to estimate the extent to which the interaction between the two variables may impact performance. This study suggests that a manager who has been in charge of a fund more than 24.33 months tends to perform well. Moreover, increasing seniority is found to be associated with decreasing performance. This may be explained by the observation that managers with greater seniority also tend to be older, and advanced age negatively impacts performance. Therefore, fund managers with high tenure and low seniority may potentially give rise to better performance than their peers.