Miracle-dz/UniFAR-FTUs huggingface dataset:
Norepinephrine increases cardiac preload and reduces preload dependency assessed by passive leg raising in septic shock patients*

Objective:To assess the effects of norepinephrine on cardiac preload, cardiac index, and preload dependency during septic shock. Design:Prospective interventional study. Setting:Medical Intensive Care Unit. Patients:We included 25 septic shock patients (62 ± 13 yrs old, Simplified Acute Physiology Score II 53 ± 12, lactate 3.5 ± 2.1 mmol/L, all receiving norepinephrine at baseline at 0.24 [25%–75% interquartile range: 0.12–0.48] &mgr;g/kg/min) with a positive passive leg raising test (defined by an increase in cardiac index ≥10%) and a diastolic arterial pressure ≤40 mm Hg. Interventions:We performed a passive leg raising test (during 1 min) at baseline. Immediately after, we increased the dose of norepinephrine (to 0.48 [0.36–0.71] &mgr;g/kg/min) and, when the hemodynamic status was stabilized, we performed a second passive leg raising test (during 1 min). We finally infused 500 mL saline. Measurements and Main Results:Increasing the dose of norepinephrine significantly increased central venous pressure (+23% ± 12%), left ventricular end-diastolic area (+9% ± 6%), E mitral wave (+19% ± 23%), and global end-diastolic volume (+9% ± 6%). Simultaneously, cardiac index significantly increased by 11% ± 7%, suggesting that norepinephrine had recruited some cardiac preload reserve. The second passive leg raising test increased cardiac index to a lesser extent than the baseline test (13% ± 8% vs. + 19% ± 6%, p < .05), suggesting that norepinephrine had decreased the degree of preload dependency. Volume infusion significantly increased cardiac index by 26% ± 15%. However, cardiac index increased by <15% in four patients (fluid unresponsive patients) while the baseline passive leg raising test was positive in these patients. In three of these four patients, the second passive leg raising test was also negative, i.e., the second passive leg raising test (after norepinephrine increase) predicted fluid responsiveness with a sensitivity of 95 [76–99]% and a specificity of 100 [30–100]%. Conclusions:In septic patients with a positive passive leg raising test at baseline suggesting the presence of preload dependency, norepinephrine increased cardiac preload and cardiac index and reduced the degree of preload dependency.
Having access to others’ mind through gaze: The role of ontogenetic and learning processes in gaze-following behavior of macaques

Abstract In primates the gaze conveys important information about what others attend to and about their intentions. The ability to follow the gaze direction of conspecifics has been established for several primate species. It has been proposed to be a precursor for more complex cognitive skills related to mind reading. Studies in humans and other primates have shown that this behavior develops during the period between infancy and adulthood; however, the mechanisms responsible for its emergence are still unknown. In a series of experiments we investigated such mechanisms in macaques (Macaca nemestrina). Results show that juvenile macaques improve their ability to follow the gaze of a human experimenter and that adults’ ability to follow gaze is more accurate than that of juveniles. Our data also show that this behavior can emerge as the result of learning processes. The discrepancy between the relatively long period of time needed for the full establishment of the gaze-following behavior and its high sensitivity to conditioning procedures may suggest that social experience and integration of this behavior with other social-cognitive skills are required for its development.
4 with Collaborators

Principal Investigators: Teresa W. -M. Fan, Richard M. Higashi, and David Crowley with Collaborators Andrew N. Lane, Teresa A. Cassel, and Peter G. Green Dept. of Chemistry, Univ. of Louisville, Louisville Center for Health and Environment, Univ. of California, Davis Dept. of Land, Air and Water Resources, Univ. of California, Davis Dept. of Soil and Environmental Sciences, Univ. of California, Riverside J.G. Brown Cancer Center, Univ. of Louisville, Louisville Crocker Nuclear Laboratory, Univ. of California, Davis Dept. of Civil and Environmental Engineering, Univ. of California, Davis
ALS 2000: the past points to the future

In this introductory review a number of issues concerning the direction of future research in ALS are addressed in relation to current understanding of this disorder and its treatment. The importance of understanding the pathways leading to motor neuron dysfunction and death is emphasized. Contemporary epidemiology, understandably genetic markers for familial ALS, needs to be widened to include as yet undocumented susceptibility-related focussed on traits. Potential avenues for therapy are considered, and the fundamental contemporary issue of clinical measurement is discussed. Neglected aspects of contemporary research, including disturbed axoplasmic flow, are brought to attention. The role of experiment derived from clinical observation, and vice versa , is described by reference to a number of past and recent contributions to the understanding of ALS. (ALS 2001; 2 (suppl genetic 1) S3-S9)
Association Among ICU Congestion, ICU Admission Decision, and Patient Outcomes*

Objectives:To employ automated bed data to examine whether ICU occupancy influences ICU admission decisions and patient outcomes. Design:Retrospective study using an instrumental variable to remove biases from unobserved differences in illness severity for patients admitted to ICU. Setting:Fifteen hospitals in an integrated healthcare delivery system in California. Patients:Seventy thousand one hundred thirty-three episodes involving patients admitted via emergency departments to a medical service over a 1-year period between 2008 and 2009. Interventions:None. Measurements and Main Results:A third of patients admitted via emergency department to a medical service were admitted under high ICU congestion (more than 90% of beds occupied). High ICU congestion was associated with a 9% lower likelihood of ICU admission for patients defined as eligible for ICU admission. We further found strong associations between ICU admission and patient outcomes, with a 32% lower likelihood of hospital readmission if the first inpatient unit was an ICU. Similarly, hospital length of stay decreased by 33% and likelihood of transfer to ICU from other units—including ICU readmission if the first unit was an ICU—decreased by 73%. Conclusions:High ICU congestion is associated with a lower likelihood of ICU admission, which has important operational implications and can affect patient outcomes. By taking advantage of our ability to identify a subset of patients whose ICU admission decisions are affected by congestion, we found that, if congestion were not a barrier and more eligible patients were admitted to ICU, this hospital system could save approximately 7.5 hospital readmissions and 253.8 hospital days per year. These findings could help inform future capacity planning and staffing decisions.
Arthroscopic Foveal Repair of Triangular Fibrocartilage Complex Peripheral Lesion With Distal Radioulnar Joint Instability

There is still controversy regarding the value of arthroscopic suture of triangular fibrocartilage complex (TFCC) peripheral tears compared with open transosseous repair because only the latter method restores foveal insertions of TFCC in case of distal radioulnar joint (DRUJ) instability. Five classes of TFCC peripheral tears are recognized in a treatment-oriented algorithm based on arthroscopic findings, and indications to proper treatment are set accordingly. Complete repairable tears (class 2) and proximal repairable tears (class 3) are associated with DRUJ instability and require foveal reattachment of the TFCC. We describe a new arthroscopic technique to repair the foveal attachment of the TFCC with the use of a suture anchor, which is indicated for class 2 and 3 TFCC peripheral tears, instead of an open repair. This technique requires a dedicated working portal to approach the fovea ulnaris. This Direct Foveal portal is used to prepare the ligament and bone and to drill and insert a suture anchor loaded with a pair of sutures. Under arthroscopic vision, a suture is passed through each limb of the ligament and tied using a small knot-pusher. This arthroscopic technique restores original TFCC anatomy and adequate DRUJ stability with less morbidity and potentially accelerated rehabilitation compared with open repair.
Dysregulations in circulating sphingolipids associate with disease activity indices in female patients with systemic lupus erythematosus: a cross-sectional study

Objective The objective of this study was to investigate the association of clinical and renal disease activity with circulating sphingolipids in patients with systemic lupus erythematosus. Methods We used liquid chromatography tandem mass spectrometry to measure the levels of 27 sphingolipids in plasma from 107 female systemic lupus erythematosus patients and 23 controls selected using a design of experiment approach. We investigated the associations between sphingolipids and two disease activity indices, the Systemic Lupus Activity Measurement and the Systemic Lupus Erythematosus Disease Activity Index. Damage was scored according to the Systemic Lupus International Collaborating Clinics damage index. Renal activity was evaluated with the British Island Lupus Activity Group index. The effects of immunosuppressive treatment on sphingolipid levels were evaluated before and after treatment in 22 female systemic lupus erythematosus patients with active disease. Results Circulating sphingolipids from the ceramide and hexosylceramide families were increased, and sphingoid bases were decreased, in systemic lupus erythematosus patients compared to controls. The ratio of C16:0-ceramide to sphingosine-1-phosphate was the best discriminator between patients and controls, with an area under the receiver-operating curve of 0.77. The C16:0-ceramide to sphingosine-1-phosphate ratio was associated with ongoing disease activity according to the Systemic Lupus Activity Measurement and the Systemic Lupus Erythematosus Disease Activity Index, but not with accumulated damage according to the Systemic Lupus International Collaborating Clinics Damage Index. Levels of C16:0- and C24:1-hexosylceramides were able to discriminate patients with current versus inactive/no renal involvement. All dysregulated sphingolipids were normalized after immunosuppressive treatment. Conclusion We provide evidence that sphingolipids are dysregulated in systemic lupus erythematosus and associated with disease activity. This study demonstrates the utility of simultaneously targeting multiple components of a pathway to establish disease associations.
Stochastic zero-sum nash games for uncertain nonlinear Markovian jump systems

In this paper, a novel adaptive learning technique is proposed to solve a stochastic zero-sum Nash game with partially unknown nonlinear systems for which the lengths of time intervals that the system spends in each mode are independent random variables with exponential distributions, i.e. the environment and the cost matrices depend on the outcome of a Markov chain. We first formulate the problem by using an optimal stopping process and then provide a verification theorem for stopping zero-sum games. A structure of 2 actors and 1 critic approximators are used to approximate the saddle-point policies and the optimal cost respectively. Effective tuning laws are proposed to solve the stochastic Nash game problem while also guaranteeing closed-loop stability with the use of rigorous Lyapunov-based stability proofs. Finally, a numerical example is used to illustrate the effectiveness of the proposed approach.
Infratrochlear neuralgia

Introduction The infratrochlear nerve supplies the medial aspect of the upper eyelid, the superolateral aspect of the nose and the lacrimal caruncle. This nerve may contribute to the pain stemming from the trochlea, but infratrochlear neuralgia has not been identified as a specific cause of pain. Methods Over a 10-year period we have been recruiting patients with pain in the internal angle of the orbit that did not show features of trochlear pain. Results Seven patients (six female, one male; mean age, 46.1 ± 18.9) presented with pain in the territory of the infratrochlear nerve. The pain appeared in the internal angle of the orbit and upper eyelid (n = 3), the superolateral aspect of the nose (n = 3), or the lacrimal caruncle (n = 1). All patients had a paroxysmal pain, with the attacks lasting five to 30 seconds. Pain attacks were mostly spontaneous, but two patients had triggers. Between attacks, all patients had local allodynia. Pain did not increase with vertical eye movements. Six patients were treated with gabapentin with complete response, and one patient experienced long-lasting relief with an anesthetic blockade of the infratrochlear nerve. Conclusion Infratrochlear neuralgia should be considered as a possible cause of pain in the internal angle of the orbit.
Generalized osteoarthritis in women: pattern of joint involvement and approaches to definition for epidemiological studies.

OBJECTIVE To ascertain whether clustering between joint sites in osteoarthritis (OA) is more common than would be expected simply from the rising prevalence of the disorder with age, and to explore a definition of generalized OA (GOA) by determining the pattern of joint group involvement, in a population sample of peri and postmenopausal women. METHODS Radiographs of the hands, knees, and hips were obtained in a population sample of 702 women aged 45 to 64 years. Distal interphalangeal, proximal interphalangeal, carpometacarpal, knee, and hip OA were assessed using the Kellgren-Lawrence grading system. Logistic regression was used to test for overall clustering of OA between joint sites, and log linear models were used to study the patterns of association between different sites. RESULTS Multiple involvement of the 5 joint groups studied occurred significantly more frequently than could be expected by chance alone (chi 2 = 52.3, df = 5, p < 0.001), and this clustering remained significant after age adjustment (chi 2 = 26.1, df = 5, p < 0.001). Thresholds could be defined for the number of involved joint groups that distinguished a polyarticular subset of OA. These thresholds varied with age and the radiographic cutoff at which OA was assigned. Thus, for grade 2+ disease, GOA could be defined by involvement of 2 or more joint groups at age 45-47 years, but required involvement of all 5 joint groups at age 60-64 years. Symmetry within joint groups was the most pronounced feature in the pattern of joint involvement in the sample as a whole, with associations between different joint groups being substantially weaker than those for symmetrical bilateral involvement of a particular joint. CONCLUSION There is a clear tendency towards polyarticular OA among women aged 45-64 years. However, there is no single threshold number of joint sites that can be used to define GOA. The pattern of joint involvement in OA is primarily symmetrical, and this pattern strongly suggests a systemic etiology in this subset of postmenopausal women.
Sex differences in attention to disgust facial expressions

ABSTRACT Research demonstrates that women experience disgust more readily and with more intensity than men. The experience of disgust is associated with increased attention to disgust-related stimuli, but no prior study has examined sex differences in attention to disgust facial expressions. We hypothesised that women, compared to men, would demonstrate increased attention to disgust facial expressions. Participants (n = 172) completed an eye tracking task to measure visual attention to emotional facial expressions. Results indicated that women spent more time attending to disgust facial expressions compared to men. Unexpectedly, we found that men spent significantly more time attending to neutral faces compared to women. The findings indicate that women’s increased experience of emotional disgust also extends to attention to disgust facial stimuli. These findings may help to explain sex differences in the experience of disgust and in diagnoses of anxiety disorders in which disgust plays an important role.
A note on selective imitation by a six-week-old infant.

GARDNER, JUDITH, and GARDNER, HOWARD. Note on Selective Imitation by a Six-Week-Old Infant. CHILD DEVELOPMENT, 1970, 41, 1209-1213. To determine whether a 6-week-old infant is capable of imitation, regular observations were made of 1 child's reactions to 4 kinds of parental behavior. Although there was little evidence of direct imitation, the data suggested that the child might be sensitive to the modal properties of the behaviors.
Pineal-adrenal Relationship : Modulating Effects of Glucocorticoids on Pineal Function to Ameliorate Thermal-stress in Goats

ABSTRACT : The purpose of the investigation was to establish how the pineal-adrenal axis plays an important role in thermoregulation in female goats under short-term heat stress. The study was conducted to observe the influence of glucocorticoids on pineal function in goats and its influence on stress alleviation capability. Melatonin and glucocorticoid secretions and several other endocrine and biochemical blood parameters reflecting the animals well being were determined over a one week period after goats had been exposed to 40°C and 60% relative humidity for 10 days. Six female goats were used in the study. These animals served as self controls prior to the start of the experiment. The study was conducted for a period of seventeen days in a psychrometric chamber at 40°Cand 60% relative humidity. Chemical pinealectomy was achieved using propranolol followed by exogenous hydrocortisone treatment. Blood samples were drawn twice daily after each treatment to find the effect of hydrocortisone on plasma glucose, total protein, total cholesterol, cortisol, insulin, aldosterone, melatonin and corticosterone. Chemical pinealectomy significantly (p≤0.05) affected plasma levels of the parameters studied and these could be significantly (p≤0.05) counteracted by administration of hydrocortisone. Chemical pinealectomy aggravated thermal stress, although administration of hydrocortisone could ameliorate the condition. This indicated a role of the pineal in support of thermoregulation. The study establishes the modulating effect of glucocorticoids on pineal activity to relieve thermal stress in goats. (
Isolation and in vitro chondrogenic potential of human foetal spine cells

Cell therapy for nucleus pulposus (NP) regeneration is an attractive treatment for early disc degeneration as shown by studies using autologous NP cells or stem cells. Another potential source of cells is foetal cells. We investigated the feasibility of isolating foetal cells from human foetal spine tissues and assessed their chondrogenic potential in alginate bead cultures. Histology and immunohistochemistry of foetal tissues showed that the structure and the matrix composition (aggrecan, type I and II collagen) of foetal intervertebral disc (IVD) were similar to adult IVD. Isolated foetal cells were cultured in monolayer in basic media supplemented with 10% Fetal Bovine Serum (FBS) and from each foetal tissue donation, a cell bank of foetal spine cells at passage 2 was established and was composed of around 2000 vials of 5 million cells. Gene expression and immunohistochemistry of foetal spine cells cultured in alginate beads during 28 days showed that cells were able to produce aggrecan and type II collagen and very low level of type I and type X collagen, indicating chondrogenic differentiation. However variability in matrix synthesis was observed between donors. In conclusion, foetal cells could be isolated from human foetal spine tissues and since these cells showed chondrogenic potential, they could be a potential cell source for IVD regeneration.
Odontogenic cysts: demographic profile in a Brazilian population over a 38-year period.

OBJECTIVE To determine the distribution of odontogenic cysts diagnosed histologically over a period of 38 years in a Brazilian population according to age, gender and site affected and to compare these data with previously reported studies from other countries. STUDY DESIGN A total of 1019 cases of odontogenic cysts diagnosed between 1970 and 2007 were studied. Clinical features obtained from the patient records and microscope slides were reviewed according to the 1992 World Health Organization classification. RESULTS The mean age was 31.0 years, and there was a predominance of females. The most frequent odontogenic cysts were radicular cysts (61.4%), followed by dentigerous cysts (20.1%) and odontogenic keratocysts (6.4%). Radicular cysts were more frequent in females (62.0%), and the maxillary teeth were the site most commonly involved (63.05%). The peak incidence of dentigerous cysts occurred in the second decade of life, with the posterior region of the mandible being the site most affected (46.3%), followed by the anterior region of the maxilla (27.8%). Odontogenic keratocysts showed a peak incidence between the third and fourth decades of life and predominance among females. The posterior region of the mandible was the site most frequently affected (65.6%). CONCLUSION The present results showed a similar frequency of odontogenic cysts in this Brazilian population and other populations around the world, with inflammatory cysts being identified as the most frequent odontogenic cyst. Radicular cysts, dentigerous cysts, and odontogenic keratocysts are the most common cystic lesions, accounting for 87.9% of all odontogenic cysts.