Miracle-dz/UniFAR-FTUs huggingface dataset:
Neurobehavioral Deficits Consistent Across Age and Sex in Youth with Prenatal Alcohol Exposure.

BACKGROUND Neurobehavioral consequences of heavy prenatal alcohol exposure are well documented; however, the role of age or sex in these effects has not been studied. The current study examined the effects of prenatal alcohol exposure, sex, and age on neurobehavioral functioning in children. METHODS Subjects were 407 youth with prenatal alcohol exposure (n = 192) and controls (n = 215). Two age groups (child [5 to 7 years] or adolescent [10 to 16 years]) and both sexes were included. All subjects completed standardized neuropsychological testing, and caregivers completed parent-report measures of psychopathology and adaptive behavior. Neuropsychological functioning, psychopathology, and adaptive behavior were analyzed with separate 2 (exposure history) × 2 (sex) × 2 (age) multivariate analyses of variance (MANOVAs). Significant effects were followed by univariate analyses. RESULTS No 3-way or 2-way interactions were significant. The main effect of group was significant in all 3 MANOVAs, with the control group performing better than the alcohol-exposed group on all measures. The main effect of age was significant for neuropsychological performance and adaptive functioning across exposure groups with younger children performing better than older children on 3 measures (language, communication, socialization). Older children performed better than younger children on a different language measure. The main effect of sex was significant for neuropsychological performance and psychopathology; across exposure groups, males had stronger language and visual spatial scores and fewer somatic complaints than females. CONCLUSIONS Prenatal alcohol exposure resulted in impaired neuropsychological and behavioral functioning. Although adolescents with prenatal alcohol exposure may perform more poorly than younger exposed children, the same was true for nonexposed children. Thus, these cross-sectional data indicate that the developmental trajectory for neuropsychological and behavioral performance is not altered by prenatal alcohol exposure, but rather, deficits are consistent across the 2 age groups tested. Similarly, observed sex differences on specific measures were consistent across the groups and do not support sexually dimorphic effects in these domains.
Interactive Effects of Ethanol and HIV-1 Proteins on Novelty-Seeking Behaviors and Addiction-Related Gene Expression.

BACKGROUND Novelty-seeking behavior is related to the reward system in the brain and can predict the potential for addiction. Alcohol use is prevalent in HIV-1-infected patients and adversely affects antiretroviral medication. The difference in vulnerability to alcohol addiction between HIV-1-infected and noninfected populations has not been fully investigated. This study was designed to determine whether HIV-1 proteins alter the effects of ethanol (EtOH) on novelty-seeking behavior using the HIV-1 transgenic (HIV-1Tg) rat as the study model and to examine the molecular mechanisms responsible for this behavior. METHODS Both HIV-1Tg and F344 control rats were tested for baseline novelty-seeking behavior, then received either EtOH (1 g/kg) at a concentration of 20% v/v or saline treatment for 13 days, and then were retested for novelty seeking. Quantitative real-time polymerase chain reaction was conducted to examine the differences in expression of 65 genes implicated in novelty seeking and alcohol addiction between strains and treatment groups. RESULTS The HIV-1 proteins significantly enhanced baseline novelty-seeking behaviors in both the hole-board and open-field tests. Chronic EtOH treatment significantly increased baseline novelty-seeking behavior in both strains, but the effects of EtOH appeared to be more robust and prominent in HIV-1Tg rats. Strain-specific patterns of altered gene expression were observed for dopaminergic, cholinergic, and glutamatergic signaling in the nucleus accumbens, suggesting the effects of HIV-1 proteins on the brain's reward system. Chronic EtOH treatment was shown to greatly modulate the effects of HIV-1 proteins in these neurotransmitter systems. CONCLUSIONS Taken together, our findings indicate that HIV-1 proteins could modify novelty-seeking behavior at the gene expression level, and EtOH treatment may enhance this behavior in both strains but to a greater extent in HIV-1Tg rats.
Delay in the Detection of Cancer: A Review of the Literature

The Consequences of Delay It would be easy to compile an impressive list of quotations testifying to the importance of cutting down the delay which precedes therapeutic action for cancer patients. Dominant professional opinion tends to coincide with common sense in arguing that the earlier the patient gets to the therapist, the more likely is his life to be saved. Thus, for example, Wiggins et al ’°’ estimated that the overall five-year cancer survival rate of 25 percent in upstate New York could be doubled if all
Comparative efficacy of the addition of ezetimibe to statin vs statin titration in patients with hypercholesterolaemia: systematic review and meta-analysis

Abstract Objective: To systematically review and analyse evidence for cholesterol-lowering efficacy of at least 4 weeks of add-on ezetimibe vs doubling statin dose, in adults with primary hypercholesterolaemia. Research design and methods: MEDLINE, EMBASE and Cochrane databases were searched to identify randomised controlled trials of ezetimibe–statin combination vs statin titration (January 1993 – March 2010). Studies were selected using predefined criteria. Two reviewers conducted screening of articles, critical appraisal and data extraction; a third reviewer resolved disagreements. The difference between treatments was analysed for four co-primary outcomes: mean percentage change from baseline in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC); and proportion of patients achieving LDL-C treatment goal. Data were combined by two sets of direct comparison fixed and random effects meta-analysis: (1) compared data in the same treatment period between groups; (2) compared the incremental change in lipid levels of add-on ezetimibe vs doubling statin dose. Heterogeneity was assessed using the I2 statistic. Results: Thirteen studies including 5080 patients were included in the meta-analyses. Data on simvastatin, atorvastatin and rosuvastatin were analysed. Results for primary and secondary outcomes were in favour of the ezetimibe–statin combination. A significantly greater percentage reduction in LDL-C levels was achieved in patients treated with ezetimibe–statin vs statin monotherapy (weighted mean difference [WMD]: −14.1% [−16.1, −12.1], p < 0.001). Reduction in LDL-C levels attributed to add-on ezetimibe was significantly greater than that for statin dose doubling (WMD: −15.3% [−19.1, −11.4], p < 0.001). Achievement of LDL-C goal favoured add-on ezetimibe over statin titration and was statistically significant (odds ratio: LDL-C treatment goal 2.45 [1.95, 3.08], p = 0.007). Conclusions: Meta-analyses were restricted by the limited number of studies with similar trial design and method of statin titration. Results indicate that add-on ezetimibe is significantly more effective in reducing LDL-C levels than doubling statin dose, enabling more patients to achieve LDL-C goal.
Effects of Tetracycline on Cartilage Degradation and Matrix Metalloproteinase Activity/Expression

The therapeutic potential of tetracyclines as antiarthritic agents stems from the newly discovered chondroprotective and/or anti-inflammatory effects of these compounds, known best for their antibacterial properties. Tetracyclines have been reported to inhibit pathologic cartilage as well as bone loss. However, most of the available information relates to bone loss. Chondroprotective effects of the tetracycline analog doxycycline have been demonstrated in a canine model of experimental osteoarthritis (Yu et al, 1992). Prophylactic administration of the compound delayed cartilage damage in this model (Yu et al, 1992). In the guinea pig model of spontaneous osteoarthritis, prophylactic treatment with doxycycline resulted in preservation of cartilage and reduction in osteophyte formation/joint space narrowing (Greenwald, 1994). Doxycycline was also found to inhibit cartilage degradation in an in vitro system of embryonic avian tibias (Cole et al, 1994). Little is known about how tetracyclines exert chondroprotective effects; it has been suggested that perhaps tetracyclines act by modulating cartilage-derived collagenase and gelatinase activity and/or expression (Cole et al, 1994; Green wald, 1994). We have reported that tetracycline exerts transcriptional downregulation of IL-1-induced stromelysin (Jonat et al., 1996). In the present study, we evaluated the
Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom

Abstract Objective: To describe the current epidemiology of acute upper gastrointestinal haemorrhage. Design: Population based, unselected, multicentre, prospective survey. Setting: 74 hospitals receiving emergency admissions in four health regions in the United Kingdom. Subjects: 4185 cases of acute upper gastrointestinal haemorrhage in which patients were aged over 16 years identified over four months. Outcome measures: Incidence and mortality. Results: The overall incidence of acute upper gastrointestinal haemorrhage in the United Kingdom is 103/100000 adults per year. The incidence rises from 23 in those aged under 30 to 485 in those aged over 75. At all ages incidence in men was more than double that in women except in elderly patients. 14% of the haemorrhages occurred in inpatients already in hospital for some other reason. In 27% of cases (37% female, 19% male) patients were aged over 80. Overall mortality was 14% (11% in emergency admissions and 33% in haemorrhage in inpatients). In the emergency admissions, 65% of deaths in those aged under 80 were associated with malignancy or organ failure at presentation. Mortality for patients under 60 in the absence of malignancy or organ failure at presentation was 0.8%. Conclusions: The incidence of acute upper gastrointestinal haemorrhage is twice that previously reported in England and similar to that reported in Scotland. The incidence increases appreciably with age. Although the proportion of elderly patients continues to rise and mortality increases steeply with age, age standardised mortality is lower than in earlier studies. Deaths occurred almost exclusively in very old patients or those with severe comorbidity.
Ethanol Induces Platelet Apoptosis

BACKGROUND Alcohol abuse incurs severe medical conditions, such as thrombocytopenia and hemorrhage, but the pathogenesis is not totally understood. Alcohol has been reported to induce apoptosis in eukaryotic cells, such as hepatocyte, nerve cell, corneal fibroblasts. However, it is still unclear whether alcohol induces platelet apoptosis. METHODS Washed human platelets were pretreated with ethanol (EtOH), and apoptotic events and platelet function were detected. In in vivo experiments, C57BL/6J mice were given EtOH by gavage. Platelet counts, tail bleeding time, and the stomach were examined. RESULTS EtOH dose dependently induces depolarization of mitochondrial inner transmembrane potential, up-regulation of Bax, down-regulation of Bcl-2, and caspase-3 activation. EtOH does not induce surface expression of P-selectin or PAC-1 binding, whereas significantly reduces collagen-, thrombin-, and ADP-induced platelet aggregation. Moreover, EtOH induces c-Jun NH2-terminal kinase activation. In an in vivo mouse model of the acute alcoholism, EtOH significantly reduces the number of circulating platelets, prolongs the tail bleeding time, and causes gastric mucosa hemorrhage. CONCLUSIONS These data demonstrate that EtOH induces mitochondria-mediated intrinsic platelet apoptosis, results in the reduction of the number of circulating platelets, and impairs in vivo hemostasis. These findings reveal the possible pathogenesis of hemorrhagic symptoms in patients experiencing acute alcohol intoxication.
Mental health and quality of life among doctors, nurses and other hospital staff

Numerous studies have shown that doctors, nurses or other hospital staff may suffer from tremendous stress at work. A high level of work-related stress might increase vulnerability to mental illness and result in a poor quality of clinical care. This study was conducted in a Taiwanese regional general hospital. Minor psychiatric disorder, depressive disorder and quality of life were assessed for all staff, using self-rating questionnaires including the Chinese Health Questionnaire 12-item version, the Center for Epidemiologic Studies Depression Scale and World Health Organization Quality of Life Scale brief version. Nearly half of the staff had either a minor psychiatric disorder or depressive disorder. Nurses and pharmacists had the highest prevalence. The risk factors included single/divorced and being a nurse or pharmacist. Quality of life for hospital staff was poor, as compared with the Taiwanese norms, and was even worse for the nurses and pharmacists. In conclusion, the management teams of hospitals should pay more attention to the mental condition of all hospital staff, especially nurses and pharmacists. Adequate staffing, support, counselling or psychological intervention are required for further management, and may logically result in better mental health on the part of the staff and a better quality of care. Copyright © 2009 John Wiley & Sons, Ltd.
Behavioral problems in school children as recognized by untrained teachers

Introduction: Behavior problems in a student at school interfere with his lessons and may disturb other students. In spite of teacher’s best effort, not all children rise up to the expectations. Behavioral problems are a major challenge for teachers. This study was undertaken with the aim of looking into the awareness of teachers into the existence of psychological problems in their students and to find out the type of problem present in the student. Materials and Method: This study was conducted in various districts of western region when the primary author was conducting teachers training for mental health project during the period of 2001 to 2003. Questionnaire developed during the first stage of research was used in the second part. Semi-structured interview was done with 212 teachers (from Eastern Terai, Western Terai and the mid hills) dealing with 23,320 students to find the different symptoms suggesting emotional and behavioural problem. Results: Out of the total 23320 students indirectly covered in the study, 8999 (38.58%) were found to have some sort of psychological problem. ‘Slow learners’ was reported to be present by 77.83% of teachers in 4.98% of their students, suddenly degrading school performance was reported by 75% of teachers in 3.65% of students. Conclusion: An average school teacher in Nepalese government schools can identify behavioural problems in their classroom . DOI: http://dx.doi. org/10.3126/jpan.v2i2. 9722 J Psychiatrists’ Association of Nepal Vol.2, No.2, 2013 26-28
Academic Difficulties in Children with Prenatal Alcohol Exposure: Presence, Profile, and Neural Correlates

BACKGROUND Academic achievement was evaluated in children with heavy prenatal alcohol exposure to determine potential strengths and weaknesses, evaluate the utility of different definitions for identifying low academic performance, and explore the neural correlates that may underlie academic performance. METHODS Children (8 to 16 years) were assessed using the WIAT-II. Patterns of performance were examined in 2 subject groups: children with heavy prenatal alcohol exposure (n = 67) and controls (n = 61). A repeated-measures MANCOVA examining group differences on academic domain (reading, spelling, math) scores was conducted. Post hoc comparisons examined within-group profiles. Numbers and percentage of children with low achievement were calculated using several criteria. In a subsample (n = 42), neural correlates were analyzed using FreeSurfer v5.3 to examine relations between cortical structure (thickness and surface area) and performance. RESULTS The alcohol-exposed group performed worse than controls on all domains and had a unique academic profile, supported by a significant group × academic domain interaction (p < 0.001). For the alcohol-exposed group, math reasoning was significantly lower than numerical operations, which was significantly lower than spelling and word reading. Over half of the alcohol-exposed group (58.2%) demonstrated low achievement on 1 or more academic domains. The number and percentage of children meeting criteria for low achievement varied based on the domain and definition used. The imaging analysis identified several surface area clusters that were differentially related to math (L superior parietal and R lateral/middle occipital) and spelling (bilateral inferior and medial temporal) performance by group, with no relations for the other academic domains. Generally, scores improved as surface area decreased in controls, whereas no relation or a positive relation was observed in the alcohol-exposed group. CONCLUSIONS Alcohol-exposed children demonstrated deficits in academic performance across domains and definitions, with a relative weakness in math functioning. Atypical brain development may contribute to these impairments in academic achievement. Understanding academic difficulties can assist in advocating effectively for alcohol-exposed children.
The efficacy profile of vilazodone, a novel antidepressant for the treatment of major depressive disorder

Abstract Objective: Vilazodone is a novel serotonin reuptake inhibitor and serotonin 1A receptor partial agonist approved for the treatment of major depressive disorder (MDD). This evaluation presents side-by-side efficacy data from two randomized, double-blind, placebo-controlled, short-term 8-week trials (referred to as randomized controlled trial [RCT]-1 [N = 410] and RCT-2 [N = 481]); efficacy data for demographic and clinical subgroups (derived from pooled RCT data); and effectiveness data from a 52-week, open-label, long-term study (N = 616). The objective is to summarize the efficacy profile of vilazodone at its approved dose of 40 mg/day. Methods: The main assessment in individual pivotal trials and pooled subgroup analyses was the change from baseline to end of treatment (EOT, 8 weeks) in the Montgomery–Åsberg Depression Rating Scale (MADRS) total score. Mixed-effects repeated-measures analyses were conducted in the placebo-controlled trials. Effectiveness analyses in the long-term study included mean MADRS score change over time. Results: Vilazodone-treated patients in both short-term studies showed greater improvement from baseline to EOT in mean MADRS scores than placebo-treated patients (least-squares mean [LSM] treatment difference: −3.2 [p = 0.001], RCT-1; −2.5 [p = 0.009], RCT-2). Clinical Global Impressions–Improvement mean scores at EOT reflected greater improvement with vilazodone compared with placebo in both studies (LSM treatment difference: −0.4 [p = 0.001], RCT-1; −0.3 [p = 0.004], RCT-2). MADRS response rates were significantly greater among patients receiving vilazodone versus those receiving placebo (RCT-1: 40.4% versus 28.1%, respectively [p = 0.007]; RCT-2: 43.7% versus 30.3%, respectively [p = 0.002]). The greater efficacy of vilazodone versus placebo was consistent for the majority of demographic and MDD characteristic subgroups. In the long-term study, the mean MADRS score improved from 29.9 (baseline) to 11.4 (week 8), 8.2 (week 24), and 7.1 (week 52). Conclusion: Vilazodone 40 mg/day resulted in clinically meaningful, statistically significant improvement in MDD symptoms in two placebo-controlled, 8-week studies. Findings are supported by subgroup analysis and open-label, long-term effectiveness data. Trial registration: Trial registration: ClinicalTrials.gov identifier: NCT00285376. Trial registration: ClinicalTrials.gov identifier: NCT00683592. Trial registration: ClinicalTrials.gov identifier: NCT00644358.
Circulating obestatin level in diabetic and obese rats

Background Obestatin has been discovered as a product of the ghrelin gene. Its physiological actions are still a matter of debate. It is likely to be involved in the control of adipocyte function. It has been already shown that obestatin secretion is negatively modulated by food intake. Aim In this study, we investigated plasma obestatin level in diabetic and obese rats and studied the correlation of this hormone with glucose, homeostasis model assessment of insulin resistance, BMI, triglycerides, and total cholesterol in these two metabolic disorders. Materials and methods A total of 30 male albino rats were divided into three groups: the control group, the diabetic group, and the obese group. Plasma obestatin levels were measured and plasma glucose, insulin, triglyceride, total cholesterol, and BMI were also evaluated. Results Diabetic rats showed significant increase in all studied parameters except plasma obestatin, insulin, and BMI, which showed significant decrease as compared with the control group. However, the results of obese rats showed significant increase in all studied parameters except plasma obestatin, which showed significant decrease compared with either control or diabetic rats, but plasma glucose was significantly decreased as compared with diabetic rats only and homeostasis model assessment of insulin resistance was significantly increased as compared with control rats. The results revealed that plasma obestatin was negatively correlated with all studied parameters in both diabetic and obese rats and positively correlated with insulin in diabetic rats, whereas it had insignificant correlation with BMI in diabetic rats and with insulin in the obese group. Conclusion The decrease in obestatin levels was associated with metabolic disorders and this may contribute, in part, to the pathophysiology of diabetes and obesity.
British Society of Gastroenterology position statement on serrated polyps in the colon and rectum

Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations—serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation: we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years (weak recommendation, low quality evidence, 90% agreement).