Miracle-dz/UniFAR-FTUs huggingface dataset:
Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig.

PURPOSE In the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro- and macrocirculatory changes. METHODS In 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x10∧6 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h. RESULTS In Control group parameters were stable, while six animals in the Sepsis group died before the 4th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour. CONCLUSION During bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.
Age-dependent loss of cholinergic neurons in learning and memory-related brain regions and impaired learning in SAMP8 mice with trigeminal nerve damage

The tooth belongs to the trigeminal sensory pathway. Dental damage has been associated with impairments in the central nervous system that may be mediated by injury to the trigeminal nerve. In the present study, we investigated the effects of damage to the inferior alveolar nerve, an important peripheral nerve in the trigeminal sensory pathway, on learning and memory behaviors and structural changes in related brain regions, in a mouse model of Alzheimer's disease. Inferior alveolar nerve transection or sham surgery was performed in middle-aged (4-month-old) or elderly (7-month-old) senescence-accelerated mouse prone 8 (SAMP8) mice. When the middle-aged mice reached 8 months (middle-aged group 1) or 11 months (middle-aged group 2), and the elderly group reached 11 months, step-down passive avoidance and Y-maze tests of learning and memory were performed, and the cholinergic system was examined in the hippocampus (Nissl staining and acetylcholinesterase histochemistry) and basal forebrain (choline acetyltransferase immunohistochemistry). In the elderly group, animals that underwent nerve transection had fewer pyramidal neurons in the hippocampal CA1 and CA3 regions, fewer cholinergic fibers in the CA1 and dentate gyrus, and fewer cholinergic neurons in the medial septal nucleus and vertical limb of the diagonal band, compared with sham-operated animals, as well as showing impairments in learning and memory. Conversely, no significant differences in histology or behavior were observed between middle-aged group 1 or group 2 transected mice and age-matched sham-operated mice. The present findings suggest that trigeminal nerve damage in old age, but not middle age, can induce degeneration of the septal-hippocampal cholinergic system and loss of hippocampal pyramidal neurons, and ultimately impair learning ability. Our results highlight the importance of active treatment of trigeminal nerve damage in elderly patients and those with Alzheimer's disease, and indicate that tooth extraction should be avoided in these populations.
Postamputation Pain and Sensory Changes in Treatment-naive Patients: Characteristics and Responses to Treatment with Tramadol, Amitriptyline, and Placebo

Background:Pain after amputation is common but difficult to treat, and few controlled treatment studies exist. Methods:In the current study, 94 treatment-naive posttraumatic limb amputees with phantom pain (intensity: mean visual analog scale score [0–100], 40 [95% confidence interval, 38–41]) were randomly assigned to receive individually titrated doses of tramadol, placebo (double-blind comparison), or amitriptyline (open comparison) for 1 month. Nonresponders were crossed over to the alternative active treatment. Results:After 1 month, phantom pain intensity was 1 (0–2) in the 48 tramadol responders (mean dose, 448 mg [95% confidence interval, 391–505 mg]), 0 (0–0) in the 40 amitriptyline responders (55 [50–59] mg), and 0 (0–0) in the 2 placebo responders, with similar effects on stump pain. Cytochrome P-450 2D6 slow metabolizers derived greater analgesia from tramadol and less from amitriptyline compared with fast metabolizers in the first treatment week (P < 0.01). Electrical pain thresholds increased and pain during suprathreshold stimulation decreased markedly on the stump and, to a lesser extent, on the contralateral limb after 1 month of treatment with amitriptyline or tramadol. Adverse effects were minor in all groups, but more common with tramadol. Conclusions:In treatment-naive patients, both amitriptyline and tramadol provided excellent and stable phantom limb and stump pain control with no major adverse events. Both drugs demonstrated consistent and large antinociceptive effects on both the stump and the intact limbs.
Delivering On Accountable Care: Lessons From A Behavioral Health Program To Improve Access And Outcomes.

Patients with behavioral health disorders often have worse health outcomes and have higher health care utilization than patients with medical diseases alone. As such, people with behavioral health conditions are important populations for accountable care organizations (ACOs) seeking to improve the efficiency of their delivery systems. However, ACOs have historically faced numerous barriers in implementing behavioral health population-based programs, including acquiring reimbursement, recruiting providers, and integrating new services. We developed an evidence-based, all-payer collaborative care program called Behavioral Health Associates (BHA), operated as part of UCLA Health, an integrated academic medical center. Building BHA required several innovations, which included using our enterprise electronic medical record for behavioral health referrals and documentation; registering BHA providers with insurance plans' mental health carve-out products; and embedding BHA providers in primary care practices throughout the UCLA Health system. Since 2012 BHA has more than tripled the number of patients receiving behavioral health services through UCLA Health. After receiving BHA treatment, patients had a 13 percent reduction in emergency department use. Our efforts can serve as a model for other ACOs seeking to integrate behavioral health care into routine practice.
The Accuracy of Stereolithography in Planning Craniofacial Bone Replacement

Stereolithography can be used to produce physical models of the craniofacial skeleton from three-dimensional computed tomography (CT) data. The purpose of this study was to assess its accuracy for modeling osseous defects of the midface. Maxillary resections simulating unilateral maxillectomy (N = 3), bilateral maxillectomy (N = 3), and unilateral orbitomaxillectomy (N = 3) were performed as for sinus tumor resection on nine fresh cadaver skulls. Stereolithographic models (SLMs) were made from the specimen's CT data. The accuracy of SLMs was determined by comparing distances between key landmarks on the skulls and SLMs. Each SLM was grossly accurate with some loss of thin delicate structures. The mean differences in overall dimensions between the SLMs and skull specimens were 1.5 mm (range: 0–5.5 mm) for craniofacial measures, 1.2 mm (range: 0–4.8 mm) for skull base measures, 1.6 (range: 0–5.8 mm) for midface measures, 1.9 mm (range: 0–7.9 mm) for maxilla measures, and 1.5 mm (range: 0–5.7 mm) for orbital measures. The mean differences in defect dimensions were 1.9 mm (range: 0.1–5.7 mm) for unilateral maxillectomy, 0.8 mm (range: 0.2–1.5 mm) for bilateral maxillectomy, and 2.5 mm (range: 0.2–7.0 mm) for orbitomaxillectomy defects. Midface SLMs may be more prone to error than those of other craniofacial regions because of the presence of thin walls and small projections. Thus, one should consider designing midface bone replacements that are larger in critical dimensions than those predicted by preoperative modeling. These findings have important implications for the planning of current surgical methods as well as future applications of tissue-engineered bone replacement.
Prunella vulgaris Attenuates Prepulse Inhibition Deficit and Attention Disruption induced by MK‐801 in Mice

Prunella vulgaris var. lilacina is widely distributed in Korea, Japan, China, and Europe, and it has been traditionally used to treat inflammation or hypertension. In the present study, we investigated the effects of the ethanolic extract of the spikes of Prunella vulgaris var. lilacina (EEPV) on dizocilpine (MK‐801)‐induced schizophrenia‐like phenotype behaviors such as the disruption of prepulse inhibition and attention deficits in mice. We also determined the effect of EEPV on MK‐801‐induced alterations in phosphorylated extracellular signal‐regulated kinase, phosphorylated protein kinase B, phospho‐glycogen synthase kinase 3‐β, and phosphorylated cAMP response element‐binding protein levels in the cortex and hippocampus of mice. MK‐801‐induced prepulse inhibition deficits were ameliorated by the administration of EEPV, as shown in the acoustic startle response test. Furthermore, EEPV attenuated the MK‐801‐induced attention deficits in the water finding test. We also found that EEPV attenuated the increased phosphorylated extracellular signal‐regulated kinase, phosphorylated protein kinase B, or phospho‐glycogen synthase kinase 3‐β levels induced by MK‐801 in the cortex but not in the hippocampus. These results suggest that EEPV could be useful for treating schizophrenia because EEPV ameliorates prepulse inhibition disruption and attention deficits induced by MK‐801. Copyright © 2013 John Wiley & Sons, Ltd.
Motorik und Kognition. Eine experimentelle Untersuchung im Kindergartenalter

Zielsetzung: Die als Masterarbeit durchgefuhrte Studie untersucht die wechselseitige Beziehung zwischen der motorischen Leistungsfahigkeit im Bereich des Gleichgewichts und der kognitiven Leistungsfahigkeit im Bereich des Arbeitsgedachtnisses bei Kindern. Dabei wurde untersucht, ob ein Training des Arbeitsgedachtnisses einen positiven Einfluss auf die Gleichgewichtsfahigkeit hat. Gleichzeitig wurde untersucht, ob umgekehrt durch ein Training der Gleichgewichtsfahigkeit ein positiver Einfluss auf das Arbeitsgedachtnis nachweisbar ist. Methode: Die Studie wurde als Interventionsstudie mit Vor-, Nach- und Followuptest angelegt. Insgesamt nahmen 94 Kinder im Alter zwischen vier und sechs Jahren teil. Die Tests wurden jeweils mit zwei Trainingsgruppen und einer Kontrollgruppe durchgefuhrt. Wahrend die Arbeitsgedachtnis-Trainingsgruppe zwischen Vor- und Nachtest ein vierwochiges Training der Arbeitsgedachtnisleistung absolvierte, wurde mit der Gleichgewicht-Trainingsgruppe im gleichen Zeitraum ein Training zur Steigerung der Leistungsfahigkeit im Bereich des Gleichgewichts durchgefuhrt. Ergebnisse: Die Auswertung der Ergebnisse zeigte bei beiden Trainingsgruppen einen signifikant positiven Einfluss der durchgefuhrten Trainings auf die Leistungsfahigkeit im entsprechenden Bereich. Wahrend das Training der Gleichgewichtsfahigkeit keinen signifikant positiven Einfluss auf die Arbeitsgedachtnisleistung ausuben konnte, verbesserte sich die Gleichgewichtsleistung durch das Arbeitsgedachtnistraining signifikant. Alle direkten Trainingseffekte blieben bis zum Zeitpunkt des Followuptests weitgehend erhalten. Schlussfolgerung: Kinder im Vorschulalter konnen innerhalb eines relativ kurzen Zeitraumes sowohl im motorischen, als auch im kognitiven Bereich durch ein entsprechendes Training signifikante Leistungssteigerungen erreichen. Es konnte zudem nachgewiesen werden, dass ein Training der Arbeitsgedachtnisleistung die motorische Leistung im Bereich des Gleichgewichts zu verbessern vermag. Die Ergebnisse weisen auf das vorhandene Potential einer vielseitigen Forderung motorischer und kognitiver Fahigkeiten im Vorschulalter hin.
Partial liver volume radioembolization induces hypertrophy in the spared hemiliver and no major signs of portal hypertension.

BACKGROUND Post-treatment contralateral hemiliver hypertrophy has created an interest in lobar liver radioembolization (RE) as a pre-surgery tool. METHODS Liver and spleen volumes and function were studied in 83 patients submitted to partial liver volume RE at 4-8 weeks (T1), 10-26 weeks (T2), and >26 weeks (T3) after RE. RESULTS More than half of the patients had cirrhosis with hepatocellular carcinoma. The main finding was a progressive increase in the volume of the spared hemiliver (mean absolute increase at T3: 230 ml). The percentage of patients in whom the baseline ratio of spared volume to total liver volume was <40% dropped from 56.6% at baseline to 29.4% at T2 (P < 0.001). A significant and progressive increase in spleen volume but not in portal vein diameter was also observed. A small percentage of patients developed hypersplenism, mostly those without cirrhosis (16.0% at T2). Six patients (five with portal vein thrombosis, cirrhosis or both) developed signs of portal hypertension by T2. CONCLUSIONS The present results warrant further studies to better elucidate the mechanism underlying this phenomenon of spared hemiliver hypertrophy and to investigate its role as an alternative to portal vein embolization in the management of patients with potentially resectable liver tumours.
Gender Identity, Co-Working Spouses and Relative Income within Households

Bertrand, Kamenica, and Pan (2015) document that in the United States there is a discontinuity to the right of 0.5 in the distribution of households according to the female share of total earnings, which they attribute to the existence of a gender identity norm. We provide an alternative explanation for this discontinuity. Using linked employer-employee data from Finland, we show that the discontinuity emerges as a result of equalization and convergence of earnings in coworking couples, and it is associated with an increase in the relative earnings of women, rather than a decrease as predicted by the norm. (JEL D12, J12, J16, J22, J31, Z13)
Mechanisms of Glucose Homeostasis After Roux-en-Y Gastric Bypass Surgery in the Obese, Insulin-Resistant Zucker Rat

Objective:Obesity-related diabetes is caused by insulin resistance and β-cell dysfunction. The current study examines changes in food intake, weight loss, body fat depots, oxygen consumption, insulin sensitivity, and incretin levels as potential mechanisms for improved glucose tolerance after Roux-en-Y gastric bypass (RYGB). Methods:Three groups of genetically obese Zucker rats were studied: RYGB, sham surgery pair-fed (PF), and sham surgery ad libitum (AL) fed rats. Changes in body weight, visceral and subcutaneous fat depots, oral glucose tolerance, insulin sensitivity, and the plasma concentrations of insulin, glucagon, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide, and peptide YY (PYY) were measured. Results:Body weight and subcutaneous fat were decreased after RYGB, compared with the PF and AL groups. The reduction in visceral fat after RYGB appeared largely because of food restriction. Glucose tolerance and insulin sensitivity were significantly improved in only the RYGB group (P < 0.05 vs. AL, PF). Euglycemic, hyperinsulinemic clamp studies indicated RYGB improved the ability of insulin to stimulate peripheral (eg, skeletal muscle) glucose uptake. Fasting total GLP-1, glucose-dependent insulinotropic peptide, and PYY levels were similar between the groups, whereas postprandial plasma levels of intact GLP-1 (7-36) amide, total GLP-1, and PYY were increased in the RYGB group compared with PF and AL controls. Conclusions:Glucose homeostasis after RYGB is associated with decreased subcutaneous fat, increased postprandial PYY, GLP-1, and insulin, as well as improved insulin sensitivity/action. Changes in food intake and visceral fat do not seem to explain improvements in insulin action after RYGB in the Zucker rat model.
Relationship between Flow-Metabolism Uncoupling and Evolving Axonal Injury after Experimental Traumatic Brain Injury

Blood flow-metabolism uncoupling is a well-documented phenomenon after traumatic brain injury, but little is known about the direct consequences for white matter. The aim of this study was to quantitatively assess the topographic interrelationship between local cerebral blood flow (LCBF) and glucose metabolism (LCMRglc) after controlled cortical impact injury and to determine the degree of correspondence with the evolving axonal injury. LCMRglc and LCBF measurements were obtained at 3 hours in the same rat from 18F-fluorodeoxyglucose and 14C-iodoantipyrine coregistered autoradiographic images, and compared to the density of damaged axonal profiles in adjacent sections and in an additional group at 24 hours using beta-amyloid precursor protein (ß-APP) immunohistochemistry. LCBF was significantly reduced over the ipsilateral hemisphere by 48 ± 15% compared with sham-controls, whereas LCMRglc was unaffected, apart from foci of elevated LCMRglc in the contusion margin. Flow-metabolism was uncoupled, indicated by a significant 2-fold elevation in the LCMRglc/LCBF ratio within most ipsilateral structures. There was a significant increase in ß-APP-stained axons from 3 to 24 hours, which was negatively correlated with LCBF and positively correlated with the LCMRglc/LCBF ratio at 3 hours in the cingulum and corpus callosum. Our study indicates a possible dependence of axonal outcome on flow-metabolism in the acute injury stage.
Beyond reminders: a conceptual framework for using short message service to promote prevention and improve healthcare quality and clinical outcomes for people living with HIV

Abstract The availability of effective antiretroviral therapy has altered HIV from being an acute disease to being a chronic, manageable condition for many people living with HIV (PLWH). Because of their ubiquity and flexibility, mobile phones with short message service (SMS) offer a unique opportunity to enhance treatment and prevention for people managing HIV. To date, very few US studies using SMS for HIV self-management have been published. In this article, we review the published SMS-based intervention research that aimed to improve healthcare quality and outcomes for PLWH and other chronic health conditions, and propose a conceptual model that integrates the communication functionality of SMS with important psychosocial factors that could mediate the impact of SMS on health outcomes. We posit that an SMS-based intervention that incorporates the elements of interactivity, frequency, timing, and tailoring of messages could be implemented to encourage greater medication adherence as well as impact other mutually reinforcing behaviors and factors (e.g., increasing patient involvement and social support, reducing risk behaviors, and promoting general health and well-being) to support better healthcare quality and clinical outcomes for PLWH. We recommend that future studies explore the potential linkages between variations in SMS characteristics and these mediating factors to determine if and how they influence the larger outcomes.
Response to fluid boluses in the fluid and catheter treatment trial.

BACKGROUND Recent emphasis has been placed on methods to predict fluid responsiveness, but the usefulness of using fluid boluses to increase cardiac index in critically ill patients with ineffective circulation or oliguria remains unclear. METHODS This retrospective analysis investigated hemodynamic responses of critically ill patients in the ARDS Network Fluid and Catheter Treatment Trial (FACTT) who were given protocol-based fluid boluses. Fluid responsiveness was defined as ≥ 15% increase in cardiac index after a 15 mL/kg fluid bolus. RESULTS A convenience sample of 127 critically ill patients enrolled in FACTT was analyzed for physiologic responses to 569 protocolized crystalloid or albumin boluses given for shock, low urine output (UOP), or low pulmonary artery occlusion pressure (PAOP). There were significant increases in mean central venous pressure (9.9 ± 4.5 to 11.1 ± 4.8 mm Hg, P < .0001) and mean PAOP (11.6 ± 3.6 to 13.3 ± 4.3 mm Hg, P < .0001) following fluid boluses. However, there were no significant changes in UOP, and there were clinically small changes in heart rate, mean arterial pressure, and cardiac index. Only 23% of fluid boluses led to a ≥ 15% change in cardiac index. There was no significant difference in the frequency of fluid responsiveness between boluses given for shock or oliguria vs boluses given only for low PAOP (24.0% vs 21.8%, P = .59). There were no significant differences in 90-day survival, need for hemodialysis, or return to unassisted breathing between patients defined as fluid responders and fluid nonresponders. CONCLUSIONS In this cohort of critically ill patients with ARDS who were previously resuscitated, the rate of fluid responsiveness was low, and fluid boluses only led to small hemodynamic changes.
Breast milk iodine concentrations in lactating mothers at Queen Sirikit National Institute of Child Health.

BACKGROUND In Thailand, Iodine Deficiency Disorder (IDD) has been one of the most serious nutritional problems for over 50 years, especially for infants and young children. Iodine is an essential component of thyroid hormones, which are necessary for brain and body development especially during the first 2 years of life. During the first 6 months of life, infants receive iodine exclusively from breast or formula milk. Several national programs have been implemented to eliminate IDD. OBJECTIVE To evaluate breast milk iodine concentrations in lactating mothers. MATERIAL AND METHOD 100 lactating mothers from Lactation Clinic, Queen Sirikit National Institute of Child Health were included in this study from September 2011 to April 2012. Mothers completed questionnaires for analyzing demographic data and iodine intake. Samples of breast milk were collected to measure iodine content. RESULTS The median value of breast milk iodine concentration was 129.7 mcg/L (IQR = 81.0, 205.7). Forty-two percent of the samples contained more than 150 mcg/L of iodine, which was in the range of sufficient iodine levels for infants. Factors relating to the iodine content in breast milk are baby's age, mother's age and mother's consumption of iodine fortified egg (p-value = 0.004, 0.035, 0.030, respectively). CONCLUSION Iodine is essential for pregnant and lactating women, as well as infants. For mothers, consumption of iodized salt, iodized fish sauce, and iodine fortified food can improve iodine status of mothers. For infants, initiating breastfeeding soon after birth and maintaining exclusive breastfeeding can help infants achieve optimal nutritional status.