Miracle-dz/UniFAR-FTUs huggingface dataset:
Inferior Parietal Cortex Hypoperfusion is the Most Specific Imaging Marker for AD Patients With Positive CSF Biomarker Assays in a Memory Clinic in France

The diagnostic accuracy of hexamethylpropyleneamine oxime (HMPAo) single-photon emission computed tomography (SPECT) in Alzheimer disease (AD) remains undetermined in a “real-life” clinical population. The objective was to determine the HMPAo SPECT hypoperfusion pattern in cognitively impaired patients with positive CSF AD biomarker and to evaluate its diagnostic accuracy. This study included 120 patients referred to a university memory clinic assessed using HMPAo SPECT, MRI, and CSF biomarkers. Three biomarker signatures suggestive of AD were analyzed (1, Aß1-42; 2, Aß1-42+t-tau and/or p-tau; 3, Aß1-42/p-tau). The clinical diagnoses were possible AD (n=29) or other causes of cognitive impairment (n=91). All CSF AD signatures were significantly (1, P=0.004; 2, P=0.017; 3, P=0.024) associated with the difference between inferior parietal perfusion and lateral dorsal frontal cortex perfusion. The hypoperfusion pattern discriminated between patients with positive CSF AD biomarkers and those with other cognitive impairments with a sensitivity of 67% to 71% and a specificity of 63% to 65% and a greatest negative predictive value (NPV) of 90%. Inferior parietal cortex hypoperfusion was the most sensitive and specific feature in AD patients diagnosed using clinical and CSF biomarker criteria. This hypoperfusion pattern was associated with an NPV of 90% and therefore discriminated sharply between AD and other cognitive disorders.
Clinical outcomes using long-term combination therapy with insulin glargine and exenatide in patients with type 2 diabetes mellitus.

OBJECTIVE To examine the long-term effects of combination insulin glargine/exenatide treatment on glycemic control. METHODS We conducted a 24-month retrospective US chart review of patients with inadequately controlled type 2 diabetes (T2DM) and hemoglobin A1c (A1C) levels >7.0% for whom glargine and exenatide were coprescribed in differing order (glargine added after exenatide [exenatide/glargine]; exenatide added after glargine [glargine/exenatide]). Treatment order groups were combined to form a pooled treatment group. Changes from baseline in A1C, patients with A1C ≤7.0%, body weight, glargine/exenatide daily dose, oral antidiabetic drug (OAD) use, and hypoglycemia were evaluated. RESULTS Treatment groups were similar at baseline; however, patients in the glargine/exenatide group (n = 121) (vs exenatide/glargine group [n = 44]) had longer disease duration (11.8 vs 8.0 years) and took fewer OADs (1.7 vs 2.3). Overall, baseline A1C was 8.8 ± 1.3% and weight was 109.5 ± 25.3 kg. Significant A1C reductions emerged at month 6 and persisted throughout 24 months (vs baseline) in both treatment groups (pooled: -0.7 ± 1.6; P<.001), and 33.0% of patients achieved an A1C level ≤7.0%. After 24 months of exenatide/glargine, body weight remained unchanged (0.7 ± 8.3 kg; P = .640). With glargine/exenatide, body weight decreased (-2.5 ± 6.7 kg; P = .001). At month 24, daily glargine dose was 0.40 ± 0.23 units/kg for the exenatide/glargine group and 0.47 ± 0.30 units/kg for the glargine/exenatide group. Hypoglycemia frequency was similar in both treatment groups. CONCLUSIONS Regardless of treatment order, long-term combined therapy with glargine and exenatide for up to 24 months in patients with inadequately controlled T2DM suggests reduction of A1C without significant weight gain or increased hypoglycemia risk.
Influence of Wind and Conductor Potential on Distributions of Electric Field and Ion Current Density at Ground Level in DC High Voltage Line to Plane Geometry

Lateral profiles of electric field and ion current density at ground level were measured precisely in a unipolar/bipolar line to plane geometry under different wind conditions and different dc voltages. Furthermore, the relationship between the field and current density is discussed. In the case of unipolar line in still air, the normalized profiles are approximately independent of the magnitude of the applied voltage and the linear dimensions of the gap, but they are strongly influenced in the bipolar case. The wind effect on the current profile is greatest at voltages close to corona onset for each experimental arrangemeht. The experimental results suggest that the usual wind extends the region of the ionic current flowing . e. the right-of- ay required for HVDC transmis-sion lines) by a factor of two or more as compared with that with no wind.
Readability assessment of online ophthalmic patient information.

IMPORTANCE Patients increasingly use the Internet to access information related to their disease, but poor health literacy is known to impact negatively on medical outcomes. Multiple agencies have recommended that patient-oriented literature be written at a fourth- to sixth-grade (9-12 years of age) reading level to assist understanding. The readability of online patient-oriented materials related to ophthalmic diagnoses is not yet known. OBJECTIVE To assess the readability of online literature specifically for a range of ophthalmic conditions. DESIGN AND SETTING Body text of the top 10 patient-oriented websites for 16 different ophthalmic diagnoses, covering the full range of ophthalmic subspecialties, was analyzed for readability, source (United Kingdom vs non-United Kingdom, not for profit vs commercial), and appropriateness for sight-impaired readers. MAIN OUTCOMES AND MEASURES Four validated readability formulas were used: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFOG). Data were compared with the Mann-Whitney test (for 2 groups) and Kruskal-Wallis test (for more than 2 groups) and correlation was assessed by the Spearman r. RESULTS None of the 160 webpages had readability scores within published guidelines, with 83% assessed as being of "difficult" readability. Not-for-profit webpages were of significantly greater length than commercial webpages (P = .02) and UK-based webpages had slightly superior readability scores compared with those of non-UK webpages (P = .004 to P < .001, depending on the readability formula used). Of all webpages evaluated, only 34% included facility to adjust text size to assist visually impaired readers. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study to assess readability of patient-focused webpages specifically for a range of ophthalmic diagnoses. In keeping with previous studies in other medical conditions, we determined that readability scores were inferior to those recommended, irrespective of the measure used. Although readability is only one aspect of how well a patient-oriented webpage may be comprehended, we recommend the use of readability scoring when producing such resources in the future. Minimum readability policies and inclusion of facilities within webpages to maximize viewing potential for visually impaired readers are important to ensure that online ophthalmic patient information is accessible to the broadest audience possible.
Neutrophil gelatinase‐associated lipocalin associated with irreversibility of pre‐liver transplant kidney dysfunction

Kidney outcomes in early post‐liver transplantation (LT) are crucial for long‐term prognosis, but difficult to predict. Among 203 adult LT patients, we studied the value of plasma neutrophil gelatinase‐associated lipocalin (NGAL) measured pre‐LT for predicting acute kidney injury (AKI), kidney‐replacement therapy within three months, and kidney dysfunction at three months post‐LT. Glomerular filtration rate (GFR) was estimated by creatinine‐based and cystatin C‐based equations. Highest NGAL levels were among patients on pre‐LT kidney‐replacement therapy, whereas NGAL exceeded 200 μg/L in only three (2%) patients with pre‐LT GFR >60 mL/min. Pre‐LT NGAL >260 μg/L predicted GFR <60 mL/min at three months post‐LT (OR 17.8, 95% CI 2.1–153) independently of 19 other variables reflecting recipient characteristics, liver and kidney function, perioperative hemodynamic stress, and immunosuppression. Of 81 patients with pre‐LT GFR <60 mL/min, 48% had GFR <60 mL/min at three months, and an NGAL level >260 μg/L predicted this outcome with 90% specificity and 46% sensitivity. NGAL failed to predict post‐LT AKI or need for temporary kidney‐replacement therapy. In conclusion, NGAL independently predicted irreversibility of pre‐LT kidney dysfunction and could thus help in optimizing patient care and in the decision to perform combined liver–kidney transplantation. Pre‐LT NGAL was not useful in patients with preserved pre‐LT kidney function or in predicting post‐LT AKI.
Temporary transverse colostomy vs loop ileostomy in diversion: a case-matched study.

HYPOTHESIS For temporary fecal diversion, transverse colostomy (TC) has superior safety, but loop ileostomy (LI) has superior management qualities. METHODS Of patients with TC or LI seen between 1988 and 1997, 63 patients were matched for diagnosis, operative procedure, and date of surgery. The 2 groups were then compared for hospital/postoperative mortality and morbidity and stoma complications. RESULTS Mortality rates were 6.3% for the TC group and 1.6% for the LI group (P =.25). Morbidity rates for stoma creation and for stoma closure were 47.6% and 10% (P =.19), respectively, for the TC group, and 36.5% and 6.3% (P>.99), respectively, for the LI group. Most morbidity events were minor, and neither procedure-related nor other medical complications showed a significant difference between the groups. However, patients with a TC were significantly more likely to experience skin trouble around the stoma (TC vs LI, 15.9% vs 3.2%) and leakage around the stoma (TC vs LI, 12.7% vs 1.6%). CONCLUSIONS Regarding safety, TC and LI should be considered equivalent options for temporary fecal diversion. We recommend further study comparing the 2 procedures with regard to patient perception and quality of life.
Failure of standard antimicrobial therapy in children aged 3-59 months with mild or asymptomatic HIV infection and severe pneumonia.

OBJECTIVE To determine whether children aged 3-59 months with mild or non-symptomatic human immunodeficiency virus (HIV) infection and WHO-defined severe pneumonia have a higher failure rate than do HIV-uninfected children when treated with the standard WHO treatment of parenteral penicillin or oral amoxicillin. METHODS This study was a planned sub-analysis of a randomized trial of 3-59-month-old children presenting with WHO-defined severe pneumonia (the APPIS study). We included two sites with high HIV prevalence in Durban, South Africa and Ndola, Zambia. Primary outcome measures were clinical treatment failure at day 2 and day 14. CLINICALTRIALS.GOV IDENTIFIER: CT00227331http://www.clinicaltrialsgov/show/NCT00227331). FINDINGS Of the 523 children enrolled, HIV status was known for 464 participants; 106 (23%) of these were infected with HIV. By day 2, 57 (12.3%) children had failed treatment and 110 (23.7%) failed by day 14. Twenty (18.9%) HIV-infected children failed by day 2 compared with 37 (10.3%) uninfected children (adjusted odds ratio (OR) 2.07; 95% confidence interval (CI): 1.07-4.00). Thirty-four (32.1%) HIV-infected children failed treatment by day 14 compared with 76 (21.2%) uninfected children (adjusted OR 1.88; 95% CI: 1.11-3.17). Analysis stratified by age showed that the greatest differential in treatment failure at day 2 and day 14 occurred in the children aged 3-5 months. CONCLUSIONS HIV-infected children with severe pneumonia fail WHO-standard treatment with parenteral penicillin or amoxicillin at day 2 and day 14 more often than do HIV-uninfected children, especially young infants. Standard case management of acute respiratory infection (ARI) using WHO treatment guidelines is inadequate in areas of high HIV prevalence and reappraisal of empiric antimicrobial therapy is urgently needed for severe pneumonia associated with HIV-1.
Determinants of Entry Cofactor Utilization and Tropism in a Dualtropic Human Immunodeficiency Virus Type 1 Primary Isolate

ABSTRACT Human immunodeficiency virus type 1 strain 89.6 is a dualtropic isolate that replicates in macrophages and transformed T cells, and its envelope mediates CD4-dependent fusion and entry with CCR5, CXCR-4, and CCR3. To map determinants of cofactor utilization by 89.6 and determine the relationship between cofactor use and tropism, we analyzed recombinants generated between 89.6 and T-cell-tropic (HXB) or macrophage-tropic (JRFL) strains. These chimeras showed that regions of 89.6 env outside V3 through V5 determine CXCR-4 utilization and T-cell line tropism as well as CCR5 utilization and macrophage tropism. However, the 89.6 env V3 domain also conferred on HXB the ability to use CCR5 for fusion and entry but not the ability to establish productive macrophage infection. CCR3 use was conferred on HXB by 89.6 env V3 or V3 through V5 sequences. While replacement of the 89.6 V3 through V5 region with HXB sequences abrogated CCR3 utilization, replacement of V3 or V4 through V5 separately did not. Thus, CCR3 use is determined by sequences within V3 through V5 and most likely can be conferred by either the V3 or the V4 through V5 domains. These results indicate that cofactor utilization and tropism in this dualtropic isolate are determined by complex interactions among multiple env segments, that distinct regions of the Env glycoprotein may be important for utilization of different chemokine receptors, and that determinants in addition to cofactor usage participate in postentry stages in the virus replication cycle that contribute to target cell tropism.
Tempo Discrimination in 3- and 4-year-old children: performances and threshold

Les durees de moins d’une seconde sont impliquees dans de nombreuses activites telles que la musique ou encore la production de rythmes. La question est de savoir comment se met en place ce traitement des durees courtes au cours des premieres annees de la vie. Plus specifiquement, la question posee par cette etude est de determiner les performances de discrimination temporelle entre 3 et 4 ans. En effet, l’enfant, au cours des 4 premieres annees, subit un developpement cognitif important. Or, tres peu de donnees sont disponibles pour cette periode essentielle car il est extremement difficile de mettre au point des protocoles experimentaux adaptes pour evaluer les performances des enfants. De plus, les donnees existantes sont contradictoires. Nos resultats montrent que les performances de discrimination s’ameliorent significativement en seulement quelques mois. L’ensemble des resultats est discute dans le cadre d’un modele developpemental.
Activation of TLR2 and TLR4 by Glycosylphosphatidylinositols Derived from Toxoplasma gondii1

GPIs isolated from Toxoplasma gondii, as well as a chemically synthesized GPI lacking the lipid moiety, activated a reporter gene in Chinese hamster ovary cells expressing TLR4, while the core glycan and lipid moieties cleaved from the GPIs activated both TLR4- and TLR2-expressing cells. MyD88, but not TLR2, TLR4, or CD14, is absolutely needed to trigger TNF-α production by macrophages exposed to T. gondii GPIs. Importantly, TNF-α response to GPIs was completely abrogated in macrophages from TLR2/4-double-deficient mice. MyD88−/− mice were more susceptible to death than wild-type (WT), TLR2−/−, TLR4−/−, TLR2/4−/−, and CD14−/− mice infected with the ME-49 strain of T. gondii. The cyst number was higher in the brain of TLR2/4−/−, but not TLR2−/−, TLR4−/−, and CD14−/−, mice, as compared with WT mice. Upon infection with the ME-49 strain of T. gondii, we observed no decrease of IL-12 and IFN-γ production in TLR2-, TLR4-, or CD14-deficient mice. Indeed, splenocytes from T. gondii-infected TLR2−/− and TLR2/4−/− mice produced more IFN-γ than cells from WT mice in response to in vitro stimulation with parasite extracts enriched in GPI-linked surface proteins. Together, our results suggest that both TLR2 and TLR4 receptors may participate in the host defense against T. gondii infection through their activation by the GPIs and could work together with other MyD88-dependent receptors, like other TLRs or even IL-18R or IL-1R, to obtain an effective host response against T. gondii infection.
Band Ligation Plus Sclerotherapy Versus Sclerotherapy Alone in Children With Extrahepatic Portal Venous Obstruction

Although endoscopic band ligation (EVL) plus sclerotherapy (EST) has shown to be superior to any individual method, there is no study in children. We therefore analyzed our experience of EST and EVL + EST in children with extrahepatic portal venous obstruction (EHPVO). Over a period of 8 years, 136 children who presented with a history of recent variceal bleeding due to EHPVO were studied; 30 of them received EVL + EST and 106 received EST alone. In the EVL + EST group, after the first session of EVL, EST was done three times weekly until variceal eradication was achieved. The mean age of these children was 7 ± 3.6 years with a male-to-female ratio of 2.6:1. The rate of eradication was comparable in both groups (100% in EVL + EST and 96% in EST). However, EVL + EST group required a significantly fewer sessions and lower volume of sclerosant (2 ± 1 vs. 4.4 ± 2 sessions, P < 0.001 and 3.1 ± 2 mL versus 7.5 ± 4 mL, P < 0.001 respectively). There were significantly less complications in EVL + EST group (10% vs. 36%, P < 0.01). Over a mean follow-up of 27 months, varices recurred in 6.6% and 10% cases, respectively. EVL + EST is a better method in the treatment of esophageal varices in children with EHPVO than EST alone, as it required fewer session and had fewer complication.
Diagnostic value of B‐type natriuretic peptide for estimating left atrial size and its usefulness for predicting all‐cause mortality and cardiovascular events among chronic haemodialysis patients

Estimating fluid balance in haemodialysis patients is essential when determining dry weight, but limited methods are currently available. B‐type natriuretic peptide (BNP) is a useful surrogate marker in patients with congestive heart failure (CHF), but whether its validity could be generalized to haemodialysis patients has not been studied well.
Effect of oral prophylactic instrumentation on the surface texture of all metal restorative materials

Introduction: In the inaccessible areas on the crown the removal of calculus and stains by hand and ultrasonic instrumentation is the method for cleaning to preserve and increase the longevity of the restoration. However, when oral prophylaxis is performed on restorative crowns, it may produce some surface alterations and may favour plaque accumulation. Statement of Problem: Many patients may have restored their teeth with artificial crowns and would come to the dental office for oral prophylaxis. If a routine oral prophylaxis is followed, its effect on the restorative materials and the plaque accumulation can be studied. Materials and Methods: A total of 15 disc shaped wax patterns were invested and casted for cast titanium (Group A) and the remaining 15 disk shaped for nickel-chromium (Group B). The obtained castings were finished and polished. All the specimens were subjected to hand and ultrasonic scaling for 15 s. Profilometer and scanning electron microscopic was used to analyze and evaluate the surface roughness. Specimens of each group were embedded on the anterior lingual aspects of the removable lower retention plates. 5 volunteers were asked to wear it in the mouth for 24 h for 7 days. After 7 days, the specimens were stained with plaque disclosing solutions and the photomicrographs were taken by the optical stereomicroscope and the plaque accumulations were assessed in percentage. Results: The difference in average surface roughness (μm) of the polished test specimens was maximum for ultrasonic scaling than hand scaling and maximum for Group A than Group B. Plaque accumulation in percentage on the treated specimens was found to be nonsignificant but, mean plaque accumulation was maximum on ultrasonic scaling surface than hand scaling and maximum for Group A than Group B. Surface roughness was found to be statistically significant after hand scaling (F = 9.377, P = 0.000) and ultrasonic scaling (F = 5.373, P = 0.0000) by Student t-test. Conclusion: The Surface roughness and plaque accumulation on the specimens were more for Group A than Group B and maximum produced by ultrasonic scaling than hand scaling.
Postnatal development of catecholamine inputs to the paraventricular nucleus of the hypothalamus in rats

Adrenergic and noradrenergic neural projections to the paraventricular nucleus of the hypothalamus (PVN) contribute importantly to viscerosensory modulation of pituitary hormone secretion. Immaturity of ascending catecholamine pathways may partially underlie the documented hyporesponsiveness of PVN neurosecretory cells to certain interoceptive stimuli in rats during the first few weeks of postnatal development. To explore this possibility, the present study compared the distribution and number of dopamine‐β‐hydroxylase (DBH)‐ and phenylethanolamine‐N‐methyltransferase (PNMT)‐positive neurons projecting to the PVN in newborn and adult rats. In addition, a quantitative analysis of DBH‐ and PNMT‐immunoreactive fibers in the medial parvocellular subnucleus, dorsal division (PVNmpd) and posterior magnocellular subnucleus, lateral division (PVNpml) was performed in adult rats and in developing rats on postnatal day (P)1, P7, P14, and P21. The numbers of PVN‐projecting neurons in the A1, C1, A2/C2, C3, or A6 catecholamine cell groups were similar in newborn and adult rats, as were the proportions of PVN‐projecting neurons in each region that were PNMT‐positive. However, fewer PVN‐projecting neurons in the C1 and C3 regions expressed DBH immunolabeling in newborn rats compared to adults. DBH immunolabeling increased progressively in the PVNmpd and PVNpml between postnatal days P1 and P21, when adult‐like levels were achieved. Conversely, PNMT immunolabeling in the same PVN subdivisions was most dense at P1, gradually decreasing to adult‐like levels by P21. These dynamic developmental changes in catecholamine synthetic enzyme immunolabeling densities in the PVN may reflect functional changes in noradrenergic and adrenergic signaling capacity in rats during the first few weeks of postnatal development. J. Comp. Neurol. 438:411–422, 2001. © 2001 Wiley‐Liss, Inc.
Calorimetric determination of the energetics of the molten globule intermediate in protein folding: apo-alpha-lactalbumin.

High-sensitivity differential scanning calorimetry has been used to characterize the energetics of the molten globule state of apo-alpha-lactalbumin. This characterization has been possible by performing temperature scans at different guanidine hydrochloride (GuHCl) concentrations in order to experimentally define the temperature-GuHCl stability surface of the protein. Multidimensional analysis of the heat capacity surface has allowed simultaneous resolution of the energetics of the unfolded and molten globule states. These experiments indicate that the intrinsic enthalpy difference (i.e., excluding additional contributions such as those arising from differential GuHCl binding) between the unfolded and native states is 31.8 kcal/mol at 25 degrees C whereas that of the molten globule and native states is only 7.7 kcal/mol. At the same temperature, the entropy changes are 99.2 and 23.7 cal/K.mol and the heat capacity changes are 1821 and 326 cal/K.mol, respectively. Analysis of the thermodynamic data indicates that in passing from the native to the molten globule state only approximately 19% of the hydrogen bonds are broken. In addition, the magnitude of delta Cp for the molten globule suggests that water does not largely penetrate into the interior of the molten globule, implying that significant hydrophobic interactions are still present in this state. These parameters provide precise energetic constraints to the allowed structural conformations of the molten globule.