Miracle-dz/UniFAR-FTUs huggingface dataset:
National Prescribing Patterns in the Management of Extrapyramidal Symptoms among Patients with Schizophrenia

Purpose: Antipsychotics, particularly typical agents, have been shown to cause extrapyramidal symptoms (EPS). We hypothesized a negative association between concomitant (at same visit) prescriptions for atypical antipsychotics and prescriptions for medications to manage EPS. Method: We combined National Ambulatory Medical Care Survey (NAMCS) data from 1993 through 1999 for visits by patients with a diagnosis of schizophrenia (ICD-9 295.0–295.9), that included a prescription for either an atypical or typical antipsychotic (but not both). We also constructed two, scale-weighted logistic regression models to separately estimate the odds and probabilities of receiving prescriptions for an antipsychotic and for a medication used to treat EPS. Results: From 1993 through 1999, there were an estimated 10,475,507 office visits with schizophrenia as a diagnosis; 7,371,625 (70.4 percent) included a prescription for a conventional (typical) antipsychotic. Thirty-four percent of visits included a prescription for a medication used to treat EPS. Being in the older age group, having Medicaid as primary coverage, belonging to an HMO, and being female significantly reduced the probability of receiving an atypical antipsychotic by 12.6 percent, 10.9 percent, 15.1 percent, and 10.2 percent, respectively. Caucasian patients were 14 percent more likely to be prescribed an atypical. Antipsychotic type had a clinically and statistically significant effect on EPS management prescribing. A prescription for an atypical antipsychotic reduced the probability of receiving a concomitant prescription for EPS management by 26.8 percent. Conclusion: As expected, we observed the hypothesized joint prescribing pattern. The results of this study suggest that atypical antipsychotic prescriptions strongly predict fewer prescriptions for EPS treatment, and, by implication, reduced need for EPS treatment in actual ambulatory care practices throughout the nation.
Integration is essential for efficient gene expression of human immunodeficiency virus type 1

A mutant of human immunodeficiency virus type 1 which carries a frameshift insertion in the integrase/endonuclease region of pol gene was constructed in vitro. Upon transfection into cells, although this mutant exhibited a normal phenotype with respect to expression of gag, pol, and env genes and to generation of progeny virions, no replication-competent virus in CD4-positive cells emerged. An assay for the single-step replication of a defective viral genome dependent on trans complementation by rev protein was established and used to monitor the early phase of viral infection process. Viral clones with a mutation in the vif, vpr, or vpu gene displayed no abnormality in the early phase. In contrast, the integrase mutant did not direct a marker gene expression after infection. Together with an observation that the mutant lacked the ability to integrate, these results indicated that the integration was required for efficient viral gene expression and productive infection of human immunodeficiency virus type 1.
Devic's neuromyelitis optica: A prospective study of seven patients treated with prednisone and azathioprine

Seven newly diagnosed patients with Devic's neuromyelitis optica were treated with long-term prednisone and azathioprine, and were followed every 2 months for at least 18 months. Their Expanded Disability Status Scale score improved significantly (mean at baseline, 9; mean at 18 months, 3; p < 0.005), and no relapses occurred for more than 18 months. Multicenter controlled studies are needed to prove the efficacy of this therapeutic regimen.
Proteomic analysis of protein profiles during early development of the zebrafish, Danio rerio

In the present study, profiles of protein expression were examined during early development of zebrafish, an increasingly popular experimental model in vertebrate development and human diseases. By 2‐DE, an initial increase in protein spots from 6 h post‐fertilization (hpf) to 8–10 hpf was observed. There was no dramatic change in protein profiles up to 18 hpf, but significant changes occurred in subsequent stages. Interestingly, 49% of the proteins detected at 6 hpf remained detectable by 1 week of age. To map the protein expression patterns in 2‐D gels, MALDI‐TOF/TOF MS was employed to identify selected protein spots from early embryos. 108 protein spots were found to match known proteins and they were derived from 55 distinct genes. Interestingly, 11 (20%) of them produced multiple protein isoforms or distinct cleavage products. Although deyolked embryos were used in the analysis, a large number of vitellogenin derivatives remained prominently present in the embryos. Other than these, most of the identified proteins are cytosolic, cytoskeletal and nuclear proteins, which are involved in diversified functions such as metabolism, cytoskeleton, translation, protein degradation, etc. Some of the proteins with interesting temporal expression profiles during development are further discussed.
Febrile seizures.

INTRODUCTION Simple febrile seizures are generalised in onset, last <15 minutes, and do not occur more than once in 24 hours. Complex febrile seizures are longer lasting, have focal symptoms, and can recur within 24 hours. This review only deals with simple febrile seizures. About 2% to 5% of children in the USA and Western Europe, and 6% to 9% of infants and children in Japan will have experienced at least one febrile seizure by the age of 5 years. Simple febrile seizures may slightly increase the risk of developing epilepsy, but have no known adverse effects on behaviour, scholastic performance, or neurocognition. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments given during episodes of fever in children with one or more previous simple febrile seizures? What are the effects of long-term (daily, for >1 month) anticonvulsant treatment in children with a history of simple febrile seizures? What are the effects of treatments on reducing the risk of subsequent epilepsy in children with a history of simple febrile seizures? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found 18 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS In this systematic review we present information relating to the effectiveness and safety of the following interventions: anticonvulsants (intermittent or continuous) and antipyretic treatments (physical antipyretic measures, paracetamol, ibuprofen).
An ergonomic assessment and fitness evaluation of young male tea factory workers in Dooars, West Bengal

Introduction: There are very few published reports on the heath status of tea garden workers of West Bengal, while reports on cardiorespiratory fineness and body composition of male tea factory workers is almost scanty. Purpose: The present study was carried out in the Dooars region of the Cooch Behar district, West Bengal to evaluate the physical fitness and morphological characteristics due to the physio-logical workload of respondents engaged in processing of tea leaves in factories within the tea-estates. Materials and methods: A cross sectional study was carried out in 18-25 years’ young male tea-garden workers (n=15) by random selection from Cooch Behar District, West Bengal (mean age 20.1) and college students (n=15) of Kolkata (mean age 21.9), who served as controls. Cardiorespiratory fitness was estimated in terms of maximum oxygen uptake (VO2 max) and physical fitness index (PFI), while morphological characters were estimated by means of physical anthropometric measures. Results: A significant difference in body surface area, body mass index, percentage of body fat (% fat), blood pressure, physical fitness index, energy expenditure, anaerobic power, mean upper arm circumference, thigh circumference, waist circum-ference and buttock circumference were found (p<0.05) in tea garden workers. No significant difference was observed in calf circumference and waist-to-hip ratio (WHR). Conclusions: On the basis of the findings of the present study using morphometric indicators and fitness markers it can be concluded that, the majority of respondents had an ectomorph stature but have good physical fitness level.
The utility of serum thyroglobulin measurement at the time of remnant ablation for predicting disease-free status in patients with differentiated thyroid cancer: a meta-analysis involving 3947 patients.

CONTEXT Decisions regarding initial therapy and subsequent surveillance in patients with differentiated thyroid cancer (DTC) depend upon an accurate assessment of the risk of persistent or recurrent disease. OBJECTIVE The objective of this study was to examine the predictive value of a single measurement of serum thyroglobulin (Tg) just before radioiodine remnant ablation (preablation Tg) on subsequent disease-free status. DATA SOURCES Sources included MEDLINE and BIOSYS databases between January 1996 and June 2011 as well as data from the author's tertiary-care medical center. STUDY SELECTION Included studies reported preablation Tg values and the outcome of initial therapy at surveillance testing or during the course of long-term follow-up. DATA EXTRACTION Two investigators independently extracted data and rated study quality using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Reviews-2 (QUADAS-2) tool. DATA SYNTHESIS Fifteen studies involving 3947 patients with DTC were included. Seventy percent of patients had preablation Tg values lower than the threshold value being examined. The negative predictive value (NPV) of a preablation Tg below threshold was 94.2 (95% confidence interval = 92.8-95.3) for an absence of biochemical or structural evidence of disease at initial surveillance or subsequent follow-up. The summary receiver operator characteristic curve based on a bivariate mixed-effects binomial regression model showed a clustering of studies using a preablation Tg below 10 ng/ml near the summary point of optimal test sensitivity and specificity. CONCLUSION Preablation Tg testing is a readily available and inexpensive tool with a high NPV for future disease-free status. A low preablation Tg should be considered a favorable risk factor in patients with DTC. Further study is required to determine whether a low preablation Tg may be used to select patients for whom radioiodine remnant ablation can be avoided.
Mindfulness-Based Cognitive Therapy for Persistent Insomnia: A Pilot Study

188 gic antidepressant aminpetine, 55% still had at least some type of sexual dysfunction after 6 months compared to 4% in the control group treated with aminpetine alone [13] . More studies are needed to address the frequency, severity and nature of this problem before its neurochemical etiology can be addressed. These case studies have important clinical implications. They suggest that when patients develop sexual dysfunction as a side effect of SSRIs, clinicians should be alert to the possibility that restoration of sexual function may not correlate temporally with medication cessation. Patients are often willing to continue taking SSRIs despite sexual side effects, but the possibility of increasing the probability of dysfunction remaining after discontinuance should be taken into consideration. Such persistent side effects could even worsen the long-term prognosis of depression [14] .
ARTHRITIS WITH ORAL TYPE I 1 COLLAGEN Results of a Multicenter , Double-Blind , Placebo-Controlled Trial

Objective. Oral administration of cartilagederived type I1 collagen (CII) has been shown to ameliorate arthritis in animal models of joint inflammation, and preliminary studies have suggested that this novel therapy is clinically beneficial and safe in patients with rheumatoid arthritis (RA). The present study was undertaken to test the safety and efficacy of 4 different dosages of orally administered CII in patients with RA. Methods. Two hundred seventy-four patients with active RA were enrolled at 6 different sites and randomized to receive placebo or 1 of 4 dosages (20,100,500, or 2,500 &day) of oral CII for 24 weeks. Efficacy parameters were assessed monthly. Cumulative response rates (percentage of patients meeting the criteria for response at any time during the study) were analyzed
Performance of the preliminary definition of improvement in juvenile chronic arthritis patients treated with methotrexate

OBJECTIVE To investigate the performance of the core set of outcome measures and the preliminary definition of improvement (PDI) in the assessment of response to methotrexate (MTX) treatment in children with juvenile chronic arthritis (JCA). METHODS Data were obtained from an open label, non-controlled trial designed to investigate the efficacy of MTX in children with JCA. All patients had the core set of variables assessed at baseline and after six months of treatment. Variables in the core set are: (1) physician global assessment of disease activity; (2) parent or patient (if appropriate in age) global assessment of overall well being; (3) functional ability; (4) number of joints with active arthritis; (5) number of joints with limited range of motion; (6) erythrocyte sedimentation rate. The PDI specifies that to be classified as improved, a patient must show at least 30% improvement from baseline in three of any six variables in the core set, with no more than one of the remaining variables worsening by more than 30%. RESULTS A total of 111 JCA patients were included in the study. According to the PDI, after six months of MTX treatment 73 patients (66%) were classified as improved and 38 (34%) as not improved. Among the core set variables, parent assessment detected the highest percentage of patients improved (72%) and functional assessment the lowest (37%). CONCLUSION The PDI identifies about two thirds of patients with JCA treated with low dose MTX as improved. This proportion is similar to that expected to improve based upon a previous controlled study of low dose, oral MTX and provides preliminary evidence of the definition’s validity.
Presurgical Orthodontics versus No Presurgical Orthodontics: Treatment Outcome of Surgical-Orthodontic Correction for Skeletal Class III Open Bite

Background: It has long been claimed that presurgical orthodontics is crucial to the outcome of surgical-orthodontic treatment for dentofacial deformity. However, in the literature, the effect of presurgical orthodontics on the treatment outcome remains controversial. The purpose of the study was therefore to investigate the effect of presurgical orthodontics on the treatment outcome in terms of facial aesthetics, occlusion, stability, and efficiency. Methods: Thirty-three adult patients with skeletal class III open bite corrected by Le Fort I posterior impaction and bilateral sagittal split osteotomy were included. The patients were divided into two groups: 13 received presurgical orthodontics, and 20 did not. Cephalometric radiographs and study models were used to evaluate the treatment outcome. Results: There were no between-group differences in facial aesthetics, overbite, or Peer Assessment Rating score. Overjet was larger in the no–presurgical orthodontics group than in the presurgical orthodontics group, but both were within normal limits. Both groups had similar maxillary and horizontal mandibular stability. Although the vertical mandibular stability was worse in the no–presurgical orthodontics group than in the presurgical orthodontics group, the direction of instability was favorable for open bite correction. Finally, longer treatment time was required in the presurgical orthodontics group compared with the no–presurgical orthodontics group (512 ± 103 days versus 342 ± 127 days; p < 0.001). Conclusions: The results suggest that in surgical-orthodontic correction of skeletal class III open bite, presurgical orthodontics has no clinically significant effects on facial aesthetics, occlusion, or stability. However, presurgical orthodontics has a significant adverse effect on efficiency. Patients receiving presurgical orthodontics undergo longer treatment time than those receiving no presurgical orthodontics.
18‐Methoxycoronaridine (18‐MC) and Ibogaine: Comparison of Antiaddictive Efficacy, Toxicity, and Mechanisms of Action

18‐MC, a novel iboga alkaloid congener, is being developed as a potential treatment for multiple forms of drug abuse. Like ibogaine (40 mg/kg), 18‐MC (40 mg/kg) decreases the intravenous self‐administration of morphine and cocaine and the oral self‐administration of ethanol and nicotine in rats; unlike ibogaine, 18‐MC does not affect responding for a nondrug reinforcer (water). Both ibogaine and 18‐MC ameliorate opioid withdrawal signs. Both ibogaine and 18‐MC decrease extracellular levels of dopamine in the nucleus accumbens, but only ibogaine increases extracellular levels of serotonin in the nucleus accumbens. Both ibogaine and 18‐MC block morphine‐induced and nicotine‐induced dopamine release in the nucleus accumbens; only ibogaine enhances cocaine‐induced increases in accumbal dopamine. Both ibogaine and 18‐MC enhance the locomotor and/or stereotypic effects of stimulants. Ibogaine attenuates, but 18‐MC potentiates, the acute locomotor effects of morphine; both compounds attenuate morphine‐induced locomotion in morphine‐experienced rats. Ibogaine produces whole body tremors and, at high doses (≥100 mg/kg), cerebellar damage; 18‐MC does not produce these effects. Ibogaine, but not 18‐MC, decreases heart rate at high doses. While 18‐MC and ibogaine have similar affinities for kappa opioid and possibly nicotinic receptors, 18‐MC has much lower affinities than ibogaine for NMDA and sigma‐2 receptors, sodium channels, and the 5‐HT transporter. Both 18‐MC and ibogaine are sequestered in fat and, like ibogaine, 18‐MC probably has an active metabolite. The data suggest that 18‐MC has a narrower spectrum of actions and will have a substantially greater therapeutic index than ibogaine.
Basal skull fractures are associated with mortality in pediatric severe traumatic brain injury

BACKGROUND Basal skull fractures (BSFs) are caused by blunt force trauma, occurring in the temporal, occipital, sphenoid, and/or ethmoid bones. In pediatric severe traumatic brain injury (sTBI), there is a paucity of data on BSFs. Our goal was to investigate the BSF prevalence, anatomy, and association with short-term outcomes in pediatric sTBI. METHODS We retrospectively reviewed all severely injured (Injury Severity Score ≥12) pediatric patients (aged <18 years) admitted to our hospital after experiencing an sTBI (Glasgow Coma Scale score ⩽8 and head Abbreviated Injury Scale score ≥4). Neuroimaging for all sTBI patients was reviewed for skull fractures. Data were analyzed with both univariate and multivariate techniques. RESULTS Of the 180 patients with sTBI, 47 had BSFs for a prevalence of 26% (69 BSFs in total; 16 sTBI patients had ≥2 BSFs). The squamous temporal bone was fractured most frequently (n=30/47 sTBI patients with BSFs). Patients with BSFs were heavier and had more facial injuries than those without (p < 0.05) but were similar in all other admission demographics, injury profiles, and clinical characteristics. Cerebrospinal fluid leak was found in 32% (n = 15 of 47) of BSF patients (otorrhea, n = 12; rhinorrhea, n = 1; otorrhea/rhinorrhea, n = 2; p < 0.001). Mortality, acute central diabetes insipidus, and fewer ventilator-free days were associated with BSFs (p < 0.005), whereas in sTBI survivors, BSFs were associated with longer lengths of stay (p < 0.05). Multiple logistic regression showed that BSFs were positively associated with the presence of subarachnoid hemorrhage (odds ratio [OR], 4.00; p = 0.001), contusion (OR, 2.48; p = 0.029), herniation (OR, 3.40; p = 0.037), and cerebral edema (OR, 2.30; p = 0.047) but negatively associated with diffuse axonal injury (OR, 0.20; p = 0.003). BSFs and mortality were strongly associated (OR, 6.87; p = 0.019). CONCLUSION BSFs occurred in 26% of pediatric sTBI patients. The temporal bone was fractured in two thirds of sTBI patients with BSFs, and one third was associated with cerebrospinal fluid leaks. BSFs represent a significant linear blunt force and are independent predictors of mortality. LEVEL OF EVIDENCE Prognostic and epidemiologic study, level III.
Effects of Adlay (Coix lachryma-jobi L. var. ma-yuen Stapf.) Hull Extracts on the Secretion of Progesterone and Estradiol In Vivo and In Vitro

Adlay (Coix lachryma-jobi L. var. ma-yuen Stapf.) has been used as a traditional Chinese medicine for dysfunction of the endocrine system. However, there have been few studies on the effects of adlay seed on the endocrine system. In the present study, both the in vivo and in vitro effects of methanolic extracts of adlay hull (AHM) on progesterone synthesis were studied. AHM was partitioned with four different solvents: water, 1-butanol, ethyl acetate, and n-hexane. Four fractions, namely, AHM-Wa (water fraction), AHM-Bu (1-butanol fraction), AHM-EA (ethyl acetate fraction), and AHM-Hex (n-hexane fraction), were respectively obtained. Granulosa cells (GCs) were prepared from pregnant mare serum gonadotropin-primed immature female rats and were challenged with different reagents, including human chorionic gonadotropin (hCG; 0.5 IU/ml), 8-bromo-adenosine-3′,5′-cyclic monophosphate (8-Br-cAMP; 0.1 mM), forskolin (10 μM), 25-OH-cholesterol (10 μM), and pregnenolone (10 μM), in the presence or absence of AHM (100 μg/ml). The functions of steroidogenic enzymes, including protein expression of the steroidogenic acute regulatory protein (StAR), cytochrome P450 side chain cleavage enzyme (P450scc), protein kinase A (PKA), and aromatase activity, were investigated. The expression of StAR mRNA was also explored by using real-time reverse transcription–polymerase chain reaction. In the in vivo study, AHM decreased plasma progesterone and estradiol levels after an intravenous injection of AHM (2 mg/ ml/kg). In the in vitro studies, AHM decreased progesterone and estradiol via inhibition of (i) the cAMP-PKA signal transduction pathway, (ii) cAMP accumulation, (iii) P450scc and 3β-HSD enzyme activities, (iv) PKA, P450scc and StAR protein expressions and StAR mRNA expression, and (v) aromatase activity in rat GCs. These results suggest that AHM decreased the production of progesterone via mechanisms involving the inhibition of the cAMP pathway, enzyme activities, and the protein expressions of P450scc and StAR in rat GCs.