Miracle-dz/UniFAR-FTUs huggingface dataset:
Centrally acting drug moxonidine decreases reactive oxygen species via inactivation of the phosphoinositide-3 kinase signaling in the rostral ventrolateral medulla in hypertensive rats

Objective: Centrally acting antihypertensive action of moxonidine is a result of activation of Imidazoline-1 receptor (I1R) in the rostral ventrolateral medulla (RVLM). Hypertension shows an increase in reactive oxygen species (ROS) in the RVLM. The present objective was to determine the phosphoinositide-3 kinase (PI3K) signaling pathway involved in the effect of moxonidine on ROS generation in the RVLM of spontaneously hypertensive rat (SHR). Methods: Wistar–Kyoto rats and SHR received intracisternal infusion (2 weeks) of tested agents which were subjected to subsequent experiments. In-situ ROS in the RVLM was evaluated by the oxidative fluorescence dye. Western blot and PCR analysis were performed to detect the expression levels of PI3K signaling pathway. Lentivirus was injected bilaterally into the RVLM for silencing PI3K signaling. Results: ROS production in the RVLM was dose-dependently reduced in SHRs treated with infusion of moxonidine (20 nmol/day), which was prevented by the I1R antagonist efaroxan but not by the &agr;2-adrenoceptor antagonist yohimbine. Moxonidine pretreatment significantly blunted cardiovascular sensitivity to injection of tempol (5 nmol) or angiotensin II (10 pmol) into the RVLM in SHR. Expression levels of PI3K/Akt, nuclear factor kappa-B (NF&kgr;B), NADPHase (NOX4), and angiotensin type I receptor (AT1R) in the RVLM were markedly decreased in SHR treated with moxonidine. Infection of lentivirus containing PI3K shRNA in the RVLM effectively prevented effects of moxonidine on cardiovascular activity and expression levels of Akt, NF&kgr;B, NOX4, and AT1R. Conclusion: The centrally antihypertensive drug moxonidine decreases ROS production in the RVLM through inactivation of the PI3K/Akt signaling pathway in hypertension.
Prognostic value of longitudinal strain of subepicardial myocardium in patients with hypertension

Objective: Global longitudinal strain is not well illustrated for the prognostic value in hypertension. This observational study investigated the prognostic value of global longitudinal strain, subendocardial longitudinal strain, and subepicardial (EpiLS) longitudinal strain in regularly treated hypertensive patients. Methods: Ninety-five hypertensive study participants (60.0% men, age 65.5 ± 12.0 years) were regularly treated for more than 1 year. We performed a two-dimensional echocardiographic study and obtained global peak systolic left ventricular longitudinal strain of subendocardial myocardium and the subepicardium (defined as subendocardial longitudinal strain and EpiLS, respectively). Cardiovascular events included cardiovascular death and any admission for stroke, acute coronary syndrome, or heart failure. Results: After a follow-up period of 7.3 ± 2.0 years, 20 (21%) study participants had cardiovascular events. Significant differences between study participants with and without cardiovascular events were noted in diuretic administration (75.0 vs. 93.3%, P = 0.018), age (71.0 ± 11.6 vs. 64.0 ± 11.8 years, P = 0.02) and EpiLS (−16.0 ± 2.0 vs. −17.7 ± 3.0%, P = 0.04). Using multivariate Cox regression analysis, EpiLS was the only independent prognostic factor (hazard ratio 1.449, 95% confidence interval 1.027–2.045, P = 0.035). Using the cut off value of −17.57% for EpiLS (median value of EpiLS), the Kaplan–Meier survival curve revealed a significant difference (P = 0.016) associated with cardiovascular outcome. Conclusion: EpiLS was the only independent prognostic factor in regularly-treated hypertensive patients. Our results indicated that involvement of subepicardial myocardium may infer worse prognosis of hypertensive heart disease.
Parent Report of Attention Problems Predicts Later Adaptive Functioning in Children with Brain Tumors

Children with brain tumors are at risk for psychological and behavioral difficulties. This study examined the ability of parent report of attention problems, withdrawal, anxiety, and depression, as well as IQ, to predict later adaptive functioning in 42 children treated for brain tumors. Age at diagnosis, SES, gender, and scores on the Neurological Predictor Scale (NPS) also were examined as predictors. Parent report of attention problems, SES, and NPS were significant predictors of later adaptive functioning across domains. This finding highlights the ability of parent report of attention problems to predict later adaptive functioning in children treated for brain tumors.
The association between home vs. ambulatory night-time blood pressure and end-organ damage in the general population

Objective: The aim of this study was to test the agreement between night-time home and night-time ambulatory blood pressure (BP) and to compare their associations with hypertensive end-organ damage for the first time in the general population. Methods: A population sample of 248 participants underwent measurements for night-time home BP (three measurements on two nights with a timer-equipped home device), night-time ambulatory BP, pulse wave velocity (PWV), carotid intima–media thickness (IMT) and echocardiographic left ventricular mass index (LVMI). Results: No significant or systematic differences were observed between mean night-time ambulatory and home BPs (systolic/diastolic difference: 0.7 ± 7.6/0.2 ± 6.0 mmHg, P = 0.16/0.64). All night-time home and ambulatory BPs were positively correlated with PWV, IMT and LVMI (P < 0.01 for all). No significant differences in Pearson's correlations between end-organ damage and night-time home or ambulatory BP were observed (P ≥ 0.11 for all comparisons using Dunn and Clark's Z), except for a slightly stronger correlation between PWV and ambulatory SBP than for home SBP (r = 0.57 vs. 0.50, P = 0.03). The adjusted R2 of all multivariable-adjusted models for PWV, IMT or LVMI that included night-time home or ambulatory SBP/DBP were within 2/1%. Conclusion: Our study demonstrates that night-time home and ambulatory measurements produce similar BP values that have comparable associations with end-organ damage in the general population even when a clinically feasible measurement protocol is used for measuring night-time home BP. In the future, night-time home BP measurement may offer a feasible and easily accessible alternative to ambulatory monitoring for the measurement of night-time BP.
Application of the Dual-Component Model of Working Memory to ADHD

Attention deficit/hyperactivity disorder (ADHD) has been associated with a deficit in working memory across both verbal and spatial domains, but the precise nature of this deficit is poorly understood. The dual-component model postulates that working memory capacity consists of two dissociable components: maintenance in primary memory (PM) and recall from secondary memory (SM). Participants diagnosed with ADHD (n = 32) and age-matched controls (n = 31) performed both verbal and spatial free-recall tasks, and subsets of these two samples were selected for further comparison based on their use of a “recency” order-of-report strategy. The primary results showed that maintenance in PM appears to be largely intact whereas recall from SM appears to be deficient in ADHD relative to age-matched controls. Similar outcomes were observed across both task domains. Implications for understanding both the underlying pathology and treatment of ADHD are discussed.
DSM-IV-Defined Inattention and Sluggish Cognitive Tempo: Independent and Interactive Relations to Neuropsychological Factors and Comorbidity

The aim of the present study was to investigate the independent relations of DSM-IV-defined inattention and behaviors characteristic of sluggish cognitive tempo (SCT) to neuropsychological factors and problem behaviors often comorbid with attention deficit/hyperactivity disorder (ADHD). By controlling for symptoms of DSM-IV-defined inattention, unique relations to SCT could be ascertained. Additionally, interactive relations of DSM-IV-defined inattention and SCT were of interest. A community-based sample of school children (N = 209; the higher end of the ADHD-symptom range was oversampled) completed neuropsychological tasks designed to measure executive function (EF), sustained attention, and state regulation. Behavioral symptoms were measured using parental and teacher ratings of the DSM-IV criteria for ADHD and Oppositional Defiant Disorder (ODD). The results showed that these two domains of inattention, DSM-IV-defined inattention and SCT, have neuropsychological processes and comorbid behavioral problems in common. However, when controlling for the overlap, DSM-IV-defined inattention was uniquely related to EF and state regulation, while SCT was uniquely related to sustained attention. In addition, the results showed an interactive relation of DSM-IV-defined inattention and SCT to ODD. Findings from the present study support the notion that DSM-IV-defined inattention constitutes a somewhat heterogeneous condition. Such results can further our theoretical understanding of the neuropsychological impairments and comorbid behavioral problems associated with ADHD symptoms.
Developmental changes of win-stay and loss-shift strategies in decision making

This study aims to clarify the developmental changes in real-life decision making when strategy is adjusted using both positive and negative feedback, that is, whether strategic adjustment evolves with age. A total of 84 participants divided into three age groups (children, adolescents, and adults) performed the standard version of the Iowa Gambling Task (IGT). Children and adolescents showed a strong bias in favor of disadvantageous choices whereas adults learned to decide advantageously during the course of the task. Interestingly, the results clearly demonstrate that children did not switch differently following gains and losses whereas adolescents and adults switched more often after a loss than after a gain, corresponding to the “loss-shift” and the “win-stay” strategies, respectively. The results also revealed that adults switched less often after losses compared to children and adolescents and, thus, used the loss-stay strategy more often than the 2 youngest groups. These new findings suggest that successful completion of the IGT by adults requires fine feedback monitoring and more frequent use of the win-stay and loss-stay strategic adjustments.
Metoclopramide unmasks potentially misleading contralateral suppression in patients undergoing adrenal vein sampling for primary aldosteronism

Objective: As metoclopramide stimulates aldosterone secretion, we tested its usefulness in the assessment of lateralization of primary aldosteronism by adrenal vein sampling (AVS). Design: Prospective within-patient study in consecutive patients undergoing AVS for primary aldosteronism subtyping. Methods: We compared the diagnostic accuracy of baseline and postmetoclopramide lateralization index and relative (to cortisol) aldosterone secretion indices (RASI) for each adrenal gland with aldosterone-producing adenoma (APA) determined by the four corners criteria as the reference diagnosis. Results: We recruited 93 consecutive patients (mean age: 52 years; women 31%). Metoclopramide increased plasma aldosterone in the inferior vena cava and in both adrenal veins. The postmetoclopramide lateralization index was accurate in identifying APA, but did not increase diagnostic accuracy over baseline lateralization index, because the RASI increased similarly in both sides. Conversely, metoclopramide raised RASI to values more than 0.90 bilaterally in non-APA patients allowing accurate identification of factitious aldosterone suppression. In contrast, RASI was 0.90 or less in 48% contralateral to the tumor in APA patients. Regression analysis showed the APA patients with persistent suppression of RASI contralaterally showed a more florid primary aldosteronism phenotype. Conclusion: Metoclopramide does not enhance lateralization of aldosterone excess in APA, but consistently increased the value of RASI in non-APA cases, thus unmasking potentially misleading suppression of aldosterone. Postmetoclopramide RASI may therefore allow a more precise diagnosis when AVS can be achieved only unilaterally.
A STUDY OF 249 PATIENTS WITH LITIGATED CLAIMS OF INJURY

BACKGROUNDPatients involved in litigation regarding claims of injury seem different in several respects from those who were not involved in litigation. Their symptoms seem unusually severe and persistent considering the type of injury that they experienced; in addition, their response to treatment is often very discouraging. A detailed prospective study of 249 patients with litigated claims of injury was performed to determine how they differ from other patients. REVIEW SUMMARYInconsistent nongenuine abnormalities were found on examination in 88.7% of the patients in the study group and in 5.4% of the control group. In both groups, the most common nongenuine abnormalities were false weakness, nonanatomic sensory disturbances, and inconsistencies of straight leg raising and forward bending. Complaints related by the patients to the litigated events often consisted of an accumulation of pre-existing symptoms, magnified discomforts of life, and the effects of aging. Treatment was frequently poorly effective even though given over long periods of time. CONCLUSIONSPatients involved in litigation frequently differ from those not involved with the legal system. Physicians and other health-care providers should be aware of this. These persons should be carefully examined to be sure that they receive medically indicated treatment and disability compensation that is appropriate and fair to all concerned parties.
Prereading skills of very-low-birth-weight prematurely born Finnish children

Our objective was to study the prereading skills of very-low-birth-weight (VLBW; ≤ 1500 g) prematurely born children at the age of five years. A regional cohort of 89 VLBW children and 152 full-term (FT) born children was assessed for letter knowledge, phonological processing, and speeded naming. Full-scale IQ (FSIQ) was assessed using a short version of WPPSI-R. The associations of parental and neonatal factors, and FSIQ with prereading skills were assessed. VLBW group had poorer prereading skills, and there were more VLBW children at-risk (performing < −1 SD) compared to FT children in phonological processing (23% vs. 9%, p = .002), letter knowledge (27% vs. 14%, p = .017), and the accuracy of speeded naming (26% vs. 13%, p = .020). VLBW children had lower average FSIQ and Performance IQ (both comparisons p < .001) than FT controls, but Verbal IQ did not differ. When FSIQ was used as a covariate, VLBW children did not differ from the FT group in prereading skills indicating that they are at risk for more global developmental problems. Lower parental level of education as well as parent's reading problems were negatively associated with VLBW children's prereading skills. Positively, about 75% of VLBW children performed within the normal range in each individual prereading skill.
The impact of a multimodal Summer Camp Training on neuropsychological functioning in children and adolescents with ADHD: An exploratory study

This study examined the combined effects of methylphenidate (MPD) and response cost and token strategy (RCT), administered in an intensive ADHD Summer Camp Training (ASCT) format, on neuropsychological functions. Forty children with ADHD were randomly assigned to either the ASCT treatment (MPD plus RCT) or a control group (MPD plus a 1-hour session of standardized parental education/counselling [SPC]). This latter group was structured to be similar to the more typical current treatment. The ASCT treatment was administered for 2½ weeks and included RCT, consisting of elements of social skill training, attention training, and sports participation. RCT was systematically applied in all daily situations and activities. Executive functions and state of regulation using the Test for Attention Performance (TAP) and the Trail-Making Test (TMT) were assessed before training and at a 6-month follow-up. Participants receiving the ASCT improved specific neuropsychological functions in attention regulation and inhibitory control tasks at the 6-month follow-up. No changes occurred for participants assigned to the control condition. The data suggest that an intensive multimodal summer camp treatment program including strategies of instrumental learning can lead to substantial and enduring improvements in neuropsychological functioning of children and adolescents with ADHD.
Facial memory deficits in children with fetal alcohol spectrum disorders

Prenatal exposure to alcohol may lead to a range of neurobehavioral effects, including impaired learning and memory. Although children with fetal alcohol spectrum disorders (FASD) exhibit both verbal and nonverbal memory impairments, their memory for faces has not been as thoroughly investigated and the extent literature provides inconsistent results. The aim of the current study was to determine whether difficulties in face memory exist in children with FASD and whether the difficulties are mediated by task demands. To address this, we used two measures of immediate and delayed facial recognition memory, the Children's Memory Scale (CMS) and Test of Memory and Learning (TOMAL). Compared to typically developing controls, children with FASD showed memory deficits on all tests and were more likely to perform in a clinically significant range. As well, children performed more poorly on the CMS compared to TOMAL, a finding consistent with the greater difficulty of the CMS task. Our results are consistent with our hypothesis that children with FASD show impairment in facial memory, particularly on demanding memory tasks.
Assessment of executive functioning in childhood epilepsy: The Tower of London and BRIEF

Children and adolescents with epilepsy are known to demonstrate executive function dysfunction, including working memory deficits and planning deficits. Accordingly, assessing specific executive function skills is important when evaluating these individuals. The present investigation examined the utility of two measures of executive functions—the Tower of London and the Behavioral Rating Inventory of Executive Functioning (BRIEF)—in a pediatric epilepsy sample. Ninety clinically referred children and adolescents with seizures were included. Both the Tower of London and BRIEF identified executive dysfunction in these individuals, but only the Tower of London variables showed significant relations with epilepsy severity variables such as age of epilepsy onset, seizure frequency, number of antiepileptic medications, etc. Further, the Tower of London and BRIEF variables were uncorrelated. Results indicate that objective measures of executive function deficits are more closely related to epilepsy severity but may not predict observable deficits, as reported by parents. Comprehensive evaluation of such deficits, therefore, should include both objective measures as well as subjective ratings from caregivers.
Efficacy and safety of sacubitril/valsartan (LCZ696) add-on to amlodipine in Asian patients with systolic hypertension uncontrolled with amlodipine monotherapy

Objective: The objective of this study is to evaluate the efficacy and safety of sacubitril/valsartan (LCZ696, an angiotensin receptor and neprilysin inhibitor) add-on to amlodipine compared with amlodipine monotherapy in Asian patients with systolic hypertension uncontrolled with amlodipine. Methods: Patients with mean clinic SBP at least 145 mmHg and less than 180 mmHg after a 4-week treatment with amlodipine 5 mg/day were randomized to receive LCZ696/amlodipine (200/5 mg/day) or amlodipine 5 mg/day for 8 weeks. The primary assessment was the superiority of LCZ696/amlodipine versus amlodipine in lowering 24-h ambulatory SBP from baseline to week 8. Secondary assessments included 24-h ambulatory DBP and pulse pressure (PP), daytime and night-time BP, clinic BP and PP, BP control/responder rate (<140/90 mmHg or a reduction ≥20/10 mmHg from baseline), and safety. Results: Of the 371 patients screened, 266 (71.7%) patients (mean age 55.4 years; 24-h SBP/DBP 139.0/86.1 mmHg at baseline) who did not respond to 4-week treatment with amlodipine 5 mg/day were randomized. At week 8, LCZ696/amlodipine provided greater reductions in 24-h SBP compared with amlodipine monotherapy from baseline (−13.9 versus −0.8 mmHg, P < 0.001). All the secondary efficacy assessments were significantly (P < 0.001) in favour of LCZ696/amlodipine, for instance, 24-h PP (−5.8 versus −0.6 mmHg). Overall, the incidence of adverse events was 20.0% with LCZ696/amlodipine and 21.3% with amlodipine. Conclusion: LCZ696/amlodipine showed significantly greater 24-h ambulatory BP and PP reductions compared with amlodipine monotherapy. Both treatments were generally well tolerated. Therefore, LCZ696/amlodipine combination could be an effective treatment for patients with systolic hypertension uncontrolled with amlodipine.
The SDQ as a mental health measurement tool in a Canadian sample of looked-after young people

The Strengths and Difficulties Questionnaire (SDQ) is used increasingly internationally in child welfare as a tool for mental-health screening, referral and outcome measurement. This study compared the SDQ scores, based on ratings by foster parents or other caregivers, of 492 young people aged 11–15 years and living in out-of-home care in Ontario, Canada, with normative SDQ scores, based on parental ratings, of a large sample of young people aged 11–15 years from the British general population. Of the Ontario looked-after young people, 57% were male and 43% female, with 86% residing in foster homes and 14% in group homes. As expected, a considerably higher proportion of the Ontario looked-after sample had SDQ scores in the at-risk range, compared with the British normative sample. The findings suggested that the SDQ is likely to prove useful as a mental health measurement tool in Canadian child welfare services.