Miracle-dz/UniFAR-FTUs huggingface dataset:
T1 mapping and amyloid cardiomyopathy: how much better can it get?

This editorial refers to ‘T1 mapping and survival in systemic AL amyloidosis’, by S.M. Banypersad et al . on page, doi:10.1093/eurheartj/ehu444 Systemic light-chain (AL) amyloidosis carries a high risk of cardiac involvement and portends poor prognosis.1 Patients with cardiac AL amyloidosis have a median survival of 8 months compared with ∼4 years when the heart is spared. Therefore, confirmation of cardiac involvement is critical for therapeutic decision-making and patient counselling. Furthermore, differentiation from other cardiomyopathies with left ventricular hypertrophy or features of restrictive physiology on echocardiography is frequently necessary. Over the last decade, cardiovascular magnetic resonance (CMR), and particularly the late gadolinium enhancement (LGE) technique, has been validated as a means to identify cardiac involvement in AL amyloidosis.2–4 The appearance of global, subendocardial LGE in combination with a dark left ventricular blood pool is the hallmark for identifying cardiac involvement. However, LGE-CMR has some limitations in patients with amyloid disease. For example, the pattern of LGE may sometimes be atypical and patchy, even in patients with advanced disease. Furthermore, a significant subset of AL amyloid patients suffer from significant renal dysfunction, where gadolinium contrast administration is problematic due to the risk of nephrogenic systemic fibrosis.1 More recently, newer CMR tissue characterization techniques such as T1 mapping have emerged.5 Myocardial T1 mapping methods are used for native (i.e. without the use of gadolinium-based contrast agents) and also for post-contrast T1 measurements. In combination with haematocrit, pre- and post-contrast measurements enable the quantification of the extracellular volume fraction (ECV). Native myocardial T1 values reflect a composite signal from both the intracellular (predominantly myocytes) …
T Cells in Multiple Sclerosis and Inflammatory Central Nervous System Diseases

Using murine monoclonal antibodies to mark total T cells, we have found rapid migration of T cells into the CSF in progressive multiple sclerosis patients, suggesting that the ongoing inflammatory responses in the CNS may depend on the continued movement of cells from the periphery into the target organ. Cloning experiments have indicated that the T cells present in the CSF during viral and post-viral encephalomyelitis represent sequestered populations of antigen-specific cells. In more chronic disease processes, these cells may also have restricted clonality as measured by the frequency of different T-cell receptor gene rearrangements on Southern blotting. It is known that there is restricted clonality of the B-cell immunoglobulin response in the CSF compartment with inflammatory CNS diseases, and with infections the majority of these so-called oligoclonal antibodies are directed against the exciting antigen and are synthesized in the CNS. Although we believe that T cells in the CNS originate from the blood, during the course of an inflammatory response the antigen and clonally-restricted populations found in the CSF may represent either selective migration or selective accumulation in the CNS. Selective migration might occur at the endothelial barrier as these cells can express Class II MHC antigens and act as antigen-presenting cells in the CNS (McCarron et al. 1985). Selective accumulation of T cells in the CNS might occur after non-specific migration of cells into the CNS followed by proliferation and expansion of T cells that have been induced by antigens in the brain. Antigen-presenting cells that are present in situ, such as astrocytes, may also play a role in the selective expansion of T cells in the CSF (Fontana et al. 1984). Alternatively, it is possible that T cells are induced to expand in the target CNS tissue non-specifically, e.g., via the CD2 pathway. In this regard, we have observed that CSF T cells exhibit alterations in stimulation by anti-T112 + anti-T113 monoclonal antibodies. The mechanism of damage to CNS tissue by immune cells is essentially unknown. For example there are no clear links between antibodies present in the CNS and CNS damage in SSPE where high titers of anti-measles antibodies are present. Whereas we did not observe high frequencies of measles-reactive cells in the CSF of a subject with SSPE, we did observe MHC non-restricted cytotoxic T cells which expressed TCR-gamma chains rather than alpha-beta chains. (ABSTRACT TRUNCATED AT 400 WORDS)
Criminal Thinking as a Risk Factor for Psychiatric Inpatient Aggression

Abstract Thinking styles that predispose offenders to antisocial behavior have been shown to predict violence and aggression among inmates. This study explored this relationship among civil psychiatric inpatients. Medical records of N = 74 discharged patients were reviewed for inpatient incidents using the Overt Aggression Scale (OAS), occurring subsequent to the administration of several measures including the Psychological Inventory of Criminal Thinking Styles (PICTS), and Brief Psychiatric Rating Scale (BPRS). Univariate negative binomial regression models demonstrated that a higher rate of aggressive incidents was predicted by higher PICTS Denial of Harm, higher BPRS Hostile Suspiciousness scores, and lower educational attainment. Violence (i.e., physical aggression towards others) was predicted by higher BPRS Hostile Suspiciousness, lower education, and younger age in univariate analyses. In multivariate negative binomial regression models using the above independent predictors, higher BPRS-Hostile Suspiciousness scores and lower educational attainment significantly predicted both outcomes. This study’s results reinforce the importance of symptom-driven hostility to predicting inpatient aggression and violence, while highlighting the relatively minor role of specific criminal thinking styles in aggressive behavior among institutionalized psychiatric patients.
Assessment of Marine Biota Doses Arising from the Radioactive Sea Discharges of the COGEMA La Hague Facility A Comprehensive Case Study ( Consensus Appraisal )

This paper reports an assessment of radiation doses to marine biota arising from the radioactive sea discharges (as liquid effluents) of the COGEMA La Hague facility. The La Hague facility is located in the northwest part of France, in the north-west tip of the Nord-Cotentin Peninsula, along the English Channel south shore. The case study was primarily based on the large amount of data from recent studies of the Nord-Cotentin Radioecology Group (GRNC) and from a recent environmental impact assessment of the La Hague facility. The primary objective of this study was to select a representative set of marine biota for the study area (i.e. the Nord-Cotentin Peninsula coast) and to assess the potential radiological impacts, in terms of biota dose-rates and their related potential health effects on marine biota, arising from the radioactive sea discharges of the COGEMA La Hague facility. For assessing potential effects to biota, the predicted biota dose rates were compared to the available guidance for the protection of populations of non-human biota. The guidance values are based on published data by international organizations (e.g. UNSCEAR and IAEA) and on a screening review of a recent database (by FASSET) on biological effects of ionizing radiation on non-human biota. The major conclusion of the case study was that the predicted dose rates to marine biota attributable to radioactive sea discharges from the La Hague facility are small, and in general, well below comparison guidance levels at which deleterious and observable health effects to populations of marine biota might, according to current knowledge, be expected. The predicted incremental dose rates arising from the La Hague facility are also, in general, well below those caused by the background radioactivity in the region. This conclusion and the dose rate predictions in this study are in close agreement with those for the marine biota of Cap La Hague reported in the MARINAII study – recently undertaken for the European Commission. This case study has been presented and discussed at a recent specific workshop of international experts held at La Hague on April 15, 2003. This paper briefly presents the case study and put a particular focus on the study consensus appraisal (which includes the major conclusion stated above) that resulted from the workshop and on an industry perspective on the emerging topic of protection of non-human biota species. The points highlighted in the consensus appraisal have been incorporated in the study final report. The reader is invited to consult the consensus appraisal, contained in the study final report, for an independent and transparent opinion on the La Hague case study that was expressed by a group of international experts. 1. Presentation of the La Hague Case Study
Closed Surfaces Without Conjugate Points.

4Hille, E. , Trans. Am. Math. Soc. , 57, 246-269 (1945). 6Dunford, N. , Ibid., 54, 185-217 (1943). 6 For the requisite properties of the weak topology see Eberlein, W. F. , these PROCEEDINGS, 33, 51-53 (1947). 7 For this definition and proofs of some of the immediately following remarks see Alaoglu, L. , and Birkhoff, G. , loc. cit. Neumann, J. von, Trans. Am. Math. Soc. , 36, 445-492 (1934). Maak, W. , Hamburg Abhandlungen, 11, 240-244 (1935).
Routing in Random Multistage Interconnections Networks: Comparing Exhaustive Search, Greedy and Neural Network Approaches

The problem of establishing point-to-point communication routes in a random multistage interconnection network (RMIN) is addressed. A neural network routing scheme is presented. This routing scheme is compared to two more traditional routing techniques—namely, exhaustive search routing and greedy routing. The main criterion that is examined is the ability of each routing methodology to solve routing problems. Results are obtained through simulation of the routing methodologies for three different RMINs. The sample RMINs are relatively small since the neural network router in its present form will only be competitive for small RMINs. The simulations show that the three routing schemes perform similarly for the three sample RMINs. Other criteria that will be touched upon are the speed and the resource utilization of each routing methodology and the pros and cons of each approach will be discussed. The results suggest that neural network routers may be appropriate for some communication applications involving RMINs.
Use of antidepressants during pregnancy and the risk of spontaneous abortion

Background: The risk of relapse of depression or the diagnosis of some other psychiatric disorders during pregnancy necessitates the use of antidepressants despite possible adverse effects. Whether such use increases the risk of spontaneous abortion is still being debated. We evaluated the risk of spontaneous abortion in relation to the use of antidepressants during pregnancy. Methods: Using a nested case–control study design, we obtained data from the Quebec Pregnancy Registry for 5124 women who had a clinically detected spontaneous abortion. For each case, we randomly selected 10 controls from the remaining women in the registry who were matched by the case’s index date (date of spontaneous abortion) and gestational age at the time of spontaneous abortion. Use of antidepressants was defined by filled prescriptions and was compared with nonuse. We also studied the classes, types and doses of antidepressants. Results: A total of 284 (5.5%) of the women who had a spontaneous abortion had at least one prescription for an antidepressant filled during the pregnancy, as compared with 1401 (2.7%) of the matched controls (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.83–2.38). After adjustment for potential confounders, we found that the use of antidepressants during pregnancy was associated with an increased risk of spontaneous abortion (OR 1.68, 95%CI 1.38–2.06). Stratified analyses showed that use of selective serotonin reuptake inhibitors alone (OR 1.61, 95% CI 1.28–2.04), serotonin–norepinephrine reuptake inhibitors alone (OR 2.11, 95% CI 1.34–3.30) and combined use of antide-pressants from different classes (OR 3.51, 95% CI 2.20–5.61) were associated with an increased risk of spontaneous abortion. When we looked at antidepressant use by type versus no use, paroxetine use alone (OR 1.75, 95% CI 1.31–2.34) and venlafaxine use alone (OR 2.11, 95% CI 1.34–3.30) were associated with an increased risk of spontaneous abortion. Interpretation: The use of antidepressants, especially paroxetine, venlafaxine or the combined use of different classes of antidepressants, during pregnancy was associated with an increased risk of spontaneous abortion.
MANAGEMENT OF REFRACTORY SYSTEMIC RHEUMATIC DISEASES

Abstract The management of refractory systemic rheumatic diseases remains a challenging issue. New immunosuppressive drugs have been developed which might improve long-term outcome, with a reasonably toxicity profile. Moreover, better understanding of the mechanisms underlying some of the systemic rheumatic disease has raised hopes for more targeted immunointerventions. In Europe, current therapy of severe systemic rheumatic diseases (SRD) usually consists in a sequential treatment with a short course of an incisive remission-inducing immunosuppressive (IS) regimen [such as high dose glucocorticoids (GC) combined to cyclophosphamide (CYC)] followed by a long term but less toxic remission-maintaining IS regimen aimed at preventing relapses [such as low dose GC combined with azathioprine (AZA)]. This approach was recently supported by prospective studies performed in ANCA-associated vasculitis (1) and lupus nephritis (2). However, significant number of patients with SRD fail to respond to this standard regimen and treatment of these refractory cases has become one of the many rheumatologist’s nightmares. Interestingly, some recent advances in basic immunology, in our understanding of the pathogenic mechanisms operating in SRD and in biotechnology have opened new prospects, some of them already applied in clinical practice. In this paper, these features will be reviewed with systemic lupus erythematosus (SLE) as an example.
Validity of a telemedicine system for the evaluation of acute-phase retinopathy of prematurity.

IMPORTANCE The present strategy to identify infants needing treatment for retinopathy of prematurity (ROP) requires repeated examinations of at-risk infants by physicians. However, less than 10% ultimately require treatment. Retinal imaging by nonphysicians with remote image interpretation by nonphysicians may provide a more efficient strategy. OBJECTIVE To evaluate the validity of a telemedicine system to identify infants who have sufficiently severe ROP to require evaluation by an ophthalmologist. DESIGN, SETTING, AND PARTICIPANTS An observational study of premature infants starting at 32 weeks' postmenstrual age was conducted. This study involved 1257 infants with birth weight less than 1251 g in neonatal intensive care units in 13 North American centers enrolled from May 25, 2011, through October 31, 2013. INTERVENTIONS Infants underwent regularly scheduled diagnostic examinations by an ophthalmologist and digital imaging by nonphysician staff using a wide-field digital camera. Ophthalmologists documented findings consistent with referral-warranted (RW) ROP (ie, zone I ROP, stage 3 ROP or worse, or plus disease). A standard 6-image set per eye was sent to a central server and graded by 2 trained, masked, nonphysician readers. A reading supervisor adjudicated disagreements. MAIN OUTCOMES AND MEASURES The validity of grading retinal image sets was based on the sensitivity and specificity for detecting RW-ROP compared with the criterion standard diagnostic examination. RESULTS A total of 1257 infants (mean birth weight, 864 g; mean gestational age, 27 weeks) underwent a median of 3 sessions of examinations and imaging. Diagnostic examination identified characteristics of RW-ROP in 18.2% of eyes (19.4% of infants). Remote grading of images of an eye at a single session had sensitivity of 81.9% (95% CI, 77.4-85.6) and specificity of 90.1% (95% CI, 87.9-91.8). When both eyes were considered for the presence of RW-ROP, as would routinely be done in a screening, the sensitivity was 90.0% (95% CI, 85.4-93.5), with specificity of 87.0% (95% CI, 84.0-89.5), negative predictive value of 97.3%, and positive predictive value of 62.5% at the observed RW-ROP rate of 19.4%. CONCLUSIONS AND RELEVANCE When compared with the criterion standard diagnostic examination, these results provide strong support for the validity of remote evaluation by trained nonphysician readers of digital retinal images taken by trained nonphysician imagers from infants at risk for RW-ROP. TRIAL REGISTRATION clinicaltrials.gov Identifier:NCT01264276.
The symmetry energy and incompressibility constrained by the observations of glitching pulsars

We investigate the masses of glitching pulsars in order to constrain their equation of state (EOS). The observations of glitches (sudden jumps in rotational frequency) may provide information on the interior physics of neutron stars. With the assumption that glitches are triggered by superfluid neutrons, the masses of glitching neutron stars can be estimated using observations of maximum glitches. Together with the observations of thermal emission from glitching pulsars Vela and J1709–4429, the slope of symmetry energy and incompressibility of nuclear matter at saturation density can be constrained. The slope of symmetry energy L should be larger than 67 MeV while the lower limit of incompressibility for symmetric nuclear matter K0 is 215 MeV. We also obtain a relationship between L and K0: 6.173 MeV + 0.283 K0 ≤ L ≤ 7.729 MeV + 0.291 K0. The restricted EOSs are consistent with the observations of 2-solar-mass neutron stars and gravitational waves from a binary neutron star inspiral.
Response to a protease-inhibitor (ritonavir)-containing combination antiretroviral regimen in HIV-infected children.

INTRODUCTION The number of antiretroviral agents available for children who are failing existing therapy is limited. Data are lacking on the use of various combination regimens and the resulting viral load dynamics in such children. METHODS Between March 1998 and March 2000, HIV-infected children younger than 18 years of age were studied in an open trial. The study regimen included ritonavir, with at least two drugs to which the virus was known or presumed to be sensitive. Subjects were ritonavir-naive and were included if they had high viral loads while receiving antiretroviral therapy. Patients had clinical assessments, CD4 counts and viral load monitoring. RESULTS Fifteen antiretroviral-experienced HIV-infected children were enrolled. Approximately 87% (13 of 15) had perinatally-acquired HIV; median age was 7.9 years (range 1.6 to 14.8). At enrolment, the median CD4 count was 557 cells/mm(3) (range 57 to 1702) and the median viral load was 72,600 copies/mL (range 3626 to 796,440). The majority of children (73.3%) had increases in CD4 counts within 12 weeks. During this period, the median increase in CD4 counts over baseline was 30.0%. Approximately 73% (eight of 11) of subjects with initial improvements in CD4 counts had sustained increases at 32 to 48 weeks. Over the first 12 weeks, 60% (nine of 15) had greater than 0.5 log(10) decreases in viral load. The improvement was sustained in 88.9% (eight of nine) of these patients at 32 to 48 weeks. Three patients discontinued therapy due to taste aversion. CONCLUSIONS Among pediatric patients with high viral loads while on existing therapy, the ritonavir-containing regimen was generally well tolerated. In a significant proportion of patients, modification of therapy was associated with sustained improvements in viral loads and CD4 counts over 32 to 48 weeks.
Brazil’s Financial Centers in the Twenty-first Century: Hierarchy, Specialization, and Concentration

The purpose of this article is to examine how the geography of Brazil’s financial centers changed since 2000 in terms of financial center hierarchy, specialization, and spatial concentration. To address these questions, we use data on employment and mergers and acquisitions in financial and business services, complemented with data on remuneration and bank assets. Our results show that São Paulo has consolidated its dominance as Brazil’s primary financial center, with market for corporate control as an important channel of this process. Rio’s decline as a financial center, which started more than fifty years ago, has continued into this century. At the same time, Brasília has emerged as the third most important financial center of Brazil. We document the recent dynamic of this territorial division of labor, with Rio’s specialization in insurance and Brasília’s dependence on government-owned banks. Finally, we show signs that Brazil’s financial center activities might be following an inverse U-shaped pattern whereby increasing geographical concentration is followed by its slow decline. Key Words: Brazil, concentration, financial centers, São Paulo, territorial division of labor.
Asthma and smoking: still a prevailing topic

1. Divisao de Pneumologia, Instituto do Coracao, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo (SP) Brasil. In the last 20 years, there has been a significant, progressive decline in the prevalence of smoking in both genders, worldwide(1) and in Brazil,(2) where that decline has been more pronounced. From 1980 to 2012, the worldwide prevalence declined from 41.2% to 31.1% in men and from 10.6% to 6.6% in women. (1) From 1989 to 2013, the prevalence of smoking in Brazil declined from 43.3% to 18.3% in men and from 27.0% to 10.8% in women. (2,3)