Miracle-dz/UniFAR-FTUs huggingface dataset:
Neurobiological substrates of antisocial and borderline personality disorder: preliminary results of a functional fMRI study.

BACKGROUND Neuropsychological and imaging studies of patients with antisocial (ASPD) and borderline personality disorder (BPD) are suggestive of frontal lobe dysfunction in these individuals. In normal subjects functional brain imaging has been used to investigate the neuroanatomy of impulse control. There are no such imaging studies in personality-disordered populations. AIM This study aimed to investigate which neuronal networks are involved in response inhibition in Cluster B personality disorders and whether these are different from healthy subjects. HYPOTHESIS We hypothesized that the personality-disordered sample would have attenuated orbitofrontal cortex responses during performance of a Go/NoGo task compared with healthy controls. METHOD Eight inpatients with a DSM-IV diagnosis of borderline or antisocial personality disorder and eight healthy controls were scanned using fMRI while performing a Go/NoGo task. Impulsivity was assessed using the Barratt Impulsivity Scale (BIS) and the Impulsiveness-Venturesomeness-Empathy (IVE) inventory. RESULTS In the control group the main focus of activation during response inhibition was in the prefrontal cortex, specifically the right dorsolateral and the left orbitofrontal cortex. Active regions in the patient group showed a more bilateral and extended pattern of activation across the medial, superior and inferior frontal gyri extending to the anterior cingulate. CONCLUSIONS fMRI is a useful tool to detect brain activation during response inhibition. ASPD and BPD patients activate different neural networks to successfully inhibit pre-potent responses.
German Foreign Cultural and Educational Policy as a Means of Soft Power

The main focus of the following article is to highlight “foreign cultural and educational policy” as a very specific variant of educational transfer. Many countries have created specific ways and institutions to further their cultural and educational interests abroad by various cultural, educational and scientific institutes. This will be discussed by taking the example of some of the core institutions of the German Foreign Cultural and Educational Policy, namely the Goethe-Institute, German Schools Abroad and the German Academic Exchange Service, which have branches in a lot of countries around the world. These will be described and analyzed as instruments of foreign policy by applying the interpretative concept of ‘soft power’ (as propelled by Joseph Nye), also showing that their proclaimed reference to ‘cooperation’ may be considered as more or less rhetoric because it is likely to obfuscate the political self-interests behind it.
Detection of Infectious HIV in Circulating Monocytes From Patients on Prolonged Highly Active Antiretroviral Therapy

Summary: The existence of a reservoir of resting CD4+ T cells harboring latent replication‐competent HIV has been demonstrated in patients on prolonged highly active antiretroviral therapy (HAART). Latently infected tissue macrophages may constitute a second HIV reservoir. The pool of these cells may be maintained by incoming infected monocytes from blood and/or by in situ viral replication. In this study, the presence of infectious HIV was investigated in highly purified monocytes from 5 patients receiving HAART with undetectable plasma viral load for up to 16 months. HIV was detected in freshly isolated monocytes and recovered following Staphylococcus aureus Cowan strain 1 (SAC) or lipopolysaccharide (LPS) activation. No new drug resistance‐associated mutation was found in monocyte‐associated HIV. These results demonstrate the long‐term persistence of infectious virus in cells of the monocyte‐macrophage lineage in patients receiving HAART. These cells are capable of releasing infectious virus under appropriate stimulations.
Implant success in people with type 2 diabetes mellitus with varying glycemic control: a pilot study.

BACKGROUND The authors conducted a prospective cohort study to explore the relationship between implant success and glycemic control in patients with type 2 diabetes mellitus. METHODS The authors used a two-phased enrollment, stratified by glycated hemoglobin (HbA1c) levels, to evaluate 50 implants in 35 subjects. The authors assessed nonsubmerged, nonrestored implants after placement, during healing and at abutment placement (35 newton centimeters) for restoration after four months. Outcomes assessed included implant success or failure, clinical complications and adverse events. RESULTS The HbA1c levels of the subjects ranged from 4.5 to 13.8 percent. All 50 implants were integrated clinically. The authors identified three minor complications in three patients having HbA1c levels ranging from 7.4 to 8.3 percent. None of these complications affected the clinical management of the cases, and the authors did not identify any adverse events. CONCLUSIONS There was no evidence of diminished clinical success or significant early healing complications associated with implant therapy based on the glycemic control levels of subjects with type 2 diabetes mellitus. CLINICAL IMPLICATIONS These findings support the continued investigation of the effects of glycemic control on implant therapy toward the development of therapeutic guidelines that will optimize implant therapy in patients with diabetes.
Preoperative Magnetic Resonance Imaging Is Associated With Baseline Neurological Status and Can Predict Postoperative Recovery in Patients With Cervical Spondylotic Myelopathy

Study Design. A blinded observational study of consecutive patients, prospectively enrolled and followed up to 1 year postoperatively. Objective. To assess whether quantitative assessment of preoperative magnetic resonance imaging (MRI) predicts baseline patient status and postoperative neurological recovery. Summary of Background Data. Factors that can predict neurological recovery in patients with cervical spondylotic myelopathy (CSM) postoperatively are of great interest. Currently, the literature regarding the significance of MRI signal changes in relation to prognosis is inconsistent and conflicting. Methods. A total of 57 consecutive patients with CSM were studied preoperatively and 1 year postoperatively. Modified Japanese Orthopaedic Association (mJOA), Nurick Grade, SF-36, neck disability index, 30-meter walk cadence (Wc) and time (Wt), grip strength, and Berg Balance Scale were administered at baseline and 1 year after surgery. Preoperative status and postoperative recovery were assessed in relation to quantitative MRI measurements pre- and postoperatively using univariate and multivariate analysis. Results. Low T1 signal change preoperatively was associated with a lower mJOA (P = 0.0030), higher Nurick Grade (P = 0.0298), decreased grip (P = 0.0152), impaired Wt, Wc (P⩽ 0.0001) and poor Berg Balance Scale (P = 0.0005) at baseline. Focal high T2 signal was associated with lower mJOA scores and higher Nurick Grade compared with diffuse T2 (P = 0.0035 P = 0.0079) or no T2 signal (P = 0.0680 P = 0.0122). Preoperative segmentation of T2 signal, showed a significant increase in Wt, Wc, and Berg Balance Scale (P = 0.0266; P = 0.0167; P = 0.0042). Preoperative T1 signal was associated with lower postoperative grip (P = 0.0260), greater Wt, Wc (P = 0.0360, P = 0.0090). Preoperative focal T2 signal had a significant association with poorer postoperative Wt, Wc (P = 0.0220) and Nurick Grade (P = 0.0230). Preoperative maximal cord compromise was negatively correlated with postoperative SF-36 mental score (P = 0.0130). Conclusion. MRI signal changes are predictive of baseline neurological status and postoperative recovery. MRI indicators of poorer outcome include the presence of low T1 signal, focal increased T2 signal and segmentation of T2 signal changes. Level of Evidence: 2
Veiled cells in chronic idiopathic inflammatory bowel disease.

The mononuclear cell system in the human gut wall of patients with Crohn's disease (CD), ulcerative colitis (UC) and normal controls was studied, with special reference to the so called antigen presenting veiled cells. These cells have already extensively been studied in the skin and are known as Langerhans' cells in the epidermis and dermis, veiled cells in the skin lymph and interdigitating cells in lymph nodes. Recently they were also found in gut associated lymphoid tissue, i.e. Peyer's patches of the rat. Here we describe the presence of similar cells in chronic idiopathic inflammatory bowel disease (CIBD). They resemble veiled cells in moving pattern, strong Ia positivity, no or only weak acid phosphatase activity, and ultrastructure. However, many of the described cells combine these characteristics with those of phagocytic macrophages. In the gut wall of controls veiled cells were virtually absent and phagocytic macrophages were almost exclusively recognized. These findings suggest that more intensive antigen handling takes place in the gut wall of CIBD patients than in normal gut. Clear cut associations with sex, age, duration or activity of disease were not observed in this limited study, and the exact significance of the presence of such cells needs further clarification.
Low use of contraception among poor women in Africa: an equity issue.

OBJECTIVE To examine the use of contraception in 13 countries in sub-Saharan Africa; to assess changes in met need for contraception associated with wealth-related inequity; and to describe the relationship between the use of long-term versus short-term contraceptive methods and a woman's fertility intentions and household wealth. METHODS The analysis was conducted with Demographic and Health Survey data from 13 sub-Saharan African countries. Wealth-related inequities in the use of contraception were calculated using household wealth and concentration indices. Logistic regression models were fitted for the likelihood of using a long-term contraceptive method, with adjustments for: wealth index quintile, fertility intentions (to space births versus to stop childbearing), residence (urban/rural), education, number of living children, marital status and survey year. FINDINGS The use of contraception has increased substantially between surveys in Ethiopia, Madagascar, Mozambique, Namibia and Zambia but has declined slightly in Kenya, Senegal and Uganda. Wealth-related inequalities in the met need for contraception have decreased in most countries and especially so in Mozambique, but they have increased in Kenya, Uganda and Zambia with regard to spacing births, and in Malawi, Senegal, Uganda, the United Republic of Tanzania and Zambia with regard to limiting childbearing. After adjustment for fertility intention, women in the richest wealth quintile were more likely than those in the poorest quintile to practice long-term contraception. CONCLUSION Family planning programmes in sub-Saharan Africa show varying success in reaching all social segments, but inequities persist in all countries.
Magnetic Resonance Imaging and Intraoperative Frozen Sectioning for the Evaluation of Risk Factors Associated With Lymph Node Metastasis in Endometrial Cancer

Introduction To analyze the accuracy of magnetic resonance imaging (MRI) and intraoperative frozen sectioning (IFS) for predicting the low- and high-risk patients and risk factors associated with lymph node (LN) metastasis in patients with surgically staged endometrial cancer. Methods The medical records of 175 patients with endometrial cancer who underwent comprehensive surgical staging including pelvic and para-aortic LN dissection between January 2008 and July 2011 were retrospectively analyzed. Results of MRI and IFS of the uterus for the evaluation of risk factors were correlated with final pathology. Results Our results showed a high specificity and negative predictive value of MRI and IFS for the evaluation of myometrial invasion and cervical stromal invasion. Of the 41 patients identified as low risk by both MRI and IFS, none had pelvic or para-aortic LN metastases in the final pathology. Conclusions The results indicate that MRI and IFS may be useful for the evaluation of risk factors associated with LN metastasis in patients with endometrial cancer. Magnetic resonance imaging and IFS can be used to accurately identify low-risk patients who do not need comprehensive surgical staging and may prevent unnecessary lymphadenectomy.
Less Alimony After Divorce – Spouses' Behavioral Response to the 2008 Alimony Reform in Germany

The 2008 alimony reform in Germany considerably reduced post-marital and caregiver alimony. We analyze how individuals adapted to these changed rulings in terms of labor supply, the intra-household allocation of leisure, and marital stability. We use the German Socio-Economic Panel (SOEP) and conduct a difference-in-difference analysis to investigate couples' behavioral responses to the reform. The results do not confirm theoretical expectations from labor supply and household bargaining models. In particular, we do not find evidence that women increase their labor supply as a result of the negative expected income effect. Neither do our results reveal that leisure is shifted from women to men as a response to the changed bargaining positions. In contrast, we find evidence that the reform has led to an increase in the probability to separate for married as opposed to non-married cohabiting couples.
Lymphocyte/monocyte ratio in osteoarticular tuberculosis in children: a haematological biomarker revisited

Introduction *Work attributed to Department of Pediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi-110031(India) This study tested the hypothesis whether the lymphocyte/monocyte ratio (L/M ratio) altered significantly during treatment of paediatric osteoarticular tuberculosis (OATB) for it to be a useful monitor of the response to therapy. Material and methods Thirty immunocompetent paediatric patients with OATB treated with 6 months of uninterrupted multidrug anti-tubercular treatment with resultant clinical and radiological healing of the lesion were included. Haemoglobin, total leucocyte, monocyte and lymphocyte count, and erythrocyte sedimentation rate (ESR) were collected at 0, 2 and 6 months, and were analysed. Results The L/M ratio altered from high (11) at the start of treatment towards normalisation (9) at 2 months and (7.7) at 6 months. There was no correlation with declining ESR levels. Conclusions The L/M ratio may have potential as an effective biomarker response.
Rheumatoid arthritis and salivary biomarkers of periodontal disease.

AIM To test the hypothesis that rheumatoid arthritis (RA) influenced levels of salivary biomarkers of periodontal disease. METHODS Medical assessments, periodontal examinations and pain ratings were obtained from 35 RA, 35 chronic periodontitis and 35 age- and gender-matched healthy controls in a cross-sectional, case-controlled study. Unstimulated whole saliva samples were analysed for interleukin-1β (IL-1β), matrix metalloproteinase-8 (MMP-8) and tumour necrosis factor-α (TNF-α) concentrations. RESULTS The arthritis and healthy groups had significantly less oral disease than the periodontitis group (P<0.0001), with the arthritis group having significantly more sites bleeding on probing (BOP) than matched controls (P=0.012). Salivary levels of MMP-8 and IL-1β were significantly elevated in the periodontal disease group (P<0.002), and IL-1β was the only biomarker with significantly higher levels in the arthritis group compared with controls (P=0.002). Arthritis patients receiving anti-TNF-α antibody therapy had significantly lower IL-1β and TNF-α levels compared with arthritis patients not on anti-TNF-α therapy (P=0.016, 0.024) and healthy controls (P<0.001, P=0.011), respectively. CONCLUSION RA patients have higher levels of periodontal inflammation than healthy controls, i.e., an increased BOP. Systemic inflammation appears to influence levels of select salivary biomarkers of periodontal disease, and anti-TNF-α antibody-based disease-modifying therapy significantly lowers salivary IL-1β and TNF-α levels in RA.
Hyperthermia is not an independent predictor of greater mortality in patients with primary intracerebral hemorrhage.

BACKGROUND Our goal was to identify independent early predictors of 30-day mortality in patients with medically treated primary intracerebral hemorrhage (PICH), and to assess the prognostic significance of hyperthermia in these cases MATERIAL/METHODS We prospectively studied 152 patients with supratentorial PICH confirmed by CT on admission. We recorded gender, age, severity of neurological deficit on admission (Scandinavian Stroke Scale), level of consciousness at admission and one day later, and maximum body temperature for the first three days after onset. Hematoma size and midline shift were assessed by CT scans. Outcome was measured by either mortality or Barthel Index functional status 30 days after stroke. RESULTS 59 patients (38.8%) died within 30 days. Patients who died had greater neurological deficit on admission and higher maximum temperature within the first 24 hours after admission, and were more likely to have impaired consciousness on admission and after 24 hours, as well as large hematoma and midline shift (P<0.05 for all differences). However, statistically only severity of neurological deficit was an independent predictor of 30-day mortality. The functional status of survivors who had hyperthermia was much worse than those who were normothermic on Day 1. CONCLUSIONS The severity of neurological deficit predicts greater 30-day mortality in patients with primary intracerebral hemorrhage. Patients with hyperthermia on the first day of hospitalization have greater 30-day mortality and worse functional status 30 days after stroke, but increased body temperature is not an independent predictor of 30-day mortality after PICH.
The impact of using different costing methods on the results of an economic evaluation of cardiac care: microcosting vs gross-costing approaches.

BACKGROUND Published guidelines on the conduct of economic evaluations provide little guidance regarding the use and potential bias of the different costing methods. OBJECTIVES Using microcosting and two gross-costing methods, we (1) compared the cost estimates within and across subjects, and (2) determined the impact on the results of an economic evaluation. METHODS Microcosting estimates were obtained from the local health region and gross-costing estimates were obtained from two government bodies (one provincial and one national). Total inpatient costs were described for each method. Using an economic evaluation of sirolimus-eluting stents, we compared the incremental cost-utility ratios that resulted from applying each method. RESULTS Microcosting, Case-Mix-Grouper (CMG) gross-costing, and Refined-Diagnosis-Related grouper (rDRG) gross-costing resulted in 4-year mean cost estimates of $16,684, $16,232, and $10,474, respectively. Using Monte Carlo simulation, the cost per QALY gained was $41,764 (95% CI: $41,182-$42 346), $42,538 (95% CI: $42 167-$42 907), and $36,566 (95% CI: $36,172-$36,960) for microcosting, rDRG-derived and CMG-derived estimates, respectively (P<0.001). CONCLUSIONS Within subject, the three costing methods produced markedly different cost estimates. The difference in cost-utility values produced by each method is modest but of a magnitude that could influence a decision to fund a new intervention.
Positive Pressure Ventilation with the Open Lung Concept Optimizes Gas Exchange and Reduces Ventilator-Induced Lung Injury in Newborn Piglets

Previous studies demonstrated that high-frequency oscillatory ventilation using the open lung concept (OLC) resulted in superior gas exchange and a reduction in ventilator-induced lung injury (VILI). We hypothesized that these beneficial effects could also be achieved by applying the OLC during positive pressure ventilation. After repeated whole-lung-lavage, newborn piglets were assigned to either OLC positive pressure ventilation (PPVOLC), OLC high-frequency oscillatory ventilation (HFOVOLC), or conventional positive pressure ventilation (PPVCON) and ventilated for 5 h. In both OLC groups, collapsed alveoli were actively recruited and thereafter stabilized using the lowest possible airway pressures. In the PPVCON group, ventilator settings were adjusted to prevent critical hypoxia. Airway pressure, blood gas analysis, pressure-volume curve, and alveolar protein infiltration was recorded. A lung injury score was used for histologic comparison. Mean airway pressures were comparable in the three ventilation groups over time (1.2-1.5 kPa). Arterial oxygenation increased to mean values above 60 kPa in both OLC groups compared with 10 kPa in the PPVCON group (p < 0.001). Maximal lung compliance was superior in both OLC groups (PPVOLC: 91 ± 23; HFOVOLC: 90 ± 31 mL/kPa/kg, p < 0.01) compared with the PPVCON group (39 ± 14 mL/kPa/kg). Alveolar protein infiltration was significantly reduced in the PPVOLC group (0.33 ± 0.10 mg/mL, p < 0.01) and the HFOVOLC group (0.40 ± 0.13 mg/mL, p < 0.01) compared with the PPVCON group (0.70 ± 0.15 mg/mL). Lung injury scores were significantly higher in the PPVCON group (33.5 ± 9.5, p < 0.01) compared with both OLC groups (PPVOLC: 10.5 ± 2.6; HFOVOLC: 11 ± 2.2). There were no differences between the two OLC groups. We conclude that, in surfactant-depleted newborn piglets, application of the OLC during PPV is feasible and results in superior gas exchange and a reduction in VILI compared with conventional PPV. These beneficial effects are comparable to HFOV.
Prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy.

PURPOSE We report on a prospective randomized comparison of transperitoneal versus retroperitoneal laparoscopic radical nephrectomy for renal tumor. MATERIALS AND METHODS Between June 1999 and June 2001, 102 consecutive eligible patients with a computerized tomography identified renal tumor were prospectively randomized to undergo either a transperitoneal (group 1, 50 patients) or retroperitoneal (group 2, 52 patients) laparoscopic radical nephrectomy with intact specimen extraction. Exclusion criteria for the study included body mass index greater than 35 or a history of prior major abdominal surgery in the quadrant of interest. Both groups were matched regarding age (63 versus 65 years, p = 0.69), BMI (29 versus 28, p = 0.89), American Society of Anesthesiologists class (2.7 versus 2.8, p = 0.37), laterality (right side 46% versus 48%, p = 0.85) and mean tumor size (5.3 versus 5.0 cm, p = 0.73). RESULTS All 102 procedures were technically successful without the need for open conversion. Compared to the transperitoneal approach, the retroperitoneal approach was associated with a shorter time to renal artery control (91 versus 34 minutes, p <0.0001), shorter time to renal vein control (98 versus 45 minutes, p <0.0001) and shorter total operative time (207 versus 150 minutes, p = 0.001). However, the transperitoneal and retroperitoneal approaches were similar in terms of estimated blood loss (180 versus 242 cc, p = 0.13), hospital stay (43 versus 45 hours, p = 0.55), intraoperative complications (10% versus 7.7%, p = 0.30), postoperative complications (20% versus 13.5%, p = 0.14) and postoperative analgesia requirements (27 versus 26 mg MSO4 equivalent p = 0.13). Pathology revealed renal cell carcinoma in 84% and 75% of cases, respectively, with no positive surgical margin in any case. CONCLUSIONS Laparoscopic radical nephrectomy can be performed efficiently and effectively with the transperitoneal or the retroperitoneal approach. While renal hilar control and total operative time may be quicker with retroperitoneoscopy, the approaches are similar in terms of other patient outcomes evaluated.