Miracle-dz/UniFAR-FTUs huggingface dataset:
Pharmacotherapy of paraphilias in the next millennium.

Paraphilias are psychiatric disorders of abnormal sexual behavior whose prevalence has markedly increased during the last decade. Treatment modalities currently used fall into three categories: surgical castration, psychotherapy, and pharmacotherapy. The pharmacological interventions consist of antiandrogens that either completely reduce testosterone secretion and/or antagonize the action of testosterone at the level of the receptor, and psychotropic drugs, namely antidepressants. Cyproterone and medroxyprogesterone acetates are the two antiandrogens more commonly used. They are only effective in relatively high doses, but have a substantial number of severe side effects which has considerably limited their use. Psychotropic drugs may be effective solely in men with a definite obsessive-compulsive disorder component. Because of the erratic results and lack of permanent eradication of the paraphilic manifestations their use in paraphilias is highly controversial. Long-acting gonadotropin-releasing hormone (GnRH) agonist analogues are the most potent antiandrogens, and selectively abolish testosterone secretion in a totally reversible fashion. They are administered parenterally once every 1 to 3 months, and have the fewest side effects. Long-acting GnRH analogues, together with psychotherapy, are highly effective in controlling selected paraphilias (pedophilia, exhibitionism, and voyeurism), and are the most promising mode of therapy in the next millennium. There is an urgent need for good methodological research; carefully designed double-blind controlled studies with a large number of subjects in order to validate or not the use of the various pharmacotherapies.
Measuring diagnostic accuracy in the absence of a "gold standard".

OBJECTIVE As the nation debates issues of national health care reform, psychiatrists seek equal status with other medical colleagues. To defend psychiatry in the national arena, the accuracy of psychiatric diagnoses must be measured. Indexes of accuracy such as sensitivity and specificity provide valuable information, yet they are rarely computed because there is no "gold standard" with which to compare them. The goal of this article is to show how this problem can be overcome and to encourage nosologists to use accuracy statistics in assessing the adequacy of psychiatric diagnoses. METHOD The authors reviewed the literature on medical decision making to find methodological approaches to assessing diagnostic accuracy in the absence of gold standards. RESULTS A lack of such standards is not unique to psychiatry and has been addressed with a variety of novel analytic procedures. Although these methods differ in many respects, each recognizes that the conventional 2 x 2 table of interrater agreement does not provide enough data for estimating diagnostic accuracy. After defining the data needed, each method provides a mathematical model that estimates accuracy statistics and the prevalence of a disorder. Most of these methods are variants of latent class analysis. The authors reanalyzed data from one of the reviewed papers to show that similar inferences about accuracy of diagnoses could be drawn from a conventional latent class analysis. CONCLUSIONS There are potential pitfalls in using latent structure methods, but their cautious use would provide valuable information for psychiatric nosology. These methods supplement, but do not replace, data about outcome, family history, laboratory studies, and other validating criteria in making accurate diagnoses.
Stress hormones enhance retrieval of fear conditioning acquired either one day or many months before

It has been known for years that systemic administration of the stress hormones, adrenocorticotrophin (ACTH), lysine-vasopressin, adrenaline, or &bgr;-endorphin, enhances retrieval of aversive behaviours acquired one or a few days before. Here we show that the pre-test i.p. injection of the hormones in rats can also enhance retrieval when given months after the original training. The effectiveness of the treatments changed with time. When animals were tested 3 months after training the hormones enhanced retrieval only at doses five times higher than those needed 1 day after training. Between 6 and 9 months from training the hormones either lost their effect (vasopressin, &bgr;-endorphin) or actually inhibited retrieval (ACTH, adrenaline). The effects of the hormones cannot be explained by a decrease in locomotor activity: none of the treatments had such an effect, as measured in an open field. However, when the animals were tested between 12 and 19 months after training, the hormones once again became as effective as they had been 1 day after training. This was so in spite of the fact that control retention levels became very low with age, probably as a result of extinction. The oscillation of the sensitivity of retrieval to the hormones does not appear to depend on changes in anxiety levels with ageing or to effects of the hormones on locomotor activity.
Meaning in Life in Three Samples of Elderly Persons with High Cognitive Functioning

The study examined the relationships between meaning in life and cognitive functioning in three elderly samples. The participants in Sample I were 78 persons aged 82–87, in Sample II 182 persons aged 83–92, and in Sample III 299 persons aged 65—69. The samples took part in interviews and cognitive tests in 1996–1997. Several interview questions together with the Sense of Coherence questionnaire were used to study the degree and content of meaning in life. Cognitive functioning was measured by Digit Span, Digit Symbol, and Word Fluency in Sample I and Mini-D in Samples II and III. Each sample was divided into the group of persons with high cognitive functioning (including those whose results in cognitive tests fell in the top third of their age cohort) and the comparison group (including the rest of the sample). The analysis showed no difference between the groups in the degree of meaning in life in any of the three samples. The content of meaning in life differed in the two groups: human relationships were reported as a reason for meaning in life and a source of strength in life more often by the persons with high cognitive functioning than by the comparison group. Moreover, those with high cognitive functioning reported that they had taken up a new activity (especially one involving social interests) that gave a sense of meaning in life after retirement more often than the comparison group. Death had positive meaning for the majority of the participants and the groups did not differ in meaning of death. The interactions between the various measures of meaning in life showed that having a sense of coherence and zest for life were factors related to the sense of meaningfulness in life. Meaning of death was not related to other measures.
Does Primary Hip Arthroscopy Result in Improved Clinical Outcomes?

Background: Hip arthroscopy has gained increasing popularity over the past decade. The need to develop metrics to evaluate success and complications in primary hip arthroscopy is an important goal. Purpose: To evaluate 2-year patient-related outcome (PRO) scores and patient satisfaction scores for a single surgeon at a high-volume referral center for all primary hip arthroscopy procedures performed. Study Design: Case series; Level of evidence, 4. Methods: During the study period between April 2008 and October 2011, data were collected on all patients who underwent primary hip arthroscopy. All patients were assessed pre- and postoperatively with 4 PRO measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), and Hip Outcome Score–Sport-Specific Subscale (HOS-SSS). Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. The number of patients who underwent revision arthroscopy, total hip arthroplasty (THA), or a resurfacing procedure during the study period was also reported. Results: A total of 595 patients were included in the study. The score improvement from preoperative to 2-year follow-up was 61.29 to 82.02 for mHHS, 62.79 to 83.05 for HOS-ADL, 40.96 to 70.07 for HOS-SSS, 57.97 to 80.41 for NAHS, and 5.86 to 2.97 for VAS. All scores were statistically significantly different (P < .0001). Overall patient satisfaction was 7.86 ± 2.3 (range, 1-10). Forty-seven (7.7%) patients underwent revision hip arthroscopy, and 54 (9.1%) patients underwent either THA or the hip resurfacing procedure during the study period. The multivariate regression analysis showed that increased age at time of surgery was a significant risk factor for conversion to THA, revision arthroscopy, and change in NAHS <10 points. Acute injury, acetabuloplasty, iliopsoas release, and patient sex were significant for 2 of these 3 types of failure. Conclusion: Primary hip arthroscopy for all procedures performed in aggregate had excellent clinical outcomes and patient satisfaction scores at short-term follow-up in this study. More studies must be conducted to determine the definition of a successful outcome. There was a 6.1% minor complication rate, which was consistent with previous studies. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty as well as the potential for revision surgery.
Treatment outcomes of extracorporeal septoplasty compared with in situ septal correction in rhinoplasty.

IMPORTANCE Extracorporeal septoplasty (ECS) in rhinoplasty is a useful surgical procedure that can achieve considerable functional and aesthetic improvements in the treatment of a deviated nose. However, to our knowledge, no study has compared the treatment outcomes of ECS with those of in situ septal correction (ISSC) in rhinoplasty. OBJECTIVE To compare the surgical outcomes of ECS with those of conventional ISSC in the treatment of a deviated nose. DESIGN, SETTING, AND PARTICIPANTS We retrospectively reviewed the medical records of 169 patients who underwent rhinoplasty from July 1, 2006, through December 31, 2012. For ECS, we used a modified technique. For ISSC, several techniques, including batten and spreader grafting and caudal cutting and suture, were used alone or in combination. Eighty-four patients underwent ECS. The remaining 85 patients, who were age- and sex-matched controls who were operated on at a similar time point, were treated by ISSC for the correction of a deviated nose. MAIN OUTCOMES AND MEASURES Surgical outcomes were assessed and compared using the anthropometric measurement of photographs and by reviewing medical records to evaluate functional outcomes and complications after surgery. RESULTS There were 52 I-shape (61.9%) and 32 C-shape (38.1%) types of external nose deviations in the ECS group. There were 59 I-shape (69.4%) and 26 C-shape (30.6%) types of external nose deviations in the ISSC group. Postoperative deviation angle (P < .001), nasofrontal (P < .05) and nasolabial (P < .001) angles, and nasal tip projection (P < .001) values were significantly improved from the preoperative values in both groups. The mean operating times of ECS and ISSC were 135 and 128 minutes, respectively. The rates of complications, such as an irregular contour of the dorsum, saddling, and postoperative infection, were similar between the 2 groups. However, no patients in the ECS group experienced postoperative nasal obstruction, whereas 5 of 78 patients (6.4%) in the ISSC group experienced persistent or unresolved nasal obstruction that required revision septoplasty. CONCLUSIONS AND RELEVANCE We found that ECS is a useful technique for markedly deviated noses that can achieve a comparable aesthetic success but better functional outcome than ISSC in rhinoplasty. LEVEL OF EVIDENCE 3.
Pulse pressure and mortality in older people.

BACKGROUND In older people, observational data are unclear concerning the relationships of systolic and diastolic blood pressure with cardiovascular and total mortality. We examined which combinations of systolic, diastolic, pulse, and mean arterial pressure best predict total and cardiovascular mortality in older adults. METHODS In 1981, the National Institute on Aging initiated its population-based Established Populations for Epidemiologic Studies of the Elderly in 3 communities. At baseline, 9431 participants, aged 65 to 102 years, had blood pressure measurements, along with measures of medical history, use of medications, disability, and physical function. During an average follow-up of 10. 6 years among survivors, 4528 participants died, 2304 of cardiovascular causes. RESULTS In age- and sex-adjusted survival analyses, the lowest overall death rate occurred among those with systolic pressure less than 130 mm Hg and diastolic pressure 80 to 89 mm Hg; relative to this group, the highest death rate occurred in those with systolic pressure of 160 mm Hg or more and diastolic pressure less than 70 mm Hg (relative risk, 1.90; 95% confidence interval, 1.47-2.46). Both low diastolic pressure and elevated systolic pressure independently predicted increases in cardiovascular (P<.001) and total (P<.001) mortality. Pulse pressure correlated strongly with systolic pressure (R = 0.82) but was a slightly stronger predictor of both cardiovascular and total mortality. In a model containing pulse pressure and other potentially confounding variables, diastolic pressure (P =.88) and mean arterial pressure (P =.11) had no significant association with mortality. CONCLUSIONS Pulse pressure appears to be the best single measure of blood pressure in predicting mortality in older people and helps explain apparently discrepant results for low diastolic blood pressure.
What is the Point? Evaluating the Structure, Color, and Semantic Traits of Computer Vision Point Clouds of Vegetation

Remote sensing of the structural and spectral traits of vegetation is being transformed by structure from motion (SFM) algorithms that combine overlapping images to produce three-dimensional (3D) red-green-blue (RGB) point clouds. However, much remains unknown about how these point clouds are used to observe vegetation, limiting the understanding of the results and future applications. Here, we examine the content and quality of SFM point cloud 3D-RGB fusion observations. An SFM algorithm using the Scale Invariant Feature Transform (SIFT) feature detector was applied to create the 3D-RGB point clouds of a single tree and forest patches. The fusion quality was evaluated using targets placed within the tree and was compared to fusion measurements from terrestrial LIDAR (TLS). K-means clustering and manual classification were used to evaluate the semantic content of SIFT features. When targets were fully visible in the images, SFM assigned color in the correct place with a high accuracy (93%). The accuracy was lower when targets were shadowed or obscured (29%). Clustering and classification revealed that the SIFT features highlighted areas that were brighter or darker than their surroundings, showing little correspondence with canopy objects like leaves or branches, though the features showed some relationship to landscape context (e.g., canopy, pavement). Therefore, the results suggest that feature detectors play a critical role in determining how vegetation is sampled by SFM. Future research should consider developing feature detectors that are optimized for vegetation mapping, including extracting elements like leaves and flowers. Features should be considered the fundamental unit of SFM mapping, like the pixel in optical imaging and the laser pulse of LIDAR. Under optimal conditions, SFM fusion accuracy exceeded that of TLS, and the two systems produced similar representations of the overall tree shape. SFM is the lower-cost solution for obtaining accurate 3D-RGB fusion measurements of the outer surfaces of vegetation, the critical zone of interaction between vegetation, light, and the atmosphere from leaf to canopy scales.
Experimental demonstration of the system performance degradation due to the combined effect of polarization-dependent loss with polarization-mode dispersion

The combined effect of polarization-mode dispersion (PMD) and polarization-dependent loss (PDL) is investigated experimentally using a recirculating fiber-loop testbed for 10-Gb/s nonreturn-to-zero transmissions over an 800-km fiber link. We find that the PDL of inline components combined with the link PMD will increase the penalty distribution. As the average link PDL varies from 1.0 to 2.1 dB with an average PMD of 18 ps, the system penalty distribution tail at 2% probability increases from 2.5 to 4.3 dB.
Substance P and vasoactive intestinal polypeptide but not calcitonin gene-related peptide concentrations are reduced in patients with moderate and severe ulcerative colitis.

BACKGROUND AND AIMS Ulcerative colitis is a chronic inflammatory condition characterized by an altered intestinal immunoinflammatory response. Since increasing evidence indicates that neuropeptides play a key role in the regulation of gastrointestinal immune function, the aims of this study were: a) to determine tissue and plasma levels of Vasoactive Intestinal Polypeptide, Substance P, and Calcitonin Gene-Related Peptide in patients with ulcerative colitis, and b) to ascertain whether a relationship exists between tissue concentrations of neuropeptides and the histological grading of mucosal inflammation. METHODS A total of 29 patients with active and 39 with inactive ulcerative colitis, and 16 control subjects took part in the study. Biopsy specimens of colonic mucosa and blood samples were obtained from each subject, and neuropeptide concentrations were measured by sensitive and specific radioimmunoassays. RESULTS Both Vasoactive Intestinal Polypeptide and Substance P concentrations were found to be significantly reduced in endoscopic biopsy specimens of patients with ulcerative colitis compared to controls (p < 0.01 and p = 0.05, respectively), and the reduction appeared to be related to the degree of mucosal inflammation; in contrast, Calcitonin Gene-Related Peptide tissue levels were unchanged. In addition, there was no significant difference in the neuropeptide plasma levels between ulcerative colitis patients and control subjects. CONCLUSIONS Taken together, our results suggest that the reduction of Vasoactive Intestinal Polypeptide and Substance P is probably a secondary phenomenon, correlated with the degree of mucosal inflammation; whatever the mechanism, the decreased availability of these neuropeptides in the local microenvironment may play an important role in the pathogenesis of ulcerative colitis, by affecting many components of the normal immune response. Moreover, based on our data, the measurement of neuropeptide plasma concentrations does not appear to be a useful tool to monitor disease activity.
Cobalt speciation and bioavailability in marine organisms

We describe comparative studies, using double-radiolabelling techniques, on the uptake and retention of cobalt species in a simple marine food chain which includes phytoplankton (Dunaliella tertiolecta and Chaetoceros pseudocurviseturn), mixed copepods (mainly Centropages sp.), and fish (the sea perch Serranus scnba). Retention of cobalt from the diet was also studied for the latter 2 organisms. Phytoplankton accumulated more than 60 times as much Co-cobalarnine as CoC12 from the water, and retained the metal for a significantly longer period (a retention half-time of 4.4 vs 0.6 d). Accumulation of CoC12 after ingestion of radiolabelled phytoplankton by copepods was not measurable, whereas retention of Co-cobalamine reached 42 % of the quantities ingested. Fish accumulated Co-cobalamine 21 times more rapidly from seawater than CoClz and retained ingested Co-cobalamine 20 times more efficiently (100 %) than ingested CoC12 (5 %). Two thirds of the ingested Co-cobalamine was retained in the fish with a retenhon half-time of 8 d. The remaining one third of the organic form was retained with a half-time of 54 d, a value which was not significantly different from that of CoClz (47 d). The results of other experiments indicated that the Co-cobalamine complex was stable in freshwater and in both 0.22 and 10 &m filtered seawater for at least several weeks. Potential size effects on cobalt intake in the diet are discussed, as are size effects on long-term loss rates of the metal. The application of the measured parameters in a simple biokinetic model shows that preferential accumulation of the Co-cobalamine con~plex over inorganic cobalt species In the food web could explain the cobalt concentrations measured in marine organisms.
Pal Lipoprotein of Escherichia coli Plays a Major Role in Outer Membrane Integrity

ABSTRACT The Tol-Pal system of gram-negative bacteria is composed of five proteins. TolA, TolQ, and TolR are inner membrane proteins, TolB is a periplasmic protein, and Pal, the peptidoglycan-associated lipoprotein, is anchored to the outer membrane. In this study, the roles of Pal and major lipoprotein Lpp were compared in Escherichia coli. lpp and tol-pal mutations have previously been found to perturb the outer membrane permeability barrier and to cause the release of periplasmic proteins and the formation of outer membrane vesicles. In this study, we showed that the overproduction of Pal is able to restore the outer membrane integrity of an lpp strain but that overproduced Lpp has no effect in a pal strain. Together with the previously reported observation that overproduced TolA complements an lpp but not a pal strain, these results indicate that the cell envelope integrity is efficiently stabilized by an epistatic Tol-Pal system linking inner and outer membranes. The density of Pal was measured and found to be lower than that of Lpp. However, Pal was present in larger amounts compared to TolA and TolR proteins. The oligomeric state of Pal was determined and a new interaction between Pal and Lpp was demonstrated.
Scanning electron microscope study of Saccharomyces cerevisiae spheroplast formation

A suspension of Saccharomyces cerevisiae NCY366 in buffered 1.2 M sorbitol containing Zymolyase-5000 (a beta-glucanase-containing preparation/showed maximum osmotic sensitivity after 30 min of incubation at 30 degrees C. A scanning electron microscope study of spheroplast formation, using a very high resolution (4-nm) machine, revealed several new morphological features. The surface of the plug in bud scars on intact cells appeared warty. The wall, which assumed a beady appearance as digestion proceded, ultimately sloughed off to reveal the furrowed surface of the plasma membrane. Bud scars were resistant to digestion and. as incubation proceeded, they became surrounded by an outer annulus, which may be the seconary septum. Wall material was completely removed from the majority of cells only after 60 min of digestion. The surface of spheroplasts was studded with particles, about 25 to 30 nm in diameter. Many spheroplasts had a single large indentation, which may be in that part of the plasma membrane originally underlying the birth scar.
TWO CLINICAL PROBLEMS IN ELDERLY MEN: OSTEOPOROSIS AND ERECTILE DYSFUNCTION

Seventy-six of 108 random men aged 50 years or over were evaluated for erectile dysfunction with interviews of patients using the International Index of Erectile Function Form and minimal evaluation. Serum hormone concentrations were measured. Bone mineral density was measured using dual energy x-ray absorptiometry. Hormone levels did not show significance in terms of erectile dysfunction or bone mineral density results. Erectile dysfunction was determined in 57 (75%) of 76 patients. Ten (13.2%) patients had osteoporosis and 45 (59.2%) had osteopenia at the bone mineral density measurements. The distribution of bone mineral density groups relating to erectile dysfunction did not show significance. The frequencies of osteoporosis and erectile dysfunction increased with age, but the association of these conditions seems to be independent of each other and hormonal changes appear not to be the major determinants for both conditions in elderly men.