Miracle-dz/UniFAR-FTUs huggingface dataset:
Subjective complaints after acquired brain injury: presentation of the Brain Injury Complaint Questionnaire (BICoQ)

The objective of the present study was to present a new complaint questionnaire designed to assess a wide range of difficulties commonly reported by patients with acquired brain injury. Patients (n = 619) had been referred to a community re‐entry service at a chronic stage after brain injury, mainly traumatic brain injury (TBI). The Brain Injury Complaint Questionnaire (BICoQ) includes 25 questions in the following domains: cognition, behavior, fatigue and sleep, mood, and somatic problems. A self and a proxy questionnaire were given. An additional question was given to the relative, about the patient's awareness of his difficulties. The questionnaires had a good internal coherence, as measured with Cronbach's alpha. The most frequent complaints were, in decreasing order, mental slowness, memory troubles, fatigue, concentration difficulties, anxiety, and dual tasking problems. Principal component analysis with varimax rotation yielded six underlying factors explaining 50.5% of total variance: somatic concerns, cognition, and lack of drive, lack of control, psycholinguistic disorders, mood, and mental fatigue/slowness. About 52% of patients reported fewer complaints than their proxy, suggesting lack of awareness. The total complaint scores were not significantly correlated with any injury severity measure, but were significantly correlated with disability and poorer quality of life (Note: only factor 2 [cognition/lack of drive] was significantly related to disability.) The BICoQ is a simple scale that can be used in addition to traditional clinical and cognitive assessment measures, and to assess awareness of everyday life problems.
Antidiabetic, antihyperlipidaemic, and antioxidant activity of Syzygium densiflorum fruits in streptozotocin and nicotinamide-induced diabetic rats

Abstract Context Syzygium densiflorum Wall. ex Wight & Arn (Myrtaceae) has been traditionally used by local tribes of the Nilgiris, Tamil Nadu, India, for the treatment of diabetes, however, no definitive experimental studies are available. Objective This study investigates the antidiabetic, antihyperlipidaemic and antioxidant activities of ethanol extract of S. densiflorum (EFSD) fruits in streptozotocin (STZ) and nicotinamide (NA)-induced diabetic rats. Materials and methods Acute oral toxicity and oral glucose tolerance were assessed in normal rats. The antidiabetic, antihyperlipidaemic and antioxidant activities were investigated in STZ − NA-induced diabetic rats. Diabetic rats were orally administered with glibenclamide (10 mg/kg b.wt), EFSD (200, 400 and 800 mg/kg b.wt) for 28 d. Further, changes in the blood glucose level (BGL), biochemical parameters, antioxidants were observed and histology of pancreas was performed. Results No toxicity and lethality were observed. Results of the following parameters are represented by treated versus disease control (STZ + NA) groups. BGL (161.33 ± 22.8 versus 476.17 ± 56.58 mg/dl), glycosylated haemoglobin (5.285 ± 0.19 versus 8.05 ± 0.55%), urea (40.32 ± 1.96 versus 75.37 ± 2.91 mg/dl), uric acid (1.2 ± 0.07 versus 2.16 ± 0.05 mg/dl), total cholesterol (89.3 ± 5.14 versus 139.7 ± 5.95 mg/dl) and triglycerides (79.65 ± 2.52 versus 108.9 ± 3.61 mg/dl) were significantly decreased, whereas haemoglobin (11.75 ± 0.73 versus 7.95 ± 0.42 g/dl), high‐density lipoprotein cholesterol (14.2 ± 1.11 versus 6.97 ± 0.84 mg/dl), total protein (45%) and liver glycogen (87%) were significantly increased in EFSD-treated diabetic group. Significant changes were observed in the enzymatic and non-enzymatic antioxidants in EFSD-treated groups (p < 0.001). Histopathological examination showed the regeneration of β-cells in Islets of Langerhans. Conclusion This study confirms the antidiabetic, antihyperlipidaemic and antioxidant activities of S. densiflorum fruits.
Heparin Thromboprophylaxis in Medical-Surgical Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Trials*

Objective:Venous thromboembolism prevention during critical illness is a widely used quality metric. The objective of this systematic review was to systematically review the efficacy and safety of heparin thromboprophylaxis in medical-surgical patients in the ICU. Data Sources:We searched EMBASE, MEDLINE, the Cochrane Controlled Trials Register, Clinicaltrials.gov, and personal files through May 2012. Study Selection:Randomized trials in adult medical-surgical ICU patients comparing any heparin (unfractionated heparin or low-molecular-weight heparin) with each other or no anticoagulant prophylaxis, evaluating deep vein thrombosis, pulmonary embolism, major bleeding, or mortality. Data Extraction:Independently, in duplicate, we abstracted trial characteristics, outcomes, and risk of bias. Data Synthesis:Seven trials involved 7,226 patients. Any heparin thromboprophylaxis compared with placebo reduced rates of deep vein thrombosis (pooled risk ratio, 0.51 [95% CI, 0.41, 0.63]; p < 0.0001; I2 = 77%) and pulmonary embolism (risk ratio, 0.52 [95% CI, 0.28, 0.97]; p = 0.04; I2 = 0%) but not symptomatic deep vein thrombosis (risk ratio, 0.86 [95% CI, 0.59, 1.25]; p = 0.43). Major bleeding (risk ratio, 0.82 [95% CI, 0.56, 1.21]; p = 0.32; I2 = 50%) and mortality (risk ratio, 0.89 [95% CI, 0.78, 1.02]; p = 0.09; I2 = 0%) rates were similar. Compared with unfractionated heparin, low-molecular-weight heparin reduced rates of pulmonary embolism (risk ratio, 0.62 [95% CI, 0.39, 1.00]; p = 0.05; I2 = 53%) and symptomatic pulmonary embolism (risk ratio, 0.58 [95% CI, 0.34, 0.97]; p = 0.04) but not deep vein thrombosis (risk ratio, 0.90 [95% CI, 0.74, 1.08]; p = 0.26; I2 = 0%), symptomatic deep vein thrombosis (risk ratio, 0.87 [95% CI, 0.60, 1.25]; p = 0.44; I2 = 0%), major bleeding (risk ratio, 0.97 [95% CI, 0.75, 1.26]; p = 0.83; I2 = 0%), or mortality (risk ratio, 0.93 [95% CI, 0.82, 1.04]; p = 0.20; I2 = 31%). Conclusions:Trial evidence to date suggests that any type of heparin thromboprophylaxis decreases deep vein thrombosis and pulmonary embolism in medical-surgical critically ill patients, and low-molecular-weight heparin compared with bid unfractionated heparin decreases pulmonary embolism and symptomatic pulmonary embolism. Major bleeding and mortality rates do not appear to be significantly influenced by heparin thromboprophylaxis in the ICU setting. Trial methodology, indirectness, and the heterogeneity and imprecision of some results temper inferences from this literature.
Cytochrome P450 mRNA Expression in the Rodent Brain: Species-, Sex-, and Region-Dependent Differences

Cytochrome P450 (P450) enzymes play a critical role in the activation and detoxication of many neurotoxic chemicals. Although research has largely focused on P450-mediated metabolism in the liver, emerging evidence suggests that brain P450s influence neurotoxicity by modulating local metabolite levels. As a first step toward better understanding the relative role of brain P450s in determining neurotoxic outcome, we characterized mRNA expression of specific P450 isoforms in the rodent brain. Adult mice (male and female) and rats (male) were treated with vehicle, phenobarbital, or dexamethasone. Transcripts for CYP2B, CYP3A, CYP1A2, and the orphan CYP4X1 and CYP2S1 were quantified in the liver, hippocampus, cortex, and cerebellum by quantitative (real-time) polymerase chain reaction. These P450s were all detected in the liver with the exception of CYP4X1, which was detected in rat but not mouse liver. P450 expression profiles in the brain varied regionally. With the exception of the hippocampus, there were no sex differences in regional brain P450 expression profiles in mice; however, there were marked species differences. In the liver, phenobarbital induced CYP2B expression in both species. Dexamethasone induced hepatic CYP2B and CYP3A in mice but not rats. In contrast, brain P450s did not respond to these classic hepatic P450 inducers. Our findings demonstrate that P450 mRNA expression in the brain varies by region, regional brain P450 profiles vary between species, and their induction varies from that of hepatic P450s. These novel data will be useful for designing mechanistic studies to examine the relative role of P450-mediated brain metabolism in neurotoxicity.
Differential Expression of Ixodes ricinus Tick Genes Induced by Blood Feeding or Borrelia burgdorferi Infection

Abstract Ixodes ricinus L. is the principal European vector of Borrelia burgdorferi sensu lato, the causative agent of Lyme borreliosis. Subtractive hybridization was used to isolate tick genes that were induced in whole ticks after blood meals on uninfected and B. burgdorferi-infected guinea pigs. Novel cDNA clones with similarity to cytochrome c oxidase, salivary secreted protein, actin, and a cysteine protease propeptide were induced after a blood meal. Novel cDNA clones with similarity to thioredoxin peroxidases, dolichyl-phosphate β-glucosyltransferase, glutathione S-transferase, defensin, ML domain-containing protein, and von Willebrand factor were induced after B. burgdorferi infection. Virtual Northern analysis was used to verify that these genes were differentially expressed in ticks after a pathogen-infected blood meal and to detect their tissues of expression. The characterization of genes that are induced after an infected blood meal is essential for gaining an understanding of the molecular mechanisms that underlie vector-pathogen interactions.
Annexin A2 Regulates the Levels of Plasmin, S100A10 and Fascin in L5178Y Cells

Annexin A2 (ANXA2) was reported as the receptor, activator, expression enhancer, or cooperator for plasmin, S100A10, and others. To delineate the effect of ANXA2 on the proteins that are probably associated with tumor development and metastasis by a credible experimental method, we generated an ANXA2 gene knockout tumor cell line, ANXA2–/– L5178Y, and compared the expression levels of plasmin, S100A10 and fascin in the generated cell line with in wild type of L5178Y at mRNA and protein levels. The results showed that the mRNA level of plasminogen (PLG) was not substantially changed in cultured ANXA2–/– cells, but the protein level of plasmin was significantly lower in the cultured ANXA2–/– cells than in cultured ANXA2+/+ cells. For S100A10 and fascin, their mRNA and protein levels were significantly lower in the cultured ANXA2–/– cells than in cultured ANXA2+/+ cells. Results indicate that ANXA2 introduces the generation or expression of plasmin, S100A10, and fascin in tumor cells. ANXA2 affects PLG/plasmin level by a way post transcription and may be an inducer or enhancer to fascin expression at transcription level. By the regulations, ANXA2 enhances the development, invasion, and metastasis of tumor. The detailed mechanism for the regulations above remains to be further investigated, but our results show the potential of ANXA2 as a new target molecule for the strategies of tumor biotherapy or tumor gene therapy.
To split behaviour into bouts, log-transform the intervals

Analysis of behaviour that is displayed in bouts depends crucially on quantitative estimates of bout criteria, that is, the lengths of the shortest intervals between bouts. Current methods estimate bout criteria by modelling the log-transformed (cumulative) frequency distributions of intervals between events. For analysis of feeding behaviour, these models will not result in biologically meaningful quantitative estimates (Tolkamp et al. 1998, Journal of Theoretical Biology194, 235-250). We proposed a method that models the frequency distribution of log-transformed interval lengths instead. Applying this method to a single data set showed that the log-transformed lengths of intervals between feeding events were distributed as two Gaussians. Here we test this model using a data set of 35 171 intervals between feeding that was obtained during an experiment with 38 cows in three dietary treatment groups. No meaningful bout criterion could be obtained for some individuals, which casts doubt on the general validity of the proposed model. Addition of a third log-normal improved the fit of the model and we hypothesized that this third population represents intervals including drinking. In a second experiment, we found the measurements to be consistent with this hypothesis. We obtained meaningful meal criteria for all individuals by fitting either a double, or a triple, log-normal model to the frequency distributions of the lengths of intervals between feeding. These log-normal models appear to be not only more biologically meaningful than log (cumulative) frequency models but also far more flexible. Copyright 1999 The Association for the Study of Animal Behaviour.
Reliable indirect competitive ELISA used for a survey of ochratoxin A in green coffee from the North of Paraná State, Brazil

The performance of an indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) based on a monoclonal antibody (mAb) for ochratoxin A (OTA) detection was evaluated in a comparative study with high-performance liquid chromatography (HPLC) analysis using 68 freshly harvested coffee samples from the North of Paraná State, Brazil. The anti-OTA mAb showed high specificity and low cross-reactivity with OTA analogues (OTB and OTα), but cross-reacted with OTC. This ic-ELISA showed a detection limit of 3.75 ngg−1 sample, when compared to 0.80 ngg−1 by HPLC, with an ic-ELISA/HPLC correlation coefficient of 0.90. As regards OTA analysis of these coffee samples, natural contamination was detected in 10 samples (14.7%) by both methods, where the ic-ELISA values (range 3.9–7.3 ngg−1) were 1.1 to 1.6-fold higher than HPLC data (2.7–4.7 ngg−1). Five samples (7.4%) were OTA positive (range 0.84–1.30 ngg−1) only by HPLC assay, probably due to the higher detection limit reached by ic-ELISA. OTA was undetectable in 53 samples (77.9%) by both methods, while all positive samples (range 0.84–7.30 ngg−1) showed OTA levels lower than 8 ngg−1 (maximum limit recommended by the European Union). The matrix interference of green coffee was minimized by dilution of sample extracts before carrying out the ELISA assay. This mAb-based ic-ELISA can be effectively applied for OTA screening in coffee, because it is simple, sensitive and sample preparation is easy.
The top clinical trial opportunities in therapeutic apheresis and neurology

Objective: The National Heart, Lung, and Blood Institute, of The National Institutes of Health, convened the 2012 State‐of‐the‐Science Symposium in therapeutic apheresis (TA) with the goals of identifying and prioritizing future research concept proposals to optimize the use of TA over the next decade. Methods: Six subcommittees, including neurology, were formed based on organ system, pathophysiology, and technology/special considerations. The subcommittees consisted of physicians, clinical subject matter experts, and basic scientists. Each subcommittee developed concept proposals that were presented, evaluated, and prioritized based on scientific importance, clinical significance, and feasibility. Results: The neurology subcommittee developed eight concept proposals. The proposals include therapeutic plasma exchange (TPE) in neuromyelitis optica; TPE versus intravenous immunoglobulin (IVIG) in anti‐muscle specific kinase associated myasthenia gravis, severe acute disseminated encephalomyelitis, and anti‐NMDA encephalitis; extracorporeal photopheresis in relapsing remitting multiple sclerosis and polymyositis; fibrinogen/low‐density lipoprotein apheresis in idiopathic sudden sensorineural hearing loss; and creation of a rare neurologic disease registry and biorepository. Conclusions: Key clinical research priorities to evaluate and optimize the use of TA on selected neurologic disorders exist. The research opportunities if addressed would provide evidence‐based data to inform the care of patients with these selected neurologic diseases. J. Clin. Apheresis 29:331–335 2014. © 2014 Wiley Periodicals, Inc.
Treatment: Withdrawal Syndrome Alcohol Protracted Withdrawal Syndrome: The Role of Anhedonia

Aims: The aim of the present study is to characterize the relevance of withdrawal symptoms during the first 12 months of abstinence and their relation to anhedonia and craving. Methods: 102 detoxified subjects meeting clinical criteria for Alcohol Dependence in Remission were recruited at various time since the detoxification and subdivided into four groups according to the length of abstinence (group 1: 15–30 days; group 2: 30–90 days; group 3: 90–180 days; group 4: 180–360). Withdrawal symptomatology was assessed through the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar). The Visual Analogue Scale (VAS) for craving, the Snaith–Hamilton Pleasure Scale (SHAPS) and the Subscale for Anhedonia in the Scale for the Assessment of Negative Symptoms (SANSanh) where the other instruments employed. Results: Both anhedonia and withdrawal symptoms were identified in all the groups considered. SHAPS score and VAS for craving showed a significant difference between group 1 and groups 2, 3, and 4. As to CIWA-Ar items, apart from “orientation/clouding of sensorium” that was higher in groups 3 and 4 with respect to both groups 1 and 2, withdrawal symptoms were not significantly different between the periods considered. SHAPS and SANSanh were positively correlated to CIWA-Ar total score, “nausea and vomiting,” and “headache/fullness in head. ” Discussion: The results of this study suggest the relevance of protracted withdrawal well beyond the limited period following the abrupt cessation of alcohol intake. The clinical dimension of anhedonia cannot be separated from the other behavioral symptoms of withdrawal and should be considered as part of the same process.
Why Do Residents Fail to Answer Their Clinical Questions? A Qualitative Study of Barriers to Practicing Evidence-Based Medicine

Purpose Physicians fail to pursue answers to most of their clinical questions, despite exhortations to practice evidence-based medicine (EBM). While studies have revealed several barriers practicing physicians experience in answering clinical questions, residents may encounter unique obstacles. The authors conducted a qualitative study to explore residents’ experience in trying to answer their clinical questions. Method In 2003, the authors studied a convenience sample of 34 residents, representing 54% of the residents in a university-based internal medicine program. A professional facilitator convened and audiotaped three focus groups with the residents, following a discussion guide. The key question elicited the barriers residents encountered in attempting to answer their clinical questions. A thematic analysis of the transcripts was performed, using the constant comparison method of analysis. Two investigators met after independently analyzing each of the transcripts to compare coding structures, review theme exemplars, and reach consensus for differences. Results Eight main themes emerged that characterize the EBM barriers, including access to medical information, skills in searching information resources, clinical question tracking, time, clinical question priority, personal initiative, team dynamics, and institutional culture. The analysis suggested a conceptual model in which residents may encounter different barriers in every step of the EBM process. Furthermore, attitudinal or cultural barriers may lead a resident to abandon the pursuit of a question before some of the technical barriers would be encountered. Conclusion Residents face several EBM barriers, some of which are unique to their status as trainees. While increased informatics training and reliable, rapid, and point-of-care access to electronic information resources remain necessary, they are not sufficient to help residents practice EBM. Educators must also attend to their attitudes toward learning and to the influence of programmatic and institutional cultures.
Telephone monitoring of adverse events during an MF59®-adjuvanted H5N1 influenza vaccination campaign in Taiwan

This study was conducted to explore a telephone-based approach for identifying and quantifying the occurrence of adverse events following immunization (AEFIs) during an MF59®-adjuvanted H5N1 vaccination program in Taiwan. From March to August 2011, each H5N1 vaccine recipient who voluntarily registered as participants within 72 h of vaccination was phone interviewed at postvaccination 7–10 and 21–24 d. Among the 292 participants, 270 and 263 interviews were completed at 7–10 and 21–24 d. Overall, 127 (48%) respondents reported local and 86 (33%) reported systemic reactions. Females (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.18–3.63), nonelderly adults aged 18–59 y (OR 3.08, 95% CI 1.11–9.45), and first-dose recipients (OR 2.16, 95% CI 1.22–3.86) were independently associated with having an AEFI within the first 7–10 d. None of the AEFIs reported were serious adverse events. In conclusion, most AEFIs to H5N1 vaccine were anticipated but varied with sex, age, and vaccine dose number. The use of modern information technologies will be a scalable alternative to efficiently enroll and monitor recipients with possible AEFIs in large campaigns involving influenza or other emerging vaccines. Further studies should compare the detection of AEFIs using telephone monitoring and standard pharmacovigilance reporting.
T2 glottic cancer. Recurrence, salvage, and survival after definitive radiotherapy.

The records of all patients with T2, NO squamous cell carcinoma of the true vocal cords treated with definitive radiotherapy at The University of Texas M. D. Anderson Cancer Center between 1970 and 1985 were analyzed to investigate treatment outcome, prognostic factors associated with tumor recurrence, and the potential impact of improved initial treatment on patient survival. There were 114 patients (male to female ratio, 13:1) with a median age of 62 years at presentation. All were treated with external beam irradiation to a modal dose of 70 Gy in 35 fractions over 7 weeks. The median field size was 25 cm2 and no elective treatment to the neck was routinely given. The crude recurrence rate after definitive radiotherapy was 32%. Of the 37 local regional failures, 32 were in the larynx only, 3 in the neck, and 2 in both the larynx and the neck. All patients who had recurrence after radiotherapy underwent salvage procedures, which increased the ultimate control rate above the clavicles to 94%. Overall and disease-specific survival rates at 5 years were 69% and 92%, respectively. Fifty patients died: 7 of laryngeal cancer, 2 of complications of salvage surgery, 13 of unrelated second cancers, and 28 of other intercurrent disease. The prospects for improved survival through more effective initial treatment of this stage of glottic cancer are therefore very limited. Significant complications of radiotherapy occurred in only 4 patients (3.5%), and overall, 74% of patients retained a functional larynx. Analysis of a wide variety of patient-, tumor-, and treatment-related variables failed to identify any statistically significant prognostic factors. (ABSTRACT TRUNCATED AT 250 WORDS)