Miracle-dz/UniFAR-FTUs huggingface dataset:
Visual reweighting in postural control is less adaptative in older adults

Postural control is based upon the fusion of sensory cues coming from multiple sources requiring continuously adaptation that may be altered due to aging, leading to the poor postural equilibrium in older adults. Therefore, the purpose of this study was to examine the adaptation in the relationship between the visual information and the body sway in older adults. Fifteen older (70 ± 7.6 years) and 15 younger adults (19 ± 1.1 years) stood upright inside of a moving room. Each participant performed 7 trials, each lasting 60 s, in which in the first 3 trials the room oscillated at 0.2 Hz, amplitude of 0.6 cm, and peak-to-peak velocity of 0.6 cm/s. In the fourth trial, the room oscillated at 0.2 Hz but with amplitude of 3.5 cm and peak-to-peak velocity of 3.5 cm/s. In the following 3 trials, the room oscillated with the same parameters of the first three trials. Body sway magnitude was examined through mean sway amplitude, and the relationship between visual information and induced body sway was examined through coherence and gain. Visual manipulation induced corresponding body sway in both older and younger adults, with no difference being observed between groups in the first three trials. In the fourth trial, mean sway amplitude, coherence and gain values were higher for the older compared to younger adults. Moreover, in the last three trials, older adults still showed higher gain values than observed for the younger adults. Taken together, these results suggest that older adults adapt to abrupt changes in visual cues, but not with the same magnitude as younger adults. Yet, older adults do not take advantage of experienced sensory changes in order to adapt the use of the vision information in the following experiences, indicating the less capability of adaptation to the sensory changes.
Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis

Article type Review article Pancreatitis is the most common and important complication of endoscopic retrograde cholangiopancreatography (ERCP). Several risk factors play a role in the formation and progression of pancreatitis. These risk factors may be related to the patient, procedure or operator. All of these risk factors should be considered and should be lowered as far as possible with attention to pathogenesis of the development of post-ERCP pancreatitis. The pathogenesis include sphincter spasm, infection, contrast toxicity and pancreatic secretion that induce the activation of proteolytic enzymes and inflammatory processes. Some methods and pharmacologic agents assessed for the prevention of pathway in the pathogenesis to decrease post-ERCP pancreatitis.
Endoscopic findings and clinical predictors of organic disease among patients with dyspepsia in Jos, Nigeria

Introduction: Dyspepsia is a common reason for seeking Medicare in the primary health care setting and beyond. However, a major challenge in evaluating patients with dyspepsia is distinguishing between peptic ulcer disease, functional dyspepsia and gastric malignancy. In most cases, the underlying cause of dyspepsia will not be obvious based on clinical history and physical examination alone. This study was carried out to characterize dyspepsia symptoms and determine predictors of organic disease among dyspepsia patients at the Jos University Teaching Hospital, Jos, Nigeria. Materials and Methods: A prospective cross-sectional study of consecutive adult patients with dyspepsia referred for gastroscopy at the Jos University Teaching Hospital (JUTH, North-Central Nigeria was carried out. After an overnight fast, a detailed clinical history and physical examination was carried on each subject before undergoing upper gastrointestinal endoscopy using Olympus fibreoptic gastroscope. Two pairs each of gastric antral and corpus biopsies were taken from each subject and examined for the presence of Helicobacter pylori using rapid urease test. The data obtained were analyzed using the SPSS Version 15.0 Statistical soft-ware package. P values of 0.05). Anorexia, weight loss and epigastric tenderness were significantly more in those with organic dyspepsia compared to non-ulcer dyspepsia (P value 0.05). Conclusion: Dyspepsia is a common condition among patients although symptoms, physical examination and the presence or otherwise of H. pylori infection have poor predictive values for organic disease at endoscopy, the presence of anorexia, weight loss and epigastric tenderness may be pointers to the presence of an underlying organic pathology at endoscopy. Keywords: Endoscopic findings, Dyspepsia, predictors, Organic Disease, Jos, Nigeria
The Low Apgar Describes the Conditions of the Newborn Infant Immediately After Birth

Background and Objectives: Approximately 9% of newborns require some assistance to begin breathing at birth. Considering to prevalence of high risk neonates, the aim of this study is to determine causes of low apgar neonatal birth. Materials and Methods: In this retrospective study, 150 neonates with apgar score less than 7 at 1 st minute and 150 neonates with normal apgar were considered randomly from 2003/08/23 to 2004/08/22 in Alzahra hospital which is the main referral center of high risk pregnancy in the north west of Iran and also 20-25 childbirth take place every day. Results: The most important cause of low apgar score in neonates Preterm labor (case 48/6%, control 11/3%, P<0/001); Congenital anomalies(case 26%, control 2/66%, P<0/001); use of general anesthesia in caesarean section (case 32/8%, control 10/4%, P= 0/006); Vaccum extraction(case 8%, control 0/7%, P<0/002); Breech presentation (case 17/3%, control 4/7%, P<0/001); Prolonged labor (case 16/7%, control 3/3%, P<0/001); Aloruptio Placenta(case 0%, control 15/4%, P<0/001); PROM (case 19/3%, control 3/3%, P<0/001). Conclusion: It was concluded that low apgar score is significantly associated with a number of fetus, maternal and delivery factors. Findings demonstrated that the main related factors to low apgar score are preterm labor, and utilization of general anesthesia in caesarean labor. The support of vaginal labor, local anesthesia instead of general anesthesia as well as prevention of preterm labor is the practical ways to prevent from low apgar score of newborn infants.
Making a Difference: The Impact of Traditional Male Role Models on Drug Sale Activity and Violence Involving Black Urban Youth

Elijah Anderson's Code of the Street provides an ethnographic account of a disadvantaged urban environment where residents face poverty and racial residential isolation. For Anderson, joblessness among African-American men deprive youth of positive male role models, creating a context for the “street code” to govern behavior, leading youth to violence. Similarly, a disadvantaged urban setting in which opportunities in legitimate labor markets are lacking fosters an environment where youth may seek illicit markets for a means of economic support. Drawing on Anderson's work, we assess the availability of male role models (older, employed black males) and the concentration of urban disadvantage on black juvenile drug sales and violent arrests across multiple cities in 2000. We find Anderson's concerns over the removal of traditional role models as a result of rising disadvantage in a Philadelphia community to be generalized to large urban areas. Specifically, we find that the presence of traditional role models reduces aggravated assaults by youth, but male role models are unable to reduce the economic lure of drug sales for black urban youth in disadvantaged environments.
High glucose and low specific cell growth but not mild hypothermia improve specific r-protein productivity in chemostat culture of CHO cells

In the biopharmaceutical sector, Chinese hamster ovary (CHO) cells have become the host of choice to produce recombinant proteins (r-proteins) due to their capacity for correct protein folding, assembly, and posttranslational modification. However, the production of therapeutic r-proteins in CHO cells is expensive and presents insufficient production yields for certain proteins. Effective culture strategies to increase productivity (qp) include a high glucose concentration in the medium and mild hypothermia (28–34 °C), but these changes lead to a reduced specific growth rate. To study the individual and combined impacts of glucose concentration, specific growth rate and mild hypothermia on culture performance and cell metabolism, we analyzed chemostat cultures of recombinant human tissue plasminogen activator (rh-tPA)-producing CHO cell lines fed with three glucose concentrations in feeding media (20, 30 and 40 mM), at two dilution rates (0.01 and 0.018 1/h) and two temperatures (33 and 37 °C). The results indicated significant changes in cell growth, cell cycle distribution, metabolism, and rh-tPA productivity in response to the varying environmental culture conditions. High glucose feed led to constrained cell growth, increased specific rh-tPA productivity and a higher number of cells in the G2/M phase. Low specific growth rate and temperature (33 °C) reduced glucose consumption and lactate production rates. Our findings indicated that a reduced specific growth rate coupled with high feed glucose significantly improves r-protein productivity in CHO cells. We also observed that low temperature significantly reduced qp, but not cell growth when dilution rate was manipulated, regardless of the glucose concentration or dilution rate. In contrast, we determined that feed glucose concentration and consumption rate were the dominant aspects of the growth and productivity in CHO cells by using multivariate analysis.
Treatment With the Dipeptidyl Peptidase-4 Inhibitor Linagliptin or Placebo Followed by Glimepiride in Patients With Type 2 Diabetes With Moderate to Severe Renal Impairment: A 52-Week, Randomized, Double-Blind Clinical Trial

Chronic kidney disease (CKD) is frequently comorbid with type 2 diabetes, and glucose-lowering treatment options are limited for such patients (1). We investigated the efficacy and safety of linagliptin, a dipeptidyl peptidase-4 inhibitor, in type 2 diabetic patients with moderate to severe renal impairment and insufficient glycemic control. This randomized, double-blind, parallel-group clinical trial comprised a 12-week, placebo-controlled phase followed by a 40-week, active-controlled extension. The study was conducted between 17 March 2010 and 18 June 2012 at 52 outpatient clinics in nine countries (ClinicalTrials.gov, NCT01087502). Patients with type 2 diabetes, HbA1c 7.0–10.0% (53–86 mmol/mol), and estimated glomerular filtration rate (eGFR) 110 mg/dL. The primary end point was change in HbA1c from baseline to week 12 in the full-analysis set (FAS; all randomized patients who received ≥1 dose of study drug and had a baseline and ≥1 postbaseline measurement of HbA1c); missing data were imputed using last observation carried forward. Secondary end points included change in HbA1c from baseline over time. The incidence of adverse events (AEs) was evaluated for the treated set (TS; all randomized patients who received ≥1 dose …
Comment on Lin et al. Risk Factors for Decline in IQ in Youth With Type 1 Diabetes Over the 12 Years From Diagnosis/Illness Onset. Diabetes Care 2015;38:236–242

Lin et al. (1) reported changes in verbal intelligence quotient (VIQ), full-scale IQ (FSIQ), and performance IQ (PIQ) monitored in young patients with type 1 diabetes (T1D) over 12 years from disease onset, and risk factors such as early onset of diabetes and history of hypoglycemic seizures had a negative impact on VIQ and FSIQ. This is an interesting prospective study on the correlation between glycemic control and the development of the central nervous system in T1D. However, there are two concerns about this study. First, the study results are concerning because two inconsistent findings were reported. First, no …
Could the Discrepancy in Perceived Emotional Care Received and Provided Be a Barrier to Active Diabetes Self-management? Insights From the Second Diabetes Attitudes, Wishes and Needs (DAWN2) Study

Low-fat diets and regular physical activity are recommended for good health, but U.K. household expenditure on butter, sugar, preserves, and soft drinks has risen steadily; fewer than half of men (46%) and women (37%) report walking for 10 min at least once per month and 67% of men and 57% of women are overweight or obese (1). With 86% of people with type 2 diabetes and 62% of those with type 1 diabetes being overweight or obese (1), their lifestyles are likely to be influenced by the overall societal trend for busy lives, quick meals, and little physical activity. The global second Diabetes Attitudes, Wishes and Needs (DAWN2) study was a multi-stakeholder survey conducted in 17 countries (2), exploring factors affecting diabetes self-management and support for people with diabetes. Nearly half of the people with diabetes surveyed (45%) reported diabetes-related distress and ∼14% had likely depression (3). Emotional support from health care professionals was reported by only 32% of people with diabetes (3). Global DAWN2 results demonstrated notable differences in findings concerning people with diabetes among participating countries (3). Here, we provide a descriptive analysis of key U.K. DAWN2 data examining potential barriers to active and optimal self-management among people with diabetes. DAWN2 (ClinicalTrials.gov identifier NCT01507116) methodology has been published previously (2). Data were generated through stakeholder-specific questionnaires, including standardized instruments …
Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

OBJECTIVE To examine, among patients with type 2 diabetes, the association between hospitalization for heart failure (hHF) and treatment with dipeptidyl peptidase 4 inhibitors (DPP-4is) versus sulfonylureas (SUs), and treatment with saxagliptin versus sitagliptin. RESEARCH DESIGN AND METHODS This was a retrospective, observational study using a U.S. insurance claims database. Patients initiated treatment between 1 August 2010 and 30 August 2013, and had no use of the comparator treatments in the prior 12 months (baseline). Each comparison consisted of patients matched 1:1 on a propensity score. Time to each outcome was compared between matched groups using Cox models. Analyses were stratified by the presence of baseline cardiovascular disease (CVD). Secondary analyses examined associations between comparator treatments and other selected cardiovascular events. RESULTS After matching, the study included 218,556 patients in comparisons of DPP-4i and SU, and 112,888 in comparisons of saxagliptin and sitagliptin. The hazard ratios (HRs) of hHF were as follows: DPP-4i versus SU (reference): HR 0.95 (95% CI 0.78–1.15), P = 0.580 for patients with baseline CVD; HR 0.59 (95% CI 0.38–0.89), P = 0.013 for patients without baseline CVD; saxagliptin versus sitagliptin (reference): HR 0.95 (95% CI 0.70–1.28), P = 0.712 for patients with baseline CVD; HR 0.99 (95% CI 0.56–1.75), P = 0.972 for patients without baseline CVD. Comparisons of the individual secondary and composite cardiovascular outcomes followed a similar pattern. CONCLUSIONS In patients with type 2 diabetes, there was no association between hHF, or other selected cardiovascular outcomes, and treatment with a DPP-4i relative to SU or treatment with saxagliptin relative to sitagliptin.
Visual assessment versus computer-assisted gray scale analysis in the ultrasound evaluation of neonatal respiratory status

Background and aim Lung ultrasound has been used to describe common respiratory diseases both by visual and computer-assisted gray scale analysis. In the present paper, we compare both methods in assessing neonatal respiratory status keeping two oxygenation indexes as standards. Patients and methods Neonates admitted to the NICU for respiratory distress were enrolled. Two neonatologists not attending the patients performed a lung scan, built a single frame database and rated the images with a standardized score. The same dataset was processed using the gray scale analysis implemented with textural features and machine learning analysis. Both the oxygenation ratio (PaO2/FiO2) and the alveolar arterial oxygen gradient (A-a) were kept as reference standards. Results Seventy-five neonates with different respiratory status were enrolled in the study and a dataset of 600 ultrasound frames was built. Visual assessment of respiratory status correlated significantly with PaO2/FiO2 (r = -0.55; p<0.0001) and the A-a (r = 0.59; p<0.0001) with a strong interobserver agreement (K = 0.91). A significant correlation was also found between both oxygenation indexes and the gray scale analysis of lung ultrasound scans using regions of interest corresponding to 50K (r = -0.42; p<0.002 for PaO2/FiO2; r = 0.46 p<0.001 for A-a) and 100K (r = -0.35 p<0.01 for PaO2/FiO2; r = 0.58 p<0.0001 for A-a) pixels regions of interest. Conclusions A semi quantitative estimate of the degree of neonatal respiratory distress was demonstrated both by a validated scoring system and by computer assisted analysis of the ultrasound scan. This data may help to implement point of care ultrasound diagnostics in the NICU.
Impact and Origin of Stigma and Discrimination in Schizophrenia: Patient Perceptions

Purpose : Stigma and discrimination faced by patients with schizophrenia are the most important barriers to accessing care and can result in long treatment delays. Stigma is universal but the nature, source, and impact of stigma vary across cultures and regions. Thus, interventions need to be specific. This study assessed the perceptions of patients with schizophrenia regarding the stigma and discrimination they face in their lives. Main determinants and sources of stigma, as well as the nature of and forms of stigma were of interest. Method : Opinions on various aspects of stigma were obtained using a semi-structured interview. One hundred patients with a diagnosis of schizophrenia, who were attending a psycho-education group in a hospital setting in Mumbai, India were surveyed. Results : The stigma and discrimination linked to schizophrenia was found to have a significant impact on the lives of these individuals. From the patient perspective, a lack of knowledge, the nature of the illness itself, and behavioral symptoms were seen as the main reasons for stigma and discrimination. Common effects of stigma were low self-esteem and discrimination in family and work settings. Providing care and treatment was identified as the most common method of combating stigma. The availability of effective treatment was thought to be the most important method of reducing stigma, which will certainly aid in the access of mental health care for patients globally. Conclusions : The stigma associated with schizophrenia represents a challenge for effective mental health care. The solution for minimizing this stigma through anti-stigma programs is essential and necessitates the collection and analysis of complex information, particularly including patient perceptions. Implications : Dealing with stigma should be part of treatment and psycho-educational programs. Better treatment and rehabilitation for the illness and its symptoms is important, but so is educating members of the community, who are viewed as the primary source of stigma and discrimination. 10.5463/sra.v1i1. 5
Predictive value of soluble ST2 in adolescent and adult patients with complex congenital heart disease

Background Soluble suppression of tumorogenicity 2 (sST2) has been shown to be of prognostic value in patients with chronic and acute left heart failure. The present study aims to assess the predictive value of sST2 levels in adult patients with complex congenital heart disease (CHD). Methods In 169 consecutive patients with complex CHD and a mean age of 28.2 ± 12.0 years, sST2 levels were compared to 32 healthy controls and associated with clinical status as well as the occurrence of major adverse cardiac events (MACE). Mean follow-up time was 35.6 ± 24.9 months. Results In CHD patients, median sST2 levels were 29.7 ng/ml compared to 26.4 ng/ml in healthy controls (p = 0.007) and increased with different types of CHD and the severity of MACE. According to ROC analysis, the most important predictors of acute heart/Fontan failure were NYHA class III/IV (AUC 0.804, p<0.001, CI 0.668–0.941), NT-proBNP levels (AUC 0.794, p<0.001, CI 0.640–0.948), γGT levels (AUC 0.793, p<0.001, CI 0.678–0.909) and sST2 levels (AUC 0.742, p = 0.004, CI 0.626–0.858), with NYHA class III/IV as the strongest independent predictor (p<0.001). All-cause mortality was best predicted by sST2 levels (AUC 0.890, p<0.001, CI 0.741–1.000), NT-proBNP levels (AUC 0.875, p = 0.001, CI 0.766–0.984) and NYHA class III/IV (AUC 0.837, p = 0.003, CI 0.655–1.000) with sST2 as the strongest independent predictor (p<0.001). Moreover, AUC increased to 0.918 combining both biomarkers and net reclassification improved with the addition of sST2. Conclusion In patients with complex CHD, sST2 may have additive value to natriuretic peptides for the prediction of all-cause mortality.
Original Article Chronic fatigue syndrome and mitochondrial dysfunction

This study aims to improve the health of patients suffering from chronic fatigue syndrome (CFS) by interventions based on the biochemistry of the illness, specifically the function of mitochondria in producing ATP (adenosine triphosphate), the energy currency for all body functions, and recycling ADP (adenosine diphosphate) to replenish the ATP supply as needed. Patients attending a private medical practice specializing in CFS were diagnosed using the Centers for Disease Control criteria. In consultation with each patient, an integer on the Bell Ability Scale was assigned, and a blood sample was taken for the "ATP profile" test, designed for CFS and other fatigue conditions. Each test produced 5 numerical factors which describe the availability of ATP in neutrophils, the fraction complexed with magnesium, the efficiency of oxidative phosphorylation, and the transfer efficiencies of ADP into the mitochondria and ATP into the cytosol where the energy is used. With the consent of each of 71 patients and 53 normal, healthy controls the 5 factors have been collated and compared with the Bell Ability Scale. The individual numerical factors show that patients have different combinations of biochemical lesions. When the factors are combined, a remarkable correlation is observed between the degree of mitochondrial dysfunction and the severity of illness (P<0.001). Only 1 of the 71 patients overlaps the normal region. The "ATP profile" test is a powerful diagnostic tool and can differentiate patients who have fatigue and other symptoms as a result of energy wastage by stress and psychological factors from those who have insufficient energy due to cellular respiration dysfunction. The individual factors indicate which remedial actions, in the form of dietary supplements, drugs and detoxification, are most likely to be of benefit, and what further tests should be carried out.