Miracle-dz/UniFAR-FTUs huggingface dataset:
Hypertrophy of the nerve roots of the cauda equina as a paraneoplastic manifestation of lymphoma.

HYPERTROPHYOFTHE caudaequinanerve rootsisanonspecific finding and may be seen in hereditary andacquireddemyelinatingneuropathiesorduetoinfiltrationofthenerve rootsbymalignancy.Wedescribeapatient with hypertrophy of the cauda equinanerverootsasalikelyparaneoplastic phenomenon. A60-year-oldmanwasseenfora 3-year history of progressive distal lower limb paresthesias. For 18 monthsbeforehisevaluation,hehad beensymptomaticwithgaitdifficulty thatwouldincreaseinthedark.Walking for prolonged distances was accompanied by leg weakness, heaviness, and numbness, all of which wouldimproveonsittingdown.On examination,hehadmildweakness ofthedistalaspectofthelowerlimb muscles with marked loss of vibrationandmoderatelossofpositionperceptioninthetoes.Perceptionoflight touchandpinprickwereintact.His lower limb reflexes were absent, he hadaflexorplantarresponse,andhe haddifficultywalkingonhistoesor heels.Hehadpositiveresultsforthe Romberg sign. Nerve conduction studies showed evidence of a mild, length-dependent,axonalperipheral neuropathy.Somatosensoryevoked potentialstudieswereremarkablefor impaired conduction in the central proprioceptive pathways below the cervical level. Cerebrospinal fluid analysis revealed a protein level of 0.138 g/dL (reference range, 0.0140.045g/dL),anormalglucoselevel, andabsenceofincreasedcellularity. Diffuseabnormalthickeningand enhancement of the cauda equina nerve roots were seen on lumbar spine magnetic resonance imaging (Figure 1). Also noted was a diffuselyabnormalT2hypointensityof all visualized osseous structures, suggestive of a marrow-replacing process. A cauda equina nerve root biopsy specimen showed increased segmental demyelination (Figure 2) with macrophages scattered throughout the endoneurium. A bone marrow aspirate and biopsy specimen showed extensive involvement by lymphoplasmacytic lymphoma. Immunoelectrophoresis showed a small monoclonal IgM. He was prescribed intravenousimmunoglobulin(IVIG) (0.4 g/kg) twice a week for 8 weeks and once a week for an additional 8 weeks. He showed transient improvement with IVIG administration. His symptoms became significantly worse once he had stopped takingIVIGforafewweeks.Hewas also prescribed rituximab, 375 mg/m 2 intravenouslyonceaweekfor 4 weeks, for his lymphoma. The IVIG therapy was restarted, but throughout 6 months the benefit from this therapy progressively decreased. Chronic inflammatory neuropa
Mood changes and “on‐off” phenomena in Parkinson's disease

Ten patients with idiopathic Parkinson's disease and motor fluctuations were rated for mood changes during discrete “off,” “on,” and “on with dyskinesia” periods. The Profile of Mood States and visual analogue scales were used. Significant changes in mood and anxiety were found to parallel changes in motor fluctuations. One patient rated his moods as consistently improving from the “off” state to the “on” state and finally to the “on with dyskinesia” state, a finding that is consistent with concomitant central dopaminergic changes. All other patients showed moods that improved significantly from the “off” state to the “on” state but then worsened significantly in the “on with dyskinesia” state, a finding that is consistent with the fact that patients feel worse when impaired by dyskinesias. It is suggested that these results argue for multiple etiologies of depression in Parkinson's disease. The literature on dopamine and depression in Parkinson's disease is briefly reviewed and the opportunity provided by “on‐off” phenomena to study the effect of dopamine on mood changes is discussed.
Exon 3 polymorphisms of dopamine D4 receptor (DRD4) gene and attention deficit hyperactivity disorder in Chinese children

Dopamine D4 receptor (DRD4) gene is implicated in the pathogenesis of attention deficit hyperactivity disorder (ADHD). The 7‐repeat allele of the variable‐number‐of‐tandem‐repeat (VNTR) polymorphism in exon 3 has been reported to be associated with ADHD. However, studies in Chinese populations have yielded conflicting results. We therefore perform another study to investigate the association between ADHD and DRD4 gene polymorphism in Chinese children in Hong Kong. In this prospective family‐based and case‐control study during January–June 2004, we recruited consecutive Chinese children diagnosed with ADHD by DSM‐IV and sex‐matched controls admitted for acute upper respiratory infection, excluding those with perinatal brain insults, mental retardation, or neurological deficits. VNTR polymorphisms of the DRD4 gene were determined by standard PCR followed by agarose gel electrophoresis. Sixty‐four ADHD cases (52 boys, 12 girls), their family members, and 64 normal controls were recruited. The 4‐repeat allele (84.4%) and the 4/4‐repeat genotype (70.3%) were the most prevalent. Both family‐based and case‐control analyses showed no association between ADHD and DRD4 gene polymorphisms (transmission dysequilibrium test (TDT): P = 0.91 and P = 0.33 for the 7‐repeat and 4‐repeat alleles, respectively; OR for the 7‐repeat allele = 2.01 (95% CI 0.07–60.4, P = 0.66), OR for the 4‐repeat allele = 1.51 (95% CI 0.80–2.85, P = 0.2)). However, the longer repeat alleles had a positive trend association with ADHD (P = 0.01) in the case‐control analysis. We concluded that ADHD is not associated with a particular VNTR polymorphism of the DRD4 gene. Further studies are needed to clarify the role of repeat length of the VNTR region of the DRD4 gene in the pathogenesis of ADHD. © 2006 Wiley‐Liss, Inc.
Corneal epithelial cells and stromal keratocytes efficently produce CC chemokine-ligand 20 (CCL20) and attract cells expressing its receptor CCR6 in mouse herpetic stromal keratitis

Purpose. CC chemokine-ligand 20 (CCL20) is known to be selectively expressed by surface-lining mucosal epithelial cells and skin epidermal keratinocytes and to attract cells such as immature dendritic cells and effector T cells via CCR6. This study evaluated the ability of corneal epithelial cells and stromal keratocytes to produce CCL20 in vitro and in vivo. Methods. Human corneal epithelial cells (HCE) and corneal keratocytes (HCK) were treated without or with various cytokines and expression of CCL20 mRNA and secreion of its protein were evaluated by RT-PCR and ELISA. Induction of CCL20 mRNA in HCE and HCK was also examined upon in vitro infection with HSV-1. Using a mouse model of herpetic stromal keratitis (HSK), induction of CCL20 expression and accumulation of cells expressing CCR6 were evaluated by RT-PCR and immunohistochemistry. Results. Not only corneal epithelial cells but also stromal keratocytes efficiently expressed CCL20 mRNA and protein upon stimulation with IL-1ß and TNF-a. In vitro infection with HSV-1 also induced CCL20 mRNA in both types of cells. In a mouse herpetic stromal keratitis model, prominent accumulation of CCL20 and CCR6 mRNA was revealed in HSV-1-infected corneas. Furthermore, immunohistochemistry demonstrated production of CCL20 by corneal epithelial cells as well as stromal keratocytes and stromal infiltration of DEC205 + dendritic cells, CD4 + T cells and CD8 + T cells. Double staining revealed that CCR6-expressing cells were mostly MHC class II + dendritic cells. Conclusions. Not only epithelial cells but also stromal keratocytes are efficient producers of CCL20 in the cornea and recruit CCR6-expressing cells such as dendritic cells into inflamed cornea.
Phase Ia/Ib trial of bispecific antibody MDX-210 in patients with advanced breast or ovarian cancer that overexpresses the proto-oncogene HER-2/neu.

PURPOSE MDX-210 is a bispecific antibody that binds simultaneously to type I Fc receptors for immunoglobulin G (IgG) (Fc gamma RI) and to the HER-2/neu oncogene protein product. MDX-210 effectively directs Fc gamma RI-positive effector cells such as monocytes and macrophages to phagocytose or kill tumor cells that overexpress HER-2/neu. The goals of this phase Ia/Ib trial were to determine the maximum-tolerated dose (MTD) and/or the optimal biologic dose (OBD) of MDX-210. PATIENTS AND METHODS Patients with advanced breast or ovarian cancer that overexpressed HER-2/neu were eligible for treatment. Cohorts of three patients received a single intravenous (IV) infusion of MDX-210 at increasing dose levels from 0.35 to 10.0 mg/m2. RESULTS Treatment was well tolerated, with most patients experiencing transient grade 1 to 2 fevers, malaise, and hypotension only. Two patients experienced transient grade 3 hypotension at 10.0 mg/m2. Transient monocytopenia and lymphopenia developed at 1 to 2 hours, but no other hematologic changes were observed. Doses of MDX-210 > or = 3.5 mg/m2 saturated > or = 80% of monocyte Fc gamma RI and produced peak plasma concentrations > or = 1 microgram/mL, which is greater than the concentration for optimal monocyte/macrophage activation in vitro. Elevated plasma levels of the monocyte products tumor necrosis factor alpha (TNF alpha), interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and neopterin were observed with maximal levels at doses > or = 7.0 mg/m2. Localization of MDX-210 in tumor tissue was demonstrated in two patients. One partial and one mixed tumor response were observed among 10 assessable patients. CONCLUSION MDX-210 is immunologically active at well-tolerated doses. The MTD and OBD is 7 to 10 mg/m2.
The association between patient experience factors and likelihood of 30-day readmission: a prospective cohort study

Objective Hospital care comprises nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission. Design Prospective cohort study. Setting Two inpatient adult medicine units at Massachusetts General Hospital, Boston, Massachusetts. Participants Eight hundred and forty-six patients admitted to study units between January 2012 and January 2016 who met eligibility criteria and consented to enrolment. Main outcome Odds of 30-day readmission. Results Of 1754 eligible participants, 846 (48%) were enrolled and 201 (23.8%) were readmitted within 30 days. Readmitted participants were less likely to have a high school diploma/GED (44.3% not readmitted vs 53.5% readmitted, P=0.02). In multivariable models adjusting for baseline differences, respondents who reported being ‘very satisfied’ with the care received during the index hospitalisation were less likely to be readmitted (adjusted OR 0.61, 95% CI 0.43 to 0.88, P=0.007). Participants reporting doctors ‘always listened to them carefully’ were less likely to be readmitted (adjusted OR 0.68, 95% CI 0.48 to 0.97, P=0.03). Participants reporting they were ‘very likely’ to be readmitted were not more likely to be readmitted (adjusted OR 1.35, 95% CI 0.83 to 2.19, P=0.22). Conclusion Participants reporting high satisfaction and good provider communication were less likely to be readmitted. Rates of readmission were increased among participants stating they were very likely to be readmitted though this association was not statistically significant. Incorporating patient-reported measures during index hospitalisations may improve readmission prediction.
Systematic review of recent guidelines for pharmacological treatments of bipolar disorders in adults.

BACKGROUND To examine the similarities and differences among practice guidelines for managing bipolar disorders (BDs) in adults. METHODS A literature search in PubMed/Medline was performed using multiple search terms and bibliographies for guidelines from July 2013 (since FDA approval of lurasidone) to June 2017. RESULTS Six treatment guidelines for BDs in adults were identified. These guidelines showed consensus on first-line treatment of mania (moodstabilizer and/or an antipsychotic), and most first-line medications for bipolar depression. However, beyond first-line treatments, the guidelines' recommendations showed major differences. Some guidelines did not specify a type of BD. In addition, there was variability in the stages when important treatments, such as electroconvulsive therapy, should be considered and in the recommended treatment-or lack of recommended treatment-for mixed episodes and features. CONCLUSIONS This review found consistency across guidelines on first-line recommendations for treating manic and depressive episodes, but wide differences for second- and third-line treatments and for other phases of BD, therefore limiting the generation of any "meta-consensus. " We recommend creating an international workgroup to reconcile the evidence and develop more unified international recommendations.
Cell renewal of the rat corneal epithelium

Abstract A stathmokinetic method to study the mitotic rate in the corneal epithelium of the rat is described and applied. Horizontal and vertical diameter sections were used. In order to analyze the mitotic rate in the various parts of the corneal epithelium, each vision field (objective 100, eye piece 12.5), comprising 182 μm basement membrane, was regarded as a separate unit. Since the number of vision fields acros the cornea varies from specimen to specimen, we constructed a mathematical method to correlate corresponding corneal areas from different eyes. Using this method it is shown that the mitotic rate is almost equal all over the cornea, with no definite reduction in the central areas. There is no area of significantly high proliferation rate, either in the limbal area or in the adjacent conjunctiva.
Personality Traits Are Associated With Cortical Development Across Adolescence: A Longitudinal Structural MRI Study.

How personality traits relate to structural brain changes in development is an important but understudied question. In this study, cortical thickness (CT) and surface area (SA), estimated using magnetic resonance imaging (MRI), were investigated in 99 participants aged 8-19 years. Follow-up MRI data were collected after on average 2.6 years for 74 individuals. The Big Five personality traits were related to longitudinal regional CT or SA development, but limited cross-sectional relations were observed. Conscientiousness, emotional stability, and imagination were associated with more age-expected cortical thinning over time. The results suggest that the substantial individual variability observed in personality traits may partly be explained by cortical maturation across adolescence, implying a developmental origin for personality-brain relations observed in adults.
Presenilins mediate PI3K/AKT and ERK activation via select signaling receptors: selectivity of PS2 i

Marine propellers are constructed with a split-hub design, permitting adjustment of the pitch of the blades, and axial removability of the blade. By virtue of the axial removability of the blades, blades can be removed easily for repair or replacement without increasing the diametral clearance between the blade tips and a tunnel or nozzle of the type in which propellers are frequently disposed. Also, individual blades can be removed without the necessity of dropping the rudder, which is necessary in many vessels utilizing solid propellers. The blades have their spindles or roots clamped in the hub, such that axial adjustment of pitch can be achieved by reducing the clamping force. The hub preferably is formed in two sections, one section being mounted to or forming part of the propeller shaft, and including recesses which partially house the blade spindles or roots. The other section preferably is made up of a plurality of independently removable clamping segments, each of which is formed with a recess which cooperates with a recess in the first section to house a blade spindle, and clamp the spindle in a fixed blade pitch position. By removal of a selected clamping segment, its blade can be removed axially rearwardly without necessitating substantial diametral clearance at the blade tips. Bolted connections are used between the clamping segments and the first section of the hub so as to facilitate both pitch adjustment and blade removal.
PPAR-inhibits ANG II-induced cell growth via SHIP 2 and 4 EBP 1

Benkirane, Karim, Farhad Amiri, Quy N. Diep, Mohammed El Mabrouk, and Ernesto L. Schiffrin. PPARinhibits ANG IIinduced cell growth via SHIP2 and 4E-BP1. Am J Physiol Heart Circ Physiol 290: H390–H397, 2006. First published September 9, 2005; doi:10.1152/ajpheart.00662. 2005. —The present study evaluated the effects of peroxisome proliferator-activated receptor (PPAR)activators on ANG II-induced signaling pathways and cell growth. Vascular smooth muscle cells (VSMC) derived from rat mesenteric arteries were treated with ANG II, with/without the AT1 receptor blocker valsartan or the AT2 receptor blocker PD-123319, after pretreatment for 24 h with the PPARactivators 15-deoxyprostaglandin J2 (15d-PGJ2) or rosiglitazone. Both 15d-PGJ2 and rosiglitazone decreased ANG II-induced DNA synthesis. Rosiglitazone treatment increased nuclear PPARexpression and activity in VSMC. However, rosiglitazone did not alter expression of PPAR/ , ERK 1/2, Akt, or ANG II receptors. 15d-PGJ2 and rosiglitazone decreased ERK 1/2 and Akt peak activity, both of which were induced by ANG II via the AT1 receptor. Rosiglitazone inhibited ANG II-enhanced phosphorylation of eukaryotic initiation factor 4E-binding protein 1 (4E-BP1), as well as Src homology (SH) 2-containing inositol phosphatase 2 (SHIP2). PPARactivation reduced ANG II-induced growth associated with inhibition of ERK 1/2, Akt, 4EBP1, and SHIP2. Modulation of these pathways by PPARactivators may contribute to regression of vascular remodeling in hypertension.
Dowling-Degos disease with asymmetrical axillary distribution and no KRT 5 exon 1 mutation.

Sir, Dowling-Degos disease (DDD) is a rare disorder characterized by acquired pigmented macules and papules in a reticulate pattern, particularly affecting the flexural areas and other major skin folds (1, 2). A female patient presented with dotted and reticulate pigmentation of the axilla, and was diagnosed as DDD both clinically and histopathologically. However, the asymmetrical distribution of the eruption was distinct from classical DDD. In contrast to recent reports in Caucasian patients with DDD (3, 4), we found no evidence of mutation of exon 1 of the keratin 5 (KRT5) gene, suggesting an aetiological heterogeneity of this disorder.
Approaches based on tree-structures classifiers to protein fold prediction

Protein fold recognition is an important task in the biological area. Different machine learning methods such as multiclass classifiers, one-vs-all and ensemble nested dichotomies were applied to this task and, in most of the cases, multiclass approaches were used. In this paper, we compare classifiers organized in tree structures to classify folds. We used a benchmark dataset containing 125 features to predict folds, comparing different supervised methods and achieving 54% of accuracy. An approach related to tree-structure of classifiers obtained better results in comparison with a hierarchical approach.
A Cremated Bone Intercomparison Study

It is now almost 10 yr since radiocarbon dating of cremated bone was first developed using the small carbonate component contained within the hydroxyapatite-based inorganic fraction. Currently, a significant number of 14C laboratories date cremated bone as part of their routine dating service. As a general investigation of cremated bone dating since this initial development, a small, cremated bone intercomparison study took place in 2005, involving 6 laboratories. Six cremated bone samples (including 2 sets of duplicates), with ages spanning approximately 1500–2800 BP, were sent to the laboratories. The results, which showed relatively good agreement amongst the laboratories and between the duplicate samples, are discussed in detail.
Opacification of the collecting system and ureters on excretory-phase CT using oral water as contrast medium.

1All authors: The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N. Caroline St./3235A, Baltimore, MD 21287. Address correspondence to S. Kawamoto (skawamo1@jhmi.edu). T is widely used as a primary imaging technique for evaluation of urinary tract abnormalities. Recently, there has been increasing interest in using CT for the evaluation of the renal collecting system and ureters because of technical advances including MDCT and 3D software development. Detailed evaluation of the renal collecting system and ureters is possible with increased spatial resolution and isotropic data sets that can now be created using MDCT. For evaluation of the renal collecting system and ureters, optimal opacification and distention is essential. Various techniques to optimize opacification and distention of the renal collecting system and ureters have been reported in the literature. To optimize opacification, abdominal compression [1–5], saline infusion [6, 7], multiple acquisitions [2], prone positioning [1, 6, 7], and furosemide administration [7] have been successfully used. Abdominal compression has also been used to improve distention of the renal collecting system [4]. As a part of a routine 3-phase CT examination in patients with suspected urinary tract abnormalities, we evaluated the degree of opacification of the renal collecting system and ureters on excretory-phase images obtained without abdominal compression, prone positioning, or IV administration of saline or furosemide. Instead, 750–1,000 mL of water was ingested as oral contrast and for diuresis. The purpose of this study is to evaluate the degree of opacification of the renal collecting system and ureters on excretory-phase contrast-enhanced CT using only oral ingestion of water without abdominal compression, saline infusion, or prone positioning.
Assessment of Technique During Pediatric Direct Laryngoscopy and Tracheal Intubation: A Simulation-Based Study

Objectives This study aimed to assess the feasibility of characterizing direct laryngoscopy (DL) and tracheal intubation (TI) technique based on videographic review and to determine the association between technical aspects of DL and TI with successful completion of intubation. Methods Physicians in pediatrics, emergency medicine, pediatric emergency, pediatric critical care, and neonatology performed TI on simulators (newborn, infant, and adult). A video laryngoscope was used without a display (ie, as a direct laryngoscope), and video recordings were reviewed. A scoring instrument characterized technical aspects of DL and TI; outcomes related to procedural performance were recorded. Interrater reliability of the instrument was assessed by weighted &kgr;; collinearity was assessed by a correlation matrix. Univariate analysis determined technical aspects of DL and TI associated with outcomes. Results Seventy-three subjects performed 206 intubations. Significant differences existed between simulators with respect to the first-attempt success (newborn, 63%; infant, 80%; adult, 42%; P < 0.001), laryngoscopy time (27 seconds vs 31 seconds vs 42 seconds, P < 0.001), and percentage of glottic opening score (68% vs 65% vs 35%, P < 0.001). Interrater reliability for the instrument was good (&kgr; = 0.68); no significant collinearity existed between data points. Position of the tip of the laryngoscope blade in the vallecula and under the proximal epiglottis was associated with improved first-attempt success. Conclusions Pediatric intubation technique can be reliably assessed using videography and video laryngoscopy. Future studies should examine video-based characterization of DL and TI technique in real patients outside the operating room, as well as whether technical aspects of intubation are associated with improved outcomes.