Miracle-dz/UniFAR-FTUs huggingface dataset:
Endothelial nitric oxide synthase intron 4a/b polymorphism and early atherosclerotic changes in hypopituitary GH-deficient adult patients.

OBJECTIVE Endothelial nitric oxide synthase (eNOS) intron 4a/b polymorphism is associated with plasma NO concentrations and coronary artery disease/hypertension in various populations. GH deficiency in adulthood predisposes to reduced NO concentrations and premature atherosclerosis. Our aim was to determine whether intron 4a/b polymorphism of eNOS gene influences endothelial function and early atherosclerotic changes in GH-deficient hypopituitary patients. DESIGN Thirty-three hypopituitary GH-deficient patients on conventional replacement therapy other than GH and 43 age-, sex-, and body mass index (BMI)-matched controls were studied in this cross-sectional case-control study. METHODS Early atherosclerotic changes were determined by flow-mediated dilation (FMD) of brachial artery and carotid artery intima-media thickness (IMT). eNOS4a/b polymorphism was detected by PCR. RESULTS Hypopituitary patients had significantly higher total/low-density lipoprotein cholesterol and fat mass and lower IGF-I concentrations compared with controls. IMT was significantly higher in patients (0.777+/-0.23 vs 0.639+/-0.17 mm, P<0.01). No significant difference was observed with respect to FMD measurements. eNOS4a/b genotype frequencies were similar between patients and controls. Patients carrying 'a' allele (a/a and a/b) had significantly higher IMT compared with controls carrying 'a' allele and bb genotype (P<0.05). However, logistic regression analysis revealed that presence of hypopituitarism, age> or =45 years, and BMI> or =27.9 kg/m(2) were significant independent predictors of IMT> or =0.65 mm. CONCLUSION No compelling data are evident to suggest that eNOS4a/b polymorphism modifies the atherosclerotic process in GH-deficient situations. A large case-control study is needed to confirm our findings.
A Comparison of Curriculum Directors, Aspiring Curriculum Directors, and Faculty Members in Occupational Therapy

There is a shortage of qualified occupational therapy faculty members who are interested in becoming curriculum directors. This study presents the results of a mail survey used to compare the demographic, educational, and career characteristics of three groups involved with occupational therapy education: curriculum directors, faculty members interested in becoming curriculum directors, and faculty members not interested in becoming curriculum directors. Although the results of the survey do not show clear and distinct profiles for each of the three groups, interesting similarities and differences do exist. In general, differences between men and women were greater than differences between groups.
The influence of age on the GH-IGF1 axis in patients with acromegaly.

OBJECTIVE The purpose of this study was to investigate the influence of age on GH and IGF1 axis, and complications in patients with acromegaly. SUBJECTS AND METHODS From the medical records, we retrospectively analyzed clinical features and complications in 87 newly diagnosed patients with active acromegaly (34 males, 53 females; aged 18-82 years) who were admitted to Tokyo Women's Medical University between 1999 and 2006. We divided the patients into three groups according to age: <or=30 years old (young group), 31-60 years old (middle-aged group), and >or=61 years old (elderly group). RESULTS The median GH levels in young, middle-aged, and elderly groups were 18.5, 8.8, and 6.7 microg/l respectively, and the IGF1 levels were 810, 717, and 740 microg/l respectively. The values were not significantly different among the groups. However, the serum IGF1 SDS were significantly higher in the elderly group (10.2) than those in young and middle-aged groups (6.6 and 6.2 respectively, P<0.001). The age difference in the higher IGF1 SDS was remarkable in female patients. In the elderly group, glucose intolerance and hypertension were found in 94 and 53% of the patients respectively and the incidences were higher than those in the other groups. CONCLUSION This study suggests that the relatively high IGF1 secretions in elderly patients might be involved in the progression of clinical complications in acromegalic patients. Therefore, awareness of the early symptoms and examination of serum GH and IGF1 are important for patients with acromegaly.
Upper Bound on SNR Gain in Wavelet Transform Predictive-Entropy Image Coding

Using the rate-distortion theory approach and assuming the Laplacian probability density function of the quantizer input signal, we propose a function which gives the signal-to-quantizing-noise ratio (SNR) gain in discrete wavelet transform predictive-entropy coding over fullband predictive image coding. The upper bound on SNR gain is determined as a function of the subband number only. The practical SNR performances of realizable wavelet still image coders are compared with their theoretical bounds. The computer simulation results of wavelet based predictive coded test images show that the SNR gain grows faster with the subband number increment than its theoretical upper bounds do.
Long-term follow-up of prenatally treated children at risk for congenital adrenal hyperplasia: does dexamethasone cause behavioural problems?

OBJECTIVES To investigate the long-term effects of prenatal treatment of congenital adrenal hyperplasia (CAH) with emphasis on behavioural problems and temperament. DESIGN A population-based long-term follow-up study of Swedish children at risk for virilising CAH, who had received treatment prenatally with dexamethasone (DEX). The questionnaire-based follow-up was performed when the children had reached school age. METHODS Standardised parent-completed questionnaires were used to evaluate adaptive functioning, behavioural/emotional problems and psychopathology, social anxiety and temperament in DEX-exposed school-aged children (n=26) and matched controls (n=35). In addition, the association between parental questionnaires and children's self-ratings was investigated. RESULTS There were no statistically significant differences between DEX-exposed children and controls in measures of psychopathology, behavioural problems and adaptive functioning. In a questionnaire on temperamental traits, DEX-exposed children were described by their parents as being more sociable than controls (P=0.042). The correlation analysis showed only modest parent-child agreement on social anxiety, i.e. the increased social anxiety in children's self-ratings was not confirmed by their parents. CONCLUSIONS DEX-treated children showed good overall adjustment. The parent-child agreement with respect to social anxiety was modest, highlighting the importance of multiple information sources and assessment methods. The clinical significance of the observed difference in sociability cannot be determined within the frameworks of this study. Additional studies of larger cohorts are essential to make more decisive conclusions on the safety of the treatment. Until then, it is important that parents are thoroughly informed about the benefits and potential risks and uncertainties of this controversial treatment.
Global molecular structure and interfaces: refining an RNA:RNA complex structure using solution X-ray scattering data.

Determining the global architecture of multicomponent systems is a central problem in understanding biomacromolecular machines. Defining interfaces among components and the global structure of multicomponent systems is a central problem in understanding the biological interactions on a molecular level. We demonstrate that solution X-ray scattering data can be used to precisely determine intermolecular interfaces from just the subunit structures, in the complete absence of intermolecular NMR restraints using an example of a 30 kDa RNA−RNA complex. The backbone root-mean-square deviation (rmsd) between structures that are determined using the scattering data and using intermolecular distance restraints is about 0.4 A. Further, we refined the global structure of the complex using scattering data as a global restraint. The rmsd in backbone structures that are determined with and without the scattering data refinement is about 3.2 A, suggesting the impact of the refinement to the overall structure. Information.
Decreased lipin 1 beta expression in visceral adipose tissue is associated with insulin resistance in polycystic ovary syndrome.

OBJECTIVE In polycystic ovary syndrome (PCOS), insulin resistance (IR) appears with high prevalence and represents the major cause of cardiometabolic complications. Lipin 1beta regulates lipid metabolism and augments insulin sensitivity. The impact of lipin 1beta expression in visceral and subcutaneous adipose tissue of PCOS patients on IR was studied for the first time. METHODS Eighty-five PCOS patients and 44 controls were enrolled for subcutaneous tissue biopsy, of whom 25 patients and 30 controls also underwent visceral adipose tissue biopsy. Gene expression of lipin 1beta was measured, together with that of peroxisome proliferator-activated receptor gamma, lipoprotein lipase, hormone-sensitive lipase, adiponectin and glucose transporter 4 in subcutaneous and visceral adipose tissue. Markers of obesity, IR and PCOS were also measured. RESULTS In PCOS patients, lipin 1beta expression in both adipose depots was lower than in controls: 0.76 (0.67-0.84) vs 1.16 (0.90-1.43) for visceral and 0.91 (0.73-1.10) vs 1.30 (1.03-1.57) for s.c. depot (both P<10(-4)). The difference remained significant after adjustment for body mass index (BMI) and also when comparing only lean patients with lean controls. In PCOS patients, visceral adipose lipin 1beta expression correlated negatively with homeostasis model assessment-IR (r=-0.474, P=0.017), BMI (r=-0.511, P=0.009) and waist circumference (r=-0.473, P=0.017), waist circumference remaining significant (P=0.027) in multiple regression. Subcutaneous lipin 1beta expression in PCOS correlated negatively with BMI, waist circumference and plasma triglycerides, and positively with high density lipoprotein-cholesterol. Subcutaneous, but not visceral lipin 1beta expression, correlated positively with the studied genes. CONCLUSIONS Lipin 1beta appears to be involved in the pathogenesis of IR in PCOS.
Adverse Events in Patients With Community-Acquired Pneumonia at an Academic Tertiary Emergency Department: Do They Contribute to Hospital Death?

A matched case-control study was carried out at a Brazilian academic medical emergency department to identify the occurrence of adverse events (AEs) in patients with community-acquired pneumonia (CAP) and disclose their association with in-hospital death. The cases comprised 101 consecutive deaths and the controls 101 discharged patients admitted for CAP from March 1996 to September 1999. Adverse events were classified according to severity, potential causes, the occurrence of nosocomial infections, and the related professional category. A total of 603 AEs were identified, predominating among the deceased patients: 456 events (75.6%) in 85 cases and 147 (24.4%) in 55 controls. Severe AEs also predominated among the cases. Procedures and nursing activities were the main AE-related potential causes. The occurrence of at least 1 AE was associated with a higher risk of death (3.25-fold). This association was stronger when either severe AEs (8.37-fold) or medical AEs (4.23-fold) were analyzed.
Extreme delta brush

Objectives: To determine continuous EEG (cEEG) patterns that may be unique to anti-NMDA receptor (NMDAR) encephalitis in a series of adult patients with this disorder. Methods: We evaluated the clinical and EEG data of 23 hospitalized adult patients with anti-NMDAR encephalitis who underwent cEEG monitoring between January 2005 and February 2011 at 2 large academic medical centers. Results: Twenty-three patients with anti-NMDAR encephalitis underwent a median of 7 (range 1−123) days of cEEG monitoring. The median length of hospitalization was 44 (range 2−200) days. Personality or behavioral changes (100%), movement disorders (82.6%), and seizures (78.3%) were the most common symptoms. Seven of 23 patients (30.4%) had a unique electrographic pattern, which we named “extreme delta brush” because of its resemblance to waveforms seen in premature infants. The presence of extreme delta brush was associated with a more prolonged hospitalization (mean 128.3 ± 47.5 vs 43.2 ± 39.0 days, p = 0.008) and increased days of cEEG monitoring (mean 27.6 ± 42.3 vs 6.2 ± 5.6 days, p = 0.012). The modified Rankin Scale score showed a trend toward worse scores in patients with the extreme delta brush pattern (mean 4.0 ± 0.8 vs 3.1 ± 1.1, p = 0.089). Conclusions: Extreme delta brush is a novel EEG finding seen in many patients with anti-NMDAR encephalitis. The presence of this pattern is associated with a more prolonged illness. Although the specificity of this pattern is unclear, its presence should raise consideration of this syndrome.
Research capability in doctoral training

Rationale:Doctoral training should provide insight into the evolution of research capability in nursing. Methods:Research designs were evaluated from abstracts of 204 theses extracted from the ASLIB database, 1983–2002. Most were from PhD/DPhil degrees, but a few were Professional Doctorates. Findings:‘Educational’ and ‘organisational’ settings dominated, indicating their sustained popularity. A total of 11 methodological frameworks were noted, with ‘Ethnography’, ‘Social history’, ‘Work environment’ and ‘Grounded theory’ being the most popular. ‘Interviews’ with individuals and ‘Questionnaire survey’ were easily the most popular of 28 different research tools/techniques. Comparing abstracts from 1997–2002 with those from 1983–1996 identified significant changes in methodologies and methods used. The frequency of ‘Phenomenology’, ‘Work environment’ and ‘Grounded theory’ methodologies increased. The ‘Patient led’ framework appeared for the first time, albeit in just a few theses. The incidence of ‘Ethnography’ declined. Some methods only appeared for the first time during the 1990s, e.g. ‘Focus groups’. Of the methods, ‘Interviews’ increased substantially but ‘Questionnaires’ decreased slightly. In terms of developing clinical research, we noted an increased frequency of ‘All experimental’ methods. Multiple methods, used in 71% of theses overall, increased in incidence during the late 1990s, a change that was significantly associated with ‘post-1992’ universities. Over time, there was a significant increase in the number of methodologies and methods used, per thesis. Conclusions:This study documents the breadth of research designs used by students researching nursing. It provides evidence for an evolution of designs with an increasing diversity that indicates a growing maturity of nursing research culture.
Parkinson disease and driving

ABSTRACT The growing literature on driving in Parkinson disease (PD) has shown that driving is impaired in PD compared to healthy comparison drivers. PD is a complex neurodegenerative disorder leading to motor, cognitive, and visual impairments, all of which can affect fitness to drive. In this review, we examined studies of driving performance (on-road tests and simulators) in PD for outcome measures and their predictors. We searched through various databases and found 25 (of 99) primary studies, all published in English. Using the American Academy of Neurology criteria, a study class of evidence was assigned (I–IV, I indicating the highest level of evidence) and recommendations were made (Level A: predictive or not; B: probably predictive or not; C: possibly predictive or not; U: no recommendations). From available Class II and III studies, we identified various cognitive, visual, and motor measures that met different levels of evidence (usually Level B or C) with respect to predicting on-road and simulated driving performance. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with PD are needed by policy makers and clinicians to develop evidence-based guidelines.
Amyloid is linked to cognitive decline in patients with Parkinson disease without dementia

ABSTRACT Objective: To determine whether amyloid burden, as indexed by Pittsburgh compound B (PiB) retention, identifies patients with Parkinson disease with mild cognitive impairment (PD-MCI) compared to those with normal cognition (PD-nl). A related aim is to determine whether amyloid burden predicts cognitive decline in a cohort of subjects with PD without dementia. Methods: In this prospective cohort study, we examined 46 subjects with PD without dementia, of whom 35 had normal cognition and 11 met criteria for PD-MCI at study baseline. All subjects underwent standardized neurologic and neuropsychological examinations and PiB PET at baseline, and clinical examinations were conducted annually for up to 5 years. Results: At baseline, precuneus PiB retention did not distinguish PD-MCI from PD-nl. Subjects with PD-MCI declined more rapidly than PD-nl subjects on cognitive tests of memory, executive function, and activation retrieval. Of the 35 PD-nl subjects, 8 progressed to PD-MCI and 1 to dementia; of the 11 PD-MCI subjects, 5 converted to dementia. Both higher PiB retention and a diagnosis of PD-MCI predicted a greater hazard of conversion to a more severe diagnosis. Baseline PiB retention predicted worsening in executive function over time. The APOE ε4 allele also related to worsening in executive function, as well as visuospatial function, activation retrieval, and performance on the Mini-Mental State Examination. In contrast to its relation to cognitive decline, PiB retention did not affect progression of motor impairment. Conclusions: At baseline measurements, amyloid burden does not distinguish between cognitively impaired and unimpaired subjects with PD without dementia, but our data suggest that amyloid contributes to cognitive, but not motor, decline over time.
Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins

Objectives: Many multiple sclerosis (MS) lesions develop around small veins that are surrounded by perivenular inflammatory cells, but whether veins in the brains of people with MS are smaller or larger than similar veins in healthy volunteers or people with other neurologic diseases remains unknown. This question can be addressed by high-resolution, high-field-strength MRI. Methods: In a cross-sectional study performed on a standard 3 T clinical scanner, we acquired whole-brain T2*-weighted images with 0.55 mm isotropic voxels and reconstructed the courses of deep and superficial veins within the white matter. We compared the apparent diameters of intralesional and perilesional veins to those of extralesional MS veins, veins in healthy volunteers, and veins in individuals with other neurologic diseases. Results: We studied veins in 19 MS cases, 9 healthy volunteers, and 8 individuals with other neurologic diseases, analyzing a total of 349 veins. The mean diameter of intralesional veins (0.76 ± 0.14 mm) was smaller than that of perilesional (1.18 ± 0.13 mm; p < 0.001) and extralesional (1.13 ± 0.14 mm; p < 0.001) veins, regardless of lesion size and location. Perilesional and extralesional MS veins were larger than non-MS veins (0.94 ± 0.14 mm; p < 0.001), and intralesional MS veins were smaller (p < 0.001). Conclusions: The small apparent size of intralesional MS veins may reflect compression by the perivascular inflammatory cuff within active lesions or hardening of the vascular wall in chronic lesions. The finding that extralesional veins are larger than similar veins in non-MS lesions may result from diffuse disease-related processes.
Higher macular volume in patients with MS receiving fingolimod

In the evaluation of patients with multiple sclerosis (MS), optical coherence tomography (OCT) is gaining traction as a tool to assess thinning of the retinal nerve fiber layer (RNFL) and, more recently, for looking at total macular volume (TMV) thickness, with both measures used as potential biomarkers for progression of disease. In medicine, it is not uncommon for structural changes to be presumed to reflect a certain physiologic process, when in fact an alternative mechanism is at play. Fingolimod (FTY-720) is a sphingosine-1-phosphate receptor modulator that is an approved oral treatment for MS and leads to reduced cortical volume loss in patients with MS.1 Similar to other disease-modifying agents, it is likely to be judged in part by its ability to slow loss of the RNFL and TMV. But would such a judgment be valid?
Sarcomeric dysfunction contributes to muscle weakness in facioscapulohumeral muscular dystrophy

Objective: To investigate whether sarcomeric dysfunction contributes to muscle weakness in facioscapulohumeral muscular dystrophy (FSHD). Methods: Sarcomeric function was evaluated by contractile studies on demembranated single muscle fibers obtained from quadriceps muscle biopsies of 4 patients with FSHD and 4 healthy controls. The sarcomere length dependency of force was determined together with measurements of thin filament length using immunofluorescence confocal scanning laser microscopy. X-ray diffraction techniques were used to study myofilament lattice spacing. Results: FSHD muscle fibers produced only 70% of active force compared to healthy controls, a reduction which was exclusive to type II muscle fibers. Changes in force were not due to changes in thin filament length or sarcomere length. Passive force was increased 5- to 12-fold in both fiber types, with increased calcium sensitivity of force generation and decreased myofilament lattice spacing, indicating compensation by the sarcomeric protein titin. Conclusions: We have demonstrated a reduction in sarcomeric force in type II FSHD muscle fibers, and suggest compensatory mechanisms through titin stiffening. Based on these findings, we propose that sarcomeric dysfunction plays a critical role in the development of muscle weakness in FSHD.
Characteristics and determinants of restless legs syndrome in pregnancy

Objective: The aim of this cohort study was to prospectively assess frequency, characteristics, and determinants of restless legs syndrome (RLS) in pregnancy and its impact on sleep. Methods: Pregnant women were prospectively studied in each trimester and 8 weeks postpartum. Assessments included interview about RLS symptoms and sleep disturbances; standardized sleep-wake questionnaires including the International Restless Legs Syndrome Scale (IRLSS) and the Pittsburgh Sleep Quality Questionnaire (PSQI); actigraphic recording of periodic limb movements (PLM); and blood tests including levels of hemoglobin, ferritin, and estrogen. Results: RLS was diagnosed in 58 of 501 women (12%). Positive family history was found in 37% of women with RLS; 59% reported onset of RLS symptoms before the 20th week; 45% had an IRLSS >20 and 100% had a PSQI >5. Hemoglobin levels <11 g/dL were found in 20% of both affected and unaffected women in the third trimester. Women with and without RLS had similar hemoglobin, ferritin, and estrogen levels. IRLSS and PLM in sleep dropped by more than 50% postpartum in women with RLS. Conclusion: We found lower prevalence and earlier onset of symptoms compared to previous studies and confirmed significant improvement after delivery. RLS is clinically relevant due to severe impact on sleep quality. Genetic factors and smoking, but not ferritin, anemia, or estrogen levels, seem to play a role in the pathophysiology of RLS in pregnancy.