Miracle-dz/UniFAR-FTUs huggingface dataset:
Single photon emission computed tomography with [99Tc]‐HM‐PAO and [123I]‐IBZM in Alzheimer's disease and dementia of frontal type: preliminary results

Dementia of frontal type (DFT) is a fairly common degenerative disease distinct from Alzheimer's disease (AD), whose reportedly distinctive instrumental feature is frontal lobe hypoperfusion on SPECT. We evaluated the cortical dopaminergic system in 6 AD, 5 DFT, and 6 control subjects with SPECT and both [99Tc]‐HM‐PAO, a perfusion tracer, and [123I]‐IBZM, a D2 postsynaptic ligand. Both in AD and DFT patients, [99Tc]‐HM‐PAO SPECT showed a relative frontal hypoperfusion. On the contrary, [123I]‐IBZM SPECT showed significantly reduced ligand uptake in superior frontal regions of DFT (0.89 ± 0.08 relative to control subjects) as compared to AD patients (0.97 ± 0.02; difference of means: 0.08, 95% Confidence Interval 0.004 to 0.156; p = 0.041). Results suggest more marked involvement of the frontal cortical dopaminergic system in DFT than in AD patients.
Improved fiber Bragg grating array OFFH-CDMA system using a novel frequency-overlapping multigroup method

The authors propose a novel frequency-overlapping multigroup scheme for a passive all-optical fast-frequency hopped code-division multiple-access (OFFH-CDMA) system based on fiber Bragg grating array (FBGA). In the conventional scheme, the users are assigned those codes constructed on the nonoverlapping frequency slots, and therefore the bandgaps between the adjacent gratings are wasted. To make a more efficient use of the optical spectrum, the proposed scheme divided the users into several groups, and assigned the codes, which interleaved to each other to the different groups. In addition to the higher utilization of the spectrum, the interleaved nature of the frequency allocations of different groups will make the groups less correlated and, hence, lower the multiple-access interference (MAI). The corresponding codeset and its constraints for this new scheme are also developed and analyzed. The performance of the system in terms of the correlation functions and bit error rate (BER) are given in both the conventional and the proposed schemes. The numerical results show that, with the multigroup scheme, performance is much improved compared to the conventional scheme
A framework for developing, implementing, and evaluating clinical prediction models in an individual participant data meta‐analysis

The use of individual participant data (IPD) from multiple studies is an increasingly popular approach when developing a multivariable risk prediction model. Corresponding datasets, however, typically differ in important aspects, such as baseline risk. This has driven the adoption of meta‐analytical approaches for appropriately dealing with heterogeneity between study populations. Although these approaches provide an averaged prediction model across all studies, little guidance exists about how to apply or validate this model to new individuals or study populations outside the derivation data. We consider several approaches to develop a multivariable logistic regression model from an IPD meta‐analysis (IPD‐MA) with potential between‐study heterogeneity. We also propose strategies for choosing a valid model intercept for when the model is to be validated or applied to new individuals or study populations. These strategies can be implemented by the IPD‐MA developers or future model validators. Finally, we show how model generalizability can be evaluated when external validation data are lacking using internal–external cross‐validation and extend our framework to count and time‐to‐event data. In an empirical evaluation, our results show how stratified estimation allows study‐specific model intercepts, which can then inform the intercept to be used when applying the model in practice, even to a population not represented by included studies. In summary, our framework allows the development (through stratified estimation), implementation in new individuals (through focused intercept choice), and evaluation (through internal–external validation) of a single, integrated prediction model from an IPD‐MA in order to achieve improved model performance and generalizability. Copyright © 2013 John Wiley & Sons, Ltd.
Self-help books for depression: how can practitioners and patients make the right choice?

BACKGROUND Depression is a common and important public health problem most often treated by GPs. A self-help approach is popular with patients, yet little is known about its effectiveness. AIM Our primary aim was to review and update the evidence for the clinical effectiveness of bibliotherapy in the treatment of depression. Our secondary aim was to identify which of these self-help materials are generally available to buy and to examine the evidence specific to these publications. METHOD Medline, CINAHL, EMBASE, PsycINFO, CCTR, PsiTri and the National Research Register were searched for randomised trials that evaluated self-help books for depression which included participants aged over 16 years with a diagnosis or symptoms of depression. Clinical symptoms, quality of life, costs or acceptability to users were the required outcome measures. Papers were obtained and data extracted independently by two researchers. A meta-analysis using a random effects model was carried out using the mean score and standard deviation of the Hamilton Rating Scale for Depression at the endpoint of the trial. RESULTS Eleven randomised controlled trials were identified. None fulfilled CONSORT guidelines and all were small, with the largest trial having 40 patients per group. Nine of these evaluated two current publications, Managing Anxiety and Depression (UK) and Feeling Good (US). A meta-analysis of 6 trials evaluating Feeling Good found a large treatment effect compared to delayed treatment (standardised mean difference = -1.36; 95% confidence interval [CI] = -1.76 to -0.96). Five self-help books were identified as being available and commonly bought by members of the public in addition to the two books that had been evaluated in trials. CONCLUSION There are a number of self-help books for the treatment of depression readily available. For the majority, there is little direct evidence for their effectiveness. There is weak evidence that suggests that bibliotherapy, based on a cognitive behavioural therapy approach is useful for some people when they are given some additional guidance. More work is required in primary care to investigate the cost-effectiveness of self-help and the most suitable format and presentation of materials.
Pelvic examination instruction and experience: a comparison of laywoman‐trained and physician‐trained students

PURPOSE: To evaluate medical student performances of pelvic examinations after completion of the obstetrics-gynecology (ob-gyn) clinical clerkship in order to compare the effectiveness of training by laywomen serving as both teachers and patients with the effectiveness of training by an attending physician as teacher, with a lay-woman serving only as the patient. The study also examined whether students were given additional training and opportunities for practice during their clinical clerkships in other disciplines. METHOD: Following completion of their ob-gyn clerk-ships in 1993 and 1994, a total of 81 students at two North Carolina medical schools answered a questionnaire eliciting demographic information, pelvic examination experience, and the content of the training they had received. The students then performed a pelvic examination on a standardized patient (SP). Their performances were evaluated by the SP using a 35-item scale, subdivided into technical and interpersonal skills. The data were analyzed by two-tailed t-tests, analysis of variance, and chi-square tests. RESULTS: The laywoman-trained students demonstrated better interpersonal skills than did the physician-trained students (p = .01). No significant difference was found in technical skills. Nearly one-fourth of the students reported that communication skills had not been taught during their ob-gyn clerkships. The students reported performing pelvic examinations often on their ob-gyn rotation but infrequently on other rotations. CONCLUSION: The authors recommend that teaching by laywomen be incorporated into the teaching of pelvic examinations and other aspects of a women's health curriculum. Interpersonal skills taught by laywomen in preclinical courses on pelvic examination may have a lasting effect that can be demonstrated after exposure to clinical clerkships. Clinical clerkships should then reinforce these skills.
Nonoperative Management of Discogenic Back Pain: A Systematic Review

Study Design. Systematic review of the literature. Objective. A systematic evaluation of the literature was performed to investigate current nonoperative management of the treatment of discogenic low back pain. Summary of Background Data. Back pain is a major health care concern with up to 39% being discogenic in origin according to one study. Nonoperative therapy is likely to be the initial treatment strategy for discogenic low back pain. Methods. PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched for clinical studies evaluating nonoperative methods of treating discogenic back pain that were published between 2000 and 2012. Only prospective randomized controlled studies that compared a nonsurgical intervention with sham or placebo therapy were included. After removal of duplicate citations, a total of 226 articles were initially identified from the search terms. From these, we identified 11 randomized controlled trials (RCTs) from which data analysis was performed. Results. The 11 RCTs investigated traction therapy, injections, and ablative techniques. Results from 5 RCTs investigating methylene blue injection, steroid injection, ramus communicans ablation, intradiscal electrothermal therapy, and biacuplasty favored intervention over sham therapy. However, results from the study on methylene blue injections have not been replicated in other RCTs. Evaluation of the selection criteria used in the studies on ramus communicans ablation and intradiscal biacuplasty and a stratified analysis of results from the RCTs on intradiscal electrothermal therapy casts doubt on whether the conclusions from these RCTs can be applied to the general patient population with discogenic pain. Conclusion. There are few high-quality studies evaluating nonoperative treatments for reducing discogenic low back pain. Although conclusions from several studies favor intervention over sham, it is unclear whether these interventions confer stable long-term benefit. There is some promise in newer modalities such as biacuplasty; however, more inclusive studies need to be performed. Level of Evidence: 2
Distribution of aromatase, estrogen receptor, and androgen receptor mRNA in the forebrain of songbirds and nonsongbirds

Androgens and estrogens are crucial for the differentiation and function of the vocal control system of songbirds. A major source of estrogens in songbirds is the cerebral aromatization of circulating testosterone by aromatase (ARO). In the vocal control system, songbirds have a unique estrogen receptor (ER)‐containing area, the nucleus hyperstriatalis ventrale pars caudale (HVC) of the caudal neostriatum. Work in the zebra finch has demonstrated ARO expression adjacent to but not in the HVC. Compared with other songbirds, such as the canary, the HVC of adult zebra finches contains only few ERs. To determine whether the disjunctive distribution of ERs and ARO in the forebrain is a songbird‐specific feature, the authors investigated ARO and ER mRNA expression in songbirds (canary, house sparrow, and zebra finch) and in nonsongbirds (budgerigar, ring dove, swift, grey partridge, and barn owl) of five avian orders. In addition, the coexpression of androgen receptor (AR) and ARO mRNAs was studied. Preoptic hypothalamic areas showed similar expression of ARO in all species. In the caudal neostriatum, ARO, AR, and ER transcripts were found only in songbirds. ARO and ER mRNA expression in the caudal forebrain was spatially separated, i.e., the HVC contained ER mRNA but very little or no ARO mRNA, and the caudomedial neostriatum contained high levels of ARO mRNA but few if any ERs. ARO and AR mRNAs, however, were coexpressed in the caudomedial neostriatum. The coexpression of ARO mRNA with AR mRNA but not with ER mRNA was found in further brain areas, such as the nucleus posterior lateralis hypothalami. The area‐specific coexpression of AR, ER, and ARO suggests various possibilities for the steroid‐dependent regulation of ARO and for the role of ARO in controlling AR‐ and ER‐dependent mechanisms. J. Comp. Neurol. 407:115–129, 1999. © 1999 Wiley‐Liss, Inc.
Molecular targets of cancer chemoprevention by garlic-derived organosulfides

AbstractThe medicinal benefits of Allium vegetables, especially garlic, have been noted throughout recorded history. The known health benefits of Allium vegetables and their constituents include cardiovascular protective effects, stimulation of immune function, reduction of blood glucose level, radioprotection, improvement of memory loss, protection against microbial, viral and fungal infections, as well as anticancer effects. Population-based case control studies have suggested an inverse correlation between dietary intake of Allium vegetables and the risk of different types of cancers. The anticarcinogenic effect of Allium vegetables including garlic is attributed to organosulfur compounds (OSC), which are highly effective in affording protection against cancer in animal models induced by a variety of chemical carcinogens. More recent studies have shown that certain naturally occurring OSC analogues can suppress proliferation of cancer cells in culture and in vivo. The OSC-induced changes in the proliferation of cancer cells are frequently associated with perturbations in cell cycle progression and induction of G2/M phase arrest. The OSC have also been demonstrated to induce apoptosis via the intrinsic pathway by altering the ratio of the Bcl-2 family of proteins both in cell culture and in in vivo models. Anti-angiogenic activity for garlic-derived OSC has also been documented. This article summarizes current knowledge on molecular targets of cancer chemoprevention by OSC.
Matching Spiracle Opening to Metabolic Need During Flight in Drosophila

The respiratory exchange system of insects must maximize the flux of respiratory gases through the spiracles of the tracheal system while minimizing water loss. This trade-off between gas exchange and water loss becomes crucial when locomotor activity is increased during flight and metabolic needs are greatest. Insects that keep their spiracles mostly closed during flight reduce water loss but limit the flux of oxygen and carbon dioxide into and out of the tracheal system and thus attenuate locomotor performance. Insects that keep their spiracles completely open allow maximum gas exchange but face desiccation stress more quickly. Experiments in which water vapor was used as a tracer gas to track changes in the conductance of the respiratory system indicated that flying fruit flies minimize potential water loss by matching the area of the open spiracles to their gas exchange required for metabolic needs. This behavior maintained approximately constant pressure for carbon dioxide (1.35 kilopascals) and oxygen (19.9 kilopascals) within the tracheal system while reducing respirometric water loss by up to 23% compared with a strategy in which the spiracles are held wide open during flight. The adaptive spiracle-closing behavior in fruit flies has general implications for the ecology of flying insects because it shows how these animals may cope with environmental challenges during high locomotor performance.
Human Osteoclast Cathepsin K Is Processed Intracellularly Prior to Attachment and Bone Resorption

Cathepsin K is a member of the papain superfamily of cysteine proteases and has been proposed to play a pivotal role in osteoclast‐mediated bone resorption. We have developed a sensitive cytochemical assay to localize and quantify osteoclast cathepsin K activity in sections of osteoclastoma and human bone. In tissue sections, osteoclasts that are distant from bone express high levels of cathepsin K messenger RNA (mRNA) and protein. However, the majority of the cathepsin K in these cells is in an inactive zymogen form, as assessed using both the cytochemical assay and specific immunostaining. In contrast, osteoclasts that are closer to bone contain high levels of immunoreactive mature cathepsin K that codistributes with enzyme activity in a polarized fashion toward the bone surface. Polarization of active enzyme was clearly evident in osteoclasts in the vicinity of bone. The osteoclasts apposed to the bone surface were almost exclusively expressing the mature form of cathepsin K. These cells showed intense enzyme activity, which was polarized at the ruffled border. These results suggest that the in vivo activation of cathepsin K occurs intracellularly, before secretion into the resorption lacunae and the onset of bone resorption. The processing of procathepsin K to mature cathepsin K occurs as the osteoclast approaches bone, suggesting that local factors may regulate this process.
Accuracy of scanography using storage phosphor plate systems and film for assessment of mandibular third molars.

OBJECTIVES The aim of this study was to compare the diagnostic accuracy of two digital photostimulable storage phosphor (PSP) systems and film for assessment of mandibular third molars before surgery. METHODS 110 patients were referred to have both their mandibular third molars removed. Each patient underwent a radiographic examination with scanography using either Digora (Soredex, Helsinki, Finland) and film or VistaScan (Dürr Dental, Beitigheim-Bissingen, Germany) and film in a randomized paired design. Two observers examined the following variables on the scanograms: bone coverage, angulation of the tooth in the bone, number of roots, root morphology and the relationship to the mandibular canal. In 75 of the pairs (Digora/film pair = 38 and Vista/film pair = 37) both third molars were eventually removed. During and after surgery the same variables were assessed, which served as reference standard for the radiographic assessments. The Wilcoxon signed-rank test tested differences in accuracy (radiographic compared with surgical findings) between Digora/film and between Vista/film. RESULTS There was no statistically significant difference between the diagnostic accuracy of film and either of the two digital receptors for assessment of mandibular third molars before surgery (P > 0.05), although Digora obtained a higher accuracy than film. CONCLUSIONS Scanography is a valuable method for examination of mandibular third molars before removal and the PSP digital receptors in this study were equal to film for this purpose.
Routine surveillance myocardial biopsies are unnecessary beyond one year after heart transplantation.

BACKGROUND Myocardial rejection is most apt to occur in the first 90 days after heart transplantation. Nevertheless, surveillance endomyocardial biopsies are often performed on a regular basis, indefinitely. The benefit of this approach to patient management is uncertain. Our objective was to determine the frequency of abnormalities and the influence of a routine annual endomyocardial biopsy on patient management. METHODS In a consecutive series of 235 transplant recipients who survived 1 year or more, the results of 1123 routine endomyocardial biopsies performed 1 year or more after transplantation were reviewed. The incidence of late rejection, presence of Quilty effect (focal endocardial or myocardial lymphocytic aggregates), and therapeutic reaction to the biopsy result were analyzed. RESULTS Of 1123 biopsy specimens in 235 patients (1 to 12 years after transplantation), 1115 (99.3%) showed no evidence of significant rejection (grade 0 or 1). Only seven (0.6%) had evidence of rejection grade 2 or worse. Of the seven abnormal biopsy specimens in seven patients, two occurred at 1 year, two at 2 years, and one each at 4, 7, and 8 years. Of these, six were treated for rejection with an increase in the immunosuppressive therapy. One patient was identified as having a symptomatic condition at the time of biopsy. A focal endocardial or myocardial accumulation of lymphocytes (Quilty effect) was present in 311 biopsy specimens (27.6%). Beyond 1 year, 33 patients died, 14 because of graft vascular disease with or without rejection and 19 because of other causes. No deaths were predicted on the basis of a routine surveillance biopsy. CONCLUSIONS Myocardial rejection is rare beyond 1 year after transplantation. The routine endomyocardial biopsy does not significantly impact patient management beyond 1 year. A selective approach to myocardial biopsies, on the basis of a change in clinical status or immunosuppressive medications, is justified.
Detection of avian metapneumovirus subtypes in turkeys using RT-PCR

This study investigated the prevalence of avian metapneumovirus (aMPV) and the detection of molecular subtypes of field strains of the virus using RT-PCR in clinically healthy turkeys and those showing signs of respiratory disease. In the RT-PCR examination of 624 tracheal tissue samples collected from a local turkey abattoir, 2.9 per cent (18/624) of samples tested positive. In the examination of tracheal swab samples collected from flocks with respiratory problems, 18 of 20 samples tested positive. When the results were assessed at flock level, aMPV infection was detected in only one of the 23 clinically healthy turkey flocks, whereas all four flocks with respiratory problems were infected. Molecular typing using primers specific to the attachment glycoprotein (G) gene showed that all 36 positive samples belonged to subtype B. Partial sequence analysis of DNA samples showed 95 per cent homology between the field types and the reference strain aMPV subtype B. Whereas clinically healthy turkeys had been vaccinated with a subtype A virus vaccine, the flocks with respiratory problems had been vaccinated with a subtype B virus vaccine. Despite four blind passages of RT-PCRpositive samples on Vero and chicken embryo fibroblast cells, no cytopathic effect was detected by microscopic examination.