Miracle-dz/UniFAR-FTUs huggingface dataset:
Acute chorea and type 1 diabetes mellitus: clinical and neuroimaging findings

The association of type 1 diabetes mellitus (T1DM) and acute chorea is rare. We report an 8‐yr‐old boy with T1DM who developed acute hemichorea–hemiballism of the right arm in whom magnetic resonance imaging (MRI) of the brain revealed hyperintense signal in putamen and considerable atrophy and focal area of gliosis in the right putamen. There was a deposition of deoxyhemoglobin indicating recent bleeding in the left lentiform nucleus. A control MRI 2 months later showed complete reabsorption of the blood component in the left lentiform nucleus. Multislice computerized tomography revealed hyperdensities in the corpus striatum and subcortical calcifications. This report describes, for the first time, findings of calcifications in the corticomedullary junction in the brain hemispheres of a child with T1DM and chorea and reviews the possible causal mechanisms of this unusual association.
Measuring Postural Sway in Sitting: A New Segmental Approach

ABSTRACT Global measures of trunk sway are traditionally used even though the trunk comprises a multiple number of segments. The authors’ aim was to measure the seated sway of typically developing children using a multisegment approach. Twenty typically developing children divided into 2 groups, older and younger than 10 years old, participated in this study. The children sat unsupported for 30 s while their posture and sway were quantified using stereophotogrammetry. The tendency in both age groups was to sit with a backward tilted pelvis and a kyphotic trunk. The sitting position was most varied in the younger group. Marker sway amplitude and velocity in sitting were age dependent, with reduced sway amplitude and velocity with increased age for all segments. Anteroposterior intersegmental angular sway was not age dependent. The difference in marker sway in the anteroposterior direction for the younger group appeared to result from an equally stable trunk supported on a less stable pelvis. Mediolateral marker sway and intersegmental angular sway showed a clearer age dependency. Trunk postural control does not appear to differ between children older and younger than 10 years old, but sagittal plane pelvic stability can explain the increased sway reported in younger children.
Magnetic resonance temperature imaging‐based quantification of blood flow‐related energy losses

This study presents a new approach for evaluating bioheat transfer equation (BHTE) models used in treatment planning, control and evaluation of all thermal therapies. First, 3D magnetic resonance temperature imaging (MRTI) data are used to quantify blood flow‐related energy losses, including the effects of perfusion and convection. Second, this information is used to calculate parameters of a BHTE model: in this paper the widely used Pennes BHTE. As a self‐consistency check, the BHTE parameters are utilized to predict the temperatures from which they were initially derived. The approach is evaluated with finite‐difference simulations and implemented experimentally with focused ultrasound heating of an ex vivo porcine kidney perfused at 0, 20 and 40 ml/min (n = 4 each). The simulation results demonstrate accurate quantification of blood flow‐related energy losses, except in regions of sharp blood flow discontinuities, where the transitions are spatially smoothed. The smoothed transitions propagate into estimates of the Pennes perfusion parameter but have limited effect on the accuracy of temperature predictions using these estimates. Longer acquisition time periods mitigate the effects of MRTI noise, but worsen the effect of flow discontinuities. For the no‐flow kidney experiments the estimates of a uniform, constant Pennes perfusion parameter are approximately zero, and at 20 and 40 ml/min the average estimates increase with flow rate to 3.0 and 4.2 kg/m3/s, respectively. When Pennes perfusion parameter values are allowed to vary spatially, but remain temporally constant, BHTE temperature predictions are more accurate than when using spatially uniform, constant Pennes perfusion values, with reductions in RMSE values of up to 79%. Locations with large estimated perfusion values correspond to high flow regions of the kidney observed in T1‐weighted MR images. This novel, MRTI‐based technique holds promise for improving understanding of thermal therapy biophysics and for evaluating biothermal models. Copyright © 2015 John Wiley & Sons, Ltd.
Profile of physical activity levels in community-dwelling older adults.

PURPOSE To examine relationships between selected sociodemographic, health-related and environmental factors and levels of physical activity in older adults across three age groups. METHODS Seven hundred sixty-four older adults (mean age = 77.4 +/- 8.6 yr) from a midsize Canadian city completed a self-administered questionnaire under researcher supervision. Level of physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Correlates of physical activity were examined using previously validated questionnaires. The findings pertaining to personal and environmental factors are presented. RESULTS Overall, significantly higher mean PASE scores were seen in those individuals in the following categories: male (P < 0.001), married or common-law (P < 0.001), not living alone (P < 0.001), not living in senior's housing (P < 0.001), higher levels of education (P < 0.001) and higher incomes (P < 0.001). Better physical health showed significant positive associations (P < 0.001) with PASE score. Individuals reporting at least four or more chronic health conditions had significantly lower PASE scores than those reporting no chronic conditions (P < 0.001). Significantly lower PASE scores were also reported in those using domestic services (P < 0.001). Higher PASE scores were related to the presence of hills, biking and walking trails, street lights, various recreation facilities, seeing others active and unattended dogs (P < 0.001 to P < 0.05). CONCLUSION An understanding of the factors that influence physical activity behavior in older adults is critical to developing effective intervention strategies that will address the problem of physical inactivity in this population, and in doing so, improve the health status and quality of life of the older adult, while having a significant impact on healthcare expenditures.
Effects of the Cognition-Enhancing Agent ABT-239 on Fetal Ethanol-Induced Deficits in Dentate Gyrus Synaptic Plasticity

Prenatal ethanol exposure causes deficits in hippocampal synaptic plasticity and learning. At present, there are no clinically effective pharmacotherapeutic interventions for these deficits. In this study, we examined whether the cognition-enhancing agent 4-(2-{2-[(2R)-2-methylpyrrolidinyl]ethyl}-benzofuran-5-yl) benzonitrile (ABT-239), a histamine H3 receptor antagonist, could ameliorate fetal ethanol-induced long-term potentiation (LTP) deficits. Long-Evans rat dams consumed a mean of 2.82 g/kg ethanol during a 4-h period each day. This voluntary drinking pattern produced a mean peak serum ethanol level of 84 mg/dl. Maternal weight gain, offspring litter size, and birth weights were not different between ethanol-consuming and control groups. A stimulating electrode was implanted in the entorhinal cortical perforant path, and a recording electrode was implanted in the dorsal dentate gyrus of urethane-anesthetized adult male offspring. Baseline input/output responses were not affected either by prenatal ethanol exposure or by 1 mg/kg ABT-239 administered 2 h before data collection. No differences were observed between prenatal treatment groups when a 10-tetanus train protocol was used to elicit LTP. However, LTP elicited by 3 tetanizing trains was markedly impaired by prenatal ethanol exposure compared with control. This fetal ethanol-induced LTP deficit was reversed by ABT-239. In contrast, ABT-239 did not enhance LTP in control offspring using the 3-tetanus train protocol. These results suggest that histamine H3 receptor antagonists may have utility for treating fetal ethanol-associated synaptic plasticity and learning deficits. Furthermore, the differential effect of ABT-239 in fetal alcohol offspring compared with controls raises questions about the impact of fetal ethanol exposure on histaminergic modulation of excitatory neurotransmission in affected offspring.
RIPK3‐Mediated Necroptosis Promotes Donor Kidney Inflammatory Injury and Reduces Allograft Survival

Kidney transplant injury occurs with ischemia and alloimmunity. Members of the receptor interacting protein kinase family (RIPK1,3) are key regulators of “necroptosis,” a newly recognized, regulated form of necrosis. Necroptosis and apoptosis death appear to be counterbalanced as caspase‐8 inhibition can divert death from apoptosis to necrosis. Inhibition of necroptosis in donor organs to limit injury has not been studied in transplant models. In this study, necroptosis was triggered in caspase inhibited tubular epithelial cells (TEC) exposed to tumor necrosis factor alpha in vitro, while RIPK1 inhibition with necrostatin‐1 or use of RIPK3−/− TEC, prevented necroptosis. In vivo, short hairpin RNA silencing of caspase‐8 in donor B6 mouse kidneys increased necroptosis, enhanced high‐mobility group box 1 release, reduced renal function and accelerated rejection when transplanted into BALB/c recipients. Using ethidium homodimer perfusion to assess necrosis in vivo, necrosis was abrogated in RIPK3−/− kidneys postischemia. Following transplantation, recipients receiving RIPK3−/− kidneys had longer survival (p = 0.002) and improved renal function (p = 0.03) when compared to controls. In summary, we show for the first time that RIPK3‐mediated necroptosis in donor kidneys can promote inflammatory injury, and has a major impact on renal ischemia–reperfusion injury and transplant survival. We suggest inhibition of necroptosis in donor organs may similarly provide a major clinical benefit.
A proposition of low cost Sensor Web implementation based on GSM/GPRS services

In past few years, automatic remote systems for monitoring a wide range of environment or process parameters have exposed a rapid growth concerning the technology issues. Entering the era of Internet of Things (IoTs), a highly dynamic and radically distributed networked system, usage of small, cheap, flexible and end-user programmable computer hardware becomes apparent. These objects, deployed in various environments, are able to communicate and to interact among themselves, with end-users or other entities in the network. Using such objects, tasks like monitoring, control or data processing can be easily done. But, in some case, the target environments are often too dangerous, hazardous, unwired, or difficult to access. In such unfriendly environments there are many challenges for monitoring systems (wireless sensor networks) deployment and maintenance. As the possible solution, in this paper we have suggested the creation of an economical remote monitoring system, based on cheap computer board (Raspberry Pi), wireless sensors and GSM/GPRS (Global System for Mobile Communications/General packet radio service). In other words, the Raspberry Pi platform is utilized as central processing unit which provides a set of services for accessing sensor data, and communicates with end users, while different types of sensors (depending of target parameters) can constitute the detection module. 3G/4G USB Modem or GSM/GPRS shields can be used as GSM/GPRS communication module in order to ensure Internet connection. A whole system presents an IoT solution, precisely a Sensor Web node, which can be accessed all over the world, and provide information from a monitored environment. Performed research shows a possibility of setting up this system for a remote communication, control function and monitoring in unfriendly environments. The usage of low cost pieces of hardware verifies that the Raspberry Pi is highly suitable for numerous IoT concept applications and especially in the unfriendly environments.
Randomized comparison of consolidation radiation versus observation in bulky Hodgkin's lymphoma with post-chemotherapy negative positron emission tomography scans

This study aimed at evaluating the role of consolidation radiation in a setting of Hodgkin's lymphoma (HL) patients, using event-free survival (EFS) as end point. Among 260 patients treated with induction chemotherapy for bulky HL, 160 patients achieved negative residual masses at 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scans. They were randomly divided into two well-matched groups to receive either 32 Gy radiotherapy to bulky area or no further therapy. At a median follow-up of 40 months, histology showed a malignancy in 14% of patients in the chemotherapy-only group (HL, 11 patients) and in 4% of patients in the chemotherapy + radiotherapy group (HL, 2 patients; carcinoma in previously irradiated area, 1 patient) (P = 0.03). All the relapses in the chemotherapy-only group involved the bulky site and the contiguous nodal regions. Thus, the overall diagnostic accuracy of FDG-PET to exclude future relapses in the patients nonprotected by radiotherapy was 86% with a false-negative rate of 14%. Our study suggests that the addition of irradiation helps improve EFS in HL patients with post-chemotherapy FDG-PET-negative residual masses.
The United States, in Comparative Counter-Terrorism

The United States, like all other democratic nations that have suffered terrorist attacks, continues to struggle with questions of how to keep its population safe while maintaining the principles of democracy and the rule of law. This Book Chapter discusses the United State’s counterterrorism policies, particularly since the September 11 terrorist attacks, and the resulting changes in societal viewpoints, political agendas, and the legal authority to combat terrorism and threats of terrorism. The government’s aggressive counterterrorism stance has influenced actions and policies outside the United States. The Author’s exploration of counterterrorism policies in the United States include: criminal law and prosecutions of terrorist acts; the investigative powers of the police and intelligence agencies; the challenges relating to proscription/listing of terrorist groups and individuals; the enactment of the PATRIOT act and other policies to provide mechanisms to disrupt and destroy terrorism financing; immigration measures including detention; and the role of the military and extraterritorial counterterrorism activities as related to detention, access to justice, and torture with accountability.
The effect of intraoperative dexmedetomidine on acute kidney injury after pediatric congenital heart surgery

Background: Dexmedetomidine has been reported to have a renal protective effect after adult open heart surgery. The authors hypothesized that intraoperative infusion of dexmedetomidine would attenuate the decrease in renal function after pediatric open heart surgery. Methods: Twenty-nine pediatric patients (1–6 years) scheduled for atrial or ventricular septal defect repair were randomly assigned to receive either continuous infusion of normal saline (control group, n = 14) or dexmedetomidine (a bolus dose of 0.5 &mgr;g/kg and then an infusion of 0.5 &mgr;g/kg/h) (dexmedetomidine group, n = 15) from anesthesia induction to the end of cardiopulmonary bypass. Serum creatinine (Scr) was measured before surgery (T0), 10 minutes after anesthesia induction (T1), 5 minutes after cardiopulmonary bypass weaning (T2), 2 hours after T2 (T3), and after postoperative day 1 (POD1) and postoperative day 2 (POD2) and estimated glomerular filtration rates (eGFRs) were calculated. Renal biomarkers were measured at T1, T2, and T3. Acute kidney injury (AKI) was defined as an absolute increase in Scr of ≥ 0.3 mg/dL or a percent increase in Scr of ≥50%. Results: The incidence of AKI during the perioperative period was significantly higher in the control group than in the dexmedetomidine group (64% [9/14] vs 27% [4/15], P = .042). eGFR was significantly lower in the control group than in the dexmedetomidine group at T2 (72.6 ± 15.1 vs 83.9 ± 13.5, P = .044) and T3 (73.4 ± 15.4 vs 86.7 ± 15.9, P = .03). Conclusion: Intraoperative infusion of dexmedetomidine may reduce the incidence of AKI and suppress post-bypass eGFR decline.
Missing the mark: the faulty logic of aggregate scoring in script concordance tests

P. Personality traits and types predict medical school stress: a sixyear longitudinal and nationwide study. Med Educ 2007;41:781–7. 9 Ross L, Nisbett RE. The Person and the Situation: Perspectives in Social Psychology. New York, NY: McGrawHill 1991. 10 Fraser K, Huffman J, Ma I, Sobczak M, McIlwrick J, Wright B, McLaughlin K. The emotional and cognitive impact of unexpected simulated patient death: a randomised controlled trial. Chest 2014;145:958–63. 11 Corvetto MA, Taekman JM. To die or not to die? A review of simulated death. Simul Healthc 2013;8:8–12. 12 Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technologyenhanced simulation: a systematic review and meta-analysis. Med Educ 2014;48:657–66. 13 Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, Shanafelt TD. Burnout among US medical students, residents, and early career physicians relative to the general US population. Acad Med 2014;89:443–51. 14 West CP, Dyrbye LN, Rabatin JT, Call TG, Davidson JH, Multari A, Romanski SA, Hellyer JM, Sloan JA, Shanafelt TD. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomised clinical trial. JAMA Intern Med 2014;174:527–33.
Virologic Determinants of Success After Structured Treatment Interruptions of Antiretrovirals in Acute HIV-1 Infection

Background:Latently infected resting memory CD4 T cells are thought to be the major reservoir that contributes to rebound viremia after cessation of antiretrovirals (ARVs). Commencing ARVs during primary HIV-1 infection (PHI) may limit the size of the latent pool and lead to improved control of viral replication during structured treatment interruption (STI). Methods:Individuals with PHI (n = 59) were randomized to receive ARVs with or without hydroxyurea. After STI, a good response was defined as maintenance of HIV-1 RNA <5000 copies/mL for 24 weeks off therapy. In a detailed prospective virologic substudy (n = 19), integrated HIV-1 DNA, total HIV-1 DNA, and cell-associated HIV-1 unspliced (US) RNA were quantified using a real-time polymerase chain reaction assay. Results:The plasma HIV-1 RNA 12 weeks after the initiation of ARVs was significantly lower in good responders (n = 7) compared with poor responders (n = 12) (P = 0.005). There were no significant differences between good and poor responders in integrated HIV-1 DNA, HIV-1 DNA, and HIV-1 US RNA. Integrated HIV-1 DNA before initiation of ARVs was strongly correlated with plasma HIV-1 RNA at week 12 (P = 0.006, r = 0.81). Conclusion:HIV-1 RNA measured 12 weeks after initiation of ARV was the only virologic variable associated with viral rebound after treatment interruption in PHI.
Exporting status and success in innovation: evidence from CIS micro data for EU countries

ABSTRACT Using a large sample of micro data from four waves of Community Innovation Survey for EU member states, we investigate the relationship between firms’ export status and different sorts of innovation activities. We find systematically positive relationship between the two, whereby the strongest correlation is found in case of product innovation and the weakest in case of organizational innovations. While aggregate data show that innovation success is increasing in firm size, we find that exporting has the strongest effect on innovation in the medium-sized firms. We also explore cross-country differences in the impact of export status on innovation. Countries with a higher share of exports in GDP and greater share of spending on research and development generally display a stronger correlation between exporting status and innovation.
Investigation of optimizing and translating pH‐sensitive pulsed‐chemical exchange saturation transfer (CEST) imaging to a 3T clinical scanner

Chemical exchange saturation transfer (CEST) MRI provides a sensitive detection mechanism that allows characterization of dilute labile protons usually undetectable by conventional MRI. Particularly, amide proton transfer (APT) imaging, a variant of CEST MRI, has been shown capable of detecting ischemic acidosis, and may serve as a surrogate metabolic imaging marker. For preclinical CEST imaging, continuous‐wave (CW) radiofrequency (RF) irradiation is often applied so that the steady state CEST contrast can be reached. On clinical scanners, however, specific absorption rate (SAR) limit and hardware preclude the use of CW irradiation, and instead require an irradiation scheme of repetitive RF pulses (pulsed‐CEST imaging). In this work, CW‐ and pulsed‐CEST MRI were systematically compared using a tissue‐like pH phantom on an imager capable of both CW and pulsed RF irradiation schemes. The results showed that the maximally obtainable pulsed‐CEST contrast is approximately 95% of CW‐CEST contrast, and their optimal RF irradiation powers are equal. Moreover, the pulsed‐CEST sequence was translated to a 3 Tesla clinical scanner and detected pH contrast from the labile creatine amine groups (1.9 ppm). Furthermore, pilot endogenous APT imaging of normal human volunteers was demonstrated, warranting future APT MRI of stroke patients to elucidate its diagnostic value. Magn Reson Med 60:834–841, 2008. © 2008 Wiley‐Liss, Inc.
Patient perspectives on quality and access to healthcare after brain injury

ABSTRACT Primary objective: To gather information about brain injury (BI) survivors’ long-term healthcare needs, quality, barriers and facilitators. Research design: Qualitative content analysis of data gathered in focus groups using semi-structured interviews. Methods: Forty-four community-dwelling adults participated at two clinical research centres in Seattle, Washington and New York, New York. Participants were asked open-ended questions about their experiences with healthcare in the community with regard to care needs, utilization, access, barriers and facilitators to health management. Results: Central themes emerged across three categories: 1) barriers to healthcare access/utilization, 2) facilitators to healthcare access/utilization, and 3) suggestions for improving healthcare after BI. The importance of communication as both a facilitator and barrier to care was mentioned by most participants. Compensatory strategies and external tools were identified as key facilitators of medical self-management. Finally, improving clinicians’ knowledge about BI emerged as a potential solution to address health needs of individuals with chronic BI. Conclusions: Additional efforts need to be made to improve access to appropriate healthcare and increase the ability for individuals to successfully navigate the healthcare system. Findings suggest several specific, low-cost modifications to healthcare delivery and strategies for improving medical self-management that can maximize long-term health maintenance for BI survivors.