Miracle-dz/UniFAR-FTUs huggingface dataset:
Anesthetic management of morbidly obese patients

BESITY, derived from the Latin word obesus, meaning "fattened by eating," is a condition of excessive body fat. ~ It is often difficult to distinguish between normal and excessive amounts of fat tissue, but when physical and mental health are affected by increased amounts of fat tissue and life expectancy is reduced, a person can be considered obese. 2 The anatomic distribution of body fat is associated with varying pathophysiologic consequences. 3-5 In android or central obesity, adipose tissue is located predominantly in the upper body (truncal distribution) and is associated with increased oxygen consumption and increased incidence of cardiovascular disease, whereas in gynecoid or peripheral obesity, adipose tissue located predominantly in the hips, buttocks, and thighs is less metabolically active so it is less closely associated with cardiovascular disease. 3 Intraabdominal fat distribution appears to be particularly associated with cardiovascular risk 4 and left ventricular dysfunction. 5 Obesity has a multifactorial origin, influenced significantly by genetic, ethnic, socioeconomic, and endocrine factors. 6 Ideal body weight (IBW) describes the weight associated with the lowest mortality rate for a given height and gender, and it can be estimated by using the Broca index: IBW (in kg) = height (in cm) - X, where X is 100 for adult men and 105 for adult women. 6'7 Normal values are individualized based on height. In clinical practice, body mass index (BMI) is used to estimate the degree of obesity.
Diffuse traumatic axonal injury in mice induces complex behavioural alterations that are normalized by neutralization of interleukin‐1β

Widespread traumatic axonal injury (TAI) results in brain network dysfunction, which commonly leads to persisting cognitive and behavioural impairments following traumatic brain injury (TBI). TBI induces a complex neuroinflammatory response, frequently located at sites of axonal pathology. The role of the pro‐inflammatory cytokine interleukin (IL)‐1β has not been established in TAI. An IL‐1β‐neutralizing or a control antibody was administered intraperitoneally at 30 min following central fluid percussion injury (cFPI), a mouse model of widespread TAI. Mice subjected to moderate cFPI (n = 41) were compared with sham‐injured controls (n = 20) and untreated, naive mice (n = 9). The anti‐IL‐1β antibody reached the target brain regions in adequate therapeutic concentrations (up to ~30 μg/brain tissue) at 24 h post‐injury in both cFPI (n = 5) and sham‐injured (n = 3) mice, with lower concentrations at 72 h post‐injury (up to ~18 μg/g brain tissue in three cFPI mice). Functional outcome was analysed with the multivariate concentric square field (MCSF) test at 2 and 9 days post‐injury, and the Morris water maze (MWM) at 14–21 days post‐injury. Following TAI, the IL‐1β‐neutralizing antibody resulted in an improved behavioural outcome, including normalized behavioural profiles in the MCSF test. The performance in the MWM probe (memory) trial was improved, although not in the learning trials. The IL‐1β‐neutralizing treatment did not influence cerebral ventricle size or the number of microglia/macrophages. These findings support the hypothesis that IL‐1β is an important contributor to the processes causing complex cognitive and behavioural disturbances following TAI.
Does surprise enhancement or repetition suppression explain visual mismatch negativity?

A long tradition of electrophysiological studies, using oddball sequences, showed that the neural responses to a given stimulus differ when their presentation occurs frequently (standards) as compared to rare, infrequent presentations (deviants). This difference, originally described in acoustic perception, can also be detected in the visual modality and is termed as visual mismatch negativity (vMMN). Also, a large number of studies detected the reduction of the neuronal response after the repetition of a given stimulus (repetition suppression – RS) and it was suggested that RS is the major mechanism of MMN, an explanation currently also supported by animal studies. However, human studies have proposed that a surprise‐related response enhancement for the deviant stimuli might also underlie vMMN. Therefore, the aim of the current study was to disentangle which neural mechanism explains vMMN better: the surprise related response enhancement for the presentation of rare deviants or the RS related to the frequent presentation of the standards. Since the MMN depends strongly on the applied categories, we tested the neural mechanisms of vMMN for different stimulus categories (faces, chairs, real and false characters) using a visual oddball paradigm. We found significant vMMN for every stimulus category. Interestingly, the neural mechanisms behind vMMN were found to be category dependent (assuming no cross‐adaptation effects): for faces and chairs it was largely driven by RS, whereas for real and false characters it was mainly due to surprise‐related changes.
Subjective visual awareness emerges prior to P3

Studies on the neural basis of visual awareness, the subjective experience of seeing, have found several potential neural correlates of visual awareness. Some of them may not directly correlate with awareness but with post‐perceptual processes, such as reporting one's awareness of the stimulus. We dissociated potential electrophysiological correlates of visual awareness from those occurring during response selection and thus co‐occurring with post‐perceptual processing. The participants performed two GO‐NOGO conditions. In the aware‐GO condition they responded with a key press when they were aware of the stimulus and withheld responding when they were unaware of it. In the unaware‐GO condition they withheld responding when they were aware and responded when they were not aware of the stimulus. Thus, event‐related potentials could be measured to aware and unaware trials when responding was required and when not required. The results revealed that the N200 amplitude (180–280 ms) over the occipital and posterior temporal cortex was enhanced in aware trials as compared with trials without awareness. This effect (visual awareness negativity, VAN) did not depend on responding. The amplitude of P3 (350–450 ms) also was enhanced in aware trials as compared with unaware trials. In addition, the amplitudes in the P3 time window depended on responding: they were greater when awareness was mapped to GO‐response than when not, suggesting that P3 reflects post‐perceptual processing, that is, it occurs after awareness has emerged. These findings support theories of visual awareness that assume a relatively early onset of visual awareness before P3.
Chronic pain disrupts the reward circuitry in multiple sclerosis

Pain commonly affects multiple sclerosis (MS) patients, and has the potential to become chronic and burden an already damaged central nervous system. Imaging studies are providing insights into brain restructuring associated with chronic pain and different chronic pain conditions seem to evoke distinct plasticity patterns. Our objective was to study the structural and functional brain changes of chronic neuropathic pain of MS. Employing structural and resting functional magnetic resonance imaging we compared MS patients with chronic central pain with MS patients without pain matched with respect to age, gender, subtype and duration of MS and disability. Mean duration of pain was 7.6 years. Comparing the pain and no‐pain groups, brain functional default‐mode network differences were found. There was decreased coactivation in the caudate nucleus and nucleus accumbens bilaterally. Also, for the relapsing‐remitting subgroup of patients, grey matter thickness changes predominated in the pain group in the mesial region of the temporal lobes, caudate, putamen, thalami and the fronto‐parietal cortex; in the group without pain, changes predominated in the frontopolar and orbitofrontal cortices and in the occipital areas. A dysfunction in the reward system in chronic pain of MS was found, particularly in the brain areas involved in its motivational aspects, as such probably reflecting the maladaptive physiology of chronic pain, and possibly the signature of pain in MS, in a disease where reward impairment seems to be already one of its features.
Livestock-owning households of Kazakstan part 1: Food resources-seasonal and regional analysis

Adult women (N = 270) in rural livestock-owning households were surveyed in three ecological regions in Kazakstan during the summer of 1998 to determine their sources of food, seasonality of food availability, and associations between diet and resources. Food patterns in each ecological region were maintained through agriculture, horticulture, animal husbandry, cash purchases, and supplemented by hunting-gathering and food exchanges. Household food resources, defined by livestock and land holdings as well as household food production, varied by ecological zones. Cattle were more common in North and Center households while sheep and goat were more common in the South. Fresh meat was consumed throughout the year by more than 60% of households surveyed, but intakes declined during spring. Center households produced and consumed significantly more varieties of dairy products. Land holdings including gardens, orchards, and crop fields were more present in South households and they grew and consumed more varieties of fruits and vegetables than elsewhere. Household production provided basic foodstuffs at 60 percent of households interviewed, specifically bread, dairy and meat products, eggs, and vegetables. Bazaar purchases provided what households did not produce. Households in the South reported the fewest purchases. Dietary patterns were seasonal, highly dependent on household production, closely related to the type of livestock kept, and regional differences were significant. Given the general lack of disposable income reported-more than 60 percent of households reported sales of livestock due to lack of money--livestock owning rural households of Kazakstan were functioning mostly at a subsistence level.
Effects of acute tryptophan depletion on central processing of CT‐targeted and discriminatory touch in humans

C‐tactile afferents (CTs) are slowly conducting nerve fibres, present only in hairy skin. They are optimally activated by slow, gentle stroking touch, such as those experienced during a caress. CT stimulation activates affective processing brain regions, alluding to their role in affective touch perception. We tested a theory that CT‐activating touch engages the pro‐social functions of serotonin, by determining whether reducing serotonin, through acute tryptophan depletion, diminishes subjective pleasantness and affective brain responses to gentle touch. A tryptophan depleting amino acid drink was administered to 16 healthy females, with a further 14 receiving a control drink. After 4 h, participants underwent an fMRI scan, during which time CT‐innervated forearm skin and CT non‐innervated finger skin was stroked with three brushes of differing texture, at CT‐optimal force and velocity. Pleasantness ratings were obtained post scanning. The control group showed a greater response in ipsilateral orbitofrontal cortex to CT‐activating forearm touch compared to touch to the finger where CTs are absent. This differential response was not present in the tryptophan depleted group. This interaction effect was significant. In addition, control participants showed a differential primary somatosensory cortex response to brush texture applied to the finger, a purely discriminatory touch response, which was not observed in the tryptophan depleted group. This interaction effect was also significant. Pleasantness ratings were similar across treatment groups. These results implicate serotonin in the differentiation between CT‐activating and purely discriminatory touch responses. Such effects could contribute to some of the social abnormalities seen in psychiatric disorders associated with abnormal serotonin function.
Delivering Quality Early Learning in Low-resource Settings: Progress and Challenges in Ethiopia

The potential of high quality early childhood care and education ECCE programmes to deliver positive outcomes for children and society is well recognised. But delivering on this potential presents huge challenges, especially in low and middle income countries. This final working paper in the Transitions in Early Childhood series focusses on Ethiopia. While in many respects Ethiopia is a success story of Education For All, in terms of increased enrolments in primary education, the early years of schooling is faced with numerous access and quality challenges. This working paper reviews the government of Ethiopia's 2010 policy framework for ECCE and highlights these different challenges in rural and urban areas of Ethiopia, drawing on survey and qualitative research data collected as part of Young Lives longitudinal research.
High-Risk HPV DNA Test for Screening Anal Lesions in HIV-Positive and Negative Patients

The high incidence of anal dysplasia is related to many factors. The infections caused by HPV and HIV seem to be determinants of the following anal Pap smear changes: atypical squamous cells of undetermined significance (ASCUS), low-grade anal intraepithelial neoplasia (LAIN) and high-grade anal intraepithelial neoplasia (HAIN). Highrisk HPV infection is confirmed by the HPV DNA test, using hybrid capture technology. Screening for anal lesions should be complemented with the anal Pap smear protocol and high-resolution anoscopy. The aim of this study was to evaluate the influence of the high-risk HPV DNA test on screening for anal lesions. We evaluated 70 HIV-positive and negative patients who had previously had anal intercourse, at CRT/AIDS Sao Paulo from January 2013 to December 2013. All of the patients underwent the high-risk HPV DNA test, anal Pap smear protocol and highresolution anoscopy. The anal lesions were treated with 90% trichloroacetic acid (TCA) and 5% imiquimod for 12 weeks. The statistical analysis was performed using hypothesis tests on proportions and the significance level was set at less than 5%. 31 HIV-positive male patients, 19 HIV-negative male patients and 20 HIV-negative female patients were evaluated. 28 HIV-positive patients were positive for the high-risk HPV DNA test and 29 patients were positive for the high-risk HPV DNA test and had anal dysplasia. Our conclusion is that it was more common for HIVpositive patients to be infected with oncogenic HPV and the oncogenic HPV was more frequent in patients with anal dysplasia.
In GnRH antagonist/rec-FSH stimulated cycles, advanced endometrial maturation on the day of oocyte retrieval correlates with altered gene expression.

BACKGROUND Previously, advanced endometrial maturation on the day of oocyte retrieval in GnRH antagonist and -agonist IVF cycles was observed. In these cycles, endometrial advancement exceeding 3 days between the histological dating and the cycle day never resulted in an ongoing clinical pregnancy. In this study, the gene expression of human endometrium on the day of oocyte retrieval in GnRH antagonist/rec-FSH cycles was analyzed, in correlation with the morphological dating. METHODS Biopsies were taken on the day of oocyte retrieval in 47 patients with 1 or 2 embryos replaced on Day 3 in the same cycle. Endometrial dating was performed according to Noyes' criteria. Biopsies from 11 patients were analyzed for gene expression with the Affymetrix HG U133 Plus 2 microarray. Data analysis, clustering and pathway analysis were performed with GCOS, GeneSpring 7.3 and Ingenuity, respectively. RESULTS According to Noyes' criteria, all endometria taken on the day of oocyte retrieval showed an advanced maturation, ranging from +d2 to +d4. The patients with a subsequent clinical pregnancy all showed a histological dating corresponding to +d2 or +d3. When comparing endometria +d2-3 to +d4, the microarray results showed a differential expression of 2550 probe sets. Significantly up-regulated genes were SERPINB6, FOXO3A, SOX17 and CDC42. Down-regulated genes of interest were NRP1, HOXA10 and OSF2. Principal component analysis and hierarchical clustering demonstrated two distinct clusters. CONCLUSIONS In stimulated cycles, endometrial gene expression on the day of oocyte retrieval discriminates between women with and without histologically advanced endometrial maturation exceeding 3 days and supports histological dating results by Noyes' criteria.
Olfactory evaluation in Mild Cognitive Impairment: correlation with neurocognitive performance and endothelial function

Mild Cognitive Impairment (MCI) is an intermediate condition between normal aging and dementia, associated with an increased risk of progression into the latter within months or years. Olfactory impairment, a well‐known biomarker for neurodegeneration, might be present in the condition early, possibly representing a signal for future pathological onset. Our study aimed at evaluating olfactory function in MCI and healthy controls in relation to neurocognitive performance and endothelial function. A total of 85 individuals with MCI and 41 healthy controls, matched for age and gender, were recruited. Olfactory function was assessed by Sniffin’ Sticks Extended Test (Burghart, Medizintechnik, GmbH, Wedel, Germany). A comprehensive neurocognitive assessment was performed. Endothelial function was assessed by flow‐mediated dilation (FMD) of the brachial artery by ultrasound. MCI individuals showed an impaired olfactory function compared to controls. The overall olfactory score is able to predict MCI with a good sensitivity and specificity (70.3 and 77.4% respectively). In MCI, olfactory identification score is correlated with a number of neurocognitive abilities, including overall cognitive status, dementia rating, immediate and delayed memory, visuospatial ability and verbal fluency. FMD was reduced in MCI (2.90 ± 2.15 vs. 3.66 ± 1.96%, P = 0.016) and was positively associated with olfactory identification score (ρs=0.219, P = 0.025). The association remained significant after controlling for age, gender, and smoking. In conclusion, olfactory evaluation is able to discriminate between MCI and healthy individuals. Systemic vascular dysfunction might be involved, at least indirectly, in olfactory dysfunction in MCI.
An acute bout of exercise modulates both intracortical and interhemispheric excitability

Primary motor cortex (M1) excitability is modulated following a single session of cycling exercise. Specifically, short‐interval intracortical inhibition and intracortical facilitation are altered following a session of cycling, suggesting that exercise affects the excitability of varied cortical circuits. Yet we do not know whether a session of exercise also impacts the excitability of interhemispheric circuits between, and other intracortical circuits within, M1. Here we present two experiments designed to address this gap in knowledge. In experiment 1, single and paired pulse transcranial magnetic stimulation (TMS) were used to measure intracortical circuits including, short‐interval intracortical facilitation (SICF) tested at 1.1, 1.5, 2.7, 3.1 and 4.5 ms interstimulus intervals (ISIs), contralateral silent period (CSP) and interhemispheric interactions by measuring transcallosal inhibition (TCI) recorded from the abductor pollicus brevis muscles. All circuits were assessed bilaterally pre and two time points post (immediately, 30 min) moderate intensity lower limb cycling. SICF was enhanced in the left hemisphere after exercise at the 1.5 ms ISI. Also, CSP was shortened and TCI decreased bilaterally after exercise. In Experiment 2, corticospinal and spinal excitability were tested before and after exercise to investigate the locus of the effects found in Experiment 1. Exercise did not impact motor‐evoked potential recruitment curves, Hoffman reflex or V‐wave amplitudes. These results suggest that a session of exercise decreases intracortical and interhemispheric inhibition and increases facilitation in multiple circuits within M1, without concurrently altering spinal excitability. These findings have implications for developing exercise strategies designed to potentiate M1 plasticity and skill learning in healthy and clinical populations.
Historic passage--reform at last.

President Barack Obama, sealing a hard-fought and historic victory, has signed into law the Democrats' comprehensive health care reform bill, the Patient Protection and Affordable Care Act, a sweeping measure that would expand coverage to 32 million uninsured Americans. Appearing March 23 in the White House East Room before gleeful members of Congress who enacted the measure and other guests, Obama said, “Today . health insurance reform becomes law in the United States of America. We have just enshrined the core principle that everybody should have some basic security when it comes to their health care. ” Two days earlier, .
Evaluation of male fertility potential by Toluidine Blue test for sperm chromatin structure assessment.

BACKGROUND We have previously suggested that the Toluidine Blue (TB) test can be used for sperm chromatin structure assessment. In this study, we wished to evaluate the clinical applicability of the TB test in assessing male fertility potential using well-defined groups of fertile and infertile men. METHODS Sixty-three fertile and 79 infertile men were tested. Infertility thresholds for the proportion of sperm with abnormal [TB dark cells (TBDCs)] and normal [TB light cells (TBLCs)] chromatin structure were set by the ROC curve analysis. RESULTS Thresholds of 45% TBDC and 20% TBLC were highly predictive for infertility (specificity of the test: 92 and 90%, respectively), but they were poor predictors of the fertility (sensitivity of the test: 42 and 32%, respectively). Odds ratio for infertility was 7.5 [95% confidence interval (CI): 2.7-20.8] when the 45% TBDC threshold was used and 4.4 (95% CI: 1.7-11.6) when the 20% TBLC threshold was used. CONCLUSIONS The TB test can be suggested for clinical use as a complementary test for standard semen analysis to diagnose male infertility.
Direct and indirect effects of attention and visual function on gait impairment in Parkinson's disease: influence of task and turning

Gait impairment is a core feature of Parkinson's disease (PD) which has been linked to cognitive and visual deficits, but interactions between these features are poorly understood. Monitoring saccades allows investigation of real‐time cognitive and visual processes and their impact on gait when walking. This study explored: (i) saccade frequency when walking under different attentional manipulations of turning and dual‐task; and (ii) direct and indirect relationships between saccades, gait impairment, vision and attention. Saccade frequency (number of fast eye movements per‐second) was measured during gait in 60 PD and 40 age‐matched control participants using a mobile eye‐tracker. Saccade frequency was significantly reduced in PD compared to controls during all conditions. However, saccade frequency increased with a turn and decreased under dual‐task for both groups. Poorer attention directly related to saccade frequency, visual function and gait impairment in PD, but not controls. Saccade frequency did not directly relate to gait in PD, but did in controls. Instead, saccade frequency and visual function deficit indirectly impacted gait impairment in PD, which was underpinned by their relationship with attention. In conclusion, our results suggest a vital role for attention with direct and indirect influences on gait impairment in PD. Attention directly impacted saccade frequency, visual function and gait impairment in PD, with connotations for falls. It also underpinned indirect impact of visual and saccadic impairment on gait. Attention therefore represents a key therapeutic target that should be considered in future research.