Miracle-dz/UniFAR-FTUs huggingface dataset:
Awareness of acute kidney injury risk factors and perspectives on its practice guidelines

ABSTRACT Objectives: Identifying and assessing risk factors for acute kidney injury (AKI) are crucial for its early detection and possible intervention to prevent AKI and associated adverse outcomes. This study aimed to investigate AKI risk factor awareness and risk assessment by healthcare professionals and to evaluate perspectives on the Kidney Disease Improving Global Outcomes AKI guidelines. Methods: This cross-sectional survey-based study was conducted among healthcare professionals (physicians and pharmacists) at XXX from December 2016 to February 2017. Results: Among the respondents (117 physicians and 135 pharmacists), 78% were aged ≤38 years, 57% were men, and 70% had <9 years of experience. Respondents varied in their knowledge of the 25 risk factors for AKI and 15 nephrotoxic drugs: 96% were aware of nephrotoxic medication, whereas 20% acknowledged female sex as an AKI risk factor, and 92% agreed with aminoglycoside, while 47% agreed with ciprofloxacin as nephrotoxic drugs. A significantly higher percentage of physicians identified individual AKI risk factors than pharmacists; however, a significantly higher percentage of pharmacists identified individual AKI-causing drugs than physicians. Although 77% of respondents encountered AKI cases in their practice, only half of them performed AKI risk assessment, and 42% stratified patients’ AKI risk according to their presenting risk factors or documented AKI in previous medical history. Seventy-one percent of respondents agreed that practice guidelines improve patient outcome, and 69% thought these guidelines help standardize care and ensure that patients are treated in consistently. Conclusion: While the majority of the respondents had a positive perspective toward AKI guidelines, a large variation in their knowledge of AKI risk factors, risk assessment, and nephrotoxic drugs was found. Educational efforts are needed to raise awareness and thereby reduce this variation.
Cognitive Impairment in Elderly Home Health Clients

Cognitive impairment is a serious and pervasive problem for ill elderly uersons in the institutional setting. Older individuals exit these facilities quickly, often requiring continued formal health care services in their homes. The prevalence of delirium and/ or dementia in older, medically ill home health clients has not been investigated. It was the purpose of this descriptive study to systematically screen a sample of elderly admissions to a visiting nurse association for cognitive impairment. One hundred individuals over the age of sixty-five were given the Mini-Mental State Exam (Folstein, Folstein & McHugh, 1975) on admission to lhe agency. Information on demographics and health status was retrieved from routine chart forms. Prevalence of imoairment was 61 %. Impaired individuals differed significantly from heir intact counterparts in relation to race, functional limitations, institutional length-of-stay and use of medications impacting on the central nervous &stem.
Multiple Point-of-Testing Nutrition Counseling Sessions Reduce Risk Factors for Chronic Disease Among Older Adults

The objectives of this study were to explore the relationships of baseline dietary intakes and frequency of attendance at point-of-testing nutrition counseling sessions to selected risk factors for chronic diseases during a 3-year intervention. This study was part of a large multidisciplinary, community-based health outreach project conducted in a rural community of northern Louisiana. Screenings, point-of-testing counseling, weekly group exercise sessions, and group nutrition education sessions were provided over a period of 3 years. Outcome variables assessed at 6-month intervals over 3 years were body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, and total and LDL cholesterol and dietary intake. Repeated measure analysis of variance was used to investigate the impact of the frequency of counseling sessions on outcome variables. Paired t-tests were used to identify points at which significant changes occurred. A total of 159 subjects ages 65 years and older participated in this study. The majority of the participants were female (62%) and White (82%). Attending the point of testing counseling for more than two sessions was important for a significant improvement in BMI (p ≤ 0.001), LDL cholesterol (p ≤ 0.03), blood glucose (p ≤ 0.03), and diastolic blood pressure (p ≤ 0.045). Participants who attended at least three sessions had significant reductions in risk factors for obesity and related chronic diseases, underscoring the importance of follow-up sessions after health screening.
Changes in serum S100β protein and Mini‐Mental State Examination after cold (28°C) and warm (34°C) cardiopulmonary bypass using different blood gas strategies (alpha‐stat and pH‐stat)

Background: The effect of cardiopulmonary bypass temperature and blood gas management on the brain is still controversial. This study was designed to compare the changes in S100β protein concentration and Mini‐Mental State Examination in patients undergoing cold (28 °C) vs. warm (34 °C) cardiopulmonary bypass using different blood gas strategies (alpha‐stat and pH‐stat).
Overexpression of plastin 3 in Sertoli cells disrupts actin microfilament bundle homeostasis and perturbs the tight junction barrier

ABSTRACT Throughout the epithelial cycle of spermatogenesis, actin microfilaments arranged as bundles near the Sertoli cell plasma membrane at the Sertoli cell-cell interface that constitute the blood-testis barrier (BTB) undergo extensive re-organization by converting between bundled and unbundled/branched configuration to give plasticity to the F-actin network. This is crucial to accommodate the transport of preleptotene spermatocytes across the BTB. Herein, we sought to examine changes in the actin microfilament organization at the Sertoli cell BTB using an in vitro model since Sertoli cells cultured in vitro is known to establish a functional tight junction (TJ)-permeability barrier that mimics the BTB in vivo. Plastin 3, a known actin microfilament cross-linker and bundling protein, when overexpressed in Sertoli cells using a mammalian expression vector pCI-neo was found to perturb the Sertoli cell TJ-barrier function even though its overexpression increased the overall actin bundling activity in these cells. Furthermore, plastin 3 overexpression also perturbed the localization and distribution of BTB-associated proteins, such as occludin-ZO1 and N-cadherin-β-catenin, this thus destabilized the barrier function. Collectively, these data illustrate that a delicate balance of actin microfilaments between organized in bundles vs. an unbundled/branched configuration is crucial to confer the homeostasis of the BTB and its integrity.
The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after Nipple-Sparing Mastectomy

Background: Nipple-sparing mastectomy is the latest advancement in the treatment of breast cancer. The authors aimed to investigate the effects of neoadjuvant and adjuvant chemotherapy in nipple-sparing mastectomy. Methods: Patients undergoing nipple-sparing mastectomy from 2006 to June of 2015 were identified. Results were stratified by presence of neoadjuvant or adjuvant chemotherapy. Results: A total of 840 nipple-sparing mastectomies were performed. Twenty-eight were in those who received neoadjuvant chemotherapy and 93 were in patients receiving adjuvant chemotherapy. Patients receiving both neoadjuvant and adjuvant chemotherapy were included in the neoadjuvant group. Nipple-sparing mastectomies that received neoadjuvant (with or without adjuvant) chemotherapy were compared to those in patients who received adjuvant chemotherapy. Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have explantation (p = 0.0239) and complete nipple-areola complex necrosis (p = 0.0021). Those with neoadjuvant (with or without adjuvant) chemotherapy were more likely to have implant explantation (p = 0.0015) and complete nipple-areola complex necrosis (p = 0.0004) compared to those with no chemotherapy. Compared to nipple-sparing mastectomies in patients with no chemotherapy, those with adjuvant chemotherapy were more likely to have a hematoma (p = 0.0021). Those that received both neoadjuvant and adjuvant chemotherapy were more likely to have complete nipple-areola complex necrosis compared with both the neoadjuvant chemotherapy–only and adjuvant chemotherapy–only groups (p < 0.0001). Conclusions: Nipple-sparing mastectomy is safe to perform in the setting of neoadjuvant and adjuvant chemotherapy. As a whole, neoadjuvant (with or without adjuvant) chemotherapy increases risk of complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Jean Martin Charcot (1825–93) and Jean Baptiste Charcot (1867–1936)

Jean Martin Charcot spent more than 30 years of his career at the Salpetriere and established the great school of neurology there. Charcot's interest in neurology was slow to evolve. He was inspired largely by his contemporary, Duchenne. Charcot was also a contemporary of Broca. Freud was among his pupils. Charcot's famous lessons dealt with all matters of neurological importance, including cerebral localisation in 1875 and 1876. Early in his career he also made several contributions to general medicine. His particular interests included hysteria and hypnotism Charcot convincingly demonstrated cortical motor centres in humans. He delineated the brain's vascular …
PTA scale for children aged 4 to 7 years: Selecting developmentally valid and reliable items

ABSTRACT The aim of this study was to select developmentally valid and reliable items for inclusion in criterion-referenced (pass > 90%) posttraumatic amnesia (PTA) scale for children aged 4 to 7 years in a prospective cohort study. Fifty-two typically developing children (26 male/26 female) aged 4 to 7 years were administered a set of 10 items (5 orientation, 5 memory) over 3–4 days. The total score obtained on the set of 10 items had poor developmental validity and test–retest reliability. Nevertheless, individual item analysis identified five items (three orientation and two memory items) that were consistently passed by >90% of the children on each day of testing. For these five items the total scores did not differ significantly either between age groups or between days of testing. Test–retest was extremely high (close to 1). The five items had excellent developmental validity and test–retest reliability. This study identified 5 (3 orientation and 2 memory) items that met our selection criterion and form a new PTA scale, the Sydney PTA scale (SYPTAS), for children aged 4 to 7 years.
Liver X receptor β: new player in the regulatory network of thyroid hormone and ‘browning’ of white fat

ABSTRACT The recent discovery of browning of white adipose tissue (WAT) has raised great research interest because of its significant potential in counteracting obesity and type II diabetes. However, the mechanisms underlying browning are still poorly understood. Liver X receptors (LXRs) are one class of nuclear receptors, which play a vital role in regulating cholesterol, triglyceride and glucose metabolism. Following our previous finding that LXRs serve as repressors of UCP1 in classic brown adipose tissue in female mice, we found that LXRs, especially LXRβ, also repress the browning process of subcutaneous adipose tissue (SAT) in male rodents fed a normal diet. Depletion of LXRs activated thyrotropin releasing hormone positive neurons in the paraventricular area of the hypothalamus, and thus stimulated secretion of thyroid-stimulating hormone from the pituitary. Consequently production of thyroid hormones in the thyroid gland and circulating thyroid hormone level were increased. Moreover, the activity of thyroid signaling in SAT was markedly increased. One unexpected finding of our study is that LXRs are indispensable in the thyroid hormone negative feedback loop at the level of the hypothalamus. LXRs maintain expression of thyroid receptors in the brain and when they are inactivated there is no negative feedback of thyroid hormone in the hypothalamus. Together, our findings have uncovered the basis of increased energy expenditure in male LXR knock-out mice and provided support for targeting LXRs in treatment of obesity.
Management of nephrotic syndrome in childhood

Abstract Although relatively uncommon in the population as a whole, nephrotic syndrome is frequently encountered as a problem in general paediatric practice and patients often require additional management by a tertiary paediatric nephrologist. This review discusses the approach to management of nephrotic syndrome in childhood, with an emphasis on the treatment of steroid-sensitive nephrotic syndrome.
Tumor detection in T1, T2, FLAIR and MPR brain images using a combination of optimization and fuzzy clustering improved by seed‐based region growing algorithm

Tumor and Edema region present in Magnetic Resonance (MR) brain image can be segmented using Optimization and Clustering merged with seed‐based region growing algorithm. The proposed algorithm shows effectiveness in tumor detection in T1 ‐ w, T2 – w, Fluid Attenuated Inversion Recovery and Multiplanar Reconstruction type MR brain images. After an initial level segmentation exhibited by Modified Particle Swarm Optimization (MPSO) and Fuzzy C – Means (FCM) algorithm, the seed points are initialized using the region growing algorithm and based on these seed points; tumor detection in MR brain images is done. The parameters taken for comparison with the conventional techniques are Mean Square Error, Peak Signal to Noise Ratio, Jaccard (Tanimoto) index, Dice Overlap indices and Computational Time. These parameters prove the efficacy of the proposed algorithm. Heterogeneous type tumor regions present in the input MR brain images are segmented using the proposed algorithm. Furthermore, the algorithm shows augmentation in the process of brain tumor identification. Availability of gold standard images has led to the comparison of the suggested algorithm with MPSO‐based FCM and conventional Region Growing algorithm. Also, the algorithm recommended through this research is capable of producing Similarity Index value of 0.96, Overlap Fraction value of 0.97 and Extra Fraction value of 0.05, which are far better than the values articulated by MPSO‐based FCM and Region Growing algorithm. The proposed algorithm favors the segmentation of contrast enhanced images. © 2017 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 27, 33–45, 2017
PD-L1, PD-L2 and PD-1 expression in metastatic melanoma: Correlation with tumor-infiltrating immune cells and clinical outcome

ABSTRACT Therapeutic blockade of PD-1/PD-L1 can have dramatic therapeutic benefit in some patients; however, the prognostic associations of PD-1 and its ligands, in the absence of therapeutic blockade have not been definitively addressed. In particular, associations of PD-L2 with immune infiltrates and with outcome have yet to be explored. We hypothesized that surface expression of both PD-L1 and PD-L2 by melanoma cells would be associated with immune cell infiltration and with overall patient survival, independent of checkpoint blockade therapy. We also characterized the heterogeneity of their distribution within a tumor and within tumors of the same patient. Tissue microarrays of metastatic melanoma samples from 147 patients were quantified for CD8+, CD45, CD4+, CD3, CD163, CD20, CD138, FoxP3, PD-1, PD-L1 and PD-L2 markers by immunohistochemistry. Relationships between the proportions of PD-L1 and PD-L2 expressing tumor cells with the immune cell count, distribution (immunotype) and patient survival were studied. Expressions of both PD-L1 and PD-L2 correlated significantly with increasing densities of immune cells in the tumor specimens and with immunotype. Positive PD-L2 expression was associated with improved overall survival and the simultaneous positive expression of both PD-1 ligands showed a higher association with survival. Significant heterogeneity of PD-L1 and PD-L2 expressions within tumors were observed, however, they were less pronounced with PD-L2. In conclusion, both are markers of immune infiltration and PD-L2, alone or in combination with PD-L1, is a marker for prognosis in metastatic melanoma patients. Larger tumor samples yield more reliable assessments of PD-L1/L2 expression.
Dectin-1-activated dendritic cells: A potent Th9 cell inducer for tumor immunotherapy

ABSTRACT Dendritic cell (DC)-based immunotherapy has great promise for cancer treatment. We have recently demonstrated that dectin-1-activated DCs trigger potent antitumor Th9 cells in vivo. Dectin-1-activated DC-induced antitumor responses rely on the induced Th9/IL-9. These findings offer new strategies for the development of more effective DC vaccines in tumor immunotherapy.
Otological Correlates of Cleft Palate

228 The most common otological consequence of cleft palate disease is otitis media with effusion, which is a topic of interest and subject to controversy. Recent investigations have revealed abnormalities of middle ear mucociliary transport (Sade, 1970) and abnormal degrees of goblet cell formation of the middle ear epithelial elements (Bak-Pederson, 1973; Shemada, 1972). Variations in histochemical and ultrastructural elements of the middle ear mucosa in patients with otitis media with effusion have also been observed (Lim, 1976; Lim and Birck, 1971; Liu, 1975; Palva, 1975). Otitis media with effusion is not a problem isolated to children with cleft palate disease. Next to simple upper respiratory infections, otitis media with effusion is the most common organic disease confronting the practicing pediatrician (Hoekelman, 1977; Mclnerney, 1978).
Oncolytic measles virus encoding interleukin-12 mediates potent antitumor effects through T cell activation

ABSTRACT Combination of oncolytic virotherapy with immunomodulators is emerging as a promising therapeutic strategy for numerous tumor entities. In this study, we developed measles Schwarz vaccine strain vectors encoding immunomodulators to support different phases in the establishment of antitumor immune responses. Therapeutic efficacy of the novel vectors was evaluated in the immunocompetent MC38cea tumor model. We identified vectors encoding an IL-12 fusion protein (MeVac FmIL-12) and an antibody against PD-L1 (MeVac anti-PD-L1), respectively, as the most effective. Treatment of established tumors with MeVac FmIL-12 achieved 90% complete remissions. Profiling of the tumor immune microenvironment revealed activation of a type 1 T helper cell-directed response, with MeVac FmIL-12 ensuring potent early natural killer and effector T cell activation as well as upregulation of the effector cytokines IFN-γ and TNF-α. CD8+ T cells were found to be essential for the therapeutic efficacy of MeVac FmIL-12. Results of this study present MeVac FmIL-12 as a novel approach for targeted IL-12 delivery and elucidate mechanisms of successful immunovirotherapy.
Emotional Expression and Language: A Longitudinal Study of Typically Developing Earlier and Later Talkers from 15 to 30 Months.

We appreciate the thoughtful commentaries written in response to our study which focuses on the relation between emotional expression and language just as productive language emerges during toddlerhood. Although children’s emotional expression and language both develop during infancy and early childhood, to date, these two communication systems have been studied primarily in isolation. The three commentators provide useful perspectives and questions for further research. Two of the commentaries are from leading clinicians in infant mental health, and a third is from a leading scholar in child language development. All three emphasize the importance of studying the phenomena we have observed in the laboratory in everyday parent–child interactions as well, not only for assessing the transactional interpretations of our findings but also for understanding more about real-life implications of differences in emotional and language communications in developing dyadic systems. We agree and will give it priority for our future work analyzing the parent– child interactions of these same 77 families videotaped during regularly scheduled home visits between the ages of 15 and 30 months. In our commentary response, we will add some more particulars to this point as we discuss the perspectives of each of our colleagues. Mechtild Papoušek brings a perspective from her pioneering work and that of her late husband, Hanus Papoušek, on early emotional communication (e.g., M. Papoušek, 2007; M. Papoušek, Bornstein, Nuzzo, Papoušek, & Symmes, 1990; M. Papoušek & Papoušek, 1989; M. Papoušek, Papoušek, & Haekel, 1987) as well as a perspective from her clinical work (M. Papoušek, Schieche, & Wurmser, 2008; Wollwerth & Papoušek, 2008) to bear on the point that preverbal communication between infant and parent involves much that is emotionally toned in its nonverbal components (and intuitive in nature for the parent) (H. Papoušek, 2002). Thus, as she
V.—On the Connection between Chemical Constitution and Physiological Action. Part. I.—On the Physiological Action of the Salts of the Ammonium Bases, derived from Strychnia, Brucia, Thebaia, Codeia, Morphia, and Nicotia

There can be no reasonable doubt that a relation exists between the physiological action of a substance and its chemical composition and constitution, understanding by the latter term the mutual relations of the atoms in the substance. There are numerous indications of such a relation, and attempts have been made to express it formally in certain cases. Thus it has been long observed, that the salts of the same base have a common physiological action, and it has been pointed out by Mr Blake that, with some exceptions, the salts of isomorphous bases have a similar action. A corresponding likeness in physiological action may be traced in salts having the same acid, but beyond these generalisations we are not aware that any approach has been made to the statement of a law connecting the physiological action of a substance with its chemical constitution.
Tufts CTSI:

National Institutes of Health (NIH) Clinical and Translational Science Awards (CTSAs) are intended to help transform the biomedical research enterprise to be more focused on, and effective in, improving the health of the public.1 The focus is on translation into health impact: from bench research to the patient bedside (the first translational step, T1), from bedside research to clinical practice (T2), and from practice into overall public benefit and policy (T3 and T4), and back across each step, as well.
Some mathematical models of frailty and their clinical implications

Frailty is a term that is used often, but commonly not defined precisely. As reviewed elsewhere most definitions share several features. Typically, older adults who are frail have a greater rate of dependence on others, so-called ‘loss of physiological reserve’ and multiple diseases. A dynamic component is often included (e.g. ‘loss of reserve’ and such synonyms as ‘unstable disability’ and ‘impaired homeostenosis’) and is manifest when, over time, patients respond less well to stress, or when those with given levels of frailty have higher rates of adverse outcomes. Still, the imprecision of the term frailty has led some to question its merit, and either to develop alternative means of classification or to stay with the concept of function and disability. Alternative methods of classification are either broadly or narrowly focussed.