Miracle-dz/UniFAR-FTUs huggingface dataset:
Amplitude-integrated EEG abnormalities in two neonates with encephalopathy due to mitochondrial dysfunction (respiratory chain complex I deficiency)

Abstract Amplitude-integrated electroencephalography (aEEG) findings in hypoxic-ischemic encephalopathy characterized by secondary energy failure have been described in detail. In contrast, reports of use of aEEG in patients with encephalopathy due to primary energy failure as seen in inherited metabolic disorders are sparse. We report two cases of lethal mitochondrial encephalopathy due to mitochondrial respiratory chain complex I deficiency. We present clinical course, laboratory evaluations, aEEG, conventional electroencephalography, magnetic resonance imaging and magnetic resonance spectroscopy findings of two cases identified with mitochondrial encephalopathy between 2002 and 2007. Both infants were born at term. Both presented with intractable seizures and mild hypotonia within the first days of life, in the absence of any evidence suggestive of hypoxic-ischemic encephalopathy. Both cases were treated with multiple anticonvulsants and in neither case were seizures fully controlled. Magnetic resonance imaging in both cases revealed a structurally normal brain and case one showed subtle diffuse deep white matter signal abnormality. Magnetic resonance spectroscopy revealed no elevation of lactate. In both cases, aEEG tracings were markedly abnormal, confirmed by electroencephalography. Case one showed status epilepticus on an abnormally high amplitude background and case two presented with a mainly discontinuous background pattern with intermittent burst-suppression pattern activity. Complex I activity in skeletal muscle homogenate was abnormally low in both patients. The use of aEEG as a valuable assessment and monitoring tool in patients with metabolic encephalopathy should be further promoted.
Promoting evidence informed service development: a study of falls services in Cheshire

Background This study investigated two initiatives for preventing falls in Cheshire: public events to raise population awareness about falls and ways of preventing falls, a programme of falls assessments and falls prevention classes. Aim The study aimed to support service development by generating local learning about: the falls risk status of older people attending the public events and their use of services for preventing falls, the efficiency and effectiveness of the falls programme. Methods A local adaptation of an instrument used in similar research was administered to assess the falls risk status of older people attending the public events. This instrument captures data about the age, sex, gait, sensory deficit, falls history, current medication, medical history, mobility and living situation of respondents. Attendees were also asked about their current use of falls services. To evaluate the falls programme data were collected about the characteristics and referral sources of service users and, for users of the falls prevention classes: their mobility and balance on joining and completing the classes; their fear of falling and confidence linked to falls at the start of the classes and six months later; the number of falls they experienced in the six months before starting and after completing the classes. Findings Of the 453 attendees screened, 64.3% were at medium risk of falling or above and 34.3% had suffered previous falls. None were accessing falls prevention services. During its first year, 324 individuals were referred to the falls programme. Overall, among those individuals who provided data for analysis, there was a statistically significant improvement in the ‘clinical’ outcomes assessed and a statistically significant reduction in the occurrence of falls. The majority of respondents indicated that they achieved an improved confidence linked to falls and a reduced fear of falling. Conclusions Studies of this type can provide a valuable contribution to local learning but the characteristics of the research collaborations developed can affect study designs and the quality of the information generated. Improved contracting arrangements between service commissioners and providers may provide an opportunity to increase the rigour of local developmental studies.
Prevention of Heart Failure by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension

Context. —Heart failure is often preceded by isolated systolic hypertension, but the effectiveness of antihypertensive treatment in preventing heart failure is not known. Objective. —To assess the effect of diuretic-based antihypertensive stepped-care treatment on the occurrence of heart failure in older persons with isolated systolic hypertension. Design. —Analysis of data from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Participants. —A total of 4736 persons aged 60 years and older with systolic blood pressure between 160 and 219 mm Hg and diastolic blood pressure below 90 mm Hg who participated in the Systolic Hypertension in the Elderly Program (SHEP). Intervention. —Stepped-care antihypertensive drug therapy, in which the step 1 drug is chlorthalidone (12.5-25 mg) or matching placebo, and the step 2 drug is atenolol (25-50 mg) or matching placebo. Main Outcome Measures. —Fatal and nonfatal heart failure. Results. —During an average of 4.5 years of follow-up, fatal or nonfatal heart failure occurred in 55 of 2365 patients randomized to active therapy and 105 of the 2371 patients randomized to placebo (relative risk [RR], 0.51; 95% confidence interval [CI], 0.37-0.71;P Conclusion. —In older persons with isolated systolic hypertension, stepped-care treatment based on low-dose chlorthalidone exerted a strong protective effect in preventing heart failure. Among patients with prior MI, an 80% risk reduction was observed.
HbA 1C : IS IT READY AS A PRIMETIME TOOL FOR PREDICTING MYOCARDIAL INFARCTION?

HbA 1c is regarded as an independent risk factor for acute myocardial infarction in patients with or without diabetes. However, studies regarding HbA 1c and increased risk of acute myocardial infarction ( A MI) are scarce. The present study is a case control study in which glyc ated hemoglobin, fasting and postprandial blood gluco se ; and fasting lipid profile were estimated in all subjects . Though HbA 1c helped distinguish between stress induced hyperglycemia and diabetes mellitus, it failed to predict risk of myocardial infarctio n. More longitudinal and prospective studies in rural areas of India are needed to establish causal relationship so that HbA 1c can be used as a prime time tool in clinical evaluation of myocardial infarction.
Is health information technology investment related to the financial performance of US hospitals? An exploratory analysis

Information systems lie at the centre of organised delivery systems, providing opportunities to improve access, outcomes, and quality benefiting consumers, providers, insurers, and purchasers. However, it is unknown whether hospital financial performance improves after investment in these systems. Our study finds that hospitals with integrated information systems had a 1.7% higher total margin and a 1.0% higher operating margin in 1993 than hospitals without integrated information systems. This greater profitability persisted between 1993-1996, with an average 0.87% greater total margin among hospitals with integrated information systems than without. Our analysis suggests that investments by US hospitals in integrated information systems contributes to improved financial performance and offers subjects for future research.
Stabilization of multiwavelength infrared lasers.

An internal mirror He-Ne laser of 1.15 μm often emits 1.16-μm laser radiation simultaneously, and sometimes oth­ er laser oscillations are also observed at 1.17 and 1.20 μm. This laser is a suitable light source of optical measurements, because it is handy, low in price, and most of the optical elements for the visible wavelength are available in this wavelength region. Stabilization of the wavelength is re­ quired in precise measurement, for example in the interferometric length measurement. The stabilized multiwave­ length laser is very useful especially in multicolor measurements, and a stabilization method was proposed by Matsumoto. A diffraction grating was utilized to obtain monochromatic beams in the method where a complicated mechanical system was needed. In this work, a new servo system was proposed to stabilize both 1.15and 1.16-μm wavelengths leaving the laser head handy and movable. This system consists of two feedback loops as shown in Fig. 1, one of which is selected to operate, depending on the stage of stabilization. A commercial laser NEO-R2, manufactured by Nihon Kagaku Engineering, was used with two optional changes: the isotope HeNe was enclosed in the tube and a thin film heater was coated on the tube to control the cavity length thermally with high response speed. This laser emits two laser radiations of 1.15 and 1.16 μm. The former is domi­ nant, and its intensity was ~80% of the total output. At first, the laser was stabilized by a two-mode method only, where two orthogonally polarized modes are balanced together in their intensities by control of the cavity length using a heat­ er.The short time stability of the wavelength was esti­ mated from the error signal of the two-mode stabilizer to be within 1 X 10. However, the resettability of the absolute wavelength was not good because this laser emitted two laser radiations. The error signal of the two-mode stabilizer, that is, the difference between two polarized components in the total output, was repeated periodically with increasing cavity
Spontaneous Necker-cube reversals may not be that spontaneous

Introduction During observation of the ambiguous Necker cube, our perception suddenly reverses between two about equally possible 3D interpretations. During passive observation, perceptual reversals seem to be sudden and spontaneous. A number of theoretical approaches postulate destabilization of neural representations as a pre-condition for reversals of ambiguous figures. In the current study, we focused on possible Electroencephalogram (EEG) correlates of perceptual destabilization, that may allow prediction of an upcoming perceptual reversal. Methods We presented ambiguous Necker cube stimuli in an onset-paradigm and investigated the neural processes underlying endogenous reversals as compared to perceptual stability across two consecutive stimulus presentations. In a separate experimental condition, disambiguated cube variants were alternated randomly, to exogenously induce perceptual reversals. We compared the EEG immediately before and during endogenous Necker cube reversals with corresponding time windows during exogenously induced perceptual reversals of disambiguated cube variants. Results For the ambiguous Necker cube stimuli, we found the earliest differences in the EEG between reversal trials and stability trials already 1 s before a reversal occurred, at bilateral parietal electrodes. The traces remained similar until approximately 1100 ms before a perceived reversal, became maximally different at around 890 ms (p = 7.59 × 10–6, Cohen’s d = 1.35) and remained different until shortly before offset of the stimulus preceding the reversal. No such patterns were found in the case of disambiguated cube variants. Discussion The identified EEG effects may reflect destabilized states of neural representations, related to destabilized perceptual states preceding a perceptual reversal. They further indicate that spontaneous Necker cube reversals are most probably not as spontaneous as generally thought. Rather, the destabilization may occur over a longer time scale, at least 1 s before a reversal event, despite the reversal event as such being perceived as spontaneous by the viewer.
Comparison of external and percutaneous pin fixation with plate fixation for intra-articular distal radial fractures. A randomized study.

BACKGROUND The most effective method for the fixation of an intra-articular distal radial fracture has not been established. Two commonly used treatment methods are external fixation combined with percutaneous pin fixation and plate fixation. We performed a prospective multicenter randomized trial to compare these two treatment strategies. METHODS A total of 137 patients with 144 intra-articular distal radial fractures were recruited into the study. The average age of the patients was forty-two years, and all patients were sixty years old or less. The patients were randomized to fracture fixation with one of the two methods. At six, twelve, and twenty-four months postoperatively, the patients were assessed with use of the Gartland and Werley point system and the modified Green and O'Brien scoring system. Arthritis was graded on radiographs according to a modification of the Knirk and Jupiter criteria. RESULTS Seventy-four (51%) of the fractures were treated with external fixation and percutaneous pin fixation, and seventy were treated with dorsal, volar, or combined plate fixation. At the time of the twenty-four-month follow-up, the results for the plate fixation group were significantly better than those for the external fixation and percutaneous pin fixation group according to the Gartland and Werley point system (p = 0.04) and the radiographic arthritis grading system (p = 0.01). The difference was especially notable among patients with AO group-C2 fractures. CONCLUSIONS Plate fixation is better than external fixation combined with percutaneous pin fixation for the treatment of intra-articular fractures of the distal part of the radius.
Correlation of procalcitonin and cytokine expression with dehiscence of wartime extremity wounds.

BACKGROUND Despite technological advances in the treatment of severe extremity trauma, the timing of wound closure remains the subjective clinical decision of the treating surgeon. Traditional serum markers are poor predictors of wound-healing. The objective of this study was to evaluate the cytokine and chemokine profiles of severe extremity wounds prior to closure to determine if wound effluent markers can be used to predict healing. METHODS Serum and effluent (exudate) samples were collected prospectively from adult volunteers with multiple high-energy penetrating extremity wounds sustained during military combat. Samples were collected prior to definitive wound closure or flap coverage. Wounds were followed clinically for six weeks. The primary clinical outcome measures were wound-healing and dehiscence. Control serum samples were collected from normal age and sex-matched adult volunteers. All samples were analyzed for the following cytokines and chemokines: procalcitonin; eotaxin; granulocyte macrophage colony stimulating factor; interferon (IFN)-gamma; interleukin (IL)-1 through 8, 10, 12, 13, and 15; IFN-gamma inducible protein-10; monocyte chemotactic protein-1; macrophage inflammatory protein-1alpha; the protein regulated on activation, normal T expressed and secreted (RANTES); and tumor necrosis factor (TNF)-alpha. RESULTS Fifty wounds were analyzed in twenty patients. Four of the fifty wounds dehisced. An increased rate of wound dehiscence was observed in patients with a concomitant closed head injury as well as in those with an associated arterial injury of the affected limb (p < 0.05). Among the serum chemokines and cytokines, only serum procalcitonin levels correlated with wound dehiscence (p < 0.05). Effluent analysis showed that, compared with wounds that healed, wounds that dehisced were associated with elevated procalcitonin, decreased RANTES protein, and decreased IL-13 concentrations (p < 0.05). No wound with an effluent procalcitonin concentration of <220 pg/mL, an IL-13 concentration of >12 pg/mL, or a RANTES protein concentration of >1000 pg/mL failed to heal. CONCLUSIONS Effluent procalcitonin, IL-13, and RANTES protein levels as well as serum procalcitonin levels correlate with wound dehiscence following closure of severe open extremity wounds. These preliminary results indicate that effluent biomarker analysis may be an objective means of determining the timing of traumatic wound closure.
Referred Pain Pattern of the Abductor Pollicis Brevis Muscle and Its Possible Mechanism

ABSTRACT. Objectives: The purpose of this study is to reveal the referred pain patterns of abductor pollcis brevis [APB] muscle and propose the possible mechanism for such patterns. Methods: Sixty-four arms of 32 healthy normal adult asymptomatic subjects were studied. Muscle pain was induced with injection of 0.2 ml of six percent hypertonic saline into the APB muscle under ultrasonographic guidance. Subjects drew in their pain areas on a pain diagram, and this drawing was transferred into the Pain Chart System® for analysis. Results: Two main referred pain patterns were observed. The most common pattern [70.3 percent], Pattern 1, localized pain around thenar area and dorsal first web space and extended proximally to the distal one-third of the forearm along the radial aspect and distally to the lateral side of second finger tip in a third of the arms. The second main pattern [23.4 percent], Pattern 2, localized pain around the thenar area and the distal part of palmaris longus muscle and the pain around medial epicondyle was also reported in a third of the arms. Conclusions: These referred pain patterns cannot be explained by peripheral or central nervous system interaction. They may be explained by the anatomical relationship of APB with the accessory slip of APB and first dorsal interosseous muscle in Pattern 1, and the palmaris longus in Pattern 2. Thus, the anatomical relationship may be alternative explanation of the referred pain.
BaSeFood: Sustainable exploitation of bioactive components from the Black Sea Area traditional foods

†Summary The Sustainable exploitation of bioactive components from the Black Sea Area traditional foods (BaSeFood) is a 3-year collaborative research programme, funded by the 7th Framework Programme, launched on the 1st of April 2009. The project, which is coordinated by Dr Filippo D’Antuono (University of Bologna), consists of a research consortium of 13 partners, namely Italy (two), the United Kingdom, Greece, Portugal, Serbia and six Black Sea area countries: Russian Federation, Ukraine (two), Romania, Bulgaria, Turkey and Georgia. BaSeFood will contribute scientifically by studying the bioactive compounds within traditional foods of the Black Sea area using rigorous analytical and biological assays. The vast array of characteristics of traditional foods will be considered, as well as any associated consumer-perceived benefits, related to health claims, so that they can be properly understood by the consumer and exploited by food processors to produce more healthy traditional foods.
Rapid Detection of Sporotrichosis by ABC-ELISA

Background: Avidin-biotin-horseradish peroxidase enzyme complex, enzyme-linked immunosorbent assay (ABCELISA) is widely used in detecting the soluble bacterial, viral antigen and antibody, but the reports of detecting mycotic antigens were few . We used the method to detect Sporothrix schenckii pathogen of sporotrichosis in smear. Aim: To provide a rapid diagnostic method for sporotrichosis. Methods: 20 cases of sporotrichosis-in doubt we scraped pus or tissue fluid from the skin lesion and perform ABCELISA by reagent vectastatin ABC kit, rabbit anti Sporothrix schenckii serum. Results: 18 of 20 cases were diagnosed as sporotrichosis. 14 of 18 cases were positive (77.8%) by ABC-ELISA stain, 5 of 18 cases were positive (27.7%) by Gram stain. Conclusion: ABC ELISA is new fashioned biological amplification technique due to its sensitivity of this method is 77.8% in smear, the specificity is 100%. Only three hours is needed, so this method can be used to detect Sporothrix shenckii rapidly.
Echocardiographic Values for Cardiac Dimensions and Left Ventricular Mass of Normal Chinese Adults

Studies evaluating potential differences in normal cardiac dimensions and body mass indices of various ethnic populations using 2D echocardiography have reported variations based on gender and ethnicity. With the currently accepted echocardiographic reference values from US studies, and the limited information available on Chinese populations, the aim of this pilot study was to determine the normal cardiac dimensions and left ventricular mass of adult Chinese using 2D-guided M-mode echocardiography. Of healthy Chinese adults (age 18 years and older) living in Hong Kong, 57 suitable participants (26 men, aged 35.7 ± 10.2 years; 31 women, aged 44.2 ± 8.5 years) were recruited. The results indicated that the mean sizes of the aortic root, left ventricular wall thickness, and left ventricular mass of Chinese men were significantly larger than those of Chinese women. Left ventricular mass of the Chinese sample population (men, 116.0 ± 20.6 g; women, 99.8 ± 20.9 g) was significantly smaller than US-based studies. The conclusions drawn are of clinical importance, especially in the assessment and management of hypertensive cardiac effects. The results of this study strongly indicate the need for a large-scale study to further establish ethnic-specific and gender-specific echocardiographic reference values for the Chinese population.
The beneficial effect of long-term supplementation of vitamin C on renal mitochondrial disturbances in streptozotocin-induced diabetic rats

Abstract Background: Oxidative stress induces renal dysfunction in diabetes, in which renal mitochondrial disturbance was implicated. Vitamin C (VC) supplementation may ameliorate the renal dysfunction in diabetics. However, it is not clear whether VC supplementation is effective for renal mitochondrial disturbances in diabetes. Objective: Investigate whether long-term continuous VC supplementation could ameliorate the renal mitochondrial disturbances in streptozotocin (STZ)-induced diabetic rats. Methods: Thirty-five male Sprague-Dawley rats were used, and diabetes was induced by an injection of STZ. The rats were divided into three groups: control rats (CON), STZ-induced diabetic rats (STZ), and diabetic rats supplemented by vitamin C (STZ-VC). The CON and STZ rats were given tap water, while STZ-VC rats received VC (1 g/L) every day for eight, 24 and 52 weeks. The kidney was isolated and homogenized. Oxygen comsumption (Vo2) was measured in mitochondria homogenate using an oxygen consumption monitor. Based on Vo2 tracings, the respiration control index (RCI) and P/O ratio (= ADP/ O ratio) were measured at week 8, 24 and 52. Results: At week eight, using either glutamate plus malate (for site I) or succinate (for site II) as substrates, both RCI and P/O ratio were not significantly different among three groups. The P/O ratio in STZ and STZ-VC rats increased from eight to 52 weeks after VC supplementation. At week 24, the P/O ratio at site II was normalized in STZ-VC rat. The increased P/O ratio (only site I) and the increased RCI (only site II) of STZ-VC rats were slower than those of STZ rats. Conclusion: Short-term VC supplementation might not influence the renal mitochondrial activity. The long-term VC supplementation could ameliorate the mitochondrial disturbances induced in STZ-induced diabetic rats.
Routine screening of brain-damaged patients: a comparison of the Rivermead Perceptual Assessment Battery and the Chessington Occupational Therapy Neurological Assessment Battery

Thirty-two brain damaged patients undergoing rehabilitation were assessed independently by the Rivermead Perceptual Assessment Battery (RPAB) and the Chessington Occupational Therapy Neurological Assessment Battery (COTNAB). The detection of perceptual deficits was similar with both batteries. The RPAB was quicker and slightly easier to use but the COTNAB was considered to give considerably more information. This led us to conclude that the COTNAB was the preferred battery for routine use in our clinical setting. Patients found both batteries acceptable with no particular preference for one over the other.