Miracle-dz/UniFAR-FTUs huggingface dataset:
Relationship of circadian pattern of urine sodium excretion to hypertension and obstructive sleep apnoea

Objectives: Obstructive sleep apnoea (OSA) and hypertension frequently coexist, and both are associated with higher night-time than daytime urine sodium excretion rate (UNaV). However, the relative contribution of each condition is unknown. We compared the circadian pattern of UNaV in hypertensive and normotensive patients with and without OSA. Methods: Hypertensive [blood pressure (BP) >140/90 or on antihypertensive medications, excluding diuretics] and normotensive (BP <135/85) patients underwent overnight polysomnography to determine the presence or absence of OSA (apnoea–hypopnoea index ≥10 or <10, respectively), same-day 24-h urine collection divided into day and night-time samples and automated evening BP measurement. Results: Twenty-six hypertensive (9 without and 17 with OSA) and 26 normotensive (15 without and 11 with OSA) patients were studied. Night-time UNaV was higher in the hypertensive than the normotensive patients. Whereas in the normotensive patients night-time UNaV was unaffected by OSA, in the hypertensive patients, it was higher in those with than without OSA (P = 0.009 for OSA × hypertension interaction). Night : day UNaV ratio was higher in hypertensive than normotensive patients, but was not significantly affected by OSA in either group. On multivariate analysis, SBP and apnoea–hypopnoea index were independent predictors of night-time UNaV (model r2 = 0.574, P < 0.001) and night : day UNaV ratio (model r2 = 0.397, P < 0.001). However, SBP was the strongest independent predictor. Conclusions: In hypertensive patients, OSA exacerbates the reversal of the normal circadian sodium excretion pattern by elevating nocturnal UNaV, possibly via its BP-elevating effects. However, OSA does not affect nocturnal UNaV in normotensive patients.
Country of birth modifies the associations of body mass and hemoglobin A1c with office blood pressure in Middle Eastern immigrants and native Swedes

Objective: Immigrant populations from the Middle East are at high risk of obesity and diabetes, but paradoxically hypertension is reported to be less prevalent. Studies of the risk factors for hypertension in these populations are scarce. The aim was to study the distribution of cardiovascular and metabolic risk factors in the Middle East immigrant population compared with native Swedes. Methods: A population-based, cross-sectional study of men and women, aged 30–75 years, born in Iraq or Sweden, was conducted in 2010–2012 in Malmö, Sweden. A 75-g oral glucose tolerance test was performed, and sociodemographic and lifestyle data were collected. Results: In participants born in Iraq (n = 1311) vs. participants born in Sweden (n = 698), without a history of cardiovascular disease (CVD), the metabolic syndrome (MetS) was more prevalent in the Iraqis (49.2 vs. 40.3%, P < 0.001). Iraqis presented with higher prevalence rates of all but one MetS entity: elevated blood pressure (BP; 46.0 vs. 61.3%, P < 0.001, data adjusted for age, sex and antihypertensive medication). Being born in Iraq independently decreased the risk of elevated SBP and DBP. Furthermore, higher BMI, waist circumference, pulse rate and hemoglobin A1c (HbA1c) values presented weaker associations with SBP and DBP in Iraqis than in Swedes. These relationships were confirmed by interactions with the country of birth. Conclusion: BP-regulating mechanisms seem to differ in the Middle Eastern compared with a nonmigrated native European population. Further studies are needed for reaching a better understanding of the mechanisms contributing to CVD in populations of mixed ethnic backgrounds.
Compound heterozygote state for GγAγ(δβ)°‐thalassemia and hereditary persistence of fetal hemoglobin

We report a hitherto undescribed interaction of a deletional (δβ)°‐thalassemia and a deletional hereditary persistence of fetal hemoglobin (HPFH) in an adult Thai individual. He was a 40‐year‐old Thai male who had the following hematologic data: Hb 13.9 g/dL, Hct 43.8%, MCV 78.0 fL, MCH 24.7 pg, MCHC 31.6 g/dL, and RDW 17.1%. Hemoglobin analysis revealed 97% Hb F with Gγ‐globin chain predominant. Globin gene analyses demonstrated that he carried the GγAγ(δβ)°‐thalassemia deletion in trans to the HPFH‐6. Hematologic data of the patient were compared to those of the heterozygotes for these high‐Hb F determinants found in his parents and an unrelated Thai patient with a compound HPFH‐6/deletion–inversion Gγ(Aγδβ)°‐thalassemia previously described. Am. J. Hematol. 80:119–123, 2005. © 2005 Wiley‐Liss, Inc.
Disability, Citizenship and Community Care: A Case for Welfare Rights?

The role of assessments in community care for disabled people in England from 1993 Social policy, rights and citizenship Community care for disabled people in the 1990s - rationing or citizenship? Managing demand at the front-line - managerial, bureaucratic and professional gate keeping Negotiating barriers in the dark? - accessing assessments Being a "competent member" of the community - services and social participation Community care assessments in the 1990s - citizenship denied? Assessment and care management policy and practice in the new Millennium - towards a new framework of citizenship?
The vascular response to vasodilators is related to the membrane content of polyunsaturated fatty acids in hypertensive patients

Objective: Abnormal vascular reactivity contributes to the pathophysiology of hypertension and hypertension-related organ damage. As the dietary content of fatty acids may affect the vascular responses, we investigated the relationship of endothelium-independent and endothelium-dependent vasodilation with the fatty acid composition of red blood cell (RBC) membranes in hypertension. Methods: In 45 uncomplicated hypertensive patients, we measured the content of fatty acids in RBC membrane as a marker of dietary intake of fatty acids, and the vasodilatory response of the brachial artery to both nitrate-donor compound (nitrate-mediated vasodilation, NMD) and postischemic reactive hyperemia (flow-mediated vasodilation, FMD). Results: Baseline diameter of the brachial artery was significantly lower and vasodilatory response to NMD was significantly greater in patients with RBC membrane polyunsaturated-to-saturated fatty acid (PUFA/SFA) ratio above the median of the distribution than in patients with PUFA/SFA ratio below the median, whereas no difference was observed in FMD. n−3 PUFA and n−6 PUFA content, and the PUFA/SFA ratio of RBC membranes were related inversely with brachial artery diameter and directly with maximal NMD, whereas no relationship of fatty acid components of RBC membrane with FMD was observed. Multivariate analysis that included demographic, anthropometric, clinical, and biochemical variables indicated that the RBC membrane PUFA/SFA ratio was an independent determinant of brachial artery diameter and NMD response. Conclusion: The endothelium-independent brachial artery vasodilation is independently related to the PUFA content of RBC membranes in patients with hypertension. This suggests the possible benefits of PUFA-enriched diets on the regulation of vascular tone and blood pressure in these patients.
Impact of liver cysts in progression of polycystic kidney disease

IntroductionLiver involvement is the most frequent extrarenal manifestation in autosomal dominant polycystic kidney disease (ADPKD). We studied the impact of liver cysts on renal function in our patients with ADPKD.Methodsa retrospective observational from January 2002 to January 2009 e divided 138 patients with ADPKD into two groups: one group of 68 patients without liver cysts and another group of 70 patients with liver cysts. Renal function was considered to be impaired when the creatinine clearance was less than 60 ml/min. Differences were considered significant at the P<0.05 level.ResultsThe liver cysts were more frequent in female patients. No renal failure survival difference was found between patients in both groups (P=0.05). Female patients with liver cysts and three or more pregnancies had a worse survival rate than female patients with liver cysts with fewer than three or no pregnancies (P<0.01). ConclusionOur study showed that there was no renal failure survival difference between patients with liver cysts compared with those without liver cysts. Female patients with liver cysts and three or more pregnancies had a greater risk of developing end stage renal disease when compared with patients with liver cysts and fewer than three or no pregnancies.
Mapping Trachoma in Kaduna State, Nigeria: Results of 23 Local Government Area-Level, Population-Based Prevalence Surveys

ABSTRACT Introduction: To prepare for global elimination of trachoma by 2020, the World Health Organization (WHO) recommends mapping of trachoma at district-level to enable planning of elimination activities in affected populations. The aim of our study was to provide data on trachoma for each local government area (LGA) of Kaduna State, Nigeria, as such data were previously unavailable. Method: As part of the Global Trachoma Mapping Project (GTMP), a population-based cross-sectional trachoma survey was conducted in each of the 23 LGAs of Kaduna State, between May and June 2013. The protocols of the GTMP were used. Results: The prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years was between 0.03% and 8% across the LGAs, with only one LGA (Igabi) having a TF prevalence ≥5%. The LGA-level prevalences of trichiasis in persons aged 15 years and older were between 0.00% and 0.78%. Eleven LGAs had trichiasis prevalences of 0.2% and over in adults; a threshold equivalent to 1 case per 1000 total population. The LGA-level proportion of households with access to improved water sources ranged from 9% to 96%, while household access to latrines ranged from 5% to 99%. Conclusion: Kaduna State has generally hypoendemic trachoma, but a few trichiasis surgeries are still required to attain the WHO elimination targets. Better access to improved water and sanitation is needed.
The Long-Term Effects of Terrorism in France

Summary France has been subjected to terrorism for the past 15 years. Several epidemiological studies have pointed to the high prevalence and severity of PTSD symptoms among the victims. Terrorism-related injuries and time elapsed since the trauma were associated with a negative prognosis. Since 1997, these findings led to the development of a medico-psychological intervention network accompanying the traditional emergency medical team, and giving pre-hospital psychological emergency care to provide secondary prevention. Specialized hospital-based psychiatric services were developed to complement this front-line network, offering an innovative system of care. Studies are needed to examine the effectiveness of this system in reducing trauma-related disorders.
Age- and Schooling-Related Effects on Executive Functions in Young Children: A Natural Experiment

We employed a cutoff design in order to examine age- and schooling-related effects on executive functions. Specifically, we looked at development of working memory and response inhibition over the period of 1 school year in prekindergarten and kindergarten students born within 4 months of each other. All children improved on executive function and word-decoding tasks from the beginning to the end of the year. Additionally, we found prekindergarten- and kindergarten-schooling effects for the working memory and word-decoding tasks (p < .05), and a trend-level prekindergarten-schooling effect for the response inhibition task (p < .10).
Peer Difficulties in Children with Epilepsy: Association with Seizure, Neuropsychological, Academic, and Behavioral Variables

Purpose/Objective: A developmental psychopathology framework was used to examine variables associated with peer problems in children with epilepsy (CWE). Variables commonly associated with peer difficulties in typically developing children, such as inattentive behavior, anxious behavior, and academic achievement were investigated. Neuropsychological functioning, age at epilepsy onset, and seizure status were also examined. Research Method/Design: Participants were 173 CWE, ages 8–15. Structural equation modeling (SEM) was used to determine which variables predicted peer problems in CWE and to test hypothesized interrelations among variables. Results: The SEM revealed that anxious behavior mediated relations between neuropsychological functioning and peer difficulties and seizure status and peer difficulties. Inattentive behavior mediated the association between neuropsychological functioning and peer difficulties. Neuropsychological functioning mediated the relation between age at epilepsy onset and inattentive behavior, anxious behavior, and academic achievement. Conclusions/Implications: As seen with typically developing children, inattentive and anxious behaviors are related to peer difficulties in CWE. Neuropsychological functioning, age at epilepsy onset, and seizure status are indirectly associated with peer difficulties; therefore, these variables are important to examine in CWE who are experiencing peer problems.
Methylphenidate, Interstimulus Interval, and Reaction Time Performance of Children with Attention Deficit/Hyperactivity Disorder: A Pilot Study

Thirteen children with attention deficit/hyperactivity disorder (ADHD: DSM-IV-TR) participated in the pilot study. They carried out a Go/No-Go test with a short (2 seconds) and long (6 seconds) interstimulus interval (ISI) when on placebo and a therapeutic dose of methylphenidate (MPH). For the long-ISI placebo condition the responses were slow and inaccurate. This pattern of response may be due to underactivation of the readiness-to-respond state that is not fully controlled by effort allocation. Speed of response and accuracy were enhanced during the short-ISI placebo condition and the long-ISI MPH condition. However, the combined effect (short ISI and MPH) resulted in a fast but inaccurate response style. This pattern of response may be due to overactivation of the readiness-to-respond state. The data of the pilot study support the stimulus shift hypothesis: MPH administration result in deterioration on tests on which children had previously done well (short ISI plus placebo versus short ISI plus MPH). In addition, the data support the idea that ADHD is associated with poor state regulation rather than motivational (delay aversion) theories or temporal-processing/time-estimation theories of ADHD. The pilot study defined empirically an issue for further study with the larger controlled sample.
The Nature of the Automatization Deficit in Chinese Children with Dyslexia

Clarifying whether automatization deficits constitute the primary causes or symptoms of developmental dyslexia, we focused on three critical issues of the dyslexic automatization deficit, namely universality, domain specificity, and severity. Thirty Chinese dyslexic children (mean age 10 years and 5 months), 30 chronological-age-, and 30 reading-level-matched children were tested in 4 areas of automaticity: motor, visual search, Stroop facilitation effects, and automatic word recognition. The results showed that the dyslexic children performed significantly worse than the CA-controls but not the RL-controls in all the tasks except for Stroop congruent-color words, on which they performed worse than children in both control groups. The deficits reflect a lag in reading experiences rather than a persistent cognitive deficit.
Noncredible Effort during Pediatric Neuropsychological Exam: A Case Series and Literature Review

Neuropsychological test interpretation rests upon the assumption that the examinee has exerted full effort. If an individual provides inadequate effort during exam, the resulting data will be invalid and represent an underestimate of the person's true abilities. Although youth have been assumed historically to be less capable of deception than adults, acts of deception in childhood are not uncommon, even in normative populations. Yet, very few cases of children who have provided suboptimal effort during neuropsychological exam have appeared in the scientific literature. We present six clinical cases illustrating that children down to at least age 8 years can present with noncredible performance. The cases include those in which clear external incentives could be identified to those in which intrinsic or psychological factors were presumed to predominate. The fairly diverse nature of the presented cases, along with other recent work, suggests that suboptimal effort in children is apt to occur more frequently than previously recognized, even if it might occur less often than in comparable adult samples. In most of the presented cases, noncredible performance would not have been detected definitively by clinical judgment alone, reinforcing the value of routinely incorporating symptom validity tests into the neuropsychological assessment of school-aged children. The number of effort tests that have demonstrated utility in children pales in comparison to those available to the adult practitioner, although recent research now supports the use of several standalone measures with pediatric patients.
Childhood abuse and neglect and cognitive flexibility in adolescents

Childhood maltreatment (CM) has been associated with diminished executive functioning in children and adults; however, there is a relative paucity of study of executive function in adolescents exposed to CM. Yet, executive dysfunction in adolescence may have important adverse consequences including increased vulnerability to risky behaviors and impaired school functioning. This study investigates the relationship between self-reported CM and an executive function, cognitive flexibility, in adolescents without identified psychiatric disorders. Effects of physical and emotional, abuse and neglect, maltreatment subtypes were explored. Thirty adolescents ages 12–17 years, 50% females, completed the retrospective self-report Childhood Trauma Questionnaire (CTQ) and were administered the Wisconsin Card Sorting Test (WCST). Correlational analyses assessed the relationship between WCST perseverative error scores norm-referenced for age and education with CTQ total scores. The relationship with nonperseverative errors, as well as with physical and emotional abuse and neglect CM subscores, were explored. Total CTQ scores showed significant associations with perseverative errors on the WCST, but not with nonperseverative errors. Significant associations with perseverative errors were seen for physical abuse and physical neglect among the CTQ subscales. The results suggest both physical abuse and physical neglect are associated with diminished cognitive flexibility in adolescents. These effects were detected in adolescents without identified psychiatric diagnoses suggesting the importance of considering executive dysfunction in adolescents exposed to CM who may not meet diagnostic criteria for an Axis I disorder and that tests of perseverative errors, such as those of the WCST, may be sensitive indicators of this dysfunction.
The antihypertensive effects of aerobic versus isometric handgrip resistance exercise

Background: Aerobic exercise reduces blood pressure (BP) on average 5–7 mmHg among those with hypertension; limited evidence suggests similar or even greater BP benefits may result from isometric handgrip (IHG) resistance exercise. Method: We conducted a randomized controlled trial investigating the antihypertensive effects of an acute bout of aerobic compared with IHG exercise in the same individuals. Middle-aged adults (n = 27) with prehypertension and obesity randomly completed three experiments: aerobic (60% peak oxygen uptake, 30 min); IHG (30% maximum voluntary contraction, 4 × 2 min bilateral); and nonexercise control. Study participants were assessed for carotid-femoral pulse wave velocity pre and post exercise, and left the laboratory wearing an ambulatory BP monitor. Results: SBP and DBP were lower after aerobic versus IHG (4.8 ± 1.8/3.1 ± 1.3 mmHg, P = 0.01/0.04) and control (5.6 ± 1.8/3.6 ± 1.3 mmHg, P = 0.02/0.04) over the awake hours, with no difference between IHG versus control (P = 0.80/0.83). Pulse wave velocity changes following acute exercise did not differ by modality (aerobic increased 0.01 ± 0.21 ms, IHG decreased 0.06 ± 0.15 ms, control increased 0.25 ± 0.17 ms, P > 0.05). A subset of participants then completed either 8 weeks of aerobic or IHG training. Awake SBP was lower after versus before aerobic training (7.6 ± 3.1 mmHg, P = 0.02), whereas sleep DBP was higher after IHG training (7.7 ± 2.3 mmHg, P = 0.02). Conclusion: Our findings did not support IHG as antihypertensive therapy but that aerobic exercise should continue to be recommended as the primary exercise modality for its immediate and sustained BP benefits.
High prevalence of cardiac electric abnormalities in patients with phaeochromocytomas.

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