Miracle-dz/UniFAR-FTUs huggingface dataset:
Topography of dilated perivascular spaces in subjects from a memory clinic cohort

Objective: To investigate whether the topography of dilated perivascular spaces (DPVS) corresponds with markers of particular small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy. Methods: Patients were recruited from an ongoing single-center prospective longitudinal cohort study of patients evaluated in a memory clinic. All patients underwent structural, high-resolution MRI, and had a clinical assessment performed within 1 year of scan. DPVS were rated in basal ganglia (BG-DPVS) and white matter (WM-DPVS) on T1 sequences, using an established 4-point semiquantitative score. DPVS degree was classified as high (score > 2) or low (score ≤ 2). Independent risk factors for high degree of BG-DPVS and WM-DPVS were investigated. Results: Eighty-nine patients were included (mean age 72.7 ± 9.9 years, 57% female). High degree of WM-DPVS was more frequent than low degree in patients with presence of strictly lobar microbleeds (45.5% vs 28.4% of subjects). High BG-DPVS degree was associated with older age, hypertension, and higher white matter hyperintensity volumes. In multivariate analysis, increased lobar microbleed count was an independent predictor of high degree of WM-DPVS (odds ratio [OR] 1.53 [95% confidence interval (CI) 1.06–2.21], p = 0.02). By contrast, hypertension was an independent predictor of high degree of BG-DPVS (OR 9.4 [95% CI 1–85.2], p = 0.04). Conclusions: The associations of WM-DPVS with lobar microbleeds and BG-DPVS with hypertension raise the possibility that the distribution of DPVS may indicate the presence of underlying small-vessel diseases such as cerebral amyloid angiopathy and hypertensive vasculopathy in patients with cognitive impairment.
GENERAL ASPECTS: An Outline of School Health Services in Japan

Every citizen receives a formal school education during his or her development. School health services are designed primarily to maintain and promote the health of pupils and students during this period. (The term “pupils” applies to elementary schools and “students” to secondary schools throughout this report.) Seen in this light, school health concerns everything related to the youngsters’ health, such as safety, school lunches, etc. This report, however, will address “health education and health administration” as specified by the Ministry of Education, Science and Culture, the government agency in charge of educational administration. The schools covered in this report range from elementary and lower secondary schools, which provide compulsory education, to some upper secondary schools. An outline of the educational system in Japan and some explanations will be given below. constitutional statement guaranteeing “all people . the right to receive an equal education correspondent to their abilities,” and obligates the people to “have all boys and girls under their protection receive ordinary education . ” To implement this directive, the fundamental Law of Education was enacted, specifying the policies to be pursued. The School Education Law, the fundamental statute on the school system, is based on this law. According to the School Education Law and various related cabinet orders, schools are differentiated as illustrated in Diagram 2. Not only national and local government schools, but private schools as well, are administered as public institutions. The schools covered by the School Education Law indlude elementary schools, lower and upper secondary schools, universities, technical colleges, schools for the physically handicapped, and kindergartens.
Synaptic vesicle exocytosis

Chemical synapses are the main mechanism of communication in the nervous system. At the presynaptic terminal, neurotransmitters are packaged into synaptic vesicles (SVs); when an action potential opens presynaptic voltage-gated Ca2+ channels, the neurotransmitters are released by Ca2+-triggered exocytosis into the synaptic cleft to activate postsynaptic receptors. SV exocytosis is restricted to the small section of the presynaptic plasma membrane called the active zone, which contains clustered Cav2 (P/Q- and N-type) voltage-gated Ca2+ channels.
Alterations of Heart Rate Variability by Vestibular Stimulation in Rabbits

Background:There is a substantial evidence that anatomicaal connections and functionalinteractions exist between vestibular and autonomic systems. The nature of these interactions, however, is complex and has not been fully defined. Heart rate variability (HRV) was used to investigate the physiological role of the vestibular system on control of heart rate. Methods:HRV including mean, standard deviation, coefficient of variation (CV), power spectrum was analyzed from R-R intervals of ECG during vestibular stimulation in rabbits. Results:Urethane anesthesia increased heart rate and maintained regular R-R intervals, however, low frequency region/high frequency region (LF/HF) was not changed. In anesthetized rabbits, electrical stimulation of the vagus nerve decreased heart rate and decreased LF/HF by increasing HF. On the contrary, electrical stimulation of the cervical sympathetic nerve increased heart rate and increased LF/HF by increasing LF. Atropine, cholinergic blocker, increased heart rate and increased LF/HF by reducing HF, and propranolol, β-adrenergic blocker, decreased heart rate and decreased LF/HF by reducing LF. In unanesthetized rabbits, stimulation of the vestibular system induced by rotation or caloric increased heart rate and increased LF/HF by increasing LF. Also electrical stimulation of the vestibular nerve produced the same effects as rotation or caloric in anesthetized rabbits. Conclusion:These results suggest that stimulation of the vestibular system increased heart rate not by inhibiting the parasympathetic nerve but by activating the sympathetic nerve. (Korean Circulation J 1999; 29(7):722-730)
Epidemiology of stroke and its subtypes in Chinese vs white populations

Objective: We aimed to systematically assess the evidence for differences in the incidence of stroke and distribution of its subtypes in Chinese compared with white populations. Methods: We comprehensively sought studies conducted since 1990 in Chinese populations of 1) first-ever stroke incidence (community-based studies only), and 2) pathologic types/subtypes of stroke (hospital- or community-based studies of first-ever or recurrent strokes). We identified community-based studies in white populations from a recent systematic review. For each study, we calculated age-standardized stroke incidence and the proportions of each pathologic type and ischemic subtype, using random-effects meta-analysis to pool proportions of stroke types/subtypes in Chinese and in white populations. Results: Age-standardized annual first-ever stroke incidence in community-based studies was higher among Chinese than white populations (for ages 45–74 years, range 205–584 vs 170–335 per 100,000, respectively). Intracerebral hemorrhage accounted for a larger, more variable proportion of strokes in China than Taiwan (range 27%–51% vs 17%–28%), in Chinese community-based than hospital-based studies (27%–51% vs 17%–30%), and in community-based Chinese than white studies (pooled proportion 33% vs 12%). Although the overall proportion of lacunar ischemic stroke appeared higher in Chinese than white populations, variable study methodologies precluded reliable comparisons. Conclusions: There is good evidence for a slightly higher overall stroke incidence and higher proportion of intracerebral hemorrhage in Chinese vs white populations, but no clear evidence for different distributions of ischemic stroke subtypes. Studies using comparable, population-based case ascertainment and similar classification methods are needed to address this.
Peripheral nerve stimulation

Peripheral nerve stimulation is the gold standard method of nerve identification in Argentina. In this article we focus on the basic principles needed to understand and perform regional blocks with the aid of a peripheral nerve stimulator, avoiding complications. Based on our experimental investigation in animals, we recommend permanently checking the equipment to always perform the blocks in an awake or slightly sedated patient and to inject the AL solution when a motor response GII is obtained with an intensity of ≤0.5 mA, a pulse duration of 100 μsec and a frequency of 2 Hz. MR at that point must disappear if intensity is decreased to 0.2 mA. Disparition of MR after local anesthetic injection is due to electrophysiologic changes of injectates and not to the physical displacement of the nerve. Paresthesia are the only protection that patients have against needle nerve contact or penetration.
Central pain modulation after subthalamic nucleus stimulation

Objective: To investigate the acute effect of subthalamic nuclei deep brain stimulation (STN-DBS) and levodopa on pain and tolerance thresholds in patients with Parkinson disease. We hypothesized that a modification of pain threshold after STN-DBS would suggest a central modification of pain perception, whereas the absence of pain threshold change after STN-DBS would correspond to a peripheral mechanism via a decrease of painful stimuli. Methods: Nineteen patients with Parkinson disease were included in this double-blind, randomized, crossover study. Postoperatively, we evaluated pain thresholds (thermal and mechanical) and motor symptoms under 3 acute conditions: stimulation on/medication off; stimulation off/medication on; and stimulation off/medication off. We also conducted a retrospective analysis of the data prospectively recorded during the follow-up of the cohort pre- and postoperatively (Unified Parkinson’s Disease Rating Scale [UPDRS] score, Hoehn and Yahr stage, equivalent levodopa daily dose, and tapping test score). Results: We found a significant increase of pain and tolerance mechanical thresholds not only after acute STN-DBS but also after acute levodopa administration. We did not find any significant correlation between postoperative clinical pain improvement and UPDRS-III improvement after acute levodopa or STN-DBS, nor with motor complications improvement assessed with UPDRS-IV after chronic STN-DBS. No correlation was found between postoperative clinical pain improvement and mechanical pain threshold modification. Conclusion: Clinical pain alleviation after STN-DBS cannot be considered merely as a consequence of motor complications improvement and could be attributable to a direct central modulation of pain perception, via increased mechanical pain and tolerance thresholds.
Robust Dependencies and Structures in Stem Cell Differentiation

Cell differentiation is a complex process governed by the timely activation of genes resulting in a specific phenotype or observable physical change. Recent reports have indicated heterogeneity in gene expression even amongst identical colonies (clones). While some genes are always expressed, others are expressed with a finite probability. In this report, a mathematical framework is provided to understand the mechanism of osteoblast (bone forming cell) differentiation. A systematic approach using a combination of entropy, pair-wise dependency and Bayesian approach is used to gain insight into the dependencies and underlying network structure. Pairwise dependencies are estimated using linear correlation and mutual information. An algorithm is proposed to identify statistically significant mutual information estimates. The robustness of the dependencies and the network structure to decreasing number of colonies (colony size) and perturbation is investigated. Perturbation is achieved by generating bootstrap samples. The methods discussed are generic in nature and can be extended to similar experimental paradigms.
Nonmydriatic ocular fundus photography among headache patients in an emergency department

Thulasi et al.1 studied the importance of funduscopic examination in patients with headache. Fundus findings are well-described in noncommunicable diseases such as hypertension, diabetes mellitus, and congenital and hereditary metabolic disorders but not in infectious diseases.2 Retinopathy has been reported in some infectious diseases like malaria, infective endocarditis, cysticercosis, HIV, and dengue.2,3 Fundus findings would aid clinicians in rural settings or underdeveloped environments in reaching a diagnosis depending on the prevalent disease in that area.
Effect of acute and prolonged mineralocorticoid receptor blockade on spontaneous and stimulated hypothalamic-pituitary-adrenal axis in humans.

CONTEXT Mineralocorticoid receptors (MRs) in the hippocampus display an important role in the control of the hypothalamic-pituitary-adrenal (HPA) axis, mediating the proactive feedback of glucocorticoids, which maintains the basal HPA activity. The systemic administration of MR antagonists enhances spontaneous and CRH-stimulated ACTH, cortisol, and DHEA secretion, while the effects of chronic treatment with MR antagonists are scanty. Our study was performed in order to clarify this point. DESIGN ACTH, cortisol, and DHEA levels were studied during the infusion of placebo, canrenoate, a MR antagonist (CAN, 200 mg i.v. bolus at 1600 h followed by 200 mg infused over 4 h), and human CRH (hCRH; 2.0 microg/kg i.v. bolus at 1800 h) before and during the last week of 28-day treatment with CAN (200 mg/day p.o.) in eight young women. RESULTS Pre-treatment sessions: CAN and hCRH administration increased ACTH, cortisol, and DHEA levels versus placebo (P<0.05). Post-treatment sessions: during placebo infusion, cortisol and DHEA were significantly amplified versus pre-treatment session (P<0.05), while ACTH levels were not modified; CAN infusion, differently from pre-treatment session, was not able to significantly increase ACTH, cortisol, and DHEA levels; ACTH, cortisol, and DHEA responses to hCRH were amplified with respect to pre-treatment session, although statistical significance was obtained for cortisol and DHEA only. CONCLUSIONS MR blockade by acute CAN administration significantly enhances the HPA activity in the afternoon, during the quiescent phase of the circadian rhythm. At the same period, prolonged treatment with CAN amplifies both spontaneous and CRH-stimulated activities of the HPA axis, while it blunts the HPA responsiveness to a further MR-mediated stimulation.
Randomized GH trial with two different dosages in combination with a GnRH analogue in short small for gestational age children: effects on metabolic profile and serum GH, IGF1, and IGFBP3 levels.

BACKGROUND GnRH analogue (GnRHa) combined with GH treatment has been proposed to increase adult height. Effect on metabolic profile and GH, IGF1, and IGFBP3 levels in short small for gestational age (SGA) children is unknown. OBJECTIVE To assess fat mass and lean body mass SDS, percentage trunk fat, blood pressure (BP), insulin sensitivity (Si), beta-cell function (disposition index, DI), lipid profile, and GH, IGF1, and IGFBP3 levels during 2 years of combined treatment. SUBJECTS Forty-one pubertal short SGA children with a mean (+/-S.D.) age of 12.1 (+/-1.0) years. DESIGN Children received 3.75 mg of leuprolide acetate depot subcutaneously every 4 weeks, and they were randomly assigned to receive 1 mg (group A) or 2 mg (group B) of GH/m(2) per day. RESULTS Percentage trunk fat increased in both groups, but to a lower extent in group B. Lean body mass SDS increased only in group B. Changes in BP, Si, DI, and lipids were similar in both groups. Si significantly decreased, but DI remained unchanged. Lipids remained normal. GH and IGF1 levels were significantly higher in group B. CONCLUSION Our study is the first to report that 2 years of combined treatment with a GnRHa and either 1 or 2 mg GH/m(2) per day does not adversely affect body composition and metabolic profile of short SGA children who come under medical attention at the onset of puberty. There was a dose-dependent effect on fat mass SDS(height), percentage trunk fat, lean body mass SDS(height), and GH and IGF1 levels in favor of treatment with GnRHa and the higher GH dose of 2 mg/m(2) per day.
Leukotriene Synthesis Inhibition and Receptor Blockade Do Not Inhibit Hypoxic Pulmonary Vasoconstriction in Sheep

&NA; Several lines of evidence suggest that leukotrienes may be mediators of hypoxic pulmonary vasoconstriction (HPV). However, the effect of leukotriene inhibition on HPV remains controversial. The present study investigated the effect of leukotriene synthesis inhibition and receptor blockade on HPV in the halothane‐anesthetized sheep. After initial baseline measurements, the pulmonary pressor response to 15 min of global hypoxia (Fio2 = 0.13) was measured. A second set of baseline measurements was obtained and the sheep then received the combined cyclooxygenasellipoxygenase inhibitor BW755C, the selective lipoxygenase inhibitor U60257, or the leukotriene receptor antagonist LY171883. Hemodynamic measurements were obtained after drug administration and during a subsequent hypoxic challenge (Fio2 = 0.13). Initial hypoxic challenge increased pulmonary artery pressure 68% and increased pulmonary vascular resistance 104%. Pulmonary hemodynamics after recovery from hypoxia were similar to initial baseline values. Drug administration had no significant hemodynamic effect. Hypoxic challenge after drug administration resulted in a pulmonary pressor response identical to the initial hypoxic challenge. Because leukotriene synthesis inhibition and receptor blockade did not alter the response to hypoxia, we conclude that leukotrienes are not obligatory mediators of HPV. A critical review of the literature supports a modulatory rather than an obligatory role for leukotrienes in HPV.
Associations between alcohol-related concerns, normative perceptions of peer alcohol use, and veterans’ drinking behavior over six months

Abstract The Veterans Health Administration (VHA) has implemented initiatives to increase rates of brief alcohol counseling (BAC). Half of eligible veterans do not receive such care. Understanding patient characteristics associated with drinking behavior may identify patients for whom BAC may be acceptable. Data collected from veterans between January 2010 and September 2011 (N = 167) were examined. Results find that alcohol-related concerns and perceptions of peer alcohol consumption are associated with reduced drinking behavior. These findings suggests that assessing drinking concerns and perceptions of peer alcohol use may help to identify patients interested in changing drinking behavior, receiving care, and assist providers in delivering appropriate counseling.
Online Hierarchical Controller for Hybrid Power System

This paper presents the basis for the development of an intelligent and autonomous energy management strategy for hybrid power system (HPS). Two hierarchical levels are proposed to control and manage the HPS. The low level is performed by a local control unit (DC-DC converters controller) of the different power sources. Dynamic equations describing the coupling of converters are derived, and a robust sliding mode dynamic controller is designed. The high level is performed by the online supervisor unit. This unit is designed by applying on-line Takagi-Sugeno fuzzy logic principles. As a result the robust control system gets rid of the limits of the HPS, which has the imprecision, uncertainty, strong coupling, and nonlinearity, to achieve its tractability, robustness, and low solution cost. Under the operation constraints related to each type of sources, the simulation results show that the optimal operation objective of HPS has been achieved.
Prevalence of AIP mutations in a large series of sporadic Italian acromegalic patients and evaluation of CDKN1B status in acromegalic patients with multiple endocrine neoplasia.

BACKGROUND Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene and the p27(KIP1) encoding gene CDKN1B have been associated with two well-defined hereditary conditions, familial isolated pituitary adenoma (FIPA) and multiple endocrine neoplasia type 4 (MEN4). Somatotropinomas are present in most AIP mutated FIPA kindreds, as well as in two-thirds of MEN4 patients who carry pituitary tumors. METHODS Germline DNA samples of 131 Italian sporadic acromegalic patients including 38 individuals with multiple tumors, and of six FIPA families (four homogeneous for prolactinomas and two heterogeneous with prolactin/nonfunctioning pituitary adenomas) were collected in a multicentric collaborative study. The prevalence of AIP and CDKN1B gene point mutations and copy number variations were evaluated. RESULTS Two novel (IVS3+1G>A and c.871G>A) and one previously described (c.911G>A) AIP mutations were detected in four apparently sporadic cases (3.1%) with relatively high age at diagnosis (49+/-18, range 30-67). No mutations/rearrangements were detected in FIPA families. The highly conserved c.871G>A substitution was detected in a patient who also carried a MEN1 mutation suggesting that she is a double heterozygote. The possible pathogenic effect on AIP splicing of the silent substitution c.144G>A found in another patient was ruled out using a minigene-based approach. CDKN1B mutations/rearrangements were neither identified in patients with multiple neoplasia nor in FIPA families. CONCLUSION AIP is mutated in about 3% of apparently sporadic acromegalic patients. The relatively high age at diagnosis, as well as its sporadic presentation, suggests that these patients are carriers of mutations with reduced pathogenicity. p27(KIP1) is unlikely to represent the common unifying nonendocrine etiology for acromegaly and cancer.
Effect of weight reduction on insulin sensitivity, sex hormone-binding globulin, sex hormones and gonadotrophins in obese children.

OBJECTIVE Obesity in men is associated with reduced insulin sensitivity and hypoandrogenism, while obesity in women is associated with reduced insulin sensitivity and hyperandrogenism. In children, the effect of obesity and weight reduction on the hypothalamo-pituitary-gonadal axis is rarely investigated. The aim of the present study was to investigate the effect of weight reduction in obese Caucasian children on insulin sensitivity, sex hormone-binding globulin (SHBG), DHEAS and the hypothalamo-pituitary-gonadal axis. METHODS One hundred and sixteen (65 females) obese children with a median age of 12.3 (7-15) years were examined before and after a 10-week stay at a weight loss camp. Examination included anthropometry and fasting blood samples measuring plasma glucose, serum insulin, SHBG, DHEAS, testosterone, 17β-oestradiol, FSH and LH. RESULTS Body mass index (BMI) decreased (P<0.01), insulin sensitivity and SHBG increased (P<0.01), independent of gender and puberty. The changes in insulin sensitivity and the changes in SHBG correlated significantly (P<0.01) independent of gender, puberty and the changes in BMI. Testosterone increased in boys (P<0.01) and tended to decrease in girls (P=0.05, in girls after menarche (P=0.03)). FSH increased in boys and girls. LH increased in boys and was unchanged in girls. CONCLUSIONS During weight loss, insulin sensitivity and SHBG increased significantly in obese children, and the changes in insulin sensitivity and the changes in SHBG correlated significantly independent of gender, puberty and the changes in BMI. There was sexual dimorphism in the changes of testosterone, with the changes in boys towards increased virilisation and the changes in girls towards less virilisation.