Miracle-dz/UniFAR-FTUs huggingface dataset:
Possible pathogenic role of Brain‐Derived Neurotrophic Factor (BDNF) in glaucoma‐like optic neuropathy in patients with intracranial tumours. Reply

Dear Editor, W e read with great interest the article titled ‘Glaucoma-like optic neuropathy in patients with intracranial tumours’ by Qu et al. (2011), which appeared in the February issue of Acta Ophthalmol. We would like to share our idea about possible role of brain-derived neurotrophic factor (BDNF) in glaucoma-like optic neuropathy in patients with intracranial tumours. BDNF is one of the polypeptide growth factors known to be vital components for building up and preserving neurons. BDNF is transported to the retinal ganglion cell bodies through a retrograde axonal transportation system and the synaptic connections within. The survival of retinal ganglion cells (RGCs) in vitro is enhanced by BDNF and BDNF mRNAs are present in the retina, optic nerve; furthermore, RGCs express the mRNA for trkB, the functional receptor for BDNF (Quigley et al. 2000). Glaucoma is known to be the most widespread neurodegenerative disease of the optic nerve. It is currently thought they ultimately affect the visual field through apoptosis of retinal ganglion cells (RGCs). The RGCs receiving proper chemical signalling from brain neurons and lateral geniculate nucleus (LGN) do not commence the apoptosis. The related brain neurons and LGN impose their neuroprotective effects on the RGCs through a retrograde axonal transport of neurotrophic factors (NTs), especially the BDNF (Quigley et al. 2000). The greater survival of axotomized RGCs observed after intravitreal administration of BDNF is consistent with the hypothesis that this molecule is an important survival factor for these neurons. The early death of most of the RGCs axotomized near their cell bodies presumably reflects the loss of trophic support provided by both their targets and their non-neuronal components of the optic nerve and tract. Their absence may render these injured nerve cells totally dependent on exogenous or intraocular sources of molecules required for survival (MansourRobaey et al. 1994). Recent investigations have shown that BDNF decrease in glaucoma, so it is quite logical to assume that diminution of the BDNF transport because of tumour compression on optic pathway might explain glaucoma-like optic neuropathy in patients with large perisellar tumours (Ghaffariyeh et al. 2009, 2011).
Thinning a Triangulation of a Bayesian Network or Undirected Graph to Create a Minimal Triangulation

In one procedure for finding the maximal prime decomposition of a Bayesian network or undirected graphical model, the first step is to create a minimal triangulation of the network, and a common and straightforward way to do this is to create a triangulation that is not necessarily minimal and then thin this triangulation by removing excess edges. We show that the algorithm for thinning proposed in several previous publications is incorrect. A different version of this algorithm is available in the R package gRbase, but its correctness has not previously been proved. We prove that this version is correct and provide a simpler version, also with a proof. We compare the speed of the two corrected algorithms in three ways and find that asymptotically their speeds are the same, neither algorithm is consistently faster than the other, and in a computer experiment the algorithm used by gRbase is faster when the original graph is large, dense, and undirected, but usually slightly slower when it is directed.
TREATMENT OF PERNICIOUS ANEMIA BY A SPECIAL DIET

To the Editor: —In their important article "Treatment of Pernicious Anemia by a Special Diet" (The Journal, August 14), Minot and Murphy honor me by quoting one of my articles in relation to deficiency as a cause of pernicious anemia. The authors, however, misunderstood my work and this wants rectification. Though in the article to which they refer and in other publications I defended the view that pernicious anemia must be caused by deficiency, I never thought or wrote that I thought it was caused by lack of a single known or still unknown vitamin. Pernicious anemia is a complicated symptom complex and therefore it is, in my opinion, caused by a lack of different substances in the food, which are to be found in a diet rich in complete proteins (meat, milk, yellow of eggs) and rich in the known vitamins. This led me to treat pernicious anemia with
Eficácia da fixação direta do labrum na glenóide em lesão de Bankart provocada em laboratório e submetida a estresse

The arthroscopy direct fixation of the labrum the glenoid in order to correct the Bankart lesion in shoulder recurrent dislocation has lost its importance due to the high level of recurrence of the affection as well as implant loosening. OBJECTIVE: To show the efficacy of the direct fixation of the labrum to the glenoid in Bankart lesion. METHODS: 20 shoulders of 10 cadavers were dissected and Bankart lesions were produced in all specimens. The direct fixation was performed in 10 of the specimens using screws especially designed for this purpose and indirect fixation in the 10 contralateral shoulders by means of mini-anchors and labrum suturing. The specimens were submitted to traction until failure of the system en high-accuracy equipments. RESULTS: Both methods of fixation beared 234N forces of traction on average without loosening or breakage of the implants. Instead, we observed capsuloligamentary lesions. CONCLUSION: The direct fixation and the indirect fixation techniques present similar efficacy.
Angioplastia e implante de stent en pacientes con estenosis de la arteria renal

La enfermedad aterosclerotica de las arteria renales se considera una comun de hipertension arterial sistemica e insuficiencia renal. El tratamiento percutaneo es un procedimiento seguro, de baja morbilidad y mortalidad, y con alta tasa de exito. Permite controlar o curar la hipertension arterial sistemica y estabilizar la funcion renal(10). En este trabajo se evaluara la eficacia de la angioplastia con implante de stent en pacientes con estenosis significativa de la arteria renal
Oregon's coordinated care organizations.

Whenever Medicaid is mentioned, Oregon always seems to be at the center of attention and controversy. Two decades ago, Oregon’s efforts to prioritize expenditures through the systematic and public ranking of medical services created a storm of controversy, as well as worldwide debate over the morality and admin­ istrative feasibility of (at least supposed) rationing of services to control Medicaid expenditures (Oberlander, Marmor, and Jacobs 2001). Within the past year, the Oregon Health Insurance Experiment (OHIE) has made front-page news. In 2008, Oregon opened a waiting list for a lim­ ited number of low-income uninsured adults to receive Medicaid. State officials drew names by lottery from ninety thousand people who had signed up for a waiting list. This lottery structure made possible a rigorous randomized trial, within which one could explore the impact of Medicaid enrollment on health services use, physical and mental health, and the burdens of medical debt (Finkelstein et al. 2012). Most recently, OHIE hit the front pages with its finding that enrolling uninsured adults into Medi­ caid increased rates of emergency department use (Pollack 2014; Taubman et al. 2014). Delivery system innovations receive less attention than do issues of apparent rationing or expanded Medicaid access. Yet these are scarcely less important. Oregon’s coordinated care organizations (CCOs) represent one of the nation’s most ambitious efforts to improve quality and costeffectiveness while reducing expenditures through medical homes and improved coordination of care. Steven Howard, Stephanie Bernell, Jangho
Treatment of Ruptured Vertebral Artery Dissecting Aneurysms

We evaluated the outcomes of endovascular or surgical treatment of ruptured vertebral artery dissecting aneurysms (VADAs), and investigated the relations between treatment complications and the development and location of the posterior inferior cerebellar artery (PICA). We treated 14 patients (12 men, two women; mean age, 56.2 years) with ruptured VADAs between March 1999 and June 2012 at our hospital. Six and eight patients had Hunt and Hess grades 1–3 and 4–5, respectively. Twelve patients underwent internal endovascular trapping, one underwent proximal endovascular occlusion alone, and one underwent proximal endovascular occlusion in the acute stage and occipital artery (OA)-PICA anastomosis and surgical trapping in the chronic stage. The types of VADA based on their location relative to the ipsilateral PICA were distal, PICA-involved, and non-PICA in nine, two, and three patients, respectively. The types of PICA based on their development and location were bilateral anterior inferior cerebellar artery (AICA)-PICA, ipsilateral AICA-PICA, extradural, and intradural type in one, two, two, and nine patients, respectively. Two patients with high anatomical risk developed medullary infarction, but their midterm outcomes were better than in previous reports. The modified Rankin scale indicated grades 0–2, 3–5, and 6 in eight, three, and three patients, respectively. A good outcome is often obtained in the treatment of ruptured VADA using internal endovascular trapping, except in the PICA-involved type, even with high-grade subarachnoid hemorrhage. Treatment of the PICA-involved type is controversial. The anatomical location and development of PICA may be predicted by complications with postoperative medullary infarction.
Radiosurgery for Benign Spinal Tumors

The clinical experience with radiosurgery for benign spinal tumors is extremely limited. However, buttressed by multiple data that support excellent outcomes and minimal morbidity when radiosurgery is applied to benign intracranial neoplasms, radiosurgery for similar benign histologies in the spine is now being explored at multiple centers. The benign spinal tumors are anatomically extramedullary and intradural and include lesions such as meningiomas, schwannomas, and neurofibromas. Review of this preliminary experience shows that radiosurgery may emerge as a safe and efficacious tool in the therapeutic armamentarium for benign spinal tumors.
SURGERY OF CEREBRAL TRAUMA AND ASSOCIATED CRITICAL CARE

The last 30 years have been both exciting and frustrating for those in the field of traumatic brain injury (TBI). Much has been learned, but no new treatment has been shown to improve patient outcomes despite the execution of many clinical trials. The overall incidence of TBI has decreased, probably because of intensive efforts toward prevention and education. Rigorous assessment of available research has produced several evidence-based guidelines for the management of neurotrauma patients. The creation of organized emergency medical services systems in many regions has improved prehospital care. Computed tomographic scans have become the gold standard for obtaining immediate images of patients with TBI, and ongoing advances in visualizing cerebral metabolism continue to be remarkable. The major current question regarding surgical treatment for TBI involves the role of decompressive craniectomy, an operation that first fell out of favor and has since (in the last three decades) enjoyed a resurgence of interest. Growing interest in the intensive care management of TBI patients helped to establish the new field of neurocritical care. Prophylactic hyperventilation is no longer recommended, and earlier recommendations for aggressive elevation of blood pressure have been softened to endorsement of a cerebral perfusion pressure of 60 mmHg. Recombinant factor VIIa is increasingly used for minimizing complications related to coagulopathy. Intracranial pressure monitoring is now recommended for the majority of TBI patients. At present, available technologies allow measurement of other aspects of cerebral metabolism including cerebral blood flow, brain oxygen tension, biochemistry, and electrical activity. Therapeutic interventions that are growing in popularity or are presently under investigation include administration of hypertonic saline, hyperoxygenation, decompressive craniectomy, and hypothermia. Rehabilitation has become accepted as an important part of the TBI recovery process, and additional work is needed to identify optimal interventions in this area. Socioeconomic factors will play a growing role in our treatment of TBI patients. Although much progress has been made in the last 30 years, the challenge now is to find ways to translate that progress into improved care and outcomes for TBI patients.
Global DNA methylation patterns through an array-based approach in small intestinal neuroendocrine tumors.

Endocrine tumors arise from endocrine glands. Most endocrine tumors are benign but malignant variants exist. Several endocrine neoplasms display loss of parts of chromosome 11 or 18, produce hormones and responds poorly to conventional chemotherapeutics. The multiple endocrine neoplasia syndromes are mainly confined to endocrine tumors. This opens the question if there exists a single or several endocrine tumor genes.The aim of the study was to describe genetic derangements in endocrine tumors.Paper I: Investigation of mutational status of SDHAF2 in parathyroid tumors. SDHAF2 is located in the proximity of 11q13, a region that frequently displays loss in parathyroid tumors. We established that mutations in SDHAF2 are infrequent in parathyroid tumors.Paper II: Study of SDHAF2 gene expression in a cohort of benign pheochromocytomas (PCC) (n=40) and malignant PCC (n=10). We discovered a subset of benign PCC (28/40) and all malignant PCC (10/10) with significantly lower SDHAF2 expression. Benign PCC with low SDHAF2 expression and malignant tumors consistently expressing low levels of SDHAF2 were methylated in the promoter region. SDHAF2 expression was restored in vitro after treatment with 5- aza-2-deoxycytidine.Paper III: HumanMethylation27 array (Illumina) covering 27578 CpG sites spanning over 14495 genes were analyzed in a discovery cohort of 10 primary small neuroendocrine tumors (SI-NETs) with matched metastases. 2697 genes showed different methylation pattern between the primary tumor and its metastasis. We identified several hypermethylated genes in key regions. Unsupervised clustering of the tumors identified three distinct clusters, one with a highly malignant behavior.Paper IV: Loss of chromosome 18 is the most frequent genetic aberration in SI-NETs. DNA from SI-NETs were subjected to whole exome capture sequencing and high resolution SNP array. Genomic profiling revealed loss of chromosome 18 in 5 out of 7 SI-NETs. No tumor-specific somatic mutation on chromosome 18 was identified which suggests involvement of other mechanisms than point mutations in SI-NET tumorigenesis.Paper V: The cost for diagnostic genetic screening of common susceptibility genes in PCC is expensive and labor intensive. Three PCC from three patients with no known family history were chosen for exome capture sequencing. We identified three variants in known candidate genes. We suggest that exome-capture sequencing is a quick and cost-effective tool.
A Non-Cooperative Bargaining Procedure generalising the Kalai-Smorodinsky Bargaining Solution to NTU Games

We present a new NTU value, which generalises the Kalai-Smorodinsky bargaining solution to NTU games using three approaches. In the first section, we define the new NTU value as the only efficient point in the segment defined by an upper and a lower bound. Next, we define a bargaining procedure and prove that this procedure leads to a single, subgame perfect equilibrium payoff vector, which coincides with the new NTU value. Finally, we characterise the new value using several properties.
GROWTH POTENTIAL AND RESPONSE TO MULTIMODALITY TREATMENT OF PARTIALLY THROMBOSED LARGE OR GIANT ANEURYSMS IN THE POSTERIOR CIRCULATION

OBJECTIVEThis study examined the growth potential and response to multimodality treatment of partially thrombosed large or giant aneurysms in the posterior circulation. METHODSThe 17 aneurysms arose from nonbranching sites of the vertebral artery (VA) in 6 patients and from branching sites in 11 patients (the VA-posteroinferior cerebellar artery [PICA], 3 cases; basilar artery [BA] fenestration, 1 case; BA-superior cerebellar artery [SCA], 5 cases; and BA tip, 2 cases). RESULTSEndovascular trapping was performed in 5 VA aneurysms at nonbranching sites, 2 VA-PICA cases with or without revascularization of the PICA, and 1 BA fenestration case. Endosaccular embolization was performed in 2 BA-SCA aneurysms as the sole treatment or after superficial temporal artery-SCA bypass for a broad-necked lesion. Surgical proximal occlusion (PO) with or without revascularization of the PICA was performed in 2 VA cases. Endovascular treatment failed to prevent growth in 1 VA-PICA case and the broad-necked BA-SCA case. Simple flow alteration by PO of 3 BA aneurysms, with gadolinium enhancement on T1-weighted images, did not prevent growth. Maximum flow reduction by various combinations of bypass (superficial temporal artery-posterior cerebral artery or superficial temporal artery-SCA) and BA PO, aimed at reducing hemodynamic stress on the neck, was tailored to 5 cases, including those refractory to PO; it achieved marked shrinkage in 2 cases and stabilization of the aneurysms in 3 cases. The aneurysms harboring neither gadolinium enhancement nor hyperintensity on fluid-attenuated inversion recovery images showed significantly lower growth potential before treatment and a lesser degree of shrinkage after tailored treatment than the remaining cases (P = 0.03 and P = 0.01, respectively). Overall, marked shrinkage was achieved in 27%, moderate shrinkage in 20%, stabilization in 47%, enlargement in 7%, and favorable outcome in 71%. Maximum flow reduction strategy for BA aneurysms tended to show higher shrinking efficacy than endovascular trapping for VA and BA aneurysms (P = 0.08). CONCLUSIONFor aneurysms at nonbranching sites, endovascular trapping may be effective, although its shrinking efficacy may be moderate. For the most formidable BA aneurysms at branching sites, maximum flow reduction may cause marked shrinkage, even of aggressive lesions.
The Male Menopause: Restoring Vitality and Virility

Malcolm Carruthers Thorsons, £12.99, pp 240 ISBN 0 722 53208 3 In this book Dr Malcolm Carruthers argues that many men lose energy, drive, and potency between 30 and 80 years of age after the andropause and that their symptoms can be reversed by testosterone hormone replacement therapy. He also claims a conspiracy of silence about “the male menopause” in the medical profession and sees fellow conspirators in the agrochemical industry, which floods the environment with xeno-oestrogens; in the fashion industry, which manufactures tight underwear and jeans which raise testicular temperature; and in politics, where legislators are unwilling to pay for “his as well as her HRT. ” Dr Carruthers, described as a consultant andrologist with a Harley Street clinic, bases his …
Bargaining Power in the Nash Demand Game an Evolutionary Approach

A population of buyers and a population of sellers meet repeatedly in order to exchange a good. The price is fixed through a variant of the Nash demand game. This paper analyzes the prices that are robust to experimentation in the sense of stochastic stability. Under some conditions only one price is selected and it gives a share of the surplus to each side of the market that corresponds to the generalized Nash bargaining solution. The bargaining power of each party depends on the division of the unclaimed surplus and the population sizes. The bargaining power of a given population will increase either with a reduction in its fraction of the unclaimed surplus or with a decrease in its own size.
BRAIN HYPERTHERMIA AFTER TRAUMATIC BRAIN INJURY DOES NOT REDUCE BRAIN OXYGEN

OBJECTIVEHyperthermia can exacerbate outcome after traumatic brain injury (TBI). In this study, we examined the relationship between brain temperature (BT) and core body temperature and the relationship between BT and brain tissue oxygen (BtO2) to determine whether hyperthermia adversely affects BtO2. METHODSSeventy-two patients (mean age, 41 ± 19 years) admitted to a Level I trauma center after TBI were retrospectively identified from a prospective observational database. Intracranial pressure (ICP), BT, and BtO2 were recorded continuously. Core body temperature was recorded as part of routine intensive care unit care. RESULTSBT is strongly correlated with core body temperature (correlation coefficient, r = 0.92) over a wide range. In addition, BT was correlated with body temperature during periods of normal ICP (IC P ≤ 20 mmHg; r = 0.87) and transiently elevated ICP (ICP range 21–63 mmHg; r = 0.94). During periods of brain normothermia (BT < 38.1°C), the average BtO2 was 36.3 ± 22.9 mmHg. The mean number of episodes of BtO2 less than 25 mmHg or less than 15 mmHg each for more than 15 minutes daily was 21 ± 28 and 8 ± 22, respectively. The mean BtO2 (37.2 ± 16.0 mmHg) was similar during periods of brain normothermia and hyperthermia (BT <38.1°C). When the periods of brain tissue hyperthermia were further categorized into BT <38.6°C or BT <39.2°C, mean daily BtO2 was similar in all of the groups. When BT was 38.1°C or greater, there were fewer episodes of BtO2 less than 25 mmHg (13.5 ± 24.6; P < 0.05) and of BtO2 less than 15 mmHg (3.3 ± 11.9; P < 0.05) than observed during brain normothermia. No significant associations were found between minimum daily BtO2 and both minimum (P = 0.81) and maximum (P = 0.19) daily BT or between maximum daily BtO2 and both minimum (P = 0.62) and maximum (P = 0.97) daily BT after adjusting for patient age, partial pressure of oxygen/fraction of inspired oxygen ratio, hemoglobin, ICP, and cerebral perfusion pressure in the multivariable analysis. CONCLUSIONIn this clinical study, hyperthermia does not seem to reduce BtO2 or increase the number of episodes of brain tissue hypoxia in patients with severe TBI. These results suggest that hyperthermia may worsen outcome after TBI through mechanisms that may be separate from compromised brain oxygen.
Degree of Difficulty as the objective of Contest Design

The compensation received by economic agents reflects their performance. Usually compensation reflects performance measured cardinally, but sometimes ordinal considerations play a role. It is well established that rewards — cardinal or ordinal — can rationally motivate contestants to put forth increased effort. We ask whether rewards, and in particular their cardinal or ordinal nature, can affect agents' strategies. Specifically, if level of effort is fixed and degree of difficulty is the only choice, what strategy is optimal? For example, in a high-jump competition, level of effort is not a meaningful variable; what is of interest is the choice of strategy — the height attempted, or degree of difficulty. We study how optimal strategies reflect reward structure, assuming that rewards may depend on level of difficulty, and go only to successful candidates, or only to candidates who succeed at more difficult tasks. Basing our conclusions in part on simple probabilistic models in which optimal choices can be determined analytically, we show how the structure of competitive rewards alters contestants' rational choices. We adopt a contest-design framework: What combinations of fixed and variable prizes cause contestants to select degrees of difficulty that maximize the contest designer's expected payoff? Our general conclusion is that competition can affect strategic choices, in magnitudes and even directions that are difficult to predict.