Miracle-dz/UniFAR-FTUs huggingface dataset:
Causes of developmental delay in children of 5 to 72 months old at the child neurology unit of Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon)

Background: According to the World Health Organization, about 5% of children world-wide of 14-year-old and under have a moderate to severe developmental disability, and up to 15% of children under 5-year-old are developmentally delayed. Purpose: To determine the prevalence, socio-demographic profile, aetiologies, and the clinical presentation of developmental delay in children less than 6-year-old at the child neurology unit in a university-affiliated hospital in Yaounde. Materials and methods: It was a crosssectional descriptive study carried out in Yaounde Gynaeco-Obstetric and Paediatric Hospital (Cameroon) from August to December 2012. Children aged between 5 - 72 months with a developmental quotient less than 70 were enrolled. Developmental delay (DD) was diagnosed and classified using the Denver developmental screening test (DDST). Data concerning the child (age, gender, severity of DD), the mother (age, age at conception, educational level, marital status), history of pregnancy and delivery, perinatal and postnatal events, results of para-clinical explorations (EEG, CT-scan, genetic tests), the severity of DD and the probable or demonstrate cause of DD were recorded on a standardized questionnaire. The chisquare test was used to compare variables. Results: During the study period, 2171 children aged 5 - 72 months consulted the paediatric department of the hospital, 296 were examined at the child neurology unit of which 153 had a developmental quotient less than 70, giving a hospital prevalence of 7.0% and a prevalence of 51.7% at the child neurology unit. The mean age was 26.6 ± 18.0 months and there were 56% males. The main reason for consulting was tonus disorder (43.8%) and the developmental area of parental concern was the motor domain (90.2%). Regarding the clinical presentation, 75.2% of our population were children with cerebral palsy. DD was severe, mild, moderate and profound respectively in 14.2%, 13.5%, 12.2%, and 11.1%. Gross DD represented 90.2% of all DD children. The causes of DD were hypoxic-ischemic encephalopathy (41.8%), epilepsy (13.7%), sequelae of meningitis (6.5%), sequelae of kernicterus (6.5%), and infectious embryofoetopathies (5.2%). Conclusion: Developmental delay is frequent in paediatric neurology, with perinatal disorders being the leading aetiologies in Cameroon. Prevention of perinatal hypoxic-ischemic encephalopathy risk factors needs to be reinforced.
Role of heparin and low-molecular-weight heparins in the management of acute ischemic stroke

The numerous large-scale randomized clinical trials performed during the last decade on either unfractionated heparin, or low molecular weight heparin have not been able to demonstrate undisputed benefits in patients with acute ischemic stroke, compared with no treatment or aspirin. However, a large number of these trials, including the International Stroke Trial and Chinese Acute Stroke Trial, exhibit severe methodological limitations and need to be interpreted with caution. Knowledge of thromboembolism pathophysiology and clinical experience leads to the theory that heparins will prevent red thrombus formation, propagation and embolism. Heparins effectively prevent venous thrombosis and pulmonary embolism. More trials are needed to test heparins in patients whose cardiocerebrovascular lesions are better defined by newer neuroimaging techniques. The efficacy of heparins has not been adequately tested in patients with defined stroke subtypes and occlusive vascular lesions. Heparins should not be indiscriminately given to all patients with acute ischemic stroke. High-quality, randomized trials that adequately study heparin use in patients using modern technology for vascular lesions and stroke subtypes are lacking, and need to be performed.
Exenatide (exendin-4)-induced pancreatitis: a case report.

Exenatide is a 39–amino acid peptide approved for the adjunctive treatment of type 2 diabetes. It is an incretin mimetic agent that is consistent in activity with the actions of glucagon-like peptide 1. Proposed mechanisms of action include enhanced glucose-dependent insulin secretion from pancreatic β-cells, restoration of first-phase insulin response, suppression of glucagon secretion, and delay of gastric emptying. Kendall et al. (1) found no evidence of cardiovascular, pulmonary, hepatic, or renal toxicities with exenatide. Nausea (39–48%) and hypoglycemia (19–27%) were the most common side effects reported. A 69-year-old man with type 2 diabetes of 15 years’ duration presented for follow-up. He had known diabetic neuropathy and retinopathy. His medical history was remarkable for coronary artery disease, gastroesophageal reflux disease, rheumatoid arthritis, and …
Watermarking in Medical Imaging for Security and Authentication

ABSTRACT Medical image watermarking has been widely recognized as a relevant technique for enhancing data security, image fidelity, authenticity and content verification in the current e-health environment where medical images are stored, retrieved and transmitted over networks. Medical image watermarking preserves image quality that is mandatory for medical diagnosis and treatment. The present paper highlights essential needs of medical image watermarking with a review of developments since 2000 and simulated experiments to demonstrate the significance of watermarking in medical information management.
Protein Kinase A Activation of the Surfactant Protein B Gene Is Mediated by Phosphorylation of Thyroid Transcription Factor 1*

Thyroid transcription factor 1 (TTF-1) is a homeodomain-containing nuclear transcription factor expressed in epithelial cells of the lung and thyroid. TTF-1 binds to and activates the transcription of genes expressed selectively in the respiratory epithelium including pulmonary surfactant A, B, C and Clara cell secretory protein. Transfection with a plasmid encoding the cyclic AMP-dependent protein kinase (protein kinase A; PKA) catalytic subunit, Cat-β, stimulated the phosphorylation of a TTF-1-flag fusion protein 6–7-fold in H441 pulmonary adenocarcinoma cells. Recombinant TTF-1 was phosphorylated by purified PKA catalytic subunit in the presence of [γ-32P]ATP. PKA catalytic subunit family members, Cat-α and Cat-β, markedly enhanced the transcriptional activation of surfactant B gene promoters by TTF-1 in vitro. Peptide mapping was used to identify a PKA phosphorylation site at the NH2 terminus of TTF-1. A 17-amino acid synthetic peptide comprising this site completely inhibited the PKA-dependent phosphorylation of TTF-1in vitro. A substitution mutation of TTF-1 (Thr9 → Ala) abolished phosphorylation by PKA and reduced transactivation of the surfactant B gene promoter. Transfection with a plasmid encoding the cAMP regulatory element binding factor inhibited transcriptional activity of the surfactant protein B gene promoter. Phosphorylation of TTF-1 mediates PKA-dependent activation of surfactant protein B gene transcription.
Some correlations between chemical structure and maximal eosinopenia in adrenalectomized and hypophysectomized mice.

1. A comparison of the first two sections with the third section in table 1 reveals that the chemical characteristics common to all the steroids which bring about maximal eosinopenia can be summarized as follows: (a) They contain 21 carbon atoms in the molecule; (b) They have a side chain of a primary hydroxyl group vicinal to a carbonyl oxygen group (primary alpha-ketol grouping); (c) They are unsaturated at C 4 ; (d) They are either four or five oxygen compounds; (e) They all have oxygen at C 3 ; (f) They all have oxygen at C 11 . 2. Maximal eosinopenic activity depends upon the position rather than upon the total number of oxygens in the molecule. All the steroids found to bring about maximal eosinopenia are 11-oxycompounds. None of the 11-desoxycompounds examined induced maximal eosinopenia. 3. (a) Oxygen at C 17 , in the absence of oxygen at C 11 , does not render a steroid maximally eosinopenic, even when it increases the total number of oxygen atoms in the molecule to four or five. (b) In the presence of oxygen at C 11 , additional oxygen at C 17 enhances (that is prolongs) activity. 4. The alcoholic as well as the ketonic oxygen at C 11 in the corticoid molecule is compatible with maximal eosinopenic activity. 5. The relationship between chemical structure and maximal eosinopenic activity (as defined in this paper) is similar to the generally accepted relationship between chemical structure and glycogenic activity of corticoids as tested in adrenalectomized mice. The essential requisite for both these effects is the oxygen substitution of the corticoid molecule at C 11 . Both these effects are enhanced by oxygen substitution at C 17 , in the presence of oxygen at C 11 .
Side effects of stimulant use

The current literature on side effects of central nervous system (CNS) stimulant medications used in the treatment of attention deficit hyperactivity disorder (ADHD) is reviewed, with particular emphasis on dose‐response effects on differing behavioural systems. The reasons for variation in findings may lie in individual differences in children, or in differing responses of target behavioural systems. These may be understood in terms of underlying pharmacological mechanisms. Social, educational and philosophical issues relating to medication use are discussed, and the need for ongoing critical clinical and research approaches, rather than polarization of professional attitudes, is emphasized.
Selective alteration at the growth‐hormone‐ releasing‐hormone nerve terminals during aging in GHRH‐green fluorescent protein mice

Growth hormone (GH) secretion decreases spontaneously during lifespan, and the resulting GH deficiency participates in aging‐related morbidity. This deficiency appears to involve a defect in the activity of hypothalamic GH‐releasing hormone (GHRH) neurons. Here, we investigated this hypothesis, as well as the underlying mechanisms, in identified GHRH neurons from adult (∼13 weeks old) and aged (∼100 weeks old) transgenic GHRH‐green fluorescent protein mice, using morphological, biochemical and electrophysiological methods. Surprisingly, the spontaneous action potential frequency was similar in adult and aged GHRH neurons studied in brain slices. This was explained by a lack of change in the intrinsic excitability, and simultaneous increases in both stimulatory glutamatergic‐ and inhibitory GABAergic‐synaptic currents of aged GHRH neurons. Aging did not decrease GHRH and enhanced green fluorescent protein contents, GHRH neuronal number or GHRH‐fibre distribution, but we found a striking enlargement of GHRH‐positive axons, suggesting neuropeptide accumulation. Unlike in adults, autophagic vacuoles were evident in aged GHRH‐axonal profiles using electron microscopy. Thus, GHRH neurons are involved in aging of the GH axis. Aging had a subtle effect at the nerve terminal level in GHRH neurons, contrasting with the view that neuronal aging is accompanied by more widespread damage.
Evaluation of serum amyloid A protein as an acute-phase reactive protein in horses.

Serum amyloid A protein (SAA) was isolated from equine acute-phase serum by repeating Sephadex G-75 gel filtration 3 times. Quantitative measurement of equine SAA was performed by the single radial immunodiffusion technique with rabbit anti-equine SAA serum. In clinically normal horses, the SAA concentration remained relatively high from immediately after birth up to 1 week of age. After this the concentration showed periodic fluctiation in the range of approximately 13 to 30 micrograms/ml. The mean (+/- SD) concentration of SAA in foals (< or = 12 months old) and in adult horses (> or = 18 months old) was 19.37 +/- 9.41 and 21.53 +/- 9.81 micrograms/ml, respectively. In mares during the perinatal period, the SAA concentration remained stable and within the normal range for 4 months before parturition. After foaling, it increased quickly and reached a peak value of 136.78 +/- 56.74 micrograms/ml on day 3 postpartum, and then began to decrease at 2 weeks postpartum returning to within the normal range by 1 month postpartum. In horses with experimentally induced inflammation, the SAA concentration increased quickly, and reached the highest value, approximately 4 to 20 times higher than pre-treatment values, on day 2 after treatment. It then returned to the base line values within 10 days to 4 weeks, concurrent with the disappearance of local inflammatory signs. The SAA concentration was very high in most horses with clinical signs of inflammation. It was concluded from these data that equine SAA was a sensitive acute-phase reactive protein which increased in the early phase of various acute inflammations.
Lose It!

Lose It! is a web-based, food and exercise diary application, assisting its users in weight control. It is part of a growing form of information technology developed to transform self-care through influencing individual care behaviors and impacting on lifestyle changes. Future implications for the development of such electronic tools require research into the connection of key variables dictated by the relevant theoretical body of knowledge and the translation of such knowledge to practice.
Dioxins and polychlorinated biphenyls (PCBs) in fish oil dietary supplements: Occurrence and human exposure in the UK

Commercially available fish oil supplements sourced from retail outlets in the UK, as well as by mail order, were surveyed in 2000–02 for dioxin (PCDD/Fs) and polychlorinated biphenyl (PCB) content. Sampled products were representative of market share. The WHO-TEQ values for these products ranged from 0.18 to 8.4 ng kg−1 for ΣPCDD/F and from 1.1 to 41 ng kg−1 for Σ dioxin-like PCBs. The results suggest a downward trend in the levels of dioxins in fish oil supplements over the last decade, since levels for similar products ranged from 0.3 to 10 ng kg−1 for ΣPCDD/F WHO-TEQ in 1996. Levels of ICES (International Council for the Exploration of the Seas) 7 PCBs in the current study ranged from 8.3 to 267 µg kg−1. Subsequent to this survey, European Union legislation has been introduced that includes a maximum limit of 2 ng kg−1 WHO-TEQ for dioxins in fish oil products for human consumption. Twelve of the 33 products reported here would have exceeded this limit. Negotiations are in progress to incorporate dioxin-like PCBs into the European Union regulations. When manufacturer-recommended doses were applied to the observed levels, the estimated upper bound human exposure to dioxins and dioxin-like PCBs from dietary intake of these products ranged from 0.02 to 7.1 pg WHO-TEQ kg−1 body weight day−1 for adults and from 0.02 to 10 pg WHO-TEQ kg−1 body weight day−1 for schoolchildren. This level rises to 1.8–8.9 pg WHO-TEQ kg−1 body weight day−1 for adults and 1.4–14 pg WHO-TEQ kg−1 body weight day−1 for schoolchildren when combined with the average exposure from the whole diet in 1997. Again, subsequent to this survey, the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) revised the UK tolerable daily intake (TDI) for mixtures of dioxins and dioxin-like PCBs from 10 to 2 pg WHO-TEQ kg−1 body weight day−1. This is in line with the tolerable weekly intake (TWI) of 14 pg WHO-TEQ kg−1 body weight set by the Scientific Committee on Food (SCF).
Enhanced recovery and nurse-led telephone follow-up post surgery.

AIM Nurse-led telephone follow-up was undertaken for patients after major colorectal surgery on the enhanced recovery programme following their discharge, with the aim of ensuring they were provided with adequate advice and information to enable their recovery at home. METHODOLOGY A total of 200 patients were prospectively called within 4 weeks of discharge home from hospital by the enhanced recovery nurse. RESULTS Diet was generally tolerated and mobility was continued at home. Many of the patients had seen a health professional since their discharge home for issues such as wound care or stoma review. Readmission rates were low and most concerns that patients reported were addressed during the telephone call. DISCUSSION It is reassuring that the majority of patients were coping well and many of the concerns reported were simply addressed over the telephone with advice. After the first 100 patients were telephoned, improvements were made to the discharge advice provided to the second 100 patients. The responses suggest that there were less community nurse visits in the second half of the patient cohort and this may be associated with changes made to discharge advice. CONCLUSION Patients continue to recover well once discharged home following colorectal surgery on the enhanced recovery pathway. Nurse-led telephone follow-up may be a suitable method for short-term follow-up and, potentially, it is also suitable for long-term follow-up of select groups of cancer patients.
Submilliarcsecond Optical Interferometry of the High-mass X-Ray Binary BP Cru with VLTI/GRAVITY

We observe the high-mass X-ray binary (HMXB) BP Cru using interferometry in the near-infrared K band with VLTI/GRAVITY. Continuum visibilities are at most partially resolved, consistent with the predicted size of the hypergiant. Differential visibility amplitude ( ) and phase ( ) signatures are observed across the He i and Brγ lines, the latter seen strongly in emission, unusual for the donor star’s spectral type. For a baseline m, the differential phase rms corresponds to an astrometric precision of . We generalize expressions for image centroid displacements and variances in the marginally resolved limit of interferometry to spectrally resolved data, and use them to derive model-independent properties of the emission such as its asymmetry, extension, and strong wavelength dependence. We propose geometric models based on an extended and distorted wind and/or a high-density gas stream, which has long been predicted to be present in this system. The observations show that optical interferometry is now able to resolve HMXBs at the spatial scale where accretion takes place, and therefore to probe the effects of the gravitational and radiation fields of the compact object on its environment.
Wide-field fluorescence lifetime imaging with optical sectioning and spectral resolution applied to biological samples

Abstract. Wide-field fluorescence lifetime imaging with spectral resolution and optical sectioning has been performed to achieve five-dimensional fluorescence microscopy. Spectral filtering has been shown to have the potential to provide functional information about biological tissue by simultaneously measuring the spectral/lifetime signature of the sample. The potential to use multispectral imaging to separate cellular components spatially by their different emission wavelengths has also been demonstrated thus reducing artefacts in the calculated lifetime maps. The instrument is based on diode-pumped solid-state laser technology and an ultrafast gated optical image intensifier. Also reported is the use of a picosecond blue laser diode as the excitation source to produce a fluorescence lifetime microscope with a footprint of less than 0.25m2.
Patients with rheumatoid arthritis benefit from early 2nd line therapy: 5 year followup of a prospective double blind placebo controlled study.

OBJECTIVE To compare 2 treatment strategies in a prospective 5 year study of patients with rheumatoid arthritis (RA): early treatment with slow acting antirheumatic drugs (SAARD) versus a "wait and see" attitude. METHODS One hundred thirty-seven patients with RA of < 2 years' duration entered a double blind placebo controlled study: patients in the "early" (E) group were treated with auranofin within one year of diagnosis of RA, and SAARD treatment in the initially placebo treated group was delayed 8 months compared with the former group. [The results after 2 years clearly favored early treatment (Borg G, Allander E, Lund B, et al: J Rheumatol 1988; 15:1747-54)]. RESULTS After a total observation period of 5 years in 75 representative patients, continued improvement in the E group was demonstrated, and differences between the 2 groups were maintained with regard to clinical variables, outcome measures, and radiographic evaluation. CONCLUSION The results indicate the existence of a therapeutic window in RA within the first 2 years of the disease.
Fatigue in systemic lupus erythematosus: contributions of disease activity, pain, depression, and perceived social support.

OBJECTIVE Pain and psychological distress are associated with fatigue, and social support may play a buffering role in the adjustment to a chronic disease. Investigations of the relationship between fatigue and disease activity in chronic diseases have provided inconclusive findings. The influence of medications on perceived fatigue remains unclear. We investigated the relationship between pain, depression, fatigue, and disease activity in patients with systemic lupus erythematosus (SLE). METHODS Participants (n = 127) completed a psychosocial questionnaire during routine clinic visits. Hierarchical multiple regression analysis was conducted to predict the contribution of disease activity, pain, depression (Beck Depression Inventory), and perceived social support to fatigue. RESULTS Disease activity as measured by SLE Disease Activity Index (SLEDAI) did not significantly predict self-reported levels of fatigue. Medication usage did not predict fatigue levels. Pain and depression were both unique positive predictors of fatigue. Controlling for pain and depression, perceived social support contributed negatively to the variance in fatigue scores, suggesting a buffering effect. This model reliably explained 42% of the variance in fatigue scores. CONCLUSION Our results emphasize the importance of depression, pain, and perceived social support in predicting reported fatigue levels in patients with SLE. In contrast, disease activity measured by SLEDAI does not appear to account for fatigue in SLE. Understanding the effect of psychosocial factors on fatigue in SLE may improve patient outcomes through psychosocial interventions aimed at reducing pain and increasing coping skills and social support.
Speech‐language characteristics of children with Sotos syndrome

The purpose of this research study was to evaluate the communication of individuals with Sotos syndrome in order to better characterize common speech and language patterns. Sixteen children with Sotos syndrome received an in‐depth communication assessment using standardized procedures. Assessments of speech skills, language skills, voice, fluency, and social‐pragmatic interactions were completed. Results of the evaluations indicated that individuals with Sotos syndrome are prone to: (a) language impairments (particularly expressive), (b) speech sound production impairments, (c) voice impairments, (d) dysfluencies (stuttering), and (e) average social‐behavioral pragmatic interaction characteristics. © 2005 Wiley‐Liss, Inc.
Myth: Ketamine should not be used as an induction agent for intubation in patients with head injury.

BACKGROUND Ketamine has many unique attributes making it well suited to certain applications in the emergency department (ED), including pediatric procedural sedation, and as an induction agent in patients with asthma and ex acerbation of chronic obstructive pulmonary disease. However, ketamine has been historically contraindicated for induction use in patients with head injury because of a concern that it may increase intracranial pressure (ICP). The most recent edition of Tintinalli and colleague’s Emergency Medicine 1 states that ketamine “should be avoided in patients with closed head injuries. ” There have been 2 more recent review articles on this topic challenging this myth. 2,3