Miracle-dz/UniFAR-FTUs huggingface dataset:
Schwimmbadlunge - Exogen-allergische Alveolitis oder Mykobakteriose?

: There have been several recent reports of pulmonary disease resulting from exposure to Mycobacterium avium complex in indoor hot tubs. The disease is thought to be due either to infection or extrinsic allergic alveolitis (EAA). In this report we describe the case of a patient who developed episodes of fever, dyspnea and cough 4-6 hours after cleaning his indoor swimming pool. A diagnosis of EAA was made on finding a restrictive lung function pattern with gas exchange abnormalities, a predominant lymphocytosis in the bronchoalveolar lavage, diffuse ground-glass opacities in the lower lobes on high-resolution computer tomography, and specific IgG antibody activity to the swimming pool water. There was no precipitin reaction or specific IgG antibody activity to microbes extracted from the water. Interestingly, the water contained Mycobacterium avium complex (MAC) in huge amounts and in this case the histopathological features of the lung biopsy specimens differed from those seen in typical EAA, but were similar to those described in "hot tub lung" caused by mycobacteria. Solely by avoidance of cleaning the swimming pool, without any pharmacological treatment, the patient recovered completely within three months. To the best of our knowledge, this is the first report of EAA possibly associated with MAC exposure in a swimming pool environment.
Considerations on Direct Antiviral Agent Therapy in Patients Having Chronic Hepatitis C from Constanta County

Abstract Introduction: Direct-acting antiviral agents (DAA) have a direct action in chronic hepatitis C, their addition to the standard therapy with interferon alfa2 (IFN) and ribavirin (RBV) significantly improving the sustained virologic response (SVR) in this disease. Objective: The study analyses the results of triple therapy inclduign DAA in terms of tolerability and efficiency. Material and method: We selected a lot of 24 patients who concluded the DAA administration period, being in the period of finalization of standard therapy at the time of the study. In all the patients clinical and paraclinical assesment was performed including laboratory tests, fibroscan, echography, etc. Results: The duration of the therapy consisting in association of DAA to the standard treatment was 3 months and led to a remarkable result represented by a high rate of negativation of viremia (83.3%). Among the adverse reactions recorded, the most important were: anemia 17 patients (70.8%), leucopenia 10 patients (41.6%), thrombocitopenia 14 patients (58.3%), hyperbilirubinemia 3 patients (12,5%); hyperuricemia 8 patients (33,3%), hypocalcemia 4 patients (16.6%), loss of weight 4 patients (16,6%), anal pruritus (16,6%); among the 24 patients, 2% did not exhibit any adverse reactions. Conclusions: Despite of the various adverse reactions recorded, the triple therapy consisting in DAA added to the standard treatment proves its utility, and the high rates of sustained viral reaction justifies its utilization. It is necessary to increase the number of patients who benefit from the advantages of triple therapy, which, after becoming larger available, could become a new standard therapy in patients with viral chronic hepatitis.
Effect of emotion on memory for words and their context

Emotion influences various cognitive processes, such as memory. This beneficial or detrimental effect can be studied with verbal material, yet in this case a broad term of context has to be taken into account. The present work reviews recent literature and proposes that traditional differentiation between semantic and environmental context should be replaced with a novel conceptualization of hippocampus‐dependent relational memory and item memory (related to the activations of cuneus and left amygdala). Additionally, instead of list‐learning paradigms, words should be memorized in the context of sentences or stories for better control over their meaning. The recent evidence suggests that of particular importance for ecological validity in research paradigms is the presence of communicative and social context of verbal material related to such processes as theory of mind and brain activations in temporoparietal junction, posterior cingulate cortex, and dorsal medial prefrontal cortex. We propose that studying memory of verbal material within context gives a better understanding of enhancing and impairing effects of emotion as well as of the underlying brain mechanisms. J. Comp. Neurol. 524:1636–1645, 2016. © 2015 Wiley Periodicals, Inc.
Absorption of Brimonidine 0.1% and 0.15% Ophthalmic Solutions in the Aqueous Humor of Cataract Patients

PurposeTo determine and compare the human aqueous humor (AH) concentrations of 2 formulations of brimonidine ophthalmic solution [0.1% brimonidine Purite (BP) (average pH 7.4 to 8.0) and 0.15% BP (average pH 6.6 to 7.4)]. Patients and MethodsSingle-center, randomized, controlled, double-masked, prospective study. Twenty-two patients were randomized to receive one 30-μL drop of 0.1% (n=11) or 0.15% BP (n=11) into the eye requiring routine cataract surgery. Solutions were administered approximately 40 to 55 minutes before surgery and AH samples (100 μL) were withdrawn from treated eyes at surgery initiation. Times from instillation to sampling were recorded. Brimonidine AH concentrations were assayed by high performance liquid chromatography-tandem mass spectrometry. ResultsMean brimonidine AH concentrations sampled 52±9 and 54±8 minutes (P=0.57) after instillation of 0.1% and 0.15% BP solutions were 59.4±42.7 and 95.5±87.5 ng/mL, respectively (P=0.23). When normalized for concentration differences between the 2 formulations, AH concentrations were similar (P=0.85). Both solutions were well tolerated with no adverse events observed. ConclusionsBrimonidine AH concentrations in human eyes after single doses of 0.1% or 0.15% BP ophthalmic solutions were proportional to the respective concentrations of the brimonidine formulation instilled. The pH difference between these 2 formulations seemed to exert no effect on brimonidine bioavailability or the tolerability of the solution.
Impact and Permanence of LASIK-induced Structural Changes in the Cornea on Pneumotonometric Measurements: Contributions of Flap Cutting and Stromal Ablation

PurposeTo determine the factors that lead to changes in intraocular pressure (IOP) measurements after laser-assisted in situ keratomileusis (LASIK) and their long-term stability. Patients and MethodsFive hundred twenty-two myopic eyes and 296 hyperopic eyes were enrolled in the study. Pneumotonometry was used to measure IOP once in the preoperative stage and twice in the postoperative stage—1 month after the operation and 1 year later. Ultrasonic pachymetry was used to determine preoperative and intraoperative corneal thicknesses and axial length of the eye, whereas optical pachymetry was used in the preoperative stage and 1 month after surgery. Corneal topography was used to determine the preoperative and postoperative mean curvature of the anterior surface of the cornea over 3 and 5-mm diameter regions. Comparative statistical analysis of the retrospective data series was performed. ResultsA highly significant reduction of IOP readings is found after LASIK for both myopic and hyperopic eyes. The reduction is stable 1 year after LASIK. In the case of myopic eyes, the reduction has a highly significant linear correlation with the amount of tissue ablated in the central region of the cornea. ConclusionsPneumotonometric IOP readings after LASIK are reduced, without recovering preoperative values even 1 year after surgery, because of flap cutting and tissue removal in the central region of the cornea. The contribution of flap cutting is estimated to be (1.6±0.8) mm Hg, whereas ablation contributes an additional (0.029±0.003) mm Hg/μm of removed tissue. This effect should be considered when evaluating the accuracy of IOP measurements in LASIK patients who are at risk for developing glaucoma.
A Smoking Cessation Intervention in Family Planning Clinics

ABSTRACT Young women are smoking at higher rates than ever, generating the potential for much smoking related disease. Many of these women, especially those at lower income levels, could be provided with smoking cessation counseling during their regular family planning clinic visits. The purpose of this study was to implement a smoking cessation intervention in public health family planning clinics, and thereby increase the number of these women who quit smoking. A quasi-experimental pilot study of 176 smokers was conducted, using a brief, multimodal smoking cessation intervention in two suburban public family planning clinics. The intervention included a protocol-based smoking cessation message, pamphlets and posters, measurement of exhaled carbon monoxide, and a follow-up letter. Exit questionnaire data showed significant increases in use of all tested cessation techniques. At four-and-a-half month follow-up, self-reported quit rates were 2% in the reference group and 15% in the subjects (95% confidence.
Prolonged corticosterone exposure induces dendritic spine remodeling and attrition in the rat medial prefrontal cortex

The stress‐responsive hypothalamo–pituitary–adrenal (HPA) axis plays a central role in promoting adaptations acutely, whereas adverse effects on physiology and behavior following chronic challenges may result from overactivity of this system. Elevations in glucocorticoids, the end‐products of HPA activation, play roles in adaptive and maladaptive processes by targeting cognate receptors throughout neurons in limbic cortical networks to alter synaptic functioning. Because previous work has shown that chronic stress leads to functionally relevant regressive alterations in dendritic spine shape and number in pyramidal neurons in the medial prefrontal cortex (mPFC), this study examines the capacity of sustained increases in circulating corticosterone (B) alone to alter dendritic spine morphology and density in this region. Subcutaneous B pellets were implanted in rats to provide continuous exposure to levels approximating the circadian mean or peak of the steroid for 1, 2, or 3 weeks. Pyramidal neurons in the prelimbic area of the mPFC were selected for intracellular fluorescent dye filling, followed by high‐resolution three‐dimensional imaging and analysis of dendritic arborization and spine morphometry. Two or more weeks of B exposure decreased dendritic spine volume in the mPFC, whereas higher dose exposure of the steroid resulted in apical dendritic retraction and spine loss in the same cell population, with thin spine subtypes showing the greatest degree of attrition. Finally, these structural alterations were noted to persist following a 3‐week washout period and corresponding restoration of circadian HPA rhythmicity. These studies suggest that prolonged disruptions in adrenocortical functioning may be sufficient to induce enduring regressive structural and functional alterations in the mPFC. J. Comp. Neurol. 524:3729–3746, 2016. © 2016 Wiley Periodicals, Inc.
Geschlechtsidentität und psychische Belastungen von erwachsenen Personen mit Intersexualität

Übersicht: Die herkömmliche Behandlung von Menschen mit Intersexualität sieht neben lebensnotwendigen Interventionen auch chirurgische und hormonelle Eingriffe zur äußerlichen Anpassung an das männliche oder weibliche Geschlecht vor. Die Autorinnen präsentieren Ergebnisse der Hamburger Studie zur Intersexualität, die die komplexen Zusammenhänge zwischen Behandlungserfahrungen, Outcome und psychischen Variablen erstmals an einer größeren Stichprobe von Menschen mit verschiedenen Formen der Intersexualität untersucht. Bei vielen Befragten zeigen sich trotz phänotypischer Angleichung an das männliche oder weibliche Geschlecht eine große Unsicherheit bezüglich der entsprechenden Geschlechtsidentität, eine hohe psychische Symptombelastung und Probleme im Bereich Sexualität.
Childhood injury prevention: The views of health visitors and nursery nurses working in deprived areas

Abstract Aim The aim of this study was to ascertain the views of health visitors and nursery nurses about childhood injury prevention in deprived areas. Method A survey was carried out amongst 51 health visitors and 7 nursery nurses attached to practices (n=47) from deprived areas who participated in a large injury prevention randomised controlled trial. Results The response rate was 97%. The most commonly cited barrier to injury prevention work in deprived areas was finance/cost to families and this was mentioned by 59% (n=32) of the respondents. Parental attitudes and understanding was considered to be important for nearly half (48%, n = 26) the respondents. Their views about what actions could be initiated at national and local levels to improve injury prevention work in deprived areas are described. At a national level 52% (n=27) of respondents suggested public awareness should be raised, and 14 (25%) of these mentioned using television for this purpose. Approximately one-third (32%, n=17) commented that at a local level, parental awareness should be raised in as many places as possible. Conclusions Health visitors and nursery nurses who responded appear to focus on child injury prevention at the micro level rather than at a broader public health level. In addition, many commented on barriers or constraints placed upon them. Further support will be needed if they are to develop a family centred public health approach.
High Prevalence of Narrow Angles Among Chinese-American Glaucoma and Glaucoma Suspect Patients

PurposeTo evaluate the prevalence of gonioscopically narrow angles in a Chinese-American population with glaucoma or glaucoma suspicion. Patients and MethodsCharts from all Chinese-American patients seen in a comprehensive ophthalmology clinic in the Chinatown district of San Francisco in 2002 were reviewed. One eye from each patient with glaucoma or glaucoma suspicion that met inclusion criteria was included (n=108). Data were collected for sex, age, race (self-declared), refraction (spherical equivalent), intraocular pressure, gonioscopy, and vertical cup-to-disk ratio. ResultsSixty percent (n=65) of Chinese-American eyes with glaucoma or glaucoma suspicion had gonioscopically narrow angles (Shaffer grade ≤2 in 3 or more quadrants). Those with narrow angles were significantly older (P=0.004) than their open angle counterparts, but the 2 groups did not differ in terms of sex, refraction, intraocular pressure, or cup-to-disk ratio (all, P≥0.071). In a multivariate model including age, sex, and refraction as predictors of angle grade (open or narrow), only age was a significant predictor of angle grade (P=0.004). ConclusionsA large proportion of Chinese-Americans in our study population with glaucoma or glaucoma suspicion had gonioscopically narrow angles. In multivariate analysis, patients with narrow angles were older than those with open angles but did not differ from them in terms of sex or refraction. Continued evaluation of angle closure glaucoma risk among Chinese-Americans is needed.
Current role challenges in New Zealand aged residential care: the potential consequences for healthcare assistant role expansion

Background: Challenges facing healthcare assistants in aged residential care are a focus of global debate. These challenges involve remuneration, education, skill mix, work conditions and organisational structures. Objectives/Aims: We enter the discussion by acknowledging current work, education and remuneration for healthcare assistants. We then consider the supervisory relationships between registered nurses (RNs), enrolled nurses (ENs) and healthcare assistants, educational levels for RNs, ENs and healthcare assistants, and the interplay between organisation and practice in aged residential care. We suggest that improving work for the healthcare assistant has the potential to lead change in all role levels.Design: Discussion paper. Conclusions/Implications for practice: We argue that adjustments to work structures, education and skill advancement of RNs, ENs and healthcare assistants could improve staff working conditions and clarify practice boundaries. The ultimate result is likely to be an improvement to quality of care and the life of residents in aged residential care.
Peripheral and central anatomical organization of cutaneous afferent subtypes in a rat nociceptive intersegmental spinal reflex

Stimulation of rat segmental dorsal cutaneous nerves (DCNs) evokes the nociceptive intersegmental cutaneus trunci muscle (CTM) reflex. The reflex consists of early and late responses, mediated by Aδ and C fibers, respectively, based on required stimulation strengths, and shows segmental differences in terms of amplitude and duration. We have now investigated whether the peripheral or central anatomy of nociceptive afferent subtypes in different DCNs also vary in a segmental manner. The numbers of different axon subtypes, determined by axon diameter, were analyzed across peripheral DCNs from T6 to L1. The central projections of T7 and T13 DCN afferents were traced using DCN injections of cholera toxin subunit B (CTB) for myelinated A fibers and isolectin B4 (IB4) for unmyelinated C fibers and both labels were quantified in the dorsal horns. Peripheral axon subtype numbers did not differ significantly across DCNs. Centrally, IB4+, but not CTB+, projection areas were different between T7 and T13, consistent with different segmental CTM neurogram responses. At both levels, A fibers projected to deeper layers of the dorsal horn than did C fibers. These termination sites are consistent with both mono‐ and polysynaptic connections between these afferents and the ascending propriospinal interneurons of the reflex. Also analyzed were the spatial distribution, the synaptic termination, and the glutamatergic transporter profiles of DCN A and C fibers and their relationship to calcitonin gene‐related peptide (CGRP) staining in the dorsal horn.
Cerebellins are differentially expressed in selective subsets of neurons throughout the brain

Cerebellins are secreted hexameric proteins that form tripartite complexes with the presynaptic cell‐adhesion molecules neurexins or ‘deleted‐in‐colorectal‐cancer’, and the postsynaptic glutamate‐receptor‐related proteins GluD1 and GluD2. These tripartite complexes are thought to regulate synapses. However, cerebellins are expressed in multiple isoforms whose relative distributions and overall functions are not understood. Three of the four cerebellins, Cbln1, Cbln2, and Cbln4, autonomously assemble into homohexamers, whereas the Cbln3 requires Cbln1 for assembly and secretion. Here, we show that Cbln1, Cbln2, and Cbln4 are abundantly expressed in nearly all brain regions, but exhibit strikingly different expression patterns and developmental dynamics. Using newly generated knockin reporter mice for Cbln2 and Cbln4, we find that Cbln2 and Cbln4 are not universally expressed in all neurons, but only in specific subsets of neurons. For example, Cbln2 and Cbln4 are broadly expressed in largely non‐overlapping subpopulations of excitatory cortical neurons, but only sparse expression was observed in excitatory hippocampal neurons of the CA1‐ or CA3‐region. Similarly, Cbln2 and Cbln4 are selectively expressed, respectively, in inhibitory interneurons and excitatory mitral projection neurons of the main olfactory bulb; here, these two classes of neurons form dendrodendritic reciprocal synapses with each other. A few brain regions, such as the nucleus of the lateral olfactory tract, exhibit astoundingly high Cbln2 expression levels. Viewed together, our data show that cerebellins are abundantly expressed in relatively small subsets of neurons, suggesting specific roles restricted to subsets of synapses.
Get Fit Kids: A Feasibility Study of a Pedometer-Based Walking Program

Introduction: Childhood obesity has reached epidemic proportions in the United States and is a complex health problem with many biological, environmental, and psychosocial causative factors. While there are many factors that must be addressed to combat the prevalence of childhood obesity, prevention is typically viewed as the best solution for children. In an effort to address childhood obesity prevention and promote daily physical activity, a 12-week, pedometer-based walking program, Get Fit Kids, was designed and implemented with elementary school children. The primary aim of this study was to assess the feasibility and effectiveness of Get Fit Kids with an underserved population of Baltimore City public elementary-school children. Methods: Children in third through fifth grades participated in this quasi-experimental study during the 2008–2009 school year. The primary research aim was to evaluate the feasibility and effectiveness of the program as measured by the change in step counts from the children.
The Use of HRT With and Without the Aid of Disc Photographs

PurposeTo evaluate the measurement of optic disc morphology using Heidelberg Retinal Tomography (HRT) with and without the aid of optic disc photos. MethodsOne hundred three children (aged 11 and 12 y, 52 boys) were selected randomly from the Singapore Cohort study of Risk Factors for Myopia. Optic nerve head topography and retinal nerve fiber layer thickness measurements were assessed using the HRT-II (Heidelberg, Germany) scanning laser ophthalmoscope. All contour lines were drawn by the same researcher on 2 occasions. The first drawing was made without optic disc photographs but using the 3-dimensional rotation assessment. The second drawing was made with the additional aid of digital monoscopic optic disc photographs. ResultsThere was a high correlation between the measurements taken with and without optic disc photographs. For the global disc area, the difference between the mean readings was 0.67 mm2 and the intraclass correlation (ICC) was 0.81 [95% confidence interval (CI) 0.73-0.86]. The mean difference for the global cup-to-disc ratio was 0.03 [ICC 0.86 (95% CI 0.80-0.90)]. The ICCs were high across almost all of the readings except rim volume, in which the ICC was 0.57 (95% CI 0.43-0.69). ConclusionsThis study shows minimal differences in HRT measured optic disc parameters when optic disc photos are used to aid in the definition of the scleral ring. Omitting the use of disc photographs in measuring HRT outputs may translate into significant savings in time and logistics in simultaneously obtaining HRT and optic disc photographs in large population-based studies.