Miracle-dz/UniFAR-FTUs huggingface dataset:
Validity of perinatal pharmacoepidemiologic studies using data from the RAMQ administrative database.

BACKGROUND The RAMQ prescription claims database (RAMQ-Rx) is increasingly being used in perinatal pharmacoepidemiologic studies; but, there are reasons to believe that results generated with the RAMQ-Rx might not be generalizable to all patient populations. OBJECTIVES Compare characteristics between pregnant women insured by the RAMQ-Rx and those insured by a private drug insurance plan. METHODS A prospective study performed within the population of pregnant women receiving prenatal care at different obstetrics and gynecology clinics affiliated to the University of Montreal, Canada, was conducted from October 2004 to March 2006. Women were eligible if they were > or =18 years of age, < or =16 weeks of gestation at the time of their first prenatal visit, and able to read and understand French or English. Eligible women were asked to fill out a self-administered questionnaire. RESULTS Three hundred and sixty-three women met inclusion criteria, of which 99 (27%) had RAMQ-Rx coverage, and 264 (73%) had a private drug insurance coverage. Compared to those who were covered by private drug insurance plans, those insured by the RAMQ-Rx were younger (30.7yrs vs. 32.1yrs; P=0.03), more likely to be immigrant (60% vs. 24%; P<0.01), and have a household income below poverty level (39% vs. 2%; P<0.01). They were also less likely to be Caucasian (69% vs. 86%; P<0.01), employed (51% vs. 87%; P<.01), and have a post-secondary education (76% vs. 95%; P<0.01). No differences were observed on smoking status and alcohol use during pregnancy. CONCLUSIONS There are substantial differences between pregnant women insured by the RAMQ-Rx and those insured by private drug insurance plans. However, these differences will most likely limit generalizability, but not internal validity, of studies using data from the RAMQ-Rx database.
Investigational therapies for the treatment of narcolepsy

ABSTRACT Introduction: Narcolepsy is a chronic sleep disorder characterized by a pentad of excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, hypnagogic/hypnopompic hallucinations, and disturbed nocturnal sleep. While non-pharmacological treatments are sometimes helpful, more than 90% of narcoleptic patients require a pharmacological treatment. Areas covered: The present review is based on an extensive Internet and PubMed search from 1994 to 2017. It is focused on drugs currently in development for the treatment of narcolepsy. Expert opinion: Currently there is no cure for narcolepsy, with treatment focusing on symptoms control. However, these symptomatic treatments are often unsatisfactory. The research is leading to a better understanding of narcolepsy and its symptoms. New classes of compounds with possible applications in the development of novel stimulant/anticataplectic medications are described. H3 receptor antagonists represent a new therapeutic option for EDS in narcolepsy. JZP-110, with its distinct mechanism of action, would be a new therapeutic option for the treatment of EDS in the coming years. In the future, hypocretin-based therapies and immune-based therapies, could modify the clinical course of the disease. However, more information would be necessary to completely understand the autoimmune process and also how this process can be altered for therapeutic benefits.
Association between serum HbA1c levels and adenomatous polyps in patients with the type 2 diabetes mellitus.

AIM This study aimed to determine whether serum hemoglobin A1c (HbA1c) levels are associated with colonic adenomatous polyps (APs) in patients with type 2 diabetes mellitus. METHODS Four hundred sixty-four patients (262 men and 202 women) with type 2 diabetes mellitus and colorectal adenomas admitted to the Central Hospital of Wuhan University from June 2003 to December 2011 were enrolled. The patients' average age was 66.4 (range 36-78) years. The patients were divided into poorly controlled (HbA1c<7.5%) and well-controlled (HbA1c≥7.5%) groups. Prevalence of diabetes, family history of diabetes and colorectal cancer, Body Mass Index, smoking and drinking history, and use of aspirin and exogenous insulin were recorded and compare. RESULTS Patients with poorly controlled diabetes had a significantly higher incidence of right-sided and more advanced APs. In addition, patients with poorly controlled disease were more likely to have positive history of smoking and use higher doses of insulin than well-controlled patients (P<0.05 for all comparisons). A multivariate analysis demonstrated that poorly-controlled diabetes independently predicted a more advanced lesion at the time of presentation, higher body mass index, and a use of higher doses of insulin. CONCLUSION Poor glycemic control in patients with the type 2 diabetes mellitus independently predicts higher tendency to develop APs and an increased risk of colorectal cancer.
PRESSOR AND NON‐PRESSOR EFFECTS OF SODIUM LOADING ON STROKE IN STROKE‐PRONE SPONTANEOUSLY HYPERTENSIVE RATS

1 Aetiological studies have shown that sodium loading increases both blood pressure and death from stroke. The present study was designed to investigate the pressor and non‐pressor effects of sodium loading on stroke in stroke‐prone spontaneously hypertensive rats (SHRSP). 2 Eighty‐five female SHRSP were used. Forty‐nine SHRSP, aged 5 months, were randomly divided into two groups with or without sodium loading and their survival times were recorded. Thirty‐six SHRSP, aged 3 months, were randomly divided into two groups and were instrumented to determine blood pressure, heart period and baroreflex sensitivity (BRS) after 4 months of sodium loading or normal rat chow. After determination of BRS, blood samples were collected for the measurement of tumour necrosis factor (TNF), interleukin (IL)‐1β, IL‐6 and angiotensin (Ang) II and brains were dissected for light microscopic examination. 3 Over the 15 month period, the mortality of control SHRSP was 37.5%, which reached 80.0% in the sodium loading group. Compared with the control group, blood pressure was increased but BRS was significantly decreased (P < 0.001) in sodium‐loaded rats. Levels of IL‐1β, IL‐6 and AngII were all significantly increased (P < 0.05) in the sodium‐loaded rats. Sodium loading also markedly increased the number of cerebral aneurysms. Multivariate regression analysis showed that IL‐6 was the most significant factor related to aneurysm formation. 4 Sodium loading increases death from stroke in SHRSP. The increased blood pressure, impaired BRS, inflammatory reaction and the formation of cerebral aneurysms may contribute to the development of stroke.
Improved model-based clustering using evolutionary optimization

As an optimization strategy Maximum Likelihood's definitive goal is to adjust a statistic model with a specific dataset, the method will adjust some variables of a statistical model from a dataset or a known distribution, so the model can “describe” each data sample and estimate the others. Clustering can be based on probability models to cover the missing values. This provides insights into when the data should conform to the model and led to development of new clustering methods such as Expectation Maximization (EM) which is based on the principle of Maximum Likelihood of unobserved variables in finite mixture models. Evolutionary Algorithms are trusted to further improve optimization tactics, in this paper Big-Bang Big-Crunch evolutionary algorithm have been used to boost model-based clustering and experimental results on the real datasets shows its superiority over the typical model-based clustering methods.
Colonisation des recifs coralliens par les larves de poissons

Par des prelevements sur la crete recifale de l'ile de moorea (polynesie francaise) la colonisation du milieu recifo-lagonaire par les larves de poissons n'est pas apparue comme un phenomene particulierement stochastique. Des cycles nycthemeraux et lunaires ont ete mis en evidence. La colonisation est vingt a trente fois plus importante la nuit que le jour et quatre fois plus forte lorsque la lune est absente que lorsqu'elle est presente. Ces cycles temoignent d'un processus actif, concernant les larves agees essentiellement. Les larves immatures, plus abondantes en milieu oceanique n'ont pas la meme distribution a petite echelle de temps. Des resultats similaires ont egalement ete observes sur d'autres iles du pacific sud. D'apres l'analyse qualitative, les larves les plus abondantes sont les gobiidae parmi cinquante familles de poissons identifiees. Les scaridae et les labridae sont egalement obtenus en grand nombre. Il existe egalement une variabilite mensuelle et annuelle des familles presentes. Quelques-unes possedent des heures preferentielles de colonisation, mais la plupart d'entre elles arrivent d'une facon groupee. Il est apparu que quatre-vingt-dix pour cents de ces larves disparaissent durant les jours suivant leur installation, ce qui expliquerait le modele de colonisation nocturne. La predation semble etre le seul processus capable d'expliquer cette difference d'abondance. Elle serait a l'origine de la densite moyenne des populations ichtyologiques de ce recif. Toutefois les variations du recrutement seraient quand meme la cause des fluctuations de densite et determineraient egalement la diversite specifique
Retained Medullary Cord in Humans: Late Arrest of Secondary Neurulation

BACKGROUND:Formation of the caudal spinal cord in vertebrates is by secondary neurulation, which begins with mesenchyme-epithelium transformation within a pluripotential blastema called the tail bud or caudal cell mass, from thence initiating an event sequence proceeding from the condensation of mesenchyme into a solid medullary cord, intrachordal lumen formation, to eventual partial degeneration of the cavitatory medullary cord until, in human and tailless mammals, only the conus and filum remain. OBJECTIVE:We describe a secondary neurulation malformation probably representing an undegenerated medullary cord that causes tethered cord symptoms. METHOD:We present 7 patients with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac, complete with issuing nerve roots, which, except in 2 infants, produced neurological deficits by tethering. RESULTS:Intraoperative motor root and direct cord stimulation indicated that a large portion of this stout neural structure was “redundant” nonfunctional spinal cord below the true conus. Histopathology of the redundant cord resected at surgery showed a glioneuronal core with ependyma-lined lumen, nerve roots, and dorsal root ganglia, corroborating the picture of a blighted spinal cord. CONCLUSION:We propose that these redundant spinal cords are portions of the medullary cord normally destined to regress but are here retained because of late arrest of secondary neurulation before the degenerative phase. Because programmed cell death almost certainly plays a central role during degeneration, defective apoptosis may be the underlying mechanism.
Glaucomatous Disease in Patients With Normal Pressure Hydrocephalus

PurposeTo investigate the relative prevalence of glaucomatous disease in patients with normal pressure hydrocephalus (NPH) compared with age-matched non-NPH controls with hydrocephalus. DesignCase-control study. ParticipantsUsing International Classification of Diseases (ICD-9) codes, we identified the medical records of 72 NPH cases and 72 age-matched controls with hydrocephalus treated at Stanford University Hospital between 1996 and 2007. MethodsAll available electronic medical records were reviewed. The diagnosis of NPH was verified based on clinical presentation, neuroimaging results, and opening pressure on initial access to cerebrospinal fluid space. Glaucoma status was determined based on history and prior medical, laser, or surgical intraocular pressure-lowering therapy. Main Outcome MeasureThe proportion of subjects determined as having glaucomatous disease in cases and controls. ResultsThe prevalence of glaucoma in NPH cases was estimated to be 18.1% in contrast to 5.6% in controls (χ2=5.403, P=0.0201). The average age of NPH cases and non-NPH controls was 75.40±13.4 and 73.96±9.92 years (mean±SD), respectively. ConclusionsWe found the prevalence of a glaucoma diagnosis to be 3-fold greater in patients with NPH as compared with age-matched non-NPH controls with hydrocephalus. These findings suggest the possiblity of an association between these 2 neurodegenerative diseases which should be studied prospectively.
Analysis of Ia-inhibitory synaptic input to cat spinal motoneurons evoked by vibration of antagonist muscles.

1. Steady-state inhibitory postsynaptic potentials (IPSPs) were evoked in tibialis anterior and extensor digitorum longus motoneurons of the cat by using tendon vibration to activate Ia-afferent fibers from the antagonist medial gastrocnemius muscle. 2. The effective synaptic currents (IN) underlying the steady-state IPSPs were measured by the use of a modified voltage-clamp technique. The amplitudes of the effective synaptic currents (1.62 +/- 0.66 nA, mean +/- SD; n = 20) extended over a fivefold range (0.5-2.7 nA) but were not correlated with the intrinsic properties of the motoneurons or with putative motor unit type. 3. We calculated the synaptic conductance (GS) underlying the steady-state Ia IPSPs from measurements of motoneuron input conductance during the activation of the Ia synaptic input. As was expected from Ohm's law, the Ia-inhibitory GS and IN were correlated (r = 0.49; P less than 0.05). Like IN, GS (175 +/- 202 nS, mean +/- SD; n = 20) was not correlated with the intrinsic properties of the motoneurons. 4. As has been reported previously for transient Ia IPSPs, the amplitudes of the steady-state IPSPs were correlated with motoneuron input resistance (r = 0.74; P less than 0.001) and homonymous Ia excitatory postsynaptic synaptic potential (EPSP) amplitude (r = 0.72; P less than 0.001). 5. The amplitudes of the steady-state Ia IPSPs and the homonymous Ia EPSPs were plotted on logarithmic axes. The slope (0.59) was significantly less than 1, which indicates that the gradient of Ia inhibition across the motoneuron pool is less steep than that of Ia excitation. (ABSTRACT TRUNCATED AT 250 WORDS)
Disease evolution on networks: the role of contact structure

Owing to their rapid reproductive rate and the severe penalties for reduced fitness, diseases are under immense evolutionary pressure. Understanding the evolutionary response of diseases in new situations has clear public–health consequences, given the changes in social and movement patterns over recent decades and the increased use of antibiotics. This paper investigates how a disease may adapt in response to the routes of transmission available between infected and susceptible individuals. The potential transmission routes are defined by a computer–generated contact network, which we describe as either local (highly clustered networks where connected individuals are likely to share common contacts) or global (unclustered networks with a high proportion of long–range connections). Evolution towards stable strategies operates through the gradual random mutation of disease traits (transmission rate and infectious period) whenever new infections occur. In contrast to mean–field models, the use of contact networks greatly constrains the evolutionary dynamics. In the local networks, high transmission rates are selected for, as there is intense competition for susceptible hosts between disease progeny. By contrast, global networks select for moderate transmission rates because direct competition between progeny is minimal and a premium is placed upon persistence. All networks show a very slow but steady rise in the infectious period.
Valve prosthesis-patient mismatch: hemodynamic, echocardiographic and clinical consequences.

OBJECTIVES The purpose is to evaluate in vivo at rest and under stress conditions hemodynamic performance of the small size St. Jude Medical Regent (SJMR) prosthetic valve in patients with a body surface area (BSA) of 1.8 ± 0.11 m(2) and to define the role of valve prosthesis- patient mismatch on left ventricular mass regression following aortic valve replacement. METHODS We evaluated 25 cases (12 males and 13 females, mean age 65.2 ± 8 years) of aortic valve replacement (17 mm SJMR in three cases and 19 mm SJMR in 22 cases). All the patients underwent at rest Doppler echocardiography before and after surgery and both basal and dobutamine stress echocardiography (DSE) at follow-up. The mean duration of follow-up was 41.3 ± 24 months. RESULTS A significant reduction in mean and peak transaortic gradients and peak transaortic velocity over time following valve replacement has been identified. After surgery, there was a significant increase of ejection fraction. DSE significantly increased heart rate, ejection fraction, peak transaortic gradient and peak transaortic velocity. All patients passed DSE without complication. Even if a significant mismatch was present in 76% of cases, the left ventricular mass decreased significantly from preoperative value of 278.7 ± 51.1 g to 181.5 ± 52.73 g, respectively. CONCLUSION Aortic valve replacement with 17 mm SJMR or 19 mm SJMR prostheses appear to provide satisfactory clinical and hemodynamic results at rest and under DSE, even in those patients with BSA of 1.8 ± 0.11 m(2) where it was not possible to enlarge the aortic annulus. Prosthesis-patient mismatch is not associated with lesser regression of left ventricular mass. Dobutamine stress echocardiography should be a useful and effective means for evaluating prosthesis hemodynamic aspects.
Non-invasive respiratory movement detection and monitoring of hidden humans using ultra wideband pulse radar

In this paper a novel method for vital parameter detection using an ultra wideband (UWB) pulse radar is presented. By using sub-nanosecond pulses the displacement of a human chest due to respiratory movement can be detected very accurately. Because of the very broadband behavior of the transmit signal the presented system is also capable of penetrating materials like walls. For signal processing we use the continuous wavelet transform (CWT) with a special background subtraction method. This allows a detection of respiration up to a distance of 5 meters and also behind walls. The radar test set-up with the used components and the applied signal processing on real measurement data are presented.
[The obese woman: pregnancy and contraception].

Obesity is a risk factor for women in both pregnancy and contraception. Obesity per se does not cause sterility, but problems in gonadotropic function can arise during periods of rapid weight gain in bulimic episodes. Dysovulation is more common in such cases than amenorrhea. In established obesity, anovulation may occur, as demonstrated by the temperature curve and hormonal levels, but it is usually due to other factors such as ovarian polycystic syndrome or Cushing's syndrome. The main problems of obesity during pregnancy are carbohydrate metabolic disorders and hypertension. In 1 study, hypertension was found in 42.4% of pregnancies of obese women vs. 5.84% in controls; 22% of cases were severe, with blood pressure over 160/100. Carbohydrate metabolic difficulties were found in 11.8% of obese subjects vs. 1.2% of controls. The main consequence of maternal obesity on the child is macrosomy; occurring in 21.3% of births vs. 5.8% in controls. 5.1% of births to obese women are postmature vs. . 7% in controls. The rate of cesareans for obese women is high. Improved fetal prognosis in pregnancies of obese women requires increased clinical surveillance for signs of hypertension or excessive weight gain and laboratory monitoring of glucose metabolism every month or even every 2 weeks. A sonogram should be done to detect macrosomy. A careful diet of 1200-1500 calories per day is recommended. 40% should be protein and 30% lipid. Rapid-absorption sugars should be excluded. Oral contraceptives appear to cause weight gain because estrogen stimulates the appetite and progestins have an anabolizing action. If weight gain exceeds 3 kg, a low dose pill and a restrictive diet should be recommended. OCs should be terminated if weight gain continues, and anomalies of glucose or lipid metabolism should be ruled out. Obesity constitutes a relative contraindication for use of combined OCs. Combined OCs may aggravate the obesity. Obesity on the other hand is a risk factor for cardiovascular accidents in OC users. IUDs are preferred for multiparous obese women. Nulliparas and multiparas with absolute contraindications to IUDs can use low-dose OCs if there are no other cardiovascular risk factors, no weight gain, and blood pressure and lipid and glucose metabolism are checked every 6 months. If these conditions cannot be met, the use of condoms or spermicides is recommended.
Differential immobilization and hierarchical involvement of chemokines in monocyte arrest and transmigration on inflamed endothelium in shear flow

Monocyte extravasation into areas of inflammation involves sequential interactions of multiple adhesion molecules. However, differential contribution of chemokines produced by cytokine‐stimulated endothelium and their receptors to leukocyte attachment and transmigration under flow conditions remains to be elucidated. The activation of endothelial cells with TNF‐α up‐regulated mRNA and protein expression of the CXC chemokine GRO‐α and the CC chemokine monocyte chemotactic protein (MCP)‐1, which act through the receptors CXCR2 and CCR2 expressed on monocytes, respectively. Whereas GRO‐α was immobilized to endothelial cells via heparan sulfate proteoglycans, MCP‐1 was secreted in a soluble form. Consequently, inhibition experiments with blocking peptide analogues and monoclonal antibodies revealed that GRO‐α and its receptor CXCR2 but not MCP‐1 and its receptors substantially contributed to conversion of rolling into firm, shear‐resistant arrest of monocytes to TNF‐α‐stimulated endothelium in physiological flow. In contrast, MCP‐1 and CCR2 but not GRO‐α and CXCR2 mediated spreading, shape change and subsequent transendothelial migration, which was evident in flow but rarely in stasis and may thus require the establishment of a diffusible MCP‐1 gradient. Differential patterns of presentation may determine a functional specialization and hierarchy of chemokines and their receptors in sequential steps of monocyte emigration on inflamed endothelium and shear flow.