Miracle-dz/UniFAR-FTUs huggingface dataset:
L’implication du Stromal Cell-derived Factor-1 alpha dans le remodelage cardiaque une semaine après un infarctus du myocarde

The injection of bone marrow stem cells in the infarcted heart was shown to improve ventricular function and scar remodelling. The chemokine Stromal Cell-derived factor-1 (SDF-1 ) is implicated in the migration of inflammatory and bone marrow derived stem cells to damaged region. Despite a local increase of SDF-1 expression in the damaged myocardium, the biological impact of the chemokine during the acute phase of remodelling in the ischemic heart remains undefined. Therefore, the present study examined the role of SDF-1 on scar expansion, cardiac hypertrophy and ventricular function in rats following myocardial infarction (MI) via administration of AMD3100 (1 mg/kg, 24 hours post-MI and continued for 6 days) a selective antagonist of the SDF-1 receptor, CXCR4. This receptor is coupled to a G i protein and induced migration and proliferation of cells. In 1week post-MI rats, chemokine expression was detected in smooth muscle and endothelial cells of blood vessels residing in the infarcted region. An SDF-1 gradient towards the infarcted region was detected in the post-MI rat heart. In 1-week post-MI rats, AMD3100 therapy reduced scar size, concomitantly improved left ventricular function and partially supressed the elevated expression of ANP mRNA in the non-infarcted left ventricule. Preliminary studies on mice showed that the reduced infarct size in AMD3100-treated post-MI mice was associated with an attenuation of neutrophil infiltration in the ischemic region. These data highlight the novel observation that pharmacological antagonism of the SDF-1 /CXCR4 axis during the acute phase of repartive fibrosis post-MI attenuated scar expansion and improved ventricular function in part via attenuation of the inflammatory response.
Ecologically-oriented neurorehabilitation of memory: Robustness of outcome across diagnosis and severity

Primary objective: The current study looked for a differential response to memory rehabilitation, testing the hypotheses that outcome would vary significantly as a function of patient diagnosis and severity of memory impairment. Research design: Unblinded, open-label, pre/post-treatment comparison of memory rehabilitation in patients stratified by diagnosis (brain injury, n = 15; stroke, n = 12; other neurological condition, n = 6) and memory impairment severity. Methods and procedures: Patients underwent an ecologically-oriented, strategy-based intervention for memory impairment and were evaluated pre- and post-treatment on seven simulations (four with alternate forms, randomized to the pre- or post-test) of everyday declarative or prospective memory tasks. Main outcomes and results: Patients at all levels of severity and in all three diagnostic groups showed equivalent, statistically significant improvement in memory performance. Neither practice effects from repeat test administration nor spontaneous recovery accounted for the improvement in memory performance. Conclusions: The current study provided evidence of improved performance in everyday memory content domains with compensatory-based cognitive rehabilitation. Comparable improvement was seen across diagnostic groups and severity ranges. Additional case series and randomized clinical trials are needed to evaluate further the efficacy of compensation-based approaches to cognitive rehabilitation.
Identifying children and adolescents with cognitive dysfunction following mild traumatic brain injury—Preliminary findings on abbreviated neuropsychological testing

Objective: Studies on cognitive function in paediatric patients suffering head trauma suggest neuropsychological impairment even after mild traumatic brain injury (MTBI). The present study examined the feasibility of abbreviated neuropsychological testing in different settings in children and adolescents following MTBI. Methods: Within the scope of two prospective studies on psychosocial and cognitive outcome, 71 school-aged children with mild, moderate or severe TBI were assessed. In addition, 15 healthy children were included in the study. The abbreviated instrument comprises three standardized tests measuring attention and memory functions (Digit Symbol, Digit Span, learning trials of the German Auditory Verbal Learning Test). Impairment rates were calculated according to a defined cut-off score for clinically significant cognitive impairment. Results: Abbreviated testing could easily be implemented both in the acute and post-acute clinical setting. Out of the children with MTBI, 12% (shortly after injury) and 30% (2 months after injury), respectively, were classified as cognitively impaired. Following moderate or severe TBI, impairment occurred in 50% of the patients. Healthy children showed the best performance, while children with severe TBI performed worst. Conclusion: Results suggest that abbreviated testing allows detection of MTBI-related cognitive dysfunction. Identified children should be referred to a clinical neuropsychologist for comprehensive assessment.
In-simulator training of driving abilities in a person with a traumatic brain injury

Aim: This study reports the case of a 23-year-old woman (MC) who sustained a severe traumatic brain injury in 2004. After her accident, her driving license was revoked. Despite recovering normal neuropsychological functions in the following years, MC was unable to renew her license, failing four on-road evaluations assessing her fitness to drive. Method: In hope of an eventual license renewal, MC went through an in-simulator training programme in the laboratory in 2009. The training programme aimed at improving features of MC's driving behaviour that were identified as being problematic in prior on-road evaluations. To do so, proper driving behaviour was reinforced via driving-specific feedback provided during the training sessions. Results: After 25 sessions in the simulator (over a period of 4 months), MC significantly improved various components of her driving. Notably, compared to early sessions, later ones were associated with a reduced cognitive load, less jerky speed profiles when stopping at intersections and better vehicle control and positioning. A 1-year retention test showed most of these improvements were consistent. Conclusions: The learning principles underlying well conducted simulator-based education programmes have a strong scientific basis. A simulator training programme like this one represents a promising avenue for driving rehabilitation. It allows individuals without a driving license to practice and improve their skills in a safe and realistic environment.
Development and validity of the Brain Injury Alert (BI Alert) screening tool for cognitive, emotional and social problems after paediatric acquired brain injury

Purpose: Validation of a new screening tool, viz., the Brain Injury Alert (BI Alert) for identification of cognitive and emotional problems after traumatic brain injury (TBI) in children. Methods: Parents and teachers of children with TBI as well as controls were interviewed using the BI Alert. Validity was determined using reference instruments (CBCL and TRF; neuropsychological functioning). Results: The BI Alert was feasible; Required assessment time: 15 minutes. Parents and teachers of children with TBI (n = 42) reported significantly more problems compared to controls (n = 29). Internal consistency (α = 0.68 for parents and 0.82 for teachers) and inter-rater reliability (r > 0.66) were good. Test–re-test reliability was reasonable (r > 0.46). Correlations with CBCL were statistically significant for the parents (r range from 0.36–0.66) and TRF emotion for the teachers (r = 0.62). The correlations with the TRF cognition and school were statistically significant for the teachers (r range from 0.43–0.63). There were only low correlations with the neuropsychological tests. Conclusions: The BI Alert is a useful, feasible and valid instrument for the cognitive screening of children with TBI by health professionals in primary care.
Clients’ perspectives of rehabilitation in one acquired brain injury residential rehabilitation unit: A thematic analysis

Primary objective: To examine clients’ perspectives on residential rehabilitation for acquired brain injury (ABI). Research design: Qualitative semi-structured interviews. Method: Seven individuals who resided in a single residential rehabilitation unit for ABI were interviewed and thematic analysis was used to identify themes in their responses. Main outcomes and results: The analysis identified four themes: rebuilding self-belief, reflecting participants’ sense of independence and confidence in their ability; recognition of personal identity, including a number of personal traits; acceptance and change, incorporating coming to terms with their ABI and identifying change; and a sense of community atmosphere, reflecting clients’ perception of their own role and relationships with others. Conclusion: The results provide in-depth qualitative understanding of how clients’ perceived their experience within a residential rehabilitation unit for ABI. Implications of the results are discussed, including the identification of potential beneficial talking therapies for clients within this setting.
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Sexual health and sexual activity in later life

The population is ageing and the rights, welfare and wellbeing of this age cohort are becoming more globally prominent and the focus of much policy development. Whilst research is leading the way and informing this in many spheres of an older person's life, this is not the case for sexual health. Campaigns of sexual health literacy and intervention are targeted at ‘at-risk’ cohorts, largely ignoring those over 60 years of age. With increases in sexually transmitted infections (STIs) in this age group and the potentially serious nature of untreated conditions, this review highlights the need for increased research, health literacy and targeted interventions. Social, societal and physical barriers preventing older adults engaging with safer sex have been identified, highlighting the extent of the attitudinal and policy shifts required to provide age parity.
Tramadol Dependence: A Case Series from India

Tramadol is an atypical, centrally acting, synthetic analgesic, acting through opioid and non-opioid systems. We present a series of seven cases, all men, who sought treatment at our centre for tramadol-dependence. The majority were using other opioids at some point in their lives. Their tramadol use had begun with a prescription of tramadol for opioid detoxification, for headache and body pains, and as an alternative to injectable opioids. The doses of tramadol used varied from 50 to 1500 mg per day. All subjects reported an experience of euphoria with tramadol use. Four patients were put on naltrexone, but had poor compliance. This case series underscores the need for caution, while using tramadol in substance-dependent patients.
Time to follow commands remains the most useful injury severity variable for predicting WeeFIM® scores 1 year after paediatric TBI

Abstract Objective: To investigate the relationship between injury severity variables, particularly time to follow commands (TFC) and long-term functional outcomes in paediatric traumatic brain injury (TBI). Methods and procedure: Participants included 40 children with moderate-to-severe TBI discharged from inpatient rehabilitation. Measures of severity were initial Glasgow Coma Scale score, TFC, duration of Post Traumatic Amnesia (PTA) and total duration of impaired consciousness (TFC + PTA). Functional outcome was measured by age-corrected Functional Independence Measure for Children (WeeFIM®) scores at 1-year after discharge. Results: Correlations indicated that injury severity variables (TFC, PTA and TFC + PTA) were all associated with functional outcome. Regression analyses revealed that TFC and TFC + PTA similarly accounted for 49% or 47% of the variance, respectively, in total WeeFIM® score. Thirty-seven of 40 children had good outcome; of the three children with TFC >26 days, two had poor outcome. Conclusion: PTA and TFC + PTA do not provide a benefit over TFC alone for prediction of long-term outcome and TFC is identified earlier in the recovery course. TFC remains an important predictor of functional outcome 1-year after discharge from inpatient rehabilitation after paediatric TBI.
Clarifying the link between traumatic brain injury and homelessness: Workshop proceedings

Abstract Purpose: To disseminate the proceedings of a 1-day multidisciplinary stakeholder workshop aimed at examining the inter-relationship between traumatic brain injury (TBI) and homelessness. Methods: Thirty-seven stakeholders participated in the workshop, including frontline workers with individuals who are homeless, physicians, nurses and other healthcare workers, researchers, policy-makers, students and individuals with lived experience of homelessness. Didactic presentations, large group discussions and break-out sessions were used to disseminate knowledge, identify service and research gaps, develop a research agenda and facilitate networking. Results: The participants identified barriers to service provision for individuals who are homeless and have sustained TBI with a focus on age- and gender-related issues, co-morbid TBI and mental illness and jurisdictional differences. Challenges and strategies related to engaging stakeholders in research with this population, as well as disseminating knowledge were discussed and research questions were identified. Conclusion: There is very little empirical literature on the topic of TBI and homelessness. The workshop identified key issues for consideration, including gaps in knowledge related to this topic.
Social Networking Sites: An Adjunctive Treatment Modality for Psychological Problems

Background: Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Materials and Methods: Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Results: Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. Conclusions: It has implications for developing social networking based adjunctive treatment modality for psychological problems.
Asynchronous Telepsychiatry in Maharashtra, India: Study of Feasibility and Referral Pattern

Context: There is a paucity of published telepsychiatry results in India. Aims: This study was conducted to assess the feasibility of asynchronous telepsychiatry and to study the referral patterns. Settings and Design: This study was conducted in the telemedicine unit of a tertiary care center and design was retrospective analysis of 94 cases, which were diagnosed and treated by telepsychiatry. Materials and Methods: All 94 patients who were referred between January 2007 and August 2013 for telepsychiatry consultations were retrospectively analyzed to assess the referral pattern and feasibility. Statistical Analysis Used: Comparisons between demographic parameters and psychiatric diagnosis was done using Chi-square test. Results: In 89 out of 94 (95%) patients it was possible to make a definitive diagnosis and recommend appropriate treatment only on the basis of data received from the primary care physician by telepsychiatry. This indicates the feasibility of telepsychiatry. The most common problems for which referrals were made included schizophrenia and other psychotic disorders, mood disorders and substance related disorders. Conclusions: This study demonstrates the feasibility of Asynchronous telepsychiatry. Additional Indian studies should be conducted to build the evidence base for the best use of asynchronous telepsychiatry.
Ruolo dei biomarcatori per la stratificazione prognostica e la personalizzazione del follow-up nel paziente con scompenso cardiaco

Recent advances in the understanding of the pathophysiology of heart failure have made available among novel diagnostic tools an increasing number of biohumoral markers. In the setting of chronic heart failure, natriuretic peptides and troponins have been proposed for routine clinical use to evaluate functional severity of cardiac damage, for prognostic stratification across the whole spectrum of disease evolution, to assess treatment effectiveness, and to guide therapy. We discuss their clinical significance and role in a tailored strategy for patient follow-up. (G Ital Cardiol 2010; 11 (5 Suppl 2): 17S-23S) Biomarkers; Guided therapy; Natriuretic peptides; Risk stratification; Troponins.
Comment on the Letter to the Editor by Professor Reiber

Dear Professor Reiber, I am extremely pleased that our study on the free light chains content in cerebrospinal fluid piques your interest. As you might remember, we discussed this topic some time ago at a meeting in Aachen. First of all, it is important to point out that we present our experimental results in this study and interpret them as described. Gladly, I implemented the changes that you suggested and have included the absolute concentrations of the free light chains in cerebrospinal fluid with this letter (please see Fig. 1 for the absolute concentration values and Figs 2–5 for the dependency of the absolute values on Q-alb). If you have an alternative theory to explain our results, we would appreciate your insight. The work describing the analytics and dynamics of immunoglobulin and other proteins in cerebrospinal fluid that you broached is familiar to us, and your papers form the basis for our interpretation of our results. Therefore, as you correctly point out, free light chains differ compared with all proteins that have been investigated, as well as immunoglobulins (IgG, IgA, IgM), with regard to their clearly lower molecular weight. For instance, kappa light chains have a molecular weight of approximately 25,000 Da; lambda light chains, due to their pronounced tendency to dimerize, weigh approximately 50,000 Da. In principle, free light chains can be synthesized in the cerebrospinal fluid, serum and everywhere in the human body by plasma cells. To that extent, we assume that these molecules behave like intact immunoglobulin. Thus, the concentration of these molecules (free kappa and lambda light chains) in the cerebrospinal fluid (CSF) comprises two components in principle: On one hand, protein diffuses from the blood past the blood-cerebrospinal fluid barrier to the CSF; on the other hand, a portion is synthesized in the CSF space.
Balance function and sensory integration after mild traumatic brain injury

Abstract Objective: This study examined the disparities in balance functions and sensory integration in patients with mild traumatic brain injuries (mTBIs) and healthy controls. Participants: One hundred and seven patients with mTBI and 107 age- and sex-matched controls were recruaited for this study. Primary measures: Symptoms of dizziness, balance functions and the ability to perform daily activities were assessed using the dizziness handicap inventory (DHI). This study also performed the postural-stability test and a modified clinical test of sensory integration by using the Biodex Stability System (BBS). Results: DHI scores (functional, emotional, physical and total self-reported scores) were substantially increased in patients following an mTBI compared with the scores of the controls (p < 0.000). The postural-stability test indices (anterior-posterior) (p = 0.045) and the sensory-integration test index (eyes-open-firm-surface index) (p = 0.006) were substantially lower in patients with mTBI than in the controls. However, indices of two other postural-stability test indices (overall and medial-lateral) and three other sensory-integration tests indices (eyes-closed-firm-surface, eyes-open-foam-surface and eyes-closed-foam-surface) measured for the mTBI group did not differ from those of the control group. Conclusion: Activities of daily living, balance in postural stability and sensory integration were strongly impaired in patients with mTBI.
A Comparative Study of Attitude of Mental Health Versus Nonmental Professionals toward Suicide

Background: Suicide is a major public health problem. Suicide can be prevented by understanding the disorder. Attitude plays a significant role in doing so. Aim: To assess the attitudes of mental health professionals and non-mental health professionals towards an act of suicide and to compare the two groups regarding their attitudes. Materials and Methods: A semistructured questionnaire having yes/no type questions was administered to 30 mental health and 30 nonmental health professionals. A blind analysis of the data was done. Statistical Analysis: Comparative analysis using mean and standard deviation and analysis of variance was performed to rate significance in differences of responses to questions that rate attitudes. Results: The results show a significant positive attitude of mental health professionals toward dealing with the patients who attempted suicide. Discussion: Considering the magnitude of the problem, simple training and education of nonmental health professionals can change their attitude toward patients who attempt suicide, which in turn leads to an optimal management. Conclusion: The study shows that the mental health professionals are much more positive in their approach towards a patient of parasuicide.