Miracle-dz/UniFAR-FTUs huggingface dataset:
Economic analyses of dementia care in Ireland and Europe : perception of services and care, the market value of informal care and changes in service utilisation attributed to comorbid depression

Dementia is a progressive syndrome causing cognitive decline and functional impairment. The economic burden of dementia is greater than that of stroke, heart disease and cancer combined: however, resources allocated to dementia care continue to be substantially lower than each of these individual disease groups. The World Health Organisation observes a growing gap between budget allocation and associated burden of mental health disorders, particularly in higher income countries. Ireland is currently estimated to provide half the OECD average level of dementia care. The aim of this thesis is to investigate the determinants of dementia care as they pertain to perception of care, value of informal care and the level of formal service utilisation. Through analysis of two datasets, the following three pieces of new evidence are obtained: 1. Perceptions of care in Ireland are determined by externalities such as socioeconomic status, and evidence suggests that access is unequal. This presents the risk of worsening symptoms and the transference of the burden of care to informal carers (e.g. friends or family). 2. Informal carers in Ireland report providing greater than 10 hours of care in 85% of cases, and this analysis finds daily care increases further with dementia progression. Estimated daily per day spend on informal dementia care is valued at the market rates and costs are found to range from €240 in early stage dementia to €570 in late stages. 3. Depression occurring in dementia substantially influences health services utilisation. Specifically, depression reduces the likelihood of accessing appropriate services but once services are accessed, increases the quantity of services required by 39%. In light of the evidence presented, this thesis draws the conclusion that greater policy focus is required to ensure ‘equal access for equal needs’, to ensure adequate community support services are available and that complicated psychiatric symptoms of dementia are appropriately detected and managed.
Managed Care for Medicare-Medicaid Dual Eligibles: Appropriateness, Availability, Payment, and Policy

The bifurcation of responsibility for caring for dual eligibles has helped create a fragmented service delivery system, fraught with administrative inefficiencies, barriers to more effective care, and incentives to shift costs. To better serve this population, the federal government and several states have developed a number of pilot initiatives that promote integration by relying on capitated managed care. However, evidence suggests that this approach may be plagued by certain problems, including lack of experience with persons who are chronically ill, incentives to under provide care, favorable selection, limited plan availability, and mixed outcome and satisfaction performance. Although case-managed approaches pursue integration without capitation, they must typically rely on voluntary provider cooperation to be successful, something that is difficult to achieve. Given the recent nature of most integration initiatives, it is recommended that policy makers continue to promote innovation in each of the following areas: care coordination, administration, provider payment, plan participation, and evaluation.
Association of Cardio-Ankle Vascular Index with Cardiovascular Disease Risk Factors and Coronary Heart Disease among Japanese Urban Workers and their Families

Purpose: Recently the cardio-ankle vascular index (CAVI) has been developed to represent the extent of arteriosclerosis in the artery from the aortic valve to the ankle. The aim of the study is to examine the association of CAVI scores with the established cardiovascular disease (CVD) risk factors and coronary heart disease (CHD). Methods: Subjects were 9,881 men and 12,033 women of company employees and their families between 20 and 70 years of age and over who participated in CVD screening in Japan. The screening included measurements of CAVI, electrocardiogram, blood pressure, lipids, serum glucose, hemoglobin A1c, height, weight, and questions on smoking and drinking status. Persons having CHD were defined as those having history of CHD and/or having abnormal Q wave and/or ischemic change in ECG. After converting CAVI scores to binary variables (normal or abnormally high CAVI scores), logistic regression analysis was conducted. Results: After adjusting for age, significant odds ratios (ORs) of abnormally high CAVI scores among men were found with diabetes mellitus (10.02, p<0.001), hypertension (8.37, p<0.001), triglycerides (2.76, p<0.001, for 150-199mg/dL and 2.85, p<0.001, for ≥200mg/dL, as reference:<150mg/dL), high density lipoprotein cholesterol (0.19, p<0.001, for 40-59mg/dL and 0.20, p<0.001 for ≥60mg/dL, as reference: <40mg/dL), body mass index (2.04, p<0.001, for <20, 2.31, p<0.001, for 28-29.9 and 3.37, p<0.001, for ≥30 as reference:20-22.9), and ex-smokers (1.20, p<0.01, as reference: non-smokers). Almost identical results were found among women, except a significant OR with current smokers (2.25, p<0.001). The significant association between CHD and abnormally high CAVI scores was found: OR=3.87, p<0.001 for men and 1.45, p<0.01 for women after adjusting for CVD risk factors. Conclusions: Our results confirmed that CAVI scores are a reliable indicator of arteriosclerosis reflecting the extent of arterial stiffness and atherosclerosis in the major artery between the aortic valve and the ankle.
Eosinophils and rhinitis

Summary Allergic rhinitis (AR) is typified by the nasal mucosal and luminal recruitment of eosinophils. These changes are evident in both seasonal and perennial disease, although the magnitude of these cellular changes is often greater with the more transient intense stimulation associated with seasonal allergen exposure than with the chronic persistent stimulation linked to perennial disease. Measures of eosinophil activation markers in nasal lavage such as eosinophil cationic protein and eosinophil protein X parallel the eosinophilic cellular changes and have been used serially to monitor allergic inflammation in association with intranasal allergen challenge and in therapeutic intervention studies. In both naturally occurring disease and laboratory allergen challenge, there is considerable inter-subject variability in the magnitude of eosinophil airway recruitment and activation. Studies evaluating the mechanisms involved in nasal eosinophil recruitment identify systemic involvement of bone marrow stimulation and tissue recruitment of circulating progenitor cells. Interleukin-5 (IL-5) is a key cytokine involved in this process, acting on both marrow and circulating progenitors, with chemokines such as stromal cell derived factor-1, RANTES (regulated on activation, normal T cell expressed and secreted) and eotaxin potentially being involved in tissue uptake and localization within the nasal airways. Inflammatory mediators such as leukotrienes acting through the cys-LT1 receptor, in conjunction with IL-5, and prostaglandin D2 acting through eosinophil-expressed DP and CRTH2 cell surface receptors also contribute in animal models of allergic inflammation. The function of nasal eosinophils in AR can be debated. Genetic and nasal challenge models, with chemokines that promote eosinophil influx, support the relevance of eosinophils to symptom expression in rhinitis while the timing of the eosinophil recruitment following intranasal allergen challenge, the relationship between eosinophils and plasma protein exudation as well as the appreciation that clinical disease expression can arise in the apparent absence of nasal eosinophilia favour a restorative function for this cell. In the absence of specific eosinophil-targeted intervention in rhinitis, it is not possible to conclusively apportion the relative involvement of eosinophils in these inductive and restorative processes but it has to be appreciated that the close association between eosinophils and clinical disease expression in rhinitis is not necessarily causal.
What is the best approach for treating urinary incontinence in Parkinson’s disease?

As Parkinson’s disease (PD) progresses, nonmotor symptoms, such as urinary incontinence, have more effect on quality of life than motor symptoms. Current treatment guidelines are based primarily on expert opinion because randomized controlled trial evidence is lacking. Although antimuscarinic drugs are often used in clinical practice, there is concern about the potential for increasing the anticholinergic burden of antiparkinsonian therapy and thus increasing the autonomic and cognitive burdens of PD. Because PD is a disease of aging, considering urinary incontinence in PD as a geriatric syndrome provides a framework for developing a treatment strategy. This article recommends multicomponent therapy and outlines an algorithm for applying lifestyle, behavioral and drug therapy, as well as surgical approaches, including transurethral resection of the prostate. Because PD patients have multiple comorbidities influencing the development of urinary incontinence, multicomponent therapy provides an alternative f.
A ‘new’ palaeolithic dog from central Europe

Kesslerloch Cave in Switzerland is one of the major Magdalenian sites in Central Europe. During a recent reanalysis of the faunal remains, we identified a cranial fragment and teeth of the domestic dog. The large maxillar fragment was directly dated to 12.225±45 bp (KIA-33350) or c. 14.100-14.600 BP. The finds are metrically well below the natural variability of wolves from both Palaeolithic and recent times and even show slight morphological differences to the wild wolves from the site. We argue that the maxilla fragment must now be considered the earliest indisputable directly dated evidence of a domestic dog. Copyright © 2010 John Wiley & Sons, Ltd.
The Effects of Breast Milk Versus Infant Formulae on Cognitive Development

Commercially-available infant formulae are designed to provide infants with the same nutritional value as breast milk; however, there are many biological components (i.e., maternally-derived antibodies) that cannot be reproduced. There is evidence in the literature to support the hypothesis that feeding with breast milk provides benefits to the infant in terms of development and cognitive outcome. The most studied components of breast milk are the long-chain polyunsaturated fatty acids, specifically docosahexaenoic acid (DHA) and arachidonic acid (AA). These non-essential fatty acids have been shown to provide a measurable advantage to breast-fed infants over their formula-fed counterparts on childhood scales of cognitive development. Recently, DHA and AA were approved as additives to infant formulae in North America. Breast milk also contains a number of growth factors and hormones that are known to have neural developmental effects, but these effects have not been quantified on behavioural scales. There are also still many more unidentified components of breast milk. Efforts to educate and encourage the feeding of breast milk over infant formulae are underway from the community to international level, with the World Health Organization publishing guidelines on the optimal duration for breastfeeding. It should be noted that there are certain advantages of some formulae over breast milk, most significantly the fact that formulae contain no contaminants (i.e., medications and their metabolites) from the maternal diet.
Variation in GPs' referral rates to specialists in internal medicine

In this article multilevel analysis (MLA) is used in order to analyse a large data set on general practitioners' (GPs') referrals to specialists in internal medicine. The hypothesis is tested that patients' morbidity is the main determinant of GPs' referral rates. From a Dutch survey among 161 GPs, referrals to specialists in internal medicine were selected. The results corroborate the main hypothesis: approximately half of the variation in the overall chance of being referred is associated with patient characteristics and approximately 45% with patients' morbidity measured in terms of the GPs' diagnosis. Referral chances differ mainly with diagnosis, which implies that the variation in the referral rates reflects a variation in case mix rather than differences in the quality of care or efficiency. The only doctor or practice characteristics that affect referral chances are the number of instruments available in a practice (more instruments, fewer referrals) and GPs' list sizes (larger lists, more referrals). I n the UK and The Netherlands, where patients do not have direct access to specialized types of care, the variation in general practitioners' (GPs') referral rates to consultants has been studied for many years. This interest in variation is related to 2 concerns. Firstly, referrals to secondary care trigger the use of expensive resources and, secondly, variation in referral rates might reflect differences in the quality of care, in the sense that some doctors may refer too few patients or that others refer too many. '' The variation in the number of referrals in relation to the number of enlisted patients or the number of doctorpatient encounters has been analysed in terms of doctor, patient or practice characteristics.3 This approach has not been very fruitful explaining variation.4'5 Wilkin and Smith5 therefore, argued that more sophisticated models of referral decisions should be developed. It is argued by other authors too1'3'6'7 that referral is a complex process, involving the interaction of both social and psychological factors. For that reason it is seen as more appropriate to explore the process of decision making, e.g. through indepth interviews,8 or by examining small numbers of actual consultations or referrals.3'6 Without questioning this it should be pointed out that a lack of this type of model may not have been the only reason why previous studies have failed to come up with explanations of variation in referral rates. For one thing, appropriate data sets for analysing the variation in referral rates are rare. One needs morbidity-specific information
HYPOGLYCAEMIC AND ANTIDIABETIC EFFECT OF ROOT EXTRACTS OF CEIBA PENTANDRA IN NORMAL AND DIABETIC RATS

The effect of the root bark extract of Ceiba pentandra (Linn) in normal and streptozotocin-induced diabetic rats was studied. Blood glucose levels were determined after oral administration of graded doses of C. pentandra (40, 75,150 and 300 mg/kg) in fasted normal and diabetic groups. In both groups, 40 and 75 mg/kg of the extract, significantly reduced blood glucose levels 8 h after administration, which was consistent and time-dependent. C. pentandra at the lower dose of 40mg/kg produced blood -glucose-lowering effect of 40.0% and 48.9%, in normal and diabetic rats respectively when compared with control rats. The higher doses of 150 and 300 mg/kg did not affect significantly the blood glucose levels. In multiple dose studies, the diabetic rats were treated orally by gavages, twice a day for 3 days. On day 3, C. pentandra (40 and 75mg/kg) significantly decreased blood and urine glucose levels as compared to initial values. The 14 h fasting blood glucose concentration was lowered by 59.8 % and 42.8% at the doses of 40 and 75 mg/kg and the corresponding urine glucose levels reductions were 95.7% and 63.6%, respectively. The results indicated that C. pentandra possessed hypoglycaemic effect. The plant extract was capable of ameliorating at lower doses, hyperglycaemia in streptozotocin-induced diabetic rats and could be a potential source for isolation of new orally active agent(s) for anti-diabetic therapy. Keywords : Ceiba pentandra , plant extract, diabetes mellitus, hypoglycaemic African Journal of Traditional, Complementary and Alternative Medicines Vol. 3(1) 2006: 129-136
The Influence of Acclimation Temperature on the Lipid Composition of the Larval Lamprey, Petromyzon marinus, Depends on Tissue and Lipid Class

This study was designed to examine the effect of thermal acclimation on the lipid composition of fat depot organs the liver and kidneys of larval sea lamprey, Petromyzon marinus. We found that 21°C-acclimated larvae possessed lower total lipid amounts in the liver (39% lower) and kidneys (30% lower) than 13°C-acclimated larvae. Relatively lower lipid contents in the liver and kidneys of 21°C-acclimated lamprey primarily resulted from a reduction in stored lipid reserve, triacylglycerol, but not the structural lipid, phospholipid. Compared to 21°C-acclimated larvae, 13°C-acclimated larvae were found to possess fewer saturated fatty acids (SFAs) and more unsaturated fatty acids (USFAs) in renal triacylglycerol and phospholipid classes, while there were no significant differences in the SFAs and USFAs of hepatic triacylglycerol, phospholipid, cholesteryl ester, fatty acid, and monoacylglycerol classes. Fewer SFAs, found in the kidney triacylglycerol of 13°C-acclimated lamprey, were due to lower 12:0 and 14:0 fatty acids, but those in the renal phospholipid class were characterized by fewer 14:0, 15:0, and 16:0 fatty acids. More USFAs in renal triacylglycerol, as indicated by a higher unsaturation index, primarily resulted from higher polyunsaturated fatty acids (18:2&ohgr;6, 18:3&ohgr;3, and 18:4&ohgr;3); whereas, in the renal phospholipid class, this was a result of higher monoenes (18:1, 20:1, and 22:1&ohgr;9) and &ohgr;3 polyunsaturated fatty acids (18:4&ohgr;3). These data suggest that the influence of thermal acclimation on the lipid composition of lamprey fat depot organs depends on tissue and lipid class.
Localization of Water Channels in the Skin of Two Species of Desert Toads, Anaxyrus (Bufo) punctatus and Incilius (Bufo) alvarius

Anuran amphibians obtain water by osmosis across their ventral skin. A specialized region in the pelvic skin of semiterrestrial species, termed the seat patch, contains aquaporins (AQPs) that become inserted into the apical plasma membrane of the epidermis following stimulation by arginine vasotocin (AVT) to facilitate rehydration. Two AVT-stimulated AQPs, AQP-h2 and AQP-h3, have been identified in the epidermis of seat patch skin of the Japanese tree frog, Hyla japonica, and show a high degree of homology with those of bufonid species. We used antibodies raised against AQP-h2 and AQP-h3 to characterize the expression of homologous AQPs in the skin of two species of toads that inhabit arid desert regions of southwestern North America. Western blot analysis of proteins gave positive results for AQP-h2-like proteins in the pelvic skin and also the urinary bladder of Anaxyrus (Bufo) punctatus while AQP-h3-like proteins were found in extracts from the pelvic skin and the more anterior ventral skin, but not the urinary bladder. Immunohistochemical observations showed both AQP-h2- and AQP-h3-like proteins were present in the apical membrane of skin from the pelvic skin of hydrated and dehydrated A. punctatus. Further stimulation by AVT or isoproterenol treatment of living toads was not evident. In contrast, skin from hydrated Incilius (Bufo) alvarius showed very weak labeling of AQP-h2- and AQP-h3-like proteins and labeling turned intense following stimulation by AVT. These results are similar to those of tree frogs and toads that occupy mesic habitats and suggest this pattern of AQP expression is the result of phylogenetic factors shared by hylid and bufonid anurans.
A Meaning of Death through Emotional Expression about Death after Nursing and Medical Students' End-of-Life Care Practice

Purpose:The purposeof this studywas tounderstand themeaning of deathexperienced bymedical andnursing students through end-of-life care practice. Methods: Data were collected by in-depth interviews with twelve (six nursing and six medical) students. Conventional qualitative content analysis was used to analyze the data. Results: This findingswereanalyzed in threeareas: 'feelingfromthewordof death', 'color associationof death', and'relation betweenlife anddeath'. Results werethree major themesand sixteencategoriesfromtheanalysis. Threemajor themesinclude 'realityof uncertaindeath','have to leave, and 'newperceptionabout death'. Sixteen categories include 'being well', 'fear', 'unknown', 'boundless', 'being with', 'out of sight', 'new start', 'go back to', 'place going by itself', 'place to meet with', 'being transformed', 'a sense of futility', 'the same point', 'a different point', 'continuousline', and'acrossroad'. Conclusion: Thefindings suggesta numberof themes that nursing and medical students reported about the end of life experiences that could be explored as a way of improving end of life care.
Molecular Systematics of Tanaidacea (Crustacea: Peracarida) Based on 18S Sequence Data, with an Amendment of Suborder/Superfamily-Level Classification

Phylogenetic relationships within Tanaidacea were analyzed based on sequence data for the 18S rRNA gene. Our results strongly supported a monophyletic group composed of Neotanaidae, Tanaoidea, and Paratanaoidea, with the first two taxa forming a clade. These results contradict three previously suggested hypotheses of relationships. Based on the molecular results, and considering morphological similarities/differences between Neotanaidomorpha and Tanaidomorpha, we demoted Suborder Neotanaidomorpha to Superfamily Neotanaoidea within Tanaidomorpha; with this change, the classification of extant tanaidaceans becomes a two-suborder, four-superfamily system. This revision required revision of the diagnoses for Tanaidomorpha and its three super-families. The results for Apseudomorpha were ambiguous: this taxon was monophyletic in the maximum likelihood and Bayesian analyses, but paraphyletic in the maximum parsimony and minimum evolution analyses.
11-ketotestosterone Synchronously Induces Oocyte Development and Silvering-Related Changes in the Japanese Eel, Anguilla japonica

To evaluate the effects of sex steroids on silvering in the Japanese eel, Anguilla japonica, the development of oocytes, eye size, digestive tract, and swim bladder were studied in relation to observations of the profiles of plasma levels of sex steroids (estradiol 17&bgr;, E2; testosterone, T; 11-ketotestosterone; 11-KT) during silvering for each sex and by administrating 11-KT to yellow eels. All steroids examined in the study increased in female eels after silvering had begun, whereas in males, only 11-KT increased significantly, and no statistical differences were found in plasma levels of E2 and T between eels in both developmental stages. 11-KT appeared to induce the early stage of oocyte growth, enlargement of the eyes, degeneration of the digestive tract and the development of the swim bladder. This suggested that 11-KT synchronously accelerates early development of the ovaries and the morphological changes, possibly in adaption to oceanic migration, and that 11-KT is one of the most important factors in early stages of development in the Japanese eel, as it appears to be in other anguillid eels.