Miracle-dz/UniFAR-FTUs huggingface dataset:
Serial MRI and CSF biomarkers in normal aging, MCI, and AD

Objective: To compare the annual change in MRI and CSF biomarkers in cognitively normal (CN), amnestic mild cognitive impairment (aMCI), and Alzheimer disease (AD). Comparisons were based on intergroup discrimination, correlation with concurrent cognitive/functional changes, relationships to APOE genotype, and sample sizes for clinical trials. Methods: We used data from the Alzheimer's Disease Neuroimaging Initiative study consisting of CN, aMCI, and AD cohorts with both baseline and 12-month follow-up CSF and MRI. The annual change in CSF (total-tau [t-tau], Aβ1-42) and MRI (change in ventricular volume) was obtained in 312 subjects (92 CN, 149 aMCI, 71 AD). Results: There was no significant average annual change in either CSF biomarker in any clinical group except t-tau in CN; moreover, the annual change did not differ by clinical group in pairwise comparisons. In contrast, annual increase in ventricular volume increased in the following order, AD > aMCI > CN, and differences were significant between all clinical groups in pairwise comparisons. Ventricular volume increase correlated with concurrent worsening on cognitive/functional indices in aMCI and AD whereas evidence of a similar correlation with change in CSF measures was unclear. The annual changes in MRI differed by APOE ε4 status overall and among aMCI while annual changes in CSF biomarkers did not. Estimated sample sizes for clinical trials are notably less for MRI than the CSF or clinical measures. Conclusions: Unlike the CSF biomarkers evaluated, changes in serial structural MRI are correlated with concurrent change on general cognitive and functional indices in impaired subjects, track with clinical disease stage, and are influenced by APOE genotype.
Physical Therapy Treatment after Cardiac Surgery : A National Survey of Practice in Greece

Physical therapy is offered to patients undergoing cardiac surgery in many countries. There is limited published data on what physical therapy treatments are provided and what exercises are recommended to patients after cardiac surgery in Europe. The aim of this survey was to establish the current practice of physical therapy for cardiac surgery patients in Greece. A prospective survey was carried out among a total population sample of physical therapists at all public and private cardiothoracic centers in Greece. A postal questionnaire was used to determine the actual physical therapy management of cardiac surgery patients. In total, 45 physical therapists (response rate 78%) from public and private hospitals completed the survey. The mean work experience as physical therapist at a department of cardiothoracic surgery was 10 ± 6 years. Preoperative information was given, according to half of the physical therapists. During the first postoperative days the patients usually received 1 to 6 treatment sessions a day by the physical therapist. Usual physical therapy treatments during the first postoperative days were breathing exercises, coughing techniques, chest wall vibrations, and mobilization. Coughing support was provided to the patients, according to 91% of the physical therapists. Manual coughing support from the physical therapist was the most common technique. In total, 93% of the physical therapists instructed the patients to perform breathing exercises on a regular basis postoperatively. Deep breathing exercises and incentive spirometry were the two most frequently used techniques. Recommendations to continue the breathing exercises for a period of between 3 days and 8 months were given postoperatively. This survey provides an initial insight into physical therapy practice for cardiac surgery patients in Greece. Further comparison between countries is warranted to improve the management of the cardiac surgery patient.
BREAST-FEEDING, POSTPARTUM AND PREPREGNANCY DISEASE ACTIVITY IN MULTIPLE SCLEROSIS

It is well known that the risk of multiple sclerosis (MS) relapse is starkly diminished during late pregnancy and increases in the postpartum period.1 These alterations in the disease activity are likely associated with pregnancy-related immunologic events serving the well-being of the fetus. Because disease-modifying drugs (DMDs) are not recommended during pregnancy or lactation, mothers need to decide whether to resume early treatment to minimize risk of postpartum relapses or to breast-feed. Interestingly, a recent study suggested that exclusive breast-feeding and concomitant suppression of menses may reduce the risk of postpartum relapses.2 The objective of our study was to determine the prevalence of breast-feeding among Finnish patients with MS and the relationship between breast-feeding, postpartum and prepregnancy relapse frequency. ### Methods. All patients with MS becoming pregnant during the years 2003-2005 in Finland who were encountered by the investigators and gave informed consent to the study protocol were enrolled in the study (n = 61; mean age 30.5 years [range 23-42 years], mean disease duration 5.7 years [range 0-17.5 years], mean total number of relapses before pregnancy 4.1 [range 1-12]). Prospective follow-up continued from early pregnancy (enrollment at 10 to 12 gestational weeks) until 6 months postpartum as described earlier.3 MS relapses, information on DMDs, and breast-feeding history were recorded. The study was approved by the ethical committee of the Turku University Hospital, Finland. ### Results. The average annual relapse rate (RR) of the cohort was 0.82 ± 0.98 (SD) relapses per woman per year during the year before pregnancy (BP). During the third trimester of pregnancy, the mean annualized RR was diminished to 0.40 ± 1.21, but increased again to 1.40 ± 1.92 during the period of 0 to 3 months postpartum (PP) (BP vs third trimester, p = 0.026, and BP vs 0 to 3 months …
Reformasi Through Our Eyes: Children as Witnesses of History in Post‐Suharto Indonesia

Focused on a children's drawing contest sponsored by a state museum, this article explores the child as witness, a figure with wide currency in Indonesia in the post-Suharto period. It argues that a visual ideology of innocence lends children's images a redemptive power to contain the destabilizing effects of violent mass media images and of political rupture more generally. Effaced in the positing of the child's eye as an ideal authentic lens through which the nation might see itself and remember its history are the complex mediations that shape children's images and the adult desires and anxieties that inform the construction of the child as witness.
Change in risk of Alzheimer disease over time

Objective: To assess whether the risk of incidence of Alzheimer disease (AD) varies over time. The increase in numbers of people at the oldest ages in the population will bring an increase in the number of people with AD. Projections of the size of the increase assume the risk of AD is constant. Methods: All persons age 65 or older in a biracial, geographically defined area were invited to participate in a home interview every 3 years. From the approximately 10,000 participants, stratified random samples were selected for detailed clinical evaluation. At each cycle, individuals determined free of AD in a previous cycle, either by examination or by high score on cognitive function tests, were sampled in the subsequent cycle for evaluation for incident AD. The evaluations for disease were structured and uniform across time. These analyses include 1,695 subjects evaluated for incident disease from 1997 through 2008. Results: AD developed in 360 participants. Change over time in risk of incident disease was assessed in logistic regression analyses including evaluation date and controlling for age, gender, education, race, interval from disease-free designation to evaluation for incident disease, and sample design. The time variable (in years) was not significant (odds ratio = 0.970, 95% confidence interval = 0.902 to 1.044). Conclusions: The null relation of evaluation date to disease incidence suggests no recent change in risk of AD over time, and supports this assumption for projections of AD.
Cognitive compensation failure in multiple sclerosis

Objectives: Compensatory processes involving the recruitment of additional cerebral areas can limit cognitive impairment caused by brain damage as revealed by fMRI. Multiple sclerosis (MS) is characterized by frequent cognitive deficiencies and diffuse brain damage. Understanding the missing or disturbed processes resulting in cognitive compensation failure is a major challenge in MS. Methods: Fifteen patients with relapsing-remitting (RR) MS and 20 healthy controls underwent an fMRI paradigm based on Go/No-go task with increasing complexity and neuropsychological and morphologic MRI examinations. Results: To perform all the Go/No-go conditions, patients with RRMS exhibited supplementary cerebral recruitment compared to controls. For the most complex condition, patients presented both collapse of additional cerebral recruitment and significant lower cognitive performance compared to controls. In patients, both response times and diffuse tissue damage were correlated with medial frontal activations. Functional connectivity analysis demonstrated strong correlation between dorsolateral prefrontal cortex and medial frontal region activations. Conclusions: High cognitive demand causes beneficial cerebral recruitment failure, leading to cognitive impairment in patients with RRMS. Functional compensatory mechanisms preserving good cognitive performances operate by a new cerebral strategy involving medial prefrontal regions recruitment, instead of cerebellar regions seen in controls. This new recruitment is diffuse tissue damage-dependent. Missing cerebellar involvement argues for an inability to generate proficient cognitive automation processes in patients, directly leading to recruitment of high-level decision-making areas. Recurrent mobilization of cortical regions could explain the limiting effect of the cognitive load on the cognitive compensatory phenomena in patients with MS.
Delaying the onset of Alzheimer disease

Objectives: There is strong epidemiologic evidence to suggest that older adults who maintain an active lifestyle in terms of social, mental, and physical engagement are protected to some degree against the onset of dementia. Such factors are said to contribute to cognitive reserve, which acts to compensate for the accumulation of amyloid and other brain pathologies. We present evidence that lifelong bilingualism is a further factor contributing to cognitive reserve. Methods: Data were collected from 211 consecutive patients diagnosed with probable Alzheimer disease (AD). Patients' age at onset of cognitive impairment was recorded, as was information on occupational history, education, and language history, including fluency in English and any other languages. Following this procedure, 102 patients were classified as bilingual and 109 as monolingual. Results: We found that the bilingual patients had been diagnosed 4.3 years later and had reported the onset of symptoms 5.1 years later than the monolingual patients. The groups were equivalent on measures of cognitive and occupational level, there was no apparent effect of immigration status, and the monolingual patients had received more formal education. There were no gender differences. Conclusions: The present data confirm results from an earlier study, and thus we conclude that lifelong bilingualism confers protection against the onset of AD. The effect does not appear to be attributable to such possible confounding factors as education, occupational status, or immigration. Bilingualism thus appears to contribute to cognitive reserve, which acts to compensate for the effects of accumulated neuropathology.
Down's Syndrome. The Psychology of Mongolism

This book is a superb review of past and present literature on Down's syndrome from both sides of the Atlantic. Each aspect of psychological development has its own chapter with evaluation at the end. A more concise summary ofsome chapters would have been helpful. The chapters on foundation of intelligence and language are particularly good. Important medical aspects which contribute to the psychological profile are given due prominencefor example, intermittent hearing loss and disproportionate delay of language development-treatment with thyroxine having no effect in those who are euthyroid. Remediation programmes are discussed and the short-term gains compared with the few long-term results. This book is strongly recommended to anybody who is interested in Down's syndrome.
Real lives, real jobs: Sustaining consumer perspective work in the mental health sector

Abstract Australian mental health policies and service standards expect that people with expertise by experience of mental health issues are actively involved at all levels of service planning, delivery, and evaluation. This consumer-led participatory research investigated the workforce issues facing consumer workers who undertake consumer perspective work in Victoria’s mental health services. A reference group with diverse experience of consumer perspective work and research in mental health services guided its design and implementation. Twenty-four consumer workers participated in focus groups or indepth interviews, and the data were analysed thematically and collaboratively in the reference group. Findings include: that consumer perspective work was viewed as enriching, challenging, and enables individuals to contribute their expertise by experience to a broader movement and cause, but educational and peer supervision options were limited and underdeveloped. Participants described working conditions that inadequately acknowledge the reality of a working life or the job demands. They also reported wide-ranging attitudinal, resource and infrastructure barriers that highlight inequalities experienced by the consumer workforce within mental health services. Leadership within the consumer workforce and the mental health sector were each seen as critical to addressing these issues. Consumer perspective work is employment, and therefore improvements in working conditions and career development opportunities are critical to achieving a sustainable consumer perspective workforce.
Computational toxicology: an overview of the sources of data and of modelling methods

Background: Toxicology has the goal of ensuring the safety of humans, animals and the environment. Computational toxicology is an area of active development and great potential. There are tangible reasons for the emerging interest in this discipline from academia, industry, regulatory bodies and governments. Results: Pharmaceuticals, personal health care products, nutritional ingredients and products of the chemical industries are all potential hazards and need to be assessed. Toxicological tests for these products are costly, frequently use laboratory animals and are time-consuming. This delays end-user access to improved products or, conversely, the timely withdrawal of dangerous substances from the market. The aim of computational toxicology is to accelerate the assessment of potentially dangerous substances through in silico models. Conclusions: In this review, we provide an overview of the development of models for computational toxicology. Addressing the significant divide between the experimental and computational worlds–believed to be a prime hindrance to computational toxicology–we briefly consider the fundamental issue of toxicological data and the assays they stem from. Different kinds of models that can be built using such data are presented: computational filters, models for specific toxicological endpoints and tools for the generation of testable hypotheses.
Immunotherapy of Lung Cancer

Although still in the early developmental stage, immunotherapy is emerging as the fourth major modality of cancer treatment. Utilization of this modality has resulted in increased rates of remission and longer remission and survival times in such malignancies as (1) melanoma, (2) soft tissue sarcoma, (3) acute leukemia, and (4) chronic leukemia, as well as the more common neoplasms, carcinomas of the breast, colon, and lung. This article reviews (1) the scientific rationale for immunotherapy of cancer in general, (2) immunoincompetence in the etiologic factors and prognosis of lung cancer, (3) principles of immunotherapy of cancer, and (4) trials of immunotherapy of lung cancer, including BCG, levamisole, and specific immunotherapy.
Developmental Differences in Psychological Adjustment and Health-Related Quality of Life in Pediatric Cancer Patients

The aims of this study were to investigate: (a) age differences in psychological adjustment (PA) and health-related quality of life (HRQOL) in pediatric cancer patients, and (b) identify predictors of PA and HRQOL. The sample included preschool, school age, and adolescent patients. Data were obtained at 3 (n = 69), 9 (n = 47), and 15 (n = 44) months after diagnosis, using standardized measures completed by the mother. Measures assessed the children's psychological adjustment (PA), health-related quality of life (HRQOL), temperament and maternal psychological adjustment. Age at diagnosis significantly affected both PA and HRQOL. At 3 months post-diagnosis, preschoolers had more externalizing behavior problems than did adolescents. Preschoolers had better HRQOL than adolescents at all 3 assessments. Maternal adjustment and child's temperament scores were the best predictors of PA; age was the best predictor of HRQOL. The results of this study suggest that preschoolers with cancer are at risk for behavior problems and adolescents are at risk for poor HRQOL. The results also highlight the importance of multi-factor models in predicting children's PA and HRQOL.
Development of the Norwegian Short-Form McGill Pain Questionnaire (NSF-MPQ)

The Short-Form McGill Pain Questionnaire (SF-MPQ) contains 15 pain descriptors (11 Sensory, four Affective). The aim was to develop a valid Norwegian SF-MPQ (NSF-MPQ). Descriptors were selected among 333 previously collected Norwegian pain adjectives, selection criteria being conceptual equivalence to the SF-MPQ and adjectives used by > 33%. Pain intensity scoring systems of the SF-MPQ were modelled. The NSF-MPQ, a pain drawing and the Disability Rating Index were presented to 277 patients from five different clinical settings. All pain descriptors were used by ≥ 33% in at least one of the five clinical groups, patients with persistent pain using most descriptors. Cronbach's α was adequately high (0.74–0.87). Spearman rank (ρ) correlations were moderate to very high between groups of pain descriptors (0.68–0.97). Pain descriptor scores showed low to moderate correlations with the two pain intensity variables (VAS and Present Pain Intensity) (0.27–0.52). All scores showed low correlations with pain area extension (0.20–0.45) and disability (0.05–0.30), indicating construct validity of the NSF-MPQ. The NSF-MPQ discriminated between two or more patient groups on item level, but discriminative ability on total score and subscore levels was mediocre. The NSF-MPQ seems to express a different construct than pain distribution and disability, and allows registration of distinctions of pain qualities.
Motor cortex inhibition

Objective: Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset behavioral diagnosis in which children often fail to meet age norms in development of motor control, particularly timed repetitive and sequential movements, motor overflow, and balance. The neural substrate of this motor delay may include mechanisms of synaptic inhibition in or adjacent to the motor cortex. The primary objective of this study was to determine whether transcranial magnetic stimulation (TMS)–evoked measures, particularly short interval cortical inhibition (SICI), in motor cortex correlate with the presence and severity of ADHD in childhood as well as with commonly observed delays in motor control. Methods: In this case-control study, behavioral ratings, motor skills, and motor cortex physiology were evaluated in 49 children with ADHD (mean age 10.6 years, 30 boys) and 49 typically developing children (mean age 10.5 years, 30 boys), all right-handed, aged 8–12 years. Motor skills were evaluated with the Physical and Neurological Examination for Subtle Signs (PANESS) and the Motor Assessment Battery for Children version 2. SICI and other physiologic measures were obtained using TMS in the left motor cortex. Results: In children with ADHD, mean SICI was reduced by 40% (p < 0.0001) and less SICI correlated with higher ADHD severity (r = −0.52; p = 0.002). Mean PANESS motor development scores were 59% worse in children with ADHD (p < 0.0001). Worse PANESS scores correlated modestly with less SICI (r = −.30; p = 0.01). Conclusion: Reduced TMS-evoked SICI correlates with ADHD diagnosis and symptom severity and also reflects motor skill development in children.
Substance misuse in a high security hospital: Three years of urine drug testing at the State Hospital, Carstairs

With the increasing evidence for the significant contribution to violence made by alcohol and drug misuse in people with mental disorder, there is emerging evidence of the importance and increasing prevalence of substance misuse problems in patients admitted to high security hospitals in the UK. Recorded routine voluntary urine drug screening of patients at the State Hospital, the high security hospital for Scotland and Northern Ireland, started in 1998. Results of urinalysis over the 3 years from 1 January 1999 to 31 December 2001 were examined. Out of 7,069 samples sent from 421 patients there were 712 (10.1%) positive results. The majority were false positives (672; 9.5%) due to prescribed medication, with only 40 (0.6%) true positives. All the true positive results in the admission unit were related to substance misuse prior to admission, the remaining true positive results were all within the continuing care wards, with no true positives in the rehabilitation wards. Even though the testing was not truly random, it is likely that the findings reflect extremely low levels of substance misuse within the hospital in contrast with findings from UK prisons. Whether urine testing contributes to the prevention of drug misuse within the hospital is unclear, and there are potential ethical and legal concerns about the urine testing process. It is important that high security hospitals are virtually drug free, to enable the uncontaminated assessment and treatment of mentally disordered offenders.
Language skills of school-aged children prenatally exposed to antiepileptic drugs

Objectives: Fetal exposure to some antiepileptic drugs (AEDs) carries increased risk of major birth defects, and may be associated with reduced intellectual abilities. The impact on language remains unclear. This study aimed to investigate the impact of fetal AED exposure on language skills. Methods: Women with epilepsy and their children were recruited to this observational study through the Australian Pregnancy Register for Women with Epilepsy and Allied Disorders. Language skills of 102 AED-exposed children were assessed using the Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4). Assessments were conducted blind to drug. Maternal epilepsy, pregnancy, and medical histories were obtained from prospectively collected records. Results: Mean CELF-4 Core Language scores of children exposed to sodium valproate in monotherapy (mean 91.5, SD 17.5) or polytherapy (mean 73.4, SD = 22.3) were significantly below the standardized test mean of 100 (p < 0.05). Mean language scores of children exposed to carbamazepine or lamotrigine monotherapy, or polytherapy without sodium valproate, were not significantly different from normal. First-trimester sodium valproate dose was negatively correlated with language scores, and significantly predicted language scores after controlling for other group differences. Conclusions: Fetal exposure to sodium valproate increases the risk of language impairment. This should be taken into account when making treatment decisions for women with epilepsy of childbearing age.