Miracle-dz/UniFAR-FTUs huggingface dataset:
Aging in Down Syndrome: Morbidity and Mortality

The life expectancy of adults with Down syndrome has increased dramatically over the last 30 years, leading to increasing numbers of adults with Down syndrome now living into middle and old age. Early-onset dementia of the Alzheimer type is highly prevalent in adults with Down syndrome in the sixth decade, and this has overshadowed other important conditions related to aging among adults with Down syndrome. The authors' aim was to update and summarize current knowledge on these conditions, and examine causes of morbidity and mortality in older people with Down syndrome by conducting a systematic review of the published literature for the period: 1993-2008. They reviewed English-language literature drawn from searches in the electronic databases Medline, CINAHL, and PsycINFO, as well as supplementary historical papers. The authors conclude that functional decline in older adults with Down syndrome cannot be assumed to be due only to dementia of the Alzheimer type (which is not inevitable in all adults with Down syndrome). Functional decline may be the result from a range of disorders, especially sensory and musculoskeletal impairments. Given the high rates of early-onset age-related disorders among adults with Down syndrome, programmatic screening, monitoring, and preventive interventions are required to limit secondary disabilities and premature mortality. With respect to assessment and treatment, in the absence of specialist disability physicians, geriatricians have a role to play.
Treatment resistant schizophrenia – review and a call to action

Recovery rates in schizophrenia remain suboptimal with up to one-third resistant to standard treatments, a population prevalence of 0.2%. Clozapine is the only evidenced-based treatment for treatment resistant schizophrenia (TRS), yet there are significant delays in its use or it may not be trialled, potentially impacting the chance of recovery. Better outcomes with earlier use of clozapine may be possible. There is emerging evidence that early treatment resistance is not uncommon from the earliest stages of psychosis. In this review, we provide an update on TRS, its epidemiology and its management, with a specific focus on the optimal use and timing of clozapine and augmentation strategies for the one-third of patients who do not respond to clozapine.
Four-week training involving ankle mobilization with movement versus static muscle stretching in patients with chronic stroke: a randomized controlled trial

ABSTRACT Background: Patients with stroke generally have diminished balance and gait. Mobilization with movement (MWM) can be used with manual force applied by a therapist to enhance talus gliding movement. Furthermore, the weight-bearing position during the lunge may enhance the stretch force. Objectives: This study aimed to compare the effects of a 4-week program of MWM training with those of static muscle stretching (SMS). Ankle dorsiflexion passive range of motion (DF-PROM), static balance ability (SBA), the Berg balance scale (BBS), and gait parameters (gait speed and cadence) were measured in patients with chronic stroke. Methods: Twenty patients with chronic stroke participated in this study. Participants were randomized to either the MWM (n = 10) or the SMS (n = 10) group. Patients in both groups underwent standard rehabilitation therapy for 30 min per session. In addition, MWM and SMS techniques were performed three times per week for 4 weeks. Ankle DF-PROM, SBA, BBS score, and gait parameters were measured after 4 weeks of training. Results: After 4 weeks of training, the MWM group showed significant improvement in all outcome measures compared with baseline (p < 0.05). Furthermore, SBA, BBS, and cadence showed greater improvement in the MWM group compared to the SMS group (p < 0.05). Conclusions: This study demonstrated that MWM training, combined with standard rehabilitation, improved ankle DF-PROM, SBA, BBS scores, and gait speed and cadence. Thus, MWM may be an effective treatment for patients with chronic stroke.
The Contribution of the Descending Pain Modulatory Pathway in Opioid Tolerance

Opioids remain among the most effective pain-relieving therapeutics. However, their long-term use is limited due to the development of tolerance and potential for addiction. For many years, researchers have explored the underlying mechanisms that lead to this decreased effectiveness of opioids after repeated use, and numerous theories have been proposed to explain these changes. The most widely studied theories involve alterations in receptor trafficking and intracellular signaling. Other possible mechanisms include the recruitment of new structural neuronal and microglia networks. While many of these theories have been developed using molecular and cellular techniques, more recent behavioral data also supports these findings. In this review, we focus on the mechanisms that underlie tolerance within the descending pain modulatory pathway, including alterations in intracellular signaling, neural-glial interactions, and neurotransmission following opioid exposure. Developing a better understanding of the relationship between these various mechanisms, within different parts of this pathway, is vital for the identification of more efficacious, novel therapeutics to treat chronic pain.
Genotypes of Enterocytozoon bieneusi in Dogs and Cats in Eastern China

Background: Enterocytozoon bieneusi is a common opportunistic pathogen found in both humans and animals. As companion animals live in close contact with human being, they may act as a zoonotic reservoir and play an important role in transmitting this parasite to humans. We evaluated the prevalence, genotypic diversity and zoonotic potential of E. bieneusi in dogs and cats in eastern China during Apr to Dec 2013. Methods: Fecal specimens from 315 dogs and 143 cats from veterinary hospitals in eastern China were examined in 2015 by internal transcribed spacer (ITS)-based PCR. Results: E. bieneusi was detected in 8.6% of canine and in 1.4% of feline samples. Seven genotypes of E. bieneusi were identified, including four known genotypes (PtEb IX, EbpC, Type IV and D) and three novel genotypes, named CHD1, CHD2 and CHD3. The dominant genotype in dogs was PtEbIX (59.3%; n=16/27). Five (CHD1, EbpC, CHD2, D and Type IV) of the seven genotypes were in the so-called zoonotic group 1, whereas genotypes PtEbIX belonged to the dog-specific group and genotypes CHD3 were placed in group 2. Conclusion: Dogs are predominately infected with host-specific genotypes of E. bieneusi, and the finding of several zoonotic genotypes in dogs and cats reminds us of potentially zoonotic transmission of microsporidiosis.
Domestic Violence: A Handbook for Health Professionals

T he UK health sector has only recently woken up to the idea that domestic violence is more than a private matter that health professionals should not get involved with. This book goes a long way to making the case for why the health sector should address domestic violence and then provides a practical outline of how to implement an appropriate response. [][1] Ed Jo Ann Rosenfeld Routledge, £16.99, pp 248 ISBN 0 415 28220 9 Rating: ! [Graphic][2] ! [Graphic][3] ! [Graphic][4] Lyn Shipway, principal lecturer in the School of Health Care … [1]: /embed/graphic-1.gif [2]: /embed/inline-graphic-1.gif [3]: /embed/inline-graphic-2.gif [4]: /embed/inline-graphic-3.gif
Simulation of Interdigitated Electrodes (IDEs) Geometry Using COMSOL Multiphysics

Interdigitated Electrodes (IDEs) based sensor in comb-like electrodes structure is also an attractive candidate in gas sensor and biosensor applications, owing to its simple structural design. The sensitivity can be improved based on geometric parameters of the sensor. Hence, in this paper, we study the physical model of the IDEs-based sensor and concern with its geometrical parameters (gap sizes, number of fingers and width of fingers) based on the finite element simulations using COMSOL Multiphysics. The simulation results were used to show the electrical field that generated by the IDEs and compare to other to find the optimum design. Based on the results, the relationship between the geometric parameters and the IDEs performances are studied. The simulation results show that the higher electric fields are generated with the smaller gap size and smaller width of fingers. Besides that, the results show that the gap size and the width of fingers affect the IDEs performance significantly compared to the number of fingers. The IDE with the design 18 fingers, 0.1 mm gap size between fingers and 0.1 mm width of the finger is the optimum design which generates 30.6 kV/m average of electric field magnitude.
Trends and Disparities in Diet Quality Among US Adults by Supplemental Nutrition Assistance Program Participation Status

Key Points Question Have disparities in diet quality of US adults according to participation and eligibility for food assistance persisted, improved, or worsened over the past 15 years? Findings This survey study found that despite an overall improvement in diet quality among US adults between 1999 and 2014, disparities persisted or worsened for most dietary components when comparing participants of the Supplemental Nutrition Assistance Program (SNAP) with income-eligible nonparticipants and higher-income individuals. For nearly all dietary components, SNAP participants do not meet recommendations for a healthful diet. Meaning Evidence-based nutrition policies are needed to reduce diet-related health disparities in the United States.
Magnetoliposomes containing magnesium ferrite nanoparticles as nanocarriers for the model drug curcumin

Magnesium ferrite nanoparticles, with diameters around 25 nm, were synthesized by coprecipitation method. The magnetic properties indicate a superparamagnetic behaviour, with a maximum magnetization of 16.2 emu g−1, a coercive field of 22.1 Oe and a blocking temperature of 183.2 K. These MgFe2O4 nanoparticles were used to produce aqueous and solid magnetoliposomes, with sizes below 130 nm. The potential drug curcumin was successfully incorporated in these nanosystems, with high encapsulation efficiencies (above 89%). Interaction by fusion between both types of drug-loaded magnetoliposomes (with or without PEGylation) and models of biological membranes was demonstrated, using FRET or fluorescence quenching assays. These results point to future applications of magnetoliposomes containing MgFe2O4 nanoparticles in cancer therapy, allowing combined magnetic hyperthermia and chemotherapy.
Build the Structure of WFSless AO System Through Deep Reinforcement Learning

We report on an aberration correction algorithm for a wavefront sensorless adaptive optics (WFSless AO) system based on deep reinforcement learning. First, it is verified that the reinforcement learning theory can be applied in our system. In addition, the deep deterministic policy gradient algorithm is introduced to build the control structure. After that, deep learning is used to deal with the messy raw images of far-field intensity distribution. We emphatically present how to design a feature extraction with the convolutional neural network in the control structure. To demonstrate the performance of this structure, some comparisons are made with the stochastic parallel gradient descent algorithm and the WFSless AO based on general modes algorithm. The results indicate that the correction speed of our method improves about 9 times and 2.5 times, respectively, for the similar correction effect.
Patient-specific simulations predict efficacy of ablation of interatrial connections for treatment of persistent atrial fibrillation

Abstract Aims Treatments for persistent atrial fibrillation (AF) offer limited efficacy. One potential strategy aims to return the right atrium (RA) to sinus rhythm (SR) by ablating interatrial connections (IAC) to isolate the atria, but there is limited clinical data to evaluate this ablation approach. We aimed to use simulation to evaluate and predict patient-specific suitability for ablation of IAC to treat AF. Methods and results Persistent AF was simulated in 12 patient-specific geometries, incorporating electrophysiological heterogeneity and fibres, with IAC at Bachmann’s bundle, the coronary sinus, and fossa ovalis. Simulations were performed to test the effect of left atrial (LA)-to-RA frequency gradient and fibrotic remodelling on IAC ablation efficacy. During AF, we simulated ablation of one, two, or all three IAC, with or without pulmonary vein isolation and determined if this altered or terminated the arrhythmia. For models without structural remodelling, ablating all IAC terminated RA arrhythmia in 83% of cases. Models with the LA-to-RA frequency gradient removed had an increased success rate (100% success). Ablation of IACs is less effective in cases with fibrotic remodelling (interstitial fibrosis 50% success rate; combination remodelling 67%). Mean number of phase singularities in the RA was higher pre-ablation for IAC failure (success 0.6 ± 0.8 vs. failure 3.2 ± 2.5, P < 0.001). Conclusion This simulation study predicts that IAC ablation is effective in returning the RA to SR for many cases. Patient-specific modelling approaches have the potential to stratify patients prior to ablation by predicting if drivers are located in the LA or RA. We present a platform for predicting efficacy and informing patient selection for speculative treatments.
A Differential Topological View of Challenges in Learning with Feedforward Neural Networks

Among many unsolved puzzles in theories of Deep Neural Networks (DNNs), there are three most fundamental challenges that highly demand solutions, namely, expressibility, optimisability, and generalisability. Although there have been significant progresses in seeking answers using various theories, e.g. information bottleneck theory, sparse representation, statistical inference, Riemannian geometry, etc., so far there is no single theory that is able to provide solutions to all these challenges. In this work, we propose to engage the theory of differential topology to address the three problems. By modelling the dataset of interest as a smooth manifold, DNNs can be considered as compositions of smooth maps between smooth manifolds. Specifically, our work offers a differential topological view of loss landscape of DNNs, interplay between width and depth in expressibility, and regularisations for generalisability. Finally, in the setting of deep representation learning, we further apply the quotient topology to investigate the architecture of DNNs, which enables to capture nuisance factors in data with respect to a specific learning task.
Long-range quantum entanglement in noisy cluster states (6 pages)

We describe a phase transition for long-range entanglement in a three-dimensional cluster state affected by noise. The partially decohered state is modeled by the thermal state of a short-range translation-invariant Hamiltonian. We find that the temperature at which the entanglement length changes from infinite to finite is nonzero. We give an upper and lower bound to this transition temperature.
Magnetic resonance imaging of the efficacy of specific inhibition of 5α‐reductase in canine spontaneous benign prostatic hyperplasia

A leading role for prostatic levels of dihydrotestosterone (DHT) in the pathogenesis of benign prostatic hyperplasia is well established, if incompletely understood. The present study provides initial confirmation that 5α‐reductase inhibition alone is sufficient to prevent prostatic accumulation of DHT and to produce epithelial regression in the canine prostate. In dogs treated with the specific 5α‐reductase inhibitor finasteride, prostatic volume decreased to one‐third of the baseline volume, while the prostatic concentration of DHT fell fivefold: both were constant in placebo control dogs. Demonstration that MR imaging can serve as an accurate modality to assess prostatic volume was provided by serial measurements of the canine prostate and by correlation of the last imaging measurement with the weight of the excised prostate. Significant intensity changes were observed in T2‐weighted images measured post‐treatment; these changes correlated with the histopathology of the prostate. These results suggest that beyond quantifying regression, multiecho T2 measurements can be useful in probing accompanying changes occurring on the cellular level. © 1991 Academic Press, Inc.
Prosthetic Foot Selection for Individuals with Lower-Limb Amputation: A Clinical Practice Guideline

Introduction This guideline was developed to present current evidence and to provide associated clinical recommendations on prosthetic foot selection for individuals with lower-limb amputation. Materials NA Methods The guideline is based upon the best available evidence as it relates prosthetic foot selection during the provision of definitive lower-limb prostheses. Where possible, recommendations are drawn from Cochrane Review, meta-analysis, systematic and narrative literature reviews, and published evidence-based guidelines. Where this standard is unavailable, alternate academic literature has been used to support individual recommendations. Results Recommendation 1: For patients ambulating at a single speed who require greater stability during weight acceptance because of weak knee extensors or poor balance, a single-axis foot should be considered. Recommendation 2: Patients at elevated risks for overuse injury (i.e., osteoarthritis) to the sound-side lower limb and lower back are indicated for an energy-storage-and-return (ESAR) foot to reduce the magnitude of the cyclical vertical impacts experienced during weight acceptance. Recommendation 3: Neither patient age nor amputation etiology should be viewed as primary considerations in prosthetic foot type. Recommendation 4: Patients capable of variable speed and/or community ambulation are indicated for ESAR feet. Conclusions These clinical practice guidelines summarize the available evidence related to prosthetic foot selection for individuals with lower limb amputation. The noted clinical practice guidelines are meant to serve only as “guides. ” They may not apply to all patients and clinical situations.
Getting it Right from the start

JOPERD • Volume 79 No. 2 • February 2008 F ernando is in sixth grade and has Down syndrome. He is in a class with Angelica who has a visual impairment, Justin who has exercise-induced asthma, and Valinda and Valerie who recently moved to the United States from Russia. Valinda and Valerie speak little English and have limited experience with most games and activities that are played in the United States. Their teacher, Mrs. Schedlin, developed her lesson plans for the hockey lead-up unit that included the lesson warm-up, the lesson focus, a game, and then closure. This year, she had these fi ve students with unique needs, as well as others with various abilities. She added modifi cations at the end of her lesson plan, such as using a Frisbee instead of a puck for Fernando, having a trained peer-tutor and a beeping ball for Angelica, using stations with specifi c task analysis for Valinda, Valerie, and Fernando (and supporting these students with two paraeducators). The fi rst lesson of the unit looked like chaos. All the students were involved in activity, and Mrs. Schedlin ran around between instruction to give out additional equipment to other students who also wanted to use the Frisbee or beeping ball for hockey. She only had enough of the “alternative equipment” for the students who “needed” it. Mrs. Schedlin then realized that some students did not even have previous experience with hockey, and she had to re-think her lesson. By the end of lesson six, several students had created their own game in a corner of the gymnasium; two students were having a sword fi ght with the hockey sticks; Valinda and Valerie were batting a ball back and forth like baseball; Justin and three others were throwing and catching the Frisbee; and Fernando and Angelica were on the fl oor with a paraeducator rolling the beeping ball to each other. Mrs. Schedlin was beside herself. Where did she go wrong? Mrs. Schedlin called the adapted physical education consultant for the district, Ms. Collier, who came to observe Mrs. Schedlin’s class. Ms. Collier commented that Mrs. Schedlin had the right ideas, but delivered the lesson in a reactionary way. Ms. Collier said that many teachers are taught to include individuals with differences as an afterthought. She encouraged Mrs. Schedlin to think of all the needs of the students and identify the objectives of the lesson before planning it to include all students. Getting it Right from the Start: Employing the Universal Design for Learning Approach to Your Curriculum
Opportunistic screening models for high-risk men and women to detect diastolic dysfunction and heart failure with preserved ejection fraction in the community

Background The prevalence of undetected left ventricular diastolic dysfunction is high, especially in the elderly with comorbidities. Left ventricular diastolic dysfunction is a prognostic indicator of heart failure, in particularly of heart failure with preserved ejection fraction and of future cardiovascular and all-cause mortality. Therefore we aimed to develop sex-specific diagnostic models to enable the early identification of men and women at high-risk of left ventricular diastolic dysfunction with or without symptoms of heart failure who require more aggressive preventative strategies. Design Individual patient data from four primary care heart failure-screening studies were analysed (1371 participants, excluding patients classified as heart failure and left ventricular ejection fraction <50%). Methods Eleven candidate predictors were entered into logistic regression models to be associated with the presence of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in men and women separately. Internal-external cross-validation was performed to develop and validate the models. Results Increased age and β-blocker therapy remained as predictors in both the models for men and women. The model for men additionally consisted of increased body mass index, moderate to severe shortness of breath, increased pulse pressure and history of ischaemic heart disease. The models performed moderately and similarly well in men (c-statistics range 0.60–0.75) and women (c-statistics range 0.51–0.76) and the performance improved significantly following the addition of N-terminal pro b-type natriuretic peptide (c-statistics range 0.61–0.80 in women and 0.68–0.80 in men). Conclusions We provide an easy-to-use screening tool for use in the community, which can improve the early detection of left ventricular diastolic dysfunction/heart failure with preserved ejection fraction in high-risk men and women and optimise tailoring of preventive interventions.