Miracle-dz/UniFAR-FTUs huggingface dataset:
A qualitative analysis of mindfulness-based cognitive therapy (MBCT) in Parkinson's disease.

OBJECTIVES To analyse the experiences of participants with Parkinson's disease (PD), who participated in an 8-week mindfulness-based cognitive therapy (MBCT) course. DESIGN AND METHOD Interpretative phenomenological analysis guided the design and method used in this study. A total of twelve participants (seven men and five women) with PD were recruited prior to and following participation in an MBCT course and interviewed with a semi-structured interview schedule. One participant who opted out of the course was also interviewed. The researcher also participated in another MBCT course to enhance their understanding of the participants' experience, keeping a detailed diary as a means of acknowledging bias in the analysis process. Themes were summarized from transcripts and later classified into superordinate themes, which were compared across all cases. Transcripts were also read and analysed by a second author and participants were given the opportunity to comment upon emerging themes. RESULTS Major themes included (1) changing patterns of coping; (2) the role of mindfulness in consolidating existing coping skills in the context of loss; (3) group support in the context of loss and society that stigmatizes difference; and (4) the dualism of experience between Parkinson's and mindful meditation. CONCLUSIONS This study has indicated that MBCT could benefit people with PD and was an acceptable form of group intervention.
Optimal management of type 2 diabetes: the evidence

This paper reviews the evidence in relation to the optimal target for HbA1c and outlines a global treatment algorithm for people with type 2 diabetes. While most guidelines recommend a general HbA1c target of 7%, recent large scale intervention studies have examined the potential benefits of lower targets. These studies have generally shown that lower HbA1c targets provide no macrovascular benefits and limited effects on microvascular complications while increasing rates of hypoglycaemia. Overall these studies do not support a general HbA1c target lower than 7.0%. However an individual's HbA1c target should be set and reviewed taking into account treatment benefits, safety, and tolerability. This may mean that an HbA1c target lower than 7% is appropriate for some when it can be easily and safely achieved but equally a higher HbA1c target may be appropriate in others. Clinicians and consumers are fortunate in having a wide range of pharmacological agents available to treat hyperglycaemia, however access to many of these options is limited in many middle and low income countries. Developing treatment algorithms is complex for several reasons. The major limitation is the limited evidence base for choosing particular treatment options or combinations of medications. However it is possible to derive a generic evidence‐informed consensus algorithm which considers availability, access and cost of medications which can be adapted for local country use.
Beyond “Culture”: Space, Identity, and the Politics of Difference

For a subject whose central rite of passage is fieldwork, whose romance has rested on its exploration of the remote ("the most other of others" [Hannerz 1986:363]), whose critical function is seen to lie in its juxtaposition of radically different ways of being (located "elsewhere") with that of the anthropologists' own, usually Western, culture, there has been surprisingly little self-consciousness about the issue of space in anthropological theory. (Some notable exceptions are Appadurai [1986, 1988], Hannerz [1987], and Rosaldo [1988, 1989].) This collection of five ethnographic articles represents a modest attempt to deal with the issues of space and place, along with some necessarily related concerns such as those of location, displacement, community, and identity. In particular, we wish to explore how the renewed interest in theorizing space in postmodernist and feminist theory (Anzaldua 1987; Baudrillard 1988; Deleuze and Guattari 1987; Foucault 1982; Jameson 1984; Kaplan 1987; Martin and Mohanty 1986)-embodied in such notions as surveillance, panopticism, simulacra, deterritorialization, postmodern hyperspace, borderlands, and marginality-forces us to reevaluate such central analytic concepts in anthropology as that of "culture" and, by extension, the idea of "cultural difference. "
Nurses' experience of caring for people with intellectual disability and dementia

AIMS AND OBJECTIVES To explore nurses' experiences of caring for older people with intellectual disability and dementia. BACKGROUND Ageing and dementia prevalence is increasing along with the life expectancy of people with intellectual disability. As a population group, people with intellectual disability have a high prevalence of dementia, which is higher within the subpopulation of Down syndrome. People with intellectual disability live in residential care, community or residential settings, and nurses are required to adapt their practices to meet the changed needs of the individual. DESIGN A qualitative Husserlian descriptive phenomenological methodology facilitated the researcher to become absorbed in the quintessence of meaning and explore nurses' experience of working with older people with intellectual disability and dementia. METHODS Ethical approval was obtained, and data were collected utilising semistructured interviews (n = 11). Interviews were transcribed and analysed using Colaizzi's framework for data analysis. RESULTS Three key themes were identified: 'knowledge of dementia', 'person-centred care' and 'transitioning within the service'. The study highlights the need for proactive planning, life story books of the patient, and funding to support client and staff. CONCLUSIONS Overall, the study highlights the importance of knowing the person, supporting the individual and recognising presenting behaviours as outside the control of the individual. RELEVANCE TO CLINICAL PRACTICE This article presents the experiences of nurses caring for the older person with intellectual disability and dementia. Transitions are often very difficult for both the person and their peers, and they experience benefit from the efforts of a multidisciplinary team facilitating a person-centred approach.
Creatinine and Surveys: An Assessment

We analysed the results of surveys on creatinine held in The Netherlands during the years 1992, 1993 and 1994. Assay results of 113 samples were reviewed: 88 human sera and 25 samples of animal origin. The results of 5 creatinine assays, 4 based on the Jaffé reaction and 1 enzymatic procedure, are discussed. The enzymatic assay showed by far the best performance, while some of the Jaffé methods differed considerably. All results were evaluated by reference to a HPLC-based selected method for creatinine. Our study shows the need for caution when applying survey performance criteria for creatinine.
Evolution of the Phenolic Content and Extractability Indices During Ripening of Nebbiolo Grapes from the Piedmont Growing Areas over Six Consecutive Years

The phenolic composition and extractability indices of grape berries play a key role in assessing red wine quality because the relationship between grape phenolic maturity and wine phenolic composition is well known. In this work, grape quality indices were determined in Nebbiolo grapes from two growing areas of Langhe (South Piedmont), at different stages throughout the ripening process in six consecutive years (2004 to 2009), with the aim of evaluating the ripening- and growing area-related changes in the grape indices separately. The effect of vintage was also investigated. Ripeness data were compared with analogous data determined in Nebbiolo grapes grown in the Carema area (North Piedmont). The vintage effect far outweighed any changes in the grape indices introduced by the ripening stage, even those arising from differences in the production area. In the Langhe and Carema zones, the average berry mass, pH, total acidity, total anthocyanins extractable at pH 3.2, total flavonoids and non-anthocyanin flavonoids extractable at pH 1, and the seed maturity index were seasonally dependent. The more ripening-affected parameters were the technological ones. This work highlights the importance of determining the phenol extractability, since it provides relevant information that allows improved management of the maceration stage.
Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac)

OBJECTIVE To compare pregnancy outcome following first-trimester fluoxetine (Prozac) exposure with pregnancy outcome in two matched control groups. Fluoxetine is a new antidepressant used by many young women. Currently, no published data exist on its safety in pregnancy. DESIGN We prospectively collected and followed up 128 pregnant women exposed to a mean daily dose of 25.8 mg (+/- 13 mg) of fluoxetine during the first trimester and compared pregnancy outcome with two matched groups of women exposed during the first trimester of pregnancy to either nonteratogens or tricyclic antidepressants. RESULTS Rates of major malformations were comparable within the three groups and did not exceed those expected in the general population. Women treated with fluoxetine had a tendency for increased risk for miscarriage when compared with women exposed to nonteratogens (relative risk, 1.9; 95% confidence interval, 0.92 to 3.92). The rate of miscarriages in the fluoxetine group was comparable with the tricyclic group (13.5% and 12.2% vs 6.8% in the nonteratogens). CONCLUSIONS Our study suggests that the use of fluoxetine during embryogenesis is not associated with an increased risk of major malformations. Women exposed to both fluoxetine and tricyclic antidepressants tended to report higher rates of miscarriage; further studies will be needed to confirm this observation and to separate the effects of the psychiatric condition from the associated drugs. Long-term studies will be warranted to rule out potential developmental teratology of fluoxetine, which affects a central nervous system neurotransmitter.
Genome scan of pedigrees multiply affected with bipolar disorder provides further support for the presence of a susceptibility locus on chromosome 12q23‐q24, and suggests the presence of additional loci on 1p and 1q

Objective To localize genes conferring susceptibility to bipolar affective disorder. Methods Seven families were selected on the basis of containing multiple cases of bipolar affective disorder present in three or more generations, an absence of schizophrenia and unilineal transmission. DNA samples from these families were genotyped with 365 microsatellite markers spaced at approximately 10 cM intervals across the whole genome. All markers were subjected to initial two‐point and three‐point analyses using LOD score and model‐free analysis. All regions producing a result significant at P<0.01 were then subjected to four‐point LOD score analysis under the assumption of heterogeneity. Results A four‐point LOD score of 2.8 was obtained using a dominant model and including unipolar cases as affected in the region of D12S342. Four‐point LOD scores of 2 were obtained around D1S243, D1S251 and D3S1265. The positive results around D1S243 were accounted for by a LOD score of 3.1 occurring in a single pedigree. Conclusions Since there has been previous strong support for linkage to the region of 12q23‐q24 around D12S342, it now seems very probable that it does indeed contain a gene influencing susceptibility to bipolar affective disorder. Some evidence for linkage in the region of 1q near to D1S251 has been reported in one previous study. It therefore seems that this region of 1q and the region of 1p close to D1S243 may also harbour susceptibility genes.
Effects of Vigabatrin on Cognitive Function and Mood When Used as Add‐on Therapy in Patients with Intractable Epilepsy

Summary: Cognitive function and mood of patients with epilepsy who received 2 g/day vigabatrin (GVG) in addition to their usual antiepileptic drugs (AEDs) was assessed on two occasions: before start of treatment (base‐line) and 4 weeks after start of treatment. A battery of selected psychological tasks measuring attention, mental speed, motor speed, central cognitive processing, and perceptuomotor performance was used, along with standardized, objective mood assessments. A comparison group (n = 15) of patients receiving stable medication was also tested to evaluate practice effects of the psychometric tests. Administration of 2 g/day GVG significantly decreased response time on a test of central cognitive processing ability (arithmetic). No adverse effect was noted on any other test of cognitive function or mood.
CD4+CD73+ T cells are associated with lower T-cell activation and C reactive protein levels and are depleted in HIV-1 infection regardless of viral suppression

Background:The role of the adenosine (ADO) suppression pathway, specifically CD39-expressing and CD73-expressing CD4+ T cells in HIV-1 infection is unclear. Methods:We evaluated the frequency and numbers of CD4+CD39+ and CD4+CD73+ T cells, activated T cells, and plasma C reactive protein (CRP) levels in 36 HIV-1-positive individuals and 10 normal controls (NC). Low-level plasma viremia was evaluated using single copy assay. Mass spectrometry was used to measure hydrolysis of ATP by ectoenzyme-expressing CD4+ T cells, whereas cyclic adenosine monophosphate (cAMP) levels were measured using enzyme immunoassay. Suppression of T-cell function by exogenous ADO and CD4+CD73+ T cells was tested by flow cytometry. Results:CD39 and CD73 are expressed in different CD4+ T-cell subsets. CD4+CD73+ T cells do not express CD25 and FOXP3, and their frequency and numbers were lower in HIV-1-positive individuals regardless of virologic suppression (P = 0.005 and P < 0.001, respectively). CD4+CD73+ numbers inversely correlated with CD4+CD38+DR+ (P = 0.002), CD8+CD38+DR+ T-cell frequency (P = 0.05), and plasma CRP levels (P = 0.01). Both subsets are required for hydrolysis of exogenous ATP to ADO and can increase CD4+ T-cell cAMP levels when incubated with exogenous ATP. Low-level viremia did not correlate with activated T-cell frequency. In vitro, ADO suppressed T-cell activation and cytokine expression. CD4+CD73+ T cells suppressed T-cell proliferation only in the presence of exogenous 5′-AMP. Conclusion:The ADO-producing CD4+CD73+ subset of T cells is depleted in HIV-1-positive individuals regardless of viral suppression and may play a key role in controlling HIV-1-associated immune activation.
Best practice in the treatment of nonmuscle invasive bladder cancer

Bladder carcinoma is the most common malignancy of the urinary tract. Approximately 75–85% of patients with bladder cancer present with a disease that is confined to the mucosa (stage Ta, carcinoma in situ) or submucosa (stage T1). These categories are grouped as nonmuscle invasive bladder cancer (NMIBC). Although the management of NMIBC tumours has significantly improved during the past few years, it remains difficult to predict the heterogeneous outcome of such tumours, especially if high-grade NMIBC is present. Transurethral resection is the initial treatment of choice for NMIBC. However, the high rates of recurrence and significant risk of progression in higher-grade tumours mandate additional therapy with intravesical agents. We discuss the role of various intravesical agents currently in use, including the immunomodulating agent bacillus Calmette-Guérin (BCG) and chemotherapeutic agents. We also discuss the current guidelines and the role of these therapeutic agents in the context of higher-grade Ta and T1 tumours. Beyond the epidemiology, this article focuses on the risk factors, classification and diagnosis, the prediction of recurrence and progression in NMIBC, and the treatments advocated for this invasive disease.
Corrective osteotomy for malunited extra-articular fractures of the distal radius: A follow-up study of 33 patients

We present a series of 33 consecutive patients treated with lengthening osteotomy due to malunited extra-articular fractures of the distal radius. Thirty-one patients were able for long-term follow-up a median (range) of seven (2–20) years after the procedure. The indication for reconstruction was mainly impaired function of the wrist. Both the anatomy and function were improved significantly postoperatively. The median radial length improved 5 mm, the radial tilt 25°, and the radial inclination improved 9°. The median improvement of forearm supination was 20°, pronation 10°, dorsal wrist flexion 10°, and volar flexion 20°. Twenty-two of 29 patients (76%) rated the functional results as good or excellent. The functional results were significantly better postoperatively, but the results were still better on the uninjured side. The grip strength on the operated hand was 82% of the uninjured hand, and the median postoperative DASH-score was 21. In five patients the graft resorbed (one fracture of the plate) and needed reoperation. All eventually healed and the anatomical and functional results were good. Another patient had symptomatic osteoarthrosis and later had a full wrist fusion. We conclude that every effort should be made to prevent malunion in the treatment of distal radius fractures, because even after anatomical correction, function is not restored fully in all patients.
Early changes in sodium and water balances in patients with acute myocardial infarction: relationship to haemodynamics and creatine kinase

Abstract. The changes in sodium and water balances during the first 4 days after an uncomplicated transmural myocardial infarction (MI) were determined in forty patients. The sodium balance was positive 4 days after MI in 80% of the patients but negative in 20%. Neither in anterior (n= 23) nor in inferior (n= 17) MI were rank correlations found between the haemodynamic parameters (cardiac index, mean arterial pressure, mean right atrial or pulmonary capillary pressures, right or left ventricular work indices) and sodium balance. However, the sodium balances correlated with the total creatine kinase (CK) release in anterior MI after 1 day (r= 0·60; P < 0·002) and after 4 days (r= 0·65; P < 0·001) but not in inferior MI. Furthermore, in anterior and inferior MI matched for their CK release, the sodium handling was different both after 1 day (– 70 in anterior v.+ 44 mmol (24 h)‐1 in inferior MI; P < 0·001) and after 4 days (–36 v.+ 147 mmol (72 h)‐1; P < 0·01), a difference unexplained by differences in medical management or in sodium intake. Finally, sodium balance correlated with the changes in left ventricular stroke work index (LVSWI) observed during this period (r= 0·48, P < 0·001), LVSWI being more stable when sodium balance was more positive.
Clinical Signs of Anesthesia

The clinical signs of anesthetic depth (heart rate, mean arterial pressure, pupil diameter, pupil reactivity to light, tearing, and eye movement) were correlated with anesthetic dose in healthy young volunteers. During halothane, halothane—nitrous oxide, Forane, or Forane–nitrous oxide anesthesia at normal PaCO2 (controlled ventilation), only hypotension in the first hour of anesthesia correlated with anesthetic dose. After five hours of halothane or halothane–nitrous oxide, blood pressure remained constant as anesthetic concentration increased. During cyclopropane, diethyl ether, and fluroxene anesthesia, only pupillary dilatation and reduced pupil reactivity to light correlated with anesthetic dose. When nitrous oxide was added to halothane, ether, or fluroxene, mean arterial pressure rose and pupils dilated. During halothane–oxygen anesthesia with spontaneous ventilation, the rise in PaCO2 allowed less hypotension and increased heart rate. Tidal volume decreased and respiratory rate increased as anesthesia deepened. During Forane–oxygen anesthesia with spontaneous respiration, mean arterial pressure, tidal volume, and minute ventilation decreased as anesthesia deepened. In healthy surgical patients anesthetized with halothane or Forane only, incision of the skin modified the clinical signs significantly. While surgery continued, this change in clinical signs persisted during Forane anesthesia, but returned to control during halothane anesthesia.
Clinical features, anthropometric characteristics, and racial influences on the 'white-coat effect' in a single-centre cohort of 1553 consecutive subjects undergoing routine ambulatory blood pressure monitoring.

BACKGROUND Patients with high office blood pressures but relatively normal readings during daytime ambulatory monitoring have been the subject of much investigation and debate. This clinical finding in part depends on an alerting reaction to the circumstances of the clinical measurement, often described as the 'white-coat effect' (WCE). Little is known of the characteristics of patients that are associated with the white coat effect in a large population of routinely referred patients. OBJECTIVE To relate the size of the WCE (defined as the difference between office and ambulatory daytime readings) to clinical features that may influence this phenomenon. METHODS We categorized 1553 consecutive subjects (51.3% men, aged 17-88 years), who had been referred to a single centre for the assessment of suspected hypertension prospectively into three groups: those aged <40, 40-59, and >/=60 years. RESULTS WCE on systolic blood pressure (SBP) increased significantly with advancing age and was correlated positively to body mass index (BMI), age and treatment. We found significant correlations to sex (higher in women) and race. WCE on diastolic blood pressure (DBP) decreased slightly with advancing age and was correlated positively to BMI and significantly to race and sex. We found no correlation to age or treatment. Caucasians had a greater WCE than did non-Caucasians (P<0. 001 for SBP and DBP) and hypertensives had greater WCE than did normotensives (P<0.0001 for SBP and DBP). Multiple linear regression analysis showed that age and BMI are the most important factors influencing WCE on SBP and DBP. CONCLUSIONS Factors such as race, age and BMI may exert important influences on the size of WCE possibly via effects on sympathetic nervous system activity.
Cataract Surgery and its Complications in Diabetic Patients

Abstract Diabetic patients are known to have an increased risk of cataract development and cataract surgery is a common surgical procedure for diabetic individuals. Cataract extraction (CE) in diabetic patients as compared to non-diabetic patients is associated with higher risks of reported complications such as capsular contraction and opacification as well as post-surgical worsening of macular edema (ME) and diabetic retinopathy (DR). In this paper, we review the pathogenesis of diabetic cataract, the risk factors contributing to cataract complications as well as DR progression, and assess preventive measures and treatment options for DR and ME following CE.