Miracle-dz/UniFAR-FTUs huggingface dataset:
Neuropsychiatric symptoms in patients with Parkinson’s disease and dementia: frequency, profile and associated care giver stress

Objective: To explore the profile of neuropsychiatric symptoms in patients with dementia associated with Parkinson’s disease (PDD). Methods: 537 patients with PDD drawn from an international multicentre clinical trial of rivastigmine were assessed using the 10-item Neuropsychiatric Inventory (NPI). A cluster analysis was used to investigate the inter-relationship of NPI items. Associations between the clusters and demographic and clinical variables were analysed. Results: 89% of the patients presented at least one symptom on the NPI, 77% had two or more symptoms and 64% had at least one symptom with a score ⩾4. The most common symptoms were depression (58%), apathy (54%), anxiety (49%) and hallucinations (44%). Patients with more severe dementia and advanced Parkinson’s disease had more neuropsychiatric symptoms. Nearly 60% of the care givers reported at least one NPI symptom to be of at least moderate severe distress. Five NPI clusters were identified: one group with few and mild symptoms (52%); a mood cluster (11%, high scores on depression, anxiety and apathy); apathy (24%; high apathy and low scores on other items); agitation (5%, high score on agitation and high total NPI score); and a psychosis cluster (8%; high scores on delusions and hallucinations). The psychosis and agitation clusters had the lowest Mini-Mental State Examination score and the highest Unified Parkinson’s Disease Rating Scale and care giver distress scores. Conclusion: Neuropsychiatric symptoms are common in patients with PDD. The profile of these symptoms differs from that in other types of dementia. Subgroups with different neuropsychiatric profiles were identified. These subgroups may be associated with distinct neurobiological changes, which should be explored in future studies.
Neurodevelopmental evaluation of 9‐month‐old infants exposed to low levels of lead in utero: involvement of monoamine neurotransmitters

The objective of this work is to investigate the neurotoxicty of low‐level lead exposure in utero on infants and the possible involvement of dopaminergic and serotonergic neurotransmitters. The correlation analysis for cord blood lead level, the concentrations of dopamine metabolite homovanillic acid (HVA) and serotonin metabolite 5‐hydroxyindoleacetic acid (5‐HIAA) in cord plasma and the neurodevelopmental scales of infants were conducted on 244 9‐month‐old children. Both score of sociability subscale and 5‐HIAA concentration were correlated with cord blood lead level. The sociability score was negatively correlated with the concentration of HVA, whereas both the coordination score and the global score were negatively correlated with the concentration of 5‐HIAA. With partial correlation analysis, after taking HVA into account, the significant negative correlation between the sociability score and the cord blood lead level that existed in the linear correlation analysis disappeared, and the score of global scale correlated negatively with lead level in cord blood. When taking 5‐HIAA into account, the scores of all the neurodevelopmental subscales except the language subscale were significantly negatively correlated with lead level in cord blood. The results indicated that low‐level lead exposure in utero could produce a neurotoxic effect on the developing serotonergic system in infants. The neurotoxicity of low‐level lead exposure in utero may affect the sociability of infants. Serotonergic activity was shown to have a potential effect on neurodevelopmental assessment. It may interfere with the association between low‐level lead exposure in utero and other neurodevelopmental performances of 9‐month‐old children. Copyright © 1999 John Wiley & Sons, Ltd.
Techniques for delivery and monitoring of TOOKAD(WST09)-mediated photodynamic therapy of the prostate: clinical experience and practicalities

Photodynamic therapy of solid organs requires sufficient PDT dose throughout the target tissue while minimizing the dose to proximal normal structures. This requires treatment planning for position and power of the multiple delivery channels, complemented by on-line monitoring during treatment of light delivery, drug concentration and oxygen levels. We describe our experience in implementing this approach in Phase I/II clinical trials of the Pd-bacteriophephorbide photosensitizer TOOKAD (WST09)-mediated PDT of recurrent prostate cancer following radiation failure. We present several techniques for delivery and monitoring of photodynamic therapy, including beam splitters for light delivery to multiple delivery fibers, multi-channel light dosimetry devices for monitoring the fluence rate in the prostate and surrounding organs, methods of measuring the tissue optical properties in situ, and optical spectroscopy for monitoring drug pharmacokinetics of TOOKAD in whole blood samples and in situ in the prostate. Since TOOKAD is a vascular-targeted agent, the design and implementation of the techniques are different than for cellular-targeted agents. Further development of these delivery and monitoring techniques will permit full on-line monitoring of the treatment that will enable real-time, patient-specific and optimized delivery of PDT.
Effects of Caloric Restriction and Overnight Fasting on Cycling Endurance Performance

Ferguson, LM, Rossi, KA, Ward, E, Jadwin, E, Miller, TA, and Miller, WC. Effects of caloric restriction and overnight fasting on cycling endurance performance. J Strength Cond Res 23(2): 560-570, 2009-In addition to aerobic endurance and anaerobic capacity, high power-to-weight ratio (PWR) is important for cycling performance. Cyclists often try to lose weight before race season to improve body composition and optimize PWR. Research has demonstrated body fat-reducing benefits of exercise after fasting overnight. We hypothesized that fasted-state exercise in calorie-restricted trained cyclists would not result in performance decrements and that their PWR would improve significantly. We also hypothesized that substrate use during fasted-state submaximal endurance cycling would shift to greater reliance on fat. Ten trained, competitive cyclists completed a protocol consisting of baseline testing, 3 weeks of caloric restriction (CR), and post-CR testing. The testing sessions measured pre- and post-CR values for resting metabolic rate (RMR), body composition, &OV0312;o2max, PWR and power-to-lean weight ratio (PLWR), and power output, as well as 2-hour submaximal cycling performance, rating of perceived exertion (RPE), and respiratory exchange ratio (RER). There were no significant differences between baseline and post-CR for submaximal trial RER, power output, &OV0312;o2, RMR, &OV0312;o2max, or workload at &OV0312;o2max. However, RPE was significantly lower, and PWR was significantly higher post-CR, whereas RER did not change. The cyclists' PWR and body composition improved significantly, and their overall weight, fat weight, and body fat percentage decreased. Lean mass was maintained. The cyclists' RPE decreased significantly during 2 hours of submaximal cycling post-CR, and there was no decrement in submaximal or maximal cycling performance after 3 weeks of CR combined with overnight fasting. Caloric restriction (up to 40% for 3 weeks) and exercising after fasting overnight can improve a cyclist's PWR without compromising endurance cycling performance.
Adoption of interorganizational system standards in supply chains: An empirical analysis of RosettaNet standards

Purpose – This study aims to empirically examine the factors that affect the adoption of RosettaNet standards. The four factors examined in this study are partners' power, trust, products' characteristics, and government influence.Design/methodology/approach – Original research using a self‐administered questionnaire that was distributed to 400 Malaysian electrical and electronics (E&E) organizations. The hypotheses were tested by employing binary logistic regression analysis.Findings – The results show that partners' power, trust, and products' characteristics have significant and positive effects on the adoption of RosettaNet standards.Research limitations/implications – The generalisability of the findings is limited as the study focuses only on E&E industry in Malaysia.Practical implications – Organizations planning to adopt RosettaNet standards will be able to make managerial decisions based on the findings from this research.Originality/value – The findings made a contribution in terms of creating a.
Serum deoxythymidine kinase gives prognostic information in chronic lymphocytic leukemia

A recently developed deoxythymidine kinase assay, utilizing iodine‐125‐iodo‐deoxyuridine as substrate and capable of detecting enzyme activity in serum from healthy humans, was used in an investigation of sera from 55 untreated patients with chronic lymphocytic leukemia (CLL). When confined to the study, the patients were classified as having progressive or indolent disease and according to Rai stage. The results showed a significant correlation between serum deoxythymidine kinase activity (S‐TK) and disease status, i.e., higher values were found in patients with progressive disease, compared to those with indolent disease. S‐TK also correlated with Rai stage. S‐TK values of more than 40 times the normal value were found in some patients. All patients with S‐TK > 8.4 units had a disease that was or became progressive during the observation period. Within the patient group with indolent disease two groups that differed with regard to prognosis could be distinguished according to their initial S‐TK values. In longitudinal studies of 18 patients with indolent disease, S‐TK was found to exceed 8.4 units only on one occasion during an observation period of up to 68 months. In patients with indolent disease, a transition to progressive disease was parallelled by an increase in S‐TK. Studies of S‐TK levels in 18 patients receiving treatment showed that S‐TK decreased during successful therapy. S‐TK was also found to increase when the disease was reactivated. From these results it is concluded that S‐TK could be used as a prognostic marker for the individual CLL patient. Furthermore, S‐TK seems to be useful for longitudinal follow‐up studies of disease status, both in indolent disease and in progressive disease during treatment.
Smoking, fat mass and activation of the tumor necrosis factor-alpha pathway.

OBJECTIVE Obesity may be associated with increased markers of inflammation that could be triggered by metabolic, physical, infectious or environmental processes. As smoking significantly increases cytokine production, we aimed to study how smoking influences the relationship between fat mass and soluble tumor necrosis factor-alpha (TNF-alpha) receptors 1 and 2 (sTNFR1 and sTNFR2). DESIGN Cross-sectional, clinical observational study. SUBJECTS A total of 133 healthy men (age: 27-53 y, body mass index (BMI): 24-30.2 kg/m(2)), 80 of whom were never-smokers and 53 smokers, matched for age, BMI and waist-to-hip ratio. MEASUREMENTS Circulating soluble fractions of the TNF-alpha receptors sTNFR1 and sTNFR2 were measured to study their relationship with fat mass (bioelectric impedance). RESULTS Smokers had significantly lower fat mass, lower fasting glucose, insulin and leptin concentrations than nonsmokers. Despite lower fat mass and insulin, smokers showed significantly increased circulating sTNFR2 levels (3.7+/-0.8 vs 3.4+/-0.7 ng/ml, P=0.03). The slopes of the relationships between sTNFR1 and fat mass, and between sTNFR2 and fat mass, were significantly steeper in smokers than in nonsmokers. In a stepwise multiple linear regression analysis, both fat mass (P<0.00001) and smoking (P=0.025) independently contributed to 13% of sTNFR1 variance and to 4% of sTNFR2 variance (P=0.03). CONCLUSION Both fat mass and smoking are related to increased activity of the TNF-alpha axis.
The “one size fits all” approach to trauma treatment: should we be satisfied?

There have been significant advances in the treatment of posttraumatic stress disorder in the last two decades. Further improvements in outcomes will be supported by recognition of the heterogeneity of symptoms in trauma populations and the development of treatments that promote the tailoring of interventions according to patient needs. Collaboration with patients regarding preferences about treatment structure, process, and outcomes is critical and will benefit the effectiveness and quality of treatments as well as the speed of their dissemination. New research methodologies are required that can incorporate important variables such as patient preferences and symptom heterogeneity without necessarily extending already lengthy study times or further complicating study designs. An example of alternative methodology is proposed.
Measurement of free light chains with assays based on monoclonal antibodies

Abstract Recently, serum free light chain (FLC) assays incorporating anti-kappa (κ) and anti-lambda (λ) FLC monoclonal antibodies have become available: N Latex FLC assay (Siemens) and Seralite® (Abingdon Health). The purpose of this review is to provide an overview of these two new monoclonal antibody-based methods. In doing so, the review will outline the performance characteristics of each method, including a summary of: assay principles, antibody specificity, analytical performance and assay performance in disease. Additionally, the review will describe the potential user benefits of adopting these new generation FLC assays, which are designed to overcome the established limitations of existing polyclonal antibody based FLC assays.
Computer‐driven automated weaning reduces weaning duration in difficult‐to‐wean patients

Background Weaning difficulties occur in 31% of total intubated patients, and result in prolonged weaning duration. A computer‐driven automated weaning system can perform a spontaneous breathing trial (SBT) automatically and display a message when the trial is successfully passed. Such a system might have a beneficial effect on difficult‐to‐wean patients. The aim of this study was to examine whether the computer‐driven automated weaning system can accelerate discontinuation of mechanical ventilation and improve outcomes in difficult‐to‐wean patients. Methods This randomized controlled study included 39 difficult‐to‐wean patients who failed their first spontaneous breathing trial. Before initiating weaning, eligible patients were randomly allocated to wean by computer‐driven automated weaning system (CDW group, n=19) or a physician‐controlled local protocol (PW group, n=20). Weaning duration, defined as the time from inclusion until first extubation, was the primary endpoint. Secondary endpoints were total duration of mechanical ventilation, the length of intensive care unit (ICU) stay, the number of reintubations, the mortality rate in the ICU, the number of noninvasive ventilations, the number of complications in the ICU, and the number of ventilator‐associated pneumonia cases. Results The weaning duration was reduced with the computer‐driven weaning as compared with the usual protocol (median 29.0 hours vs. 45.5 hours, P=0.044). Total duration of mechanical ventilation and duration of the ICU stay did not differ between the CDW and PW groups. There was no difference in the number of reintubations between the CDW and PW groups (3 and 4 patients, P=0.732). The study groups showed comparable numbers of tracheostomy, selfextubations, ventilator‐associated pneumonia, and non‐invasive ventilation. Mortality in the ICU was similar in the CDW and the PW groups (21.1% vs. 20.0%, P=0.935). Conclusion The computer‐driven automated weaning system can reduce weaning duration in difficult‐to‐wean patients as compared with a physician‐controlled weaning protocol.
A hybrid context aware system for tourist guidance based on collaborative filtering

In the area of ambient intelligence there is a need to address user needs according with context features. Recently, the synergy between context aware computing and collaborative filtering is leading to enhance recommender systems with capabilities always nearer to user needs. Specifically, in the domain of tourism it is useful to proactively suggest right sets of attractive locations, events and so on. This work defines a context aware recommender system aimed at suggesting pertinent points of interest (POIs) to tourists. In particular, the approach is strongly based on the synergy between soft computing and data mining techniques. The general framework integrates user profiles, history of social networking and POIs data. Then by defining collaborative filtering approach on the history meaningful POIs are extracted. Indeed, soft computing techniques are mainly applied in order to support activity of unsupervised users and POIs classification. On the other hand, data mining techniques are exploited in order to extract rules able to associate user profile and context features with an eligible set of recommendable POIs. Experimental results show performance in terms of recommendations accuracy.
Exploring the spatial pattern of mental health expenditure.

BACKGROUND Recent years have witnessed growing interest in cross-sectional variations in municipality mental health expenditure. However, empirical work to date has not examined the links between such variability and demand and supply factors, particularly in the spatial domain. AIMS OF THE STUDY The aim is to examine whether a local authority's spending decisions in the mental health field respond to neighbouring expenditure decisions. We explore a number of reasons why there might be interdependence between local authorities' decisions, labelling them the demonstrative, market leader, contextual, directive, shared resource and inducement effects. METHODS Exploratory techniques from spatial data analysis are used to test for the existence of spatial structure. Drawing hypotheses from these initial exploratory analyses, we then adopt a reduced form demand and supply model, extended to incorporate possible policy interaction. The analysis of expenditure and cost variations has traditionally been based on regression models under the classical assumption that the observations are independent. But omitting the recognition that observations are interdependent might lead to erroneous statistical conclusions. Hence, we use spatial econometric techniques that explicitly take into account the potential interdependence of data in order to study the sources of spending variation between municipalities. RESULTS The exploratory data analyses reveal the presence of positive significant spatial correlation. Per capita mental health spending distributes in clusters, with the highest concentrations in metropolitan areas such as Greater London, Greater Manchester and Birmingham. The estimated spatial regression models indicate that spatial autocorrelation characterises local expenditure decisions, consistent with some degree of policy interdependence between neighbouring municipalities. Comparing the results from our spatial model with those from a classical ('non-spatial') model suggests that the differences in the regression coefficients could be explained by the evident spatial pattern of the phenomenon, since the omission of the lagged dependent variable induces bias in the OLS estimates. IMPLICATIONS FOR HEALTH POLICIES These results help central and local decision makers understand the factors that influence local spending levels, including variations between municipalities in their achievement of expenditure-related and perhaps other performance targets. The actual patterns of spatial interaction may well be more complex than simple contiguity (the structure assumed here), but there seems little doubt that positive interdependence is an important feature of decision making. IMPLICATIONS FOR FURTHER RESEARCH Statistical interrogation of a panel dataset would allow exploration of both time-series and cross-municipality variation in mental health expenditure. Subsequent analysis would also benefit from more disaggregated data (e.g. at a census ward level) and the accompanying use of spatial multilevel techniques.
Not all hemophagocytes are created equally: appreciating the heterogeneity of the hemophagocytic syndromes

Purpose of reviewThe deadly macrophage activation syndrome (MAS) constitutes one of the few rheumatologic emergencies. MAS is part of a larger group of diseases referred to as hemophagocytic syndromes that are seen in infections, malignancies, or genetic immunodeficiencies. Because of the clinical similarity of these diseases, many clinicians are tempted to approach them all similarly, both in diagnostic criteria and treatment paradigms. New work in the field suggests that not all hemophagocytic syndromes are equal. We will review the latest literature from both human and murine models related to the diagnosis, etiology, and treatment of hemophagocytic syndromes including MAS. Recent findingsMore specific diagnostic criteria for the different hemophagocytic syndromes are being developed. Animal models suggest at least two different mechanisms by which hemophagocytic syndromes arise: enhanced antigen presentation and excessive Toll-like receptor signaling. Work in humans suggests different cytokine profiles, and different treatment strategies for the variety of hemophagocytic syndromes. SummaryThe recent studies reviewed in this article suggest that despite clinical similarities the different hemophagocytic syndromes are indeed likely heterogeneous. Diagnostic criteria and treatment strategies tailored to the underlying disease or genetic context are needed and will hopefully be addressed by future work in this field.
Training Adaptations Associated With an 8-Week Instability Resistance Training Program With Recreationally Active Individuals

Sparkes, R and Behm, DG. Training adaptations associated with an 8-week instability resistance training program with recreationally active individuals. J Strength Cond Res 24(7): 1931-1941, 2010-Instability devices are popular training modalities; however, their training effectiveness has not been well established. The objective of this study was to determine differences in physiological and performance measures after stable and unstable resistance training. Eighteen subjects (10 men and 8 women) resistance trained 3 d·wk−1 under either stable or unstable conditions for 8 weeks. Pre and posttraining measures included chest press isometric force and electromyographic activity of the triceps brachii and pectoralis major under stable and unstable conditions and 1-legged throwing distance, balance, countermovement jump (CMJ) and drop jump (DJ) heights. There were no significant training group effects found with any measure. However, there was a tendency (p = 0.06) for the unstable training group to improve the stable to unstable chest press force ratio to a greater degree (24.8%) than the stable group (10.8%). There were significant overall pre to posttraining improvements in maximum voluntary isometric contraction (MVIC) force (13.3%: p < 0.0001), unstable/stable force (18.2%: p = 0.0005), bench press (11%: p < 0.0001), squat (14.9%: p < 0.0001), CMJs (11.2%: p = 0.002), and DJs (3.3%: p = 0.001), wobble board contacts (12.4%: p = 0.03), and wobble board on-off ratios (62%: p = 0.005). There was a significant (p < 0.0001) 42.2% greater MVIC force and 43.2 and 33.2% greater triceps (p = 0.003) and pectoral (p = 0.005) neuromuscular efficiency with stable vs. unstable isometric chest press. It appears that instability resistance training, which reportedly uses lower forces, can increase strength and balance in previously untrained young individuals similar to training with more stable machines employing heavier loads.