Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-Term PM2.5 Exposure and Respiratory, Cancer, and Cardiovascular Mortality in Older US Adults

The impact of chronic exposure to fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5)) on respiratory disease and lung cancer mortality is poorly understood. In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living across the conterminous United States between 2000 and 2008, we examined the association between chronic PM2.5 exposure and cause-specific mortality. We evaluated confounding through adjustment for neighborhood behavioral covariates and decomposition of PM2.5 into 2 spatiotemporal scales. We found significantly positive associations of 12-month moving average PM2.5 exposures (per 10-μg/m3 increase) with respiratory, chronic obstructive pulmonary disease, and pneumonia mortality, with risk ratios ranging from 1.10 to 1.24. We also found significant PM2.5-associated elevated risks for cardiovascular and lung cancer mortality. Risk ratios generally increased with longer moving averages; for example, an elevation in 60-month moving average PM2.5 exposures was linked to 1.33 times the lung cancer mortality risk (95% confidence interval: 1.24, 1.40), as compared with 1.13 (95% confidence interval: 1.11, 1.15) for 12-month moving average exposures. Observed associations were robust in multivariable models, although evidence of unmeasured confounding remained. In this large cohort of US elderly, we provide important new evidence that long-term PM2.5 exposure is significantly related to increased mortality from respiratory disease, lung cancer, and cardiovascular disease.
Rate of dementia diagnoses according to the degree of aging of the population

ABSTRACT Background: There is a lack of information regarding geographical differences in the incidence and prevalence of dementia diagnosis according to the degree of aging of the population. The objectives of this study were to analyze the rate of dementia diagnoses, and to compare the dementia subtypes and the clinical characteristics of the patients depending on the degree of aging of their municipalities. Methods: We used data from the Registry of Dementias of Girona (ReDeGi), containing the cases of dementia diagnosed in the memory clinics of the Health Region of Girona, in Catalonia (Spain), during 2007–2012. The municipalities were classified by a cluster analysis as aged or young municipalities according to their proportion of older people using population ageing indicators. The incidence rates of dementia diagnosis in each type of municipality were compared. Results: The ReDeGi registered 4,314 cases in the municipalities under surveillance. The clinical incidence of dementia was lower in aged municipalities (4.5 vs. 6.1 cases per 1,000 person-years aged 65 and over). Patients from young municipalities had an increased frequency of behavioral and psychological symptoms of dementia. Conclusions: The environment may influence the clinical manifestations of dementia that predispose people to visit health specialists and obtain a diagnosis.
Effect of Cardiac Resynchronization Therapy on Inflammation in Congestive Heart Failure: A Review

Congestive heart failure is associated with increased levels of several inflammatory mediators, and animal studies have shown that infusion of a number of cytokines can induce heart failure. However, several drugs with proven efficacy in heart failure have failed to affect inflammatory mediators, and anti‐inflammatory therapy in heart failure patients has thus far been disappointing. Hence, to what extent heart failure is caused by or responsible for the increased inflammatory burden in the patient is still unclear. Over the past couple of decades, resynchronization therapy with a biventricular pacemaker has emerged as an effective treatment in a subset of heart failure patients, reducing both morbidity and mortality. Such treatment has also been shown to affect the inflammation associated with heart failure. In this study, we review recent data on the association between heart failure and inflammation, and in particular how resynchronization therapy can affect the inflammatory process.
The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial

ABSTRACT Background: Earlier research showed that multi-component dyadic interventions – including a combination of intervention strategies and addressing both the person with dementia and caregiver – have a beneficial impact on the mental and physical health of people with dementia and their family caregivers. A randomized controlled trial (RCT) of a multi-component dyadic intervention, which is a translated and adapted version of an intervention that has been shown to be effective in the US by Teri et al. (2003), was performed. The effects on caregivers’ mood (primary outcome), burden, general health, and salivary cortisol levels (secondary outcomes) were studied. Methods: Community-dwelling people with dementia and their family caregivers (N = 111 dyads) were randomly assigned. The experimental group received eight home visits during three months, combining physical exercise and support (psycho-education, communication skills training, and planning of pleasant activities). Both the physical exercise and support component were directed at both the person with dementia and the caregiver. The comparison group received monthly information bulletins and phone calls. There were three measurements at baseline (prior to the intervention), at three months, and at six months into the intervention. Data were analyzed with Generalized Estimating Equations (GEE) based on an intention-to-treat analysis of all available data. Results: All analyses showed no benefits of the intervention over time on any of the outcomes. Conclusion: The negative results might be explained by the translation and adaptation of the intervention that has been shown to be effective in the US: the intervention was shortened and did not include cognitive reframing. However, only the health effects on people with dementia and not on caregivers were studied in the US. Several other factors might also have played a role, which are important for future studies to take into account. These are: the usual health care in the country or region of implementation; the wishes and needs of participants for specific intervention components; the room for improvement regarding these components; the inclusion of positive outcome measures, such as pleasure, and the quality of the relationship.
Immune Response of Healthy Adults to the Ingested Probiotic Lactobacillus casei Shirota

Daily ingestion of a probiotic drink containing Lactobacillus casei Shirota (LcS; 1.3 × 1010 live cells) by healthy adults for (1) 4‐week LcS, (2) 6‐week discontinuation of LcS and (3) a final 4 weeks of LcS was investigated. There was a significant increase in expression of the T cell activation marker CD3+CD69+ in ex vivo unstimulated blood cells at weeks 10 and 14, and there was a significant increase in the NK cell marker CD3+CD16/56+ in ex vivo unstimulated blood cells at weeks 4, 10 and 14. Expression of the NK cell activation marker CD16/56+CD69+ in ex vivo unstimulated blood cells was 62% higher at week 10 and 74% higher at week 14. Intracellular staining of IL‐4 in ex vivo unstimulated and PMA‐/ionomycin‐stimulated CD3+ β7+ integrin blood cells was significantly lower at weeks 10 and 14. Intracellular staining of IL‐12 in ex vivo unstimulated and LPS‐stimulated CD14+ blood cells was significantly lower at weeks 4, 10 and 14. Intracellular staining of TNF‐α in LPS‐stimulated CD14+ blood cells was significantly lower at weeks 4, 10 and 14. Mucosal salivary IFN‐γ, IgA1 and IgA2 concentrations were significantly higher at week 14, but LcS did not affect systemic circulating influenza A‐specific IgA or IgG and tetanus‐specific IgG antibody levels. In addition to the decrease in CD3+β7+ integrin cell IL‐4 and a reduced CD14+ cell pro‐inflammatory cytokine profile, at week 14 increased expression of activation markers on circulating T cells and NK cells and higher mucosal salivary IgA1 and IgA2 concentration indicated a secondary boosting effect of LcS.
What is the potential for improving care and lowering cost for persons with dementia?

The increasing prevalence of dementia with population aging has heightened interest in understanding patterns of utilization and health expenditures in persons with dementia (PWD) among policy officials, practicing physicians, and health system. While a substantial part of this interest is concerned with the high costs of care for people diagnosed with dementia (Kelley et al., 2015), less attention has been focused on the costs and consequences of missed or delayed diagnosis in those who screen positive for dementia. The article on “Healthcare resource utilization and cost in dementia: are there differences between patients screened positive for dementia with and those without a formal diagnosis of dementia in primary care in Germany? ” by Michalowsky and colleagues (Michalowsky et al., 2015) in this issue makes a particularly important contribution in this regard.
Characteristics of neurocognitive functions in mild cognitive impairment with depression

ABSTRACT Background: Previous studies suggest that there is a strong association between depression and cognitive decline, and that concurrent depressive symptoms in MCI patients could contribute to a difference in neurocognitive characteristics compared to MCI patients without depression. The authors tried to compare neurocognitive functions between MCI patients with and without depression by analyzing the results of neuropsychological tests. Methods: Participants included 153 MCI patients. Based on the diagnosis of major depressive disorder, the participants were divided into two groups: depressed MCI (MCI/D+) versus non-depressed MCI (MCI/D−). The general cognitive and functional statuses of participants were evaluated. And a subset of various neuropsychological tests was presented to participants. Demographic and clinical data were analyzed using Student t-test or χ 2 test. Results: A total of 153 participants were divided into two groups: 94 MCI/D+ patients and 59 MCI/D− patients. Age, sex, and years of education were not significantly different between the two groups. There were no significant differences in general cognitive status between MCI/D+ and MCI/D− patients, but MCI/D+ participants showed significantly reduced performance in the six subtests (Contrasting Program, Go-no-go task, Fist-edge-palm task, Constructional Praxis, Memory Recall, TMT-A) compared with MCI/D− patients. Conclusions: There were significantly greater deficits in neurocognitive functions including verbal memory, executive function, attention/processing speed, and visual memory in MCI/D+ participants compared to MCI/D−. Once the biological mechanism is identified, distinct approaches in treatment or prevention will be determined.
Variational Approach to Monte Carlo Renormalization Group.

We present a Monte Carlo method for computing the renormalized coupling constants and the critical exponents within renormalization theory. The scheme, which derives from a variational principle, overcomes critical slowing down, by means of a bias potential that renders the coarse grained variables uncorrelated. The two-dimensional Ising model is used to illustrate the method.
Cohort effects in verbal memory function and practice effects: a population-based study

ABSTRACT Background: In many developed countries, cognitive functioning (as measured by neuropsychological tests) appears to be improving over time in the population at large, in parallel with the declining age-specific incidence of dementia. Here, we investigated cohort effects in the age-associated trajectories of verbal memory function in older adults. We sought to determine whether they varied by decade of birth and, if so, whether the change would be explained by increasing educational attainment. Methods: Pooling data from two prospective US population-based studies between 1987 and 2015, we identified four birth cohorts born 1902–1911, 1912–1921, 1922–1931, and 1932–1943. Among these cohorts, we compared age-associated trajectories both of performance and of practice effects on immediate and delayed recall of a 10-item Word List. We used mixed effects models, first including birth cohorts and cohort X age interaction terms, and then controlling for education and education X age interaction. Results: We observed significant cohort effects in performance (baseline and age-associated trajectories) in both immediate recall and delayed recall, with function improving between the earliest- and latest-born cohorts. For both tests, we also observed cohort effects on practice effects with the highest levels in the latest-born cohorts. Including education in the models did not attenuate these effects. Conclusions: In this longitudinal population study, across four decade-long birth cohorts, there were significant improvements in test performance and practice effects in verbal memory tests, not explained by education. Whether this reflects declining disease incidence or other secular trends awaits further investigation.
The needs of older people with mental health problems in a Portuguese psychiatric setting

ABSTRACT Background: This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems. Methods: A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE. Results: The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients’ main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = −8.58, p < 0.001; Z = −11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients. Conclusions: Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients’ perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.
Characterizing and Comparing the Seasonality of Influenza‐Like Illnesses and Invasive Pneumococcal Diseases Using Seasonal Waveforms

Abstract The seasonalities of influenza‐like illnesses (ILIs) and invasive pneumococcal diseases (IPDs) remain incompletely understood. Experimental evidence indicates that influenza‐virus infection predisposes to pneumococcal disease, so that a correspondence in the seasonal patterns of ILIs and IPDs might exist at the population level. We developed a method to characterize seasonality by means of easily interpretable summary statistics of seasonal shape—or seasonal waveforms. Nonlinear mixed‐effects models were used to estimate those waveforms based on weekly case reports of ILIs and IPDs in 5 regions spanning continental France from July 2000 to June 2014. We found high variability of ILI seasonality, with marked fluctuations of peak amplitudes and peak times, but a more conserved epidemic duration. In contrast, IPD seasonality was best modeled by a markedly regular seasonal baseline, punctuated by 2 winter peaks in late December to early January and January to February. Comparing ILI and IPD seasonal waveforms, we found indication of a small, positive correlation. Direct models regressing IPDs on ILIs provided comparable results, even though they estimated moderately larger associations. The method proposed is broadly applicable to diseases with unambiguous seasonality and is well‐suited to analyze spatially or temporally grouped data, which are common in epidemiology.
EEG beta 2 power as surrogate marker for memory impairment: a pilot study

ABSTRACT Background: Memory deficits are dominant in dementia and are positively correlated with electroencephalographic (EEG) beta power. EEG beta power can predict the progression of Alzheimer´s (AD) as early as at the stage of mild cognitive impairment (MCI) and could possibly be used as surrogate marker for memory impairment. The objective of this study is to analyze the relationship between frontal and parietal EEG beta power and memory-test outcome. Frontal and parietal beta power is analyzed for a resting state and an eyes-closed backward counting condition and related to memory impairment parameters. Methods: A total of 28 right-handed female geriatric patients (mean age = 80.6) participated voluntarily in this study. Beta 1 (12.9–19.2 Hz) and beta 2 (19.2–32.4 Hz) EEG power at F3, F4, Fz, P3, P4, and Pz are correlated with immediate wordlist recall, delayed wordlist recall, recognition of learned words, and delayed figure recall. For classification between impaired and intact memory, we calculated a binary logistic regression model with memory impairment as a dependent variable and beta 2 power as an independent variable. Results: We found significant positive correlations between frontal and parietal beta power and delayed memory recall. A significant correlation (Bonferroni correction, p < 0.05) was found at F4 beta 2 during backward counting. The binary logistic regression model with F4 beta 2 power during the counting condition as a predictor yielded a sensitivity of 76.9% (95% CI) and a specificity of 73.3% (95% CI) for classifying patients into “verbal-memory impaired” and “intact. ” Conclusions: EEG beta 2 power recorded during a backward counting condition with eyes closed can be used as surrogate marker for verbal memory impairment in geriatric patients. Antidepressant treatment was correlated with EEG data in resting state but not in counting condition. Further studies are necessary to verify the results of this pilot study.
Spinal and pelvic kinematics in osteoarthrosis of the hip joint.

: Angular displacement of the pelvis and the lumbar spine was measured in a group of 19 patients with unilateral osteoarthrosis of the hip joint and a group of 10 control subjects of similar ages for comparison, and the means for each were calculated. All of the patients showed an increase in both sagittal plane (P less than 0.005) and coronal plane (P less than 0.01) movements of the pelvis, when compared with the control group. Two patterns of spinal movement were evident. One group showed a significant decrease in coronal plane movements and the other group showed a significant increase in coronal plane movements. Characteristic patterns of movement were identified and the variations between different patients recorded.
Neurologic pearls.

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Towards a theory of functional magnetic resonance spectroscopy (fMRS): A meta-analysis and discussion of using MRS to measure changes in neurotransmitters in real time.

Proton magnetic resonance spectroscopy is a powerful tool to investigate neurochemistry and physiology in vivo. Recently researchers have started to use MRS to measure neurotransmitter changes related to neural activity, so called functional MRS (fMRS). Particular interest has been placed on measuring glutamate changes associated with neural function, but differences are reported in the size of changes seen. This review discusses fMRS, and includes meta-analyses of the relative size of glutamate changes seen in fMRS, and the impact experimental design and stimulus paradigm may have. On average glutamate was found to increase by 6.97% (±1.739%) in response to neural activation. However, factors of experimental design may have a large impact on the size of these changes. For example an increase of 4.749% (±1.45%) is seen in block studies compared to an increase of 13.429% (±3.59) in studies using event related paradigms. The stimulus being investigated also seems to play a role with prolonged visual stimuli showing a small mean increase in glutamate of 2.318% (±1.227%) while at the other extreme, pain stimuli show a mean stimulation effect of 14.458% (±3.736%). These differences are discussed with regards to possible physiologic interpretations, as well experimental design implications.
Knowledge of Urban Population Regarding Diabetes Mellitus and its Complication: A Community Based Study

Aim: To assess the knowledge on diabetes among diabetic patients of urban poor. Background: Diabetes has been a major threat to public health as 3.2 million deaths are attributed to diabetes every year. The management of diabetes depends on knowledge of patient, self care activities and knowledge on symptoms and complications. Materials and methods: The study was carried out in the Urban Health Center area of Belgaum. The knowledge on diabetes, signs or symptoms and complications was assessed among diabetic patients, by using scoring system. Data were analyzed using percentages, proportions and statistical test (chi-square test) was used for categorical data. Results: The study revealed that 108(56.25%) knew about diabetes out of 192 diabetic patients. More than half, 142 (73.93%) patient knew the impact of diabetes on other organs. Sixteen (11.26%) said kidneys, 13(9.13%) as heart and 45(31.69%) said that diabetes affects multiple organs. Majority 142 (73.95%) of patients had knowledge of complications. DOI: http://dx.doi. org/10.3126/jonmc.v3i1. 10057 Journal of Nobel Medical College Vol.3(1) 2014; 62-65
The effect of cancer on suicide among elderly Holocaust survivors.

Jewish-Israelis of European origin with cancer have higher suicide rates relative to their counterparts in the general population. We investigated whether this effect results from the high proportion of Holocaust survivors among them, due to vulnerabilities arising from the earlier traumas they sustained. The study was based on all Jewish-European persons with cancer, 60 years and over, diagnosed in Israel between 1999 and 2007. The standardized incidence ratios were not significantly different between the exposed and nonexposed groups (men: 0.90, 95% CI 0.60-1.19; women: 0.95, 95% CI 0.55-1.37). Past exposure to maximum adversity did not increase the suicide risk among persons with cancer.