Miracle-dz/UniFAR-FTUs huggingface dataset:
Diagnosis and Assessment of Sleep and Circadian Rhythm Disorders

Sleep and wakefulness are fundamental behavioral and neurobiological states that characterize all higher animals, including human beings. This article presents an overview of the current state of our knowledge concerning the function of sleep and sleep-wake rhythms, the neurobiology of circadian rhythms, how wakefulness and sleep are studied, and the clinical assessment and diagnosis of sleep and circadian rhythm disorders. Major theories of the function of sleep and sleep-wake rhythms are reviewed, including ecological or environmental advantage, physical restoration, optimizing waking function, learning and integration of experience, and survival. The author then reviews what is known about the neurobiology of endogenous circadian rhythms and how they are affected by environmental time cues. How sleep is studied using polysomnography (PSG) is explained, and the PSG characteristics of the three major neurobehavioral states, wakefulness, rapid eye movement (REM) sleep, and non-rapid eye movement (NREM) sleep, are described. Systems of classifying sleep disorders are reviewed, including those of the DSM-IV-TR, the International Classification of Sleep Disorders, and the ICD-10. Methods of assessing sleep complaints are then described, including taking an accurate history from the patient and bed partner, use of sleep history questionnaires and sleep-wake diaries, use of actigraphy, and use of PSG.
The effects of hypo‐ and hyperglycaemia on the hypoxic ventilatory response in humans

Animal and tissue studies have indicated that the carotid bodies are sensitive to glucose concentrations within the physiological range. This glucose sensitivity may modulate the ventilatory response to hypoxia, with hyperglycaemia suppressing the hypoxic response and hypoglycaemia stimulating it. This study was designed to determine whether hypo‐ and hyperglycaemia modulate the hypoxic ventilatory response in humans. In 11 normal research participants, glucose levels were clamped at 2.8 and 11.2 mmol l−1 for 30 min. At the start and end of each clamp, blood was drawn for hormone measurement and the isocapnic hypoxic ventilatory response was measured. Because generation of reactive oxygen species may be a common pathway for the interaction between glucose and oxygen levels, the experiments were repeated with and without pretreatment for 1 week with vitamins C and E. Hypoglycaemia caused an increase in the counter‐regulatory hormones, a 54% increase in isocapnic ventilation, and a 108% increase in the hypoxic ventilatory response. By contrast, hyperglycaemia resulted in small but significant increases in both ventilation and the hypoxic ventilatory response. Antioxidant vitamin pretreatment altered neither response. In conclusion, the stimulant effect of hypoglycaemia on the hypoxic ventilatory response is consistent with a direct effect on the carotid body, but an indirect effect through the activation of the counter‐regulatory response cannot be excluded. The mechanisms behind the mild stimulating effect of hyperglycaemia remain to be elucidated.
Through-the-wall tomographic imaging using chirp signals

This paper presents a feasibility study of using chirp signal for through-the-wall radar imaging and indoor positioning applications. Chirp signal enables frequency diversity while multistatic geometry of tomographic imaging enables space diversity. Pulse compression of chirp aims for range compression of received signals. Beamforming reconstruction algorithm is then applied on compressed signals to produce the final image. In the computer simulation experiments, we have considered using chirp signal and pulsed sine signal as transmitting signals for point targets imaging with building walls in different situations. This study draws a conclusion that using chirp signals, high-quality imaging and positioning results can be obtained.
The Effect of Food Price Changes on Child Labour: Evidence from Uganda

Abstract Most people in developing countries spend up to 60 per cent of their income on food, even though the majority of them are farmers. Hence, a change in food prices affects both their revenue as well as expenditure, and it may thereby affect their labour market decisions. Using the Uganda National Panel Survey and monthly regional food prices, this paper examines the effect of changes in food prices on child labour. The empirical evidence shows that an increase in food prices is linked to an increase in the probability and the intensity of child labour. We find the effect of food price increases to be smaller among landowning households, which is consistent with the view that landowning households can better compensate for price shocks. The empirical results suggest that periodic shocks in food prices may have longer lasting effects on economic development in developing countries through the channel of child labour.
Actual versus predicted first-year utilization patterns of teriparatide in patients with employer-sponsored health insurance*

ABSTRACT Objective: To characterize first-year utilization patterns of teriparatide derived from a claims database analysis versus predictions from an economic model. Research design and methods: Claims data for actual teriparatide utilization were obtained from an integrated administrative database of approximately 3.4 million beneficiaries. A control group included patients with osteoporosis but without the use of teriparatide. An economic model, which relied on first-year market share projections, predicted the utilization of teriparatide from the demographic characteristics of the plan. Predictions were compared to actual utilization for eight health plans within the database. Main outcome measures: Demographic and clinical characteristics, number of teriparatide patients, and days of teriparatide therapy. Results: Less than 1% of patients diagnosed with osteoporosis received teriparatide. Teriparatide-treated patients, compared to other patients with osteoporosis, were older and more likely to have experienced a previous fracture or to have received previous osteoporosis pharmacotherapy. For the combined 505 300 lives in the eight plans used for the comparative analysis, there were 134 teriparatide patients; the model predicted 131. For individual plans, the predictions varied in their accuracy. The greatest under-prediction for one plan was 17 patients (40 predicted vs. 57 actual), while the greatest over-prediction was 18 patients (34 predicted vs. 16 actual). For the other 6 plans, the predictions were within four patients of the actual number of teriparatide users. A similar pattern of differences was observed by comparing actual versus predicted days of teriparatide therapy across the eight plans. Limitations: Some clinical details of the actual patient cohorts, such as bone mineral density results, were not available in the database. The comparisons made between the teriparatide model predictions and actual utilization were based on analyses of a single model and do not speak to the broader issue of the accuracy of predictive economic models in general. Conclusions: Overall, first-year teriparatide utilization was relatively limited, consistent with model predictions. Predictions for individual plans varied in their accuracy.
Characterizing disability at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda

Abstract Purpose: There is a need to better measure disability as an outcome to understand the magnitude of the problem and its impact on health and socio-economic status. The aim of this study was to characterize the physical disabilities present at the Iganga-Mayuge Demographic Surveillance Site (IM-DSS) in Uganda. Methods: WHODAS 2.0 was used to examine the consequences of disability on activity limitations and participation in society. One thousand five hundred and fourteen individuals over the age of 18 at the IM-DSS with previously identified physical disabilities were included. Total and domain scores were calculated, and regression analyses examined differences by age, sex, education, occupation and SES. Results: The mean total score was 40.72. Domain 2 – getting around, had the highest mean score (57.21), followed by household activities (55.18). Domains 5.2 (work/school activities) and 6 (participation in society) also had relatively high mean scores – 47.71 and 49.44, respectively. Conclusion: This study serves as an indication of what the major limitations are among individuals in rural Uganda with physical disabilities. In general, individuals with disabilities had the most trouble on getting around, life activities and participation in society. This can guide public health planners and policy-makers on priorities to ameliorate the impact of disabilities in this population. Implications for Rehabilitation This study found that in general, individuals with disabilities had the most trouble on getting around, life activities and participation in society. This can guide public health planners and policy-makers on rehabilitation priorities to ameliorate the impact of disabilities in this population. Efforts can be made to develop and implement rehabilitation programs that cater to the needs of vulnerable populations including females and older individuals. Programs that focus on education and employment for physically disabled individuals ought to be given priority. These could include legislative changes, and modification of the physical environment, among others.
Conceptualization of PhysioFun game: A low-cost videogame for home-based stroke rehabilitation

Nowadays stroke represents one of the most common health care problems, being the major cause of disability worldwide. The patients, stroke victims, face a series of motor disabilities that jeopardize their own autonomy as individuals in society. With the purpose of giving back autonomy to these patients, health stakeholders recommend physiotherapy sessions to restore the damages of the stroke. However, the current physiotherapy sessions are insufficient for an effective recovery due to inadequate time per session. In this paper is presented the conceptualization of a videogame aimed to support home based rehabilitation that could lead to a low-cost effective upper limb recovery, in the context of a Portuguese reality.
Tyrosine Phosphorylation of Phosphoinositide-Dependent Kinase 1 by the Insulin Receptor IsNecessary for Insulin Metabolic Signaling

ABSTRACT In L6 myoblasts, insulin receptors with deletion of the C-terminal 43 amino acids (IRΔ43) exhibited normal autophosphorylation and IRS-1/2 tyrosine phosphorylation. The L6 cells expressing IRΔ43 (L6IRΔ43) also showed no insulin effect on glucose uptake and glycogen synthase, accompanied by a >80% decrease in insulin induction of 3-phosphoinositide-dependent protein kinase 1 (PDK-1) activity and tyrosine phosphorylation and of protein kinase B (PKB) phosphorylation at Thr308. Insulin induced the phosphatidylinositol 3 kinase-dependent coprecipitation of PDK-1 with wild-type IR (IRWT), but not IRΔ43. Based on overlay blotting, PDK-1 directly bound IRWT, but not IRΔ43. Insulin-activated IRWT, and not IRΔ43, phosphorylated PDK-1 at tyrosines 9, 373, and 376. The IR C-terminal 43-amino-acid peptide (C-terminal peptide) inhibited in vitro PDK-1 tyrosine phosphorylation by the IR. Tyr→Phe substitution prevented this inhibitory action. In the L6hIR cells, the C-terminal peptide coprecipitated with PDK-1 in an insulin-stimulated fashion. This peptide simultaneously impaired the insulin effect on PDK-1 coprecipitation with IRWT, on PDK-1 tyrosine phosphorylation, on PKB phosphorylation at Thr308, and on glucose uptake. Upon insulin exposure, PDK-1 membrane persistence was significantly reduced in L6IRΔ43 compared to control cells. In L6 cells expressing IRWT, the C-terminal peptide also impaired insulin-dependent PDK-1 membrane persistence. Thus, PDK-1 directly binds to the insulin receptor, followed by PDK-1 activation and insulin metabolic effects.
A Review of Plasma Exchange in Sepsis

Background: Severe sepsis involves a generalised inflammatory response, mediated by a number of cellular and humoral factors. Modulation of this response holds the promise of improved survival. Plasma exchange has been suggested as an adjunctive therapy in grave infective illnesses such as meningococcaemia, because it might remove harmful bacterial products and excessive endogenous inflammatory mediators. Aims: The aim of this article is to outline plasma exchange as an adjunctive therapy in sepsis, with an emphasis on the available clinical and experimental evidence for its use. Methods: A literature review was performed using Medline including all English language references to exchange transfusion, plasma exchange, plasmapheresis, plasma filtration and sepsis. Relevant texts and conference proceedings booklets were also hand searched. Results: Uncontrolled human data from case reports of more than 40 patients treated with plasma exchange for severe sepsis suggest a survival rate of over 70%. Animal studies produced conflicting results depending on the species and the model of sepsis employed. The only controlled clinical trial was too small to make conclusions regarding mortality. Conclusions: Plasma exchange remains an intuitively attractive but unproven therapy in sepsis. More controlled clinical trials are needed.
A quality management approach to guide the executive management team through the product/service innovation process

The innovation process has a considerable rate of failure, from 40% to 80%, depending on the experts consulted. This paper developed a quality management approach, to help Executive Management Teams to handle the innovation process in a better way, based on the problem-solving procedure and the application of quality tools and techniques. It includes three major phases: ‘External Environment Investigation’, ‘Strategic Decision Making’, ‘Innovation Project Execution’, and a series of steps are arranged to span across the approach in each phase. A case study is conducted to demonstrate how the quality management approach proposed in this research can be used as a guideline to drive the product and service innovation process. The ideas and benefits of the proposed approach are further discussed.
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities

Considerable evidence is available in support of an independent association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular disease, which is particularly strong for systemic arterial hypertension and growing for ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death. The pathogenesis of cardiovascular disease in OSAS is not completely understood but likely to be multifactorial, involving a diverse range of mechanisms including sympathetic nervous system overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. The present report, which arose out of a European Union Cooperation in the field of Scientific and Technical Research (COST) action on OSAS (COST B26), reviews the current evidence for an independent association and proposes research priorities to identify the underlying mechanisms involved, with a view to identifying novel therapeutic strategies. Large-scale collaborative studies of carefully defined patient populations with obstructive sleep apnoea syndrome, adequately controlled for potential confounders, are needed. Such studies carry the prospect of evaluating potential interactions between different basic mechanisms operating in obstructive sleep apnoea syndrome and cardiovascular disease, and interactions with other related disorders, such as obesity, diabetes and dyslipidaemia. Furthermore, translational studies involving cell culture and animal models linked to studies of obstructive sleep apnoea syndrome patients are necessary to integrate basic mechanisms with the clinical disorder.
Paraneoplastic Disorders in Thymoma Patients

Thymic malignancy is often associated with paraneoplastic neurological diseases (PNDs) and recognition of these disorders is important for physicians who treat these patients. The most common thymoma-associated PNDs are myasthenia gravis (MG), acquired neuromyotonia (Isaacs’ syndrome), encephalitis, Morvan’s syndrome, and myositis. Diagnosis of these disorders is complex but often aided by testing for specific autoantibodies, including those to the acetylcholine receptor for MG and to contactin-associated protein-like 2, protein of the voltage-gated potassium channel complex, in patients with acquired neuromyotonia, Morvan’s syndrome, or encephalitis. Patients who manifest these disorders should be screened for thymoma at diagnosis, and worsening of these PNDs may be associated with recurrent thymoma. These disorders can cause profound disability but usually respond to immunotherapy, and often improve with thymoma treatment. Close cooperation among a team of specialists is required to take proper care of these patients.
Occupational UV-Exposure is a Major Risk Factor for Basal Cell Carcinoma: Results of the Population-Based Case-Control Study FB-181

Objective: The aim of this study was to investigate the role of occupational and nonoccupational ultraviolet (UV)-exposure concerning the development of basal cell carcinoma (BCC). Methods: We undertook a population-based multicenter case–control study. Patients with first incident BCC (n = 836) were propensity score matched by age and sex to controls without skin cancer (n = 836). Sociodemographic characteristics, clinical characteristics, and lifetime UV-exposure were assessed by trained investigators. The differential estimation of occupational and nonoccupational UV-exposure dosages was based on validated instruments and established reference values. Associations were assessed using multivariable-adjusted conditional logistic regression models. Results: Individuals with high levels of occupational UV-exposure were at significantly increased BCC-risk compared with individuals with low [odds ratio (OR) 1.84; 95% confidence interval (95% CI) 1.19 to 2.83 and moderate (OR 1.97; 95% CI 1.20 to 3.22) occupational UV-exposure. Nonoccupational UV-exposure was not independently associated with BCC. Conclusion: Skin cancer prevention strategies should be expanded to the occupational setting.
The Marginal Cost of Species Preservation: The Northern Spotted Owl

Abstract Because species survival is not certain, the decision to "save" a species is not an all-or-nothing choice but rather a marginal one. The appropriate unit for both benefit and cost functions is the likelihood of survival and the appropriate question is how certain we want to be of species survival. The intensity of the species preservation debate is also fired by strong equity concerns. We illustrate these points for the case of the northern spotted owl by constructing a marginal cost curve for its survival and by disaggregating welfare loss by region and by market level.
Comparative proteomic analysis of the nucleus accumbens during extinction and reinstatement of morphine dependence.

BACKGROUND The aim of this study was to detect differentially expressed proteins in the nucleus accumbens between the states of extinction and reinstatement ofmorphine addiction. Numerous studies on the neurobiological mechanisms concerning drug craving and relapse have been reported to date, but data on their relationship with the underlying key molecular mechanisms involved remain limited. METHODS In this study, 40 male Sprague-Dawley rats were equally randomized into a saline group and a morphine group. Both groups received drug self-administration training, after which extinction models were established naturally. The groups were further divided into two subgroups for extinction and reinstatement tests. Cerebral nucleus accumbens masses were measured for total protein extraction. Two-dimensional electrophoresis was performed to determine differential protein spots. These differential proteins were then enzymolysed and identified using mass spectrography. RESULTS The proteins were classified as fatty acid-binding protein, serine/threonine protein phosphatase 2A catalytic subunit beta isoform, serine/threonine protein phosphatase 2A catalytic subunit alpha isoform, serine/threonine protein phosphatase 2A regulatory subunit B2 subunit gamma or heat shock protein 90 co-chaperone CDC37. CONCLUSION Significant changes in five proteins were detected between extinction and reinstatement. These proteins are correlated with phosphorylation and the tricarboxylic acid cycle.
In Vivo Phosphorylation of Partner Switching Regulators Correlates with Stress Transmission in the Environmental Signaling Pathway of Bacillus subtilis

ABSTRACT Exposure of bacteria to diverse growth-limiting stresses induces the synthesis of a common set of proteins which provide broad protection against future, potentially lethal stresses. Among Bacillus subtilis and its relatives, this general stress response is controlled by the σB transcription factor. Signals of environmental and energy stress activate σB through a multicomponent network that functions via a partner switching mechanism, in which protein-protein interactions are governed by serine and threonine phosphorylation. Here, we tested a central prediction of the current model for the environmental signaling branch of this network. We used isoelectric focusing and immunoblotting experiments to determine the in vivo phosphorylation states of the RsbRA and RsbS regulators, which act in concert to negatively control the RsbU environmental signaling phosphatase. As predicted by the model, the ratio of the phosphorylated to unphosphorylated forms of both RsbRA and RsbS increased in response to salt or ethanol stress. However, these two regulators differed substantially with regard to the extent of their phosphorylation under both steady-state and stress conditions, with RsbRA always the more highly modified. Mutant analysis showed that the RsbT kinase, which is required for environmental signaling, was also required for the in vivo phosphorylation of RsbRA and RsbS. Moreover, the T171A alteration of RsbRA, which blocks environmental signaling, also blocked in vivo phosphorylation of RsbRA and impeded phosphorylation of RsbS. These in vivo results corroborate previous genetic analyses and link the phosphorylated forms of RsbRA and RsbS to the active transmission of environmental stress signals.
Apolipoprotein E 4 Count Affects Age at Onset of Alzheimer Disease, but Not Lifetime Susceptibility

Results: Models that assumed a proportion of invulnerable individuals provided strongly improved fit to the data. These models estimated the 100-year lifetime incidence of AD at 72%, implying that 28% of individuals would not develop AD over any reasonable life expectancy. We confirmed the acceleration of AD onset in individuals with 1 or, especially, 2 APOE 4 alleles, but observed no meaningful difference in 100-year lifetime incidence related to number of 4 alleles.
Positive Employee Performance: An Innovative Approach to Employee Discipline

Positive discipline is a disciplinary process which replaces the use of punishment as a way to modify undesirable employee behaviors. This article addresses the application of this almost exclusively private-sector disciplinary tool to the Pinellas County, Florida labor force. A preliminary examination of its operation indicates that supervisors support the use of positive discipline because of its efficacy in addressing and responding to disciplinary problems. Positive discipline appears to be part of a larger trend that favors participative management and progressive disciplinary policies as responses to the changing values of the American work force.