Miracle-dz/UniFAR-FTUs huggingface dataset:
Blood flow restriction increases metabolic stress but decreases muscle activation during high‐load resistance exercise

Introduction: We investigated differences in metabolic stress (lactate) and muscle activation (electromyography; EMG) when high‐load resistance exercise (HL) is compared with a condition in which blood flow restriction (BFR) is applied during the exercise or during the rest interval. Methods: Twelve participants performed HL with BFR during the intervals (BFR‐I), during the set (BFR‐S), and without BFR. Each condition consisted of 3 sets of 8 repetitions with knee extension at 70% of 1‐repetition maximum. Lactate and root mean square (RMS) from the surface EMG of the vastus lateralis were calculated. Results: Lactate increased in all protocols but was higher with BFR‐I than with BFR‐S and HL. RMS decreased under all conditions, with a larger effect size in BFR‐I (1.47) than in BFR‐S (0.66) and HL (0.59). Discussion: BFR‐I increases lactate, possibly as a result of reduced restoration of ATP. Muscle activation seems to be impacted by mechanical stress but may be reduced by metabolic stress. Muscle Nerve 57: 107–111, 2018
Reliability of the Brazilian Portuguese version of the Neuropsychiatric Inventory (NPI) for patients with Alzheimer's disease and their caregivers

ABSTRACT Background: Behavioral symptoms and caregivers' responses may differ among various ethnic and cultural groups. Therefore it is important to have a reliable instrument to assess behavioral disturbances of dementia in various cultures. The Neuropsychiatric Inventory (NPI) has been widely used in many countries. To date there has been no reliability study of this instrument in Brazil. Methods: The psychometric properties of the Brazilian Portuguese version of the NPI were studied in a sample of 36 Alzheimer's disease (AD) outpatients from southern Brazil. Test-retest, inter-rater reliability and internal consistency were estimated. The profile of neuropsychiatric symptoms and caregiver distress were also evaluated. The NPI was translated into Portuguese and then back translated to English. Results: The Brazilian Portuguese version of the NPI showed good inter-rater and test-retest reliability with the coefficients of all scales > 0.85. Internal consistency was also good (Cronbach's α 0.70 for total severity and distress). Apathy provided higher NPI scores of total severity and distress. Conclusions: This NPI version was found to be a reliable instrument for the evaluation of neuropsychiatric symptoms and caregiver distress due to dementia in AD. The profile of behavioral disturbances was similar to that observed in other countries. Severity of dementia may have biased some caregivers' answers.
Toward improved education about methicillin-resistant Staphylococcus aureus: A Mental Models Approach to identify the Dutch general public’s beliefs

To identify the relevant beliefs and knowledge (‘mental models’) present among the Dutch general public concerning methicillin-resistant Staphylococcus aureus (MRSA), 17 interviews were conducted followed by a confirmatory questionnaire (n=239). 62% of the public heard of MRSA before via the media. Although the public recognizes well-known risk factors and consequences of MRSA, the public is only slightly aware of its threat to society. Misconceptions exist regarding origin and spread (e.g., that MRSA is caused by overburdened muscles). Besides, knowledge gaps were found concerning prevention, reservoir, and origin (importance of hygiene measures, presence on the skin, MRSA among cattle). These beliefs must be considered by those designing risk communication and guidelines about MRSA for the public.
Reminiscences of a former editor

Professor David Ames, the editor-in-chief of International Psychogeriatrics, has kindly asked some of us who edited the journal at one time or another to write a personal piece. I was asked because I edited the journal longer than anyone else – from 1996 to 2003. I decided in 2003 that I would give up my editorship and my National Health Service (U.K.) consultant's post. It also coincided with my 65th birthday, which was declared by von Bismarck, the nineteenth-century Chancellor of Germany, to be the age of retirement when a pension would be received. The decision was not meant by me to be taken too seriously but it was convenient. My record will not last of course, since David Ames will have completed two terms, which will finish in 2011. The job is like that of the U.S. President, namely, two terms only!
Impact of volumetric muscle loss injury on persistent motoneuron axotomy

Volumetric muscle loss (VML) occurs following significant traumatic injury or surgical removal of skeletal muscle, resulting in nonrecoverable loss of tissue and long‐term dysfunction. Perhaps less recognized is that VML injuries inherently disrupt the neuromuscular unit, resulting in fiber denervation and presumptive motor unit rearrangement, expansion, and/or loss. To characterize neural dysfunction we quantified motoneuron axotomy, in efforts to understand how this relates to the temporal coordination of neuromuscular and morphological alterations due to injury.
Frey Syndrome — An Unusual Phenomenon after Parotid Surgery

ALTHOUGH gustatory sweating occurring after parotid trauma was described as early as 1853 and was studied by Frey in 1923, it did not assume major surgical importance until surgery of the parotid gland became more common. Because of the rarity of severe degrees of this syndrome, another case is presented. Case Report A 32-year-old woman had had surgical removal of the entire left parotid gland for mucoepidermoid carcinoma 20 months before being seen at Tripler United States Army Hospital. The left facial nerve was dissected free of tumor, without damage to any major branches. After operation there was minimal dysfunction .
Dysfunctional Thoughts about Caregiving Questionnaire: psychometric properties of a new measure

ABSTRACT Background: This study examines the psychometric properties of the Dysfunctional Thoughts about Caregiving Questionnaire (DTCQ). Methods: DTCQ was administered to 227 dementia family caregivers. Results: Principal components analyses resulted in a two-factor solution: Perception of Sole Responsibility and Perfectionism. The DTCQ has a strong internal consistency and an adequate temporal stability. The DTCQ score differentiated between depressed and non-depressed caregivers, although only in the female group. Construct validity was also supported by significant relationships between DTCQ scores and global dysfunctional attitudes, social support, seeking social support and number of hours per day engaged in caring. The dysfunctional thoughts about caregiving specify rigid and inappropriate contingencies to guide and assess behavior while acting as cognitive barriers that make healthy care difficult. Conclusion: The results of this study showed that such dysfunctional thoughts have a significant relationship to variables identified as mediators in caregiving stress models. The DTCQ has potential uses for both research and clinical purposes.
Muscle imaging in laminopathies: Synthesis study identifies meaningful muscles for follow‐up

Introduction: Particular fibroadipose infiltration patterns have been recently described by muscle imaging in congenital and later onset forms of LMNA‐related muscular dystrophies (LMNA‐RD). Methods: Scores for fibroadipose infiltration of 23 lower limb muscles in 34 patients with LMNA‐RD were collected from heat maps of 2 previous studies. Scoring systems were homogenized. Relationships between muscle infiltration and disease duration and age of onset were modeled with random forests. Results: The pattern of infiltration differs according to disease duration but not to age of disease onset. The muscles whose progression best predicts disease duration were semitendinosus, biceps femoris long head, gluteus medius, and semimembranosus. Discussion: In LMNA‐RD, our synthetic analysis of lower limb muscle infiltration did not find major differences between forms with different ages of onset but allowed the identification of muscles with characteristic infiltration during disease progression. Monitoring of these specific muscles by quantitative MRI may provide useful imaging biomarkers in LMNA‐RD. Muscle Nerve 58:812–817, 2018
Screening properties of the German IQCODE with a two-year time frame in MCI and early Alzheimer's disease

ABSTRACT Background: The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a widely used screening tool for dementia. We aimed to determine the ability of the German version of the 16-item IQCODE with a two-year time frame to discriminate healthy mature control participants (NC) from mild cognitive impairment (MCI) and probable early Alzheimer's disease (AD) patients (all with Mini-mental State Examination (MMSE) scores ≥ 24/30) and to optimize diagnostic discriminability by shortening the IQCODE. Methods: 453 NC (49.7% women, age = 69.5 years ± 8.2, education = 12.2 ± 2.9), 172 MCI patients (41.9% women, age = 71.5 years ± 8.8, education = 12.3 ± 3.1) and 208 AD patients (59.1% women, age = 76.0 years ± 6.4, education = 11.4 ± 2.9) participated. Stepwise binary logistic regression analyses (LR) were used to shorten the test. Receiver operating characteristic curves (ROC) determined sensitivities, specificities, and correct classification rates (CCRs) for (a) NC vs. all patients; (b) NC vs. MCI; and (c) NC vs. AD patients. Results: The mean IQCODE was 3.00 for NC, 3.35 for MCI, and 3.73 for AD. CCRs were 85.5% (NC-patient group), 79.9% (NC-MCI), and 90.7% (NC-AD), respectively. The diagnostic discriminability of the shortened 7-item IQCODE (i.e. items 1, 2, 3, 5, 7, 10, 14) was comparable with the longer version (i.e. 7-item CCRs: NC-patient group: 85.3%; NC-MCI: 80.1%, NC-AD: 90.5%). Conclusions: The German 16-item IQCODE with two-year time frame showed excellent screening properties for MCI and early AD patients. An abbreviated 7-item version demonstrated equally high diagnostic discriminability, thus allowing for more economical screening.
Is there any additional evidence for the epidemiological transition hypothesis of elderly suicides?

A recent study reported the relationship between suicide rates in both sexes in the age bands 65–74 and 75+ years and the Gross National Domestic Product (GDP), a measure of socio-economic status, as being curvilinear (inverted U-shaped curve) and fitting the quadratic equation y = a + bx−cx2 (where y is the suicide rate, x is the Gini coefficient and a, b and c are constants) (Shah, 2010). This relationship was explained using the epidemiological transition hypothesis (Shah and Bhat, 2010) and the explanatory model included the following sequence of events (Shah, 2010): (i) countries with low socio-economic status have poorly developed healthcare system; (ii) a poorly developed healthcare system is associated with increased child mortality; (iii) increased child mortality rates result in reduced life expectancy; and (iv) reduced life expectancy leads to fewer people reaching old age, the age at which the risk of suicide is high. In order to provide support for this hypothesis other data sources related to socio-economic status, quality and quantity of healthcare services and life expectancy were examined.
Systematic Reviews and Meta- and Pooled Analyses Quantifying the Dose-Response Relationship Between Circulating Folate Concentrations and Colorectal Cancer in Cohort Studies: A Meta-Analysis Based on a Flexible Meta-Regression Model

Most epidemiologic studies on folate intake suggest that folate may be protective against colorectal cancer, but the results on circulating (plasma or serum) folate are mostly inconclusive. We conducted a meta-analysis of case-control studies nested within prospective studies on circulating folate and colorectal cancer risk by using flexible meta-regression models to test the linear and nonlinear dose-response relationships. A total of 8 publications (10 cohorts, representing 3,477 cases and 7,039 controls) were included in the meta-analysis. The linear and nonlinear models corresponded to relative risks of 0.96 (95% confidence interval (CI): 0.91, 1.02) and 0.99 (95% CI: 0.96, 1.02), respectively, per 10 nmol/L of circulating folate in contrast to the reference value. The pooled relative risks when comparing the highest with the lowest category were 0.80 (95% CI: 0.61, 0.99) for radioimmunoassay and 1.03 (95% CI: 0.83, 1.22) for microbiological assay. Overall, our analyses suggest a null association between circulating folate and colorectal cancer risk. The stronger association for the radioimmunoassay-based studies could reflect differences in cohorts and study designs rather than assay performance. Further investigations need to integrate more accurate measurements and flexible modeling to explore the effects of folate in the presence of genetic, lifestyle, dietary, and hormone-related factors.
The Impact of Transvenous Cardiac Devices on Vascular Access Patency in Hemodialysis Patients

Creating a vascular access in the presence of a cardiovascular implantable electronic device (CIED) in a patient with or approaching end‐stage renal disease can be challenging. In this study, we aimed to evaluate the impact of a CIED on the outcomes of vascular access creation in hemodialysis patients and determine their effects on vascular access patency. This is a single‐center retrospective review of hemodialysis patients who underwent vascular access creation after CIED placement. Outcomes of vascular access creation and need for endovascular interventions were compared between patients with vascular access created ipsilateral and contralateral to the site of CIED. Comparing patients with arteriovenous (AV) access created ipsilateral to CIED placement (n = 19) versus the contralateral side (n = 17), the primary failure rate was 78.9% versus 35.3% (p = 0.02). For AV accesses that were matured, the median primary patency durations for AV accesses created ipsilateral to the CIED was 11.2 months compared to 7.8 months for AV accesses created contralateral to the CIED (p = 1.00). AV accesses created ipsilateral to a CIED have a higher primary failure rate compared with the contralateral arm and should be avoided as much as possible.
Readmission of psychiatric patients in India: sociodemographic factors

Readmission is a complex and common phenomenon. This study intends to analyse the sociodemographic and clinical factors associated with readmission and also compare it with similar study done at same institute in India 25 years earlier. A medical records review for all admissions in an adult psychiatry unit of a specialised hospital in southern India was done for the period from July 2010 to June 2011. Patients' sociodemographic characteristics and clinical details were recorded and statistical tests like chi-square test and logistic regression were applied. These data and results were also compared to a similar study done at the same centre 25 years earlier. Of all the admissions during the study period, 27.2% were readmissions. Female sex, income below the poverty level and higher education were predictive of readmission. In comparison with readmitted group of the earlier study, there was a significant difference with regards to age, education, marital status and duration of hospital stay in the current readmitted group. This study emphasises the importance of interplay of sociodemographic factors in utilisation and effectiveness of psychiatric care and services. Certain sociodemographic factors influence and determine readmission rates.
The public, the press and tobacco research

Correspondence to : Dr Houston. Abstract Articles that are written in a manner that is easily understandable by the lay press and that are effectively presented to the media by the medical journals in which they are published can receive a "multi plier" effect when the popular press reports the findings in news stories. This was the case with three articles con cerning the RJ Reynolds advertising campaign using the "Old Joe" cartoon camel and its appeal to children that were published on 11 December 1991 in the Journal of the American Medical Association (JAMA). The editors of JAMA and the authors of one of the JAMA papers prepared carefully for subsequent press attention. The response by the lay press was overwhelmingly positive, indicating the potential for gen erating substantial media coverage of scientific articles. Legislative policy is largely driven by public opinion, which is in part shaped by the media. Recognising this, the tobacco industry has chosen not to argue its case in the scientific literature, but rather directly in the media. For years the industry has been successful in convincing many Americans that tobacco use does not cause disease, but rather that the relation between smoking and many illnesses is merely a "statistical association. " This use of the media is exemplified by the industry's full page advertisements claiming that the results of the multiple risk factor intervention trial (MRFIT) proved that smoking did not lead to heart disease.1 The success of the tobacco
How Can We Reconcile the Findings of Keyes et al. ’ s Study With the Experience of Our Patients in Clinical Practice?

( – 1388) shows us that women currently using hormonal contraception (HC) have better scores on the Center for Epidemiologic Studies Depression Scale and report fewer suicide attempts, it does not show us that HC protects women from mood disorders or that HC is free of the mood-related side effects which cause high rates of discontinuation. The groups compared in the Keyes et al. study were different in many ways; the women using HC were younger, were more likely to engage in positive health behaviors, and had lower depression scores at each prior interview. Women with mood disorders are more likely to avoid or discontinue HC and more likely to experience worsening mood while on HC. The negative mood-related side effects experienced by women using HC (irritability and lability) are not captured by a screening tool for clinical depression, such as the depression scale used in this study. The database used in this study was longitudinal and multiwave, so the authors could have compared changes in depressive symptoms among women who switched from hormonal to nonhormonal contraceptive methods (and vice versa) across different waves. Only if the same women experienced greater levels of depressive symptoms after discontinuing HC and fewer symptoms when they restarted HC could we conclude that HC may protect women from mood disorders.
Financial and Medico‐Legal Implications of Late‐Start Dialysis: Understanding the Present Policies through a Window of Past Performance

In the United States, multiple stakeholders have impacted the timing of dialysis initiation for patients with end‐stage renal disease. The optimal policy to start dialysis for this vulnerable population remains unknown. Historically, patients initiated dialysis weeks after the appearance of uremic symptoms. This changed not only due to an evolution in medical providers' practice but also due to changes in the care delivery system, the political imperatives, and the economic driving forces surrounding the care of these patients. One large randomized control trial looked at patient outcomes with strategies of early versus late start. The trial included an economic analysis. Depending on the specific comparison, cost was either lower in the late‐start group or was equivalent between groups. This result would tend to favor a late‐start strategy, where patients had an additional 6 months of dialysis‐free time. However, the generalizability of this analysis has been questioned. Future care models that would include patients before and after dialysis initiation would be ideal to study cost and quality at the time of this transition of care. The recently implemented CMS Quality Incentive Program is one mechanism that could use such findings to implement a high‐value strategy for patients starting chronic dialysis therapies.
The Axonal Hypothesis and Magnetic Resonance Spectroscopy of MS

Douglas L. Arnold, MD, Professor ofNeurology & Neurosurgery at McGill University, is Director of the Magnetic Resonance Spectroscopy Unit at the Montreal Neurological Institute. Dr. Arnold received his B. Sc. from McGill University, Montreal, Canada and an MD degree from Cornell University Medical College, New York City. He returned to McGill University to complete two years ofresidency in internal medicine and three years of neurology residency After completing a post-doctoral fellowship inMR spectroscopy with Prof. G. K. Radda in the department of Biochemistry at the University of Oxford, he returned to Montreal to join the staff ofthe Montreal Neurological Institute & McGill University. Since that time he has been using MR spectroscopy to investigate and manage patients with neurological disorders. He is the recipient of more than 15 major research grants and is actively involved in both laboratory and clinical research related to multiple sclerosis, epilepsy, ALS, and other diseases ofthe nervous system. Dr. Arnold has published more thnm 75 peer-reviewed articles and 14 book chapters.
Genetics of the Evolutionary Process . By Theodosius Dobzhansky. Pp. 505. (Columbia University Press, New York and London, 1970). Price £4.95.

seeking, isolated, family unit of today. Modern society has to develop social institutions which will replace the inter-personal functions traditionally performed within the tribe, but outside the immediate family. The papers and discussions in this symposium concentrated on the earlier phases of the family life cycle, on child-development, on adolescent maturity and on contraception and its consequences. On this last topic, Anne McLaren presented a most interesting paper on possible future modifications in the biological regulation of reproduction covering also problems of infertility, the extent of artificial insemination, and the rather remote but real possibilities of egg transfer and vitriparity. Thorsten Sjovall followed this with the plea that man must bring up to date his thinking and moral attitudes to sex in the light of his newly achieved competence to control reproduction. The traditional attitudes of shame and guilt where sex is concerned may have been an appropriate response when the occurrence of pregnancy could not be prevented with any certainty, but now this is no longer the case, at least for those equipped with the available knowledge and techniques, new and more positive sexual moralities should prevail and should, where necessary, be taught to rising generations. In addition to providing scientific information on the most effective forms of contraception, the basis of such teaching should be, according to Sjovall, that 'human sexuality is a means of expressing and satisfying individual needs for safety and/or intimacy: on rare chosen occasions such behaviour will also fulfil reproductive intentions and thereby add considerably to a shared emotional experience'. While developments in contraceptive techniques have fundamentally altered family life, in particular the role of the wife, changes in building construction have now made it possible, as Su Rogers showed, to modify houses in accordance with a family's changing size and needs. All this shows how effectively men and women can, if they wish, now control their total environment. The technical potentialities are immense, the only worry is whether man can use them positively for human welfare rather than negatively for human destruction. Because of the diversity of interests and topics discussed, this symposium, while difficult to summarize, is stimulating in many ways. It is excellently edited, and the bibliography containing references to a wide range of modern literature on family life, is valuable.