Miracle-dz/UniFAR-FTUs huggingface dataset:
Missed diagnosis: The emerging crisis of borderline personality disorder in older people

Objective: Clinical experience suggests a growing prevalence of borderline personality disorder in aged residential care and psychiatric facilities with attendant difficulties in their management. This paper reviews the literature concerning the prevalence, phenomenology and diagnosis of borderline personality disorder in old age. The aim is to elucidate the phenomenological differences in old age and thus improve identification of the disorder. Methods: A systematic search was conducted using MEDLINE, PubMed, EMBASE and PsycINFO databases, employing the search terms including ‘personality disorder’, ‘borderline personality disorder’, ‘aged care’, ‘gerontology’, ‘geriatric psychiatry’ and ‘life span’. The search included articles in English involving participants 65+ years. Long-term prospective studies of borderline personality disorder, long-term follow-up studies and studies involving older adults from 50+ years were also examined. Results: There is a paucity of literature on borderline personality disorder in the elderly. No diagnostic or rating instruments have been developed for borderline personality disorder in the elderly. The phenomenology of borderline personality disorder in the aged population differs in several respects from that seen in younger adults, causing some of the difficulties in reaching a diagnosis. Escalations of symptoms and maladaptive behaviours usually occur when the diagnosis of borderline personality disorder is either not made or delayed. Improved identification of borderline personality disorder in older patients, together with staff education concerning the phenomenology, aetiology and management of these patients, is urgently needed. Conclusion: Diagnostic instruments for borderline personality disorder in the elderly need to be developed. In the interim, suggestions are offered concerning patient symptoms and behaviours that could trigger psychiatric assessment and advice concerning management. A screening tool is proposed to assist in the timely diagnosis of borderline personality disorder in older people. Timely identification of these patients is needed so that they can receive the skilled help, understanding and treatment needed to alleviate suffering in the twilight of their lives.
Descriptions of health states associated with increasing severity and frequency of hypoglycemia: a patient-level perspective

Aims We sought to develop descriptions of health states associated with daytime and nocturnal hypoglycemia in a structured fashion from the patient’s perspective under different combinations of severity and frequency of hypoglycemic events. Methods An expert meeting followed by two patient focus groups was used to develop comprehensive descriptions of acute consequences of severe and non-severe, daytime and nocturnal hypoglycemia. Patients with diabetes (type 1 = 85, type 2 = 162) from a survey panel then validated these descriptions and assessed how often they worried and took different actions to prevent hypoglycemia. Severity and frequency of hypoglycemia were compared with respect to how often people worried and took actions to prevent an event. The effect of hypoglycemia on 35 different life activities was quantitatively compared for patients who had and had not experienced a severe hypoglycemic event. Results At least 95% of respondents agreed that the detailed patient-level descriptions of health states accurately reflected their experience of severe and non-severe, daytime and nocturnal hypoglycemia, thereby validating these descriptions. Respondents who had experienced a severe hypoglycemic event were generally more adversely affected in their worries and actions and life events than those who experienced only non-severe events; those who experienced nocturnal events were more affected than those who experienced only daytime events. Conclusion The negative psychosocial consequences and undesirable compensatory behaviors arising from hypoglycemia underscore the importance of preventing severe episodes, particularly severe nocturnal episodes. These validated descriptions for hypoglycemia from the patient’s perspective may also help inform future qualitative and quantitative research.
TiO2 nanotube surfaces: 15 nm--an optimal length scale of surface topography for cell adhesion and differentiation.

Studies of biomimetic surfaces in medicine and biomaterial fields have explored extensively how the micrometer-scale topography of a surface controls cell behavior, but only recently has the nanoscale environment received attention as a critical factor for cell behavior. Several investigations of cell interactions have been performed using surface protrusion topographies at the nanoscale; such topographies are typically based on polymer demixing, ordered gold cluster arrays, or islands of adhesive ligands at distinct length scales. Recent work has indicated that the fabrication of ordered TiO2 nanotube layers with controlled diameters can be achieved by anodization of titanium in adequate electrolytes. Such surfaces can almost ideally be used as nanoscale spacing models for size-dependent cellular response. This is particularly important as these studies are carried out on titanium surfaces—a material used for clinical titanium implantations for the purpose of bone, joint, or tooth replacements. Therefore, principles elucidated from this work can guide implant surface modifications toward an optimized surface geometry and profile to best fit and cell interactions for adequate bone growth.
Myelodysplastic features and symptoms mimicking cystic fibrosis in a child with an intracellular vitamin B 12 deficiency

To the Editor: An infant presented with symptoms of cystic fibrosis (CF), delayed psychomotor development, and later megaloblastic anemia. The patient, born at term, non-consanguineous parents, had increased mucus production after birth, followed by repeated airway infections (Staphylococcus aureus), hypoxia, and failure to thrive. Sweat test showed elevated chloride concentration 80mmol/L [1,2]. CF treatment resulted in clinical improvement. At 4 months of age, his blood values decreased and 3 months later, immunoglobulin levels were extremely low. Bone marrow biopsy demonstrated a left shift in both the granulocytopoiesis and erythropoiesis. There were 10–15% blasts, expressing myeloid markers but no morphological dysplasia among granulocytes (Fig. 1). The erythropoiesis showed moderate megaloblastic features. Two repeated bone marrow examinations revealed the same morphology with no chromosomal deletions. Since cobalamin levels were normal, MDS in association with CF was suspected; the patient had no clinical signs of malignancy. The patient was followed clinically, and given red blood cell and platelet transfusions and immunoglobulin infusions weekly. In spite of normal cobalamin concentration, he was supplemented with oral B12 over an 8-week period. An improvement in blood values was noted, but again decreased after withdrawal of the B12 treatment. At 12 months of age, homocysteine and methylmalonate were analyzed, which showed extremely high levels, 34 and 35 umol/L, respectively. B12 injections were started, which resulted in normalized blood values and lung symptoms. No transcobalamin II could be detected. Normal methymalonic acid and homocysteine levels have been maintained on B12 supplementation 1 mg intramuscularly per week and 1 mg orally per day. Megaloblastic anemia includes abnormalities in DNA synthesis and repair, resulting in bone marrow dysmorphology [3,4,5]. The methylation of homocysteine into methionine is dependent on interplay between folatederivatives (methyltetrahydrofolate) and B12 (cobalamin) [6,7]. The signs of megaloblastic anemia are caused by trapping of methylating tetrahydrofolates secondary to the to the cobalamine deficiency. This patient’s first symptoms were increased mucus production in the airways, which could have been of neurological origin, caused by the lowered methionine synthesis [8]. Vitamin B12 deficiency can mimic both neurological symptoms and the diagnosis of MDS. These findings suggest that intracellular vitamin B12 deficiency should be excluded in differential diagnosis of MDS, if no cytogenetic aberrations can be found [8].
Recursive form of general limited memory variable metric methods

In this report we propose a new recursive matrix formulation of limited memory variable metric methods. This approach can be used for an arbitrary update from the Broyden class (and some other updates) and also for the approximation of both the Hessian matrix and its inverse. The new recursive formulation requires approximately $4 m n$ multiplications and additions per iteration, so it is comparable with other efficient limited memory variable metric methods. Numerical experiments concerning Algorithm 1, proposed in this report, confirm its practical efficiency.
Establishment and characterization of a human colon carcinoma cell line (KMS‐4) from a patient with hereditary adenomatosis of the colon and rectum

A human colon carcinoma cell line was established from a metastatic lymph node of a patient with hereditary adenomatosis of the colon and rectum (ACR). Cells of this line, designated KMS‐4, have been continuously propagated in culture during the past 24 months. The cells growing on the surface of culture dishes showed epithelial features, and, when inoculated into athymic nude mice, produced adenocarcinomas with a morphology similar to that of the original tumor. Electron micrographs showed that the cultured cells have desmosomes and numerous surface microvilli typical of colon epithelium. Chromosomal analysis revealed the cell line to be of human origin with a diptoid mode of chromosome number, but the karyotypes examined were all abnormal. Most of the metaphases Commonly had such abnormalities as 7p+, 12p+, +13, +16 and 17p+, accompanied by loss of chromosome No. 19 and/or 20, and, interestingly, all the metaphases contained 7p+ and +13. The cells had a log phase doubling time of 48 to 72 h. The cloning efficiency of the cells was 0.06% in the soft agar medium. Neither 12‐0‐tetradecanoytphorbol‐13‐acetate nor bile acids enhanced cell proliferation. The cells abundantly secreted CEA protein into the culture medium (700 ng/ml/106 cells during a 48 h period). The present colon carcinoma cell line derived from a genetically defined individual with ACR should prove useful for research in human oncology or genetics.
Catalytic and substrate-binding domains of endoglucanase 2 from Bacteroides succinogenes

Endoglucanase 2 (EG2) of the cellulolytic ruminal anaerobe Bacteroides succinogenes is a 118-kilodalton (kDa) enzyme which binds to cellulose and produces cellotetraose as the end product of hydrolysis. The purified enzyme was treated with the protease trypsin in an attempt to isolate peptides which retained the ability to either hydrolyze soluble carboxymethyl cellulose or bind to insoluble cellulose. There was no loss in endoglucanase activity (carboxymethylcellulase) over a period of 2 h following the addition of trypsin. In comparison, there was a greater than eightfold reduction in the binding of carboxymethylcellulase activity to crystalline cellulose. A Lineweaver-Burk plot with amorphous cellulose as the substrate revealed that the trypsin-digested enzyme had an identical Vmax but a 1.9-fold-lower Km in comparison with the intact enzyme. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the trypsin-digested enzyme revealed two major peptides of 43 and 51 kDa (p43 and p51). The 43-kDa peptide was able to bind to both amorphous and crystalline cellulose, whereas p51 did not. Purified p51 had a molar activity toward carboxymethyl cellulose which was identical to that of the intact enzyme, but activity toward both amorphous and crystalline cellulose was reduced approximately twofold. Two high-titer monoclonal antibodies from mice immunized with the intact protein recognized p43 but not p51. The results are consistent with a bifunctional organization of EG2, in which the 118-kDa enzyme is composed of a 51-kDa catalytic domain and a highly antigenic 43-kDa substrate-binding domain. In terms of its domain structure and activity toward cellulose, EG2 is very similar to cellobiohydrolase II of Trichoderma reesei.
Two-stage adaptive noise cancellation for intermittent-signal applications (Corresp.)

A novel two-stage adaptive signal extractor for intermittent signal applications is presented. If the presence and absence of the signal can be detected, the first stage will adapt only while the signal is absent and thereby effect a reduction in noise, whereas the second stage will adapt only when the signal is present and thereby effect a reduction in the distortion caused by the gust stage. Bounds on performance are derived, and performance improvement relative to a conventional one-stage adaptive noise canceller is assessed.
A Generic Evaluation of a Categorical Compositional-distributional Model of Meaning University of Oxford MSc Computer Science

Until this research, the evaluation work on the categorical model of sentence meaning (Coecke et al.) [6] has only been limited to small datasets that contain simple phrases with no recursive grammatical structures. Each of them only considered limited language units individually [16][19][30][31]. In this project, the categorical framework is instantiated on some concrete distributional models. It is the first unified practical model that handles most language units (nouns, verbs, prepositions, adjectives, adverbs, relative pronouns, conjunctions, and disjunctions) and complex grammatical structures (arbitrary sentences of any lengths). This project also conducts the first large-scale generic evaluation for the categorical model, based on the “termdefinition” classification method first introduced by (Kartsaklis et al.) [19]. Specifically, the experiment is divided into the following steps. First, how well the categorical model performs on di↵erent types of phrases, including simple subject/object/possessive relative pronoun phrases, prepositions, and adjective phrases. Here, the categorical model gives good results in general. The second step is to mix all simple phases of di↵erent types. In this case, the categorical model also gives better results than the bag-of-words baseline models. The last step is to introduce complex sentences with recursive grammatical structures, the experiment shows that categorical doesn’t give better results than the baseline methods in this case. Based on the experiment and its results, a detailed discussion is given at the end to analyze the cause for all results obtained. Some insights into building practical categorical models are shared, and some potential future work is mentioned. 5 Chapter
Effects of biologically delivered NGF, BDNF and bFGF on striatal excitotoxic lesions

IMMORTALIZED rat fibroblasts, genetically altered to secrete NGF, BDNF, and bFGF, were implanted in rat brain near the striatum 7 days before striatal infusion of excitotoxic quantities of an NMDA-receptor agonist. Analysis of striatal damage 7 days after lesioning revealed that implantation of NGF-secreting cells reduced the size of the excitotoxic lesions by more than 80% when compared with control cells, while implanting of bFGF-secreting cells caused a 30% decrease in excitotoxic lesion size. BDNF-secreting fibroblasts caused no protective sparing in the striatum in this lesion model. This finding shows that biological delivery of NGF and bFGF by grafting of genetically altered cells protects against glutamate toxicity in the adult striatum while grafting of BDNF- producing cells does not. Such observations begin to define a spectrum of neurotrophic agents able to mitigate the cell loss seen in neurodegeneration.
Accuracy and precision of two in-shoe pressure measurement systems

The recent rapid adoption of insole pressure measurement systems for clinical and ergonomic evaluations of human gait has necessitated a comprehensive understanding of the accuracy and precision of such systems. Five bench experiments were performed to examine the Pedar and F-Scan in-shoe pressure measurement systems. The insoles examined were the Pedar Y-sized right insole and the F-scan insole trimmed to the size and shape of a Pedar Y-sized insole. Data were sampled at 50 Hz at different levels of applied pressure, calibration procedure, duration of pressure application, insole age of use and experiment day or week. The system accuracy was determined by the per cent error of measurement, the system precision by the 95% tolerance interval of the per cent error. The results show that system accuracy and precision varied among levels of applied pressure, calibration procedure, duration of pressure application and insole age of use. The Pedar system showed the greatest accuracy and precision when the insole was new and measurements were taken (1) after a system calibration as specified by the manufacturer, (2) in the 50 - 500 kPa pressure range and (3) within a few seconds after pressure was applied. Under this condition, the measurement error was in the range -0.6 to 2.7%, and the magnitude (upper bound minus lower bound) of the 95% tolerance intervals was from 13.5 to 18.7%. Measuring less than 35 kPa with the Pedar system is not recommended. To ensure the accuracy and precision of the F-Scan system, users are recommended to estimate the range of the applied pressure and then choose a similar pressure level for calibration. Under this condition, the measurement error was in the range 1.3 - 5.8% and the magnitude (upper bound minus lower bound) of the 95% tolerance intervals was estimated to be in the range 1.1 - 14.8%. When the calibration pressure was outside this range of applied pressure, the per cent errors were considerably higher, ranging from -26.3 to 33.9%.
Effect of Donor Age on Function of Isolated Human Islets

This study intended to evaluate the impact of donor age on the function of isolated islets. Analysis of human islets from cadaveric donors (age 16–70 years) was performed using glucose-stimulated insulin release (GSIR) (n = 93), islet ATP content (n = 27), diabetic nude mouse bioassay (n = 72), and the insulin secretory function after single-donor clinical islet allotransplantation (n = 7). The GSIR index was significantly higher in younger donors (age ≤40 years) than in older donors and negatively correlated with the donor age (r = −0.535). Islet ATP was higher in younger donors (115.7 ± 17.7 vs. 75.7 ± 6.6 pmol/μg DNA). The diabetes reversal rate of mice with 2,000 IE was significantly higher in younger donors (96 vs. 68%). C-peptide increment to glucose during intravenous glucose tolerance test at days 90–120 after clinical transplantation showed negative correlation with donor age (r = −0.872) and positive correlation with the islet mass (r = 0.832). On the other hand, acute insulin response to arginine only showed correlation with the islet mass and not with donor age. These results show that insulin secretory response to glucose deteriorates with increasing age and that it may be related to changes in ATP generation in β-cells.
Frequency responses of two- and three-tone distortion product otoacoustic emissions in Mongolian gerbils.

The frequency responses of distortion product otoacoustic emission (DPOAEs) were investigated in adult Mongolian gerbils. The main goal was to investigate in this species the extent to which DPOAE measurements might be useful in estimating cochlear frequency-tuning characteristics. Specifically, this study investigated the parameter space for generation of DPOAEs to determine those regions, if any, where the emission responses gave "simple" frequency responses, i.e., responses similar in form to typical neural responses. At the same time, it was desired to determine in this species the existence, extent, and nature of the more complex three-tone emission frequency responses as observed in some other species [e.g., Martin et al., Hearing Res. 136, 105-123 (1999)]. In the present work, two-tone frequency response curves (f2/f1 ratio functions) were obtained by varying the lower frequency, f1, while holding the f2 frequency and both amplitudes (L1, L2) constant. Only for frequencies, f2, near 8 kHz did the response at the emission frequency, 2 f1-f2, form a simple, relatively broad peak. At all lower frequencies, the two-tone frequency response curve was typically complex and composed of multiple peaks. In comparison, three-tone frequency responses were constructed by fixing the primary stimulus pair (f1, f2) and varying a third tone widely in frequency (f3) and intensity (L3). Points in f3 and L3 which caused a criterion reduction in primary emission amplitude (at 2 f1-f2) were used to construct emission suppression tuning curves (STCs). Only for primary frequencies, f2, at 8 kHz and above were the emission STCs found to be simple, with shapes similar to neural frequency-tuning curves. At lower primary frequencies, particularly for relatively low primary frequency ratios (low f2/f1), three-tone responses were very complex. This complex response usually included a region of anomalous suppression in which very low suppression levels (L3) could result in significant decreases in the primary emission amplitude, often exceeding 12 dB. Regions of such anomalous suppression were typically observed under the following conditions: (1) for all f2 frequencies from 0.5 to 4 kHz; (2) for f3 frequencies between 1.4 and 8 kHz; (3) i.e., for f3 frequencies 1-3 octaves above the primary frequency, f2; (4) at L3 levels often 10 dB lower or more than the usual "best frequency" threshold, i.e., even lower than the relative minimum threshold found near the primary stimulus frequencies; (5) exhibiting sharp amplitude decreases often accompanied by emission phase shifts of about 180 deg; (6) present in both cubic emissions (2 f1-f2 and 2 f2-f1); (7) to be less extreme at larger primary stimulus frequency ratios (larger f2/f1); and (8) less extreme at larger intensity ratios (larger L1/L2). Because of the anomalous behavior at f2 frequencies below 8 kHz, "simple" emission STCs were typically only obtainable, if at all, near the extreme boundaries of the parameter space giving measurable emission amplitudes.
Patterns of invasion in the Laurentian Great Lakes in relation to changes in vector activity

The Laurentian Great Lakes basin has been invaded by at least 182 non‐indigenous species. A new invader is discovered every 28 weeks, which is the highest rate recorded for a freshwater ecosystem. Over the past century, invasions have occurred in phases linked to changes in the dominant vectors. The number of ship‐vectored invaders recorded per decade is correlated with the intensity of vessel traffic within the basin. Ballast water release from ocean vessels is the putative vector for 65% of all invasions recorded since the opening of the St. Lawrence Seaway in 1959. As a preventive measure, ocean vessels have been required since 1993 to exchange their freshwater or estuarine ballast with highly saline ocean water prior to entering the Great Lakes. However, this procedure has not prevented ship‐vectored species introductions. Most ships visiting the Great Lakes declare ‘no ballast on board’ (NOBOB) and are exempt from the regulation, even though they carry residual water that is discharged into the Great Lakes during their activities of off‐loading inbound cargo and loading outbound cargo. Recently introduced species consist predominantly of benthic invertebrates with broad salinity tolerance. Such species are most likely to survive in a ballast tank following ballast water exchange, as well as transport in the residual water and tank sediments of NOBOB ships. Thus, the Great Lakes remain at risk of being invaded by dozens of euryhaline invertebrates that have spread into Eurasian ports from whence originates the bulk of foreign ships visiting the basin.