Polycystic ovary syndrome in women using valproate: a review.

Valproate (VPA) is a highly effective drug successfully employed in several neuropsychiatric diseases. In the last 15 years, an increased prevalence of polycystic ovary syndrome (PCOS) associated with VPA use has been reported in both women with epilepsy and women with bipolar disorders. However, data on this subject are contrasting and it is possible that different factors might play a role in the development of PCOS in these patients. The risk of developing PCOS during VPA treatment seems to be higher in women with epilepsy than in women with bipolar disorders, and this might be due to an underlying neuroendocrine dysfunction related to the seizure disorder. Gynecologists must be aware of the possibility that PCOS in these populations of patients might be related to VPA use, and a careful multi-specialist approach is required for evaluating the risks and benefits of this treatment in the presence of features of PCOS

Differential neuropsychological profiles in Parkinsonian patients with or without vascular lesions.

The purpose of this study is to compare the neuropsychological profile of patients affected by parkinsonism and vascular lesions to that in patients with PD alone (PD) and to evaluate whether the brain vascular lesion load is associated with neuropsychological variables. Thirty-six nondemented patients with parkinsonism were divided into 3 groups of 12 patients each, according to both clinical history and the presence of brain vascular lesions and/or dopaminergic denervation as revealed by magnetic resonance and dopamine transporter imaging, respectively. The first group had vascular lesions without dopaminergic denervation (VP group); the second group had vascular lesions and dopaminergic denervation (DD) (VP+DD group); and the third group consisted of patients with dopaminergic denervation (PD group) without vascular lesions. All patients underwent neurological and neuropsychological assessments. The groups differed in disease duration, age at onset, and cerebrovascular risk factors. The VP and VP+DD groups performed worse than the PD group on frontal/executive tasks. Regardless of the presence of dopaminergic denervation, cerebrovascular lesions in hemispheric white matter, basal ganglia, and cerebellum have an important effect in determining early onset and severity of cognitive impairment in patients with parkinsonism

Elemental analysis of particulate matter by X-ray fluorescence methods: A green approach to air quality monitoring

This review explores X-ray fluorescence (XRF) spectrometry for elemental analysis of particulate matter (PM) for air quality monitoring. The introduction presents PM classification based on size and composition, covering various elemental analysis methods while highlighting the increasing interest in XRF due to its non-destructive, rapid, and green features. The fundamental concepts of XRF and the experimental configurations commonly used are discussed, focusing on Energy Dispersive X-Ray Fluorescence (EDXRF) and Total Reflection X-Ray Fluorescence (TXRF). PM sampling devices and substrate are described, with a specific emphasis on filtering membranes for EDXRF and reflecting substrates for TXRF. Sample preparation strategies and procedures are presented. Qualitative and quantitative analysis is described, with a particular focus on the calibration approaches implemented for PM. Finally, the challenges faced by XRF in becoming a recognized reliable analytical technique for PM analysis, comparable to other standardized techniques for PM filters analysis, while capitalizing on its green advantages

Nash Social Welfare in Selfish and Online Load Balancing (Short Paper)

In load balancing problems there is a set of clients, each wishing to select a resource from a set of permissible ones, in order to execute a certain task. Each resource has a latency function, which depends on its workload, and a client's cost is the completion time of her chosen resource. Two fundamental variants of load balancing problems are selfish load balancing (aka. load balancing games), where clients are non-cooperative selfish players aimed at minimizing their own cost solely, and online load balancing, where clients appear online and have to be irrevocably assigned to a resource without any knowledge about future requests. We revisit both problems under the objective of minimizing the Nash Social Welfare, i.e., the geometric mean of the clients' costs. To the best of our knowledge, despite being a celebrated welfare estimator in many social contexts, the Nash Social Welfare has not been considered so far as a benchmarking quality measure in load balancing problems. We provide tight bounds on the price of anarchy of pure Nash equilibria and on the competitive ratio of the greedy algorithm under very general latency functions, including polynomial ones. For this particular class, we also prove that the greedy strategy is optimal, as it matches the performance of any possible online algorithm

Topological Influence and Locality in Swap Schelling Games

Residential segregation is a wide-spread phenomenon that can be observed in almost every major city. In these urban areas residents with different racial or socioeconomic background tend to form homogeneous clusters. Schelling’s famous agent-based model for residential segregation explains how such clusters can form even if all agents are tolerant, i.e., if they agree to live in mixed neighborhoods. For segregation to occur, all it needs is a slight bias towards agents preferring similar neighbors. Very recently, Schelling’s model has been investigated from a game-theoretic point of view with selfish agents that strategically select their residential location. In these games, agents can improve on their current location by performing a location swap with another agent who is willing to swap. We significantly deepen these investigations by studying the influence of the underlying topology modeling the residential area on the existence of equilibria, the Price of Anarchy and on the dynamic properties of the resulting strategic multi-agent system. Moreover, as a new conceptual contribution, we also consider the influence of locality, i.e., if the location swaps are restricted to swaps of neighboring agents. We give improved almost tight bounds on the Price of Anarchy for arbitrary underlying graphs and we present (almost) tight bounds for regular graphs, paths and cycles. Moreover, we give almost tight bounds for grids, which are commonly used in empirical studies. For grids we also show that locality has a severe impact on the game dynamics

Commencement of flash glucose monitoring is associated with a decreased rate of depressive disorders among persons with diabetes (FLARE-NL7)

INTRODUCTION: Depressive disorders are more common among persons with diabetes, as compared with persons without diabetes. The burden of glucose management is known to associate with depressive symptoms. This study aims to assess the effects of commencement of FreeStyle Libre flash glucose monitoring (FSL-FGM) on the mental health status of persons with diabetes. RESEARCH DESIGN AND METHODS: Post-hoc analysis of data from a 1-year prospective nationwide FSL-FGM registry. Participants who used FSL-FGM for 12 months and completed the 12-Item Short Form Health Survey version 2 (SF-12v2) questionnaires at baseline, 6 and 12 months were included. An SF-12v2 Mental Component Score (MCS) of ≤45 was used as a cut-off to discriminate between persons with and without a depressive disorder. RESULTS: A total of 674 patients were included with a mean age of 48.2 (±15.8) years, 51.2% men, 78.2% type 1 diabetes and baseline HbA1c 62.8 (±13.4) mmol/mol (7.9±1.2%). At baseline, 235 (34.9%) persons had an SF-12 MCS ≤45 while after 6 and 12 months these numbers decreased: 202 (30.0%, p<0.01) and 173 (25.7%, p<0.01). Overall, MCS improved from 48.5 at baseline to 50.7 after 6 months and 51.3 after 12 months. In multivariable regression analysis, age and MCS at baseline were associated with improvement of MCS after 12 months of FSL-FGM use. CONCLUSIONS: This analysis suggests that use of FSL-FGM is associated with a decreased rate of depressive disorders among persons with diabetes. Future studies are needed to corroborate these findings

Adherence to insulin pump treatment declines with increasing age in adolescents with type 1 diabetes mellitus

Aim This study assessed the impact of illness perceptions, emotional responses to the disease and its management, and patient characteristics on the adherence to optimal insulin pump management in adolescents with type 1 diabetes mellitus. Methods From May to December 2013 and May 2015 to September 2016, we investigated 90 adolescents (50% boys), 12-18 years with type 1 diabetes. We analysed the association of optimal adherence to insulin pump therapy to age, gender, diabetes duration, results of questionnaires relating to fear and problems of self-testing, illness perceptions, emotional distress and family conflicts. Optimal adherence was defined as bolusing insulin on average >= 2.5/3 main meals/d. Results Adolescents with suboptimal adherence were on average 1.8 years older (95% Confidence Interval 1.09-2.50 years, P <.001) than those with optimal adherence. After adjustment for age, no other patient or parent factors were related to optimal adherence. Conclusion Adherence to insulin pump self-management in adolescents with type 1 diabetes declined with increasing age, illustrating the challenges of transition of self-management from parents to the adolescent patient themselves

Skin advanced glycation end product accumulation is poorly refected by glycemic control in type 2 diabetic patients (ZODIAC-9)

Background: Glycemic memory can be reflected by tissue accumulation of advanced glycation end products (AGEs). In type 1 diabetes mellitus (T1DM) patients, hemoglobin A1c (HbA1c) levels over various time periods poorly predicted the accumulation of different AGEs in skin biopsies. Our aim was to investigate whether HbA1c assessments can predict the change in skin AGEs during time in type 2 diabetes mellitus (T2DM). Methods: We included 452 T2DM patients participating in a shared-care setting, who are screened annually for HbA1c and diabetic complications. Baseline and follow-up levels of skin AGEs were assessed with a validated noninvasive autofluorescence (AF) method, which is based on the fluorescence characteristics of certain AGEs. Results: Our study population had a mean age of 65 years and 54% were female. After a mean follow-up duration of 3.3 years, linear regression analyses showed weak relationships among different assessments of HbA1c (baseline, maximum, mean, and variance of HbA1c) and skin AF at follow-up. Baseline skin AF and age were predictors of skin AF at follow-up, but diabetes duration, smoking, and creatinine were of less or no predictive value for skin AF at follow-up. Conclusions: In our T2DM population, integrated HbA1c assessments over years poorly predict the change in skin AGE level measured by skin AF. These findings agree with results in patients with T1DM. This suggests either the need for longer exposure to glucose disturbances to change tissue AGEs or other mechanisms, such as oxidative stress, leading to AGE accumulation.</p