628 research outputs found
Multiple system atrophy
This is a practical guide to diagnosing and managing multiple system atrophy (MSA). We explain the newly published Movement Disorders Society Consensus Diagnostic Criteria, which include new ‘Clinically Established MSA’ and ‘Possible Prodromal MSA’ categories, hopefully reducing time to diagnosis. We then highlight the key clinical features of MSA to aid diagnosis. We include a list of MSA mimics with suggested methods of differentiation from MSA. Lastly, we discuss practical symptom management in people living with MSA, including balancing side effects, with the ultimate aim of improving quality of life
Factor structure and construct validity of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer)
Background: The ASCOT-Carer is a self-report instrument designed to measure social care-related quality of life (SCRQoL). This article presents the psychometric testing and validation of the ASCOT-Carer four response-level interview (INT4) in a sample of unpaid carers of adults who receive publicly-funded social care services in England.
Methods: Unpaid carers were identified through a survey of users of publicly-funded social care services in England. 387 carers completed a face-to-face or telephone interview. Data on variables hypothesised to be related to SCRQoL (for example, characteristics of the carer, cared-for person and care situation) and measures of carer experience, strain, health-related quality of life and overall QoL were collected. Relationships between these variables and overall SCRQoL score were evaluated through correlation, ANOVA and regression analysis to test the construct validity of the scale. Internal reliability was assessed using Cronbach’s alpha and feasibility by the number of missing responses.
Results: The construct validity was supported by statistically significant relationships between SCRQoL and scores on instruments of related constructs, as well as with characteristics of the carer and care recipient in univariate and multivariate analyses. A Cronbach’s alpha of 0.87 (7 items) indicates that the internal reliability of the instrument is satisfactory and a low number of missing responses (<1%) indicates a high level of acceptance.
Conclusions: The results provide evidence to support the construct validity, factor structure, internal reliability and feasibility of the ASCOT-Carer INT4 as an instrument for measuring social care-related quality of life of unpaid carers who care for adults with a variety of long-term conditions, disability or problems related to old age
Promotion of plasma membrane repair by vitamin E
Severe vitamin E deficiency results in lethal myopathy in animal models. Membrane repair is an important myocyte response to plasma membrane disruption injury as when repair fails, myocytes die and muscular dystrophy ensues. Here we show that supplementation of cultured cells with α-tocopherol, the most common form of vitamin E, promotes plasma membrane repair. Conversely, in the absence of α-tocopherol supplementation, exposure of cultured cells to an oxidant challenge strikingly inhibits repair. Comparative measurements reveal that, to promote repair, an anti-oxidant must associate with membranes, as α-tocopherol does, or be capable of α-tocopherol regeneration. Finally, we show that myocytes in intact muscle cannot repair membranes when exposed to an oxidant challenge, but show enhanced repair when supplemented with vitamin E. Our work suggests a novel biological function for vitamin E in promoting myocyte plasma membrane repair. We propose that this function is essential for maintenance of skeletal muscle homeostasis
Stochastic population growth in spatially heterogeneous environments
Classical ecological theory predicts that environmental stochasticity
increases extinction risk by reducing the average per-capita growth rate of
populations. To understand the interactive effects of environmental
stochasticity, spatial heterogeneity, and dispersal on population growth, we
study the following model for population abundances in patches: the
conditional law of given is such that when is small the
conditional mean of is approximately , where and are the abundance and per
capita growth rate in the -th patch respectivly, and is the
dispersal rate from the -th to the -th patch, and the conditional
covariance of and is approximately . We show for such a spatially extended population that if
is the total population abundance, then ,
the vector of patch proportions, converges in law to a random vector
as , and the stochastic growth rate equals the space-time average per-capita growth rate
\sum_i\mu_i\E[Y_\infty^i] experienced by the population minus half of the
space-time average temporal variation \E[\sum_{i,j}\sigma_{ij}Y_\infty^i
Y_\infty^j] experienced by the population. We derive analytic results for the
law of , find which choice of the dispersal mechanism produces an
optimal stochastic growth rate for a freely dispersing population, and
investigate the effect on the stochastic growth rate of constraints on
dispersal rates. Our results provide fundamental insights into "ideal free"
movement in the face of uncertainty, the persistence of coupled sink
populations, the evolution of dispersal rates, and the single large or several
small (SLOSS) debate in conservation biology.Comment: 47 pages, 4 figure
Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.
BACKGROUND: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. METHODS: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. RESULTS: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. CONCLUSION: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. TRIAL REGISTRATION: PROSPERO NO: CRD42013003721
The motion of point particles in curved spacetime
This review is concerned with the motion of a point scalar charge, a point
electric charge, and a point mass in a specified background spacetime. In each
of the three cases the particle produces a field that behaves as outgoing
radiation in the wave zone, and therefore removes energy from the particle. In
the near zone the field acts on the particle and gives rise to a self-force
that prevents the particle from moving on a geodesic of the background
spacetime. The field's action on the particle is difficult to calculate because
of its singular nature: the field diverges at the position of the particle. But
it is possible to isolate the field's singular part and show that it exerts no
force on the particle -- its only effect is to contribute to the particle's
inertia. What remains after subtraction is a smooth field that is fully
responsible for the self-force. Because this field satisfies a homogeneous wave
equation, it can be thought of as a free (radiative) field that interacts with
the particle; it is this interaction that gives rise to the self-force. The
mathematical tools required to derive the equations of motion of a point scalar
charge, a point electric charge, and a point mass in a specified background
spacetime are developed here from scratch. The review begins with a discussion
of the basic theory of bitensors (part I). It then applies the theory to the
construction of convenient coordinate systems to chart a neighbourhood of the
particle's word line (part II). It continues with a thorough discussion of
Green's functions in curved spacetime (part III). The review concludes with a
detailed derivation of each of the three equations of motion (part IV).Comment: LaTeX2e, 116 pages, 10 figures. This is the final version, as it will
appear in Living Reviews in Relativit
The clinical meaningfulness of ADAS-Cog changes in Alzheimer's disease patients treated with donepezil in an open-label trial
Physics, Astrophysics and Cosmology with Gravitational Waves
Gravitational wave detectors are already operating at interesting sensitivity
levels, and they have an upgrade path that should result in secure detections
by 2014. We review the physics of gravitational waves, how they interact with
detectors (bars and interferometers), and how these detectors operate. We study
the most likely sources of gravitational waves and review the data analysis
methods that are used to extract their signals from detector noise. Then we
consider the consequences of gravitational wave detections and observations for
physics, astrophysics, and cosmology.Comment: 137 pages, 16 figures, Published version
<http://www.livingreviews.org/lrr-2009-2
Hyperon Photoproduction in the Nucleon Resonance Region
Cross-sections and recoil polarizations for the reactions gamma + p --> K^+ +
Lambda and gamma + p --> K^+ + Sigma^0 have been measured with high statistics
and with good angular coverage for center-of-mass energies between 1.6 and 2.3
GeV. In the K^+Lambda channel we confirm a structure near W=1.9 GeV at backward
kaon angles, but our data shows a more complex s- and u- channel resonance
structure than previously seen. This structure is present at forward and
backward angles but not central angles, and its position and width change with
angle, indicating that more than one resonance is playing a role. Rising
back-angle cross sections at higher energies and large positive polarization at
backward angles are consistent with sizable s- or u-channel contributions. None
of the model calculations we present can consistently explain these aspects of
the data.Comment: 5 pages, 3 figures, submitted to Physical Review Letter
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