Predicting ambulatory capacity in Parkinson's disease to analyze progression, biomarkers, and trial design

Background: In Parkinson's disease (PD), gait and balance is impaired, relatively resistant to available treatment and associated with falls and disability. Predictive models of ambulatory progression could enhance understanding of gait/balance disturbances and aid in trial design. Objectives: To predict trajectories of ambulatory abilities from baseline clinical data in early PD, relate trajectories to clinical milestones, compare biomarkers, and evaluate trajectories for enrichment of clinical trials. Methods: Data from two multicenter, longitudinal, observational studies were used for model training (Tracking Parkinson's, n = 1598) and external testing (Parkinson's Progression Markers Initiative, n = 407). Models were trained and validated to predict individuals as having a “Progressive” or “Stable” trajectory based on changes of ambulatory capacity scores from the Movement Disorders Society Unified Parkinson's Disease Rating Scale parts II and III. Survival analyses compared time-to-clinical milestones and trial outcomes between predicted trajectories. Results: On external evaluation, a support vector machine model predicted Progressive trajectories using baseline clinical data with an accuracy, weighted-F1 (proportionally weighted harmonic mean of precision and sensitivity), and sensitivity/specificity of 0.735, 0.799, and 0.688/0.739, respectively. Over 4 years, the predicted Progressive trajectory was more likely to experience impaired balance, loss of independence, impaired function and cognition. Baseline dopamine transporter imaging and select biomarkers of neurodegeneration were significantly different between predicted trajectory groups. For an 18-month, randomized (1:1) clinical trial, sample size savings up to 30% were possible when enrollment was enriched for the Progressive trajectory versus no enrichment. Conclusions: It is possible to predict ambulatory abilities from clinical data that are associated with meaningful outcomes in people with early PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Propriedades mesomórficas de tensioactivos cataniónicos

Dissertação apresentada à Universidade de Coimbra para cumprimento dos requisitos necessário à obtenção de grau de Mestre em Química, na especialidade de Química FísicaNeste trabalho foram preparados vários compostos de uma nova classe de moléculas anfifílicas, os tensioactivos cataniónicos, resultantes da formação de um par tensioactivo aniónico-catiónico com remoção dos respectivos contra-iões. Após a síntese dos compostos, foi efectuado um estudo do seu comportamento de fase térmico (termotrópico) e em meio aquoso (liotrópico). Os tensioactivos preparados diferem quanto ao número total de caudas (2 ou 3 caudas), quanto ao número de carbonos nas caudas (de 8 até 18) e quanto à natureza química das cabeças hidrofílicas (amónio, sulfato e carboxilato). Dada a diversidade dos compostos preparados, pretendeu-se esclarecer a influência da geometria e natureza química dos compostos no comportamento de fase desta classe de tensioactivos. A caracterização da fase sólida e a análise dos comportamentos termotrópicos e liotrópicos dos compostos foram realizadas com base nas técnicas de: microanálise elemental, absorção atómica, condutividade, microscopia óptica com luz polarizada, análise térmica diferencial (DTA), calorimetria diferencial de varrimento (DSC), difracção de raios-X de pequeno ângulo (SAXS), penetração de fase com varrimento e microscopia de transmissão electrónica com criogenia (Cryo-TEM). Com base nos resultados experimentais pretende-se fazer um estudo de descrição e racionalização das propriedades dos tensioactivos cataniónicos, nomeadamente o estudo do efeito da assimetria estrutural das moléculas na natureza e sequência de mesofases formadas

The effects of building management practices on residential property prices in Hong Kong

Building management and maintenance has gained its importance after a series of disastrous building-related incidents in Hong Kong. To facilitate the management of an apartment building, homeowners usually form an owners’ association among themselves and/or appoint an external property management agent (PMA) to manage the building on their behalf. Empirical studies found that the involvement of these bodies was conducive to a better-performing built environment, and that premium was added to better-performing properties. Yet, these studies often took the formation of owners’ association and engagement of external PMA in a building as dichotomous variables in exploratory models, and thus ignored the variations in the adopted building management practices in different buildings even with the same building management setting. Making use of the data collected from two previous research projects, a hedonic price analysis was carried out to study whether specific building management practices added value to the properties concerned. The analysis results indicated that properties in buildings with good documentations (eg keeping of as-built architectural drawings and incident records), thoughtful emergency planning (eg presence of emergency plan and regular fire drills) and property-all-risk insurance coverage were sold at a premium, ceteris paribus. Policy and practical implications then follow

Principle of selectivity in housing rehabilitation subsidies: case study in Hong Kong

Housing subsidies have to be selective given the tight public budget and need for public accountability. Nevertheless, inappropriately chosen screening criteria can result in inefficient resource allocation. This article attempts to empirically justify the selection or eligibility criteria of subsidy schemes for housing rehabilitation in Hong Kong where urban decay has been an age-old problem. It outlines the development of a statistical model designed to identify determinants of the dilapidation level of housing in the city. Based on the results of a dilapidation assessment on 390 multiowned apartment buildings using the Dilapidation Index, the extent to which the residential buildings under investigation were dilapidated was regressed against the eligibility criteria. The results revealed that older and unmanaged buildings were more derelict, with the development scale and rateable value correlated to the dilapidation level. The article concludes with policy considerations and practical implications

Assessing the disability inclusiveness of university buildings

With rights to access becoming basic human rights, a tool for building disability inclusiveness assessment is necessary to tell how far we have gone to include people with disabilities in buildings. This article proposes a Building Inclusiveness Assessment Score (BIAS) framework which is made up of two hierarchies of inclusion attributes, namely the Physical Disability Inclusion Sub-score (PDIS) and the Visual Impairment Inclusion Sub-score (VIIS). The tool allows simple, quantitative and more objective assessments of buildings. Using the tool, forty-eight university buildings from four universities in Hong Kong were assessed for illustrating its real-life application

Achieving sustainable urban renewal in Hong Kong: strategy for dilapidation assessment of high rises

Approximately 4% of the private buildings in Hong Kong are older than their design lives of 50 years. In addition to the engineering factor, the lack of timely maintenance and proper management has led to a serious problem of building dilapidation in the old urban areas. On account of the high-rise high-density urban setting in Hong Kong, the problem has engendered severe safety and health hazards for the local community. Although different ways of urban renewal or regeneration exist to revitalize the urban environment, it appears that redevelopment is most frequently used. However, the speed of dilapidation would probably exceed the economy’s capability of absorbing redevelopments. In addition, redevelopments have detrimental effects on the social fabric and create a large volume of demolition and construction waste that greatly surpasses the current landfill capacity in Hong Kong. A sustainable strategy for urban renewal is, therefore, urgently needed. This research aims to establish an existing profile of the building conditions in Hong Kong and evaluate the suitability of various urban renewal strategies for different buildings through the establishment of a structured building assessment scheme called the Dilapidation Index (DI). In total, 393 private residential buildings randomly selected from 4 districts in Hong Kong were assessed by using the DI. The results indicated that the assessed buildings in Sham Shui Po were more problematic than those in other districts. The results also suggested that physical conditions and management factors play nearly equal parts in differentiating the well-performing buildings from the dilapidated ones. The DI developed in this research is beneficial to different parties with an interest in the quality of the urban built environment because it can help people identify problematic buildings for further actions

Urban renewal in Hong Kong: a community aspiration study

Coupled with the growing number of aged private residential buildings, the lack of proper building care culture has led to serious problems of building dilapidation and urban decay in Hong Kong, particularly in the old urban areas. Not only is the cityscape ruined, but also the health and safety of the residents and general public as a whole are jeopardized. To arrest urban decay, redevelopment has long been adopted to renew rundown areas. However, the approach usually has a negative impact on the existing social fabric and causes a reduction in social capital. Given that older buildings usually have a larger proportion of older residents, and that the elderly population tends to be financially less well-off, this group of residents is more adversely affected by the negative impact of social destruction due to redevelopment. Recently, building rehabilitation has been gaining popularity. Yet, with a view to a sustainable strategy for urban renewal, it is necessary to balance the interests of different stakeholders. The alternative ways the community perceives different approaches to urban renewal in Hong Kong is a worthwhile topic to study. In this paper, the community\u27s attitudes towards redevelopment and rehabilitation as urban renewal options are examined through a structured questionnaire survey. The survey findings are discussed with emphases on their policy implications. Recommendations will be drawn with respect to the community engagement process that enhances the likelihood of arriving at a more balanced urban renewal strategy

A survey of the health and safety conditions of apartment buildings in Hong Kong

A high-density built environment poses challenges to the idea of sustainable development in respect of health (e.g. SARS outbreak) and safety (e.g. fire and structural problems). To examine the seriousness of the high-density problem, this study aims to survey the health and safety performance of apartment buildings in a densely populated city, Hong Kong, using a simplified assessment scheme. An assessment scheme based on a hierarchy of building performance indicators concerning the quality of: (a) architectural design, (b) building services design, (c) the surrounding environment, (d) operations and maintenance, and (e) management approaches was developed. One hundred forty (140) apartment buildings were surveyed and assessed through site inspections, desk searches, and interviews. A performance analysis was conducted to examine and compare the overall health and safety performance of the buildings. We found that there were considerable variations in health and safety conditions across buildings, even though they are located within a single district. Most of the variations in building health and safety conditions were attributed to differences in building management systems rather than building design. Enhancing strategic management approaches (e.g. a better delineation of owners’ rights and duties) appears to be the most critical factor that underperformers should consider in order to improve their buildings