Background. Parkinson’s disease (PD) is a common neurodegenerative disease associated with accumulation of misfolding proteins and increased neuroinflammation, which may further impair the glymphatic ...system. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system activity and its relationship with systemic oxidative stress status in PD patients. Methods. Magnetic resonance imaging and neuropsychological tests were conducted on 25 PD patients with normal cognition (PDN), 25 PD patients with mild cognitive impairment (PD-MCI), 38 PD patients with dementia (PDD), and 47 normal controls (NC). Oxidative stress status was assessed by plasma DNA level. Differences in ALPS-index among the subgroups were assessed and further correlated with cognitive functions and plasma DNA levels. Results. The PD-MCI and PDD groups showed significantly lower ALPS-index compared to normal controls. The ALPS-index was inversely correlated with plasma nuclear DNA, mitochondrial DNA levels, and cognitive scores. Conclusions. Lower diffusivity along the perivascular space, represented by lower ALPS-index, indicates impairment of the glymphatic system in PD patients. The correlation between elevated plasma nuclear DNA levels and lower ALPS-index supports the notion that PD patients may exhibit increased oxidative stress associated with glymphatic system microstructural alterations.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
In this work, we discuss the ammonium nitrogen adsorption and reusability from aqueous solution by using poly(sodium acrylate) (PANa) hydrogels (Polymers 1–6) under different amount of crosslinker ...and initiator. The PANa hydrogels were synthesized from the neutralized acrylic acid (AA) monomer via free radical thermal polymerization by using ammonium persulfate (APS) as an initiator and N,N′‐methylene‐bisacrylamide (MBA) as a crosslinker. These polymers exhibited glass transition temperatures (Tg) of 68–88°C and Td values (5% weight loss temperature) in the range of 190–221°C under nitrogen atmosphere. The PANa hydrogels had swollen ratios ranging from 387 to 4,063%, related to the crosslinking density. The final equilibrium adsorption capacity of the polymers was in the range of 20–39 ppm with an initial ammonium nitrogen concentration of 100 ppm. Among them, Polymer 3 without MBA crosslinker displayed the highest swollen characteristic along with the most efficient adsorption capacity. In comparison, the as‐prepared high crosslinking density hydrogels showed relative lower adsorption capability but higher reusability. The polymer composition in this work determines the ability to absorb and desorb ammonium nitrogen compound.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Aims/Introduction
Clinical studies show that either heart rate variability (HRV) or electrochemical skin conductance (ESC) alone can serve as a simple and objective method for screening ...cardiovascular autonomic neuropathy (CAN). We tested the hypothesis that combining these two quantitative approaches can not only reinforce accuracy in CAN screening but also provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already had CAN in outpatient clinics.
Materials and Methods
Each patient received a complete battery of cardiovascular autonomic reflex tests (CARTs), with ESC measured by SUDOSCAN, time domain of HRV measured by standard deviation of all normal RR intervals (SDNN) and frequency domain of HRV (low frequency LF, high frequency HF, and LF/HF ratio), and peripheral blood studies for vascular risk factors. Severity of CAN was measured by CAN score.
Results
The 90 T2DM patients included 50 males and 40 females. Those with more severe CAN had lower values in feet ESC (P = 0.023) and SDNN (P < 0.0001). Multiple linear regression analysis also showed that feet ESC and SDNN value (P = 0.003 and P < 0.0001) were significantly associated with CAN score. Combining SDNN and feet ESC also can increase the diagnostic accuracy of CAN with respective to sensitivity and specificity by using receiver operating characteristic analysis.
Conclusions
Combining the results of SDNN and feet ESC can not only assess, but also quantitatively reflect the progress or improvement of autonomic nerve function (including sympathetic and parasympathetic activity) in patients with T2DM.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background. Several comorbidities contribute to an increased risk of infections in Parkinson’s disease (PD) as the disease progresses. However, few studies have examined the correlation between ...sepsis and PD. Aim. The aim of this study is to disclose the presentation and outcome of serious infection in patients with PD in the emergency department. Methods. This retrospective cohort study enrolled patients with PD who had serious infection and were admitted to the emergency department between January 2007 and December 2013. For clinical comparison, we compared the clinical features, laboratory data, and outcomes with those of age- and sex-matched patients who had serious infection but not PD. Results. There were a total of 1,200 episodes of infected PD patients and 2,400 age- and sex-matched infected patients without PD as disease controls. PD patients had fewer comorbidities and lower severity of infectious disease but longer hospital stays than control group patients. The incidences of respiratory tract and urinary tract infections were higher in PD patients. The levels of inflammatory and organ dysfunction biomarkers in PD were lower and compatible with the severity of infectious disease. A total of 86 (7.2%) infected PD patients died during the 28-day admission compared to 339 (14.1%) in non-PD patients. Serum C-reactive protein, bandemia, and lactate could be used to predict mortality in infected PD patients. Conclusions. In infected patients with PD, respiratory and urinary tract infections were the two most common infectious sources. Empiric therapy based on experience could treat both respiratory and urinary tract infections. Early diagnosis and treatment are essential for survival.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
To realize the superiority of data transmission with reduced modal dispersion in OM4- and OM5-mulitmode fiber (MMF), a single transverse mode (SM) vertical cavity surface emitting laser (VCSEL), ...directly encoded with large-capacity data formats for transmissions in OM5-MMF and OM4-MMF, are compared. The SM-VCSEL contains a 12-μm mesa formed by double-oxidized AlGaAs layers, which confines a current-flow area within an aperture of 3 μm. The SM-VCSEL is lasing with a carrier-to-noise ratio of 34.4 dB and a linewidth of 0.05 nm. The SM-VCSEL is biased at 10Ith to provide a modulation bandwidth of 21.4 GHz and a relative intensity noise of -138 dBc/Hz. By encoding the SM-VCSEL with four-level pulse amplitude modulation (PAM-4) at 64 Gbit/s, the bit error ratio (BER) of 32-GBaud PAM-4 data is improved from 7.9 × 10 -5 to 4.9 × 10 -5 under a KP4-FEC criterion by replacing OM4-MMF with OM5-MMF. After OM5-MMF transmission, a bathtub BER plot shows bottom-eye, middle-eye, and top-eye jitter tolerances of 9.3, 10.6, and 7.1 ps, which are much wider than 6.9, 10.1, and 6.5 ps for OM4-MMF, respectively. When encoding the 16-QAM OFDM at 100 Gbit/s, OM5-MMF allows data transmission at 96-Gbit/s with a corresponding error vector magnitude, signal-to-noise ratio, and BER of 16.7%, 15.4 dB, and 3.6 × 10 -3 under preleveling at a slope of 0.3 dB/GHz. Because of the high effective modal bandwidth and low modal dispersion of the OM5-MMF, a relatively low receiving power penalty of 0.1 dB between 100-m and back-to-back (BtB) transmissions is obtained with either the pre-emphasized PAM-4 or the preleveled QAM-OFDM data format. By contrast, the receiving power penalty is 1.04 dB between 100 m and BtB cases during OM4-MMF transmission.
Tourist citizenship behaviours play a crucial role in the cocreation of tourism experience, yet few studies have determined the antecedent variables affecting such behaviours. The present study ...investigated the association between tour leader likeability and tourist citizenship behaviours and the mediating influence of perceived value. Survey data from 264 tourists indicated that tour leader likeability positively affected perceived value and tourist citizenship behaviours. Perceived value positively affected tourist citizenship behaviours. Perceived value mediated the relationship between tour leader likeability and tourist citizenship behaviours. The research contributed to increase knowledge by providing insights on the relationships among tour leader likeability, perceived value, and tourist citizenship behaviours with a focus on tourist value cocreation. The results can be applied to travel managers in terms of human resource management and customer relationships.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Mortality and disability following ischemic stroke (IS) remains unacceptably high with respect to the conventional therapies. This study tested the effect of erythropoietin (EPO) on long-term ...neurological outcome in patients after acute IS. This study aimed to evaluate the safety and efficacy of two consecutive doses of EPO (5,000 IU/dose, subcutaneously administered at 48 hours and 72 hours after acute IS) on improving the 90-day combined endpoint of recurrent stroke or death that has been previously reported. A secondary objective was to evaluate the long-term (that is, five years) outcome of patients who received EPO.
This was a prospective, randomized, placebo-controlled trial that was conducted between October 2008 and March 2010 in a tertiary referral center. IS stroke patients who were eligible for EPO therapy were enrolled into the study.
The results showed that long-term recurrent stroke and mortality did not differ between group 1 (placebo-control; n = 71) and group 2 (EPO-treated; n = 71). Long-term Barthel index of <35 (defining a severe neurological deficit) was lower in group 2 than group 1 (P = 0.007). Multiple-stepwise logistic-regression analysis showed that EPO therapy was significantly and independently predictive of freedom from a Barthel index of <35 (P = 0.029). Long-term major adverse neurological event (MANE; defined as: death, recurrent stroke, or long-term Barthel index < 35) was lower in group 2 than group 1 (P = 0.04). Log-Rank test showed that MANE-free rate was higher in group 2 than group 1 (P = 0.031). Multiple-stepwise Cox-regression analysis showed that EPO therapy and higher Barthel Index at day 90 were independently predictive of freedom from long-term MANE (all P <0.04).
EPO therapy significantly improved long-term neurological outcomes in patients after IS.
ISRCTN71371114 . Registered 10 October 2008.
The sensitivity and specificity of biomarkers and scoring systems used for predicting fatality of severe sepsis patients remain unsatisfactory. This study aimed to determine the prognostic value of ...circulating plasma DNA levels in severe septic patients presenting at the Emergency Department (ED).
Sixty-seven consecutive patients with severe sepsis and 33 controls were evaluated. Plasma DNA levels were estimated by real-time quantitative polymerase chain reaction assay using primers for the human β-hemoglobin and ND2 gene. The patients' clinical and laboratory data on admission were analyzed.
The median plasma nuclear and mitochondria DNA levels for severe septic patients on admission were significantly higher than those of the controls. The mean plasma nuclear DNA level on admission correlated with lactate concentration (γ = 0.36, p = 0.003) and plasma mitochondrial DNA on admission (γ = 0.708, p < 0.001). Significant prognostic factors for fatality included mechanical ventilation within the first 24 hours (p = 0.013), mean sequential organ failure assessment (SOFA) score on admission (p = 0.04), serum lactate (p < 0.001), and both plasma nuclear and mitochondrial DNA on admission (p < 0.001). Plasma mitochondrial DNA was an independent predictor of fatality by stepwise logistic regression such that an increase by one ng/mL in level would increase fatality rate by 0.7%.
Plasma DNA has potential use for predicting outcome in septic patients arriving at the emergency room. Plasma mitochondrial DNA level on admission is a more powerful predictor than lactate concentration or SOFA scores on admission.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
By using the Lu 3 Al 5 O 12 :Ce 3+ /CaAlSiN 3 :Eu 2+ phosphor codoped fluorescent glass as a phosphor in front of an InGaN laser diode (LD), a novel white-lighting and visible light communication ...(VLC) module is demonstrated. By enlarging the fluorescent glass thickness from 0.7 to 1 mm, the CCT of the generated white light is increased from 7373 to 25000 K, and the maximal illuminance is enlarged from 1306 to 1356 lux. The pure LD-beam-based VLC can lengthen its transmission distance from 0.5 to 16 m, associated with allowable data rate slightly decreased from 14.8 to 10.8 Gb/s. When using the divergent white light as a carrier for VLC transmission, the allowable data rate upgrades from 1.6 to 4.4 Gb/s within 0.5-m distance in free space by thinning the fluorescent glass from 1 to 0.7 mm. Lengthening the white-lighting distance to 1 m for the VLC system still permits 16-QAM OFDM data transmission as high as 2.8 Gb/s. Such a Lu 3 Al 5 O 12 :Ce 3+ /CaAlSiN 3 :Eu 2+ phosphor codoped fluorescent glass not only converts the blue LD beam for white lighting efficiently, but also preserves sufficient data capacity with acceptable signal-to-noise ratio for indoor VLC application.
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