Health-related quality of life in the Cambridge City over-75s Cohort (CC75C): development of a dementia-specific scale and descriptive analyses.

BACKGROUND: The assessment of Health Related Quality of Life (HRQL) is important in people with dementia as it could influence their care and support plan. Many studies on dementia do not specifically set out to measure dementia-specific HRQL but do include related items. The aim of this study is to explore the distribution of HRQL by functional and socio-demographic variables in a population-based setting. METHODS: Domains of DEMQOL's conceptual framework were mapped in the Cambridge City over 75's Cohort (CC75C) Study. HRQL was estimated in 110 participants aged 80+ years with a confirmed diagnosis of dementia with mild/moderate severity. Acceptability (missing values and normality of the total score), internal consistency (Cronbach's alpha), convergent, discriminant and known group differences validity (Spearman correlations, Wilcoxon Mann-Whitney and Kruskal-Wallis tests) were assessed. The distribution of HRQL by socio-demographic and functional descriptors was explored. RESULTS: The HRQL score ranged from 0 to 16 and showed an internal consistency Alpha of 0.74. Validity of the instrument was found to be acceptable. Men had higher HRQL than women. Marital status had a greater effect on HRQL for men than it did for women. The HRQL of those with good self-reported health was higher than those with fair/poor self-reported health. HRQL was not associated with dementia severity. CONCLUSIONS: To our knowledge this is the first study to examine the distribution of dementia-specific HRQL in a population sample of the very old. We have mapped an existing conceptual framework of dementia specific HRQL onto an existing study and demonstrated the feasibility of this approach. Findings in this study suggest that whereas there is big emphasis in dementia severity, characteristics such as gender should be taken into account when assessing and implementing programmes to improve HRQL.

Environmental factors, spatial variation, and specific requirements of Chironomidae in Mediterranean reference streams

Chironomidae spatial distribution was investigated at 63 near-pristine sites in 22 catchments of the Iberian Mediterranean coast. We used partial redundancy analysis to study Chironomidae community responses to a number of environmental factors acting at several spatial scales. The percentage of variation explained by local factors (23.3%) was higher than that explained by geographical (8.5%) or regional factors(8%). Catchment area, longitude, pH, % siliceous rocks in the catchment, and altitude were the best predictors of Chironomidae assemblages. We used a k-means cluster analysis to classified sites into 3 major groups based on Chironomidae assemblages. These groups were explained mainly by longitudinal zonation and geographical position, and were defined as 1) siliceous headwater streams, 2) mid-altitude streams with small catchment areas, and 3) medium-sized calcareous streams. Distinct species assemblages with associated indicator taxa were established for each stream category using IndVal analysis. Species responses to previously identified key environmental variables were determined, and optima and tolerances were established by weighted average regression. Distinct ecological requirements were observed among genera and among species of the same genus. Some genera were restricted to headwater systems (e.g., Diamesa), whereas others (e.g., Eukiefferiella) had wider ecological preferences but with distinct distributions among congenerics. In the present period of climate change, optima and tolerances of species might be a useful tool to predict responses of different species to changes in significant environmental variables, such as temperature and hydrology.

Prevalencia de la sintomatología del Síndrome de Asperger y variables asociadas en preescolares españoles

Asperger’s Syndrome (AS) forms part of the whole spectrum of autistic disorders. Until recently it has not been studied in early ages. The aim of this study is to determine the AS’s prevalence of symptoms in general preschool, rural and urban population. In addition, the association of the development areas and symptoms of anxiety and the presence of symptoms of AS was analized. The sample ofthis study consisted in 1104 preschool children between 3-6 years old. The presence of AS’s symptoms was evaluated by a screening tool for psychiatric disorders. This tool was applied to both, preschooler’s parents and their teachers The prevalence of symptoms of AS for parents and teachers was 11.7‰ and 8.1‰, respectively. The presence of AS’s symptoms was associated with language compression delays, general and fine motor coordination, self-help skills and impairment in game activities. In addition, our results showed that the AS has a strong association with specific phobia symptoms and tics. We conclude that an early detection of AS’s symptoms is possible since we found similar prevalence described in other recent researches. Given the impairment associated with AS, its detection is highly recommended

Determination of phenobarbital in human plasma by a specific liquid chromatography method: application to a bioequivalence study

A liquid chromatography method was developed and validated for the determination of phenobarbital in human plasma using phenytoin as internal standard. The drugs were extracted from plasma by liquid-liquid extraction and separated isocratically on a C12 analytical column, maintained at 35 ºC, with water:acetonitrile:methanol (58.8:15.2:26, v/v/v) as mobile phase, run at a flow rate of 1.2 mL/min with detection at 205 nm. The method was linear in the range of 0.1-4 μg/mL (r²=0.9999) and demonstrated acceptable results for the precision, accuracy and stability studies. The method was successfully applied for the bioequivalence study of two tablet formulations (test and reference) of phenobarbital 100 mg after single oral dose administration to healthy human volunteers.

Production of policlonal antisera specific to plant viruses by rabbit oral immunization

Serological techniques are of great importance for plant virus identification and characterization. The major limiting factor for using these techniques for plant virus identification is the requirement of a good virus purified preparation to be used in immunizing animals for antiserum production. In the present study, two New Zealand rabbits were orally immunized with extracts from cowpea (Vigna unguiculata) plants systemically infected with Cowpea severe mosaic virus (CPSMV) and with extracts from papaya (Carica papaya) infected with Papaya lethal yellowing virus (PLYV). The leaf extracts were prepared in saline solution 0.15 M in the rate of 1:1 (w/v) and clarified by a centrifugation of 10,000 g for 10 min. The clarified extracts containing the viruses were orally administered to the New Zealand rabbits in two series of five daily doses of 1.0 ml each. The obtained policlonal antisera were shown to be very specific to their respective viruses in double immunodiffusion and indirect ELISA. These seem to be the first antisera specific for plant virus obtained by rabbit oral immunization. The results open up some possibilities for producing antisera to plant viruses of difficult purification. It is a simple, fast and inexpensive method for production of antisera for plant viruses when compared to the traditional techniques that involve rabbit injections with purified virus preparations.

A model for specific interactions of manganese-phthalocyanine in protic media

Extinction coefficients (e) changes of manganese phthalocyanine (Mn-Pc) were studied in different organic solvents and related to solvent polarity scales; (Kosower's values (Z), Dimroth's values (E T), donor numbers (DN) and linear solvation energy relationships (LSER) or linear free energy relationships (LFER));, theoretical molecular orbital calculations and ligand/solvent coordination processes in order to predict molecular interaction with the medium and identification of predominant intermolecular forces.

Islet antigen-specific T cells and regulatory T cells in type 1 diabetes

T cells are the key players in the development of type 1 diabetes (T1D), mediating autoimmune reactions leading to the destruction of insulin producing beta cells in the islets. We aimed to analyze the role of different T-cell subtypes in the autoimmunity and pathogenesis of T1D. The frequency of islet antigen-specific (GAD65-, proinsulin-, and insulin-specific) CD4+ T cells was investigated in vitro in T1D patients, at-risk individuals (diabetes-associated autoantibody positive), and in controls, using MHC class II tetramers. An overall higher frequency of CD4+ T-cells recognizing the GAD65 555−567 peptide was detected in at-risk individuals. In addition, increased CD4+ T-cell responses to the same GAD65 epitope displaying a memory phenotype were observed in at-risk and diabetic children, which demonstrate a previous encounter with the antigen in vivo. Avidity and phenotypic differences were also observed among CD4+ T-cell clones induced by distinct doses of GAD65 autoantigen. T-cell clones generated at the lowest peptide dose displayed the highest avidity and expressed more frequently the TCR Vβ5.1 chain than low-avidity T cells. These findings raise attention to the antigen dose when investigating the diversity of antigen-specific T cells. Furthermore, an increased regulatory response during the preclinical phase of T1D was also found in genetically at-risk children. Higher frequencies of regulatory T (Treg) cells (CD4+CD25_high HLA-DR-/CD69-) and natural killer T (NKT) cells (CD161+Vbeta11+) were observed in children with multiple autoantibodies compared to autoantibody-negative controls. Taken together, these data showed increased frequency of islet-specific CD4+ T-cells, especially to the GAD65 555-567 epitope, and Treg and NKT cell upregulation in children at-risk for T1D, suggesting their importance in T1D pathogenesis

Lifelong learning travels : single actors´ perception and talk of lifelong learning in a specific organizational context

I mars 2003 certifierades en finländsk advokatbyrå av den Europeiska kommissionen som den bästa i Europa inom specialkategorin livslångt lärande. Advokatbyrån var överraskad över utnämningen emedan de inte aktivt och/eller medvetet implementerat eller utövat en livslångt lärandestrategi i sin verksamhet bland sin personal. Byrån deltog i en tävling om bästa arbetsplats i Europa ("Best workplaces in Europe 2003") utan att vara medveten om den Europeiska kommissionens special- kategorier. Emedan advokatbyrån inte medvetet implementerat en livslångt lärandestrategi bland sin personal formar aktörerna, vars uppfattning och prat denna avhandling handlar om, sina föreställningar och sitt prat om livslångt lärande efter utnämningen. Översättningsprocessen av en idé utlöses sålunda i denna studie av en extern händelse. I sin avhandling beskriver Annica Isacsson hur och varför en idé (livslångt lärande) föds (på nytt) på en institutionell nivå, hur idén reser och förändras i en process av översättning, hur idén landar i två organisationer samt hur idén om livslångt lärande uppfattas och beskrivs av lokala aktörer i två olika organisationer. Fokus i studien ligger sålunda på enskilda aktörers uppfattning om ett kontroversiellt koncept i en lokal kontext. Teoretiskt möts och sammanlänkas teori om livslångt lärande, sociokulturella teorier om lärande och teorier om organisatoriskt lärande. Isacssons avhandling visar på hur livslångt lärande inte enbart, i en organisatorisk kontext, handlar om individuell kompetensutveckling utan också om organisatoriskt lärande i vilken lärande av andra organisationsmedlemmar och organisationer ingår. Studien visar vidare på hur enskilda aktörers prat påverkas av det institutionella fältet och av den tidsanda inom vilken diskursen livslångt lärande föds, rör sig och ingår.

Applications of graph transformation in tools for domain-specific modeling languages

The use of domain-specific languages (DSLs) has been proposed as an approach to cost-e ectively develop families of software systems in a restricted application domain. Domain-specific languages in combination with the accumulated knowledge and experience of previous implementations, can in turn be used to generate new applications with unique sets of requirements. For this reason, DSLs are considered to be an important approach for software reuse. However, the toolset supporting a particular domain-specific language is also domain-specific and is per definition not reusable. Therefore, creating and maintaining a DSL requires additional resources that could be even larger than the savings associated with using them. As a solution, di erent tool frameworks have been proposed to simplify and reduce the cost of developments of DSLs. Developers of tool support for DSLs need to instantiate, customize or configure the framework for a particular DSL. There are di erent approaches for this. An approach is to use an application programming interface (API) and to extend the basic framework using an imperative programming language. An example of a tools which is based on this approach is Eclipse GEF. Another approach is to configure the framework using declarative languages that are independent of the underlying framework implementation. We believe this second approach can bring important benefits as this brings focus to specifying what should the tool be like instead of writing a program specifying how the tool achieves this functionality. In this thesis we explore this second approach. We use graph transformation as the basic approach to customize a domain-specific modeling (DSM) tool framework. The contributions of this thesis includes a comparison of di erent approaches for defining, representing and interchanging software modeling languages and models and a tool architecture for an open domain-specific modeling framework that e ciently integrates several model transformation components and visual editors. We also present several specific algorithms and tool components for DSM framework. These include an approach for graph query based on region operators and the star operator and an approach for reconciling models and diagrams after executing model transformation programs. We exemplify our approach with two case studies MICAS and EFCO. In these studies we show how our experimental modeling tool framework has been used to define tool environments for domain-specific languages.

Transcriptional Profiling of Organ‐Specific Autoimmunity in Human

Our understanding of the pathogenesis of organ‐specific autoinflammation has been restricted by limited access to the target organs. Peripheral blood, however, as a preferred transportation route for immune cells, provides a window to assess the entire immune system throughout the body. Transcriptional profiling with RNA stabilizing blood collection tubes reflects in vivo expression profiles at the time the blood is drawn, allowing detection of the disease activity in different samples or within the same sample over time. The main objective of this Ph.D. study was to apply gene‐expression microarrays in the characterization of peripheral blood transcriptional profiles in patients with autoimmune diseases. To achieve this goal a custom cDNA microarray targeted for gene‐expression profiling of human immune system was designed and produced. Sample collection and preparation was then optimized to allow gene‐expression profiling from whole‐blood samples. To overcome challenges resulting from minute amounts of sample material, RNA amplification was successfully applied to study pregnancy related immunosuppression in patients with multiple sclerosis (MS). Furthermore, similar sample preparation was applied to characterize longitudinal genome‐wide expression profiles in children with type 1 diabetes (T1D) associated autoantibodies and eventually clinical T1D. Blood transcriptome analyses, using both the ImmunoChip cDNA microarray with targeted probe selection and genome‐wide Affymetrix U133 Plus 2.0 oligonucleotide array, enabled monitoring of autoimmune activity. Novel disease related genes and general autoimmune signatures were identified. Notably, down‐regulation of the HLA class Ib molecules in peripheral blood was associated with disease activity in both MS and T1D. Taken together, these studies demonstrate the potential of peripheral blood transcriptional profiling in biomedical research and diagnostics. Imbalances in peripheral blood transcriptional activity may reveal dynamic changes that are relevant for the disease but might be completely missed in conventional cross‐sectional studies.

Reduction of specific energy consumption of a thermomechanical pulping plant

Kuumahiertoprosessi on erittäin energiaintensiivinen prosessi, jonka energianominaiskulutus (EOK) on yleisesti 2–3.5 MWh/bdt. Noin 93 % energiasta kuluu jauhatuksessa jakautuen niin, että kaksi kolmasosaa kuluu päälinjan ja yksi kolmasosa rejektijauhatuksessa. Siksi myös tämän työn tavoite asetettiin vähentämään energian kulutusta juuri pää- ja rejektijauhatuksessa. Päälinjan jauhatuksessa tutkimuskohteiksi valittiin terityksen, tehojaon ja tuotantotason vaikutus EOK:een. Rejektijauhatuksen tehostamiseen pyrittiin yrittämällä vähentää rejektivirtaamaa painelajittelun keinoin. Koska TMP3 laitoksen jauhatuskapasiteettia on nostettu 25 %, tavoite oli nostaa päälinjan lajittelun kapasiteettia saman verran. Toisena tavoitteena oli pienentää rejektisuhdetta pää- ja rejektilajittelussa ja siten vähentää energiankulutusta rejektijauhatuksessa. Näitä tavoitteita lähestyttiin vaihtamalla päälinjan lajittimiin TamScreen-roottorit ja rejektilajittimiin Metso ProFoil-roottorit ja optimoimalla kuitufraktiot sihtirumpu- ja prosessiparametrimuutoksin. Syöttävällä terätyypillä pystyttiin vähentämään EOK:ta 100 kWh/bdt, mutta korkeampi jauhatusintensiteetti johti myös alempiin lujuusominaisuuksiin, korkeampaan ilmanläpäisyyn ja korkeampaan opasiteettiin. Myös tehojaolla voitiin vaikuttaa EOK:een. Kun ensimmäisen vaiheen jauhinta kuormitettiin enemmän, saavutettiin korkeimmillaan 70 kWh/bdt EOK-vähennys. Tuotantotason mittaamisongelmat heikensivät tuotantotasokoeajojen tuloksia siinä määrin, että näiden tulosten perusteella ei voida päätellä, onko EOK tuotantotasoriippuvainen vai ei. Päälinjan lajittelun kapasiteettia pystyttiin nostamaan TS-roottorilla vain 18 % jääden hieman tavoitetasosta. Rejektilajittelussa pystyttiin vähentämään rejektimäärää huomattavasti Metso ProFoil-roottorilla sekä sihtirumpu- ja prosessiparametrimuutoksin. Lajittamokehityksellä saavutettu EOK-vähennys arvioitiin massarejektisuhteen pienentymisen ja rejektijauhatuksessa käytetyn EOK:n avulla olevan noin 130 kWh/bdt. Yhteenvetona voidaan todeta, että tavoite 300 kWh/bdt EOK-vähennyksestä voidaan saavuttaa työssä käytetyillä tavoilla, mikäli niiden täysi potentiaali hyödynnetään tuotannossa.

Free Prostate-specific Antigen Forms and Kallikrein-related Peptidase 2: Tools for Prostate Cancer Diagnostics

Prostate-specific antigen (PSA) is a marker that is commonly used in estimating prostate cancer risk. Prostate cancer is usually a slowly progressing disease, which might not cause any symptoms whatsoever. Nevertheless, some cases of cancer are aggressive and need to be treated before they become life-threatening. However, the blood PSA concentration may rise also in benign prostate diseases and using a single total PSA (tPSA) measurement to guide the decision on further examinations leads to many unnecessary biopsies, over-detection, and overtreatment of indolent cancers which would not require treatment. Therefore, there is a need for markers that would better separate cancer from benign disorders, and would also predict cancer aggressiveness. The aim of this study was to evaluate whether intact and nicked forms of free PSA (fPSA-I and fPSA-N) or human kallikrein-related peptidase 2 (hK2) could serve as new tools in estimating prostate cancer risk. First, the immunoassays for fPSA-I and free and total hK2 were optimized so that they would be less prone to assay interference caused by interfering factors present in some blood samples. The optimized assays were shown to work well and were used to study the marker concentrations in the clinical sample panels. The marker levels were measured from preoperative blood samples of prostate cancer patients scheduled for radical prostatectomy. The association of the markers with the cancer stage and grade was studied. It was found that among all tested markers and their combinations especially the ratio of fPSA-N to tPSA and ratio of free PSA (fPSA) to tPSA were associated with both cancer stage and grade. They might be useful in predicting the cancer aggressiveness, but further follow-up studies are necessary to fully evaluate the significance of the markers in this clinical setting. The markers tPSA, fPSA, fPSA-I and hK2 were combined in a statistical model which was previously shown to be able to reduce unnecessary biopsies when applied to large screening cohorts of men with elevated tPSA. The discriminative accuracy of this model was compared to models based on established clinical predictors in reference to biopsy outcome. The kallikrein model and the calculated fPSA-N concentrations (fPSA minus fPSA-I) correlated with the prostate volume and the model, when compared to the clinical models, predicted prostate cancer in biopsy equally well. Hence, the measurement of kallikreins in a blood sample could be used to replace the volume measurement which is time-consuming, needs instrumentation and skilled personnel and is an uncomfortable procedure. Overall, the model could simplify the estimation of prostate cancer risk. Finally, as the fPSA-N seems to be an interesting new marker, a direct immunoassay for measuring fPSA-N concentrations was developed. The analytical performance was acceptable, but the rather complicated assay protocol needs to be improved until it can be used for measuring large sample panels.