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Background: The multidisciplinary approach in the management of Amyotrophic Lateral Sclerosis (ALS) has been shown to provide superior care to devolved care, with better survival, improved quality of care, and quality of life. Access to expert multidisciplinary management should be a standard for patients with ALS. This analysis explores the patient journey from symptom onset and first engagement with health services, to the initial visit to a specialist ALS Multidisciplinary Clinic (MDC) in Dublin, Ireland.Methods: A retrospective exploratory multi-method study details the patient journey to the MDC. Data from medical interviews and systematic chart review identifies interactions with the health services and key timelines for thirty five new patients presenting with a diagnosis of ALS during a 6 month period in 2013.Results: The time from first symptom to diagnosis was a mean of 16 months (median 13 months), with a mean interval of 19 months (median 14.6) from first symptoms to arrival at the MDC. The majority of patients were seen by a general practitioner, and subsequently by neurology services. There was an average of four contacts with health services and 4.8 investigations/tests, prior to their first Clinic visit. On the first visit to the MDC patients are linked into an integrated 'system' that can provide specialist care and link with voluntary, palliative and community services as required.Conclusions: Engagement with a multidisciplinary team has implications for service utilization and quality of life of patients and their families. We have demonstrated that barriers exist that delay referral to specialist services. Comprehensive data recording and collection, using multiple data sources can reconstruct the timelines of the patient journey, which can in turn be used to identify pathways that can expedite early referral to specialist services. [ABSTRACT FROM AUTHOR]

In late medieval Bruges, the poor tables, lay-run parochial charitable institutions that fed the resident paupers of the parish, obtained regular income by investing gifts and surplus funds in annuity rents, low-interest loans secured by property. The market in annuity rents provided an important source of inexpensive long-term credit that the merchant bankers, deposit bankers, and pawnbrokers of Bruges did not or could not supply, allowing the property owners of Bruges to draw upon the value of their immovable property without alienating it. Charitable gifts thus not only fed the poor but also kept capital circulating within the urban economy. [ABSTRACT FROM AUTHOR]

Aims: The potential of a powdered preparation of the bacteriocin, lacticin 3147, was investigated for the inhibition of Listeria monocytogenes and Bacillus cereus. Methods and Results: A 10% solution of reconstituted demineralized whey powder was fermented with Lactococcus lactis DPC3147 for the generation of a lacticin 3147 containing powdered product. A 99·9% reduction in L. monocytogenes numbers occurred in the presence of the lacticin 3147 powder within 2 h in natural yogurt, and an 85% reduction was observed in cottage cheese within the same time frame. Counts of B. cereus were reduced by 80% in soup, in the presence of 1% (w/w) lacticin 3147 powder, within 3 h. Conclusions: A powdered preparation of lacticin 3147 was effective for the control of Listeria and Bacillus in natural yogurt, cottage cheese and soup. Significance and Impact of the Study: The bioactive lacticin 3147 powder may find broad applications for control of Gram-positive pathogens/spoilage bacteria in a range of foods. [ABSTRACT FROM AUTHOR]

A physical map of the CXC chemokine locus on chromosome 4 has been constructed by PCR analysis and PFGE mapping of YAC clones. The genes for IL8, GRO1, PPBP, PF4, SCYB5 (ENA-78) and SCYB6 (GCP-2) have been co-localized on a 335-kb genomic fragment. The GRO2 and GRO3 genes did not map within this region and based on analysis of a YAC contig overlapping IL8 we speculate that GRO2 and GRO3 map downstream of this region. We have also assigned the novel CXC chemokine gene, SCYB9B (alias H174/βR1) to chromosome 4q21, upstream and within 12 kb of INP10. Like INP10 and MIG, INP10 and SCYB9B are arranged in a head to tail manner. The chromosomal arrangement of these genes appears to reflect the evolution of this multigene family and supports the theory that it arose by gene duplication. [ABSTRACT FROM AUTHOR]

The document titled "Theme 01 - Epidemiology and Informatics" provides a comprehensive overview of research conducted by multiple authors on the topics of amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The authors explore various aspects of these neurodegenerative diseases, including epidemiology, informatics, and clinical characteristics. The document features a wide range of contributors from different countries, highlighting the global nature of ALS and FTD research. This resource would be valuable for library patrons interested in studying the epidemiology and informatics of ALS and FTD. [Extracted from the article]

We investigate theoretically the role of carrier trapping on the efficiency of single-layer organic light-emitting diodes (OLEDs) by incorporating traps into the OLED device model of Davids et al. [J. Appl. Phys. 82, 6319 (1997)]. Carrier trapping directly affects the density and mobility balance between electrons and holes through its effects on injection and mobility. In addition, trap-mediated changes in density alter recombination rates and spatial profiles of recombination that become important when excited state quenching at metallic contacts is considered. We illustrate these various influences of traps on device efficiency through computations on a series of model devices. Good agreement is obtained with previous experiments by Menon et al. [Chem. Mater. 14, 3668 (2002)], where energetic disorder from transport traps was shown to reduce device efficiency. Our model, however, predicts circumstances where traps will improve device efficiency as well and can assist with selection of contacts to realistic organic materials. [ABSTRACT FROM AUTHOR]

Presents a study which examined the interface between evaporated aluminum and poly(p-phenylenevinylene) (PPV) in situ using x-ray photoelectron spectroscopy. Materials and methods used; Description of the spectrum of a PPV film; Characteristics of the spectra after aluminum metal deposition.

Objective: To evaluate the contribution of composite foods to vegetable and fruit intakes in Irish adults and to compliance with dietary guidelines for vegetable and fruit intake.Design: Data were analysed from the North/South Ireland Food Consumption Survey of 18-64-year-old adults (n=1379; 662 men, 717 women), which used a 7-day food diary to estimate food intake.Results: The mean intake of vegetables (excluding potatoes) was 140 g day(-1) (men 149 g day(-1); women 132 g day(-1)), of fruit was 136 g day(-1) (men 133 g day(-1); women 140 g day(-1)) and of potatoes was 227 g day(-1) (men 296 g day(-1); women 163 g day(-1)). The mean daily intakes of vegetables, fruit and potatoes from composite foods were 37 g (26%), 6 g (5%) and 17 g (7%), respectively. The mean intake of vegetables from composite foods was unrelated to age or gender, but increased with increasing social class and level of education attained. The proportions of men and women meeting the recommendation for >or=400 g day(-1) (5 servings of 80 g per day) of vegetables and fruit were 21% (15% excluding composite foods) and 19% (12% excluding composite foods), respectively. Compliance with the dietary recommendation decreased with decreasing levels of educational attainment and social class.Conclusion: Intakes of vegetables and fruit are low compared with current dietary recommendations, particularly in those of lower levels of educational attainment and social class. Composite foods are an important source of vegetables (less importantly of fruit) and should be included when estimating vegetable intakes. Failure to do so may result in bias in estimates of intake and of compliance with dietary guidelines for population groups, as well as misclassification of individuals by level of intake. [ABSTRACT FROM AUTHOR]

Power wheelchair prescription, utilization, satisfaction, and cost for patients with amyotrophic lateral sclerosis: preliminary data for evidence-based guidelines. Stage at which riluzole treatment prolongs survival in patients with amyotrophic lateral sclerosis: a retrospective analysis of data from a dose-ranging study. Support needs and interventions for family caregivers of patients with amyotrophic lateral sclerosis (ALS): a narrative review with report of telemedicine experiences at the time of COVID-19 pandemic. [Extracted from the article]

2018; 32 (1): 231 - 45. 15 A Programme for Amyotrophic Lateral Sclerosis Care in Europe (ALS-CarE). https://clinicaltrials.gov/ct2/show/NCT03081338. 2010; 9 (3): 327 - 53. 5 A Programme for Amyotrophic Lateral Sclerosis Care in Europe (ALS-CarE). https://clinicaltrials.gov/ct2/show/NCT03081338. ALS Focus-a new survey program for people with ALS and caregivers: results from Survey 1 on insurance needs and financial burdens. [Extracted from the article]

What is known and Objective The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. Methods For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List ( GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme ( HSE- PCRS) dispensing database. Results Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE- PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. What is new and conclusion The HSE- PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation. [ABSTRACT FROM AUTHOR]

A spectroscopic study of the kinetic interaction between protein and gold nanoparticles is presented here. Mie scattering in conjunction with excitation of surface plasmons on the surface of the nanoparticles allows access to kinetic information regarding the interactions. The influence of the geometrical shape and size of the nanoparticles regarding the binding of a protein is investigated. Spherical nanoparticles of 60 and 100 nm diameters as well as ellipsoidal (rod-shaped) particles of dimension 20 by 60 nm for the minor and major axes respectively have been used. By fitting the experimental data with theoretical predictions, the size of the nanoparticle and the distribution in the sample, the shape, the influence of sedimentation and the necessary kinetic parameters have been determined. Simulations were also carried out to predict the Raman spectra of selected molecules for in-depth analysis of the detailed reactions. [ABSTRACT FROM AUTHOR]

Energetic disorder plays a critical role in governing the performance of organic light-emitting diodes (OLEDs). This is particularly true for polymer-based OLEDs in which disorder can be controlled but not eliminated. Contrary to the common assumption that energetic disorder has only a negative effect on performance, we provide experimental evidence of improved efficiency when the energetic disorder is increased upon deliberate addition of traps via an increase in polymer chain length distribution. We use numerical calculations to extract the mechanisms responsible for the observed improvements and discuss the general conditions under which traps can be introduced to increase device efficiency. [ABSTRACT FROM AUTHOR]

Thin polycrystalline films of perylenetetracarboxylic dianyhydride (PTCDA), an organic molecular solid, exhibits substantial anisotropies in its electronic transport properties. Only electrons transport in the directions along molecular planes, while mainly holes transport in the direction normal to molecular planes. A series of measurements on both field effect transistors with PTCDA active layers and light emitting diodes with PTCDA transport layers documents the anisotropy seen in the electronic transport in thin films of PTCDA. © 1997 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, numerous reports describe the generation and increasing utility of non-small-cell lung cancer (NSCLC) patient-derived xenografts (PDX) from tissue biopsies. While PDX have proven useful for genetic profiling and preclinical drug testing, the requirement of a tissue biopsy limits the available patient population, particularly those with advanced oligometastatic disease. Conversely, 'liquid biopsies' such as circulating tumour cells (CTCs) are minimally invasive and easier to obtain. Here, we present a clinical case study of a NSCLC patient with advanced metastatic disease, a never smoker whose primary tumour was EGFR and ALK wild-type. We demonstrate for the first time, tumorigenicity of their CTCs to generate a patient CTC-derived eXplant (CDX). Patients and methods: CTCs were enriched at diagnosis and again 2 months later during disease progression from 10 ml blood from a 48-year-old NSCLC patient and implanted into immunocompromised mice. Resultant tumours were morphologically, immunohistochemically, and genetically compared with the donor patient's diagnostic specimen. Mice were treated with cisplatin and pemetrexed to assess preclinical efficacy of the chemotherapy regimen given to the donor patient. Results: The NSCLC CDX expressed lung lineage markers TTF1 and CK7 and was unresponsive to cisplatin and pemetrexed. Examination of blood samples matched to that used for CDX generation revealed absence of CTCs using the CellSearch EpCAM-dependent platform, whereas size-based CTC enrichment revealed abundant heterogeneous CTCs of which ~80% were mesenchymal marker vimentin positive. Molecular analysis of the CDX, mesenchymal and epithelial CTCs revealed a common somatic mutation confirming tumour origin and showed CDX RNA and protein profiles consistent with the predominantly mesenchymal phenotype. Conclusions: This study shows that the absence of NSCLC CTCs detected by CellSearch (EpCAM+) does not preclude CDX generation, highlighting epithelial to mesenchymal transition and the functional importance of mesenchymal CTCs in dissemination of this disease. [ABSTRACT FROM AUTHOR]

Objective: To describe the consumption of ready-to-eat-breakfast cereals (RTEBCs) in Irish adults and its impact on adequacy and safety of micronutrient intakes and compliance with dietary recommendations.Design: Analysis for this paper used data from the North/South Ireland Food Consumption Survey that estimated habitual food intake using a 7-day food diary in a representative sample of adults aged 18-64 years ( 662 men, 717 women).Results: Despite the small quantity consumed (mean 28.6 g day-1 or 4.7% of total energy intake), RTEBCs made an important contribution to the mean daily intake of carbohydrate (8.1%), starch (10.8%), dietary fibre (9.8%) and non-starch polysaccharides (NSP) (10.8%) in consumers. Increased consumption was associated with a more fibre-dense diet and with greater compliance with dietary recommendations for fat, carbohydrate and NSP. Fortified RTEBCs contributed significantly to mean daily intakes of iron (18%), thiamin (14%), riboflavin (17%), niacin (15%), vitamin B6 (13%), total folate (18%) and vitamin D (10%) and most of the contribution was from micronutrients added to RTEBCs. Increased consumption of fortified RTEBCs was associated with an increased nutrient density for a number of micronutrients and with a lower prevalence of dietary inadequacy of calcium, iron, riboflavin and folate, particularly in women. However, it was not associated with intakes in excess of the Tolerable Upper Intake Level for any micronutrient.Conclusions: The consumption of RTEBCs is associated with improved compliance with dietary recommendations for fat, carbohydrate and fibre, with a more micronutrient-dense diet and a reduced risk of dietary inadequacy for calcium, iron, riboflavin and folate, without increasing the risk of excessive intakes of micronutrients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of primary care group visits (chronic care clinics) on the process and outcome of care for diabetic patients.Research Design and Methods: We evaluated the intervention in primary care practices randomized to intervention and control groups in a large-staff model health maintenance organization (HMO). Patients included diabetic patients > or = 30 years of age in each participating primary care practice, selected at random from an automated diabetes registry. Primary care practices were randomized within clinics to either a chronic care clinic (intervention) group or a usual care (control) group. The intervention group conducted periodic one-half day chronic care clinics for groups of approximately 8 diabetic patients in their respective doctor's practice. Chronic care clinics consisted of standardized assessments; visits with the primary care physician, nurse, and clinical pharmacist; and a group education/peer support meeting. We collected self-report questionnaires from patients and data from administrative systems. The questionnaires were mailed, and telephoned interviews were conducted for nonrespondents, at baseline and at 12 and 24 months; we queried the process of care received, the satisfaction with care, and the health status of each patient. Serum cholesterol and HbA1c levels and health care use and cost data was collected from HMO administrative systems.Results: In an intention-to-treat analysis at 24 months, the intervention group had received significantly more recommended preventive procedures and helpful patient education. Of five primary health status indicators examined, two (SF-36 general health and bed disability days) were significantly better in the intervention group. Compared with control patients, intervention patients had slightly more primary care visits, but significantly fewer specialty and emergency room visits. Among intervention participants, we found consistently positive associations between the number of chronic care clinics attended and a number of outcomes, including patient satisfaction and HbA1c levels.Conclusions: Periodic primary care sessions organized to meet the complex needs of diabetic patients imrproved the process of diabetes care and were associated with better outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Following several reports of linkage of obesity related phenotypes to human chromosome 20q we sought to determine whether variations of the melanocortin 3 receptor (MC3R) gene are associated with obesity. DESIGN: We screened the MC3R gene coding region and approximately 2 kb of 5' and 3' flanking sequences for DNA variants in unrelated extremely obese women and average weight controls using polymerase chain reaction (PCR) single strand conformation polymorphism (SSCP) analysis and DNA sequencing. SUBJECTS: 124 unrelated extremely obese women (body mass index, (BMI) ≥ 40 kg/m²) and 85 average weight controls (BMI <27 kg/m²). MEASUREMENTS: Radiation hybrid (RH) mapping was performed to localize the MC3R gene. 5' and 3' flanking sequences of MC3R gene were cloned. PCR-SSCP and DNA sequencing were used to detect mutations in the MC3R gene coding region and flanking sequences. RESULTS: RH mapping localized the MC3R gene to 20q13, between markers D20S100 and D20S149. 1083 bp 5' and 653 bp 3' flanking region of the MC3R gene were cloned. A missense mutation (±241, codon 81 ATT/GTT, Ile → Val) was found in the IVIC3R coding region. Four more variants were detected in the 5' flanking sequence: -201(C → G), -239 (A → G), -762(A → T) and -769(T → C). Compared with controls, no significant allele frequency differences were found. Racial differences were found for the +241, -201, -239 and -762 polymorphisms. CONCLUSIONS: Several sequence variants were found in the MC3R gene coding region and in 5' flanking sequences. However, none of the variants were associated with obesity phenotypes. The linkage of extreme human obesity on 20q13 is likely caused by genes other than MC3R. [ABSTRACT FROM AUTHOR]

Objectives: To define discrete developmental levels of understanding of the ways in which normal children and adolescents link autonomy and will to moral obligation and to study the correlation between this progression and previously identified stages of conscience conceptualization.Method: One hundred thirty-two normal volunteers between the ages of 5 and 17 years were individually interviewed using the moral volition section of the semistructured Stilwell Conscience Interview. Analysis of the interviews resulted in five levels of understanding of moral self-evaluation and volitionally chosen behavior.Results: Analyses of variance and covariance showed that the five levels of moral volition had significant correlation with five conceptualization stages, with stage criteria showing a stronger correlation than age. Self-identified tasks of oughtness were hierarchically defined beginning with those defining a morality of restraint followed by moralities of mastery/sufficiency, virtuous striving, idealization, and individual responsibility. Perception of increased independence of self in interaction with conscience was noteworthy at stages 4 and 5.Conclusions: Moral volition is the domain of conscience functioning that defines understanding of moral self-evaluation and volitionally chosen actions; five levels of understanding can be demonstrated in normal children between the ages of 5 and 17 years. [ABSTRACT FROM AUTHOR]