Grasping the big picture: impact analysis of screening tools for timely referral for device-aided therapies.

Several screening tools are available to assist general neurologists in the timely identification of patients with advanced Parkinson's disease (PD) who may be eligible for referral for a device-aided therapy (DAT). However, it should be noted that not all of these clinical decision rules have been developed and validated in a thorough and consistent manner. Furthermore, only a limited number of head-to-head comparisons have been performed. Available studies suggest that D-DATS has a higher positive predictive value and higher specificity than the 5-2-1 criteria, while the sensitivity of both screening tools is similar. However, unanswered questions remain regarding the validity of the decision rules, such as whether the diagnostic performance measures from validation studies are generalizable to other populations. Ultimately, the question is whether a screening tool will effectively and efficiently improve the quality of life of patients with PD. To address this key question, an impact analysis should be performed. The authors intend to set up a multinational cluster randomised controlled trial to compare the D-DATS and 5-2-1 criteria on the downstream consequences of implementing these screening tools, with a particular focus on the impact on disability and quality of life.

Application of lime peel oil composite nanoemulsion to prevent toxigenic fungi in nuts.

Food byproduct oils may have antimicrobial impacts when used in coating and preservation. Nuts are known to suffer from toxigenic fungi and their related mycotoxins. The present study utilized lime oil emulsion to minimize fungal infection and reduce aflatoxin B1 (AFB1). Besides, it evaluated lime oil's impact on nuts' protection against oxidation and deterioration during storage. Lime oil was extracted using hydrodistillation, and gas chromatography (GC-MS) evaluated volatile constituents. Oil was loaded into a composite emulsion of whey protein, Arabic gum, gelatin, and carboxymethyl cellulose. The antimicrobial and antifungal properties of the nut-coating emulsion were evaluated. A simulated Aspergillus flavus infection experiment evaluated composite resistance for fungal infection and AFB1 production. Oxidation and acidity changes in nuts oil composition were evaluated by proximate analysis, fatty acid composition, and induction period. The oil majority was recorded for terpenes and monoterpenes, including limonene (44.69 ± 2.11%). The emulsion was characterized by zeta potential (-21.16 ± 1.28 mV), stability (99.61 ± 0.02%), and polydispersity index (0.41 ± 0.05). Antimicrobial properties recorded a high antibacterial inhibition zone (up to 28.37 ± 0.11 mm) and anti-mycotoxigenic fungi (up to 37.61 ± 0.24 mm). For the simulated experiment, fungal growth reduction ranged between 78.02% for filmed-peanut and 84.5% for filmed-almond, while AFB1 was not detected in filmed hazelnut and almond. During the one-year storage of samples, there was a slight change in nut oil composition and oxidation progress in filmed nuts, while there was a significant change in non-filmed nuts. The result recommended lime-composite as an edible nut coating that prevents aflatoxigenic contamination, oxidation changes, and improved shelf life.

A Comprehensive Study of Lupin Seed Oils and the Roasting Effect on Their Chemical and Biological Activity.

The present investigation aimed to study the impact of roasting on the chemical composition and biological activities of sweet and bitter lupin seed oils. Lupin oils were extracted using petroleum ether (40-60) with ultrasonic assisted method. Lupin Fatty acids, phytosterols, carotenoids, and total phenolic contents were determined. In addition, antioxidant, antimicrobial, and antifungal activities were evaluated. The results showed a ratio between 7.50% to 9.28% of oil content in lupin seed. Unroasted (bitter and sweet) lupin oil contained a high level of oleic acid ω9 (42.65 and 50.87%), followed by linoleic acid ω6 (37.3 and 34.48%) and linolenic acid ω3 (3.35 and 6.58%), respectively. Concerning phytosterols, unroasted (bitter and sweet lupin) seed oil reflected high values (442.59 and 406.18 mg/100 g oil, respectively). Bitter lupin oil contains a high amount of phenolics, although a lower antioxidant potency compared to sweet lupin oil. This phenomenon could be connected with the synergistic effect between phenolics and carotenoids higher in sweet lupin oil. The results reflected a more efficiently bitter lupin oil against anti-toxigenic fungi than sweet lupin oil. The roasting process recorded enhances the antimicrobial activity of bitter and sweet lupin seed oil, which is linked to the increment in bioactive components during the roasting process. These results concluded that lupin oil deems a novel functional ingredient and a valuable dietary fat source. Moreover, lupin oil seemed to have antifungal properties, which recommended its utilization as a carrier for active-antifungal compounds in food products.

Restless legs syndrome in Parkinson's disease: relationship with quality of life and medication.

OBJECTIVES: We aimed to disclose the relationship between restless leg syndrome (RLS) and antiparkinsonian treatment, and its effect on quality of life (QoL) in patients with Parkinson's disease (PD). BACKGROUND: Previous studies documented the prevalence of RLS among patients with PD to be higher than in the general population, but conclusions regarding the aetiology and impact were contradictory. METHODS: We examined 101 patients with idiopathic PD. All participants completed the five-dimension/five-level-EuroQoL questionnaire (EQ-5D-5L) and the International Restless-Legs-syndrome-study-group rating Scale (IRLS). RESULTS: The prevalence of RLS was 22.77 %. There were no statistically significant differences in levodopa or dopamine agonists (DA) doses between RLS-positive and negative participants. However, the use of levodopa as the last night-time medication was connected with a higher risk of RLS (OR=2.049, p=0.041). There was significantly lower prevalence of RLS in patients after surgical treatment for PD (p=0.024). Participants with RLS were at a greater risk for sleep disturbances (OR=3.866, p=0.023) and excessive daytime sleepiness (OR=7.202, p<0.001). Greater RLS symptoms were associated with worse QoL (higher IRLS score predicted higher EQ5D5L score, p=0.023). CONCLUSION: RLS is prevalent among PD patients and night-time dopaminergic over-excitation with levodopa plays an important role in its pathogenesis. Since the symptoms of RLS are associated with decreased QoL, early accurate diagnosis and appropriate adjustment of dopaminergic therapy can lead to immediate relief from RLS symptoms and to QoL improvement (Tab. 4, Fig. 1, Ref. 34).

Higher prevalence of restless legs syndrome/Willis-Ekbom disease in multiple sclerosis patients is related to spinal cord lesions.

BACKGROUND: Multiple sclerosis (MS) is connected with higher prevalence of secondary restless legs syndrome/Willis-Ekbom disease (RLS/WED). Aim of this study was to determine risk factor for developing symptoms of RLS in MS patients. METHODS: In cross-sectional study we examined 200 random MS patients. After obtaining informed consents, patients undervent a structured interview based on RLS and MS symptoms and characteristics, demographic, and health-related data. Than we collected results of brain/spinal cord magnetic resonance imaging (MRI). Blood samples were examined for blood count and biochemistry. RESULTS: From all 200 subjects, 26% were RLS-positives (95% CI: 20-32%). From positive patients, 44% had negative family history for RLS, and developed secondary RLS after onset of MS. Compared to RLS-negatives, the positives had significantly higher prevalence of spinal cord lesions (p=0.01). Presence of spinal pathology was connected with higher risk of RLS development (OR=3.846, 95%CI:1.304-11.346). There were no statistically significant differences in the levels of red blood cells, iron metabolism parameters, or levels of B or D vitamins. CONCLUSION: Risk of RLS/WED in MS increases with presence of lesions in spinal cord. The role of decreased dopamine delivery to lower spinal regions as the pathological background must be proved by more detailed research.

Blends of rapeseed oil with black cumin and rice bran oils for increasing the oxidative stability.

For the increase of oxidative stability and phytonutrient contents of rapeseed oil 5, 10 and 20 % blends with rice bran oil and black cumin oil were prepared. Profiles of different bioactive lipid components of blends including tocopherols, tocotrienols, phytosterols and phytostanols as well as fatty acid composition were carried out using HPLC and GLC. Rancimat was used for detecting oxidative stability of the fatty material. The blends with black cumin seed oil characterized higher level of α- and γ-tocopherols as well as all isomers of tocotrienols. Presence of rice bran oil in blends leads to increased tocotrienols amounts, ß-sitosterol and squalene. Blending resulted in lowering ratio of PUFA/SFA and improves stability of these oils. The ratio of omega-6/omega-3 raises from 2.1 in rapeseed oil to 3.7 and 3.0 in blends with black cumin and rice bran oils, respectively. Addition of 10 and 20 % of black cumin and rice bran oils to rapeseed oil were influenced on the oxidative stability of prepared blends. The results appear that blending of rapeseed oil with black cumin seed oil or rice bran oil enhanced nutritional and functional properties via higher oxidative stability as well as improved phytonutrient contents.

Impact of kidney transplantation on restless legs syndrome.

AIM: Our study was to assess the impact of kidney transplantation on restless legs syndrome (RLS) in end stage renal disease (ESRD) patients. METHODS: A total of 75 patients after a successful kidney transplantation (39 males, 36 females) were assessed consecutively. All patients completed the self reported questionnaire focused on RLS 6 months after kidney transplantation with investigation of selected laboratory parameters. The questionnaire met the International Restless Legs Syndrome Study Group criteria for RLS diagnosis. RESULTS: 30 (40.54%) out of 75 patients met the RLS diagnostic criteria. From this RLS positive group, 8 (26.7%) of them reported a complete regression of symptoms, 13 (43.3%) reported symptoms relief, 6 (20.0%) were without any change and 3 (10.0%) reported worsening of symptoms after kidney transplantation. In the RLS positive group, the majority of patients (26-86.7%) reported the occurrence of the symptoms in the evening and 21 (70.0%) of RLS positive patients reported the onset of symptoms after the onset of renal disease. CONCLUSION: Although the secondary RLS in EDRS patients is very common, it is often unrecognized or misdiagnosed. We concluded that kidney transplantation, except the primary benefit to kidney replacement and to its function, has a secondary impact on other conditions such as RLS (Tab. 5, Fig. 4, Ref. 17).

Evaporative production of bright atomic solitons.

We describe a method of producing bright atomic solitons of 7Li through efficient radio frequency evaporation in a combined magnetic and optical trap. Solitons released in a magnetic waveguide propagate without dispersion, with lifetimes limited by two-body dipolar relaxation. We show how the method can be used to deterministically produce pairs of solitons.

Study of mechanical effects on the quality of fish feed during different stages of manufacturing.

Successful aquaculture highly depends on ensuring the quality feed which mostly depends on the proper feedstuffs selection and the manufacturing process. This study was undertaken to monitor the deviation of protein level and the mechanical effects on different biofactors viz. protein, moisture, ash, crude lipid and fiber in feed during manufacture. Samples were collected at randomly and batch wise from the prominent feed industry during the production period. Samples were collected from two different production level viz. 'Final Mixer' and 'Finished Feed' and third other sample was prepared as 'Control Mixer' on the dry basis. All the samples were analyzed by using proper analytical procedure in the laboratory of fish nutrition. The percentage of protein content was 17.9 in control mixer and 18.46 in final mixer which finally decreased to 17.03% in finished feed. In control mixer ash content was 25.74 and 23.1% in final mixer which increased in finished feed to 24.68%. Lipid content increased in finished feed (6.1%) rather than the final mixer (5.95%) and the control mixer (3.75%). However, crude fiber content decreased from control mixer to finished feed thoroughly. Crude fiber content in control mixer was 7.4% which decreased to 6.86 and 6.56% in final mixer and finished feed respectively. Again a relation may be drawn between the moisture content and ash and lipid content with crude fiber. By this study it was observed quality of feed is highly influenced by quality machine.