Objectives:
Research estimates that a significant percentage of individuals with mild cognitive impairment (MCI) experience functional difficulties. In addition to reduced accuracy on measures of ...everyday function, cross-sectional research has demonstrated that speed of performing instrumental activities of daily living (IADLs) is slowed in individuals with MCI. The present study investigated whether baseline and longitudinal changes in speed and accuracy of IADL performance differed between persons with MCI and cognitively normal peers.
Design:
Linear mixed models were used to estimate the group differences in longitudinal performance on measures of IADLs.
Setting:
Assessments were conducted at university and medical research centers.
Participants:
The sample consisted of 80 participants with MCI and 80 control participants who were enrolled in the Alzheimer’s Disease Research Center’s Measuring Independent Living in the Elderly Study.
Measurements:
Instrumental activities of daily living speed and accuracy were directly assessed using selected domains of the Financial Capacity Instrument, the Timed IADL assessment, and driving-related assessments (Useful Field of View, Road Sign Test).
Results:
Individuals with MCI performed worse on speed and accuracy measures of IADLs in comparison to cognitively normal peers and demonstrated significantly steeper rates of decline over three years in either speed or accuracy in all domains assessed.
Conclusion:
Both speed and accuracy of performance on measures of IADL are valuable indices for early detection of functional change in MCI. The performance pattern may reflect a trade-off between speed and accuracy that can guide clinical recommendations for maintaining patient independence.
Heterotrophic bacterial abundance and productivity were measured during five and four cruises, respectively, in the northwest Arabian Sea as part of the US JGOFS Process Study, which provided a new ...view of seasonal bacterial dynamics in that part of the basin influenced by monsoonal forcing. In this paper, surface layer data are used to address two questions concerning the influence of the monsoon cycle on bacterial dynamics: (1) Is there a bacterial bloom in the SW Monsoon? and (2) Is bacterial production low during the oligotrophic Spring Intermonsoon? An extensive comparison of epifluorescence microscopy and flow cytometry, unprecedented at this scale, detected essentially the same heterotrophic bacterial populations and distributions, with some between-cruise differences. Use of the two methods allowed us to extend our observations in space and time. Bacterial productivity, both in the surface layer and integrated over the euphotic zone, was elevated less than 2-fold during the Southwest Monsoon. Levels of bacterial abundance and production were low during the Northeast Monsoon, then increased in March during the Spring Intermonsoon. There was some stimulation of abundance or production inshore in response to coastal upwelling. In general, the basin was enriched in bacterial biomass >5×10
8 cells l
−1 throughout the year, relative to other tropical regimes, presumably in response to overall high PP and DOC levels. Seasonally uniform DOC levels may be regulated in part by intense bacterial utilization rates, but also reflect seasonal consistency in PP.
The administration of dopaminergic medication to treat the symptoms of Parkinson's disease (PD) is associated with addictive behaviors and impulse control disorders. Little is known, however, on how ...PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavioral addiction patients with and without PD.
= 2,460 treatment-seeking men diagnosed with a behavioral addiction were recruited from a university hospital. Sociodemographic, impulsivity Barratt Impulsiveness Scale (BIS-11), and personality Temperament and Character Inventory-Revised (TCI-R) measures were taken upon admission to outpatient treatment. Patients in the PD group were older and had a higher prevalence of mood disorders than patients without PD. In terms of personality characteristics and impulsivity traits, PD patients appeared to present a more functional profile than PD-free patients with a behavioral addiction. Our results suggest that PD patients with a behavioral addiction could be more difficult to detect than their PD-free counterparts in behavioral addiction clinical setting due to their reduced levels of impulsivity and more standard personality traits. As a whole, this suggests that PD patients with a behavioral addiction may have different needs from PD-free behavioral addiction patients and that they could potentially benefit from targeted interventions.
Background & Aims Symptoms suggestive of colorectal cancer may originate outside the colorectum. Computed tomographic colonography (CTC) is used to examine the colorectum and abdominopelvic organs ...simultaneously. We performed a prospective randomized controlled trial to quantify the frequency, nature, and consequences of extracolonic findings. Methods We studied 5384 patients from 21 UK National Health Service hospitals referred by their family doctor for the investigation of colorectal cancer symptoms from March 2004 through December 2007. The patients were assigned randomly to groups that received the requested test (barium enema or colonoscopy, n = 3574) or CTC (n = 1810). We determined the frequency and nature of extracolonic findings, subsequent investigations, ultimate diagnosis, and extracolonic cancer diagnoses 1 and 3 years after testing patients without colorectal cancer. Results Extracolonic pathologies were detected in 959 patients by CTC (58.7%), in 42 patients by barium enema analysis (1.9%), and in no patients by colonoscopy. Extracolonic findings were investigated in 142 patients (14.2%) and a diagnosis was made for 126 patients (88.1%). Symptoms were explained by extracolonic findings in 4 patients analyzed by barium enema (0.2%) and in 33 patients analyzed by CTC (2.8%). CTC identified 72 extracolonic neoplasms, however, barium enema analysis found only 3 (colonoscopy found none). Overall, CTC diagnosed extracolonic neoplasms in 72 of 1634 patients (4.4%); 26 of these were malignant (1.6%). There were significantly more extracolonic malignancies detected than expected 1 year after examination, but these did not differ between patients evaluated by CTC (22.2/1000 person-years), barium enema (26.5/1000 person-years; P = .43), or colonoscopy (32.0/1000 person-years; P = .88). Conclusions More than half of the patients with symptoms of colorectal cancer are found to have extracolonic pathologies by CTC analysis. However, the proportion of patients found to have extracolonic malignancies after 1 year of CTC examination is not significantly greater than after barium enema or colonoscopy examinations. International Standard Randomised Controlled Trials no: 95152621.isrctn.com.
Summary
Donor bone marrow engraftment, which resulted in complete normalization of white cell β‐galactosidase levels in a patient with presymptomatic juvenile onset GM1‐gangliosidosis (McKusick ...230600), did not improve long‐term clinical outcome.
Barth Syndrome and Neutropenia Dale, David C.; Bolyard, Audrey Anna; Marrero, Tracy M. ...
Blood,
11/2013, Letnik:
122, Številka:
21
Journal Article
Recenzirano
Odprti dostop
Barth syndrome is an X-linked, hereditary cause for neutropenia, cardiomyopathy, muscle weakness and growth retardation. It is attributable to mutations of TAZ, a gene encoding a highly conserved ...acyltransferase necessary for the maintenance of the phospholipids of the inner layers of mitochrondrial membranes. There is a wide diversity in the TAZ mutations but as yet no recognized genotype-phenotype correlations.
We collected and analyzed data for 83 patients (all males, Severe Chronic Neutropenia International Registry, Barth Syndrome Foundation and NHS Barth Syndrome Service in the UK). Fifty-four are currently less than 18 years old (median age 13.6 years, range 0.2-31.6 years). Absolute neutrophil counts (ANC) varied remarkably (median 1.1 x 109/L, range 0.14-5.4 x 109/L). A few patients have cyclic variations in the ANCs, but most have not had a sufficient series to determine if the variations show periodicity. Mouth ulcers, bleeding gums, skin infections, and upper respiratory infections were the most common complications, but pneumonia, sepsis, and more severe infections occurred sporadically. Comparisons of reported events for the population suggest that patients with baseline neutrophil counts< 0.5 x 109/L have more infections than patients with higher counts.
Data were available for 42 patients with neutropenia sufficiently severe to be treated with G-CSF by their physicians. On average, G-CSF was begun at 5.8 years (median age 4.3, range 0.05-21.5 years), with the median dose of 1.67 mcg/kg/d, mean 2.78 +/- 0.78 (SEM) mcg/kg/d (range 0.45-12.8 mcg/kg/d), with an average exposure of 7.3 years.
With longitudinal follow-up, 15 patients have had cardiac transplants and no patients have developed AML or received bone marrow transplantation and treatment responses to G-CSF are maintained long term. Bone marrow examinations were generally not performed, either before or on G-CSF treatment. Longitudinal observation suggests that the hematological profiles of individual patients are largely unchanged from childhood into adulthood, without evidence of worsening or amelioration. Additional clinical and laboratory data are need to define the genetic determinants and hematological features of Barth syndrome.
Dale:Amgen: Consultancy, Research Funding.
Models in Ecosystem Science Canham, Charles D; Cole, Jonathan J; Lauenroth, William K
2021, 2021-04-13
eBook
Quantitative models are crucial to almost every area of ecosystem science. They provide a logical structure that guides and informs empirical observations of ecosystem processes. They play a ...particularly crucial role in synthesizing and integrating our understanding of the immense diversity of ecosystem structure and function. Increasingly, models are being called on to predict the effects of human actions on natural ecosystems. Despite the widespread use of models, there exists intense debate within the field over a wide range of practical and philosophical issues pertaining to quantitative modeling. This book--which grew out of a gathering of leading experts at the ninth Cary Conference--explores those issues. The book opens with an overview of the status and role of modeling in ecosystem science, including perspectives on the long-running debate over the appropriate level of complexity in models. This is followed by eight chapters that address the critical issue of evaluating ecosystem models, including methods of addressing uncertainty. Next come several case studies of the role of models in environmental policy and management. A section on the future of modeling in ecosystem science focuses on increasing the use of modeling in undergraduate education and the modeling skills of professionals within the field. The benefits and limitations of predictive (versus observational) models are also considered in detail. Written by stellar contributors, this book grants access to the state of the art and science of ecosystem modeling.
Abstract
Laparoscopic adjustable gastric bands are a popular and effective surgical option to treat morbid obesity. The overall complication rate is 10–20% and the most common complication is of ...‘slippage’. Although other complications such as gastric band migration and erosion have been reported, the phenomenon of a migrated gastric band connecting tube eroding into the colon (after port removal) is seldom reported in the literature. In this article we describe such a case of an incidentally found colonic erosion on colonoscopy and describe the subsequent laparoscopic repair, as well as a review of the literature.
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