Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India.

PubMed

Rajkumar, Anto P; Petit, Cheryl P; Rachana, Arun; Deinde, Funmi; Shyamsundar, G; Thangadurai, P; Jacob, Kuruthukulangara S

2018-04-01

Cognitive deficits, self-reported or found following electroconvulsive therapy (ECT), and their correlates are diverse. Despite the characteristics of people receiving ECT in Asia differ widely from the west, pertinent research from Asia remains sparse. We investigated the correlates of self-reported, mini-mental status examination (MMSE) defined, and autobiographical memory deficits in a cohort that received ECT in a south Indian tertiary-care setting. 76 consecutive consenting people were recruited within seven days of completing their ECT course. Memory was assessed by a subjective Likert scale, MMSE, and an autobiographical memory scale (AMS). Psychopathology was assessed by brief psychiatric rating scale, and serum cortisol levels were estimated by chemi-luminescence immunoassays. Relevant sociodemographic and clinical data were collected from the participants, and their medical records. The correlates were analysed using generalised linear models after adjusting for the effects of potential confounders. Self-reported, MMSE-defined, and autobiographical memory deficits were present in 27.6% (95%CI 17.6-37.7%), 42.1% (95%CI 31.0-53.2%), and 36.8% (95%CI 26.0-47.7%) of participants, respectively. Agreement between the memory deficits was poor. Age, less education, duration of illness, hypothyroidism, and past history of another ECT course were significantly associated with MMSE-defined deficits. Age, anaemia, past ECT course, and pre-ECT blood pressure were significantly associated with autobiographical memory deficits, while residual psychopathology and cortisol levels were significantly associated with self-reported memory deficits. Self-reported, MMSE-defined, and autobiographical memory deficits are common at the completion of ECT course, and their correlates differ. All service users receiving ECT need periodic cognitive assessments evaluating multiple cognitive domains. Copyright © 2018 Elsevier B.V. All rights reserved.

Study of Mini-Mental State Exam evolution in community-dwelling subjects aged over 60 years without dementia.

PubMed

Watfa, G; Husson, N; Buatois, S; Laurain, M C; Miget, P; Benetos, A

2011-12-01

In recent years, the Mini-Mental State Examination (MMSE) has been widely used and has been proposed for cognitive decline screening in the framework of a systematic geriatric evaluation in health centers. The aim of the present longitudinal study was to identify the potential determinants of MMSE score and its evolution over a 4-year period in a population aged over sixty years with good general health without dementia and consulting for a health check-up. Longitudinal study. The preventive medical center (CMP) in Nancy. 687 subjects over 60 years of age (mean age 65.6 ± 5.07 years) were included from the Senior health examination study. All subjects underwent 2 visits over a period of 4 years. MMSE measurement and a self-administered questionnaire of emotional and psychological state were evaluated at baseline and at the follow-up visit. The major components of total variance of baseline MMSE were represented by education level, practice of regular physical activity, nervousness and despair. Multivariate analysis identified 3 variables at baseline visit that independently predicted annual changes in MMSE: MMSE score, education level and "Difficulty in social relations" (r= -0.222, 0.154 and -0.255 respectively). Education level and several psychological factors may influence MMSE score and its evolution over time in community-dwelling subjects aged over 60 years without dementia. In these subjects, a low MMSE score does not predict cognitive decline over a period of 4 years. Therefore, the reliability of MMSE in this type of population is questionable.

A negentropy minimization approach to adaptive equalization for digital communication systems.

PubMed

Choi, Sooyong; Lee, Te-Won

2004-07-01

In this paper, we introduce and investigate a new adaptive equalization method based on minimizing approximate negentropy of the estimation error for a finite-length equalizer. We consider an approximate negentropy using nonpolynomial expansions of the estimation error as a new performance criterion to improve performance of a linear equalizer based on minimizing minimum mean squared error (MMSE). Negentropy includes higher order statistical information and its minimization provides improved converge, performance and accuracy compared to traditional methods such as MMSE in terms of bit error rate (BER). The proposed negentropy minimization (NEGMIN) equalizer has two kinds of solutions, the MMSE solution and the other one, depending on the ratio of the normalization parameters. The NEGMIN equalizer has best BER performance when the ratio of the normalization parameters is properly adjusted to maximize the output power(variance) of the NEGMIN equalizer. Simulation experiments show that BER performance of the NEGMIN equalizer with the other solution than the MMSE one has similar characteristics to the adaptive minimum bit error rate (AMBER) equalizer. The main advantage of the proposed equalizer is that it needs significantly fewer training symbols than the AMBER equalizer. Furthermore, the proposed equalizer is more robust to nonlinear distortions than the MMSE equalizer.

Performance Comparison between CDTD and STTD for DS-CDMA/MMSE-FDE with Frequency-Domain ICI Cancellation

NASA Astrophysics Data System (ADS)

Takeda, Kazuaki; Kojima, Yohei; Adachi, Fumiyuki

Frequency-domain equalization (FDE) based on the minimum mean square error (MMSE) criterion can provide a better bit error rate (BER) performance than rake combining. However, the residual inter-chip interference (ICI) is produced after MMSE-FDE and this degrades the BER performance. Recently, we showed that frequency-domain ICI cancellation can bring the BER performance close to the theoretical lower bound. To further improve the BER performance, transmit antenna diversity technique is effective. Cyclic delay transmit diversity (CDTD) can increase the number of equivalent paths and hence achieve a large frequency diversity gain. Space-time transmit diversity (STTD) can obtain antenna diversity gain due to the space-time coding and achieve a better BER performance than CDTD. Objective of this paper is to show that the BER performance degradation of CDTD is mainly due to the residual ICI and that the introduction of ICI cancellation gives almost the same BER performance as STTD. This study provides a very important result that CDTD has a great advantage of providing a higher throughput than STTD. This is confirmed by computer simulation. The computer simulation results show that CDTD can achieve higher throughput than STTD when ICI cancellation is introduced.

Joint Frequency-Domain Equalization and Despreading for Multi-Code DS-CDMA Using Cyclic Delay Transmit Diversity

NASA Astrophysics Data System (ADS)

Yamamoto, Tetsuya; Takeda, Kazuki; Adachi, Fumiyuki

Frequency-domain equalization (FDE) based on the minimum mean square error (MMSE) criterion can provide a better bit error rate (BER) performance than rake combining. To further improve the BER performance, cyclic delay transmit diversity (CDTD) can be used. CDTD simultaneously transmits the same signal from different antennas after adding different cyclic delays to increase the number of equivalent propagation paths. Although a joint use of CDTD and MMSE-FDE for direct sequence code division multiple access (DS-CDMA) achieves larger frequency diversity gain, the BER performance improvement is limited by the residual inter-chip interference (ICI) after FDE. In this paper, we propose joint FDE and despreading for DS-CDMA using CDTD. Equalization and despreading are simultaneously performed in the frequency-domain to suppress the residual ICI after FDE. A theoretical conditional BER analysis is presented for the given channel condition. The BER analysis is confirmed by computer simulation.

Total homocysteine and cognition in a tri-ethnic cohort

PubMed Central

Wright, C.B.; Lee, H.-S.; Paik, M.C.; Stabler, S.P.; Allen, R.H.; Sacco, R.L.

2005-01-01

Objective: Several studies implicate elevated homocysteine as a risk factor for dementia and cognitive decline, but most studies have involved subjects older than 55 years from homogeneous populations. The authors examined homocysteine and cognition in a tri-ethnic community sample 40 years and older. Method: The Northern Manhattan Study includes 3,298 stroke-free subjects. Of these 2,871 had baseline fasting total homocysteine (tHcy) levels and Mini-Mental State Examination (MMSE) scores available. The authors used multiple linear regression to examine the cross-sectional association between baseline tHcy levels and mean MMSE scores adjusting for sociodemographic and vascular risk factors. Results: Homocysteine levels were related to age, renal function, and B12 deficiency. Those with B12 deficiency had tHcy levels five points higher (9.4 vs 14.4 nmol/L). Mean MMSE scores differed by age, sex, and race-ethnic group. Those with hypertension, diabetes, cardiac disease, and B12 deficiency had lower MMSE scores. In multivariate analyses, elevated tHcy was associated with lower mean MMSE scores for those older than 65 but not for those 40 to 64. Adjusting for B12 deficiency and sociodemographic factors the mean MMSE was 2.2 points lower for each unit increase in the log tHcy level (95% CI −3.6, −0.9). Adding vascular risk factors to the model did not attenuate this effect (mean MMSE −2.2 points; 95% CI −3.5, −0.9). Conclusions: Elevated homocysteine was independently associated with decreased cognition in subjects older than 65 in this tri-ethnic cohort, adjusting for sociodemographic and vascular risk factors. PMID:15277617

A Longitudinal Study of the Mini-Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education.

PubMed

Skoog, Johan; Backman, Kristoffer; Ribbe, Mats; Falk, Hanna; Gudmundsson, Pia; Thorvaldsson, Valgeir; Borjesson-Hanson, Anne; Ostling, Svante; Johansson, Boo; Skoog, Ingmar

2017-06-01

To examine level of and change in cognitive status using the Mini-Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians. Three-year longitudinal study with examinations at ages 97, 99, and 100. Trained psychiatric research nurses examined participants at their place of living. A representative population-based sample of 97-year-old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden. A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables. Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3-year follow-up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3-year follow-up. Participants with more education had higher MMSE scores, but there was no association between education and linear change. MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Telomere Length, Long-Term Black Carbon Exposure, and Cognitive Function in a Cohort of Older Men: The VA Normative Aging Study.

PubMed

Colicino, Elena; Wilson, Ander; Frisardi, Maria Chiara; Prada, Diddier; Power, Melinda C; Hoxha, Mirjam; Dioni, Laura; Spiro, Avron; Vokonas, Pantel S; Weisskopf, Marc G; Schwartz, Joel D; Baccarelli, Andrea A

2017-01-01

Long-term air pollution exposure has been associated with age-related cognitive impairment, possibly because of enhanced inflammation. Leukocytes with longer telomere length (TL) are more responsive to inflammatory stimuli, yet TL has not been evaluated in relation to air pollution and cognition. We assessed whether TL modifies the association of 1-year exposure to black carbon (BC), a marker of traffic-related air pollution, with cognitive function in older men, and we examined whether this modification is independent of age and of C-reactive protein (CRP), a marker of inflammation. Between 1999 and 2007, we conducted 1-3 cognitive examinations of 428 older men in the Veterans Affairs (VA) Normative Aging Study. We used covariate-adjusted repeated-measure logistic regression to estimate associations of 1-year BC exposure with relative odds of being a low scorer (≤ 25) on the Mini-Mental State Examination (MMSE), which is a proxy of poor cognition. Confounders included age, CRP, and lifestyle and sociodemographic factors. Each doubling in BC level was associated with 1.57 (95% CI: 1.20, 2.05) times higher odds of low MMSE scores. The BC-MMSE association was greater only among individuals with longer blood TL (5th quintile) (OR = 3.23; 95% CI: 1.37, 7.59; p = 0.04 for BC-by-TL-interaction). TL and CRP were associated neither with each other nor with MMSE. However, CRP modified the BC-MMSE relationship, with stronger associations only at higher CRP (5th quintile) and reference TL level (1st quintile) (OR = 2.68; 95% CI: 1.06, 6.79; p = 0.04 for BC-by-CRP-interaction). TL and CRP levels may help predict the impact of BC exposure on cognitive function in older men. Citation: Colicino E, Wilson A, Frisardi MC, Prada D, Power MC, Hoxha M, Dioni L, Spiro A III, Vokonas PS, Weisskopf MG, Schwartz JD, Baccarelli AA. 2017. Telomere length, long-term black carbon exposure, and cognitive function in a cohort of older men: the VA Normative Aging Study. Environ Health Perspect 125:76-81; http://dx.doi.org/10.1289/EHP241.

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson’s Disease

PubMed Central

Kim, Ryul; Kim, Han-Joon; Kim, Aryun; Jang, Mi-Hee; Kim, Hyun Jeong; Jeon, Beomseok

2018-01-01

Objective Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson’s disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level. Methods A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7–12 years, or 13 or more years). Results Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions. Conclusion Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings. PMID:29316782

Cognitive changes after parathyroidectomy in patients with secondary hyperparathyroidism.

PubMed

Chou, Fong-Fu; Chen, Jin-Bor; Hsieh, Kun-Chou; Liou, Chia-Wei

2008-04-01

Cognitive impairment was frequently reported in uremic patients with dialysis, but improvements of cognition after parathyroidectomy for symptomatic secondary hyperparathyroidism have never been reported before. Thirty-nine patients, who were successfully operated on with total parathyroidectomy plus autotransplantation were enrolled. Twenty-three dialysis patients, age >50 years, who had a serum level of intact parathyroid hormone (iPTH) greater than 650 pg/ml, and who did not undergo parathyroidectomy were selected as the control group. The mini-mental state examination (MMSE) and the clinical dementia rating (CDR) test were administered to all patients. Before the operation, educational level, symptoms of bone pain, skin itching, general weakness and insomnia were recorded and serum levels of calcium, phosphorus, alkaline phosphatase (Alk-ptase), iPTH, aluminum, and hemoglobin were measured in the study and control groups. At 12-week postoperatively, serum levels of calcium, phosphorus, Alk-ptase, iPTH, and aluminum were measured again and at 16-week postoperatively, the MMSE and the CDR test were administered again. In the control group, both MMSE and CDR test were administered again after the period or 16-week. Serum calcium level was only significant difference (p = 0.002), whereas clinical symptoms, gender, etiologies of secondary hyperparathyroidism, duration of dialysis, educational level, age, and serum levels of phosphorus, Alk-ptase, iPTH, aluminum, and hemoglobin were not significantly different between the two groups. The educational level was the only factor affecting MMSE scores (p = 0.003). In the study group, at 12-week postoperatively, symptoms improved significantly, serum levels of calcium, phosphorus, Alk-ptase, iPTH, and aluminum decreased significantly, and at 16-week postoperatively, MMSE scores increased from 25 +/- 5 (mean +/- SD) to 26 +/- 5 (p < 0.001) and CDR scales decreased significantly (p < 0.001). Neither MMSE scores nor CDR scales of the control group changed significantly after the 16-week period. Parathyroidectomy for symptomatic secondary hyperparathyroidism can improve cognition.

Interleukin-6 is associated with cognitive function: the Northern Manhattan Study

PubMed Central

Wright, C.B.; Sacco, R.L.; Rundek, T.R.; Delman, J.B.; Rabbani, L.E.; Elkind, M.S.V.

2006-01-01

Background and purpose Inflammation has been linked to cognitive decline and dementia but the mechanism is not clear and few studies have included Hispanic and black subjects that may be at increased risk of these disorders. Methods We performed a cross-sectional analysis of the association between inflammatory marker levels and cognition in the stroke-free population-based cohort of the Northern Manhattan Study. Mini Mental State Exam (MMSE) scores were the continuous outcome and we adjusted for sociodemographic and vascular risk factors as well as subclinical atherosclerosis. Results Of the inflammatory markers, only interleukin (IL)-6 levels were associated with the MMSE. In univariate analysis age, hypertension, diabetes, smoking, moderate alcohol use, total homocysteine, carotid intima media thickness, and body mass index were positively associated with IL-6 levels. Hispanics compared to whites, those with less than a high school education, hypertension, cardiac disease, and total homocysteine were associated with lower MMSE scores. In a multivariate linear regression model, IL-6 was negatively associated with MMSE score adjusting for sociodemographic and vascular risk factors. Conclusions IL-6 levels were negatively associated with performance on the MMSE in this multiethnic cohort. Adjusting for vascular disease and subclinical atherosclerosis did not attenuate the association, suggesting a direct effect on the brain. PMID:16501663

Moments and Root-Mean-Square Error of the Bayesian MMSE Estimator of Classification Error in the Gaussian Model.

PubMed

Zollanvari, Amin; Dougherty, Edward R

2014-06-01

The most important aspect of any classifier is its error rate, because this quantifies its predictive capacity. Thus, the accuracy of error estimation is critical. Error estimation is problematic in small-sample classifier design because the error must be estimated using the same data from which the classifier has been designed. Use of prior knowledge, in the form of a prior distribution on an uncertainty class of feature-label distributions to which the true, but unknown, feature-distribution belongs, can facilitate accurate error estimation (in the mean-square sense) in circumstances where accurate completely model-free error estimation is impossible. This paper provides analytic asymptotically exact finite-sample approximations for various performance metrics of the resulting Bayesian Minimum Mean-Square-Error (MMSE) error estimator in the case of linear discriminant analysis (LDA) in the multivariate Gaussian model. These performance metrics include the first, second, and cross moments of the Bayesian MMSE error estimator with the true error of LDA, and therefore, the Root-Mean-Square (RMS) error of the estimator. We lay down the theoretical groundwork for Kolmogorov double-asymptotics in a Bayesian setting, which enables us to derive asymptotic expressions of the desired performance metrics. From these we produce analytic finite-sample approximations and demonstrate their accuracy via numerical examples. Various examples illustrate the behavior of these approximations and their use in determining the necessary sample size to achieve a desired RMS. The Supplementary Material contains derivations for some equations and added figures.

Cereal Intake Increases and Dairy Products Decrease Risk of Cognitive Decline among Elderly Female Japanese.

PubMed

Otsuka, R; Kato, Y; Nishita, Y; Tange, C; Nakamoto, M; Tomida, M; Imai, T; Ando, F; Shimokata, H

2014-01-01

If cognitive decline can be prevented through changes in daily diet with no medical intervention, it will be highly significant for dementia prevention. This longitudinal study examined the associations of different food intakes on cognitive decline among Japanese subjects. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 298 males and 272 females aged 60 to 81 years at baseline who participated in the follow-up study (third to seventh wave) at least one time. Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in all study waves. Nutritional intake was assessed using a 3-day dietary record in the second wave. Cumulative data among participants with an MMSE >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) for an MMSE score ≤27 in each study wave according to a 1 standard deviation (SD) increase of each food intake at baseline were estimated, after adjusting for age, follow-up time, MMSE score at baseline, education, body mass index, annual household income, current smoking status, energy intake, and history of diseases. In men, after adjusting for age, and follow-up period, MMSE score at baseline, the adjusted OR for a decline in MMSE score was 1.20 (95% CI, 1.02-1.42; p=0.032) with a 1-SD increase in cereal intake. After adjusting for education and other confounding variables, the OR for a decrease in MMSE score did not reach statistical significance for this variable. In women, multivariate adjusted OR for MMSE decline was 1.43 (95% CI, 1.15-1.77; p=0.001) with a 1-SD increase in cereal intake and 0.80 (95% CI, 0.65-0.98; p=0.034) with a 1-SD increase in milk and dairy product intake. This study indicates that a 1-SD (108 g/day) decrease in cereal intake and a 1-SD (128 g/day) increase in milk and dairy product intake may have an influence of cognitive decline in community-dwelling Japanese women aged 60 years and older. Further studies are needed in order to explore the potential causal relationship.

Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study.

PubMed

Murayama, H; Shinkai, S; Nishi, M; Taniguchi, Y; Amano, H; Seino, S; Yokoyama, Y; Yoshida, H; Fujiwara, Y; Ito, H

2017-01-01

Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. Longitudinal study. Community-based. A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.

Handling missing Mini-Mental State Examination (MMSE) values: Results from a cross-sectional long-term-care study.

PubMed

Godin, Judith; Keefe, Janice; Andrew, Melissa K

2017-04-01

Missing values are commonly encountered on the Mini Mental State Examination (MMSE), particularly when administered to frail older people. This presents challenges for MMSE scoring in research settings. We sought to describe missingness in MMSEs administered in long-term-care facilities (LTCF) and to compare and contrast approaches to dealing with missing items. As part of the Care and Construction project in Nova Scotia, Canada, LTCF residents completed an MMSE. Different methods of dealing with missing values (e.g., use of raw scores, raw scores/number of items attempted, scale-level multiple imputation [MI], and blended approaches) are compared to item-level MI. The MMSE was administered to 320 residents living in 23 LTCF. The sample was predominately female (73%), and 38% of participants were aged >85 years. At least one item was missing from 122 (38.2%) of the MMSEs. Data were not Missing Completely at Random (MCAR), χ 2 (1110) = 1,351, p < 0.001. Using raw scores for those missing <6 items in combination with scale-level MI resulted in the regression coefficients and standard errors closest to item-level MI. Patterns of missing items often suggest systematic problems, such as trouble with manual dexterity, literacy, or visual impairment. While these observations may be relatively easy to take into account in clinical settings, non-random missingness presents challenges for research and must be considered in statistical analyses. We present suggestions for dealing with missing MMSE data based on the extent of missingness and the goal of analyses. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Tracking with time-delayed data in multisensor systems

NASA Astrophysics Data System (ADS)

Hilton, Richard D.; Martin, David A.; Blair, William D.

1993-08-01

When techniques for target tracking are expanded to make use of multiple sensors in a multiplatform system, the possibility of time delayed data becomes a reality. When a discrete-time Kalman filter is applied and some of the data entering the filter are delayed, proper processing of these late data is a necessity for obtaining an optimal estimate of a target's state. If this problem is not given special care, the quality of the state estimates can be degraded relative to that quality provided by a single sensor. A negative-time update technique is developed using the criteria of minimum mean-square error (MMSE) under the constraint that only the results of the most recent update are saved. The performance of the MMSE technique is compared to that of the ad hoc approach employed in the Cooperative Engagement Capabilities (CEC) system for processing data from multiple platforms. It was discovered that the MMSE technique is a stable solution to the negative-time update problem, while the CEC technique was found to be less than desirable when used with filters designed for tracking highly maneuvering targets at relatively low data rates. The MMSE negative-time update technique was found to be a superior alternative to the existing CEC negative-time update technique.

MMSE and MoCA in Parkinson’s disease and dementia with Lewy bodies: a multicenter 1-year follow-up study

PubMed Central

Weis, L.; Bostantjopoulou, S.; Stefanova, E.; Falup-Pecurariu, C.; Kramberger, M. G.; Geurtsen, G. J.; Antonini, A.; Weintraub, D.; Aarsland, D.

2016-01-01

The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are the most commonly used scales to test cognitive impairment in Lewy body disease (LBD), but there is no consensus on which is best suited to assess cognition in clinical practice and most sensitive to cognitive decline. Retrospective cohort study of 265 LBD patients [Parkinson’s disease (PD) without dementia (PDnD, N = 197), PD with dementia (PDD, N = 40), and dementia with Lewy bodies (DLB, N = 28)] from an international consortium who completed both the MMSE and MoCA at baseline and 1-year follow-up (N = 153). Percentage of relative standard deviation (RSD%) at baseline was the measure of inter-individual variance, and estimation of change (Cohen’s d) over time was calculated. RSD% for the MoCA (21 %) was greater than for the MMSE (13 %) (p = 0.03) in the whole group. This difference was significant only in PDnD (11 vs. 5 %, p < 0.01), but not in PDD (30 vs. 19 %, p = 0.37) or DLB (15 vs. 14 %, p = 0.78). In contrast, the 1-year estimation of change did not differ between the two tests in any of the groups (Cohen’s effect <0.20 in each group). MMSE and MoCA are equal in measuring the rate of cognitive changes over time in LBD. However, in PDnD, the MoCA is a better measure of cognitive status as it lacks both ceiling and floor effects. PMID:26852137

Optical Coherence Tomography Noise Reduction Using Anisotropic Local Bivariate Gaussian Mixture Prior in 3D Complex Wavelet Domain.

PubMed

Rabbani, Hossein; Sonka, Milan; Abramoff, Michael D

2013-01-01

In this paper, MMSE estimator is employed for noise-free 3D OCT data recovery in 3D complex wavelet domain. Since the proposed distribution for noise-free data plays a key role in the performance of MMSE estimator, a priori distribution for the pdf of noise-free 3D complex wavelet coefficients is proposed which is able to model the main statistical properties of wavelets. We model the coefficients with a mixture of two bivariate Gaussian pdfs with local parameters which are able to capture the heavy-tailed property and inter- and intrascale dependencies of coefficients. In addition, based on the special structure of OCT images, we use an anisotropic windowing procedure for local parameters estimation that results in visual quality improvement. On this base, several OCT despeckling algorithms are obtained based on using Gaussian/two-sided Rayleigh noise distribution and homomorphic/nonhomomorphic model. In order to evaluate the performance of the proposed algorithm, we use 156 selected ROIs from 650 × 512 × 128 OCT dataset in the presence of wet AMD pathology. Our simulations show that the best MMSE estimator using local bivariate mixture prior is for the nonhomomorphic model in the presence of Gaussian noise which results in an improvement of 7.8 ± 1.7 in CNR.

The influence of the uplink noise on the performance of satellite data transmission systems

NASA Astrophysics Data System (ADS)

Dewal, Vrinda P.

The problem of transmission of binary phase shift keying (BPSK) modulated digital data through a bandlimited nonlinear satellite channel in the presence of uplink, downlink Gaussian noise and intersymbol interface is examined. The satellite transponder is represented by a zero memory bandpass nonlinearity, with AM/AM conversion. The proposed optimum linear receiver structure consists of tapped-delay lines followed by a decision device. The linear receiver is designed to minimize the mean square error that is a function of the intersymbol interface, the uplink and the downlink noise. The minimum mean square error equalizer (MMSE) is derived using the Wiener-Kolmogorov theory. In this receiver, the decision about the transmitted signal is made by taking into account the received sequence of present sample, and the interfering past and future samples, which represent the intersymbol interference (ISI). Illustrative examples of the receiver structures are considered for the nonlinear channels with a symmetrical and asymmetrical frequency responses of the transmitter filter. The transponder nonlinearity is simulated by a polynomial using only the first and the third orders terms. A computer simulation determines the tap gain coefficients of the MMSE equalizer that adapt to the various uplink and downlink noise levels. The performance of the MMSE equalizer is evaluated in terms of an estimate of the average probability of error.

Is there information contained within the sentence-writing component of the mini mental state examination? A retrospective study of community dwelling older people.

PubMed

Shenkin, Susan D; Starr, John M; Dunn, Joanne M; Carter, Samantha; Deary, Ian J

2008-12-01

To investigate the relationship between features of the MMSE written sentence and cognitive function, depression and disability. MMSE sentences from 191 community dwelling individuals without dementia from the Lothian Birth Cohort 1921 (LBC1921) study were: (a) photocopied and (b) typed as written. Sentences were rated for objective criteria: word number and frequency, first person usage, time orientation, and letter case. Twenty healthy raters (50% male, age 20-26 years), blind to all other data, rated each handwritten and typed sentence for subjective criteria: legibility, 'emotional' tone (positive to negative), estimated age, health, and intelligence. As part of the LBC1921 volunteers had results available for cognitive ability tests (from which we extracted a general cognitive ability factor, g), Hospital Anxiety and Depression Score (HADS), and Townsend disability scores. 43.5% of subjects were male, mean age 78.6, SD 0.43 years. There was no significant association between the objective sentence criteria, legibility or tone and measured cognitive ability or physical disability. However, estimates of intelligence from the MMSE written sentence correlated significantly with current cognitive ability (r = 0.29, p < 0.001). There was a trend towards sentences with a negative tone being associated with a higher HADS-depression score (rho = -0.12, p = 0.09). In community dwelling people aged around 80 years, despite no association between objectively rated features of the MMSE sentence and intelligence or disability, raters were able to make better-than-chance estimates of subjects' intelligence test scores. (c) 2008 John Wiley & Sons, Ltd.

Engaged Lifestyle, Personality, and Mental Status Among Centenarians

PubMed Central

Baenziger, Joan; MacDonald, Maurice; Siegler, Ilene C.; Poon, Leonard W.

2010-01-01

This study assessed engaged lifestyle activities (e.g., volunteering, traveling, and public speaking) for centenarians of the Georgia Centenarian Study. A total of 285 centenarians and near-centenarians (i.e., 98 years and older) and their proxy informants participated in this study. The Mini-Mental Status Examination (MMSE) was assessed for all centenarians, and proxy informants reported on lifestyle activities and personality traits of the centenarians. Results suggested that participants who had volunteered, traveled, and those who had given public talks and balanced their checkbooks were more likely to show relatively high mental status scores (i.e., MMSE > 17). Personality traits were found to be moderators in the relationship between engaged lifestyle and mental status: Participants with high levels of Emotional Stability, Extraversion, Openness, and Conscientiousness and with high levels of engaged lifestyle were more likely to show relatively high mental status scores (i.e., MMSE > 17), whereas participants with low levels of Emotional Stability, Extraversion, Openness, Agreeableness, and Conscientiousness and with low levels of engaged lifestyle were more likely to show relatively low mental status scores (i.e., MMSE < 18). The results suggest that engaged lifestyle, particularly in combination with personality traits, plays an important role in the level of cognitive functioning among oldest old adults. PMID:21132076

[An exploratory study on the diagnostic cutoff value of International HIV-associated Dementia Scale in minority ethnic groups with different educational levels, in Guangxi].

PubMed

Zhao, Ting-ting; Feng, Qi-ming; Liang, Hao; Tang, Xian-yan; Wei, Bo

2011-11-01

Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated. 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated. When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P < 0.001). When considering the extent of cultural differences did influence the prevalence of infection, the different education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P < 0.001). People with only primary education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P < 0.001). The IHDS diagnostic sector in Guangxi minority groups was lower than the internationally recommended level of diagnostic cutoff value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.

Using the Folstein Mini Mental State Exam (MMSE) to explore methodological issues in cognitive aging research.

PubMed

Monroe, Todd; Carter, Michael

2012-09-01

Cognitive scales are used frequently in geriatric research and practice. These instruments are constructed with underlying assumptions that are a part of their validation process. A common measurement scale used in older adults is the Folstein Mini Mental State Exam (MMSE). The MMSE was designed to screen for cognitive impairment and is used often in geriatric research. This paper has three aims. Aim one was to explore four potential threats to validity in the use of the MMSE: (1) administering the exam without meeting the underlying assumptions, (2) not reporting that the underlying assumptions were assessed prior to test administration, (3) use of variable and inconsistent cut-off scores for the determination of presence of cognitive impairment, and (4) failure to adjust the scores based on the demographic characteristics of the tested subject. Aim two was to conduct a literature search to determine if the assumptions of (1) education level assessment, (2) sensory assessment, and (3) language fluency were being met and clearly reported in published research using the MMSE. Aim three was to provide recommendations to minimalize threats to validity in research studies that use cognitive scales, such as the MMSE. We found inconsistencies in published work in reporting whether or not subjects meet the assumptions that underlie a reliable and valid MMSE score. These inconsistencies can pose threats to the reliability of exam results. Fourteen of the 50 studies reviewed reported inclusion of all three of these assumptions. Inconsistencies in reporting the inclusion of the underlying assumptions for a reliable score could mean that subjects were not appropriate to be tested by use of the MMSE or that an appropriate test administration of the MMSE was not clearly reported. Thus, the research literature could have threats to both validity and reliability based on misuse of or improper reported use of the MMSE. Six recommendations are provided to minimalize these threats in future research.

Optical Coherence Tomography Noise Reduction Using Anisotropic Local Bivariate Gaussian Mixture Prior in 3D Complex Wavelet Domain

PubMed Central

Sonka, Milan; Abramoff, Michael D.

2013-01-01

In this paper, MMSE estimator is employed for noise-free 3D OCT data recovery in 3D complex wavelet domain. Since the proposed distribution for noise-free data plays a key role in the performance of MMSE estimator, a priori distribution for the pdf of noise-free 3D complex wavelet coefficients is proposed which is able to model the main statistical properties of wavelets. We model the coefficients with a mixture of two bivariate Gaussian pdfs with local parameters which are able to capture the heavy-tailed property and inter- and intrascale dependencies of coefficients. In addition, based on the special structure of OCT images, we use an anisotropic windowing procedure for local parameters estimation that results in visual quality improvement. On this base, several OCT despeckling algorithms are obtained based on using Gaussian/two-sided Rayleigh noise distribution and homomorphic/nonhomomorphic model. In order to evaluate the performance of the proposed algorithm, we use 156 selected ROIs from 650 × 512 × 128 OCT dataset in the presence of wet AMD pathology. Our simulations show that the best MMSE estimator using local bivariate mixture prior is for the nonhomomorphic model in the presence of Gaussian noise which results in an improvement of 7.8 ± 1.7 in CNR. PMID:24222760

Three-dimensional holoscopic image coding scheme using high-efficiency video coding with kernel-based minimum mean-square-error estimation

NASA Astrophysics Data System (ADS)

Liu, Deyang; An, Ping; Ma, Ran; Yang, Chao; Shen, Liquan; Li, Kai

2016-07-01

Three-dimensional (3-D) holoscopic imaging, also known as integral imaging, light field imaging, or plenoptic imaging, can provide natural and fatigue-free 3-D visualization. However, a large amount of data is required to represent the 3-D holoscopic content. Therefore, efficient coding schemes for this particular type of image are needed. A 3-D holoscopic image coding scheme with kernel-based minimum mean square error (MMSE) estimation is proposed. In the proposed scheme, the coding block is predicted by an MMSE estimator under statistical modeling. In order to obtain the signal statistical behavior, kernel density estimation (KDE) is utilized to estimate the probability density function of the statistical modeling. As bandwidth estimation (BE) is a key issue in the KDE problem, we also propose a BE method based on kernel trick. The experimental results demonstrate that the proposed scheme can achieve a better rate-distortion performance and a better visual rendering quality.

Regression-Based Estimates of Observed Functional Status in Centenarians

PubMed Central

Mitchell, Meghan B.; Miller, L. Stephen; Woodard, John L.; Davey, Adam; Martin, Peter; Burgess, Molly; Poon, Leonard W.

2011-01-01

Purpose of the Study: There is lack of consensus on the best method of functional assessment, and there is a paucity of studies on daily functioning in centenarians. We sought to compare associations between performance-based, self-report, and proxy report of functional status in centenarians. We expected the strongest relationships between proxy reports and observed performance of basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). We hypothesized that the discrepancy between self-report and observed daily functioning would be modified by cognitive status. We additionally sought to provide clinicians with estimates of centenarians’ observed daily functioning based on their mental status in combination with subjective measures of activities of daily living (ADLs). Design and Methods: Two hundred and forty-four centenarians from the Georgia Centenarian Study were included in this cross-sectional population-based study. Measures included the Direct Assessment of Functional Status, self-report and proxy report of functional status, and the Mini-Mental State Examination (MMSE). Results: Associations between observed and proxy reports were stronger than between observed and self-report across BADL and IADL measures. A significant MMSE by type of report interaction was found, indicating that lower MMSE performance is associated with a greater discrepancy between subjective and objective ADL measures. Implications: Results demonstrate associations between 3 methods of assessing functional status and suggest proxy reports are generally more accurate than self-report measures. Cognitive status accounted for some of the discrepancy between observed and self-reports, and we provide clinicians with tables to estimate centenarians’ performance on observed functional measures based on MMSE and subjective report of functional status. PMID:20974657

The effect of CPAP therapy on insulin-like growth factor and cognitive functions in obstructive sleep apnea patients.

PubMed

Kanbay, Asiye; Demir, Neslihan Cerrah; Tutar, Nuri; Köstek, Osman; Özer Şimşek, Zuhal; Buyukoglan, Hakan; Demir, Ramazan; Parrino, Liborio

2017-07-01

Cognitive impairment is common among patients with obstructive sleep apnea syndrome (OSAS). In this study, we aimed to investigate the effect of continuous positive airway pressure (CPAP) therapy on serum insulin-like growth factor-1 (IGF-1) levels and cognitive functions in patients with OSAS. Thirty-three patients with newly diagnosed OSAS and 17 healthy-control subjects enrolled in the study. All individuals completed the mini-mental state examination (MMSE) to evaluate cognitive function. Blood samples were taken at the end of the polysomnography in the morning and the same procedures were repeated 3 months after starting CPAP treatment. In the OSAS group, the baseline MMSE score was 23.5 ± 3.6, and serum IGF-1 level was 79.1 ± 36.1 ng/mL. Both values were significantly lower compared with the control group (mean MMSE score = 28.1 ± 1.4, P = 0.0001; mean serum IGF-1 level = 147.1 ± 49.1 ng/mL, P < 0.0001). Three months after CPAP treatment, OSAS patients showed a significant improvement in MMSE scores (26.5 ± 2.8, P = 0.0001) and serum IGF-1 level (129.1 ± 58.2, P = 0.0001). In contrast, baseline and third-month measurements for IGF-1 levels and MMSE scores were not significantly different in the control group. The results indicate that effective CPAP therapy in OSAS patients leads to significant improvement in cognitive functions and IGF-1 even in a short-term follow-up. Cognitive function assessment might be a part of evaluation in OSAS patients. © 2015 John Wiley & Sons Ltd.

People with Parkinson Disease and Normal MMSE Score Have a Broad Range of Cognitive Performance

PubMed Central

Burdick, DJ; Cholerton, B; Watson, GS; Siderowf, A; Trojanowski, JQ; Weintraub, D; Ritz, B; Rhodes, SL; Rausch, R; Factor, SA; Wood-Siverio, C; Quinn, JF; Chung, KA; Srivatsal, S; Edwards, KL; Montine, TJ; Zabetian, CP; Leverenz, JB

2014-01-01

Background Cognitive impairment, including dementia, is common in Parkinson disease (PD). The Mini-Mental State Examination (MMSE) has been recommended as a screening tool for PDD, with values below 26 indicative of possible dementia. Using a detailed neuropsychological battery, we examined the range of cognitive impairment in PD patients with a MMSE score ≥ 26. Methods In this multi-center, cross-sectional, observational study, we performed neuropsychological testing in a sample of 788 PD patients with MMSE ≥ 26. Evaluation included tests of global cognition, executive function, language, memory, and visuospatial skills. A consensus panel reviewed results for 342 subjects and assigned a diagnosis of no cognitive impairment, mild cognitive impairment, or dementia. Results 67% of the 788 subjects performed 1.5 standard deviations below the normative mean on at least one test. On eight of the 15 tests, more than 20% of subjects scored 1.5 standard deviations or more below the normative mean. Greatest impairments were found on Hopkins Verbal Learning and Digit Symbol Coding tests. The sensitivity of the MMSE to detect dementia was 45% in a subset of participants who underwent clinical diagnostic procedures. Conclusions A remarkably wide range of cognitive impairment can be found in PD patients with a relatively high score on the MMSE, including a level of cognitive impairment consistent with dementia. Given these findings, clinicians must be aware of the limitations of the MMSE in detecting cognitive impairment, including dementia, in PD. PMID:25073717

Weak independent association signals between IDE polymorphisms, Alzheimer's disease and cognitive measures.

PubMed

Mueller, Jakob C; Riemenschneider, Matthias; Schoepfer-Wendels, Andreas; Gohlke, Henning; Konta, Lidija; Friedrich, Patricia; Illig, Thomas; Laws, Simon M; Förstl, Hans; Kurz, Alexander

2007-05-01

Functional and genetic studies suggest that insulin-degrading enzyme (IDE) may be a strong functional and positional candidate. As there is a lack of consensus in regards to the level and location of IDE association signals we aimed to clarify these discrepancies through genotyping 28 SNPs in a large case-control collective together with quantitative measures of cognitive ability (MMSE). Four SNPs (rs11187007, rs2149632_ide12, rs11187033, rs11187040) were found to be associated with AD (nominal p<0.01). Tests with MMSE scores adjusted for disease duration identified associations, with the most significant result for rs1999763 (nominal p=0.008). Similarly, different reconstructed IDE haplotypes were associated with AD and higher MMSE scores. The association signals are only borderline significant after adjustment for multiple testing, but add further evidence to previous published results on the association between IDE and AD or MMSE. A subgroup analysis indicated more prominent associations with AD in younger, and with MMSE in older patients. There may be two independent effects mediated by IDE variants, risk for AD and modification of disease progression.

Sources of Variation on the Mini-Mental State Examination in a Population-Based Sample of Centenarians

PubMed Central

Dai, Ting; Davey, Adam; Woodard, John L.; Miller, L. Stephen; Gondo, Yasuyuki; Kim, Seock-Ho; Poon, Leonard W.

2013-01-01

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini-Mental State Examination (MMSE, M=16.2, SD=8.8, Range 0–30) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98–108, 16% men, 21% African-American, 38% community-dwelling) from the Georgia Centenarian Study (2001–2008) by age, education, sex, race, and residential status. Multiple-Indicator Multiple-Causes (MIMIC) models were used to identify systematic domain-level differences on MMSE scores by key demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race, and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cut-offs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation, with no evidence for interactions among centenarian characteristics. Adjusting for education was not sufficient to account for differences by race; adjusting for residential status was not sufficient to account for differences by age. PMID:23889552

Norms of the Mini-Mental state Examination for Japanese subjects that underwent comprehensive brain examinations: the Kashima Scan Study.

PubMed

Yakushiji, Yusuke; Horikawa, Etsuo; Eriguchi, Makoto; Nanri, Yusuke; Nishihara, Masashi; Hirotsu, Tatsumi; Hara, Hideo

2014-01-01

The distribution of the Mini-Mental State Examination (MMSE) scores by age and educational level was investigated in subjects that underwent comprehensive brain examinations. This cross-sectional study included 1,414 adults without neurological disorders who underwent health-screening tests of the brain, referred to as the "Brain Dock," in our center. The MMSE scores were compared between age groups (40-44, 45-49, 50-54, 55-59, 60-64, 65-69, or ≥70 years) and educational levels [the low education level group (6-12 years) and the high education level group (≥13 years)]. The median age was 59 years, and 763 (54%) were women. There was no significant difference in the MMSE total score between women and men. The stepwise method of the multiple linear regression analysis confirmed that a higher age [β value, -0.129; standard error (S.E.), 0.020; p<0.001], low education level (6-12 years) (β value, -0.226; S.E., 0.075; p=0.003), and women (β values, 0.148; S.E., 0.066; p=0.024) was significantly associated with decreased MMSE score. In general, both the percentile scores and mean scores decreased with aging and were lower in the low education level group than in the high education level group. The degree of decrement in scores with age was stronger in the low education level group than in the high education level group. The provided data for age- and education-specific reference norms will be useful for both clinicians and investigators who perform comprehensive brain examinations to assess the cognitive function of subjects.

The relationship between Piaget and cognitive levels in persons with Alzheimer's disease and related disorders.

PubMed

Matteson, M A; Linton, A D; Barnes, S J; Cleary, B L; Lichtenstein, M J

1996-02-01

Clinical observations and research studies have documented that people with Alzheimer's disease and related disorders (ADRD) appear to regress developmentally during the course of the disease. The purpose of this study was to prospectively determine the association between changes in Piaget levels of cognitive development and cognitive decline in nursing home residents in various stages of ADRD. Fifty-seven people were tested three times at yearly intervals, using the Folstein Mini-Mental State Exam to determine cognitive levels and a set of 14 Piaget tasks to determine cognitive developmental levels: 1) Formal Operations; 2) Concrete Operations; 3) Preoperational; and 4) Sensorimotor. Mean MMSE scores declined from 12.7 to 9.4, and there was a downward trend in Piaget levels over the study period. ANOVA showed significant differences (p < 0.0005, Years 1, 2, 3) in MMSE scores among all Piaget levels, and Spearman rho analysis showed significant correlations between Piaget levels and MMSE for each year (p < 0.0005, Years 1, 2, 3). The results suggest that there is a concurrent decline in cognitive developmental levels and cognition in people in various stages of Alzheimer's disease and related disorders.

Development of Super-Ensemble techniques for ocean analyses: the Mediterranean Sea case

NASA Astrophysics Data System (ADS)

Pistoia, Jenny; Pinardi, Nadia; Oddo, Paolo; Collins, Matthew; Korres, Gerasimos; Drillet, Yann

2017-04-01

Short-term ocean analyses for Sea Surface Temperature SST in the Mediterranean Sea can be improved by a statistical post-processing technique, called super-ensemble. This technique consists in a multi-linear regression algorithm applied to a Multi-Physics Multi-Model Super-Ensemble (MMSE) dataset, a collection of different operational forecasting analyses together with ad-hoc simulations produced by modifying selected numerical model parameterizations. A new linear regression algorithm based on Empirical Orthogonal Function filtering techniques is capable to prevent overfitting problems, even if best performances are achieved when we add correlation to the super-ensemble structure using a simple spatial filter applied after the linear regression. Our outcomes show that super-ensemble performances depend on the selection of an unbiased operator and the length of the learning period, but the quality of the generating MMSE dataset has the largest impact on the MMSE analysis Root Mean Square Error (RMSE) evaluated with respect to observed satellite SST. Lower RMSE analysis estimates result from the following choices: 15 days training period, an overconfident MMSE dataset (a subset with the higher quality ensemble members), and the least square algorithm being filtered a posteriori.

Analysis of the Bayesian Cramér-Rao lower bound in astrometry. Studying the impact of prior information in the location of an object

NASA Astrophysics Data System (ADS)

Echeverria, Alex; Silva, Jorge F.; Mendez, Rene A.; Orchard, Marcos

2016-10-01

Context. The best precision that can be achieved to estimate the location of a stellar-like object is a topic of permanent interest in the astrometric community. Aims: We analyze bounds for the best position estimation of a stellar-like object on a CCD detector array in a Bayesian setting where the position is unknown, but where we have access to a prior distribution. In contrast to a parametric setting where we estimate a parameter from observations, the Bayesian approach estimates a random object (I.e., the position is a random variable) from observations that are statistically dependent on the position. Methods: We characterize the Bayesian Cramér-Rao (CR) that bounds the minimum mean square error (MMSE) of the best estimator of the position of a point source on a linear CCD-like detector, as a function of the properties of detector, the source, and the background. Results: We quantify and analyze the increase in astrometric performance from the use of a prior distribution of the object position, which is not available in the classical parametric setting. This gain is shown to be significant for various observational regimes, in particular in the case of faint objects or when the observations are taken under poor conditions. Furthermore, we present numerical evidence that the MMSE estimator of this problem tightly achieves the Bayesian CR bound. This is a remarkable result, demonstrating that all the performance gains presented in our analysis can be achieved with the MMSE estimator. Conclusions: The Bayesian CR bound can be used as a benchmark indicator of the expected maximum positional precision of a set of astrometric measurements in which prior information can be incorporated. This bound can be achieved through the conditional mean estimator, in contrast to the parametric case where no unbiased estimator precisely reaches the CR bound.

Cognitive function variations in postmenopausal women treated with continuous, combined HRT or tibolone. A comparison.

PubMed

Pan, Hsien-An; Wang, Shan-Tair; Pai, Ming-Chyi; Chen, Chih-Hung; Wu, Meng-Hsing; Huang, Ko-En

2003-05-01

To compare cognitive function in postmenopausal women receiving continuous hormone replacement therapy and those receiving tibolone. This was a 6-month, prospective, single-blind, single center, randomized study. A total of 50 healthy, postmenopausal women were enrolled. In the end, 40 women completed the 6-month follow-up. One group (23 subjects) received conjugated equine estrogens (CEE), 0.625 mg/d, and medroxyprogesterone acetate (MPA), 5 mg/d. The other group (17 subjects) received tibolone, 2.5 mg/d. Their serum estradiol levels and Cognitive Abilities Screening Instrument (CASI) and Mini-Mental State Examination (MMSE) scores were obtained before starting and after 3 and 6 months of treatment. There was a significant increase in the serum estradiol level in the CEE + MPA group, especially after 3 months of treatment, but there was no increase in the estradiol level in the tibolone group. The CASI and MMSE scores of the CEE + MPA group and the tibolone group after 3 and 6 months of treatment showed no significant difference between the two groups apart from the MMSE at the 3-month follow-up. We saw an increasing trend in CASI and MMSE scores after treatment in both groups; however, the increases were not statistically significant. The rate of increase of both CASI and MMSE scores in the CEE + MPA group was greater than in the tibolone group, though the difference was not significant. This preliminary study demonstrated that both CEE + MPA and tibolone can preserve cognitive function and may be able to prevent cognitive decline in postmenopausal women during short-term treatment. Our results also show that continuous, combined CEE + MPA seems to be marginally more effective than tibolone in improving cognitive processes; however, long-term study is needed to follow-up such effect.

Correlates of Level and Change in the Mini-Mental State Examination

ERIC Educational Resources Information Center

Soubelet, Andrea; Salthouse, Timothy A.

2011-01-01

The goal of the current project was to determine (a) the cognitive abilities assessed by the Mini Mental State Examination (MMSE; M. F. Folstein, S. E. Folstein, & P. R. McHugh, 1975), (b) whether the same abilities are associated with MMSE performance among people of different ages, and (c) whether the same abilities are involved in changes…

Cross-cultural comparisons of the Mini-mental State Examination between Japanese and U.S. cohorts

PubMed Central

Meguro, Kenichi; Ishii, Hiroshi; Yamaguchi, Satoshi; Saxton, Judith A.; Ganguli, Mary

2009-01-01

Background The Mini-mental State Examination (MMSE) is widely used in Japan and the U.S.A. for cognitive screening in the clinical setting and in epidemiological studies. A previous Japanese community study reported distributions of the MMSE total score very similar to that of the U.S.A. Methods Data were obtained from the Monongahela Valley Independent Elder's Study (MoVIES), a representative sample of community-dwelling elderly people aged 65 and older living near Pittsburgh, U.S.A., and from the Tajiri Project, with similar aims in Tajiri, Japan. We examined item-by-item distributions of the MMSE between two cohorts, comparing (1) percentage of correct answers for each item within each cohort, and (2) relative difficulty of each item measured by Item Characteristic Curve analysis (ICC), which estimates log odds of obtaining a correct answer adjusted for the remaining MMSE items, demographic variables (age, gender, education) and interactions of demographic variables and cohort. Results Median MMSE scores were very similar between the two samples within the same education groups. However, the relative difficulty of each item differed substantially between the two cohorts. Specifically, recall and auditory comprehension were easier for the Tajiri group, but reading comprehension and sentence construction were easier for the MoVIES group. Conclusions Our results reaffirm the importance of validation and examination of thresholds in each cohort to be studied when a common instrument is used as a dementia screening tool or for defining cognitive impairment. PMID:18925977

Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults.

PubMed

Trzepacz, Paula T; Hochstetler, Helen; Wang, Shufang; Walker, Brett; Saykin, Andrew J

2015-09-07

The Montreal Cognitive Assessment (MoCA) was developed to enable earlier detection of mild cognitive impairment (MCI) relative to familiar multi-domain tests like the Mini-Mental State Exam (MMSE). Clinicians need to better understand the relationship between MoCA and MMSE scores. For this cross-sectional study, we analyzed 219 healthy control (HC), 299 MCI, and 100 Alzheimer's disease (AD) dementia cases from the Alzheimer's Disease Neuroimaging Initiative (ADNI)-GO/2 database to evaluate MMSE and MoCA score distributions and select MoCA values to capture early and late MCI cases. Stepwise variable selection in logistic regression evaluated relative value of four test domains for separating MCI from HC. Functional Activities Questionnaire (FAQ) was evaluated as a strategy to separate dementia from MCI. Equi-percentile equating produced a translation grid for MoCA against MMSE scores. Receiver Operating Characteristic (ROC) analyses evaluated lower cutoff scores for capturing the most MCI cases. Most dementia cases scored abnormally, while MCI and HC score distributions overlapped on each test. Most MCI cases scored ≥ 17 on MoCA (96.3%) and ≥ 24 on MMSE (98.3%). The ceiling effect (28-30 points) for MCI and HC was less using MoCA (18.1%) versus MMSE (71.4%). MoCA and MMSE scores correlated most for dementia (r = 0.86; versus MCI r = 0.60; HC r = 0.43). Equi-percentile equating showed a MoCA score of 18 was equivalent to MMSE of 24. ROC analysis found MoCA ≥ 17 as the cutoff between MCI and dementia that emphasized high sensitivity (92.3%) to capture MCI cases. The core and orientation domains in both tests best distinguished HC from MCI groups, whereas comprehension/executive function and attention/calculation were not helpful. Mean FAQ scores were significantly higher and a greater proportion had abnormal FAQ scores in dementia than MCI and HC. MoCA and MMSE were more similar for dementia cases, but MoCA distributes MCI cases across a broader score range with less ceiling effect. A cutoff of ≥ 17 on the MoCA may help capture early and late MCI cases; depending on the level of sensitivity desired, ≥ 18 or 19 could be used. Functional assessment can help exclude dementia cases. MoCA scores are translatable to the MMSE to facilitate comparison.

Differential effects of enriched environment at work on cognitive decline in old age.

PubMed

Then, Francisca S; Luck, Tobias; Luppa, Melanie; König, Hans-Helmut; Angermeyer, Matthias C; Riedel-Heller, Steffi G

2015-05-26

The aim of the present study was to investigate how different mentally demanding work conditions during the professional life-i.e., enriched environments at work-might influence the rate of cognitive decline in old age. Individuals (n = 1,054) of the Leipzig Longitudinal Study of the Aged, a representative population-based cohort study of individuals aged 75 years and older, underwent cognitive testing via the Mini-Mental State Examination (MMSE) in up to 6 measurement waves. Type and level of mentally demanding work conditions in the participants' former professional life were classified based on the O*NET job descriptor database. In multivariate mixed-model analyses (controlling for sociodemographic and health-related factors), a high level of mentally demanding work tasks stimulating verbal intelligence was significantly associated with a better cognitive functioning at baseline (on average 5 MMSE points higher) as well as a lower rate of cognitive decline (on average 2 MMSE points less) over the 8-year follow-up period compared with a low level. The rate of cognitive decline in old age was also significantly lower (on average 3 MMSE points less) in individuals who had a high level of mentally demanding work tasks stimulating executive functions than those who had a low level. The results suggest that a professional life enriched with work tasks stimulating verbal intelligence and executive functions may help to sustain a good cognitive functioning in old age (75+ years). The findings thus emphasize that today's challenging work conditions may also promote positive health effects. © 2015 American Academy of Neurology.

The sensitivity and specificity of subjective memory complaints and the subjective memory rating scale, deterioration cognitive observee, mini-mental state examination, six-item screener and clock drawing test in dementia screening.

PubMed

Ramlall, S; Chipps, J; Bhigjee, A I; Pillay, B J

2013-01-01

The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal age-related cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. A sample of 140 participants aged ≥60 years living in a residential facility for the aged were assessed clinically and assigned caseness for dementia using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised diagnostic criteria. Sensitivity and specificity of a selection of the following screening measures were tested using receiver operating characteristic (ROC) analysis for individual and combined tests: the Mini-Mental State Examination (MMSE), Six-Item Screener (SIS), Subjective Memory Complaint, Subjective Memory Complaint Clinical (SMCC), Subjective Memory Rating Scale (SMRS), Deterioration Cognitive Observee (DECO) and the Clock Drawing Test (CDT). Using ROC analyses, the SMCC, MMSE and CDT were found to be 'moderately accurate' in screening for dementia with an area under the curve (AUC) >0.70. The AUCs for the SIS (0.526), SMRS (0.661) and DECO (0.687) classified these measures as being 'less accurate'. At recommended cutoff scores, the SMCC had a sensitivity of 90.9% and specificity of 45.7%; the MMSE had a sensitivity of 63.6% and a specificity of 76.0%, and the CDT had a sensitivity of 44.4% and a specificity of 88.9%. Combining the SMCC and MMSE did not improve their predictive power except for a modest increase when using the sequential rule. The SMCC is composed of valid screening questions that have high sensitivity, are simple to administer and ideal for administration at the community or primary health care level as a first level of 'rule-out' screening. The MMSE can be included at a second stage of screening at the general hospital level and the CDT in specialist clinical settings. Sequential use of the SMCC and MMSE will improve the specificity of the former and the sensitivity of the latter. Copyright © 2013 S. Karger AG, Basel.

Cognitive impairment and mortality among the oldest-old Chinese.

PubMed

An, Ruopeng; Liu, Gordon G

2016-12-01

This study examined the relationship between cognitive impairment status and all-cause mortality among the oldest-old Chinese. A total of 7474 survey participants 80 years of age and above came from the Chinese Longitudinal Healthy Longevity Survey 1998-2012 waves. Baseline cognitive impairment status was assessed using the Chinese version of the mini-mental state examination (MMSE), with total score ranging from 0 to 30. Cox proportional hazards regressions were performed to examine the relationship between baseline cognitive impairment status in 1998 and subsequent all-cause mortality during 1998-2012, adjusting for various individual characteristics at baseline. Compared with those with no or mild cognitive impairment (18 ≤ MMSE score ≤ 30) at baseline, participants with moderate-to-severe cognitive impairment (0 ≤ MMSE score ≤ 17) were 28% (95% confidence interval = 20%, 37%) more likely to die during the follow-up period from 1998 to 2012. A dose-response relationship between baseline severity level of cognitive impairment and mortality was evident. Compared with those without cognitive impairment (25 ≤ MMSE score ≤ 30) at baseline, those having mild cognitive impairment (18 ≤ MMSE score ≤ 24), moderate cognitive impairment (10 ≤ MMSE score ≤ 17), and severe cognitive impairment (0 ≤ MMSE score ≤ 9), were 20% (13%, 28%), 38% (27%, 51%), and 47% (33%, 62%) more likely to die during the follow-up period. No statistically significant gender differences in the relationship between cognitive impairment status and mortality were found. Baseline cognitive impairment was inversely associated with longevity among the oldest-old Chinese. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Usefulness of the Montreal Cognitive Assessment (MoCA) in Huntington's disease.

PubMed

Gluhm, Shea; Goldstein, Jody; Brown, Daniel; Van Liew, Charles; Gilbert, Paul E; Corey-Bloom, Jody

2013-10-01

The Montreal Cognitive Assessment (MoCA) is a brief screening instrument for dementia that is sensitive to executive dysfunction. This study examined its usefulness for assessing cognitive performance in mild, moderate, and severe Huntington's disease (HD), compared with the use of the Mini-Mental State Examination (MMSE). We compared MoCA and MMSE total scores and the number of correct answers in 5 cognitive-specific domains in 104 manifest HD patients and 100 matched controls. For the total HD sample, and for the moderate and severe patients, significant differences between both MoCA and MMSE total scores and almost all cognitive-specific domains emerged. Even mild HD subjects showed significant differences with regard to total score and several cognitive domains on both instruments. We conclude that the MoCA, although not necessarily superior to the MMSE, is a useful instrument for assessing cognitive performance over a broad level of functioning in HD. © 2013 Movement Disorder Society.

Normative data for the Tygerberg Cognitive Battery and Mini-Mental Status Examination in a South African population.

PubMed

Roos, Annerine; Calata, Dorothy; Jonkers, Liesl; Maritz, Stephan J; Kidd, Martin; Daniels, Willie M U; Hugo, Frans J

2010-01-01

Normative data for the Tygerberg Cognitive Battery (TCB) and Mini-Mental Status Examination (MMSE) (in South Africa) have not been formally examined before. The TCB was developed for the bedside pen-and-paper screening of cognitive impairment in each of the 6 main cognitive domains, including attention and concentration, speech, memory, praxis, gnosis, and executive functioning. The test is also used to diagnose different neuropsychiatric conditions. The MMSE is an established screen of cognitive status, which is often used as a comparative standard for novel screening tests such as the TCB. The TCB was initially developed in English and Afrikaans, and a Xhosa version was also initiated with this study so that the 3 most common languages of the region could be accommodated. The first aim of the study was to estimate normative test performance on the TCB and MMSE among controls, and the second aim was to develop a Xhosa version of the TCB. Assessments of the TCB and MMSE were carried out in a population of healthy individuals (n = 157). In addition, healthy Xhosa-speaking participants (n = 14) were screened using a Xhosa version of the TCB. Reliability scores for all forms of the TCB were satisfactory. Age and education correlated significantly with TCB scores (r = -0.26, P < .01; r = 0.64, P < .01, respectively), whereas only education significantly correlated with MMSE scores (r = 0.32, P < .05). Normative values were calculated accordingly, that is, controlled for the effects of age and education. The TCB scores also correlated significantly with MMSE scores (r = 0.49, P < .05), demonstrating the potential of the TCB to serve as an alternate cognitive assessment tool, along with the MMSE, to focus neuropsychiatric investigations. Scores on the Xhosa version differed significantly on speech, praxis, and gnosis between the Afrikaans and English participant scores. These normative data can be used to increase precision and to provide an impartial evaluation when applying TCB to evaluate the cognitive ability of neuropsychiatrically impaired adult patients. However, age and education effects should be considered when computing the results of cognitive assessment. Copyright 2010 Elsevier Inc. All rights reserved.

Mini-Mental State Exam performance of older African Americans: effect of age, gender, education, hypertension, diabetes, and the inclusion of serial 7s subtraction versus "world" backward on score.

PubMed

Hawkins, Keith A; Cromer, Jennifer R; Piotrowski, Andrea S; Pearlson, Godfrey D

2011-11-01

The Mini-Mental State Exam (MMSE) is a clinically ubiquitous yet incompletely standardized instrument. Though the test offers considerable examiner leeway, little data exist on the normative consequences of common administration variations. We sought to: (a) determine the effects of education, age, gender, health status, and a common administration variation (serial 7s subtraction vs. "world" spelled backward) on MMSE score within a minority sample, (b) provide normative data stratified on the most empirically relevant bases, and (c) briefly address item failure rates. African American citizens (N = 298) aged 55-87 living independently in the community were recruited by advertisement, community recruitment, and word of mouth. Total score with "world" spelled backward exceeded total score with serial 7s subtraction across all levels of education, replicating findings in Caucasian samples. Education is the primary source of variance on MMSE score, followed by age. In this cohort, women out-performed men when "world" spelled backward was included, but there was no gender effect when serial 7s subtraction was included in MMSE total score. To ensure an appropriate interpretation of MMSE scores, reports, whether clinical or in publications of research findings, should be explicit regarding the administration method. Stratified normative data are provided.

Age, education, and changes in the Mini-Mental State Exam scores of older women: findings from the Nun Study.

PubMed

Butler, S M; Ashford, J W; Snowdon, D A

1996-06-01

To describe the relationship of Mini-Mental State Exam (MMSE) scores and changes over time in MMSE scores to age and education in a population of older women. A prospective study of a defined population. Various motherhouses and church-run health care facilities in the Eastern, Midwestern, and Southern regions of the United States. Catholic sisters (nuns) participating in the Nun Study, a study of aging and Alzheimer's Disease. The 678 participants were 75 to 102 years old (mean 83.3, standard deviation 5.5, median 82.3) at the time of the first functional assessment. Second assessments were obtained an average of 1.6 years later on 575 survivors. The outcome variables were MMSE scores at the first assessment (Time-one), and MMSE scores at the second assessment (Time-two). The independent variables were age at Time-one, and education (bachelor's degree or no bachelor's degree). Time-one MMSE scores decreased with age at Time-one. The decrease in MMSE scores with age was less in sisters with bachelor's degrees than in sisters without bachelor's degrees. The changes in MMSE scores had a "U-shaped" relationship with Time-one score, where the greatest declines occurred in sisters with intermediate Time-one scores. Stratified analysis by age, education, and Time-one MMSE scores of 20 or greater because of the small numbers of sisters with Time-one scores less than 20. In sisters with Time-one MMSE scores in the categories 20 to 23, 24 to 26, or 27 to 30, older ages at Time-one were associated with greater decline in those with bachelor's degrees, but not in those without bachelor's degrees. Also, lower education was associated with greater decline in sisters aged 75 to 84 years at Time-one, but this education effect disappeared or reversed in sisters who were 85 years of age or older at Time-one. Cognitive function as measured by the MMSE decreased with age at Time-one, most steeply as a function of age in those without bachelor's degrees. Cognitive function declined over 1.6 years within individuals, and the extent of decline increased with age in the sisters with bachelor's degrees. The extent of decline varied with age and education in an interactive manner, which may have been attributable to a hardy survivor effect in lower educated sisters. It may be necessary to consider such interactions whenever changes in function are studied, particularly when analyses are stratified by the initial level of function.

[Effect of aluminum exposure on cognitive function in electrolytic workers and its influential factors].

PubMed

Lu, Xiao-ting; Liang, Rui-feng; Jia, Zhi-jian; Wang, Hao; Song, Wen-fei; Li, Qiu-ying; Niu, Qiao

2013-02-01

To clarify the effect of aluminum exposure on the cognitive function in electrolytic workers and the prevalence of mild cognitive impairment (MCI) among them by prevalence survey, and to investigate its influential factors. Sixty-six retired workers from the electrolysis workshop of an electrolytic aluminum plant were selected as an aluminum exposure group, while 70 retired workers from a flour mill in the same region were selected as a control group. MCI patients were screened out by Mini-Mental State Examination (MMSE); the blood aluminum level was measured by inductively coupled plasma-mass spectrometry; multivariate statistical analysis was used to investigate the influential factors for MMSE scores and the correlation between blood aluminum level and MCI prevalence. The aluminum exposure group showed a significantly higher blood aluminum level than the control group (25.18 ± 2.65 µg/L vs 9.97 ± 2.83 µg/L, P < 0.01). The total MMSE score of the aluminum exposure group (26.13 ± 2.57) was significantly lower than that of the control group (27.89 ± 1.91) (P < 0.05), particularly the scores on time and place orientation, short-term memory, calculation ability, and language skill (P < 0.05). The detection rate of MCI was significantly higher in the aluminum exposure group (18.2%) than in the control group (5.7%) (P < 0.01). The main influential factors for MMSE scores were gender, age, education level, and blood aluminum level. The logistic regression analysis indicated that the MCI prevalence was significantly correlated with blood aluminum level in the study population (OR = 1.168, P < 0.01). Long-term exposure to aluminum can cause cognitive disorders in electrolytic workers and may be one of the risk factors for MCI. Advanced age, male, low education level, and high blood aluminum level may be high-risk factors for cognitive impairment.

Cognitive decline and survival in Alzheimer's disease according to education level.

PubMed

Bruandet, A; Richard, F; Bombois, S; Maurage, C A; Masse, I; Amouyel, P; Pasquier, F

2008-01-01

We tested the hypothesis that a higher education level is associated with faster cognitive decline and lower survival in a cohort of 670 Alzheimer's disease patients, followed for 3.5 years at the Lille-Bailleul memory centre. The patients were categorized in 3 groups according to educational levels: low (12 years). Cognitive function was measured with the Mini Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (DRS). Survival was analyzed with a Cox model. Analyses were adjusted for age, sex, cholinesterase inhibitor treatment, diabetes, hypertension, visible vascular lesions on MRI, baseline DRS and MMSE. The adjusted mixed random model showed that MMSE declined faster for patients with high and intermediate educational levels compared with those with a low educational level (p < 0.0001). The mean annually adjusted DRS decline was highest for the groups with the most education (p = 0.05). The mortality risk was not higher in the better-educated groups (high vs. low: RR = 0.84; 95% CI = 0.35-1.99, intermediate vs. low: RR = 0.82; 95% CI = 0.41-1.63). In our cohort, highly educated patients had a faster cognitive decline than less educated patients but similar mortality rates. Our findings support the cognitive reserve hypothesis. (c) 2007 S. Karger AG, Basel.

[Relationship between status of physical and mental function and quality of life among the elderly people admitted from long-term care insurance].

PubMed

Kim, Hyeong Seon; Bae, Nam Kyou; Kwon, In Sun; Cho, Young Chae

2010-07-01

This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. The mean scores of QOL among all the subjects was 55.4 ± 15.62 (Grade I: 49.7 ± 14.17, Grade II: 56.8 ± 14.62, Grade III: 59.4 ± 16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

Three screening methods for cognitive dysfunction using the Mini-Mental State Examination and Korean Dementia Screening Questionnaire.

PubMed

Choi, Seong Hye; Park, Moon Ho

2016-02-01

To screen for and determine cognitive dysfunction, cognitive tests and/or informant reports are commonly used. However, these cognitive tests and informant reports are not always available. The present study investigated three screening methods using the Mini-Mental State Examination (MMSE) as the cognitive test, and the Korean dementia screening questionnaire (KDSQ) as the informant report. Participants were recruited from the Korea Clinical Research Center for Dementia of South Korea, and included 2861 patients with Alzheimer's disease (dementia), 3519 patients with mild cognitive impairment and 1375 controls with no cognitive dysfunction. Three screening methods were tested: (i) MMSE alone (MMSE(cut-off) ); (ii) a conventional combination of MMSE and KDSQ (MMSE+KDSQ(cut-off) ); and (iii) a decision tree with MMSE and KDSQ (MMSE+KDSQ(decision tree) ). For discriminating any cognitive dysfunction from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.784). For discriminating dementia from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.899). For discriminating mild cognitive impairment from controls, MMSE(cut-off) had the highest area under the receiver operating characteristic curve (0.683). MMSE+KDSQ(decision tree) showed the highest sensitivity for all discriminations. For overall classification accuracy, MMSE+KDSQ(decision tree) had the highest value (70.0%). These three methods had different advantageous properties for screening and staging cognitive dysfunction. As there might be different availability across clinical settings, these three methods can be selected and used according to situational needs. © 2015 Japan Geriatrics Society.

The mini mental state examination at the time of Alzheimer's disease and related disorders diagnosis, according to age, education, gender and place of residence: a cross-sectional study among the French National Alzheimer database.

PubMed

Pradier, Christian; Sakarovitch, Charlotte; Le Duff, Franck; Layese, Richard; Metelkina, Asya; Anthony, Sabine; Tifratene, Karim; Robert, Philippe

2014-01-01

was firstly to describe the MMSE (Mini-Mental State Examination) score upon initial diagnosis of Alzheimer's disease and related disorders among the French population, according to age. Secondly, education, gender and place of residence were studied as factors potentially associated with delayed Alzheimer's disease diagnosis. we conducted a cross sectional analysis of the French National Alzheimer database (BNA). Data from 2008 to 2012 were extracted. Patients were selected at the moment of their first diagnosis of AD (n = 39,451). The MMSE score at initial diagnosis dropped significantly with increasing age. The test score increased with the degree of educational background regardless of age. Gender and place of residence were significantly related to the MMSE score, women and persons living in medical institutions having lower MMSE scores under the age of 90 years and at all educational levels. Health care professionals should be aware of these risk factors in order to maximize chances of earliest possible diagnosis of Alzheimer's disease and related disorders.

Converting MMSE to MoCA and MoCA 5-minute protocol in an educationally heterogeneous sample with stroke or transient ischemic attack.

PubMed

Wong, Adrian; Black, Sandra E; Yiu, Stanley Y P; Au, Lisa W C; Lau, Alexander Y L; Soo, Yannie O Y; Chan, Anne Y Y; Leung, Thomas W H; Wong, Lawrence K S; Kwok, Timothy C Y; Cheung, Theodore C K; Leung, Kam-Tat; Lam, Bonnie Y K; Kwan, Joseph S K; Mok, Vincent C T

2018-05-01

The Montreal Cognitive Assessment (MoCA) is psychometrically superior over the Mini-mental State Examination (MMSE) for cognitive screening in stroke or transient ischemic attack (TIA). It is free for clinical and research use. The objective of this study is to convert scores from the MMSE to MoCA and MoCA-5-minute protocol (MoCA-5 min) and to examine the ability of the converted scores in detecting cognitive impairment after stroke or TIA. A total of 904 patients were randomly divided into training (n = 623) and validation (n = 281) samples matched for demography and cognition. MMSE scores were converted to MoCA and MoCA-5 min using (1) equipercentile method with log-linear smoothing and (2) Poisson regression adjusting for age and education. Receiver operating characteristics curve analysis was used to examine the ability of the converted scores in differentiating patients with cognitive impairment. The mean education was 5.8 (SD = 4.6; ranged 0-20) years. The entire spectrum of MMSE scores was converted to MoCA and MoCA-5 min using equipercentile method. Relationship between MMSE and MoCA scores was confounded by age and education, and a conversion equation with adjustment for age and education was derived. In the validation sample, the converted scores differentiated cognitively impaired patients with area under receiver operating characteristics curve 0.826 to 0.859. We provided 2 methods to convert scores from the MMSE to MoCA and MoCA-5 min based on a large sample of patients with stroke or TIA having a wide range of education and cognitive levels. The converted scores differentiated patients with cognitive impairment after stroke or TIA with high accuracy. Copyright © 2018 John Wiley & Sons, Ltd.

Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination.

PubMed

Xie, Haiqun; Zhang, Chengguo; Wang, Yukai; Huang, Shuyun; Cui, Wei; Yang, Wenbin; Koski, Lisa; Xu, Xiping; Li, Youbao; Zheng, Meili; He, Mingli; Fu, Jia; Shi, Xiuli; Wang, Kai; Tang, Genfu; Wang, Binyan; Huo, Yong

2016-01-01

Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.

Aging-Related Oxidative Stress: Positive Effect of Memory Training.

PubMed

Pesce, Mirko; Tatangelo, Raffaella; La Fratta, Irene; Rizzuto, Alessia; Campagna, Giovanna; Turli, Cinzia; Ferrone, Alessio; Franceschelli, Sara; Speranza, Lorenza; Patruno, Antonia; Ballerini, Patrizia; De Lutiis, Maria Anna; Felaco, Mario; Grilli, Alfredo

2018-02-01

The cognitive impairment characterizing the phenotype of older adults has been related to the efficiency of the antioxidant system. This study aimed at investigating the effect of memory training (MT) on memory, global cognitive functioning, and the oxidant and antioxidant capacity of plasma. We recruited 52 healthy subjects aged over 60. Twenty-nine subjects were submitted to 6-months of MT (Experimental Group, EG), and 23 were used as a Control Group (CG). Global cognitive functioning was assessed by the Mini-Mental State Examination (MMSE) and Short- and Long-Term Memory (STM and LTM, respectively) by the Rey Auditory Verbal Learning Test (RAVLT) at baseline (T0) and after 6-months (T1). Meanwhile, Reactive Oxygen Metabolites derivative compounds (d-ROMs), Biological Antioxidant Potential (BAP), and their ratio were evaluated on plasma. Results showed that the MMSE and RAVLT scores improved in EG at T1. At the same time, the d-ROMs levels significantly decreased, while the BAP and BAP/d-ROMs ratio showed an opposite trend. In both groups, the MMSE and LTM scores were negatively associated with d-ROMs levels, and positively correlated with BAP levels and the BAP/d-ROMs ratio. When we considered the Δvalue (Δvariable = variable post-MT minus variable pre-MT) in EG, the ΔMMSE and ΔLTM scores were negatively associated to Δd-ROMs, and positively to ΔBAP and ΔBAP/dROM. In conclusion, our results suggest that MT improves memory and global cognitive functioning. These processes were significantly associated to increase in resistance against oxidative stress at the plasma level in healthy older adults. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cognitive Function in Ambulatory Patients with Systolic Heart Failure: Insights from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial

PubMed Central

Graham, Susan; Ye, Siqin; Qian, Min; Sanford, Alexandra R.; Di Tullio, Marco R.; Sacco, Ralph L.; Mann, Douglas L.; Levin, Bruce; Pullicino, Patrick M.; Freudenberger, Ronald S.; Teerlink, John R.; Mohr, J. P.; Labovitz, Arthur J.; Lip, Gregory Y. H.; Estol, Conrado J.; Lok, Dirk J.; Ponikowski, Piotr; Anker, Stefan D.; Thompson, John L. P.; Homma, Shunichi

2014-01-01

We sought to determine whether cognitive function in stable outpatients with heart failure (HF) is affected by HF severity. A retrospective, cross-sectional analysis was performed using data from 2, 043 outpatients with systolic HF and without prior stroke enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial. Multivariable regression analysis was used to assess the relationship between cognitive function measured using the Mini-Mental Status Exam (MMSE) and markers of HF severity (left ventricular ejection fraction [LVEF], New York Heart Association [NYHA] functional class, and 6-minute walk distance). The mean (SD) for the MMSE was 28.6 (2.0), with 64 (3.1%) of the 2,043 patients meeting the cut-off of MMSE <24 that indicates need for further evaluation of cognitive impairment. After adjustment for demographic and clinical covariates, 6-minute walk distance (β-coefficient 0.002, p<0.0001), but not LVEF or NYHA functional class, was independently associated with the MMSE as a continuous measure. Age, education, smoking status, body mass index, and hemoglobin level were also independently associated with the MMSE. In conclusion, six-minute walk distance, but not LVEF or NYHA functional class, was an important predictor of cognitive function in ambulatory patients with systolic heart failure. PMID:25426862

Estimators of The Magnitude-Squared Spectrum and Methods for Incorporating SNR Uncertainty

PubMed Central

Lu, Yang; Loizou, Philipos C.

2011-01-01

Statistical estimators of the magnitude-squared spectrum are derived based on the assumption that the magnitude-squared spectrum of the noisy speech signal can be computed as the sum of the (clean) signal and noise magnitude-squared spectra. Maximum a posterior (MAP) and minimum mean square error (MMSE) estimators are derived based on a Gaussian statistical model. The gain function of the MAP estimator was found to be identical to the gain function used in the ideal binary mask (IdBM) that is widely used in computational auditory scene analysis (CASA). As such, it was binary and assumed the value of 1 if the local SNR exceeded 0 dB, and assumed the value of 0 otherwise. By modeling the local instantaneous SNR as an F-distributed random variable, soft masking methods were derived incorporating SNR uncertainty. The soft masking method, in particular, which weighted the noisy magnitude-squared spectrum by the a priori probability that the local SNR exceeds 0 dB was shown to be identical to the Wiener gain function. Results indicated that the proposed estimators yielded significantly better speech quality than the conventional MMSE spectral power estimators, in terms of yielding lower residual noise and lower speech distortion. PMID:21886543

Tocopherol in Elder Self-Neglect

NASA Technical Reports Server (NTRS)

Aung, K.; Burnett, J.; Dyer, C.; Smith, S. M.

2009-01-01

Although elder self-neglect is the most common form of elder mistreatment, its pathophysiology is not well understood. Alpha-tocopherol is a lipid soluble antioxidant required for the preservation of cell membranes. Since the association between tocopherol and cognitive impairment in older adults has been described, we explored the possibility of its role in elder self-neglect. OBJECTIVE: (1) To determine whether serum tocopherol levels are associated with elder self-neglect, and (2) to assess the association of serum tocopherol levels and cognitive function in elder self-neglect. METHODS: Serum tocopherol levels were measured in a cohort of 67 self-neglecting elders and 67 matched controls, recruited for the Consortium for Research in Elder Self-neglect of Texas. Pearson s correlation tests were performed to assess bivariate associations between serum tocopherol levels and cognitive function. RESULTS: Mean serum alpha-tocopherol levels were 10.8 +/- 4.7 ug/mL in self-neglect group and 13.0 +/- 4.9 ug/mL in control group (p = 0.006, unpaired student s t-test). None of the participants from either group had alpha-tocopherol level lower than the reference range. Mean serum gamma-tocopherol levels were 2.0 +/- 1.0 ug/mL in self-neglect group and 2.0 +/- 1.1 in control group (p=0.83). Proportion of the elders with gamma-tocopherol level lower than the reference range were 4.5% (3/66) in self-neglect group and 10.4% (7/67) in control group (p=0.32, Fisher s Exact Test). Among the self-neglecting elders, no association was found between serum alpha-tocopherol levels and the Mini-Mental State Examination (MMSE) or the Wolf-Klein Clock Drawing Test (CDT) scores (r =-0.42, p=0.75 for MMSE; r=0.08, p=0.54 for CDT). No association was found between serum gamma-tocopherol levels and the MMSE or the CDT (r=-0.12, p=0.35 for MMSE; r=0.05, p=0.68 for CDT). CONCLUSION: In our sample, neither alpha-tocopherol nor gamma-tocopherol appears to have a role in pathophysiology of elder self-neglect. Nevertheless, significantly lower serum alpha-tocopherol levels in the self neglect group merits further research.

Decision trees for the analysis of genes involved in Alzheimer's disease pathology.

PubMed

Mestizo Gutiérrez, Sonia L; Herrera Rivero, Marisol; Cruz Ramírez, Nicandro; Hernández, Elena; Aranda-Abreu, Gonzalo E

2014-09-21

Alzheimer's disease (AD) is characterized by a gradual loss of memory, orientation, judgement and language. There is still no cure for this disorder. AD pathogenesis remains fairly unknown and its underlying molecular mechanisms are not yet fully understood. Several studies have shown that the abnormal accumulation of beta-amyloid and tau proteins occurs 10 to 20 years before the onset of symptoms of the disease, so it is extremely important to identify changes in the brain before the first symptoms. We used decision trees to classify 31 individuals (9 healthy controls and 22 AD patients in three different stages of disease) according to the expression of 69 genes previously reported in a meta-analysis, plus the expression levels of APP, APOE, BACE1, NCSTN, PSEN1, PSEN2 and MAPT. We also included in our analysis the MMSE (Mini-Mental State Examination) scores and number of NFT (neurofibrillary tangles). Results allowed us to generate a model of classification values for different AD stages of severity, according to MMSE scores, and achieve the identification of the expression level of protein tau that may possibly determine the onset (incipient stage) of AD. We used decision trees to model the different stages of AD (severe, moderate, incipient and control) based on the meta-analysis of gene expression levels plus MMSE and NFT scores. Both classifiers reported the variable MMSE as most informative, however it we were found that the protein tau also an important role in the onset of AD. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Hybrid Multiuser Detector Based on MMSE and AFSA for TDRS System Forward Link

PubMed Central

Yin, Zhendong; Liu, Xiaohui

2014-01-01

This study mainly focuses on multiuser detection in tracking and data relay satellite (TDRS) system forward link. Minimum mean square error (MMSE) is a low complexity multiuser detection method, but MMSE detector cannot achieve satisfactory bit error ratio and near-far resistance, whereas artificial fish swarm algorithm (AFSA) is expert in optimization and it can realize the global convergence efficiently. Therefore, a hybrid multiuser detector based on MMSE and AFSA (MMSE-AFSA) is proposed in this paper. The result of MMSE and its modified formations are used as the initial values of artificial fishes to accelerate the speed of global convergence and reduce the iteration times for AFSA. The simulation results show that the bit error ratio and near-far resistance performances of the proposed detector are much better, compared with MF, DEC, and MMSE, and are quite close to OMD. Furthermore, the proposed MMSE-AFSA detector also has a large system capacity. PMID:24883418

The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly.

PubMed

Guerrero-Berroa, Elizabeth; Luo, Xiaodong; Schmeidler, James; Rapp, Michael A; Dahlman, Karen; Grossman, Hillel T; Haroutunian, Vahram; Beeri, Michal Schnaider

2009-12-01

The mini-mental state exam (MMSE) has been used to address questions such as determination of appropriate cutoff scores for differentiation of individuals with intact cognitive function from patients with dementia and rate of cognitive decline. However, little is known about the relationship of performance in specific cognitive domains to subsequent overall decline. To examine the specific and/or combined contribution of four MMSE domains (orientation for time, orientation for place, delayed recall, and attention) to prediction of overall cognitive decline on the MMSE. Linear mixed models were applied to 505 elderly nursing home residents (mean age = 85, > 12 years education = 27%; 79% F, mean follow-up = 3.20 years) to examine the relationship between baseline scores of these domains and total MMSE scores over time. Orientation for time was the only domain significantly associated with MMSE decline over time. Combination of poor delayed recall with either attention or orientation for place was associated with significantly increased decline on the MMSE. The MMSE orientation for time predicts overall decline on MMSE scores over time. A good functioning domain added to good functioning delayed recall was associated with slower rate of decline. Copyright (c) 2009 John Wiley & Sons, Ltd.

Identification of measurement differences between English and Spanish language versions of the Mini-Mental State Examination. Detecting differential item functioning using MIMIC modeling.

PubMed

Jones, Richard N

2006-11-01

Knowledge of the extent to which measurement of adult cognitive functioning differs between Spanish and English language administrations of the Mini-Mental State Examination (MMSE) is critical for inclusive, representative, and valid research of older adults in the United States. We sought to demonstrate the use of an item response theory (IRT) based structural equation model, that is, the MIMIC model (multiple indicators, multiple causes), to evaluate MMSE responses for evidence of differential item functioning (DIF) attributable to language of administration. We studied participants in a dementia case registry study (n = 1546), 42% of whom were examined with the Spanish language MMSE. Twelve of 21 items were identified as having significant uniform DIF. The 4 most discrepant included orientation to season, orientation to state, repeat phrase, and follow command. DIF accounted for two-thirds of the observed difference in underlying level of cognitive functioning between Spanish- and English-language administration groups. Failing to account for measurement differences may lead to spurious inferences regarding language group differences in level of underlying level of cognitive functioning. The MIMIC model can be used to detect and adjust for such measurement differences in substantive research.

The Effects of Express Lane Eligibility on Medicaid and CHIP Enrollment among Children

PubMed Central

Blavin, Fredric; Kenney, Genevieve M; Huntress, Michael

2014-01-01

Objective To estimate the impact of Express Lane Eligible (ELE) implementation on Medicaid/CHIP enrollment in eight states. Data Sources/Study Setting 2007 to 2011 data from the Statistical Enrollment Data System (SEDS) on Medicaid/CHIP enrollment. Study Design We estimate difference-in-difference equations, with quarter and state fixed effects. The key independent variable is an indicator for whether the state had ELE in place in the given quarter, allowing the experience of statistically matched non-ELE states to serve as a formal counterfactual against which to assess the changes in the eight ELE states. The model also controls for time-varying economic and policy factors within each state. Data Collection/Extraction Methods We obtained SEDS enrollment data from CMS. Principal Findings Across model specifications, the ELE effects on Medicaid enrollment among children were consistently positive, ranging between 4.0 and 7.3 percent, with most estimates statistically significant at the 5 percent level. We also find that ELE increased combined Medicaid/CHIP enrollment. Conclusions Our results imply that ELE has been an effective way for states to increase enrollment and retention among children eligible for Medicaid/CHIP. These results also imply that ELE-like policies could improve take-up of subsidized coverage under the ACA. PMID:24476128

Optimal design of minimum mean-square error noise reduction algorithms using the simulated annealing technique.

PubMed

Bai, Mingsian R; Hsieh, Ping-Ju; Hur, Kur-Nan

2009-02-01

The performance of the minimum mean-square error noise reduction (MMSE-NR) algorithm in conjunction with time-recursive averaging (TRA) for noise estimation is found to be very sensitive to the choice of two recursion parameters. To address this problem in a more systematic manner, this paper proposes an optimization method to efficiently search the optimal parameters of the MMSE-TRA-NR algorithms. The objective function is based on a regression model, whereas the optimization process is carried out with the simulated annealing algorithm that is well suited for problems with many local optima. Another NR algorithm proposed in the paper employs linear prediction coding as a preprocessor for extracting the correlated portion of human speech. Objective and subjective tests were undertaken to compare the optimized MMSE-TRA-NR algorithm with several conventional NR algorithms. The results of subjective tests were processed by using analysis of variance to justify the statistic significance. A post hoc test, Tukey's Honestly Significant Difference, was conducted to further assess the pairwise difference between the NR algorithms.

Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study.

PubMed

Krug, Rodrigo de Rosso; Silva, Anna Quialheiro Abreu da; Schneider, Ione Jayce Ceola; Ramos, Luiz Roberto; d'Orsi, Eleonora; Xavier, André Junqueira

2017-04-01

To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations.

PubMed

Creavin, Sam T; Wisniewski, Susanna; Noel-Storr, Anna H; Trevelyan, Clare M; Hampton, Thomas; Rayment, Dane; Thom, Victoria M; Nash, Kirsty J E; Elhamoui, Hosam; Milligan, Rowena; Patel, Anish S; Tsivos, Demitra V; Wing, Tracey; Phillips, Emma; Kellman, Sophie M; Shackleton, Hannah L; Singleton, Georgina F; Neale, Bethany E; Watton, Martha E; Cullum, Sarah

2016-01-13

The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. We included studies that compared the 11-item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all-cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all-cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of Diseases (ICD) and the Clinical Dementia Rating. At least three authors screened all citations.Two authors handled data extraction and quality assessment. We performed meta-analysis using the hierarchical summary receiver-operator curves (HSROC) method and the bivariate method. We retrieved 24,310 citations after removal of duplicates. We reviewed the full text of 317 full-text articles and finally included 70 records, referring to 48 studies, in our synthesis. We were able to perform meta-analysis on 28 studies in the community setting (44 articles) and on 6 studies in primary care (8 articles), but we could not extract usable 2 x 2 data for the remaining 14 community studies, which we did not include in the meta-analysis. All of the studies in the community were in asymptomatic people, whereas two of the six studies in primary care were conducted in people who had symptoms of possible dementia. We judged two studies to be at high risk of bias in the patient selection domain, three studies to be at high risk of bias in the index test domain and nine studies to be at high risk of bias regarding flow and timing. We assessed most studies as being applicable to the review question though we had concerns about selection of participants in six studies and target condition in one study.The accuracy of the MMSE for diagnosing dementia was reported at 18 cut points in the community (MMSE score 10, 14-30 inclusive) and 10 cut points in primary care (MMSE score 17-26 inclusive). The total number of participants in studies included in the meta-analyses ranged from 37 to 2727, median 314 (interquartile range (IQR) 160 to 647). In the community, the pooled accuracy at a cut point of 24 (15 studies) was sensitivity 0.85 (95% confidence interval (CI) 0.74 to 0.92), specificity 0.90 (95% CI 0.82 to 0.95); at a cut point of 25 (10 studies), sensitivity 0.87 (95% CI 0.78 to 0.93), specificity 0.82 (95% CI 0.65 to 0.92); and in seven studies that adjusted accuracy estimates for level of education, sensitivity 0.97 (95% CI 0.83 to 1.00), specificity 0.70 (95% CI 0.50 to 0.85). There was insufficient data to evaluate the accuracy of the MMSE for diagnosing dementia subtypes.We could not estimate summary diagnostic accuracy in primary care due to insufficient data. The MMSE contributes to a diagnosis of dementia in low prevalence settings, but should not be used in isolation to confirm or exclude disease. We recommend that future work evaluates the diagnostic accuracy of tests in the context of the diagnostic pathway experienced by the patient and that investigators report how undergoing the MMSE changes patient-relevant outcomes.

Clinical utility of the mini-mental status examination when assessing decision-making capacity.

PubMed

Pachet, Arlin; Astner, Kevin; Brown, Lenora

2010-03-01

The main objectives of this study were to examine the relationship between cognitive deficits, as measured by the Mini-Mental Status Examination (MMSE), and decision-making capacity and to determine whether the sensitivity and specificity of the MMSE varied based upon the patient population assessed. Using a sample size of 152 patients and varying cutoff scores, the MMSE demonstrated extremely poor sensitivity. In contrast, the MMSE had excellent specificity when scores of 19 or less were obtained. In our sample, not one patient, regardless of diagnosis, was deemed to have capacity if their MMSE score was below 20. However, reliance on the MMSE for scores above 19 would too frequently lead to misclassification and incorrect assumptions about a patient's decision-making abilities. Although a score below 20 consistently yielded findings of incapability in our sample, it remains our opinion that the MMSE should not be used as a stand-alone tool to make determinations related to capacity, especially when considering the complexities associated with capacity evaluations and the vital areas, such as executive functioning and individual values and beliefs, which are omitted by the MMSE.

Conversion of the Mini-Mental State Examination to the International Classification of Functioning, Disability and Health terminology and scoring system.

PubMed

De Vriendt, P; Gorus, E; Bautmans, I; Mets, T

2012-01-01

In older patients, evaluation of the cognitive status is crucial. The Mini-Mental State Examination (MMSE) is widely used for screening of cognition, providing fairly high sensitivity, specificity and reproducibility. Recently, a consensus emerged on the necessity of an international and transparent language, as provided by the WHO's International Classification of Functioning, Disability and Health (ICF). Most assessment tools however are not in accordance with the ICF. To reformulate the MMSE according to the ICF, both for the individual items and for the scoring system. MMSE data (scores varying from 3 to 30/30) of (1) 217 cognitively healthy elderly, (2) 60 persons with mild cognitive impairment, (3) 60 patients with mild Alzheimer's disease (AD), and (4) 60 patients with moderate/severe AD were obtained from studies at a university hospital setting. Subjects were aged 65 years or more and recruited either through advertisement (group 1), from the geriatric day hospital (groups 2 and 3), or the geriatric ward (group 4). The allocation to the groups was done after multidisciplinary evaluation. The conversion of the MMSE to ICF-MMSE was done by content comparison and by subsequent translation of the scoring system using automatic algorithms. All MMSE items were converted to the corresponding ICF categories. Three ICF domains were addressed: global and specific mental functions, general tasks and demands, divided over 6 ICF categories (orientation time/place, sustaining attention, memory functions, mental functions of language, undertaking a simple task). Scores on individual items were transformed according to their relative weight on the original MMSE scale, and a total ICF-MMSE score from 0 (no problem) to 100 (complete problem) was generated. Translation was satisfying, as illustrated by a good correlation between MMSE and ICF-MMSE. The diagnostic groups were distributed over the ICF-MMSE scores as expected. For each ICF domain, ICF-MMSE subscores were higher with increasing severity in cognitive decline. There was a higher dispersion, in accordance with the more detailed scoring possibilities of the ICF-MMSE. It is possible to adapt the MMSE to the ICF concept. This adaptation enhances interdisciplinary communication since it provides more clarity in assessment, with better visibility of the areas covered by the instrument. Copyright © 2011 S. Karger AG, Basel.

[Correlates of change in cognitive function during a two-year follow-up period in a comprehensive health examination for the community-dwelling elderly for the prevention of geriatric syndromes and bed-ridden state].

PubMed

Iwasa, Hajime; Suzuki, Takao; Yoshida, Yuko; Kwon, Jinhee; Yoshida, Hideyo; Kim, Hunkyung; Sugiura, Miho; Furuna, Taketo

2006-11-01

We explored correlates of change in cognitive function during a two-year follow-up period among the community-dwelling elderly in Japan, using a population-based prospective approach. The participants analyzed in the present study were 260 men and 222 women aged 70 to 84 years at baseline, living in an urban Japanese community. Data such as change in cognitive function during two years (calculated by subtracting baseline Mini-Mental State Examination [MMSE] score from follow-up MMSE score: a negative value means a decrease in MMSE scores during the two-year period) as an outcome variable, age, education, hearing and vision problems, IADL deficit (measured by the Tokyo Metropolitan Institute of Gerontology of Index of Competence), problems related to memory complaint, living alone, hemoglobin level, as explanatory variables, and the baseline MMSE score, depressive status (measured by the Mini-International Neuropsychiatric Interview), chronic conditions (hypertension, stroke, and diabetes mellitus) as covariates, were collected during a comprehensive health examination survey for the elderly. We conducted multivariate regression analysis by genders to explore correlates of change in cognitive function. The results showed that higher age (beta = -0.18), presence of hearing problem (beta = -0.21), presence of IADL deficit (beta = -0.15), and memory complaint (beta = -0.20) in men, and higher age (beta = -0.27), low education level (beta = -0.25) and lower hemoglobin level (beta = 0.16) in women, were significantly associated with change in cognitive function when adjusting for the potential confounders. These factors may be reliable predictors for cognitive decline.

Association between oxidized low-density lipoprotein and cognitive impairment in patients with ischemic stroke.

PubMed

Wang, A; Liu, J; Meng, X; Li, J; Wang, H; Wang, Y; Su, Z; Zhang, N; Dai, L; Wang, Y; Wang, Y

2018-01-01

The association between oxidized low-density lipoprotein (oxLDL) and cognitive impairment is unclear. This study aimed to investigate the potential association between oxLDL and cognitive impairment among patients with acute ischemic stroke. We measured the levels of oxLDL and recorded the Mini-Mental State Examination (MMSE) score in patients with acute ischemic stroke who were recruited from the Study of Oxidative Stress in Patients with Acute Ischemic Stroke. Cognitive impairment was defined as an MMSE score of <24. The association between oxLDL and cognitive impairment was assessed by multivariate logistic or linear regression analysis. Other clinical variables of interest were also studied. A total of 3726 patients [1287 (34.54%) female] were included in this study, with a mean age of 63.62 ± 11.96 years. After adjusting for potential confounders in our logistic regression model, each SD increase in oxLDL was associated with a 26% increase in the prevalence of cognitive impairment (odds radio, 1.26; 95% confidence interval, 1.13-1.39; P < 0.0001). Similarly, higher oxLDL was associated with lower MMSE scores, with a 0.56-point decrease in MMSE score for every SD increase in oxLDL in a linear regression analysis (β = -0.56; 95% confidence interval, -0.81 to -0.32; P < 0.0001). There were no significant interactions between oxLDL and age, sex or education levels for cognitive impairment (all interactions, P > 0.05). Elevated levels of oxLDL were associated with a higher prevalence of cognitive impairment in patients with ischemic stroke. © 2017 EAN.

Glucose impairment and ghrelin gene variants are associated to cognitive dysfunction.

PubMed

Mora, M; Mansego, M L; Serra-Prat, M; Palomera, E; Boquet, X; Chaves, J F; Puig-Domingo, M

2014-04-01

Cognitive state and brain volume have been related to body mass index, abdominal fat, waist-hip ratio, components of metabolic syndrome (MS) and ghrelin. Genetic variations within the ghrelin gene have been recently associated to MS. The aim of our study was to investigate cognitive state by Mini-Mental State Examination (MMSE) in relation to MS components (ATP-III criteria) and ghrelin gene polymorphisms in dwelling individuals aged ≥70. 280 subjects (137 men/143 women, age 77.03 ± 5.92) from the Mataró Ageing Study were included. Individuals were phenotypically characterized by anthropometric variables, lipids, glucose, blood pressure and MMSE. SNPs -501AC (rs26802), -994CT (rs26312), -604GA (rs27647), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene were studied. Genotypes were determined by polymerase chain reaction and SNapshot minisequencing. 22.1 % had MMSE <24. MMSE <24 was associated with age (p < 0.001), female gender (p = 0.016), low education (p < 0.001) and glucose impairment or diabetes (p = 0.040). MMSE was influenced by obesity, central obesity, MS and glucose impairment. This latter association remained significant after adjustment by gender, age, alcohol, educational level, GDS and ApoE genotype (p = 0.009). Ghrelin SNPs were associated to MMSE: M72L C/A genotype showed lower score than C/C (p = 0.032, after adjusting for confounders 0.049); L90G A/T genotype showed lower score than A/A (p = 0.054, after adjusting 0.005). MMSE <24 was associated to L90G (39.1 % in A/T genotype vs 19.3 % in A/A, p = 0.026, after adjusting for confounders p = 0.002, OR 6.18 CI 1.93-21.75). Glucose impairment and L90G Ghrelin gene variant influence cognitive function in old dwelling individuals participating in the Mataró Ageing Study.

Cognitive problems in patients in a cardiac rehabilitation program after an out-of-hospital cardiac arrest.

PubMed

Boyce-van der Wal, L W; Volker, W G; Vliet Vlieland, T P M; van den Heuvel, D M J; van Exel, H J; Goossens, P H

2015-08-01

Estimate prevalence of cognitive problems due to hypoxic brain injury in out-of-hospital cardiac arrest (OHCA) survivors referred for cardiac rehabilitation and association with quality of life as well as autonomy and participation. Prospective cohort study. Consecutive OHCA patients. The Mini-Mental State Examination (MMSE), Cognitive Failures Questionnaire (CFQ) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were administered 4 weeks after the OHCA. Cognitive problems were defined if MMSE <28, CFQ >32 or IQCODE >3.6. The Impact on Participation and Autonomy Questionnaire (IPAQ) (participation/autonomy), the SF-36 Health Survey (SF-36) (quality of life) and the Hospital Anxiety Depression Scale (HADS) (anxiety/depression) were administered. Correlations between cognitive problems and participation/autonomy and quality of life were calculated. 63 of 77 patients were male (82%), median age 59 years (range 15-84). MMSE median 29 (interquartile range 28-30), CFQ mean 20.9 (SD 9.4) and IQCODE mean 3.1 (SD 0.2). Eighteen patients (23%) scored positive for cognitive problems. Significant correlations were found between MMSE and IPAQ: autonomy inside (r = -0.38), family role (r = -0.26), autonomy outside (r = -0.32), social relations (r = -0.38) and social functioning (r = 0.32). MMSE was related to SF-36: social functioning (r = 0.32). The CFQ was related to IPAQ: autonomy outdoors (r = 0.29) and SF-36: bodily pain (r = -0.37), vitality (r = -0.25), mental health (r = -0.35) and role emotional (r = -0.40). The IQCODE was related to IPAQ: autonomy indoors (r = 0.26) and to SF-36: vitality (r = -0.33) and social functioning (r = -0.41). Twenty-three percent of the patients referred for cardiac rehabilitation showed cognitive problems. Associations were found between cognitive problems and several aspects of participation/autonomy and perceived quality of life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive impairment: a randomized controlled trial.

PubMed

Bruer, Robert A; Spitznagel, Edward; Cloninger, C Robert

2007-01-01

This study explored the temporal limits of cognitive change from an intention-to-treat with group music therapy. Elderly cognitively-impaired psychiatric inpatients (N = 28) participated in an 8-week randomized control trial using a crossover design. Once a week, subjects were assigned either to music therapy or a control treatment (age-appropriate movie). The Mini-Mental State Exam (MMSE) assessed cognition 3 times every week: prior to the intervention, immediately after the mid-afternoon intervention, and the morning following the intervention. Comparisons between conditions included weekly changes in individual subject's MMSE scores from weekly baseline to both the 2 follow-ups and the following week's baseline. Significant next morning improvements in MMSE scores were found within intent-to-treat music therapy cases as compared to control cases. While all the subjects in this study were cognitively impaired, only 17 had been formally diagnosed with dementia. Based on a Cochrane Collaboration suggestion that music therapy studies within geriatric populations look specifically at the treatment of dementia, a final generalized estimating equation model considered only the change within the 17 dementia-diagnosed subjects. Immediately after the intervention, MMSE scores in the dementia-diagnosed subjects assigned to music therapy improved 2.00 points compared to the dementia-diagnosed subjects assigned to the control group (Z = 1.99, p < .05). Next-day MMSE test scores in the dementia-diagnosed subjects assigned to music therapy showed average improvements of 3.69 points compared to the control subjects (Z = 3.38, p < .001). By the following week, no significant cognitive differences remained between the two groups. It was concluded that a reasonable music therapy intervention facilitated by a trained and accredited music therapist significantly improved next-morning cognitive functioning among dementia patients. With many music therapists working in geriatric settings, more research is justified to both replicate this study and provide better guidance into the effective use of music therapy in the treatment of dementia.

Effects of Transient Versus Chronic Loneliness on Cognitive Function in Older Adults: Findings From the Chinese Longitudinal Healthy Longevity Survey.

PubMed

Zhong, Bao-Liang; Chen, Shu-Lin; Conwell, Yeates

2016-05-01

Loneliness is a risk factor for poor cognitive function in older adults (OAs); to date, however, no studies have explored whether transient and chronic loneliness have differential effects on OAs' cognitive function. The present study evaluates the impacts of transient versus chronic loneliness on cognitive function in OAs. A 6-year follow-up cohort study. Rural and urban communities of 22 provinces in China. 2,995 OAs who were cognitively healthy (the modified Mini-Mental State Examination [mMMSE] ≥ 14) and completed the 2005, 2008, and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. Self-report loneliness and mMMSE. Both transient (β = -0.389, t = -2.191, df = 2994, p = 0.029) and chronic loneliness (β = -0.640, t = -2.109, df = 2994, p = 0.035) were significantly associated with lower mMMSE scores 6 years later, net of potential confounding effects of baseline covariates. Sensitivity analyses found that regression coefficients of mMMSE scores on transient loneliness were statistically significant and relatively stable across samples with various levels of cognitive function. In contrast, coefficients of mMMSE scores on chronic loneliness were statistically significant only among samples with normal cognitive function and the absolute values of these coefficients increased with the degree of cognitive health of the analytic sample. In the sample with mMMSE greater than or equal to 21, the coefficient of chronic loneliness was 2.59 times as large as that of transient loneliness (-1.017 versus -0.392). Both transient and chronic loneliness are significant predictors of cognitive decline in OAs. Relative to transient loneliness, chronic loneliness has more pronounced negative effects on the brain health of OAs. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

A Pilot Study: The Beneficial Effects of Combined Statin-exercise Therapy on Cognitive Function in Patients with Coronary Artery Disease and Mild Cognitive Decline.

PubMed

Toyama, Kensuke; Sugiyama, Seigo; Oka, Hideki; Hamada, Mari; Iwasaki, Yuri; Horio, Eiji; Rokutanda, Taku; Nakamura, Shinichi; Spin, Joshua M; Tsao, Philip S; Ogawa, Hisao

2017-01-01

Objective Hypercholesterolemia, a risk factor in cognitive impairment, can be treated with statins. However, cognitive decline associated with "statins" (HMG-CoA reductase inhibitors) is a clinical concern. This pilot study investigated the effects of combining statins and regular exercise on cognitive function in coronary artery disease (CAD) patients with prior mild cognitive decline. Methods We recruited 43 consecutive CAD patients with mild cognitive decline. These patients were treated with a statin and weekly in-hospital aerobic exercise for 5 months. We measured serum lipids, exercise capacity, and cognitive function using the mini mental state examination (MMSE). Results Low-density lipoprotein cholesterol levels were significantly decreased, and maximum exercise capacity (workload) was significantly increased in patients with CAD and mild cognitive decline after treatment compared with before. Combined statin-exercise therapy significantly increased the median (range) MMSE score from 24 (22-25) to 25 (23-27) across the cohort (p<0.01). Changes in body mass index (BMI) were significantly and negatively correlated with changes in the MMSE. After treatment, MMSE scores in the subgroup of patients that showed a decrease in BMI were significantly improved, but not in the BMI-increased subgroup. Furthermore, the patients already on a statin at the beginning of the trial displayed a more significant improvement in MMSE score than statin-naïve patients, implying that exercise might be the beneficial aspect of this intervention as regards cognition. In a multivariate logistic regression analysis adjusted for age >65 years, sex, and presence of diabetes mellitus, a decrease in BMI during statin-exercise therapy was significantly correlated with an increase in the MMSE score (odds ratio: 4.57, 95% confidence interval: 1.05-20.0; p<0.05). Conclusion Statin-exercise therapy may help improve cognitive dysfunction in patients with CAD and pre-existing mild cognitive decline.

[Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population].

PubMed

Lobo, A; Saz, P; Marcos, G; Día, J L; de la Cámara, C; Ventura, T; Morales Asín, F; Fernando Pascual, L; Montañés, J A; Aznar, S

1999-06-05

The revalidation of the Mini Examen Cognoscitivo (MEC), first Spanish version (1978) of the Mini-Mental Status Examination (MMSE) and documentation of "population-based norms" should clarify the potential confusion induced by later versions of MMSE. The Zaragoza Study on the prevalence of dementia and depression in a representative sample of the elderly community (N = 1,080). MEC-35 and MEC-30 points, and validated, Spanish versions of Geriatric Mental State (GMS), History and Aetiology Schedule (HAS) and Social Status Schedule (SSS). a) validation of MEC (standardized lay interviewers) against the gold standard of psychiatric diagnosis (DSM-III-R), two months later; b) "population-based norms" in the "healthy" population, and c) comparison with other MMSE versions. The instrument fulfills criteria of "feasibility", "content", "procedural" and "construct validity". Test-retest reliability: weighted kappa = 0.637. MEC-30 (cut-off point 23/24), sensitivity = 89.8%, specificity = 75.1% (80.8% with the cut-off at 22/23), and ROC curve, AUC = 0.920. The coefficients of individual items were satisfactory and the specificity increases in MEC-35 (83.9%). Other MMSE Spanish versions have not improved these coefficients. "Population-based norms" confirm the hypothesized influence of age and education level. MEC-30 is the version with most comparable results with the MMSE in USA. The validity of MEC is confirmed in the elderly population, with the same cut-off points recommended in the original standardization. MEC-30 is the best version for international comparisons.

Comparison of the montreal cognitive assessment and the mini-mental state examination as screening tests in hemodialysis patients without symptoms.

PubMed

Lee, Sun Hwa; Cho, AJin; Min, Yang-Ki; Lee, Young-Ki; Jung, San

2018-11-01

Cognitive impairment in end-stage renal disease patients is associated with an increased risk of mortality. We examined the cognitive function in hemodialysis (HD) patients and compared the Korean versions of the Montreal Cognitive Assessment (K-MoCA) and of the Mini-Mental State Examination (K-MMSE) to identify the better cognitive screening instrument in these patients. Thirty patients undergoing hemodialysis and 30 matched reference group of apparently healthy control were included. All subjects underwent the K-MoCA, K-MMSE and a neuropsychological test battery to measure attention, visuospatial function, language, memory and executive function. All cognitive data were converted to z-scores with appropriate age and education level prior to group comparisons. Cognitive performance 1.0 SD below the mean was defined as modest cognitve impairment while 1.5 below the mean was defined as severe cognitive impairment. Modest cognitive impairment in memory plus other cognitive domains was detected in 27 patients (90%) while severe cognitive impairment in memory plus other cognitive domains was detected in 23 (77%) patients. Total scores in the K-MoCA were significantly lower in HD patients than in the reference group. However, no significant group difference was found in the K-MMSE. The K-MMSE ROC AUC (95% confidence interval) was 0.72 (0.59-0.85) and K-MoCA ROC AUC was 0.77 (0.65-0.89). Cognitive impairment is common but under-diagnosed in this population. The K-MoCA seems to be more sensitive than the K-MMSE in HD patients.

Parathyroid Hormone Levels and Cognition

NASA Technical Reports Server (NTRS)

Burnett, J.; Smith, S.M.; Aung, K.; Dyer, C.

2009-01-01

Hyperparathyroidism is a well-recognized cause of impaired cognition due to hypercalcemia. However, recent studies have suggested that perhaps parathyroid hormone itself plays a role in cognition, especially executive dysfunction. The purpose of this study was to explore the relationship of parathyroid hormone levels in a study cohort of elders with impaied cognition. Methods: Sixty community-living adults, 65 years of age and older, reported to Adult Protective Services for self-neglect and 55 controls matched (on age, ethnicity, gender and socio-economic status) consented and participated in this study. The research team conducted in-home comprehensive geriatric assessments which included the Mini-mental state exam (MMSE), the 15-item geriatric depression scale (GDS) , the Wolf-Klein clock test and a comprehensive nutritional panel, which included parathyroid hormone and ionized calcium. Students t tests and linear regression analyses were performed to assess for bivariate associations. Results: Self-neglecters (M = 73.73, sd=48.4) had significantly higher PTH levels compared to controls (M =47.59, sd=28.7; t=3.59, df=98.94, p<.01). There was no significant group difference in ionized calcium levels. Overall, PTH was correlated with the MMSE (r=-.323, p=.001). Individual regression analyses revealed a statistically significant correlation between PTH and MMSE in the self-neglect group (r=-.298, p=.024) and this remained significant after controlling for ionized calcium levels in the regression. No significant associations were revealed in the control group or among any of the other cognitive measures. Conclusion: Parathyroid hormone may be associated with cognitive performance.

Mini-Mental Status Examination: mixed Rasch model item analysis derived two different cognitive dimensions of the MMSE.

PubMed

Schultz-Larsen, Kirsten; Kreiner, Svend; Lomholt, Rikke Kirstine

2007-03-01

This study published in two companion papers assesses properties of the Mini-Mental State Examination (MMSE) with the purpose of improving the efficiencies of the methods of screening for cognitive impairment and dementia. An item analysis by conventional and mixed Rasch models was used to explore empirically derived cognitive dimensions of the MMSE, to assess item bias, and to construct diagnostic cut-points. The scores of 1,189 elderly residents were analyzed. Two dimensions of cognitive function, which are statistically and conceptually different from those obtained in previous studies, were derived. The corresponding sum scales were (1) age-correlated MMSE scale (A-MMSE scale: orientation to time, attention/calculation, naming, repetition, and three-stage command) and (2) non-age-correlated MMSE scale (B-MMSE scale: orientation to place, registration, recall, reading, and copying). The "writing" item was not included due to differential effects of age and sex. The analysis also showed that the study sample consisted of two cognitively different groups of elderly. The findings indicate that a two-scale solution is a stable and statistically supported framework for interpreting data obtained by means of the MMSE. Supplementary analyses are presented in the companion paper to explore the performance of this item response theory calibration as a screening test for dementia.

Determinants of Quality of Life in the Acute Stage Following Stroke

PubMed Central

Jeong, Bo-Ok; Kang, Hee-Ju; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Kim, Joon-Tae; Park, Man-Seok; Cho, Ki-Hyun; Yoon, Jin-Sang

2012-01-01

Objective This study aimed to investigate the factors influence the quality of life (QOL) of survivors of an acute stroke. Methods For 422 stroke patients, assessments were made within two weeks of the index event. QOL was measured using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF), which has four domains related to physical factors, psychological factors, social relationships, and environmental context. Associations of each four WHOQOL-BREF domain score with socio-demographic characteristics (age, sex, education, marital status, religion, and occupation), stroke severity (National Institutes of Health Stroke Scale), physical disability (Barthel Index), cognitive function (Mini-Mental Status Examination: MMSE), grip strength, and psychological distress (Hospital Anxiety and Depression Scale depression and anxiety subscale: HADS-D and HADS-A) were investigated using the linear regression models. Results Higher physical domain scores were independently associated with higher MMSE scores, stronger hand-grip strength, and lower HADS-D and HADS-A scores; higher psychological domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D and HADS-A scores; higher social relationships domain scores were independently associated with lower HADS-D and HADS-A scores; and higher environmental domain scores were independently associated with higher educational level, higher MMSE scores, and lower HADS-D scores. Conclusion Psychological distress and impaired cognitive function were independently associated with lower QOL in patients with acute stroke. However, stroke severity, physical disability and other socio-demographic factors were less significantly associated with QOL. These findings underscore the importance of psychological interventions for improving QOL during the acute phase following stroke. PMID:22707962

Carotid intima-media thickness and cognitive function in a middle-aged and older adult community: a cross-sectional study.

PubMed

Wang, Anxin; Chen, Guojuan; Su, Zhaoping; Liu, Xiaoxue; Yuan, Xiaodong; Jiang, Ruixuan; Cao, Yibin; Chen, Shuohua; Luo, Yanxia; Guo, Xiuhua; Wu, Shouling; Zhao, Xingquan

2016-10-01

The relationship between atherosclerosis and cognitive function is less well studied in Chinese populations. In addition, the results among middle-aged adults have been mixed. We aimed to investigate the association of atherosclerosis measured by carotid intima-media thickness (CIMT) and cognitive function in middle-aged and older adults from a Chinese community. Participants in the Asymptomatic Polyvascular Abnormalities in Community study (APAC) who had completed the CIMT detection and cognitive function measurements in 2012/2013 were included. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Multivariate linear regression analysis was used to analyze the association between CIMT and MMSE. Then, a stratified analysis was performed separately in middle-aged and older adults. A total of 3227 participants were included in this study (mean age 57.9 years, range 43-93 years); 56.6 % of them were men, 66.0 % were middle-aged adults. After adjusting for potential confounders, larger CIMT was associated with lower MMSE scores, with a 0.75-point decrease in MMSE score for every 1-mm increase in CIMT (β = - 0.75, P = 0.0020). The association remained statistically significant in middle-aged adults (β = - 0.57, P = 0.0390), and was stronger in older adults and adults with low education levels. There is a significant association between CIMT and cognitive function among middle-aged and older adults sampled from a Chinese population. This association was stronger in older adults and adults with low education levels.

Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores

PubMed Central

Miravitlles, Marc; Molina, Jesús; Quintano, José Antonio; Campuzano, Anna; Pérez, Joselín; Roncero, Carlos

2018-01-01

Background COPD assessment test (CAT) is a short, easy-to-complete health status tool that has been incorporated into the multidimensional assessment of COPD in order to guide therapy; therefore, it is important to understand the factors determining CAT scores. Methods This is a post hoc analysis of a cross-sectional, observational study conducted in respiratory medicine departments and primary care centers in Spain with the aim of identifying the factors determining CAT scores, focusing particularly on the cognitive status measured by the Mini-Mental State Examination (MMSE) and levels of depression measured by the short Beck Depression Inventory (BDI). Results A total of 684 COPD patients were analyzed; 84.1% were men, the mean age of patients was 68.7 years, and the mean forced expiratory volume in 1 second (%) was 55.1%. Mean CAT score was 21.8. CAT scores correlated with the MMSE score (Pearson’s coefficient r=−0.371) and the BDI (r=0.620), both p<0.001. In the multivariate analysis, the usual COPD severity variables (age, dyspnea, lung function, and comorbidity) together with MMSE and BDI scores were significantly associated with CAT scores and explained 45% of the variability. However, a model including only MMSE and BDI scores explained up to 40% and BDI alone explained 38% of the CAT variance. Conclusion CAT scores are associated with clinical variables of severity of COPD. However, cognitive status and, in particular, the level of depression explain a larger percentage of the variance in the CAT scores than the usual COPD clinical severity variables. PMID:29563782

Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores.

PubMed

Miravitlles, Marc; Molina, Jesús; Quintano, José Antonio; Campuzano, Anna; Pérez, Joselín; Roncero, Carlos

2018-01-01

COPD assessment test (CAT) is a short, easy-to-complete health status tool that has been incorporated into the multidimensional assessment of COPD in order to guide therapy; therefore, it is important to understand the factors determining CAT scores. This is a post hoc analysis of a cross-sectional, observational study conducted in respiratory medicine departments and primary care centers in Spain with the aim of identifying the factors determining CAT scores, focusing particularly on the cognitive status measured by the Mini-Mental State Examination (MMSE) and levels of depression measured by the short Beck Depression Inventory (BDI). A total of 684 COPD patients were analyzed; 84.1% were men, the mean age of patients was 68.7 years, and the mean forced expiratory volume in 1 second (%) was 55.1%. Mean CAT score was 21.8. CAT scores correlated with the MMSE score (Pearson's coefficient r =-0.371) and the BDI ( r =0.620), both p <0.001. In the multivariate analysis, the usual COPD severity variables (age, dyspnea, lung function, and comorbidity) together with MMSE and BDI scores were significantly associated with CAT scores and explained 45% of the variability. However, a model including only MMSE and BDI scores explained up to 40% and BDI alone explained 38% of the CAT variance. CAT scores are associated with clinical variables of severity of COPD. However, cognitive status and, in particular, the level of depression explain a larger percentage of the variance in the CAT scores than the usual COPD clinical severity variables.

A Mendelian randomization study of testosterone and cognition in men

PubMed Central

Zhao, Jie V.; Lam, Tai Hing; Jiang, Chaoqiang; Cherny, Stacey S.; Liu, Bin; Cheng, Kar Keung; Zhang, Weisen; Leung, Gabriel M.; Schooling, C Mary

2016-01-01

Testosterone replacement for older men is increasingly common, with some observations suggesting a protective effect on cognitive function. We examined the association of endogenous testosterone with cognitive function among older men in a Mendelian randomization study using a separate-sample instrumental variable (SSIV) analysis estimator to minimize confounding and reverse causality. A genetic score predicting testosterone was developed in 289 young Chinese men from Hong Kong, based on selected testosterone-related single nucleotide polymorphisms (rs10046, rs1008805 and rs1256031). The association of genetically predicted testosterone with delayed 10-word recall score and Mini-Mental State Examination (MMSE) score was assessed at baseline and follow-up using generalized estimating equation among 4,212 older Chinese men from the Guangzhou Biobank Cohort Study. Predicted testosterone was not associated with delayed 10-word recall score (−0.02 per nmol/L testosterone, 95% confidence interval (CI) −0.06–0.02) or MMSE score (0.06, 95% CI −0.002–0.12). These estimates were similar after additional adjustment for age, education, smoking, use of alcohol, body mass index and the Framingham score. Our findings do not corroborate observed protective effects of testosterone on cognitive function among older men. PMID:26864717

Prognosis of Treatment Outcomes by Cognitive and Physical Scales.

PubMed

Jakavonytė-Akstinienė, Agnė; Dikčius, Vytautas; Macijauskienė, Jūratė

2018-01-01

The aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini-Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = -0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale - the risk of falling was higher in patients with severe cognitive impairment. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient's discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.

Effects of multisensory stimulation on cognition, depression and anxiety levels of mildly-affected Alzheimer's patients.

PubMed

Ozdemir, Leyla; Akdemir, Nuran

2009-08-15

The purpose of this study was to investigate and assess the effects of musical therapy, painting inanimate-animate object pictures, and orientation to time-place-person interventions on the cognitive state, depression, and anxiety levels of mildly-affected Alzheimer's patients. The study using a quasi-experimental design was conducted with 27 mildly-affected Alzheimer's patients. The effects of the multisensory stimulation were evaluated with the "Mini Mental State Examination," the "Geriatric Depression Scale," and the "Beck Anxiety Scale." All of these were administered one day prior to beginning the study, immediately after its completion, and three weeks thereafter. A significant negative correlation was determined to exist between the MMSE-depression scores and MMSE-anxiety scores; the correlation between the depression-anxiety scores, on the other hand, had a positive significance. The shifts over time in the MMSE, depression and anxiety scores were significant. The primary conclusion of the study is that the multisensory stimulation method applied to mildly-affected Alzheimer's patients had a positive effect on their cognitive state, depression, and anxiety, and that this effect continued for three weeks following completion of the study intervention, with a tendency to decline progressively.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty.

PubMed

Ihle, Andreas; Gouveia, Élvio R; Gouveia, Bruna R; Freitas, Duarte L; Jurema, Jefferson; Odim, Angenay P; Kliegel, Matthias

2017-09-01

It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.

High Sensitivity Cardiac Troponin T and Cognitive Function in the Oldest Old: The Leiden 85-Plus Study.

PubMed

Bertens, Anne Suzanne; Sabayan, Behnam; de Craen, Anton J M; Van der Mast, Roos C; Gussekloo, Jacobijn

2017-01-01

Impaired cardiac function has been related to accelerated cognitive decline in late-life. To investigate whether higher levels of high sensitivity cardiac troponin T (hs-cTnT), a sensitive marker for myocardial injury, are associated with worse cognitive function in the oldest old. In 455 participants of the population-based Leiden 85-plus Study, hs-cTnT was measured at 86 years. Cognitive function was measured annually during four years with the Mini-Mental State Examination (MMSE). Participants in the highest gender-specific tertile of hs-cTnT had a 2.0-point lower baseline MMSE score than participants in the lowest tertile (95% confidence interval (CI) (95% CI 0.73-3.3), and had a 0.58-point steeper annual decline in MMSE during follow-up (95% CI 0.06-1.1). The associations remained after adjusting for sociodemographic and cardiovascular risk factors excluding those without a history of overt cardiac disease. In a population-based sample of the oldest old, higher levels of hs-cTnT were associated with worse cognitive function and faster cognitive decline, independently from cardiovascular risk factors and a history of overt cardiac disease.

Dietary Vitamin K Intake Is Associated with Cognition and Behaviour among Geriatric Patients: The CLIP Study.

PubMed

Chouet, Justine; Ferland, Guylaine; Féart, Catherine; Rolland, Yves; Presse, Nancy; Boucher, Kariane; Barberger-Gateau, Pascale; Beauchet, Olivier; Annweiler, Cedric

2015-08-12

Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ≥65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins) study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 µg/day versus the other two thirds combined). Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE); behaviour with Frontotemporal Behavioral Rating Scale (FBRS). Age, gender, social problems, education, body mass index (BMI), comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH), vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64), those with higher intake had higher (i.e., better) mean MMSE score (22.0 ± 5.7 versus 19.9 ± 6.2, p = 0.024) and lower (i.e., better) FBRS score (1.5 ± 1.2 versus 1.9 ± 1.3, p = 0.042). In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted β = 1.66, p = 0.013) and inversely associated with FBRS score (adjusted β = -0.33, p = 0.037). Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = -0.24, p = 0.001). Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.

C allele of the rs2209972 single nucleotide polymorphism of the insulin degrading enzyme gene and Alzheimer's disease in type 2 diabetes, a case control study.

PubMed

Gutiérrez-Hermosillo, Hugo; Díaz De León-González, Enrique; Palacios-Corona, Rebeca; Cedillo-Rodríguez, Javier Armando; Camacho-Luis, Abelardo; Reyes-Romero, Miguel Arturo; Medina-Chávez, Juan Humberto; Blandón, Pedro A

2015-02-20

In the last few decades we have witnessed an interesting transformation of the population pyramids throughout the world. As the population's life expectancy increases, there are more chronic diseases such as diabetes mellitus and dementias, and both of them have shown an association. To determine the association between Alzheimer's disease in diabetic patients and the insulin degrading enzyme in outpatients of a second level Hospital in Monterrey, Mexico. This was a case control study in which we included outpatients from the Geriatrics Clinic of a Hospital in Northeastern Mexico. Cases were patients with a Mini Mental Score Exam (MMSE) below 24 and DSM-IV criteria for Dementia. Controls were patients who had MMSE scores greater than 24. Data from 97 patients were analyzed. Regarding physical examination and the results of laboratory tests, there were no differences between the two groups (p>0.05). A 98% prevalence of the insulin degrading enzyme was documented in the sample studied. We found an association between a homozygous status for the CC genotype and Dementia with an estimated Odds Ratio (OR) of 2.5 (CI 95% 1.6-3.3) on the bivariate test, while, on the multivariate analysis, the OR was estimated 3.3 (CI 95% 1.3-8.2). Evidence shows that cognitive impairment is more frequent among those exposed to the C allele of the rs2209972 SNP of the insulin degrading enzyme gene. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

42 CFR 457.218 - Repayment of Federal funds by installments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... amount to be repaid exceeds 21/2 percent of the estimated or actual annual State share for the State CHIP... State CHIP program is ongoing, CMS uses the annual estimated State share of State CHIP expenditures... State CHIP program has been terminated by Federal law or by the State, CMS uses the actual State share...

42 CFR 457.218 - Repayment of Federal funds by installments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... amount to be repaid exceeds 21/2 percent of the estimated or actual annual State share for the State CHIP... State CHIP program is ongoing, CMS uses the annual estimated State share of State CHIP expenditures... State CHIP program has been terminated by Federal law or by the State, CMS uses the actual State share...

TrackCC: A Practical Wireless Indoor Localization System Based on Less-Expensive Chips

PubMed Central

Li, Xiaolong; Zheng, Yan; Cai, Jun; Yi, Yunfei

2017-01-01

This paper aims at proposing a new wireless indoor localization system (ILS), called TrackCC, based on a commercial type of low-power system-on-chip (SoC), nRF24LE1. This type of chip has only l output power levels and acute fluctuation for a received minimum power level in operation, which give rise to many practical challenges for designing localization algorithms. In order to address these challenges, we exploit the Markov theory to construct a (l+1)×(l+1) -sized state transition matrix to remove the fluctuation, and then propose a priority-based pattern matching algorithm to search for the most similar match in the signal map to estimate the real position of unknown nodes. The experimental results show that, compared to two existing wireless ILSs, LANDMARC and SAIL, which have meter level positioning accuracy, the proposed TrackCC can achieve the decimeter level accuracy on average in both line-of-sight (LOS) and non-line-of-sight (NLOS) senarios. PMID:28617313

[Toward constructing a system for detecting and coping with senile dementia in early stages among community-dwelling older people].

PubMed

Fujiwara, Yoshinori; Amano, Hidenori; Mori, Setsuko; Watanabe, Shuichiro; Kumagai, Shu; Yoshida, Yuko; Kim, Jungnim; Takabayashi, Koji; Yoshida, Hiroto; Ishihara, Miyuki; Eguchi, Fusako; Fuse, Sumie; Morita, Masahiro; Nagai, Hiroko; Shinkai, Shoji

2003-08-01

To establish a community health care system for screening community-dwelling older people with mild cognitive decline (MCD) and early diagnosis by a medical specialist. Out of all the elderly residents aged 65 years and over living in Yoita town in 2000 (n = 1673), 1544 participated in the interview survey held at community halls or at home (92.3% response). They underwent a Mini-Mental State Examination (MMSE) for assessment of cognitive function and answered questionnaires covering socio-demographic, psychological, physical and medical, and social activity items (2000/11). We defined cognitive decline as an MMSE < or = 1 SD below the age-specific mean (n = 371). Out of a total eligible population of 332, 158 pairs of subjects and their proxies participated in a follow-up survey (2001/11). The subjects themselves underwent MMSE again, and were asked for complaints of memory-related problems. Proxies answered about functional capacity and memory-related problems of subjects, for which we assessed the level of dementia with the Clinical Dementia Rating (CDR). We established criteria for encouragement to undergo detailed examination by a medical specialist as follows. 1) MMSE scores < or = 1 SD below age-specific means at both baseline and follow-up surveys, or 2) CDR > or = 0.5, and 3) not due to mental retardation. Non-participants had significant higher MMSE scores but were younger in the follow-up survey. Out of 96 subjects eligible for the detailed examination, 47 participants showed a tendency for older age with lower MMSE scores or younger age with higher MMSE scores than the average in the follow-up survey. The detailed examinations confirmed dementia of Alzheimer's type in 22 and vascular dementia in 13 on DSM-IV or magnetic resonance imaging. During our screening, 8 community care saloons were opened and the number of facilities for older people with cognitive decline is increasing. To establish a community health care system to screen and cope with community-dwelling older people with MCD in earlier stages, increased awareness of residents with slight MCD is especially important. Our attempt also suggested the importance of educational lectures, methods for testing cognitive function, and dementia care activity.

Cognition and quality of life after chemotherapy plus radiotherapy (RT) vs. RT for pure and mixed anaplastic oligodendrogliomas: radiation therapy oncology group trial 9402.

PubMed

Wang, Meihua; Cairncross, Gregory; Shaw, Edward; Jenkins, Robert; Scheithauer, Bernd; Brachman, David; Buckner, Jan; Fink, Karen; Souhami, Luis; Laperriere, Normand; Mehta, Minesh; Curran, Walter

2010-07-01

Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. For survivors, MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95% CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95% CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival. (c) 2010 Elsevier Inc. All rights reserved.

Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas: Radiation Therapy Oncology Group Trial 9402

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang Meihua, E-mail: mwang@phila.acr.or; Cairncross, Gregory; Shaw, Edward

2010-07-01

Purpose: Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Methods and Materials: Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. Results: For survivors,more » MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95% CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95% CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. Conclusion: MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival.« less

Effect of music intervention on the cognitive and depression status of senior apartment residents in Taiwan

PubMed Central

Tai, Shu-Yu; Wang, Ling-Chun; Yang, Yuan-Han

2015-01-01

Objective To identify the effect of music intervention on cognitive function and depression status of residents in senior citizen apartments based on the existing evidence regarding music therapy. Methods An experimental study was conducted from November 2008 to December 2009. Sixty healthy senior apartment residents over 65 years of age were recruited and separated into two groups. According to their opinion, 41 took part in the music intervention group and 19 in the comparison group. The music intervention involved Buddhist hymns. The short-term effects were evaluated based on the measurement of cognitive function and depression level using the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale-short form (GDS-SF) at the baseline, 1 month, and 4 months. Results The means of the initial and the 1-month MMSE and GDS-SF scores did not differ between the two groups. The 4-month MMSE score significantly declined compared with the initial level in the comparison group, whereas no significant change was observed in the experimental group. Moreover, the 4-month GDS-SF score significantly improved in both groups compared with the initial level. Conclusion Music intervention may postpone cognitive decline in healthy residents preferring Buddhist hymns in the senior citizen apartments in 4 months follow-up, and intense contact with participants may improve their mood status. PMID:26109859

The level of cognitive function and recognition of emotions in older adults

PubMed Central

Singh-Manoux, Archana; Batty, G. David; Ebmeier, Klaus P.; Jokela, Markus; Harmer, Catherine J.; Kivimäki, Mika

2017-01-01

Background The association between cognitive decline and the ability to recognise emotions in interpersonal communication is not well understood. We aimed to investigate the association between cognitive function and the ability to recognise emotions in other people’s facial expressions across the full continuum of cognitive capacity. Methods Cross-sectional analysis of 4039 participants (3016 men, 1023 women aged 59 to 82 years) in the Whitehall II study. Cognitive function was assessed using a 30-item Mini-Mental State Examination (MMSE), further classified into 8 groups: 30, 29, 28, 27, 26, 25, 24, and <24 (possible dementia) MMSE points. The Facial Expression Recognition Task (FERT) was used to examine recognition of anger, fear, disgust, sadness, and happiness. Results The multivariable adjusted difference in the percentage of accurate recognition between the highest and lowest MMSE group was 14.9 (95%CI, 11.1–18.7) for anger, 15.5 (11.9–19.2) for fear, 18.5 (15.2–21.8) for disgust, 11.6 (7.3–16.0) for sadness, and 6.3 (3.1–9.4) for happiness. However, recognition of several emotions was reduced already after 1 to 2-point reduction in MMSE and with further points down in MMSE, the recognition worsened at an accelerated rate. Conclusions The ability to recognize emotion in facial expressions is affected at an early stage of cognitive impairment and might decline at an accelerated rate with the deterioration of cognitive function. Accurate recognition of happiness seems to be less affected by a severe decline in cognitive performance than recognition of negatively valued emotions. PMID:28977015

Effects of transient versus chronic loneliness on cognitive function in older adults: Findings from the Chinese Longitudinal Healthy Longevity Survey

PubMed Central

Zhong, Bao-Liang; Chen, Shu-Lin; Conwell, Yeates

2016-01-01

Objectives Loneliness is a risk factor for poor cognitive function in older adults (OAs), however, to date, no studies have explored whether transient and chronic loneliness have differential effects on OAs’ cognitive function. The present study evaluates the impacts of transient versus chronic loneliness on cognitive function in OAs. Design A 6-year follow-up cohort study. Setting Rural and urban communities of 23 provinces in China. Participants 2995 OAs who were cognitively healthy (the modified Mini-mental State Examination [mMMSE] ≥ 14) and completed the 2005, 2008 and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey. Measurements Self-report loneliness and mMMSE. Results Both transient (β=−0.389, t=−2.191, df=2994, P=0.029) and chronic loneliness (β=−0.640, t=−2.109, df=2994, P=0.035) were significantly associated with lower mMMSE scores six years later, net of potential confounding effects of baseline covariates. Sensitivity analyses found that regression coefficients of mMMSE scores on transient loneliness were statistically significant and relatively stable across samples with various levels of cognitive function. In contrast, coefficients of mMMSE scores on chronic loneliness were statistically significant only among samples with normal cognitive function and the absolute values of these coefficients increased with the degree of cognitive health of the analytic sample. In the sample with mMMSE≥21, the coefficient of chronic loneliness was 2.59 times as large as that of transient loneliness (−1.017 versus −0.392). Conclusions Both transient and chronic loneliness are significant predictors of cognitive decline in OAs. Relative to transient loneliness, chronic loneliness has more pronounced negative effects on the brain health of OAs. PMID:26905049

[Performance of an abbreviated mini mental examination to detect dementia in older people].

PubMed

Jiménez, Daniel; Lavados, Manuel; Rojas, Paula; Henríquez, Claudio; Silva, Fernando; Guillón, Marta

2017-07-01

The usefulness of the abbreviated Mini-Mental State Examination included in the Chilean Functional assessment of elderly people (MM-SE-EFAM) to detect Dementia has not been determined. To assess the performance of the MMSE-EFAM to detect dementia. We studied a non-probabilistic sample of subjects older than 65 years who had been assessed by the MMSE-EFAM in a Chilean primary care center during a period of 6 months. Patients underwent clinical evaluation by a neurologist blinded to MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied. The clinical diagnosis of Dementia was established in 13 of the 54 peoples evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals (CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95% CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95% CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic variables did not influence test performance in both cases. MMSE-EFAM has a low sensitivity to detect patients with Dementia and it is not an effective screening tool. These results are in agreement with the evidence and international guidelines that do not support the use of cognitive screening tools to detect dementia in the older general population.

4C.05: PWV IS AN INDEPENDENT DETERMINANT OF COGNITIVE DYSFUNCTION IN CKD PATIENTS.

PubMed

Karasavvidou, D; Pappas, K; Stagikas, D; Makridis, D; Katsinas, C; Kalaitzidis, R

2015-06-01

Cognitive dysfunction has long been recognized as a complication of chronic kidney disease (CKD), through several putative mechanisms, including high BP, large and small artery damage. Our study tests the hypothesis that large artery stiffness and microvascular damage are related to brain microcirculation changes as reflected by impaired cognitive function in CKD patients.(Figure is included in full-text article.) : Two hundred seventeen patients (50 with CKD stage 1; 67 stage 2; 53 stage 3; 47 stage 4), with mean age 58.4 years (64.5% males), were enrolled in a cross-sectional study. Cognitive function was assessed using Mini Mental State Examination (MMSE). Full score on the MMSE is 30; cognitive impairment was defined as <26 and cognitive dysfunction as <19. Educational level was categorized as lower versus higher education. Using the Sphygmocor system and an oscillometric device, we directly measured brachial SBP (bSBP) and pulse pressure (bPP), carotid SBP (cSBP) and pulse pressure (cPP) and estimated aortic SBP (aSBP) and pulse pressure (aPP) from the radial pressure waveform. Pulse Pressure Amplification (PPA), augmentation index (AIx) and carotid-femoral pulse wave velocity (cfPWV) were calculated. The risk of cognitive dysfunction increased significantly from CKD stage 3 to 4 (p < 0.01). Table. In univariate analysis, age (p < 0.001), education level (p < 0.001) stages of CKD (p < 0.004), cfPWV (p < 0.029), AIx (p < 0.03), bSBP (p < 0.002), aSBP (p < 0.012), cSBP (p < 0.015) and cPP (p < 0.002) were significantly and negatively associated with MMSE. In multivariate regression analysis, adjusted for CKD stages, the remaining independent factor significantly (p < 0.02) associated with cognitive dysfunction was cfPWV. Carotid-femoral PWV may be a more sensitive marker of cognitive dysfunction than other parameters of central blood pressure. Since high cfPWV is associated with high pressure pulsatility at the cerebrovascular level, these data suggest that the later could play a pathophysiological role in cognitive dysfunction. In clinical practice, measuring aortic stiffness may help predicting the cognitive decline. Whether, the reduction in aortic stiffness following treatment translates into improved cognitive outcomes remains to be determined.

Low intakes of carotene, vitamin B2 , pantothenate and calcium predict cognitive decline among elderly patients with diabetes mellitus: The Japanese Elderly Diabetes Intervention Trial.

PubMed

Araki, Atsushi; Yoshimura, Yukio; Sakurai, Takashi; Umegaki, Hiroyuki; Kamada, Chiemi; Iimuro, Satoshi; Ohashi, Yasuo; Ito, Hideki

2017-08-01

The present study aimed to examine whether nutrient intakes predicted cognitive decline among elderly patients with diabetes mellitus. This study evaluated data from a 6-year prospective follow up of 237 elderly patients (aged ≥65 years) with diabetes mellitus, and the associations of baseline nutrient intakes with cognitive decline. Cognitive decline was defined as a ≥2-point decrease in the Mini-Mental State Examination (MMSE) score. Intakes of food and nutrients were assessed using a validated food frequency questionnaire, and were compared between patients with cognitive decline and intact cognition. Analysis of covariance and logistic regression analysis were used to compare the changes in the MMSE score during the follow up among intake tertile groups for each nutrient. Compared with men with intact cognition, the men with cognitive decline had lower baseline intakes of calcium, vitamin A, vitamin B 2 , pantothenate, soluble fiber, green vegetables and milk. However, no significant associations between cognitive decline and nutrient intakes were observed among women. After adjusting for age, body mass index, glycated hemoglobin levels, history of severe hypoglycemia, previous stroke and baseline MMSE score, we found that cognitive decline was significantly associated with low intakes of carotene, vitamin B 2 , pantothenate, calcium and green vegetables. Multiple logistic regression analysis showed that intakes of nutrients and green vegetables predicted cognitive decline after adjusting for age, body mass index, glycated hemoglobin levels, baseline MMSE score, and incident stroke during the follow up. These findings suggest that sufficient intakes of carotene, vitamin B 2 , pantothenate, calcium and vegetables could help prevent cognitive decline among elderly men with diabetes mellitus. Geriatr Gerontol Int 2017; 17: 1168-1175. © 2016 Japan Geriatrics Society.

Effects of Cognition, Function, and Behavioral and Psychological Symptoms on Medicare Expenditures and Health Care Utilization for Persons With Dementia.

PubMed

Jutkowitz, Eric; Kane, Robert L; Dowd, Bryan; Gaugler, Joseph E; MacLehose, Richard F; Kuntz, Karen M

2017-06-01

Clinical features of dementia (cognition, function, and behavioral/psychological symptoms [BPSD]) may differentially affect Medicare expenditures/health care utilization. We linked cross-sectional data from the Aging, Demographics, and Memory Study to Medicare data to evaluate the association between dementia clinical features among those with dementia and Medicare expenditures/health care utilization (n = 234). Cognition was evaluated using the Mini-Mental State Examination (MMSE). Function was evaluated as the number of functional limitations (0-10). BPSD was evaluated as the number of symptoms (0-12). Expenditures were estimated with a generalized linear model (log-link and gamma distribution). Number of hospitalizations, institutional outpatient visits, and physician visits were estimated with a negative binomial regression. Medicare covered skilled nursing days were estimated with a zero-inflated negative binomial model. Cognition and BPSD were not associated with expenditures. Among individuals with less than seven functional limitations, one additional limitation was associated with $123 (95% confidence interval: $19-$227) additional monthly Medicare spending. Better cognition and poorer function were associated with more hospitalizations among those with an MMSE less than three and less than six functional limitations, respectively. BPSD had no effect on hospitalizations. Poorer function and fewer BPSD were associated with more skilled nursing among individuals with one to seven functional limitations and more than four symptoms, respectively. Cognition had no effect on skilled nursing care. No clinical feature was associated with institutional outpatient care. Of individuals with an MMSE less than 15, poorer cognition was associated with fewer physician visits. Among those with more than six functional limitations, poorer function was associated with fewer physician visits. Poorer function, not cognition or BPSD, was associated with higher Medicare expenditures. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Improving detection of dementia in Asian patients with low education: combining the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly.

PubMed

Narasimhalu, Kaavya; Lee, June; Auchus, Alexander P; Chen, Christopher P L H

2008-01-01

Previous work combining the Mini-Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) has been conducted in western populations. We ascertained, in an Asian population, (1) the best method of combining the tests, (2) the effects of educational level, and (3) the effect of different dementia etiologies. Data from 576 patients were analyzed (407 nondemented controls, 87 Alzheimer's disease and 82 vascular dementia patients). Sensitivity, specificity and AUC values were obtained using three methods, the 'And' rule, the 'Or' rule, and the 'weighted sum' method. The 'weighted sum' rule had statistically superior AUC and specificity results, while the 'Or' rule had the best sensitivity results. The IQCODE outperformed the MMSE in all analyses. Patients with no education benefited more from combined tests. There was no difference between Alzheimer's disease and vascular dementia populations in the predictive value of any of the combined methods. We recommend that the IQCODE be used to supplement the MMSE whenever available and that the 'weighted sum' method be used to combine the MMSE and the IQCODE, particularly in populations with low education. As the study population selected may not be representative of the general population, further studies are required before generalization to nonclinical samples. (c) 2007 S. Karger AG, Basel.

Chocolate Consumption is Associated with a Lower Risk of Cognitive Decline.

PubMed

Moreira, Afonso; Diógenes, Maria José; de Mendonça, Alexandre; Lunet, Nuno; Barros, Henrique

2016-05-06

Cocoa-related products like chocolate have taken an important place in our food habits and culture. In this work, we aim to examine the relationship between chocolate consumption and cognitive decline in an elderly cognitively healthy population. In the present longitudinal prospective study, a cohort of 531 participants aged 65 and over with normal Mini-Mental State Examination (MMSE; median 28) was selected. The median follow-up was 48 months. Dietary habits were evaluated at baseline. The MMSE was used to assess global cognitive function at baseline and at follow-up. Cognitive decline was defined by a decrease ≥ 2 points in the MMSE score between evaluations. Relative risk (RR) and 95% confidence interval (95% CI) estimates were adjusted for age, education, smoking, alcohol drinking, body mass index, hypertension, and diabetes. Chocolate intake was associated with a lower risk of cognitive decline (RR = 0.59, 95% CI 0.38-0.92). This protective effect was observed only among subjects with an average daily consumption of caffeine lower than 75 mg (69% of the participants; RR = 0.50, 95% CI 0.31-0.82). To our knowledge, this is the first prospective cohort study to show an inverse association between regular long-term chocolate consumption and cognitive decline in humans.

Cognitive performance on the mini-mental state examination and the montreal cognitive assessment across the healthy adult lifespan.

PubMed

Gluhm, Shea; Goldstein, Jody; Loc, Kiet; Colt, Alexandra; Liew, Charles Van; Corey-Bloom, Jody

2013-03-01

We sought to compare age-related performance on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) across the adult lifespan in an asymptomatic, presumably normal, sample. The MMSE is the most commonly used brief cognitive screening test; however, the MoCA may be better at detecting early cognitive dysfunction. We gave the MMSE and MoCA to 254 community-dwelling participants ranging in age from 20 to 89, stratified by decade, and we compared their scores using the Wilcoxon signed rank test. For the total sample, the MMSE and MoCA differed significantly in total scores as well as in visuospatial, language, and memory domains (for all of these scores, P<0.001). Mean MMSE scores declined only modestly across the decades; mean MoCA scores declined more dramatically. There were no consistent domain differences between the MMSE and MoCA during the third and fourth decades; however, significant differences in memory (P<0.05) and language (P<0.001) emerged in the fifth through ninth decades. We conclude that the MoCA may be a better detector of age-related decrements in cognitive performance than the MMSE, as shown in this community-dwelling adult population.

Cognitive Impairment and Risk Factors in Elderly People Living in Fluorosis Areas in China.

PubMed

Li, Mang; Gao, Yanhui; Cui, Jing; Li, Yuanyuan; Li, Bingyun; Liu, Yang; Sun, Jing; Liu, Xiaona; Liu, Hongxu; Zhao, Lijun; Sun, Dianjun

2016-07-01

Residents living in fluorosis areas generally experienced long-term exposure to excessive fluoride in drinking water. The adverse effects of high fluoride levels on the nervous system have been studied; however, the effect of fluoride exposure on cognitive functions of elderly people in fluorosis areas is rarely reported. This study was aimed to find out the potential risk factors of cognitive impairment among elderly people who lived in fluorosis areas of China. A total of 511 subjects, aged 60 years or above, were investigated in fluorosis areas of Heilongjiang Province, Inner Mongolia Autonomous Region, Qinghai Province, and Xinjiang Uygur Autonomous Region. The Mini-Mental State Examination (MMSE) was used to examine cognitive functions of the study subjects. Based on the MMSE scores, the study subjects were divided into normal group and cognitive impairment group that consisted of mild, moderate, and severe groups. Multivariable logistic regression showed that a higher risk of cognitive impairment was associated with increased age and decreased education levels. Multiple linear regression analysis revealed that MMSE scores were negatively associated with serum homocysteine (Hcy) levels. However, both urinary fluoride and serum Hcy levels in the normal group were not the lowest among the four groups. Spearman's correlation analysis showed that urinary fluoride levels were positively correlated with serum Hcy (r s = 0.209, P < 0.01). Our study suggests that people with cognitive impairment in fluorosis areas have elevated serum Hcy levels, which was positively correlated with urinary fluoride concentrations. A certain low dose of fluoride intake may play a potential protective rather than harmful role in cognitive functions; however, high fluoride exposure is a potential risk factor for cognitive impairment.

Association between age associated cognitive decline and health related quality of life among Iranian older individuals.

PubMed

Kazazi, Leila; Foroughan, Mahshid; Nejati, Vahid; Shati, Mohsen

2018-04-01

Age associated cognitive decline or normal cognitive aging is related with lower levels of functioning in real life, and may interfere with maintaining independence and health related quality of life (HRQL). In this study, health related quality of life and cognitive function in community-dwelling older adults were evaluated with the aim of exploring the association between them by adjusting for potential confounders. This cross-sectional study, was implemented on 425 community-dwelling older adults aged 60 and over, between August 2016 and October 2016 in health centers of the municipality of Tehran, Iran, using Mini Mental State Examination (MMSE) to assess cognitive function and Short Form-36 scales (SF-36) to assess HRQL. The relation between HRQL and cognitive function was evaluated by Pearson's correlation coefficient, and the impact of cognitive function on HRQL adjusted for potential confounders was estimated by linear regression model. All analyses were done using SPSS, version 22.0. A positive significant correlation between cognitive function and quality of life (r=0.434; p<0.001) and its dimensions was observed. Two variables of educational level (B=2.704; 95% CI: 2.09 to 3.30; p<0.001) and depression (B=2.554; 95% CI: 2.00 to 3.10; p<0.001) were assumed as potential confounder by changing effect measure after entering the model. After adjusting for potential confounders in regression model, the association between MMSE scores and quality of life persisted (B=2.417; 95% CI: 1.86 to 2.96; p<0.001). The results indicate that cognitive function was associated with HRQL in older adults with age associated cognitive function. Two variables of educational level and depression can affect the relation between cognitive decline and HRQL.

Depression and dementia in Parkinson's disease.

PubMed

Sinanović, Osman; Hudić, Josip; Zukić, Sanela; Kapidžić, Almasa; Zonić, Lejla; Vidović, Mirjana

2015-03-01

Parkinson's disease (PD) is a neurodegenerative disorder causing not only motor dysfunction but also cognitive, psychiatric, autonomic and sensory disturbances. Depression is the most common psychiatric disturbance identified in patients with PD and has been shown to be more common in PD than in other chronic and disabling disorders, occurring in approximately 40% of PD patients. However, the prevalence and clinical features associated with depression in PD remain controversial. Dementia is increasingly recognized as a symptom associated with idiopathic PD, and is found in up to 40% of all patients suffering from that condition. The aim of this study was to estimate the prevalence of depressive and dementia symptoms in PD patients. The study included 35 consecutive patients with PD, 13 (37.4%) male and 22 (62.6%) female (mean age 62.9 ± 11.0, range 36-85 years), mean duration of disease 4.7 ± 2.9 (range 1-10) years, hospitalized during one year at Clinical Department of Neurology, Tuzla University Clinical Center, Tuzla, Bosnia and Herzegovina. The Mini Mental State Examination (MMSE) was used for assessment of cognitive deterioration and Beck Depression Inventory (BDI) for depression. Computerized tomography was performed in all patients. According to BDI scale, depressive symptoms were present in all 35 PD patients: minimal in 4 (11.4%), low in 7 (20%), moderate in 8 (22.8%), severe in 9 (25.4%) and extreme in 7 (20%) patients. On MMSE scale, 9 (25.4%) patients were free from cognitive deterioration and 26 (74.6%) patients had moderate to severe deterioration, but 21 (60%) patients (7 (33.33%) male and 14 (66.66%) female) had symptoms of dementia (MMSE score ≤ 23). Using MMSE scale, 8 (22.8%) patients were free from dementia and 27 (77.2%) patients had some cognitive deterioration. Very mild symptoms of dementia were found in 6 (25.9%) and overt features of dementia in 21 (74.1%) PD patients. So, out of 35 PD study patients, 21 (60%) (7 (33.3%) male and 14 (66.7%) female) had symptoms of dementia (MMSE score ≤ 23). In conclusion, depressive and dementia symptoms are common in PD patients.

Use of the MC-FAQ and MMSE-FAQ in cognitive screening of older African Americans, Hispanic Americans, and European Americans.

PubMed

Tappen, Ruth M; Rosselli, Monica; Engstrom, Gabriella

2012-11-01

The purpose of this study was to examine the performance of the Mini-Cog-Functional Activities Questionnaire (MC-FAQ) and the Mini-Mental State Examination-Functional Activities Questionnaire (MMSE-FAQ) in cognitive screening of a multiethnic sample of older adults. This is a descriptive psychometric study. Cognitive screening was done in senior centers, at health fairs, and within the nine participating memory disorder centers in the State of Florida. African American, Hispanic American, and European American older adults who participated in this screening were matched on gender, age within 3 years and education within 3 years yielding a sample of 225. The MC-FAQ is a combination of the Mini-Cog and Functional Activities Questionnaire. The MMSE-FAQ combines the MMSE with the FAQ. The Geriatric Depression Scale was used to assess depressive symptoms. African Americans reported significantly less depressive symptoms (F[2, 217] = 10.31, p <0.001) and European Americans had significantly higher mean MMSE scores than the other two groups (F[2, 222] = 3.33, p = 0.037). Participants did not differ by ethnic group on the MC-FAQ or MMSE-FAQ classifications of normal, mild cognitive impairment, or dementia. Age, years of education, and depressive symptoms were significant predictors of MC-FAQ and MMSE-FAQ classifications. The results suggest that these combinations of screening measures may have less culture bias than the MMSE alone. Sensitivity and specificity should be evaluated in these groups with confirmatory neurological and psychiatric diagnosis. 2012 American Association for Geriatric Psychiatry

Cognitive Evolution by MMSE in Poststroke Patients

ERIC Educational Resources Information Center

da Costa, Fabricia Azevedo

2010-01-01

The aim of this study was to investigate the cognitive and clinical evolution of post-acute stroke patients and the evolution of each Mini-Mental State Examination (MMSE) item. A longitudinal study was conducted with 42 poststroke individuals in rehabilitation. The MMSE and the National Institutes of Health Stroke Scale were used to assess…

Coordinated Analysis of Age, Sex, and Education Effects on Change in MMSE Scores

PubMed Central

2013-01-01

Objectives. We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Method. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Results. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. Conclusion. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ. PMID:23033357

Coordinated analysis of age, sex, and education effects on change in MMSE scores.

PubMed

Piccinin, Andrea M; Muniz-Terrera, Graciela; Clouston, Sean; Reynolds, Chandra A; Thorvaldsson, Valgeir; Deary, Ian J; Deeg, Dorly J H; Johansson, Boo; Mackinnon, Andrew; Spiro, Avron; Starr, John M; Skoog, Ingmar; Hofer, Scott M

2013-05-01

We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.

A portable optical reader and wall projector towards enumeration of bio-conjugated beads or cells

PubMed Central

McArdle, Niamh A.; Kendlin, Jane L.; O’Connell, Triona M.; Ducrée, Jens

2017-01-01

Measurement of the height of a packed column of cells or beads, which can be direclty related to the number of cells or beads present in a chamber, is an important step in a number of diagnostic assays. For example, haematocrit measurements may rapidly identify anemia or polycthemia. Recently, user-friendly and cost-efficient Lab-on-a-Chip devices have been developed towards isolating and counting cell sub-populations for diagnostic purposes. In this work, we present a low-cost optical module for estimating the filling level of packed magnetic beads within a Lab-on-a-Chip device. The module is compatible with a previously introduced, disposable microfluidic chip for rapid determination of CD4+ cell counts. The device is a simple optical microscope module is manufactured by 3D printing. An objective lens directly interrogates the height of packed beads which are efficiently isolated on the finger-actuated chip. Optionally, an inexpensive, battery-powered Light Emitting Diode may project a shadow of the microfluidic chip at approximately 50-fold magnification onto a nearby surface. The reader is calibrated with the filling levels of known concentrations of paramagnetic beads within the finger actuated chip. Results in direct and projector mode are compared to measurements from a conventional, inverted white-light microscope. All three read-out methods indicate a maximum variation of 6.5% between methods. PMID:29267367

[Effects of COPD on cognitive functions: a case control study].

PubMed

Sarınç Ulaşlı, Sevinç; Oruç, Serdar; Günay, Ersin; Aktaş, Orçun; Akar, Olcay; Koyuncu, Tülay; Ünlü, Mehmet

2013-01-01

Assessment of disease severity, effects of disease on health status and future events should be considered to direct treatment strategies in chronic obstructive pulmonary disease (COPD) management. Although extrapulmonary effects of COPD are well known, effects of COPD on cognitive functions have not been evaluated sufficiently. therefore we aimed to determine cognitive functions of copd patients in the present study. 112 COPD patients with moderate, severe and very severe irreversible airway obstruction and 44 age matched healthy subjects without COPD and systemic diseases as control group were enrolled to the study. Mini mental state examination (MMSE) was performed to evaluate cognitive functions. MMSE results were compared between patient and control groups. Moreover relationship between exacerbation frequency and cognitive functions was evaluated. Total 156 subjects as 112 COPD patients and 44 healthy subjects were included to the study. Mean age of COPD patients was 65.03 ± 7.63 years, and mean age of control group was 63.63 ± 8.96 years (p= 0.364). Mean score of MMSE in COPD patients was 23.8 ± 4.39, and mean score of MMSE in control group was 26.7 ± 2.88. We determined a significant difference in terms of MMSE scores betweeen patient and control group (p< 0.0001). MMSE scores and FEV1 values were significantly different among patients with moderate, sevre and very severe airflow obstruction (p= 0.001; p< 0.0001 respectively). We found a significant negative correlation between MMSE results and exacerbation frequency during last year (p= 0.003; r= -0.239). Lower MMSE scores of COPD patients than subjects in control group indicates the impairment of cognitive functions in COPD patients. Moreover a negative relationship between MMSE scores with exacerbation frequency during last year suggests that prevention from exacerbation can decrease cognitive impairment in COPD patients. We believe that assessment of cognitive functions and preventive strategies should be considered in COPD management.

Hardware architecture design of a fast global motion estimation method

NASA Astrophysics Data System (ADS)

Liang, Chaobing; Sang, Hongshi; Shen, Xubang

2015-12-01

VLSI implementation of gradient-based global motion estimation (GME) faces two main challenges: irregular data access and high off-chip memory bandwidth requirement. We previously proposed a fast GME method that reduces computational complexity by choosing certain number of small patches containing corners and using them in a gradient-based framework. A hardware architecture is designed to implement this method and further reduce off-chip memory bandwidth requirement. On-chip memories are used to store coordinates of the corners and template patches, while the Gaussian pyramids of both the template and reference frame are stored in off-chip SDRAMs. By performing geometric transform only on the coordinates of the center pixel of a 3-by-3 patch in the template image, a 5-by-5 area containing the warped 3-by-3 patch in the reference image is extracted from the SDRAMs by burst read. Patched-based and burst mode data access helps to keep the off-chip memory bandwidth requirement at the minimum. Although patch size varies at different pyramid level, all patches are processed in term of 3x3 patches, so the utilization of the patch-processing circuit reaches 100%. FPGA implementation results show that the design utilizes 24,080 bits on-chip memory and for a sequence with resolution of 352x288 and frequency of 60Hz, the off-chip bandwidth requirement is only 3.96Mbyte/s, compared with 243.84Mbyte/s of the original gradient-based GME method. This design can be used in applications like video codec, video stabilization, and super-resolution, where real-time GME is a necessity and minimum memory bandwidth requirement is appreciated.

Do subjective memory complaints predict senile Alzheimer dementia?

PubMed

Jungwirth, Susanne; Zehetmayer, Sonja; Weissgram, Silvia; Weber, Germain; Tragl, Karl Heinz; Fischer, Peter

2008-01-01

Many elderly complain about their memory and undergo dementia screening by the Mini-Mental State Examination (MMSE). While objective memory impairment always precedes Alzheimer dementia (AD) it is unclear whether subjective memory complaints are predicting AD. We tried to answer this question in a prospective cohort study. The 75-years old non-demented inhabitants of Vienna-Transdanube were investigated for conversion to AD after 30 months. The predictive value of subjective memory complaints was analysed in two groups: subjects with high MMSE-score (28-30) and subjects with low MMSE-score (23-27). Only in subjects with high MMSE univariate analyses showed an association between subjective memory complaints and incident AD. In both groups the verbal memory test was the main predictor of AD in multivariate analyses. We suggest to perform memory testing in subjects complaining about memory irrespective of their performance in a screening procedure like the MMSE.

Effect of bone chip orientation on quantitative estimates of changes in bone mass using digital subtraction radiography.

PubMed

Mol, André; Dunn, Stanley M

2003-06-01

To assess the effect of the orientation of arbitrarily shaped bone chips on the correlation between radiographic estimates of bone loss and true mineral loss using digital subtraction radiography. Twenty arbitrarily shaped bone chips (dry weight 1-10 mg) were placed individually on the superior lingual aspect of the interdental alveolar bone of a dry dentate hemi-mandible. After acquiring the first baseline image, each chip was rotated 90 degrees and a second radiograph was captured. Follow-up images were created without the bone chips and after rotating the mandible 0, 1, 2, 4, and 6 degrees around a vertical axis. Aluminum step tablet intensities were used to normalize image intensities for each image pair. Follow-up images were registered and geometrically standardized using projective standardization. Bone chips were dry ashed and analyzed for calcium content using atomic absorption. No significant difference was found between the radiographic estimates of bone loss from the different bone chip orientations (Wilcoxon: P > 0.05). The correlation between the two series of estimates for all rotations was 0.93 (Spearman: P < 0.05). Linear regression analysis indicated that both correlates did not differ appreciably ( and ). It is concluded that the spatial orientation of arbitrarily shaped bone chips does not have a significant impact on quantitative estimates of changes in bone mass in digital subtraction radiography. These results were obtained in the presence of irreversible projection errors of up to six degrees and after application of projective standardization for image reconstruction and image registration.

[Using the MMSE as a cognitive screener among Turkish and Moroccan migrants].

PubMed

Zwart, L A R; Goudsmit, M; van Campen, J P C M; Rijkers, C J M; Wind, A W

2015-02-01

The Dutch population of first generation Turkish and Moroccan migrants is ageing. Among them hypertension and diabetes mellitus are frequent findings, which will probably cause an increased incidence of dementia. The language barrier, low education and cultural differences make the diagnosis more difficult. To what extent the MMSE can be used as a cognitive screener in this population will be investigated in this retrospective study.Patients received standard diagnostics, a professional translator addressed the language barrier. Correspondence was scored on characteristics of dementia, a procedure was used to diagnose without including the MMSE score. The optimal cut-off was calculated with the Youden Index and Area under the ROC (AUROC).106 patients were included, 61% had no education. Average MMSE-score was 16, with dementia 12, without 19. The AUROC was 0.85, optimal cut-off was 18 with a Youden index of 0.61.By using a professional translator the MMSE can possibly be used as a cognitive screener in this population. However, the cognitive skills addressed by the MMSE require an education and language skills. Developing a test that is independent of education and language barrier will probably be better.

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination.

PubMed

Mancuso, Mauro; Demeyere, Nele; Abbruzzese, Laura; Damora, Alessio; Varalta, Valentina; Pirrotta, Fabio; Antonucci, Gabriella; Matano, Alessandro; Caputo, Marina; Caruso, Maria Giovanna; Pontiggia, Giovanna Teresa; Coccia, Michela; Ciancarelli, Irene; Zoccolotti, Pierluigi

2018-01-01

The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures. About a third of patients (35.3%) had a performance lower than the cutoff (<22) on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive deficits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected by the MMSE, demonstrating the importance of cognitive profiling.

Predictors of Cognitive and Functional Decline in Patients With Alzheimer Disease Dementia From Brazil.

PubMed

Oliveira, Fabricio F; Chen, Elizabeth S; Smith, Marilia C; Bertolucci, Paulo H F

2016-01-01

Little is known on how risk factors for Alzheimer disease (AD) dementia affect disease progression, much less for populations with low mean schooling, whereas the transcription of APOE may be regulated by nongenetic factors. In this 44-month cohort study, 214 consecutive outpatients with late-onset AD were assessed for rates of cognitive and functional decline by way of Clinical Dementia Rating and Mini-Mental State Examination (MMSE) scores, keeping blinded assessment of APOE haplotypes. Subjects were evaluated for sex, schooling, age of dementia onset, and cerebrovascular risk factors (including Framingham risk scores). Of the 214 patients, there were 146 (68.2%) women and 113 (52.8%) APOE4+ carriers. The mean age of AD onset was 73.4±6.5 years-old, negatively correlated with time to Clinical Dementia Rating >1.0 (β=-0.132; ρ<0.001), MMSE=20 (β=-0.105; ρ<0.001), and MMSE=15 (β=-0.124; ρ=0.003), more significantly for women and APOE4+ carriers. Mean schooling was 4.18±3.7 years, correlated with time to MMSE=20 and MMSE=15 for women and APOE4+ carriers. Body mass index was correlated with time to MMSE=20 only for men (ρ=0.006). The 10-year coronary heart disease risk was correlated with time to MMSE=20 only for APOE4+ carriers (ρ=0.015). These outcomes suggest interactions among genomic effects of cognitive reserve, cerebral perfusion, and hormonal changes over mechanisms of neurodegeneration.

Discrimination between stages of Alzheimer's disease with subsets of Mini-Mental State Examination items. An analysis of Consortium to Establish a Registry for Alzheimer's Disease data.

PubMed

Fillenbaum, G G; Wilkinson, W E; Welsh, K A; Mohs, R C

1994-09-01

To identify minimal sets of Mini-Mental State Examination (MMSE) items that can distinguish normal control subjects from patients with mild Alzheimer's disease (AD), patients with mild from those with moderate AD, and those with moderate from those with severe AD. Two randomly selected equivalent half samples. Results of logistic regression analysis from data from the first half of the sample were confirmed by receiver operating characteristic curves on the second half. Memory disorders clinics at major medical centers in the United States affiliated with the Consortium to establish a Registry for Alzheimer's Disease (CERAD). White, normal control subjects (n = 412) and patients with AD (n = 621) who met CERAD criteria; nonwhite subjects (n = 165) and persons with missing data (n = 27) were excluded. Three four-item sets of MMSE items that discriminate, respectively, (1) normal controls from patients with mild AD, (2) patients with mild from those with moderate AD, and (3) patients with moderate from those with severe AD. The MMSE items discriminating normal controls from patients with mild AD were day, date, recall of apple, and recall of penny; those discriminating patients with mild from those with moderate AD were month, city, spelling world backward, and county, and those discriminating patients with moderate from those with severe AD were floor of building, repeating the word table, naming watch, and folding paper in half. Performance on the first two four-item sets was comparable with that of the full MMSE; the third set distinguished patients with moderate from those with severe AD better than chance. A minimum set of MMSE items can effectively discriminate normal controls from patients with mild AD and between successive levels of severity of AD. Data apply only to white patients with AD. Performance in minorities, more heterogeneous groups, or normal subjects with questionable cognitive status has not been assessed.

A new statistical methodology predicting chip failure probability considering electromigration

NASA Astrophysics Data System (ADS)

Sun, Ted

In this research thesis, we present a new approach to analyze chip reliability subject to electromigration (EM) whose fundamental causes and EM phenomenon happened in different materials are presented in this thesis. This new approach utilizes the statistical nature of EM failure in order to assess overall EM risk. It includes within-die temperature variations from the chip's temperature map extracted by an Electronic Design Automation (EDA) tool to estimate the failure probability of a design. Both the power estimation and thermal analysis are performed in the EDA flow. We first used the traditional EM approach to analyze the design with a single temperature across the entire chip that involves 6 metal and 5 via layers. Next, we used the same traditional approach but with a realistic temperature map. The traditional EM analysis approach and that coupled with a temperature map and the comparison between the results of considering and not considering temperature map are presented in in this research. A comparison between these two results confirms that using a temperature map yields a less pessimistic estimation of the chip's EM risk. Finally, we employed the statistical methodology we developed considering a temperature map and different use-condition voltages and frequencies to estimate the overall failure probability of the chip. The statistical model established considers the scaling work with the usage of traditional Black equation and four major conditions. The statistical result comparisons are within our expectations. The results of this statistical analysis confirm that the chip level failure probability is higher i) at higher use-condition frequencies for all use-condition voltages, and ii) when a single temperature instead of a temperature map across the chip is considered. In this thesis, I start with an overall review on current design types, common flows, and necessary verifications and reliability checking steps used in this IC design industry. Furthermore, the important concepts about "Scripting Automation" which is used in all the integration of using diversified EDA tools in this research work are also described in detail with several examples and my completed coding works are also put in the appendix for your reference. Hopefully, this construction of my thesis will give readers a thorough understanding about my research work from the automation of EDA tools to the statistical data generation, from the nature of EM to the statistical model construction, and the comparisons among the traditional EM analysis and the statistical EM analysis approaches.

Naming and verbal learning in adults with Alzheimer's disease, mild cognitive impairment and in healthy aging, with low educational levels.

PubMed

Hübner, Lilian Cristine; Loureiro, Fernanda; Tessaro, Bruna; Siqueira, Ellen Cristina Gerner; Jerônimo, Gislaine Machado; Gomes, Irênio; Schilling, Lucas Porcello

2018-02-01

Language assessment seems to be an effective tool to differentiate healthy and cognitively impaired aging groups. This article discusses the impact of educational level on a naming task, on a verbal learning with semantic cues task and on the MMSE in healthy aging adults at three educational levels (very low, low and high) as well as comparing two clinical groups of very low (0-3 years) and low education (4-7 years) patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy controls. The participants comprised 101 healthy controls, 17 patients with MCI and 19 with AD. Comparisons between the healthy groups showed an education effect on the MMSE, but not on naming and verbal learning. However, the clinical groups were differentiated in both the naming and verbal learning assessment. The results support the assumption that the verbal learning with semantic cues task is a valid tool to diagnose MCI and AD patients, with no influence from education.

Grinding damage assessment on four high-strength ceramics.

PubMed

Canneto, Jean-Jacques; Cattani-Lorente, Maria; Durual, Stéphane; Wiskott, Anselm H W; Scherrer, Susanne S

2016-02-01

The purpose of this study was to assess surface and subsurface damage on 4 CAD-CAM high-strength ceramics after grinding with diamond disks of 75 μm, 54 μm and 18 μm and to estimate strength losses based on damage crack sizes. The materials tested were: 3Y-TZP (Lava), dense Al2O3 (In-Ceram AL), alumina glass-infiltrated (In-Ceram ALUMINA) and alumina-zirconia glass-infiltrated (In-Ceram ZIRCONIA). Rectangular specimens with 2 mirror polished orthogonal sides were bonded pairwise together prior to degrading the top polished surface with diamond disks of either 75 μm, 54 μm or 18 μm. The induced chip damage was evaluated on the bonded interface using SEM for chip depth measurements. Fracture mechanics were used to estimate fracture stresses based on average and maximum chip depths considering these as critical flaws subjected to tension and to calculate possible losses in strength compared to manufacturer's data. 3Y-TZP was hardly affected by grinding chip damage viewed on the bonded interface. Average chip depths were of 12.7±5.2 μm when grinding with 75 μm diamond inducing an estimated loss of 12% in strength compared to manufacturer's reported flexural strength values of 1100 MPa. Dense alumina showed elongated chip cracks and was suffering damage of an average chip depth of 48.2±16.3 μm after 75 μm grinding, representing an estimated loss in strength of 49%. Grinding with 54 μm was creating chips of 32.2±9.1 μm in average, representing a loss in strength of 23%. Alumina glass-infiltrated ceramic was exposed to chipping after 75 μm (mean chip size=62.4±19.3 μm) and 54 μm grinding (mean chip size=42.8±16.6 μm), with respectively 38% and 25% estimated loss in strength. Alumina-zirconia glass-infiltrated ceramic was mainly affected by 75 μm grinding damage with a chip average size of 56.8±15.1 μm, representing an estimated loss in strength of 34%. All four ceramics were not exposed to critical chipping at 18 μm diamond grinding. Reshaping a ceramic framework post sintering should be avoided with final diamond grits of 75 μm as a general rule. For alumina and the glass-infiltrated alumina, using a 54 μm diamond still induces chip damage which may affect strength. Removal of such damage from a reshaped framework is mandatory by using sequentially finer diamonds prior to the application of veneering ceramics especially in critical areas such as margins, connectors and inner surfaces. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Low-power chip-level optical interconnects based on bulk-silicon single-chip photonic transceivers

NASA Astrophysics Data System (ADS)

Kim, Gyungock; Park, Hyundai; Joo, Jiho; Jang, Ki-Seok; Kwack, Myung-Joon; Kim, Sanghoon; Kim, In Gyoo; Kim, Sun Ae; Oh, Jin Hyuk; Park, Jaegyu; Kim, Sanggi

2016-03-01

We present new scheme for chip-level photonic I/Os, based on monolithically integrated vertical photonic devices on bulk silicon, which increases the integration level of PICs to a complete photonic transceiver (TRx) including chip-level light source. A prototype of the single-chip photonic TRx based on a bulk silicon substrate demonstrated 20 Gb/s low power chip-level optical interconnects between fabricated chips, proving that this scheme can offer compact low-cost chip-level I/O solutions and have a significant impact on practical electronic-photonic integration in high performance computers (HPC), cpu-memory interface, 3D-IC, and LAN/SAN/data-center and network applications.

Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia.

PubMed

Jansen, Willemijn J; Ossenkoppele, Rik; Tijms, Betty M; Fagan, Anne M; Hansson, Oskar; Klunk, William E; van der Flier, Wiesje M; Villemagne, Victor L; Frisoni, Giovanni B; Fleisher, Adam S; Lleó, Alberto; Mintun, Mark A; Wallin, Anders; Engelborghs, Sebastiaan; Na, Duk L; Chételat, Gäel; Molinuevo, José Luis; Landau, Susan M; Mattsson, Niklas; Kornhuber, Johannes; Sabri, Osama; Rowe, Christopher C; Parnetti, Lucilla; Popp, Julius; Fladby, Tormod; Jagust, William J; Aalten, Pauline; Lee, Dong Young; Vandenberghe, Rik; Resende de Oliveira, Catarina; Kapaki, Elisabeth; Froelich, Lutz; Ivanoiu, Adrian; Gabryelewicz, Tomasz; Verbeek, Marcel M; Sanchez-Juan, Páscual; Hildebrandt, Helmut; Camus, Vincent; Zboch, Marzena; Brooks, David J; Drzezga, Alexander; Rinne, Juha O; Newberg, Andrew; de Mendonça, Alexandre; Sarazin, Marie; Rabinovici, Gil D; Madsen, Karine; Kramberger, Milica G; Nordberg, Agneta; Mok, Vincent; Mroczko, Barbara; Wolk, David A; Meyer, Philipp T; Tsolaki, Magda; Scheltens, Philip; Verhey, Frans R J; Visser, Pieter Jelle; Aarsland, Dag; Alcolea, Daniel; Alexander, Myriam; Almdahl, Ina S; Arnold, Steven E; Baldeiras, Inês; Barthel, Henryk; van Berckel, Bart N M; Blennow, Kaj; van Buchem, Mark A; Cavedo, Enrica; Chen, Kewei; Chipi, Elena; Cohen, Ann D; Förster, Stefan; Fortea, Juan; Frederiksen, Kristian S; Freund-Levi, Yvonne; Gkatzima, Olymbia; Gordon, Mark Forrest; Grimmer, Timo; Hampel, Harald; Hausner, Lucrezia; Hellwig, Sabine; Herukka, Sanna-Kaisa; Johannsen, Peter; Klimkowicz-Mrowiec, Aleksandra; Köhler, Sebastian; Koglin, Norman; van Laere, Koen; de Leon, Mony; Lisetti, Viviana; Maier, Wolfgang; Marcusson, Jan; Meulenbroek, Olga; Møllergård, Hanne M; Morris, John C; Nordlund, Arto; Novak, Gerald P; Paraskevas, George P; Perera, Gayan; Peters, Oliver; Ramakers, Inez H G B; Rami, Lorena; Rodríguez-Rodríguez, Eloy; Roe, Catherine M; Rot, Uros; Rüther, Eckart; Santana, Isabel; Schröder, Johannes; Seo, Sang W; Soininen, Hilkka; Spiru, Luiza; Stomrud, Erik; Struyfs, Hanne; Teunissen, Charlotte E; Vos, Stephanie J B; van Waalwijk van Doorn, Linda J C; Waldemar, Gunhild; Wallin, Åsa K; Wiltfang, Jens; Zetterberg, Henrik

2018-01-01

Cerebral amyloid-β aggregation is an early event in Alzheimer disease (AD). Understanding the association between amyloid aggregation and cognitive manifestation in persons without dementia is important for a better understanding of the course of AD and for the design of prevention trials. To investigate whether amyloid-β aggregation is associated with cognitive functioning in persons without dementia. This cross-sectional study included 2908 participants with normal cognition and 4133 with mild cognitive impairment (MCI) from 53 studies in the multicenter Amyloid Biomarker Study. Normal cognition was defined as having no cognitive concerns for which medical help was sought and scores within the normal range on cognitive tests. Mild cognitive impairment was diagnosed according to published criteria. Study inclusion began in 2013 and is ongoing. Data analysis was performed in January 2017. Global cognitive performance as assessed by the Mini-Mental State Examination (MMSE) and episodic memory performance as assessed by a verbal word learning test. Amyloid aggregation was measured with positron emission tomography or cerebrospinal fluid biomarkers and dichotomized as negative (normal) or positive (abnormal) according to study-specific cutoffs. Generalized estimating equations were used to examine the association between amyloid aggregation and low cognitive scores (MMSE score ≤27 or memory z score≤-1.28) and to assess whether this association was moderated by age, sex, educational level, or apolipoprotein E genotype. Among 2908 persons with normal cognition (mean [SD] age, 67.4 [12.8] years), amyloid positivity was associated with low memory scores after age 70 years (mean difference in amyloid positive vs negative, 4% [95% CI, 0%-7%] at 72 years and 21% [95% CI, 10%-33%] at 90 years) but was not associated with low MMSE scores (mean difference, 3% [95% CI, -1% to 6%], P = .16). Among 4133 patients with MCI (mean [SD] age, 70.2 [8.5] years), amyloid positivity was associated with low memory (mean difference, 16% [95% CI, 12%-20%], P < .001) and low MMSE (mean difference, 14% [95% CI, 12%-17%], P < .001) scores, and this association decreased with age. Low cognitive scores had limited utility for screening of amyloid positivity in persons with normal cognition and those with MCI. In persons with normal cognition, the age-related increase in low memory score paralleled the age-related increase in amyloid positivity with an intervening period of 10 to 15 years. Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.

Is Social Network a Protective Factor for Cognitive Impairment in US Chinese Older Adults? Findings from the PINE Study.

PubMed

Li, Mengting; Dong, Xinqi

2018-01-01

Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of US Chinese older adults aged 60 and above in the greater Chicago area, with a sample size of 3,157. Social network was assessed by network size, volume of contact, proportion kin, proportion female, proportion co-resident, and emotional closeness. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). Linear regression and quantile regression were performed. Every 1-point increase in network size (b = 0.048, p < 0.001) and volume of contact (b = 0.049, p < 0.01) and every 1-point decrease in proportion kin (b = -0.240, p < 0.01) and proportion co-resident (b = -0.099, p < 0.05) were associated with higher level of global cognition. Similar trends were observed in specific cognitive domains, including episodic memory, working memory, executive function, and C-MMSE. However, emotional closeness was only significantly associated with C-MMSE (b = 0.076, p < 0.01). Social network has differential effects on female versus male older adults. This study found that social network dimensions have different relationships with global and domains of cognitive function. Quantitative and structural aspects of social network were essential to maintain an optimal level of cognitive function. Qualitative aspects of social network were protective factors for C-MMSE. It is necessary for public health practitioners to consider interventions that enhance different aspects of older adults' social network. © 2017 S. Karger AG, Basel.

Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients

NASA Astrophysics Data System (ADS)

Lestari, S.; Mistivani, I.; Rumende, C. M.; Kusumaningsih, W.

2017-08-01

Mild cognitive impairment (MCI) is defined as cognitive impairment that may never develop into dementia. Cognitive impairment is one long-term complication of a stroke. The Mini Mental State Examination (MMSE), which is commonly used as a screening tool for cognitive impairment, has a low sensitivity to detect cognitive impairment, especially MCI. Alternatively, the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) has been reported to have a higher sensitivity than the MMSE. The aim of this study was to compare the proportion of MCI identified between the MMSE and MoCA-Ina in stroke patients. This was a cross-sectional study of stroke outpatients who attended the Polyclinic Neuromuscular Division, Rehabilitation Department, and Polyclinic Stroke, Neurology Department Cipto Mangunkusumo General Hospital, Jakarta. The proportion of MCI identified using the MMSE was 31.03% compared to 72.41% when using the MoCA-Ina. This difference was statistically significant (Fisher’s exact test, p = 0.033). The proportion of MCI in stroke patients was higher when using the MoCA-Ina compared to the MMSE. The MoCA-Ina should be used as an alternative in the early detection of MCI in stroke patients, especially those undergoing rehabilitation.

RELIC: a novel dye-bias correction method for Illumina Methylation BeadChip.

PubMed

Xu, Zongli; Langie, Sabine A S; De Boever, Patrick; Taylor, Jack A; Niu, Liang

2017-01-03

The Illumina Infinium HumanMethylation450 BeadChip and its successor, Infinium MethylationEPIC BeadChip, have been extensively utilized in epigenome-wide association studies. Both arrays use two fluorescent dyes (Cy3-green/Cy5-red) to measure methylation level at CpG sites. However, performance difference between dyes can result in biased estimates of methylation levels. Here we describe a novel method, called REgression on Logarithm of Internal Control probes (RELIC) to correct for dye bias on whole array by utilizing the intensity values of paired internal control probes that monitor the two color channels. We evaluate the method in several datasets against other widely used dye-bias correction methods. Results on data quality improvement showed that RELIC correction statistically significantly outperforms alternative dye-bias correction methods. We incorporated the method into the R package ENmix, which is freely available from the Bioconductor website ( https://www.bioconductor.org/packages/release/bioc/html/ENmix.html ). RELIC is an efficient and robust method to correct for dye-bias in Illumina Methylation BeadChip data. It outperforms other alternative methods and conveniently implemented in R package ENmix to facilitate DNA methylation studies.

Neuropsychometric tests in cross sectional and longitudinal studies - a regression analysis of ADAS - cog, SKT and MMSE.

PubMed

Ihl, R; Grass-Kapanke, B; Jänner, M; Weyer, G

1999-11-01

In clinical and drug studies, different neuropsychometric tests are used. So far, no empirical data have been published to compare studies using different tests. The purpose of this study was to calculate a regression formula allowing a comparison of cross-sectional and longitudinal data from three neuropsychometric tests that are frequently used in drug studies (Alzheimer's Disease Assessment Scale, ADAS-cog; Syndrom Kurz Test, SKT; Mini Mental State Examination, MMSE). 177 patients with dementia according to ICD10 criteria were studied for the cross sectional and 61 for the longitudinal analysis. Correlations and linear regressions were calculated between tests. Significance was proven with ANOVA and t-tests using the SPSS statistical package. Significant Spearman correlations and slopes in the regression occurred in the cross sectional analysis (ADAS-cog-SKT r(s) = 0.77, slope = 0.45, SKT-ADAS-cog slope = 1.3, r2 = 0.59; ADAS-cog-MMSE r2 = 0.76, slope = -0.42, MMSE-ADAS-cog slope = -1.5, r2 = 0.64; MMSE-SKT r(s) = -0.79, slope = -0.87, SKT-MMSE slope = -0.71, r2 = 0.62; p<0.001 after Bonferroni correction; N = 177) and in the longitudinal analysis (SKT-ADAS-cog, r(s) = 0.48, slope = 0.69, ADAS-cog-SKT slope = 0.69, p<0.001, r2 = 0.32, MMSE-SKT, r(s) = 0.44, slope = -0.41, SKT-MMSE, slope = -0.55, p<0.001, r2 = 0.21). The results allow calculation of ADAS-scores when SKT scores are given, and vice versa. In longitudinal studies or in the course of the disease, scores assessed with the ADAS-cog and the SKT may now be statistically compared. In all comparisons, bottom and ceiling effects of the tests have to be taken into account.

Potential Effects of Wood Chip Mill Harvests on Economic Returns and Forest Management Practices of Nonindustrial Private Forest Landowners in North Carolina

Treesearch

Anthony Snider; Frederick Cubbage; Robert Moulton

2001-01-01

Four approaches were used to estimate the market effects of wood chip mills for nonindustrial private forest (NIPF) landowners. First, we used economic welfare analyses to estimate potential changes in consumer and producer surplus that might be attributed to increased stumpage demand created by wood chip mills. Better markets would consistently increase economic...

Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year

PubMed Central

Winchester, J.; Dick, M.B.; Gillen, D.; Reed, B.; Miller, B.; Tinklenberg, J.; Mungas, D.; Chui, H.; Galasko, D.; Hewett, L.; Cotman, C.W.

2013-01-01

AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N = 104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian = 69.8%; Latino/Hispanic Americans = 20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2 h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted. PMID:22959822

Development and validation of a new cognitive screening test: The Hong Kong Brief Cognitive Test (HKBC).

PubMed

Chiu, Helen F K; Zhong, Bao-Liang; Leung, Tony; Li, S W; Chow, Paulina; Tsoh, Joshua; Yan, Connie; Xiang, Yu-Tao; Wong, Mike

2018-07-01

To develop and examine the validity of a new brief cognitive test with less educational bias for screening cognitive impairment. A new cognitive test, Hong Kong Brief Cognitive Test (HKBC), was developed based on review of the literature, as well as the views of an expert panel. Three groups of subjects aged 65 or above were recruited after written consent: normal older people recruited in elderly centres, people with mild NCD (neurocognitive disorder), and people with major NCD. The brief cognitive test, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA), were administered to the subjects. The performance of HKBC in differentiating subjects with major NCD, mild NCD, and normal older people were compared with the clinical diagnosis, as well as the MMSE and MoCA scores. In total, 359 subjects were recruited, with 99 normal controls, 132 subjects with major NCD, and 128 with mild NCD. The mean MMSE, MoCA, and HKBC scores showed significant differences among the 3 groups of subjects. In the receiving operating characteristic curve analysis of the HKBC in differentiating normal subjects from those with cognitive impairment (mild NCD + major NCD), the area under the curve was 0.955 with an optimal cut-off score of 21/22. The performances of MMSE and MoCA in differentiating normal from cognitively impaired subjects are slightly inferior to the HKBC. The HKBC is a brief instrument useful for screening cognitive impairment in older adults and is also useful in populations with low educational level. Copyright © 2018 John Wiley & Sons, Ltd.

Mild cognitive impairment in symptomatic and asymptomatic cerebrovascular disease.

PubMed

Popović, Irena Martinić; Serić, Vesna; Demarin, Vida

2007-06-15

We tried to evaluate and to compare usefulness of two brief cognitive tests in early detection of cognitive decline in subjects with increased cerebrovascular (CV) risk. As CV risk factors are recognised as important in etiology of dementia, we also aimed to determine the possible associations of specific CV risk factors and cognitive results. Patients (PGs) with first-ever stroke or TIA (N=110) and CV symptoms-free controls (CGs) with CV risk factors present (N=45) matched for age, gender and education level were tested using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) on admission, at three- and six-month points. In all subjects, detailed CV risk factors profile was assessed. We observed the decrement in cognitive performance during the six-month study period in both groups, more evident if MoCA (p<0.001) than if MMSE was used (p=0.022). Six months after first stroke/TIA 83.6% PGs scored below normal range on MoCA. In PGs, positive associations for cognitive decrement and multiple CV risk factors (>2) were found (p=0.034 for MMSE; p=0.002 for MoCA). In CGs, positive associations were found for cognitive decrement and arterial hypertension with increased IMT values (p<0.001 for MMSE) and for multiple CV risk factors and arterial hypertension (p=0.003 for MoCA). The use of MoCA could aid to early recognition of cognitive deficits in persons with increased CV risk. Individuals with multiple CV risk factors seem to have increased risk of cognitive decline.

A retrospective analysis of the sentence writing component of the Mini Mental State Examination: cognitive and affective aspects.

PubMed

Press, Yan; Velikiy, Natalia; Berzak, Alex; Tandeter, Howard; Peleg, Roni; Freud, Tamar; Punchik, Boris; Dwolatzky, Tzvi

2012-01-01

One of the components of the Mini Mental State Examination (MMSE) is the request to write a sentence. We investigated the relationship between the characteristics of the written sentence of the MMSE and the cognitive and affective status of elderly patients. The characteristics of the sentence were compared to the total MMSE score, sociodemographic characteristics, tests evaluating cognition and affective status, and diagnoses. The number of words was significantly associated with the degree of cognitive impairment, whereas the emotional polarity of sentences and concerns about health were associated with depression. Characteristics of the MMSE sentence may provide important additional information regarding both cognition and affect when assessing older people. Copyright © 2012 S. Karger AG, Basel.

Cortical connectivity and memory performance in cognitive decline: A study via graph theory from EEG data.

PubMed

Vecchio, F; Miraglia, F; Quaranta, D; Granata, G; Romanello, R; Marra, C; Bramanti, P; Rossini, P M

2016-03-01

Functional brain abnormalities including memory loss are found to be associated with pathological changes in connectivity and network neural structures. Alzheimer's disease (AD) interferes with memory formation from the molecular level, to synaptic functions and neural networks organization. Here, we determined whether brain connectivity of resting-state networks correlate with memory in patients affected by AD and in subjects with mild cognitive impairment (MCI). One hundred and forty-four subjects were recruited: 70 AD (MMSE Mini Mental State Evaluation 21.4), 50 MCI (MMSE 25.2) and 24 healthy subjects (MMSE 29.8). Undirected and weighted cortical brain network was built to evaluate graph core measures to obtain Small World parameters. eLORETA lagged linear connectivity as extracted by electroencephalogram (EEG) signals was used to weight the network. A high statistical correlation between Small World and memory performance was found. Namely, higher Small World characteristic in EEG gamma frequency band during the resting state, better performance in short-term memory as evaluated by the digit span tests. Such Small World pattern might represent a biomarker of working memory impairment in older people both in physiological and pathological conditions. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

Validation of the Argentine version of the Memory Binding Test (MBT) for Early Detection of Mild Cognitive Impairment

PubMed Central

Roman, Fabian; Iturry, Mónica; Rojas, Galeno; Barceló, Ernesto; Buschke, Herman; Allegri, Ricardo F.

2016-01-01

ABSTRACT Background: "Forgetfulness" is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2=14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI. PMID:29213458

Kidney function and cognitive decline in an oldest-old Chinese population.

PubMed

Bai, Kunhao; Pan, Yujing; Lu, Fanghong; Zhao, Yingxin; Wang, Jinwei; Zhang, Luxia

2017-01-01

Early-stage chronic kidney disease has been suggested to be correlated with cognitive decline, but the association has rarely been explored in the oldest old. This prospective study included 284 Chinese participants aged 80 years or older with serum creatinine levels <150 µmol/L. The median follow-up time was 3.3 years, and 247 (87.0%) participants provided valid data at their last visit. Kidney function was evaluated by measuring the estimated glomerular filtration rate (eGFR) at baseline, and cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at both baseline and annual visits. A reliable decrease in the MMSE score over the follow-up period was observed based on a Reliable Change Index of 1.645 (equivalent to a 90% confidence interval [CI]), which was used to define cognitive decline. Poisson regression models were built to analyze the association between baseline kidney function and cognitive decline. A total of 18 (7.3%) cases of incident cognitive decline were observed during the follow-up period. After adjusting for potential confounders, the relative risk of developing cognitive decline was 4.03 (95% CI 1.09-13.81) among participants with an eGFR of 30-59 mL/min/1.73 m 2 compared to participants with an eGFR of ≥60 mL/min/1.73 m 2 . Early-stage chronic kidney disease was correlated with cognitive decline in an oldest-old Chinese population.

42 CFR 431.998 - Difference resolution and appeal process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.998 Difference resolution and appeal... care claims in Medicaid or CHIP within 20 business days after the disposition report of claims review... CHIP agencies with personnel that are responsible for Medicaid and CHIP policy and operations, the...

42 CFR 431.998 - Difference resolution and appeal process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.998 Difference resolution and appeal... care claims in Medicaid or CHIP within 20 business days after the disposition report of claims review... CHIP agencies with personnel that are responsible for Medicaid and CHIP policy and operations, the...

42 CFR 431.998 - Difference resolution and appeal process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.998 Difference resolution and appeal... care claims in Medicaid or CHIP within 20 business days after the disposition report of claims review... CHIP agencies with personnel that are responsible for Medicaid and CHIP policy and operations, the...

42 CFR 431.998 - Difference resolution and appeal process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.998 Difference resolution and appeal... care claims in Medicaid or CHIP within 20 business days after the disposition report of claims review... CHIP agencies with personnel that are responsible for Medicaid and CHIP policy and operations, the...

42 CFR 431.998 - Difference resolution and appeal process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.998 Difference resolution and appeal... care claims in Medicaid or CHIP within 20 business days after the disposition report of claims review... CHIP agencies with personnel that are responsible for Medicaid and CHIP policy and operations, the...

Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study.

PubMed

Farooqui, Zishaan; Bakulski, Kelly M; Power, Melinda C; Weisskopf, Marc G; Sparrow, David; Spiro, Avron; Vokonas, Pantel S; Nie, Linda H; Hu, Howard; Park, Sung Kyun

2017-01-01

Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. In a 1993-2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Among men 51-98 at baseline, higher patella Pb concentration (IQR: 21μg/g) was associated with -0.13 lower baseline MMSE (95% CI: -0.25, -0.004) and faster longitudinal MMSE decline (-0.016 units/year, 95% CI: -0.032, -0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: -0.026, -0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: -0.027, -0.002). We found weaker associations with tibia Pb. Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. Copyright © 2016 Elsevier Inc. All rights reserved.

Methylation and demethylation of intermediates selenide and methylselenol in the metabolism of selenium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ohta, Yuki; Suzuki, Kazuo T.

2008-01-15

All nutritional selenium sources are transformed into the assumed common intermediate selenide for the syntheses of selenoproteins for utilization and/or of selenosugar for excretion. Methylselenol [monomethylselenide, MMSe] is the assumed intermediate leading to other methylated metabolites, dimethylselenide (DMSe) and trimethylselenonium (TMSe) for excretion, and also to the intermediate selenide from methylselenocysteine and methylseleninic acid (MSA). Here, related methylation and demethylation reactions were studied in vitro by providing chemically reactive starting substrates ({sup 76}Se-selenide, {sup 77}Se-MMSe and {sup 82}Se-DMSe) which were prepared in situ by the reduction of the corresponding labeled proximate precursors ({sup 76}Se-selenite, {sup 77}Se-MSA and {sup 82}Se-dimethylselenoxide (DMSeO),more » respectively) with glutathione, the three substrates being incubated simultaneously in rat organ supernatants and homogenates. The resulting chemically labile reaction products were detected simultaneously by speciation analysis with HPLC-ICP-MS after converting the products and un-reacted substrates to the corresponding oxidized derivatives (selenite, MSA and DMSeO). The time-related changes in selenium isotope profiles showed that demethylation of MMSe to selenide was efficient but that of DMSe to MMSe was negligible, whereas methylation of selenide to MMSe, and MMSe to DMSe were efficient, and that of DMSe to TMSe occurred less efficiently. The present methylation and demethylation reactions on equilibrium between selenide, MMSe and DMSe without producing selenosugar and selenoproteins indicated that DMSe rather than TMSe is produced as the end product, suggesting that DMSe is to be excreted more abundantly than TMSe. Organ-dependent differences in the methylation and demethylation reactions were characterized for the liver, kidney and lung.« less

Acrylamide formation in plantain (Musa paradisiaca) chips influenced by different ripening stages: A correlation study with respect to reducing sugars, amino acids and phenolic content.

PubMed

Shamla, L; Nisha, P

2017-05-01

The effect of ripening on the formation of acrylamide in deep fried plantain chips made from Nendran variety (Musa paradisiaca) was investigated. The precursors of acrylamide formation, reducing sugars (glucose and fructose) and ten major amino acids, were quantified during different stages of ripening using HPLC and correlated with acrylamide formation. The total phenolic content and total flavonoid content were also estimated and correlated with acrylamide formation. Both glucose and fructose increased during ripening and demonstrated a positive correlation on formation of acrylamide (correlation coefficient of r=0.95 and 0.94 respectively (p<0.05), whereas asparagine, was poorly correlated (p>0.05). The decreased levels of phenolic content during ripening of plantain were negatively correlated with acrylamide formation in the deep fried chips prepared. Thus the selection of proper ripening stage renders reduced formation of acrylamide in plantain chips to a reasonable extend. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Miniaturized On-Chip Colorimeter for Detecting NPK Elements

PubMed Central

Liu, Rui-Tao; Tao, Lu-Qi; Liu, Bo; Tian, Xiang-Guang; Mohammad, Mohammad Ali; Yang, Yi; Ren, Tian-Ling

2016-01-01

Recently, precision agriculture has become a globally attractive topic. As one of the most important factors, the soil nutrients play an important role in estimating the development of precision agriculture. Detecting the content of nitrogen, phosphorus and potassium (NPK) elements more efficiently is one of the key issues. In this paper, a novel chip-level colorimeter was fabricated to detect the NPK elements for the first time. A light source–microchannel photodetector in a sandwich structure was designed to realize on-chip detection. Compared with a commercial colorimeter, all key parts are based on MEMS (Micro-Electro-Mechanical System) technology so that the volume of this on-chip colorimeter can be minimized. Besides, less error and high precision are achieved. The cost of this colorimeter is two orders of magnitude less than that of a commercial one. All these advantages enable a low-cost and high-precision sensing operation in a monitoring network. The colorimeter developed herein has bright prospects for environmental and biological applications. PMID:27527177

A Miniaturized On-Chip Colorimeter for Detecting NPK Elements.

PubMed

Liu, Rui-Tao; Tao, Lu-Qi; Liu, Bo; Tian, Xiang-Guang; Mohammad, Mohammad Ali; Yang, Yi; Ren, Tian-Ling

2016-08-04

Recently, precision agriculture has become a globally attractive topic. As one of the most important factors, the soil nutrients play an important role in estimating the development of precision agriculture. Detecting the content of nitrogen, phosphorus and potassium (NPK) elements more efficiently is one of the key issues. In this paper, a novel chip-level colorimeter was fabricated to detect the NPK elements for the first time. A light source-microchannel photodetector in a sandwich structure was designed to realize on-chip detection. Compared with a commercial colorimeter, all key parts are based on MEMS (Micro-Electro-Mechanical System) technology so that the volume of this on-chip colorimeter can be minimized. Besides, less error and high precision are achieved. The cost of this colorimeter is two orders of magnitude less than that of a commercial one. All these advantages enable a low-cost and high-precision sensing operation in a monitoring network. The colorimeter developed herein has bright prospects for environmental and biological applications.

Increased Risk for Falling Associated with Subtle Cognitive Impairment: Secondary Analysis of a Randomized Clinical Trial

PubMed Central

Gleason, Carey E.; Gangnon, Ronald E.; Fischer, Barbara L.; Mahoney, Jane E.

2009-01-01

Background/Aims Having dementia increases patients’ risk for accidental falls. However, it is unknown if having mild cognitive deficits also elevates a person's risk for falls. This study sought to clarify the relationship between subtle cognitive impairment, measured with a widely-used, clinic-based assessment, the Mini Mental State Exam (MMSE), and risk for falls. Methods In a secondary analysis of the Kenosha County Falls Prevention Study, a randomized controlled trial targeting older adults at risk for falls, we examined the association between baseline MMSE and prospective rate of falls over 12 months in 172 subjects randomized to control group. Results Using univariate analysis, the rate of falls increased with each unit decrease in MMSE score down to at least 22 (rate ratio 1.25, 95% confidence interval (CI) 1.09–1.45, p = 0.0026). Using stepwise multivariate regression, controlling for ability to perform activities of daily living, use of assistive device, current exercise, and arthritis, the association between MMSE score and falls rate persisted (rate ratio 1.20, 95% CI 1.03–1.40, p = 0.021). Conclusion Minimal decrements on the MMSE were associated with elevations in rate of falls, suggesting that subtle cognitive deficits reflected in MMSE scores above a cut-off consistent with a diagnosis of dementia, can influence risk for falls. PMID:19602883

[Serum level of S100B as a marker of progression of vascular mild cognitive impairment into subcortical vascular dementia and therapy effectiveness].

PubMed

Levada, O A; Traïlin, A V

2012-01-01

We evaluated serum level of S100B in 11 patients with subcortical vascular dementia (SVD) and 19 patients with subcortical vascular mild cognitive impairment (SVMCI). Comparable groups were age-matched (79.18 +/- 7.76 in SVD group, 77.84 +/- 3.83 in SVMCI; P = 0.53). 22 patients were assessed after 1 month therapy. It was shown that the serum S100B level significantly increased--(0.065 +/- 0.020) micro/l (P = 0.0005) in SVD patients comparing to SVMCI ones - (0.043 +/- 0.010) microg/l. S100B level was significantly correlated with the clinical parameters: MMSE performance (r(s) = -0.61), CDR (r(s) = 0.58), attention task (r(s) = -0.46), pseudobulbar syndrome severity (r(s) = 0.37) and walking alteration (r(s)= 0.37). In patients with reduction of S100B level due to therapy (positive dynamics, n = 12) we registered significant improvement of some clinical parameters: MMSE, attention level, walking. In patients with increasing of S100B level (negative dynamics, n = 10) we didn't registered improvement of any clinical parameters. We made the conclusion that the serum level of S100B could be used as marker of progression SVMCI into SVD and therapy effectiveness.

The Influence of Noise Reduction on Speech Intelligibility, Response Times to Speech, and Perceived Listening Effort in Normal-Hearing Listeners.

PubMed

van den Tillaart-Haverkate, Maj; de Ronde-Brons, Inge; Dreschler, Wouter A; Houben, Rolph

2017-01-01

Single-microphone noise reduction leads to subjective benefit, but not to objective improvements in speech intelligibility. We investigated whether response times (RTs) provide an objective measure of the benefit of noise reduction and whether the effect of noise reduction is reflected in rated listening effort. Twelve normal-hearing participants listened to digit triplets that were either unprocessed or processed with one of two noise-reduction algorithms: an ideal binary mask (IBM) and a more realistic minimum mean square error estimator (MMSE). For each of these three processing conditions, we measured (a) speech intelligibility, (b) RTs on two different tasks (identification of the last digit and arithmetic summation of the first and last digit), and (c) subjective listening effort ratings. All measurements were performed at four signal-to-noise ratios (SNRs): -5, 0, +5, and +∞ dB. Speech intelligibility was high (>97% correct) for all conditions. A significant decrease in response time, relative to the unprocessed condition, was found for both IBM and MMSE for the arithmetic but not the identification task. Listening effort ratings were significantly lower for IBM than for MMSE and unprocessed speech in noise. We conclude that RT for an arithmetic task can provide an objective measure of the benefit of noise reduction. For young normal-hearing listeners, both ideal and realistic noise reduction can reduce RTs at SNRs where speech intelligibility is close to 100%. Ideal noise reduction can also reduce perceived listening effort.

42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Basic elements of Medicaid and CHIP eligibility... ADMINISTRATION Requirements for Estimating Improper Payments in Medicaid and CHIP § 431.974 Basic elements of Medicaid and CHIP eligibility reviews. (a) General requirements. (1) States selected in any given year for...

42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Basic elements of Medicaid and CHIP eligibility... ADMINISTRATION Requirements for Estimating Improper Payments in Medicaid and CHIP § 431.974 Basic elements of Medicaid and CHIP eligibility reviews. (a) General requirements. (1) States selected in any given year for...

42 CFR 431.974 - Basic elements of Medicaid and CHIP eligibility reviews.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Basic elements of Medicaid and CHIP eligibility... ADMINISTRATION Requirements for Estimating Improper Payments in Medicaid and CHIP § 431.974 Basic elements of Medicaid and CHIP eligibility reviews. (a) General requirements. (1) States selected in any given year for...

Differential item functioning analysis with ordinal logistic regression techniques. DIFdetect and difwithpar.

PubMed

Crane, Paul K; Gibbons, Laura E; Jolley, Lance; van Belle, Gerald

2006-11-01

We present an ordinal logistic regression model for identification of items with differential item functioning (DIF) and apply this model to a Mini-Mental State Examination (MMSE) dataset. We employ item response theory ability estimation in our models. Three nested ordinal logistic regression models are applied to each item. Model testing begins with examination of the statistical significance of the interaction term between ability and the group indicator, consistent with nonuniform DIF. Then we turn our attention to the coefficient of the ability term in models with and without the group term. If including the group term has a marked effect on that coefficient, we declare that it has uniform DIF. We examined DIF related to language of test administration in addition to self-reported race, Hispanic ethnicity, age, years of education, and sex. We used PARSCALE for IRT analyses and STATA for ordinal logistic regression approaches. We used an iterative technique for adjusting IRT ability estimates on the basis of DIF findings. Five items were found to have DIF related to language. These same items also had DIF related to other covariates. The ordinal logistic regression approach to DIF detection, when combined with IRT ability estimates, provides a reasonable alternative for DIF detection. There appear to be several items with significant DIF related to language of test administration in the MMSE. More attention needs to be paid to the specific criteria used to determine whether an item has DIF, not just the technique used to identify DIF.

Development of a tool for assessment and care planning for dementia-related problem behaviors in home and community-based services programs: the Problem Behavior Inventory.

PubMed

Phillips, V L; Diwan, Sadhna; Egner, Amanda

2002-01-01

To describe development, validity, and application of the Problem Behavior Inventory (PBI), a tool to assess dementia-related problem behaviors (DRPBs) in community-based populations. Demographic, contact, and disease-specific data were extracted from client files from a Medicaid-funded home and community-based services program. Primary caregivers completed standard surveys relating to the care recipients' memory, mood, and behaviors. The client (care recipient) completed the Mini-Mental Status Exam (MMSE). Cognitively impaired clients, enrolled in the Community Care Services Program (CCSP) during a reference month, and their primary caregivers, were identified by CCSP case managers for participation in the study. Primary caregivers completed the Revised Memory and Behavior Problem Checklist (RMBPC). Clients screening positive for the presence of DRPBs based on caregiver responses to the RMBPC were then assessed using the Problem Behavior Inventory (PBI). Within the CCSP sample, the most prevalent behavior was appearing sad or depressed (67%), while the most frequent behavior was seeking attention, occurring at least daily in 58% of the group. The most bothersome behaviors were being sexually inappropriate, wandering, and misbehaving in public. Examination by behavior category (physical, verbal, mood, etc.) revealed a strong relationship between level of bother and behavior frequency. Frequency of verbal behaviors was positively related to MMSE scores, whereas frequency of ADL-related behaviors was inversely related to MMSE scores. Bother scores were not associated with MMSE scores. This study documents that the PBI is a valid, useful, and feasible tool for assessing DRPBs in community populations. Case managers using the PBI can determine specific problem behavior areas among client populations and for individual clients and institute client-specific interventions to address each issue.

The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

PubMed Central

Punchick, Boris; Freud, Tamar; Press, Yan

2016-01-01

Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658

The traveling salesman problem as a new screening test in early Alzheimer's disease: an exploratory study. Visual problem-solving in AD.

PubMed

De Vreese, Luc Pieter; Pradelli, Samantha; Massini, Giulia; Buscema, Massimo; Savarè, Rita; Grossi, Enzo

2005-12-01

In the clinical setting, brief general mental status tests tend to detect early-stage Alzheimer's disease (AD) less well than more specific cognitive tests. Some preliminary information was collected on the diagnostic accuracy of the Traveling Salesman Problem (TSP) compared with the Mini-Mental State Examination (MMSE) in recognizing early AD from normal aging. Fifteen AD outpatients (mean +/- SD MMSE: 24.45 +/- 2.61) and 30 age- and education-matched controls were submitted in a single blind protocol to a paper-and-pencil visually-presented version of the TSP, containing a random array of 30 points (TSP30). The task consisted of drawing the shortest continuous path, passing through each point once and only once, and returning to the starting point. Path lengths for subjects' solutions were computed and compared with the optimal solution given by a specific evolutionary algorithm called GenD. TP30 discriminated significantly better between AD subjects and controls (ROC curve AUC = 0.976; 95% CI 0.94-1.01) compared with the MMSE corrected for age and education (ROC curve AUC = 0.877; 95% CI 0.74-1.005). A path length of 478.2354, taken as "cut-off point", classified correctly subjects with a sensitivity of 93.3% and a specificity of 99.3%, whereas a score corrected for age and education of 25.85 on the MMSE had a sensitivity of 73.3% and a specificity of 96.7%. The TSP seems to be particularly sensitive to early AD and independent of patient's age and educational level. The high diagnostic ability, simplicity, and independence of age and education make the TSP promising as a screening test for early AD.

Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year.

PubMed

Winchester, J; Dick, M B; Gillen, D; Reed, B; Miller, B; Tinklenberg, J; Mungas, D; Chui, H; Galasko, D; Hewett, L; Cotman, C W

2013-01-01

AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N=104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian=69.8%; Latino/Hispanic Americans=20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2 h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted. Copyright © 2012. Published by Elsevier Ireland Ltd.

Comparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions.

PubMed Central

Death, J.; Douglas, A.; Kenny, R. A.

1993-01-01

Clock drawing is a quick, easy to remember test that is well received by patients. It is a good screening test for Alzheimer's disease in the outpatient setting. We evaluated its usefulness compared with the standard Mini Mental State Examination (MMSE) in elderly acute medical and surgical hospital admissions. Within 48 hours of admission, 117 patients over 70 years old were administered the MMSE and asked to draw a clock. Using the MMSE as the standard, clock drawing had a sensitivity of 77% and a specificity of 87%. Patients with discrepant scores were then further evaluated. The findings suggest that normal clock drawing ability reasonably excludes cognitive impairment or other causes of an abnormal MMSE in elderly acute medical and surgical hospital admissions, where cognitive impairment is common and frequently missed. PMID:8255833

The Telephone Interview for Cognitive Status: Creating a crosswalk with the Mini-Mental State Exam

PubMed Central

Fong, Tamara G.; Fearing, Michael A.; Jones, Richard N.; Shi, Peilin; Marcantonio, Edward R.; Rudolph, James L.; Yang, Frances M.; Kiely, Dan K.; Inouye, Sharon K.

2009-01-01

Background Brief cognitive screening measures are valuable tools for both research and clinical applications. The most widely used instrument, the Mini-Mental State Examination (MMSE) is limited in that it must be administered face-to-face, cannot be used in participants with visual or motor impairments, and is protected by copyright. Alternative screening instruments, such as the Telephone Interview for Cognitive Status (TICS) have been developed and may provide a valid alternative with comparable cut point scores to rate global cognitive function. Methods MMSE, TICS-30, and TICS-40 scores from 746 community dwelling elders who participated in the Aging, Demographics, and Memory Study (ADAMS) were analyzed with equipercentile equating, a statistical process of determining comparable scores based on percentile equivalents on different forms of an examination. Results Scores from the MMSE and the TICS-30 and TICS-40 corresponded well and clinically relevant cut point scores were determined; for example, an MMSE score of 23 is equivalent to 17 and 20 on the TICS-30 and TICS-40, respectively. Conclusions These findings provide scores that can be used to link TICS and MMSE scores directly. Clinically relevant and important MMSE cut points and the respective ADAMS TICS-30 and TICS-40 cut point scores have been included to identify the degree of cognitive impairment among respondents with any type of cognitive disorder. These results will help with the widespread application of the TICS in both research and clinical practice. PMID:19647495

Factors Influencing Cognitive Function in Subjects With COPD.

PubMed

Dag, Ersel; Bulcun, Emel; Turkel, Yakup; Ekici, Aydanur; Ekici, Mehmet

2016-08-01

The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit. Copyright © 2016 by Daedalus Enterprises.

Montreal Cognitive Assessment (MoCA): validation study for frontotemporal dementia.

PubMed

Freitas, Sandra; Simões, Mário R; Alves, Lara; Duro, Diana; Santana, Isabel

2012-09-01

The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment, having surpassed the well-known limitations of the Mini-Mental State Examination (MMSE). The aim of the present study was to validate the MoCA as a cognitive screening test for behavioral-variant frontotemporal dementia (bv-FTD) by examining its psychometric properties and diagnostic accuracy. Three matched subgroups of participants were considered: bv-FTD (n = 50), Alzheimer disease (n = 50), and a control group of healthy adults (n = 50). Compared with the MMSE, the MoCA demonstrated consistently superior psychometric properties and discriminant capacity, providing comprehensive information about the patients' cognitive profiles. The diagnostic accuracy of MoCA for bv-FTD was extremely high (area under the curve AUC [MoCA] = 0.934, 95% confidence interval [CI] = 0.866-.974; AUC [MMSE] = 0.772, 95% CI = 0.677-0.850). With a cutoff below 17 points, the MoCA results for sensitivity, specificity, positive predictive value, negative predictive value, and classification accuracy were significantly superior to those of the MMSE. The MoCA is a sensitive and accurate instrument for screening the patients with bv-FTD and represents a better option than the MMSE.

Income Eligibility Thresholds, Premium Contributions, and Children's Coverage Outcomes: A Study of CHIP Expansions

PubMed Central

Gresenz, Carole Roan; Edgington, Sarah E; Laugesen, Miriam J; Escarce, José J

2013-01-01

Objective To understand the effects of Children's Health Insurance Program (CHIP) income eligibility thresholds and premium contribution requirements on health insurance coverage outcomes among children. Data Sources 2002–2009 Annual Social and Economic Supplements of the Current Population Survey linked to data from multiple secondary data sources. Study Design We use a selection correction model to simultaneously estimate program eligibility and coverage outcomes conditional upon eligibility. We simulate the effects of three premium schedules representing a range of generosity levels and the effects of income eligibility thresholds ranging from 200 to 400 percent of the federal poverty line. Principal Findings Premium contribution requirements decrease enrollment in public coverage and increase enrollment in private coverage, with larger effects for greater contribution levels. Our simulation results suggest minimal changes in coverage outcomes from eligibility expansions to higher income families under premium schedules that require more than a modest contribution (medium or high schedules). Conclusions Our simulation results are useful counterpoints to previous research that has estimated the average effect of program expansions as they were implemented without disentangling the effects of premiums or other program features. The sensitivity to premiums observed suggests that although contribution requirements may be effective in reducing crowd-out, they also have the potential, depending on the level of contribution required, to nullify the effects of CHIP expansions entirely. The persistence of uninsurance among children under the range of simulated scenarios points to the importance of Affordable Care Act provisions designed to make the process of obtaining coverage transparent and navigable. PMID:23398477

Income eligibility thresholds, premium contributions, and children's coverage outcomes: a study of CHIP expansions.

PubMed

Gresenz, Carole Roan; Edgington, Sarah E; Laugesen, Miriam J; Escarce, José J

2013-04-01

To understand the effects of Children's Health Insurance Program (CHIP) income eligibility thresholds and premium contribution requirements on health insurance coverage outcomes among children. 2002-2009 Annual Social and Economic Supplements of the Current Population Survey linked to data from multiple secondary data sources. We use a selection correction model to simultaneously estimate program eligibility and coverage outcomes conditional upon eligibility. We simulate the effects of three premium schedules representing a range of generosity levels and the effects of income eligibility thresholds ranging from 200 to 400 percent of the federal poverty line. Premium contribution requirements decrease enrollment in public coverage and increase enrollment in private coverage, with larger effects for greater contribution levels. Our simulation results suggest minimal changes in coverage outcomes from eligibility expansions to higher income families under premium schedules that require more than a modest contribution (medium or high schedules). Our simulation results are useful counterpoints to previous research that has estimated the average effect of program expansions as they were implemented without disentangling the effects of premiums or other program features. The sensitivity to premiums observed suggests that although contribution requirements may be effective in reducing crowd-out, they also have the potential, depending on the level of contribution required, to nullify the effects of CHIP expansions entirely. The persistence of uninsurance among children under the range of simulated scenarios points to the importance of Affordable Care Act provisions designed to make the process of obtaining coverage transparent and navigable. © Health Research and Educational Trust.

Study of Thread Level Parallelism in a Video Encoding Application for Chip Multiprocessor Design

NASA Astrophysics Data System (ADS)

Debes, Eric; Kaine, Greg

2002-11-01

In media applications there is a high level of available thread level parallelism (TLP). In this paper we study the intra TLP in a video encoder. We show that a well-distributed highly optimized encoder running on a symmetric multiprocessor (SMP) system can run 3.2 faster on a 4-way SMP machine than on a single processor. The multithreaded encoder running on an SMP system is then used to understand the requirements of a chip multiprocessor (CMP) architecture, which is one possible architectural direction to better exploit TLP. In the framework of this study, we use a software approach to evaluate the dataflow between processors for the video encoder running on an SMP system. An estimation of the dataflow is done with L2 cache miss event counters using Intel® VTuneTM performance analyzer. The experimental measurements are compared to theoretical results.

Modeling the Association between 43 Different Clinical and Pathological Variables and the Severity of Cognitive Impairment in a Large Autopsy Cohort of Elderly Persons

PubMed Central

Nelson, Peter T.; Abner, Erin L.; Schmitt, Frederick A.; Kryscio, Richard J.; Jicha, Gregory A.; Smith, Charles D.; Davis, Daron G.; Poduska, John W.; Patel, Ela; Mendiondo, Marta S.; Markesbery, William R.

2009-01-01

We evaluated the association between mini-mental status examination (MMSE) scores proximal to death and the values of 43 different clinical and pathological parameters. Studies were performed using data from 334 elderly, longitudinally evaluated research subjects who had undergone autopsy and satisfied inclusion criteria from an initial study group of 501. Interindividual variance in MMSE scores was used as a surrogate for the severity of cognitive impairment linked to aging (CILA). A statistical linear regression-based model provided a framework for assessing the parameters with significant, direct impact on CILA severity. Strong association between CILA and Alzheimer’s disease (AD) pathology, especially isocortical neurofibrillary tangles, was evident. The pattern of association between AD lesion densities with cognitive impairment severity was biologically informative, with neuritic plaques having more impact in relatively high-functioning individuals. Abundant isocortical Lewy bodies tended to be an additive pathology correlating with final MMSE scores approximately 10 points lower. In a subset of cases we found evidence for association between TDP-43-related pathology and CILA severity, independent of AD or hippocampal sclerosis. There was no support for independent association between CILA severity and most evaluated indices including diffuse plaques, argyrophilic grains, heart disease, education level, apolipoprotein E alleles or diabetes. PMID:19021630

Factors Associated with Performance-based Physical Function of Older Veterans of the PLAAF: A Pilot Study

PubMed Central

Chen, Da-Wei; Jin, Yan-Bin; Liu, Wei; Du, Wen-Jin; Li, Hua-Jun; Chen, Jin-Wen; Xu, Wei

2014-01-01

[Purpose] This study investigated the factors associated with performance-based physical function of older veterans of the People’s Liberation Army Air Force of China (PLAAF). [Subjects and Methods] A cross-sectional survey of 146 older veterans of the PLAAF was carried out. Their physical function was measured using the Chinese Mini-Physical Performance Testing (CM-PPT). The demographics and health status (including physical measures, blood chemical tests, chronic diseases, and number of morbidities) were collected from health examination reports and computer records of case history. Cognition was measured using the Mini-Mental Status Examination (MMSE). [Results] In multiple linear regressions, age, MMSE, Parkinsonism, and chronic obstructive pulmonary disease were independently associated with CM-PPT, while previous stroke and albumin level reached borderline statistical significance. The association between the number of morbidities and CM-PPT was significant after adjustment for MMSE and demographics. The CM-PPT of low (0 or 1), medium (2 to 4) and high count (5 or more) morbidities were 11.3±3.9, 10.2±4.1, 6.1±3.8 respectively, and the difference among these three groups was significant. [Conclusion] Some modified conditions and the number of chronic diseases might be associated with the physical function of older veterans of the PLAAF. PMID:24648625

Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study

PubMed Central

Farooqui, Zishaan; Bakulski, Kelly M.; Power, Melinda C.; Weisskopf, Marc G.; Sparrow, David; Spiro, Avron; Vokonas, Pantel S.; Nie, Huiling; Hu, Howard; Park, Sung Kyun

2016-01-01

Background Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. Methods In a 1993–2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Results Among men 51–98 at baseline, higher patella Pb concentration (IQR: 21 µg/g) was associated with −0.13 lower baseline MMSE (95% CI: −0.25, −0.004) and faster longitudinal MMSE decline (−0.016 units/year, 95% CI: −0.032, −0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: −0.026, −0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: −0.027, −0.002). We found weaker associations with tibia Pb. Conclusions Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. PMID:27770710

Clinical Significance of Cerebrovascular Biomarkers and White Matter Tract Integrity in Alzheimer Disease: Clinical correlations With Neurobehavioral Data in Cross-Sectional and After 18 Months Follow-ups.

PubMed

Wu, Ming-Kung; Lu, Yan-Ting; Huang, Chi-Wei; Lin, Pin-Hsuan; Chen, Nai-Ching; Lui, Chun-Chung; Chang, Wen-Neng; Lee, Chen-Chang; Chang, Ya-Ting; Chen, Sz-Fan; Chang, Chiung-Chih

2015-07-01

Cerebrovascular risk factors and white matter (WM) damage lead to worse cognitive performance in Alzheimer dementia (AD). This study investigated WM microstructure using diffusion tensor imaging in patients with mild to moderate AD and investigated specific fiber tract involvement with respect to predefined cerebrovascular risk factors and neurobehavioral data prediction cross-sectionally and after 18 months. To identify the primary pathoanatomic relationships of risk biomarkers to fiber tract integrity, we predefined 11 major association tracts and calculated tract specific fractional anisotropy (FA) values. Eighty-five patients with AD underwent neurobehavioral assessments including the minimental state examination (MMSE) and 12-item neuropsychiatric inventory twice with a 1.5-year interval to represent major outcome factors. In the cross-sectional data, total cholesterol, low-density lipoprotein, vitamin B12, and homocysteine levels correlated variably with WM FA values. After entering the biomarkers and WM FA into a regression model to predict neurobehavioral outcomes, only fiber tract FA or homocysteine level predicted the MMSE score, and fiber tract FA or age predicted the neuropsychiatric inventory total scores and subdomains of apathy, disinhibition, and aberrant motor behavior. In the follow-up neurobehavioral data, the mean global FA value predicted the MMSE and aberrant motor behavior subdomain, while age predicted the anxiety and elation subdomains. Cerebrovascular risk biomarkers may modify WM microstructural organization, while the association with fiber integrity showed greater clinical significance to the prediction of neurobehavioral outcomes both cross-sectionally and longitudinally.

Education and trajectories of cognitive decline over 9 years in very old people: methods and risk analysis.

PubMed

Muniz-Terrera, Graciela; Matthews, Fiona; Dening, Tom; Huppert, Felicia A; Brayne, Carol

2009-05-01

the investigation of cognitive decline in the older population has been hampered by analytical considerations. Most studies of older people over prolonged periods suffer from loss to follow-up, yet this has seldom been investigated fully to date. Such considerations limit our understanding of how basic variables such as education can affect cognitive trajectories. we examined cognitive trajectories in a population-based cohort study in Cambridge, UK, of people aged 75 and over in whom multiple interviews were conducted over time. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Socio-demographic variables were measured, including educational level and social class. An age-based quadratic latent growth model was fitted to cognitive scores. The effect of socio-demographic variables was examined on all latent variables and the probability of death and dropout. at baseline, age, education, social class and mobility were associated with cognitive performance. Education and social class were not related to decline or its rate of change. In contrast, poor mobility was associated with lower cognitive performance, increased cognitive decline and increased rate of change of cognitive decline. Gender, age, mobility and cognitive ability predicted death and dropout contrary to much of the current literature, education was not related to rate of cognitive decline or change in this rate as measured by MMSE. Higher levels of education do not appear to protect against cognitive decline, though if the MMSE is used in the diagnostic process, individuals with less education may be diagnosed as having dementia somewhat earlier.

Effect of Area-Level Socioeconomic Deprivation on Risk of Cognitive Dysfunction in Older Adults.

PubMed

McCann, Adrian; McNulty, Helene; Rigby, Jan; Hughes, Catherine F; Hoey, Leane; Molloy, Anne M; Cunningham, Conal J; Casey, Miriam C; Tracey, Fergal; O'Kane, Maurice J; McCarroll, Kevin; Ward, Mary; Moore, Katie; Strain, J J; Moore, Adrian

2018-02-12

To investigate the relationship between area-level deprivation and risk of cognitive dysfunction. Cross-sectional analysis. The Trinity, Ulster, and Department of Agriculture (TUDA) study from 2008 to 2012. Community-dwelling adults aged 74.0 ± 8.3 without dementia (N = 5,186; 67% female). Adopting a cross-jurisdictional approach, geo-referenced address-based information was used to map and link participants to official socioeconomic indicators of deprivation within the United Kingdom and the Republic of Ireland. Participants were assigned an individual deprivation score related to the smallest administrative area in which they lived. These scores were categorized into comparable quintiles, that were then used to integrate the datasets from both countries. Cognitive health was assessed using the Mini-Mental State Examination (MMSE); cognitive dysfunction was defined as a MMSE score of 24 or less. Approximately one-quarter of the cohort resided within the most-deprived districts in both countries. Greater area-level deprivation was associated with significantly lower MMSE scores; fewer years of formal education; greater anxiety, depression, smoking and alcohol use, and obesity; and more adverse outcomes, including higher blood pressure and diabetes risk. After adjustment for relevant covariates, area deprivation was associated with significantly higher risk of cognitive dysfunction (odds ratio =1.40, 95% confidence interval = 1.05-1.87, P = .02, for most vs least deprived). This analysis combining data from two health systems shows that area deprivation is an independent risk factor for cognitive dysfunction in older adults. Adults living in areas of greatest socioeconomic deprivation may benefit from targeted strategies aimed at improving modifiable risk factors for dementia. Further cross-national analysis investigating the impact of area-level deprivation is needed to address socioeconomic disparities and shape future policy to improve health outcomes in older adults. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Estimating minimal important differences for several scales assessing function and quality of life in patients with attention-deficit/hyperactivity disorder.

PubMed

Hodgkins, Paul; Lloyd, Andrew; Erder, M Haim; Setyawan, Juliana; Weiss, Margaret D; Sasané, Rahul; Nafees, Beenish

2017-02-01

Defining minimal important difference (MID) is critical to interpreting patient-reported outcomes data and treatment efficacy in clinical trials. This study estimates the MID for the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) and the Child Health and Illness Profile-Parent Report (CHIP-CE-PRF76) among parents of young people with attention-deficit/hyperactivity disorder (ADHD) in the UK. Parents of children (6-12 years; n=100) and adolescents (13-17 years; n=117) with ADHD completed a socio-demographic form, the CHIP-CE-PRF76, the WFIRS-P, and the Pediatric Quality of Life scale at baseline and 4 weeks later. At follow-up, a subset of parents completed anchor questions measuring change in the child/adolescent from baseline. MIDs were estimated using anchor-based and distribution-based methods, and separately for children and adolescents. The MID estimates for overall change in the WFIRS-P total score ranged from 11.31 (standard error of measurement) to 13.47 (anchor) for the total sample. The range of MID estimates for the CHIP-CE-PRF76 varied by domain: 6.80-7.41 (satisfaction), 6.18-7.34 (comfort), 5.60-6.72 (resilience), 6.06-7.57 (risk avoidance), and 4.00-5.63 (achievement) for the total sample. Overall, MID estimates for WFIRS-P MID and CHIP-CE-PRF76 were slightly higher for adolescents than for children. This study estimated MIDs for these instruments using several methods. The observed convergence of the MID estimates increases confidence in their reliability and could assist clinicians and decision makers in deriving meaningful interpretations of observed changes in the WFIRS-P and CHIP-CE in clinical trials and practice.

Single-chip source-free terahertz spectroscope across 0.04-0.99 THz: combining sub-wavelength near-field sensing and regression analysis.

PubMed

Wu, Xue; Sengupta, Kaushik

2018-03-19

This paper demonstrates a methodology to miniaturize THz spectroscopes into a single silicon chip by eliminating traditional solid-state architectural components such as complex tunable THz and optical sources, nonlinear mixing and amplifiers. The proposed method achieves this by extracting incident THz spectral signatures from the surface of an on-chip antenna itself. The information is sensed through the spectrally-sensitive 2D distribution of the impressed current surface under the THz incident field. By converting the antenna from a single-port to a massively multi-port architecture with integrated electronics and deep subwavelength sensing, THz spectral estimation is converted into a linear estimation problem. We employ rigorous regression techniques and analysis to demonstrate a single silicon chip system operating at room temperature across 0.04-0.99 THz with 10 MHz accuracy in spectrum estimation of THz tones across the entire spectrum.

Shapes of the Trajectories of Five Major Biomarkers of Alzheimer’s Disease

PubMed Central

Jack, Clifford R.; Vemuri, Prashanthi; Wiste, Heather J.; Weigand, Stephen D.; Lesnick, Timothy G.; Lowe, Val; Kantarci, Kejal; Bernstein, Matt A.; Senjem, Matthew L.; Gunter, Jeffrey L.; Boeve, Bradley F.; Trojanowski, John Q.; Shaw, Leslie M.; Aisen, Paul S.; Weiner, Michael W.; Petersen, Ronald C.; Knopman, David S.

2013-01-01

Objective To characterize the shape of the trajectories of Alzheimer’s Disease (AD) biomarkers as a function of MMSE. Design Longitudinal registries from the Mayo Clinic and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Patients Two different samples (n=343 and n=598) were created that spanned the cognitive spectrum from normal to AD dementia. Subgroup analyses were performed in members of both cohorts (n=243 and n=328) who were amyloid positive at baseline. Main Outcome Measures The shape of biomarker trajectories as a function of MMSE, adjusted for age, was modeled and described as baseline (cross-sectional) and within-subject longitudinal effects. Biomarkers evaluated were cerebro spinal fluid (CSF) Aβ42 and tau; amyloid and fluoro deoxyglucose position emission tomography (PET) imaging, and structural magnetic resonance imaging (MRI). Results Baseline biomarker values generally worsened (i.e., non-zero slope) with lower baseline MMSE. Baseline hippocampal volume, amyloid PET and FDG PET values plateaued (i.e., non-linear slope) with lower MMSE in one or more analyses. Longitudinally, within-subject rates of biomarker change were associated with worsening MMSE. Non-constant within-subject rates (deceleration) of biomarker change were found in only one model. Conclusions Biomarker trajectory shapes by MMSE were complex and were affected by interactions with age and APOE status. Non-linearity was found in several baseline effects models. Non-constant within-subject rates of biomarker change were found in only one model, likely due to limited within-subject longitudinal follow up. Creating reliable models that describe the full trajectories of AD biomarkers will require significant additional longitudinal data in individual participants. PMID:22409939

Microbleeds do not affect rate of cognitive decline in Alzheimer disease.

PubMed

van der Vlies, Annelies E; Goos, Jeroen D C; Barkhof, Frederik; Scheltens, Philip; van der Flier, Wiesje M

2012-08-21

To investigate the relationship between brain microbleeds (MBs) and the rate of cognitive decline in Alzheimer disease (AD). In this cohort study, we studied 221 patients with AD with available baseline MRI scans (1.0 or 1.5 T) and at least 2 Mini-Mental State Examinations (MMSE) scores obtained more than 1 year apart from our memory clinic. Mean ± SD follow-up time was 3 ± 1 years, and patients had a median of 4 MMSE scores (range 2-17). We used linear mixed models with sex and age as covariates to investigate whether MBs influenced the rate of cognitive decline. Mean age was 68 ± 9 years, 109 (49%) patients were female, and the baseline MMSE score was 22 ± 4. There were 39 patients (18%) with MBs (median 2, range 1-27) and 182 without. Linear mixed models showed that overall patients declined 2 MMSE points per year. We found no association of the presence of MBs with baseline MMSE or change in MMSE. Adjustment for atrophy, white matter hyperintensities, lacunes, and vascular risk factors did not change the results nor did stratification for MB location, APOE ε4 carriership, or age at onset (≤65 years vs >65 years). Repeating the analyses with number of MBs as predictor rendered similar results. MBs did not influence the rate of cognitive decline in patients with AD. The formerly reported increased risk of mortality in patients with MBs seems not to be attributable to a steeper rate of decline per se but might be due to vascular events, including (hemorrhagic) stroke.

Validity of a semantically cued recall procedure for the mini-mental state examination.

PubMed

Yuspeh, R L; Vanderploeg, R D; Kershaw, D A

1998-10-01

The validity of supplementing the three-item recall portion of the Mini-Mental State Examination (MMSE) with a cued recall procedure to help specify the nature of patients' memory problems was examined. Subjects were 247 individuals representing three diagnostic groups: Alzheimer's disease (AD), subcortical vascular ischemic dementia (SVaD), and normal controls. Individuals were administered a battery of neuropsychological tests, including the MMSE, as part of a comprehensive evaluation for the presence of dementia or other neurologic disorder. MMSE performance differed among groups. The three-item free recall performance also differed among groups, with post hoc analyses revealing the AD and SVaD groups were more impaired than controls but did not differ significantly from each other. Following a cued recall procedure of the MMSE three-items, groups differed, with post hoc analyses showing that AD patients failed to benefit from cues, whereas SVaD patients performed significantly better and comparable to control subjects. Significant correlations between the MMSE three-item cued recall performance and other memory measures demonstrated concurrent validity. Consistent with previous research indicating that SVaD is associated with memory encoding and retrieval deficits, whereas AD is associated with consolidation and storage problems, the present study supported the validity of the cued recall procedure of the three items on the MMSE in helping to distinguish between patients with AD and those with a vascular dementia with primarily subcortical pathology; however, despite these findings, a more extensive battery of neuropsychological measures is still recommended to consistently assess subtle diagnostic differences in these memory processes.

Bi-level multilayered microelectronic device package with an integral window

DOEpatents

Peterson, Kenneth A.; Watson, Robert D.

2002-01-01

A bi-level, multilayered package with an integral window for housing a microelectronic device. The device can be a semiconductor chip, a CCD chip, a CMOS chip, a VCSEL chip, a laser diode, a MEMS device, or a IMEMS device. The multilayered package can be formed of a low-temperature cofired ceramic (LTCC) or high-temperature cofired ceramic (HTCC) multilayer processes with the window being simultaneously joined (e.g. cofired) to the package body during LTCC or HTCC processing. The microelectronic device can be flip-chip bonded and oriented so that the light-sensitive side is optically accessible through the window. A second chip can be bonded to the backside of the first chip, with the second chip being wirebonded to the second level of the bi-level package. The result is a compact, low-profile package, having an integral window that can be hermetically-sealed.

A 0.18 μm CMOS low-power radiation sensor for asynchronous event-driven UWB wireless transmission

NASA Astrophysics Data System (ADS)

Bastianini, S.; Crepaldi, M.; Demarchi, D.; Gabrielli, A.; Lolli, M.; Margotti, A.; Villani, G.; Zhang, Z.; Zoccoli, G.

2013-12-01

The paper describes the design of a readout element, proposed as a radiation monitor, which implements an embedded sensor based on a floating-gate transistor. The paper shows the design of a microelectronic circuit composed of a sensor, an oscillator, a modulator, a transmitter and an integrated antenna. A prototype chip has recently been fabricated and tested exploiting a commercial 180 nm, four metal CMOS technology. Simulation results of the entire behavior of the circuit before submission are presented along with some measurements of the actual chip response. In addition, preliminary tests of the performance of the Ultra-Wide Band transmission via the integrated antenna are summarized. As the complete chip prototype area is less than 1 mm2, the chip fits a large variety of applications, from spot radiation monitoring systems in medicine to punctual measurements of radiation level in High-Energy Physics experiments. A sensitivity of 1 mV/rad was estimated within an absorbed dose range up to 10 krad and a total power consumption of about 165 μW.

Payload transportation system study

NASA Technical Reports Server (NTRS)

1976-01-01

A standard size set of shuttle payload transportation equipment was defined that will substantially reduce the cost of payload transportation and accommodate a wide range of payloads with minimum impact on payload design. The system was designed to accommodate payload shipments between the level 4 payload integration sites and the launch site during the calendar years 1979-1982. In addition to defining transportation multi-use mission support equipment (T-MMSE) the mode of travel, prime movers, and ancillary equipment required in the transportation process were also considered. Consistent with the STS goals of low cost and the use of standardized interfaces, the transportation system was designed to commercial grade standards and uses the payload flight mounting interfaces for transportation. The technical, cost, and programmatic data required to permit selection of a baseline system of MMSE for intersite movement of shuttle payloads were developed.

Binaural noise reduction via cue-preserving MMSE filter and adaptive-blocking-based noise PSD estimation

NASA Astrophysics Data System (ADS)

Azarpour, Masoumeh; Enzner, Gerald

2017-12-01

Binaural noise reduction, with applications for instance in hearing aids, has been a very significant challenge. This task relates to the optimal utilization of the available microphone signals for the estimation of the ambient noise characteristics and for the optimal filtering algorithm to separate the desired speech from the noise. The additional requirements of low computational complexity and low latency further complicate the design. A particular challenge results from the desired reconstruction of binaural speech input with spatial cue preservation. The latter essentially diminishes the utility of multiple-input/single-output filter-and-sum techniques such as beamforming. In this paper, we propose a comprehensive and effective signal processing configuration with which most of the aforementioned criteria can be met suitably. This relates especially to the requirement of efficient online adaptive processing for noise estimation and optimal filtering while preserving the binaural cues. Regarding noise estimation, we consider three different architectures: interaural (ITF), cross-relation (CR), and principal-component (PCA) target blocking. An objective comparison with two other noise PSD estimation algorithms demonstrates the superiority of the blocking-based noise estimators, especially the CR-based and ITF-based blocking architectures. Moreover, we present a new noise reduction filter based on minimum mean-square error (MMSE), which belongs to the class of common gain filters, hence being rigorous in terms of spatial cue preservation but also efficient and competitive for the acoustic noise reduction task. A formal real-time subjective listening test procedure is also developed in this paper. The proposed listening test enables a real-time assessment of the proposed computationally efficient noise reduction algorithms in a realistic acoustic environment, e.g., considering time-varying room impulse responses and the Lombard effect. The listening test outcome reveals that the signals processed by the blocking-based algorithms are significantly preferred over the noisy signal in terms of instantaneous noise attenuation. Furthermore, the listening test data analysis confirms the conclusions drawn based on the objective evaluation.

42 CFR 431.970 - Information submission requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.970 Information submission requirements... payments in Medicaid and CHIP, that include but are not limited to— (1) Adjudicated fee-for-service (FFS... contracts, rate information, and any quarterly updates applicable to the review year for CHIP and, as...

42 CFR 431.970 - Information submission requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.970 Information submission requirements... payments in Medicaid and CHIP, that include but are not limited to— (1) Adjudicated fee-for-service (FFS... contracts, rate information, and any quarterly updates applicable to the review year for CHIP and, as...

42 CFR 431.970 - Information submission requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.970 Information submission requirements... payments in Medicaid and CHIP, that include but are not limited to— (1) Adjudicated fee-for-service (FFS... contracts, rate information, and any quarterly updates applicable to the review year for CHIP and, as...

42 CFR 431.970 - Information submission requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.970 Information submission requirements... payments in Medicaid and CHIP, that include but are not limited to— (1) Adjudicated fee-for-service (FFS... contracts, rate information, and any quarterly updates applicable to the review year for CHIP and, as...

42 CFR 431.970 - Information submission requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for Estimating Improper Payments in Medicaid and CHIP § 431.970 Information submission requirements... payments in Medicaid and CHIP, that include but are not limited to— (1) Adjudicated fee-for-service (FFS... contracts, rate information, and any quarterly updates applicable to the review year for CHIP and, as...

Self-administered Gerocognitive Examination (SAGE): a brief cognitive assessment Instrument for mild cognitive impairment (MCI) and early dementia.

PubMed

Scharre, Douglas W; Chang, Shu-Ing; Murden, Robert A; Lamb, James; Beversdorf, David Q; Kataki, Maria; Nagaraja, Haikady N; Bornstein, Robert A

2010-01-01

To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. Adults aged above 59 years with sufficient vision and English literacy were recruited from geriatric and memory disorder clinics, educational talks, independent living facilities, senior centers, and memory screens. After Self-administered Gerocognitive Examination (SAGE) screening, subjects were randomly selected to complete a clinical evaluation, neurologic examination, neuropsychologic battery, functional assessment, and mini-mental state examination (MMSE). Subjects were identified as dementia, MCI, or normal based on standard clinical criteria and neuropsychologic testing. Two hundred fifty-four participants took the SAGE screen and 63 subjects completed the extensive evaluation (21 normal, 21 MCI, and 21 dementia subjects). Spearman rank correlation between SAGE and neuropsychologic battery was 0.84 (0.76 for MMSE). SAGE receiver operating characteristics on the basis of clinical diagnosis showed 95% specificity (90% for MMSE) and 79% sensitivity (71% for MMSE) in detecting those with cognitive impairment from normal subjects. This study suggests that SAGE is a reliable instrument for detecting cognitive impairment and compares favorably with the MMSE. The self-administered feature may promote cognitive testing by busy clinicians prompting earlier diagnosis and treatment.

A comparative study of behavioral and psychological symptoms of dementia in patients with Alzheimer's disease and vascular dementia referred to psychogeriatric services in Korea and the U.K.

PubMed

Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2005-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in consecutive series of referrals to a psychogeriatric service in Korea and the U.K. using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale and the Cornell Scale for Depression in Dementia (CSDD). Results were analyzed separately for Alzheimer's disease and vascular dementia. Koreans in both diagnostic groups had lower Mini-mental State Examination (MMSE) scores and higher BEHAVE-AD total and subscale scores for most subscales. In both countries, for both diagnostic groups, the total BEHAVE-AD score and several subscale scores were negatively correlated with the MMSE scores. Logistic regression analysis for Alzheimer's disease revealed that BEHAVE-AD total and most subscale scores independently predicted the country of origin in addition to the MMSE scores predicting the same. These differences in BPSD are most likely explained by the lower MMSE scores in the Korean sample. However, genuine differences in BPSD between the two countries can only be critically examined in a cross-cultural population-based epidemiological study for both diagnostic categories using validated instruments to measure BPSD and controlling for the influence of MMSE score.

Evaluation of the Addenbrooke's Cognitive Examination's validity in a brain injury rehabilitation setting.

PubMed

Gaber, Tarek A-Z K

2008-07-01

Several reports have warned of the Mini Mental State Examination's (MMSE) inability to detect gross memory and high executive impairments. Addenbrooke's Cognitive Examination-Revised (ACE-R) has gained enormous popularity in dementia screening as it addresses the main shortcomings of MMSE. This study aimed at evaluating the use of ACE-R and to establish its sensitivity compared to MMSE in a cohort of brain injury patients. ACE-R was administered to a cohort of chronic brain injury patients. All patients had a cognitive impairment which was severe enough to prevent them working or studying. Patients with significant mental health, sensory, communication or physical impairments were excluded. Thirty-six patients were recruited, 31 males with a mean age of 37 years. For an upper cut-off value of 27/30 for MMSE and 88/100 for ACE-R, their sensitivities were 36% and 72%, respectively. For a lower cut-off value of 24/30 and 82/100 the tests sensitivities were 11% and 56%, respectively. Analysis of the ACE-R sub-tests indicated that memory and verbal fluency sub-tests showed the most dramatic impairment. MMSE is insensitive as a screening test in brain injury patients. The results show ACE-R to be a sensitive, easily administered test.

On a stronger-than-best property for best prediction

NASA Astrophysics Data System (ADS)

Teunissen, P. J. G.

2008-03-01

The minimum mean squared error (MMSE) criterion is a popular criterion for devising best predictors. In case of linear predictors, it has the advantage that no further distributional assumptions need to be made, other then about the first- and second-order moments. In the spatial and Earth sciences, it is the best linear unbiased predictor (BLUP) that is used most often. Despite the fact that in this case only the first- and second-order moments need to be known, one often still makes statements about the complete distribution, in particular when statistical testing is involved. For such cases, one can do better than the BLUP, as shown in Teunissen (J Geod. doi: 10.1007/s00190-007-0140-6, 2006), and thus devise predictors that have a smaller MMSE than the BLUP. Hence, these predictors are to be preferred over the BLUP, if one really values the MMSE-criterion. In the present contribution, we will show, however, that the BLUP has another optimality property than the MMSE-property, provided that the distribution is Gaussian. It will be shown that in the Gaussian case, the prediction error of the BLUP has the highest possible probability of all linear unbiased predictors of being bounded in the weighted squared norm sense. This is a stronger property than the often advertised MMSE-property of the BLUP.

Estimation of glycaemic index of peach palm (Bactris gasipaes) cooked fruits and chips, and pitahaya (Hylocereus spp.) pulp.

PubMed

Jiménez, Gin; Gómez, Georgina; Pérez, Ana M; Blanco-Metzler, Adriana

2012-09-01

The glycaemic index (GI) is a physiological measure of a food's potential to increase postprandial blood glucose, as compared to the effect produced by food taken as reference, such as glucose or white bread. Currently researchers and consumers are interested in low GI foods, since their consumption is associated with better weight control and reduced risk of incidence of chronic diseases, like diabetes. In the present study, the GI value for peach palm cooked fruit, peach palm chips and pitahaya pulp was estimated. The methodology established by the FAO/WHO for determining the GI of food was used. A total of 12 healthy, non-smoking volunteers were selected and they ingested the fore mentioned foods on different occasions, in 25 g portions of available carbohydrates, after 12-14 h overnight fast. Blood glucose levels were measured in 30 min intervals up to 120 min after ingestion. Average GI value was 48 +/- 11 for the pitahaya pulp and 35 +/- 6 for the peach palm cooked fruit, which may be classified as low glyceamic index foods. The GI of peach palm chips was 60 +/- 7, corresponding to a food with a moderate GI. The processing for producing the chips caused an increase in the GI value when compared to the cooked fruit, probably because the stages of miIling, moulding and baking promote availability of starch during hydrolysis by the digestive enzymes.

42 CFR 431.980 - Eligibility review procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.980 Eligibility review procedures. (a) Active case reviews. The agency must verify eligibility for all selected active cases for Medicaid and CHIP for the... must review all selected negative cases for Medicaid and CHIP for the review month to determine whether...

42 CFR 431.980 - Eligibility review procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.980 Eligibility review procedures. (a) Active case reviews. The agency must verify eligibility for all selected active cases for Medicaid and CHIP for the... must review all selected negative cases for Medicaid and CHIP for the review month to determine whether...

42 CFR 431.960 - Types of payment errors.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.960 Types of payment errors. (a) General rule. State or provider errors identified for the Medicaid and CHIP improper payments measurement under the... been paid by a third party but were inappropriately paid by Medicaid or CHIP. (v) Pricing errors. (vi...

42 CFR 431.980 - Eligibility review procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.980 Eligibility review procedures. (a) Active case reviews. The agency must verify eligibility for all selected active cases for Medicaid and CHIP for the... must review all selected negative cases for Medicaid and CHIP for the review month to determine whether...

42 CFR 431.960 - Types of payment errors.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.960 Types of payment errors. (a) General rule. State or provider errors identified for the Medicaid and CHIP improper payments measurement under the... been paid by a third party but were inappropriately paid by Medicaid or CHIP. (v) Pricing errors. (vi...

42 CFR 431.960 - Types of payment errors.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.960 Types of payment errors. (a) General rule. State or provider errors identified for the Medicaid and CHIP improper payments measurement under the... been paid by a third party but were inappropriately paid by Medicaid or CHIP. (v) Pricing errors. (vi...

42 CFR 431.960 - Types of payment errors.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.960 Types of payment errors. (a) General rule. State or provider errors identified for the Medicaid and CHIP improper payments measurement under the... been paid by a third party but were inappropriately paid by Medicaid or CHIP. (v) Pricing errors. (vi...

42 CFR 431.980 - Eligibility review procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.980 Eligibility review procedures. (a) Active case reviews. The agency must verify eligibility for all selected active cases for Medicaid and CHIP for the... must review all selected negative cases for Medicaid and CHIP for the review month to determine whether...

Soy food and isoflavone intake reduces the risk of cognitive impairment in elderly Japanese women.

PubMed

Nakamoto, Mariko; Otsuka, Rei; Nishita, Yukiko; Tange, Chikako; Tomida, Makiko; Kato, Yuki; Imai, Tomoko; Sakai, Tohru; Ando, Fujiko; Shimokata, Hiroshi

2018-01-18

Data were derived from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Subjects comprised 403 men and 373 women aged 60-81 years at baseline who participated in the follow-up study at least once. Bean, soy product and soy isoflavone intake was assessed using a 3-day dietary record at baseline. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). MMSE scores of ≤23 were used to define cognitive impairment. The relationship between bean, soy product and soy isoflavone intake and cognitive impairment was assessed using a generalized estimating equation. Multivariate-adjusted odds ratios (95% confidence intervals) for cognitive impairment with a 1 s.d. increase in total bean, total soybean and total soy isoflavone intakes were 0.48 (0.28-0.81; p = 0.006), 0.51 (0.32-0.83; p = 0.007), and 0.55 (0.32-0.93; p = 0.026), respectively, in women. Total soybean and soy isoflavone intake might decrease the risk of cognitive impairment in elderly Japanese women.

Single-chip photonic transceiver based on bulk-silicon, as a chip-level photonic I/O platform for optical interconnects.

PubMed

Kim, Gyungock; Park, Hyundai; Joo, Jiho; Jang, Ki-Seok; Kwack, Myung-Joon; Kim, Sanghoon; Kim, In Gyoo; Oh, Jin Hyuk; Kim, Sun Ae; Park, Jaegyu; Kim, Sanggi

2015-06-10

When silicon photonic integrated circuits (PICs), defined for transmitting and receiving optical data, are successfully monolithic-integrated into major silicon electronic chips as chip-level optical I/Os (inputs/outputs), it will bring innovative changes in data computing and communications. Here, we propose new photonic integration scheme, a single-chip optical transceiver based on a monolithic-integrated vertical photonic I/O device set including light source on bulk-silicon. This scheme can solve the major issues which impede practical implementation of silicon-based chip-level optical interconnects. We demonstrated a prototype of a single-chip photonic transceiver with monolithic-integrated vertical-illumination type Ge-on-Si photodetectors and VCSELs-on-Si on the same bulk-silicon substrate operating up to 50 Gb/s and 20 Gb/s, respectively. The prototype realized 20 Gb/s low-power chip-level optical interconnects for λ ~ 850 nm between fabricated chips. This approach can have a significant impact on practical electronic-photonic integration in high performance computers (HPC), cpu-memory interface, hybrid memory cube, and LAN, SAN, data center and network applications.

Scalable Motion Estimation Processor Core for Multimedia System-on-Chip Applications

NASA Astrophysics Data System (ADS)

Lai, Yeong-Kang; Hsieh, Tian-En; Chen, Lien-Fei

2007-04-01

In this paper, we describe a high-throughput and scalable motion estimation processor architecture for multimedia system-on-chip applications. The number of processing elements (PEs) is scalable according to the variable algorithm parameters and the performance required for different applications. Using the PE rings efficiently and an intelligent memory-interleaving organization, the efficiency of the architecture can be increased. Moreover, using efficient on-chip memories and a data management technique can effectively decrease the power consumption and memory bandwidth. Techniques for reducing the number of interconnections and external memory accesses are also presented. Our results demonstrate that the proposed scalable PE-ringed architecture is a flexible and high-performance processor core in multimedia system-on-chip applications.

Physical properties and estimated glycemic index of protein-enriched sorghum based chips.

PubMed

Jiang, Hongrui; Hettiararchchy, Navam S; Horax, Ronny

2018-03-01

Sorghum is a gluten-free grain and more attention has been given to the nutritional properties and recently its usage as a wheat replacement in food products. In the present work, protein-enriched sorghum based snack chips, prepared from sorghum meal with soy protein isolates and soy flour to meet the final protein content of 35.7%, were produced. The effect of varying baking powder (1.5-2.5%), dough sheet thickness (0.7-1.7 mm), and baking time (6-12 min) on the physical properties of the snack chips was investigated using a central composite design of response surface methodology. Under baking temperature of 160 °C, with baking powder added, the water activity and puffiness of chips significantly increased. Baking time was the most significant factor for all the parameters detected except for puffiness. The optimized conditions of preparing protein-enriched sorghum chips were baking powder 2.5%, dough sheet thickness 0.7 mm, and baking time 7.66 min. The estimated glycemic index (eGI) of the protein-enriched sorghum chips (eGI = 59.8) was significantly lower than soybean-free sorghum chips. The gluten-free protein-enriched sorghum chips developed could be considered as protein rich with lower intermediate-glycemic index classified healthy snacks and potential commercialization.

Delayed Recall and Working Memory MMSE Domains Predict Delirium following Cardiac Surgery.

PubMed

Price, Catherine C; Garvan, Cynthia; Hizel, Loren P; Lopez, Marcos G; Billings, Frederic T

2017-01-01

Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery. Following surgery, delirium was assessed throughout ICU stay using the Confusion Assessment Method for ICU delirium and the Richmond Agitation and Sedation Scale. Cardiac surgery patients who developed delirium (n = 137) had lower total MMSE scores than patients who did not develop delirium (n = 457). In particular, orientation to place, working memory, delayed recall, and language domain scores were lower. Of these, only the working memory and delayed recall domains predicted delirium in a regression model adjusting for history of chronic obstructive pulmonary disease, age, sex, and duration of cardiopulmonary bypass. For each word not recalled on the three-word delayed recall assessment, the odds of delirium increased by 50%. For each item missed on the working memory index, the odds of delirium increased by 36%. Of the patients who developed delirium, 47% had a primary impairment in memory, 21% in working memory, and 33% in both domains. The area under the receiver operating characteristics curve using only the working memory and delayed recall domains was 0.75, compared to 0.76 for total MMSE score. Delirium risk is greater for individuals with reduced MMSE scores on the delayed recall and working memory domains. Research should address why patients with memory and executive vulnerabilities are more prone to postoperative delirium than those with other cognitive limitations.

Measurement Error, Reliability, and Minimum Detectable Change in the Mini-Mental State Examination, Montreal Cognitive Assessment, and Color Trails Test among Community Living Middle-Aged and Older Adults.

PubMed

Feeney, Joanne; Savva, George M; O'Regan, Claire; King-Kallimanis, Bellinda; Cronin, Hilary; Kenny, Rose Anne

2016-05-31

Knowing the reliability of cognitive tests, particularly those commonly used in clinical practice, is important in order to interpret the clinical significance of a change in performance or a low score on a single test. To report the intra-class correlation (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) for the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Color Trails Test (CTT) among community dwelling older adults. 130 participants aged 55 and older without severe cognitive impairment underwent two cognitive assessments between two and four months apart. Half the group changed rater between assessments and half changed time of day. Mean (standard deviation) MMSE was 28.1 (2.1) at baseline and 28.4 (2.1) at repeat. Mean (SD) MoCA increased from 24.8 (3.6) to 25.2 (3.6). There was a rater effect on CTT, but not on the MMSE or MoCA. The SEM of the MMSE was 1.0, leading to an MDC (based on a 95% confidence interval) of 3 points. The SEM of the MoCA was 1.5, implying an MDC95 of 4 points. MoCA (ICC = 0.81) was more reliable than MMSE (ICC = 0.75), but all tests examined showed substantial within-patient variation. An individual's score would have to change by greater than or equal to 3 points on the MMSE and 4 points on the MoCA for the rater to be confident that the change was not due to measurement error. This has important implications for epidemiologists and clinicians in dementia screening and diagnosis.

Comparison of two commonly used clinical cognitive screening tests to diagnose mild cognitive impairment in heart failure with the golden standard European Consortium Criteria.

PubMed

Alagiakrishnan, Kannayiram; Mah, Darren; Dyck, Jason R B; Senthilselvan, Ambikaipakan; Ezekowitz, Justin

2017-02-01

This study on mild cognitive impairment (MCI) in heart failure (HF) compares the utility of Montreal Cognitive Assessment (MoCA) to the Mini-Mental Status Exam (MMSE) for diagnosing MCI in a HF population when compared to the golden standard European Consortium Criteria (ECC). Participants were recruited from the Alberta HEART study at the Mazankowski Alberta Heart Institute in Edmonton and St. Mary's hospital in Camrose. This study enrolled 53 community adults aged>50years: 33 HF and 20 controls. Participants were assessed using both the MMSE and MoCA for MCI. MCI was diagnosed using the golden standard, European Consortium Criteria. Sensitivity and specificity analysis, positive and negative predictive values, likelihood ratios and kappa statistic were calculated. The mean age was 72.8years (SD 8.4), 60.4% were females and 34% had underlying ischemic heart disease. Overall, two thirds of patients (22/33, 66%) with HF had MCI. In comparison to European Consortium Criteria, the sensitivity and specificity of MoCA were 82% and 91% in identifying individuals with MCI, and MMSE were 9% and 91%, respectively. The positive and negative predictive values for MoCA were 95% and 71%, and for MMSE were 67% and 33%, respectively. Kappa statistics showed good agreement between MoCA and consortium criteria (kappa=0.68) and a low agreement between MMSE and consortium criteria (kappa=0.07). Cognitive dysfunction is common in patients with HF. Overall, the MoCA seems to be a better screening tool than MMSE for MCI in HF patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Influence of habitual chocolate consumption over the Mini-Mental State Examination in Spanish older adults].

PubMed

Orozco Arbelaez, Edilbeto; Banegas, José Ramón; Rodríguez Artalejo, Fernando; López García, Esther

2017-07-28

There are associations described between dementia, mild cognitive impairment (MCI) and foods with a high content of polyphenols. To assess the infl uence of habitual chocolate consumption over the MMSE in Spanish older adults. Cross-sectional study, using data of the follow-up of the Seniors-Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) cohort. Habitual chocolate consumption in the last year was assessed with a computerized dietary history; differences between dark chocolate and milk chocolate were recorded. Chocolate intake was classified into the following categories: no consumption, < 10 g/day, and ≥ 10 g/day. Validated MMSE scores for Spain were obtained during an interview and different cutoff points were used to define ≤ 25, ≤ 24 and ≤ 23. Linear and logistic regression models were used to calculate adjusted beta coefficients and odds ratios (OR). Compared to non-consumers, participants with a habitual chocolate consumption of ≥ 10 g/d had a better MMSE score (adjusted beta coefficient and 95% confidence interval: 0.26 (0.02-0.50; p trend = 0.05); for dark chocolate, the results were also statistically significant (0.48 [0.18-0.78]; p trend < 0.001). Total chocolate consumption was not associated with higher likelihood of having MCI. However, dark chocolate consumption was associated with less likelihood of MCI (OR and 95%CI for MMSE ≤ 25: 0.39 [0.20-0.77]; for MMSE ≤ 24: 0.26 [0.10-0.67]; and for MMSE ≤ 23: 0.25 [0.07-0.82]). Our results suggest that habitual dark chocolate consumption might improve cognitive function among the older population.

Cognitive impairment, the Mini-Mental State Examination and socio-demographic and dental variables in the elderly in Brazil.

PubMed

Miranda, Leonardo de Paula; Silveira, Marise F; Oliveira, Thatiane L; Alves, Sâmia F F; Júnior, Hercílio M; Batista, André U D; Bonan, Paulo R F

2012-06-01

Dementia, a syndrome characterised by multiple cognitive impairments, is an increasing medical and social problem across the world. The Mini-Mental State Examination (MMSE) is the instrument most often used in the evaluation of cognitive compromise and dementia in elderly individuals. It is noteworthy that there is a scarcity of works in the literature on the dimensions of the MMSE and its relation to dental variables in the elderly. To evaluate the condition of cognitive impairment, the dimensions of the MMSE, and the latter's relation to socio-demographic and dental variables in elderly individuals of Montes Claros, Minas Gerais, Brazil. This is a cross-sectional descriptive study, whereby 218 elderly users of the system were evaluated at the Sistema Único de Saúde (Brazilian health service) in Montes Claros. The collection of data involved the realisation of structured interviews and clinical dentistry examinations. The screening of cognitive impairment was carried out with the Portuguese version of MMSE. The data were subjected to descriptive and bivariate analyses. The prevalence of cognitive impairment found was 6.4%. A statistically significant association was observed between cognitive decline and age, marital status and use of dental prostheses. An association was also noted between several dimensions of MMSE and edentulism (time orientation, attention and calculation, and final score) and use of prostheses (except evocation memory and language). It was noticed that those who were 80 years old or more, not married and using prostheses were more likely to manifest cognitive impairment. Associations between some MMSE dimensions were established, including the final score, with edentulism and the use of prostheses. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

PubMed

Lim, Magdalene Yeok Leng; Loo, Jenny Hooi Yin

2018-07-01

To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment. Copyright © 2018 John Wiley & Sons, Ltd.

Time-of-flight PET image reconstruction using origin ensembles.

PubMed

Wülker, Christian; Sitek, Arkadiusz; Prevrhal, Sven

2015-03-07

The origin ensemble (OE) algorithm is a novel statistical method for minimum-mean-square-error (MMSE) reconstruction of emission tomography data. This method allows one to perform reconstruction entirely in the image domain, i.e. without the use of forward and backprojection operations. We have investigated the OE algorithm in the context of list-mode (LM) time-of-flight (TOF) PET reconstruction. In this paper, we provide a general introduction to MMSE reconstruction, and a statistically rigorous derivation of the OE algorithm. We show how to efficiently incorporate TOF information into the reconstruction process, and how to correct for random coincidences and scattered events. To examine the feasibility of LM-TOF MMSE reconstruction with the OE algorithm, we applied MMSE-OE and standard maximum-likelihood expectation-maximization (ML-EM) reconstruction to LM-TOF phantom data with a count number typically registered in clinical PET examinations. We analyzed the convergence behavior of the OE algorithm, and compared reconstruction time and image quality to that of the EM algorithm. In summary, during the reconstruction process, MMSE-OE contrast recovery (CRV) remained approximately the same, while background variability (BV) gradually decreased with an increasing number of OE iterations. The final MMSE-OE images exhibited lower BV and a slightly lower CRV than the corresponding ML-EM images. The reconstruction time of the OE algorithm was approximately 1.3 times longer. At the same time, the OE algorithm can inherently provide a comprehensive statistical characterization of the acquired data. This characterization can be utilized for further data processing, e.g. in kinetic analysis and image registration, making the OE algorithm a promising approach in a variety of applications.

Time-of-flight PET image reconstruction using origin ensembles

NASA Astrophysics Data System (ADS)

Wülker, Christian; Sitek, Arkadiusz; Prevrhal, Sven

2015-03-01

The origin ensemble (OE) algorithm is a novel statistical method for minimum-mean-square-error (MMSE) reconstruction of emission tomography data. This method allows one to perform reconstruction entirely in the image domain, i.e. without the use of forward and backprojection operations. We have investigated the OE algorithm in the context of list-mode (LM) time-of-flight (TOF) PET reconstruction. In this paper, we provide a general introduction to MMSE reconstruction, and a statistically rigorous derivation of the OE algorithm. We show how to efficiently incorporate TOF information into the reconstruction process, and how to correct for random coincidences and scattered events. To examine the feasibility of LM-TOF MMSE reconstruction with the OE algorithm, we applied MMSE-OE and standard maximum-likelihood expectation-maximization (ML-EM) reconstruction to LM-TOF phantom data with a count number typically registered in clinical PET examinations. We analyzed the convergence behavior of the OE algorithm, and compared reconstruction time and image quality to that of the EM algorithm. In summary, during the reconstruction process, MMSE-OE contrast recovery (CRV) remained approximately the same, while background variability (BV) gradually decreased with an increasing number of OE iterations. The final MMSE-OE images exhibited lower BV and a slightly lower CRV than the corresponding ML-EM images. The reconstruction time of the OE algorithm was approximately 1.3 times longer. At the same time, the OE algorithm can inherently provide a comprehensive statistical characterization of the acquired data. This characterization can be utilized for further data processing, e.g. in kinetic analysis and image registration, making the OE algorithm a promising approach in a variety of applications.

Methylphenidate hydrochloride improves cognitive function in patients with advanced cancer and hypoactive delirium: a prospective clinical study

PubMed Central

Gagnon, Bruno; Low, Graeme; Schreier, Gil

2005-01-01

Objective To investigate the clinical improvement observed in patients with advanced cancer and hypoactive delirium after the administration of methylphenidate hydrochloride. Methods Fourteen patients with advanced cancer and hypoactive delirium were seen between March 1999 and August 2000 at the Palliative Care Day Hospital and the inpatient Tertiary Palliative Care Unit of Montreal General Hospital, Montréal. They were chosen for inclusion in a prospective clinical study on the basis of (1) cognitive failure documented by the Mini-Mental State Examination (MMSE), (2) sleep–wake pattern disturbances, (3) psychomotor retardation, (4) absence of delusions or hallucinations, and (5) absence of an underlying cause to explain the delirium. All patients were treated with methylphenidate, and changes in their cognitive function were measured using the MMSE. Results All 14 patients showed improvement in their cognitive function as documented by the MMSE. The median pretreatment MMSE score (maximum score 30) was 21 (mean 20.9, standard deviation [SD] 4.9), which improved to a median of 27 (mean 24.9, SD 4.7) after the first dose of methylphenidate (p < 0.001, matched, paired Wilcoxon signed rank test). One patient died before reaching a stable dose of methylphenidate. In the other 13 patients, the median MMSE score further improved to 28 (mean 27.8, SD 2.4) (p = 0.02 compared with the median MMSE score documented 1 hour after the first dose of methylphenidate). All patients showed an improvement in psychomotor activities. Conclusions Hypoactive delirium that cannot be explained by an underlying cause (metabolic or drug-induced) in patients with advanced cancer appears to be a specific syndrome that could be improved by the administration of methylphenidate. PMID:15798785

[Test of thermal deformation for electronic devices of high thermal reliability].

PubMed

Li, Hai-yuan; Li, Bao-ming

2002-06-01

Thermal deformation can be caused by high partial heat flux and greatly reduce thermal reliability of electronic devices. In this paper, an attempt is made to measure the thermal deformation of high power electronic devices under working condition using laser holographic interferometry with double exposure. Laser holographic interferometry is an untouched measurement with measurement precision up to micron dimension. The electronic device chosen for measurement is a type of solid state relay which is used for ignition of rockets. The output circuit of the solid state relay is made up of a MOSFET chip and the power density of the chip can reach high value. In particular situations thermal deformation and stress may significantly influence working performance of the solid state relay. The bulk deformation of the chip and its mount is estimated by number of interferential stripes on chip surface. While thermal stress and deformation can be estimated by curvature of interferential stripes on chip surface. Experimental results indicate that there are more interferential stripes on chip surface and greater flexural degree of stripes under high power. Therefore, these results reflect large out-of-plain displacement and deformed size of the chip with the increase of load current.

Identification, amounts, and kinetics of extraction of C-glucosidic ellagitannins during wine aging in oak barrels or in stainless steel tanks with oak chips.

PubMed

Jourdes, Michaël; Michel, Julien; Saucier, Cédric; Quideau, Stéphane; Teissedre, Pierre-Louis

2011-09-01

The C-glucosidic ellagitannins are found in wine as a result of its aging in oak barrels or in stainless steel tanks with oak chips. Once dissolved in this slightly acidic solution, the C-glucosidic ellagitannins vescalagin can react with nucleophilic entities present in red wine, such as ethanol, catechin, and epicatechin, to generate condensed hybrid products such as the β-1-O-ethylvescalagin and the flavano-ellagitannins (acutissimin A/B and epiacutissimin A/B), respectively. During this study, we first monitored the extraction kinetic and the evolution of the eight major oak-derived C-glucosidic ellagitannins in red wines aged in oak barrels or in stainless steel tank with oak chips. Their extraction rates appeared to be faster during red wine aging in stainless steel tanks with oak chips. However, their overall concentrations in wines were found higher in the wine aged in barrels. The formation rates of the vescalagin-coupled derivatives were also estimated for the first time under both red wine aging conditions (i.e., oak barrels or stainless steel tanks with oak chips). As observed for the oak-native C-glucosidic ellagitannins, the concentrations of these vescalagin derivatives were higher in the red wine aged in oak barrels than in stainless steel tanks with oak chips. Despite these differences, their relative composition was similar under both red wine aging conditions. Finally, the impact of the oak chips size and toasting level on the C-glucosidic ellagitannins concentration in wine was also investigated.

White matter lesion severity is associated with reduced cognitive performances in patients with normal CSF Abeta42 levels.

PubMed

Stenset, V; Hofoss, D; Johnsen, L; Skinningsrud, A; Berstad, A E; Negaard, A; Reinvang, I; Gjerstad, L; Fladby, T

2008-12-01

To identify possible associations between white matter lesions (WML) and cognition in patients with memory complaints, stratified in groups with normal and low cerebrospinal fluid (CSF) Abeta42 values. 215 consecutive patients with subjective memory complaints were retrospectively included. Patients were stratified into two groups with normal (n = 127) or low (n = 88) CSF Abeta42 levels (cut-off is 450 ng/l). Cognitive scores from the Mini-Mental State Examination (MMSE) and the Neurobehavioral Cognitive Status Examination (Cognistat) were used as continuous dependent variables in linear regression. WML load was used as a continuous independent variable and was scored with a visual rating scale. The regression model was corrected for possible confounding factors. WML were significantly associated with MMSE and all Cognistat subscores except language (repetition and naming) and attention in patients with normal CSF Abeta42 levels. No significant associations were observed in patients with low CSF Abeta42. WML were associated with affection of multiple cognitive domains, including delayed recall and executive functions, in patients with normal CSF Abeta42 levels. The lack of such associations for patients with low CSF Abeta42 (i.e. with evidence for amyloid deposition), suggests that amyloid pathology may obscure cognitive effects of WML.

Cognitive and physical functions related to the level of supervision and dependence in the toileting of stroke patients.

PubMed

Sato, Atsushi; Okuda, Yutaka; Fujita, Takaaki; Kimura, Norihiko; Hoshina, Noriyuki; Kato, Sayaka; Tanaka, Shigenari

2016-01-01

This study aimed to clarify which cognitive and physical factors are associated with the need for toileting assistance in stroke patients and to calculate cut-off values for discriminating between independent supervision and dependent toileting ability. This cross-sectional study included 163 first-stroke patients in nine convalescent rehabilitation wards. Based on their FIM Ⓡ instrument score for toileting, the patients were divided into an independent-supervision group and a dependent group. Multiple logistic regression analysis and receiver operating characteristic analysis were performed to identify factors related to toileting performance. The Minimental State Examination (MMSE); the Stroke Impairment Assessment Set (SIAS) score for the affected lower limb, speech, and visuospatial functions; and the Functional Assessment for Control of Trunk (FACT) were analyzed as independent variables. The multiple logistic regression analysis showed that the FIM Ⓡ instrument score for toileting was associated with the SIAS score for the affected lower limb function, MMSE, and FACT. On receiver operating characteristic analysis, the SIAS score for the affected lower limb function cut-off value was 8/7 points, the MMSE cut-off value was 25/24 points, and the FACT cut-off value was 14/13 points. Affected lower limb function, cognitive function, and trunk function were related with the need for toileting assistance. These cut-off values may be useful for judging whether toileting assistance is needed in stroke patients.

Global cognition and 8-year survival among Japanese community-dwelling older adults.

PubMed

Iwasa, Hajime; Kai, Ichiro; Yoshida, Yuko; Suzuki, Takao; Kim, Hunkyung; Yoshida, Hideyo

2013-08-01

We sought to examine the longitudinal relationship between cognitive function and all-cause mortality among Japanese community-dwelling older adults, using an 8-year prospective cohort study design with mortality surveillance. A total of 454 men and 386 women, aged 70 years and older, participated in the study. The Mini Mental State Examination (MMSE) was administered to assess global cognition. The total MMSE score and subscale scores were used as independent variables, and age, gender, education level, chronic disease, sensory deficit, depressive symptoms, and instrumental activities of daily living were used as covariates. During the follow-up period, 191 subjects (139 men and 52 women) died, and 64 subjects (31 men and 33 women) moved to a different region of Japan and were lost to follow-up. Use of the multivariate Cox proportional hazards model, adjusted for potential confounders, showed that global cognition was significantly and independently associated with mortality (hazard ratio [HR] = 1.59, 95% confidence interval [CI]: 1.14-2.23 and HR = 2.81, 95% CI: 1.77-4.36 for the middle [24-27 points] and lowest [0-23 points] categories, respectively). Among the MMSE subscales, place orientation (HR = 1.57, 95% CI: 1.09-2.25), calculation (HR = 1.67, 95% CI: 1.18-2.35), and delayed recall (HR = 1.42, 95% CI: 1.03-1.96), were also significantly and independently associated with mortality. Our study suggests that among older individuals, those with lower levels of cognitive function are more likely to have a shorter lifespan compared with those with higher cognitive functioning. Copyright © 2012 John Wiley & Sons, Ltd.

Cognitive Dysfunction and Malnutrition Are Independent Predictor of Dysphagia in Patients with Acute Exacerbation of Congestive Heart Failure

PubMed Central

Yamanaka, Shinsuke; Takahashi, Yoshimi; Fujita, Hiroshi; Yamaguchi, Nobuhiro; Onoue, Noriko; Ishizuka, Takeshi; Shinozaki, Tsuyoshi; Kohzuki, Masahiro

2016-01-01

Early detection and intervention for dysphagia is important in patients with congestive heart failure (CHF). However, previous studies have focused on how many patients with dysphagia develop CHF. Studies focusing on the comorbidity of dysphagia in patients with CHF are rare. Additionally, risk factors for dysphagia in patients with CHF are unclear. Thus, the aim of this study was to clarify risk factors for dysphagia in patients with acute exacerbation of CHF. A total of 105 patients, who were admitted with acute exacerbation of CHF, were enrolled. Clinical interviews, blood chemistry analysis, electrocardiography, echocardiography, Mini-Mental State Examination (MMSE), exercise tolerance tests, phonatory function tests, and evaluation of activities of daily living (ADL) and nutrition were conducted on admission. After attending physicians permitted the drinking of water, swallowing screening tests were performed. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (non-DG) based on Functional Oral Intake Scale level. Among the 105 patients, 38 had dysphagia. A greater number of patients had history of aspiration pneumonia and dementia, and there was a higher age, N-terminal pro-B-type natriuretic peptide level in the DG compared with the non-DG. MMSE scores, exercise tolerance, phonatory function, status of ADL, nutrition, albumin, and transthyretin were lower in the DG compared with the non-DG. In multivariate analysis, after adjusting for age and sex, MMSE, BI score, and transthyretin was independently associated with dysphagia. Comorbidity of dysphagia was 36.1% in patients with acute exacerbation of CHF, and cognitive dysfunction and malnutrition may be an independent predictor of dysphagia. PMID:27898735

Cognitive Dysfunction and Malnutrition Are Independent Predictor of Dysphagia in Patients with Acute Exacerbation of Congestive Heart Failure.

PubMed

Yokota, Junichi; Ogawa, Yoshiko; Yamanaka, Shinsuke; Takahashi, Yoshimi; Fujita, Hiroshi; Yamaguchi, Nobuhiro; Onoue, Noriko; Ishizuka, Takeshi; Shinozaki, Tsuyoshi; Kohzuki, Masahiro

2016-01-01

Early detection and intervention for dysphagia is important in patients with congestive heart failure (CHF). However, previous studies have focused on how many patients with dysphagia develop CHF. Studies focusing on the comorbidity of dysphagia in patients with CHF are rare. Additionally, risk factors for dysphagia in patients with CHF are unclear. Thus, the aim of this study was to clarify risk factors for dysphagia in patients with acute exacerbation of CHF. A total of 105 patients, who were admitted with acute exacerbation of CHF, were enrolled. Clinical interviews, blood chemistry analysis, electrocardiography, echocardiography, Mini-Mental State Examination (MMSE), exercise tolerance tests, phonatory function tests, and evaluation of activities of daily living (ADL) and nutrition were conducted on admission. After attending physicians permitted the drinking of water, swallowing screening tests were performed. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (non-DG) based on Functional Oral Intake Scale level. Among the 105 patients, 38 had dysphagia. A greater number of patients had history of aspiration pneumonia and dementia, and there was a higher age, N-terminal pro-B-type natriuretic peptide level in the DG compared with the non-DG. MMSE scores, exercise tolerance, phonatory function, status of ADL, nutrition, albumin, and transthyretin were lower in the DG compared with the non-DG. In multivariate analysis, after adjusting for age and sex, MMSE, BI score, and transthyretin was independently associated with dysphagia. Comorbidity of dysphagia was 36.1% in patients with acute exacerbation of CHF, and cognitive dysfunction and malnutrition may be an independent predictor of dysphagia.

Cognitive performance of patients with chronic heart failure on sacubitril/valsartan : A retrospective cohort study.

PubMed

De Vecchis, R; Ariano, C; Di Biase, G; Noutsias, M

2018-02-15

Sacubitril, a neprilysin inhibitor in the combination molecule sacubitril/valsartan, slows down degradation of endogenous natriuretic peptides, thereby enhancing their beneficial cardiovascular effects. However, sacubitril might also promote neuronal dysfunction and cognitive impairment in patients with chronic heart failure (CHF) treated with sacubitril/valsartan, due to possible neprilysin inhibition at the level of Central Nervous System. A retrospective cohort study was undertaken to detect the effects exerted by sacubitril/valsartan on cognitive function in CHF patients. The patients' clinical data were examined for information provided in the Mini-Mental State Examination (MMSE), which was routinely administered during clinical visits at two centers from 15 March to 31 October 2017. Patients in the sacubitril/valsartan group had a clinical history of at least 3 months of continuous sacubitril/valsartan administration. The control group comprised CHF patients on conventional therapy not taking sacubitril/valsartan. In the between-group comparison, patients were matched for mean age, educational level, sex, NYHA class, and comorbidities. In the present retrospective study only patients in NYHA class II-III were enrolled. The mean MMSE score was 22.72 ± 2.68 (mean ± standard deviation [SD]) in the sacubitril/valsartan group (n = 51 patients) vs. 21.96 ± 2.73 (mean ± SD) in the control group (n = 51; p = 0.1572, independent samples t-test). Thus, a similar mild-to-moderate impairment in cognitive performance was found in the comparison between the two groups. In our study, we did not find any evidence of the alleged harmful influence of sacubitril/valsartan on cognitive function. Patients taking sacubitril/valsartan for at least 3 months had similar mean MMSE scores to control subjects.

The Effects of Intellectual, Physical, and Social Activity on Further Prognosis in Mild Cognitive Impairment.

PubMed

Bidzan, Leszek; Bidzan, Mariola; Pąchalska, Maria

2016-07-19

BACKGROUND Our goal was to specify the relationship between the level of activity (intellectual, physical, and social) in persons diagnosed with mild cognitive impairment (MCI) and the further progression of cognitive dysfunction. MATERIAL AND METHODS We examined 193 patients diagnosed with MCI (according to the criteria of the Working Group on Mild Cognitive Impairment) and under treatment at our Mental Disorders Clinic. It was assumed that these persons would remain under systematic psychiatric observation until dementia was diagnosed. The present study results from a seven-year observation period. The mini-mental state examination (MMSE), the Activity Scale (with the intellectual, physical, and social subscales), and the Instrumental Activities of Daily Living (IADL) scale were used to evaluate the participants' status at baseline. The MMSE was re-administered after one year and again at the end of the observation (either upon diagnosis of dementia or after seven years). At each meeting with the participant, the clinical diagnosis was verified to determine if the patient had dementia or not. Of the 193 people initially qualified for the study, 75 were available for the final analysis. RESULTS It was found that there was no statistically significant difference in the baseline MMSE scores between the persons with stable MCI and the persons who had progressed to dementia. However, statistically significant differences in the level of activity at baseline on both the global IADL scale and the Activity Scale between those with stable MCI and those who had progressed to dementia were found. These differences were manifested in the IADL subscales for telephone use, shopping, transportation, and personal finances, and in the physical activity subscale. CONCLUSIONS An evaluation of intellectual, physical, and social activity can be useful in determining the prognosis for the future course of MCI.

Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

PubMed Central

Dong, XinQi; Simon, Melissa; Rajan, Kumar; Evans, Denis A.

2011-01-01

Aim This study aimed to examine the cross-sectional association between cognitive function and elder abuse. Methods The Chicago Health and Aging Project (CHAP) is a population-based study conducted in a geographically defined community (n = 8,932). We identified 238 CHAP participants who had elder abuse reported to a social services agency. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (perceptual speed), and both immediate and delayed recall of the East Boston Memory Test (episodic memory). An index of global cognitive function scores was derived by averaging the z-scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk of elder abuse. Results After adjusting for confounders, lowest tertiles of global cognition (odd's ratio, OR 4.18, 95% confidence interval, 95% CI 2.44–7.15), MMSE (OR 2.97, 95% CI 1.93–4.57), episodic memory (OR 2.27, 95% CI 1.49–3.43) and perceptual speed (OR 2.37, 95% CI 1.51–3.73) were associated with increased risk of elder abuse. The lowest levels of global cognitive function were associated with an increased risk of physical abuse (OR 3.56, 95% CI 1.08–11.67), emotional abuse (OR 3.02, 95% CI 1.41–6.44), caregiver neglect (OR 6.24, 95% CI 2.68–14.54), and financial exploitation (OR 3.71, 95% CI 1.88–7.32). Conclusion Lower levels of global cognitive function, MMSE, episodic memory and perceptual speed are associated with an increased risk of elder abuse. PMID:22095098

42 CFR 431.992 - Corrective action plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.992 Corrective action plan. (a) The State agency must develop a separate corrective action plan for Medicaid and CHIP, which is not required to be approved by... which the State's Medicaid or CHIP error rates are posted on the CMS contractor's Web site. (d) The...

42 CFR 431.958 - Definitions and use of terms.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.958 Definitions and use of terms. Active case means a case containing information on a beneficiary who is enrolled in the Medicaid or CHIP program in the... purposes of the PERM eligibility reviews under this part, the entity that performs the Medicaid and CHIP...

42 CFR 431.958 - Definitions and use of terms.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.958 Definitions and use of terms. Active case means a case containing information on a beneficiary who is enrolled in the Medicaid or CHIP program in the... purposes of the PERM eligibility reviews under this part, the entity that performs the Medicaid and CHIP...

42 CFR 431.992 - Corrective action plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.992 Corrective action plan. (a) The State agency must develop a separate corrective action plan for Medicaid and CHIP, which is not required to be approved by... which the State's Medicaid or CHIP error rates are posted on the CMS contractor's Web site. (d) The...

42 CFR 431.958 - Definitions and use of terms.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.958 Definitions and use of terms. Active case means a case containing information on a beneficiary who is enrolled in the Medicaid or CHIP program in the... purposes of the PERM eligibility reviews under this part, the entity that performs the Medicaid and CHIP...

42 CFR 431.992 - Corrective action plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.992 Corrective action plan. (a) The State agency must develop a separate corrective action plan for Medicaid and CHIP, which is not required to be approved by... which the State's Medicaid or CHIP error rates are posted on the CMS contractor's Web site. (d) The...

42 CFR 431.958 - Definitions and use of terms.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.958 Definitions and use of terms. Active case means a case containing information on a beneficiary who is enrolled in the Medicaid or CHIP program in the... purposes of the PERM eligibility reviews under this part, the entity that performs the Medicaid and CHIP...

42 CFR 431.958 - Definitions and use of terms.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Estimating Improper Payments in Medicaid and CHIP § 431.958 Definitions and use of terms. Active case means a case containing information on a beneficiary who is enrolled in the Medicaid or CHIP program in the... purposes of the PERM eligibility reviews under this part, the entity that performs the Medicaid and CHIP...

The Influence of Cognitive Status on Elder Food Choice and Meal Service Satisfaction.

PubMed

Crogan, Neva L; Short, Robert; Dupler, Alice E; Heaton, Grace

2015-11-01

This article describes the testing of a new nursing home food delivery system that empowers elders to choose the foods they want to eat and gives them an active voice in menu development. Using a 2-group, repeated measures design, 61 elderly residents from 2 eastern Washington nursing homes were recruited to participate in a 6-month study. Outcome measures included food and meal service satisfaction, body weight, serum prealbumin, and food intake. Serum prealbumin levels and body weight increased post intervention for treatment group residents. Mini-Mental Status Examination (MMSE) scores were not associated with the changes in serum prealbumin, body weight, or food intake. The MMSE scores did not influence the resident's ability to actively participate in the rate the food process or choose the foods they liked and preferred to eat. Cognitive impaired older adults experienced weight gain similarly to higher functioning elderly individuals. © The Author(s) 2012.

Acceptance of New Medicaid Patients by Primary Care Physicians and Experiences with Physician Availability among Children on Medicaid or the Children's Health Insurance Program

PubMed Central

Decker, Sandra L

2015-01-01

Objective To estimate the relationship between physicians' acceptance of new Medicaid patients and access to health care. Data Sources The National Ambulatory Medical Care Survey (NAMCS) Electronic Health Records Survey and the National Health Interview Survey (NHIS) 2011/2012. Study Design Linear probability models estimated the relationship between measures of experiences with physician availability among children on Medicaid or the Children's Health Insurance Program (CHIP) from the NHIS and state-level estimates of the percent of primary care physicians accepting new Medicaid patients from the NAMCS, controlling for other factors. Principal Findings Nearly 16 percent of children with a significant health condition or development delay had a doctor's office or clinic indicate that the child's health insurance was not accepted in states with less than 60 percent of physicians accepting new Medicaid patients, compared to less than 4 percent in states with at least 75 percent of physicians accepting new Medicaid patients. Adjusted estimates and estimates for other measures of access to care were similar. Conclusions Measures of experiences with physician availability for children on Medicaid/CHIP were generally good, though better in states where more primary care physicians accepted new Medicaid patients. PMID:25683869

Efficacy of acetylcholinesterase inhibitors versus nootropics in Alzheimer's disease: a retrospective, longitudinal study.

PubMed

Tsolaki, M; Pantazi, T; Kazis, A

2001-01-01

The aim of this study was to investigate the efficacy of nootropics (piracetam, aniracetam, nimodopine and dihydroergicristine) versus acetylcholinesterase inhibitors (AChE-Is) (tacrine and donepezil) in the treatment of Alzheimer's disease. This is a retrospective study of 510 patients with Alzheimer's disease. To determine clinical efficacy of treatment, we used the mean change over time in scores for the following tests: the Mini-Mental State Examination (MMSE); the Cambridge Cognitive Examination for the Elderly; and the Functional Rating Scale for Symptoms of Dementia. In all patients and in patients with severe Alzheimer's disease (baseline MMSE < 11), no significant differences were seen in the neuropsychological test scores between the two treatment groups. In patients with moderate dementia (baseline MMSE between 11 and 20), however, there was a significantly greater deterioration, as shown on the CAMCOG scale, after 12 months' treatment for patients receiving AChE-Is compared with those receiving nootropics (-4.38 for AChE-Is group versus 1.48 for nootropics group). For patients with mild dementia (baseline MMSE score between 21 and 26), there was a significantly greater deterioration on the MMSE scale for each time-point in the nootropics group compared with the AChE-Is group. In conclusion, we did not find any strong evidence that a difference in efficacy exists between AChE-Is and nootropics in the treatment of Alzheimer's disease.

[Effect of modified huanglian wendan decoction in treating senile patients with mild cognitive impairment of turbid-phlegm blocking orifice syndrome].

PubMed

Guo, Ren-zhen; Zhou, Wen-quan; Luo, Zeng-gang

2010-01-01

To observe the clinical efficacy of modified Huanglian Wendan Decoction (HWD) in treating senile mild cognitive impairment (MCI) of turbid-phlegm blocking orifice syndrome. With a block randomized, double-blinded and controlled design adopted, the 64 patients of MCI selected from December 2007 to February 2009 were randomly and equally assigned to two groups. The treatment group was treated with HWD in dose of 200 mL, twice a day; the control group was given Aniracetam 0.2 g (for patients over 70-years-old, 0.1 g) three times a day. And the illusive medicine in dosage-form of capsule/decoction simulated to that used in the opposite group was applied. The medication and observation lasted for three months. Chinese medicine syndrome, cognition capacity (by MMSE), laboratory indexes [acetylcholine (Ach), superoxide dismutase (SOD), malondialdehyde (MDA)] and safety related indexes in patients were observed. After treatment, MMSE score increased in both groups, but the increment in the treatment group was significantly higher than that in the control group (P<0.01); Chinese medicine syndrome estimated by scoring showed that after treatment, all scores of syndromes, excepting the expectoration, were improved in the treatment group with the post-treatment scores significantly lower than those in the control group respectively (P<0.05 or P<0.01); while in the control group, lowering of scores only showed in some symptoms such as poor memory, heavy head or dizziness, and heavy sensation in limbs and body. Serum levels of Ach and SOD decreased and MDA increased in both groups after treatment, but the change of Ach was more significant in the treatment group (P<0.01). No obvious adverse reactions were found during the treatment. For treatment of MCI, HWD shows effects in improving patients' symptoms, cognition capacity and elevating serum Ach content better than that of Aniracetam; and with effects for raising SOD activity and reducing MDA level similar to those of Aniracetam.

Ubiquitin ligase CHIP functions as an oncogene and activates the AKT signaling pathway in prostate cancer.

PubMed

Cheng, Li; Zang, Jin; Dai, Han-Jue; Li, Feng; Guo, Feng

2018-07-01

Carboxyl terminus of Hsc-70-interacting protein (CHIP) is an E3 ubiquitin ligase that induces the ubiquitination and degradation of numerous tumor-associated proteins and serves as a suppressor or promoter in tumor progression. To date, the molecular mechanism of CHIP in prostate cancer remains unknown. Therefore, the present study investigated the biological function of CHIP in prostate cancer cells and obtained evidence that CHIP expression is upregulated in prostate cancer tissues. The CHIP vector was introduced into DU145 cancer cells and the cell biological behaviour was examined through a series of experiments, including cell growth, cell apoptosis and migration and invasion assays. The results indicated that the overexpression of CHIP in DU145 prostatic cancer cells promoted cell proliferation through activation of the protein kinase B (AKT) signaling pathway, which subsequently increased cyclin D1 protein levels and decreased p21 and p27 protein levels. The overexpression of CHIP significantly increased the migration and invasion of the DU145 cells, which is possible due to activation of the AKT signaling pathway and upregulation of vimentin. The expression level of CHIP was observed to be increased in human prostate cancer tissues compared with the adjacent normal tissue. Furthermore, the CHIP expression level exhibited a positively association with the Gleason score of the patents. These findings indicate that CHIP functions as an oncogene in prostate cancer.

Oxygen consumption by oak chips in a model wine solution; Influence of the botanical origin, toast level and ellagitannin content.

PubMed

Navarro, María; Kontoudakis, Nikolaos; Giordanengo, Thomas; Gómez-Alonso, Sergio; García-Romero, Esteban; Fort, Francesca; Canals, Joan Miquel; Hermosín-Gutíerrez, Isidro; Zamora, Fernando

2016-05-15

The botanical origin, toast level and ellagitannin content of oak chips in a model wine solution have been studied in terms of their influence on oxygen consumption. French oak chips released significantly higher amounts of ellagitannins than American oak chips at any toast level. The release of ellagitannins by oak chips decreased as the toast level increased in the French oak but this trend was not so clear in American oak. Oxygen consumption rate was clearly related to the level of released ellagitannins. Therefore, oak chips should be chosen for their potential to release ellagitannins release should be considered, not only because they can have a direct impact on the flavor and body of the wine, but also because they can protect against oxidation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Controlling acrylamide in French fry and potato chip models and a mathematical model of acrylamide formation: acrylamide: acidulants, phytate and calcium.

PubMed

Park, Yeonhwa; Yang, Heewon; Storkson, Jayne M; Albright, Karen J; Liu, Wei; Lindsay, Robert C; Pariza, Michael W

2005-01-01

We previously reported that in potato chip and French fry models, the formation of acrylamide can be reduced by controlling pH during processing steps, either by organic (acidulants) or inorganic acids. Use of phytate, a naturally occurring chelator, with or without Ca++ (or divalent ions), can reduce acrylamide formation in both models. However, since phytate itself is acidic, the question remains as to whether the effect of phytate is due to pH alone or to additional effects. In the French fry model, the effects on acrylamide formation of pH, phytate, and/or Ca++ in various combinations were tested in either blanching or soaking (after blanching) steps. All treatments significantly reduced acrylamide levels compared to control. Among variables tested, pH may be the single most important factor for reducing acrylamide levels, while there were independent effects of phytate and/or Ca++ in this French fry model. We also developed a mathematical formula to estimate the final concentration of acrylamide in a potato chip model, using variables that can affect acrylamide formation: glucose and asparagine concentrations, cut potato surface area and shape, cooking temperature and time, and other processing conditions.

Single-chip photonic transceiver based on bulk-silicon, as a chip-level photonic I/O platform for optical interconnects

PubMed Central

Kim, Gyungock; Park, Hyundai; Joo, Jiho; Jang, Ki-Seok; Kwack, Myung-Joon; Kim, Sanghoon; Gyoo Kim, In; Hyuk Oh, Jin; Ae Kim, Sun; Park, Jaegyu; Kim, Sanggi

2015-01-01

When silicon photonic integrated circuits (PICs), defined for transmitting and receiving optical data, are successfully monolithic-integrated into major silicon electronic chips as chip-level optical I/Os (inputs/outputs), it will bring innovative changes in data computing and communications. Here, we propose new photonic integration scheme, a single-chip optical transceiver based on a monolithic-integrated vertical photonic I/O device set including light source on bulk-silicon. This scheme can solve the major issues which impede practical implementation of silicon-based chip-level optical interconnects. We demonstrated a prototype of a single-chip photonic transceiver with monolithic-integrated vertical-illumination type Ge-on-Si photodetectors and VCSELs-on-Si on the same bulk-silicon substrate operating up to 50 Gb/s and 20 Gb/s, respectively. The prototype realized 20 Gb/s low-power chip-level optical interconnects for λ ~ 850 nm between fabricated chips. This approach can have a significant impact on practical electronic-photonic integration in high performance computers (HPC), cpu-memory interface, hybrid memory cube, and LAN, SAN, data center and network applications. PMID:26061463

Predictors of Rapid Cognitive Decline in Patients with Mild-to-Moderate Alzheimer Disease: A Prospective Cohort Study with 12-Month Follow-Up Performed in Memory Clinics.

PubMed

Tchalla, Achille E; Clément, Jean-Pierre; Saulnier, Isabelle; Beaumatin, Betty; Lachal, Florent; Gayot, Caroline; Bosetti, Anaïs; Desormais, Iléana; Perrochon, Anaïck; Preux, Pierre-Marie; Couratier, Philippe; Dantoine, Thierry

2018-04-23

Alzheimer disease (AD) is particularly devastating, with no cure, no means of prevention, and no proven way to slow progression. AD is associated with the worsening of cognitive function attributable to a variety of factors of which little is known. Our main objective was to determine factors associated with rapid cognitive decline (RCD) in older AD patients. We conducted a 12-month, prospective, multi-centre cohort study. Community-living individuals aged ≥65 years with mild-to-moderate AD were included. RCD was defined as the loss of ≥3 points/year in the Mini-Mental State Examination (MMSE) score. Potential individual-level predictors were collected at baseline. A total of 521 individuals were included. The mean age was 80.8 ± 9.0 years and 66.0% were females. The average baseline MMSE score was 20.5 ± 4.5. The incidence of RCD was 40.9% (95% confidence interval [CI], 36.7-45.1). RCD was more common in patients with moderate (53.5%) than mild (22.3%) AD. The factors associated with RCD were: a parental history of dementia (odds ratio [OR], 2.32 [95% CI, 1.24-4.21], p = 0.011), psychotic symptoms (OR, 2.06 [95% CI, 1.22-3.48], p = 0.007), malnutrition (OR, 1.61 [95% CI, 1.06-2.63], p = 0.028), and the female gender (OR, 1.48 [95% CI, 1.03-2.15], p = 0.036). An MMSE score < 20 at treatment onset was also associated with RCD (p < 0.001). The factors associated with RCD were an MMSE score < 20 at treatment onset, female gender, psychotic symptoms, malnutrition, and a family history of dementia. These results may be directly relevant to patients, their families, and their physicians, enabling early anticipation of difficult clinical trajectories and poor functional outcomes. © 2018 S. Karger AG, Basel.

Psychometric Properties of the Folstein Mini-Mental State Examination

ERIC Educational Resources Information Center

Lopez, Michael N.; Charter, Richard A.; Mostafavi, Beeta; Nibut, Lorraine P.; Smith, Whitney E.

2005-01-01

Criterion-referenced (Livingston) and norm-referenced (Gilmer-Feldt) techniques were used to measure the internal consistency reliability of Folsteins Mini-Mental State Examination (MMSE) on a large sample (N = 418) of elderly medical patients. Two administration and scoring variants of the MMSE Attention and Calculation section (Serial 7s only…

Memory complaints and APOE-epsilon4 accelerate cognitive decline in cognitively normal elderly.

PubMed

Dik, M G; Jonker, C; Comijs, H C; Bouter, L M; Twisk, J W; van Kamp, G J; Deeg, D J

2001-12-26

To investigate to what extent subjective memory complaints and APOE-epsilon4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, > or =27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task-15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-epsilon4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-epsilon4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-epsilon4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. Both memory complaints and APOE-epsilon4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-epsilon4 allele because they have an additional risk.

Cinnamon users with prediabetes have a better fasting working memory: a cross-sectional function study.

PubMed

Wahlqvist, Mark L; Lee, Meei-Shyuan; Lee, Jiunn-Tay; Hsu, Chih-Cheng; Chou, Yu-Ching; Fang, Wen-Hui; Liu, Hsiao-Yu; Xiu, Lili; Andrews, Zane B

2016-04-01

Working memory (WM) is impaired in prediabetes. We hypothesized that culinary herbs and spices may decrease insulin resistance (IR) and improve WM in prediabetes. Healthy people aged ≥60 years with prediabetes (fasting blood glucose 100-125 mg/dL) (47 men and 46 women) whose food and culinary herb intakes were established with a food frequency questionnaire had body composition assessed and fasting glucose and insulin measured. Working memory and Mini-Mental State Examination (MMSE) were assessed on the same occasion. The contributions to associations between WM and diet, body fat, and IR were estimated by linear regression. Compared with nonusers, cinnamon users had significantly less frequent physical activity (2.9 vs. 4.4 times per week) and more often used fresh ginger (93.3% vs. 64.1%) and ginger in cooking (60.0% vs. 32.1%). Cinnamon users also had a better WM (2.9 vs. 2.5, P < .001). Cinnamon had a significant effect (users were 0.446 higher), but not ginger or curry usage, in predicting WM. For sociodemographic variables, only education (years) was significant in predicting WM (β = 0.065). Other significant determinants of WM were total fat mass (kilograms) (β = -0.024) and MMSE (β = 0.075). After adjustment for age and sex, cinnamon use, education, and MMSE remained significant individual predictors. In the final model, in which all variables listed were adjusted simultaneously, cinnamon users still had a significantly higher WM than nonusers. Cinnamon usage is associated with a better WM, not accounted for by dietary quality or IR, in untreated prediabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

Pilot-Assisted Channel Estimation for Orthogonal Multi-Carrier DS-CDMA with Frequency-Domain Equalization

NASA Astrophysics Data System (ADS)

Shima, Tomoyuki; Tomeba, Hiromichi; Adachi, Fumiyuki

Orthogonal multi-carrier direct sequence code division multiple access (orthogonal MC DS-CDMA) is a combination of time-domain spreading and orthogonal frequency division multiplexing (OFDM). In orthogonal MC DS-CDMA, the frequency diversity gain can be obtained by applying frequency-domain equalization (FDE) based on minimum mean square error (MMSE) criterion to a block of OFDM symbols and can improve the bit error rate (BER) performance in a severe frequency-selective fading channel. FDE requires an accurate estimate of the channel gain. The channel gain can be estimated by removing the pilot modulation in the frequency domain. In this paper, we propose a pilot-assisted channel estimation suitable for orthogonal MC DS-CDMA with FDE and evaluate, by computer simulation, the BER performance in a frequency-selective Rayleigh fading channel.

Bayesian estimation of the discrete coefficient of determination.

PubMed

Chen, Ting; Braga-Neto, Ulisses M

2016-12-01

The discrete coefficient of determination (CoD) measures the nonlinear interaction between discrete predictor and target variables and has had far-reaching applications in Genomic Signal Processing. Previous work has addressed the inference of the discrete CoD using classical parametric and nonparametric approaches. In this paper, we introduce a Bayesian framework for the inference of the discrete CoD. We derive analytically the optimal minimum mean-square error (MMSE) CoD estimator, as well as a CoD estimator based on the Optimal Bayesian Predictor (OBP). For the latter estimator, exact expressions for its bias, variance, and root-mean-square (RMS) are given. The accuracy of both Bayesian CoD estimators with non-informative and informative priors, under fixed or random parameters, is studied via analytical and numerical approaches. We also demonstrate the application of the proposed Bayesian approach in the inference of gene regulatory networks, using gene-expression data from a previously published study on metastatic melanoma.

Distribution of plant nutrient elements and carbon in particle size fractions of broiler litter ash

USDA-ARS?s Scientific Manuscript database

An estimated 10.8 million tons of broiler litter and 3.0 million tons of turkey litter were produced in the United States in 2009. Poultry litter is a mixture of manure, bedding material (e.g., wood chips, sawdust, or straw), feathers, and spilled feed. Poultry litter contains high levels of Ca, N...

Fractographic analysis of anterior bilayered ceramic crowns that failed by veneer chipping.

PubMed

Du, Qian; Swain, Michael V; Zhao, Ke

2014-05-01

To fractographically analyze the reasons for the chipping of veneering porcelain in clinically failed anterior lithium disilicate glass-ceramic (LDG) and glass-infi ltrated alumina (GIA) crowns. Five anterior bilayered ceramic crowns with clinical veneer chipping failure were retrieved, of which three were LDG crowns and two were GIA crowns. The fractured surfaces of the failed restorations were examined using stereomicroscopy and scanning electron microscopy (SEM). The principles of fractography were used to identify the location and dimensions of the critical crack and to estimate the stress at failure. All five anterior crowns failed by cohesive failure within the veneer on the labial surface. Fractography showed that the critical crack initiated at the incisal contact area and propagated gingivally. The estimated stresses at failure for veneer chipping were lower than the characteristic strength of the veneer materials. Within the limitations of this in-vivo study, the contact damage, fatigue, and processing fl aws within the veneer are important reasons leading to chipping of veneering porcelain in anterior LDG and GIA crowns.

Fault tolerance issues in nanoelectronics

NASA Astrophysics Data System (ADS)

Spagocci, S. M.

The astonishing success story of microelectronics cannot go on indefinitely. In fact, once devices reach the few-atom scale (nanoelectronics), transient quantum effects are expected to impair their behaviour. Fault tolerant techniques will then be required. The aim of this thesis is to investigate the problem of transient errors in nanoelectronic devices. Transient error rates for a selection of nanoelectronic gates, based upon quantum cellular automata and single electron devices, in which the electrostatic interaction between electrons is used to create Boolean circuits, are estimated. On the bases of such results, various fault tolerant solutions are proposed, for both logic and memory nanochips. As for logic chips, traditional techniques are found to be unsuitable. A new technique, in which the voting approach of triple modular redundancy (TMR) is extended by cascading TMR units composed of nanogate clusters, is proposed and generalised to other voting approaches. For memory chips, an error correcting code approach is found to be suitable. Various codes are considered and a lookup table approach is proposed for encoding and decoding. We are then able to give estimations for the redundancy level to be provided on nanochips, so as to make their mean time between failures acceptable. It is found that, for logic chips, space redundancies up to a few tens are required, if mean times between failures have to be of the order of a few years. Space redundancy can also be traded for time redundancy. As for memory chips, mean times between failures of the order of a few years are found to imply both space and time redundancies of the order of ten.

Predictors of Performance on the MMSE and the DRS-2 Among American Indian Elders

PubMed Central

Jervis, Lori L.; Fickenscher, Alexandra; Beals, Janette; Cullum, C. Munro; Novins, Douglas K.; Manson, Spero M.; Arciniegas, David B.

2015-01-01

Little is known about factors that predict older American Indians’ performance on cognitive tests. This study examined 137 American Indian elders’ performance on the MMSE and the Dementia Rating Scale—Second Edition (DRS-2). Multivariate regression identified younger age, more education, not receiving Supplemental Security Income, and frequent receipt of needed health care as predictors of better performance on the MMSE. Better performance on the DRS-2 was predicted by more education, boarding school attendance, not receiving Supplemental Security Income, and frequent receipt of needed health care. This study points to the importance of economic and educational factors on cognitive test performance among American Indian elders. PMID:21037127

Predictors of performance on the MMSE and the DRS-2 among American Indian elders.

PubMed

Jervis, Lori L; Fickenscher, Alexandra; Beals, Janette; Cullum, C Munro; Novins, Douglas K; Manson, Spero M; Arciniegas, David B

2010-01-01

Little is known about factors that predict older American Indians' performance on cognitive tests. This study examined 137 American Indian elders' performance on the MMSE and the Dementia Rating Scale-Second Edition (DRS-2). Multivariate regression identified younger age, more education, not receiving Supplemental Security Income, and frequent receipt of needed health care as predictors of better performance on the MMSE. Better performance on the DRS-2 was predicted by more education, boarding school attendance, not receiving Supplemental Security Income, and frequent receipt of needed health care. This study points to the importance of economic and educational factors on cognitive test performance among American Indian elders.

Variables Associated with Cognitive Function in Elderly California Seventh-day Adventists

PubMed Central

Fraser, Gary E.; Singh, Pramil N.; Bennett, Hannelore

2012-01-01

From a cohort of white, non-Hispanic California Seventh-day Adventists, 99 subjects over age 75 years in 1991 were randomly selected. Dietary habits and educational status had been measured in 1976. Subjects completed the Mini-Mental State Examination (MMSE) in 1991, and at that time, they or caregivers also gave information on current medical problems and drug therapy. Those who ate more calories in 1976 had lower MMSE scores in 1991 (p = 0.03), an association strengthened by excluding those with previous stroke or Parkinson’s disease by 1991. This raises the possibility that higher consumption of calories in middle age may accelerate the decline in cognitive function seen with aging, as apparently occurs in some animals. Less-educated subjects had lower MMSE scores, especially among the very elderly. The statistical model predicts that the negative association between use of psychotropic drugs and MMSE score (p = 0.004) is particularly potent in those cognitively impaired for other reasons. If causal, this suggests that physicians should use these agents very cautiously in such subjects. PMID:8651216

Variables associated with cognitive function in elderly California Seventh-day Adventists.

PubMed

Fraser, G E; Singh, P N; Bennett, H

1996-06-15

From a cohort of white, non-Hispanic California Seventh-day Adventists, 99 subjects over age 75 years in 1991 were randomly selected. Dietary habits and educational status had been measured in 1976. Subjects completed the Mini-Mental State Examination (MMSE) in 1991, and at that time, they or caregivers also gave information on current medical problems and drug therapy. Those who ate more calories in 1976 had lower MMSE scores in 1991 (p = 0.03), an association strengthened by excluding those with previous stroke or Parkinson's disease by 1991. This raises the possibility that higher consumption of calories in middle age may accelerate the decline in cognitive function seen with aging, as apparently occurs in some animals. Less-educated subjects had lower MMSE scores, especially among the very elderly. The statistical model predicts that the negative association between use of psychotropic drugs and MMSE score (p = 0.004) is particularly potent in those cognitively impaired for other reasons. If causal, this suggests that physicians should use these agents very cautiously in such subjects.

Aflatoxin M1 in Tarhana chips.

PubMed

Özçam, Mustafa; Obuz, Ersel; Tosun, Halil

2014-01-01

Tarhana chips are a popular traditional fermented food consumed widely in the Kahramanmaraş region of Turkey. Tarhana chips are different from many other types of fermented food in that they are produced in the form of tortilla chips. Cereal and yoghurt are the main ingredients in Tarhana chips. Aflatoxin M1 (AFM1) levels in dairy and dairy-based products are of concern for human health. To investigate AFM1 contamination, a total of 40 samples were collected from Kahramanmaraş region and AFM1 levels were determined by competitive enzyme-linked immunosorbent assay (ELISA). Furthermore, physicochemical characteristics of Tarhana chips were investigated and compared with classic fried chips in terms of nutritional value. Based on data obtained from enzyme-linked immunosorbent assay, 21 (52.5%) out of 40 samples contained AFM1 in the range 0.5-36.6 ng/kg, so AFM1 levels of all samples were below the legal limit.

Comparing Mini-Mental State Examination and Attention and Digit Span in elderly exposed to polychlorinated biphenyls and polychlorinated dibenzofurans.

PubMed

Lin, Kao-Chang; Huang, Po-Chang; Yeh, Poh-Shiow; Kuo, Jinn-Rung; Ke, Der-Shin

2010-12-01

Polychlorinated biphenyls (PCB)/polychlorinated dibenzofurans (PCDF) are known to affect central nervous functioning. In recent studies, elderly patients who have been exposed to these have been noted to have psychological deficits. There is little known about which test is sensitive to neurotoxins in cognitive evaluation. The objective of the present study was to compare the significance between selective psychological tests in cognitive assessment in PCB-laden elderly. A retrospective PCB/PCDF exposed cohort was observed. Exposed elderly aged ≥ 60 years and registered in Central Health Administration were enrolled, and similar age- and sex-matched subjects served as non-exposed controls. The Mini-Mental State Examination (MMSE) and Attention and Digit Span (ADS) were tested in both groups. Student's t-test, χ(2) -test and linear regression models were used for statistical analysis.  A total of 165 exposed patients and 151 controls were analyzed. The exposed group included 49% men, a mean age of 69.3 ± 6.4 years and an education level of 4.0 ± 3.9 years. The controls included 52% men, a mean age of 69.9 ± 5.5 years and an education level of 4.5 ± 3.2 years. There was no statistical difference in MMSE before and after adjusting for the confounding variables of age, sex and education (P= 0.16 vs P= 0.12). However, ADS-forward and ADS-total scores showed a significant decline in the exposed subjects (P= 0.0001 vs P= 0.001). Using a linear regression among stratified PCB and cognitive functioning (≤30 ppb; 31-89; ≥90), a dose effect was found at the medium (31-89 ppb) and high exposure (≧90 ppb) levels. Our observations showed attention and short-term memory were impaired in PCB-laden elderly patients. Higher exposure level showed lower cognitive functioning in ADS. The MMSE was insensitive to neurotoxins. The present study shows that the selective test has a decisive role in toxic-related cognitive assessments. © 2010 The Authors. Psychogeriatrics © 2010 Japanese Psychogeriatric Society.

Exposure to smoking in movies and smoking initiation among black youth.

PubMed

Dal Cin, Sonya; Stoolmiller, Mike; Sargent, James D

2013-04-01

Black adolescents see more substance use in mainstream media but seem less responsive to it than other U.S. adolescents. Black-oriented media may be more personally relevant to them. To determine smoking exposure separately for black-oriented (BSME) and mainstream (MMSE) movies and assess their longitudinal relationships with smoking among black and other-race adolescents. Two-wave (2007-2009) national cohort survey of 2341 nonsmoking (at baseline) U.S. adolescents (aged 13-19 years), analyzed in 2012. The surveys determined BMSE and MMSE based on respondents' exposure to random subsets of 50 movies from a contemporary sample of 95 black-oriented and 288 mainstream movies previously content-coded for smoking. Outcome was smoking initiation. Black teens had significantly more BMSE and MMSE than other teens (p's <0.001). At follow-up, 23.5% of black and 29.0% of nonblack respondents had tried smoking. Among black respondents, BMSE was related to smoking initiation at follow-up but MMSE was not. For other adolescents, both BMSE and MMSE were related to smoking initiation. A prospective relationship was found between exposure to smoking in movies and smoking initiation. Among black adolescents in the U.S., this was only for black-oriented movies, suggesting the importance of personal relevance of the exposures. Parents, practitioners, and producers should be aware of these potential influences of media on black teen viewers. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Utility of TICS-M for the assessment of cognitive function in older adults.

PubMed

de Jager, Celeste A; Budge, Marc M; Clarke, Robert

2003-04-01

Routine screening of high-risk elderly people for early cognitive impairment is constrained by the limitations of currently available cognitive function tests. The Telephone Interview of Cognitive Status is a novel instrument for assessment of cognitive function that can be administered in person or by telephone. To evaluate the determinants and utility of TICS-M (13-item modified version) for assessment of cognitive function in healthy elderly people. The utility of TICS-M was compared with more widely used MMSE and CAMCOG in a cross-sectional survey of 120 older (62 to 89 years) UK adults. The TICS-M cognitive test scores (27.97, SD 4.15) were normally distributed in contrast with those for MMSE and CAMCOG that had a negatively skewed distribution. TICS-M scores were inversely correlated with age (r = -0.21) and with the NART fullscale IQ (r = -0.35), but were independent of years of education in this cohort. TICS-M was highly correlated with MMSE (r = 0.57) and with CAMCOG (r = 0.62) scores. The time required to complete the test is comparable to MMSE and substantially less than CAMCOG. The normal distribution of TICS-M test scores suggest that this test is less constrained by the ceiling effect which limits the utility of MMSE and CAMCOG test scores in detecting early cognitive impairment. TICS-M is an appropriate instrument to assess cognitive function in both research and in clinical practice. Copyright 2003 John Wiley & Sons, Ltd.

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery.

PubMed

Kim, Joonho; Na, Han Kyu; Byun, Justin; Shin, Jiwon; Kim, Sungsoo; Lee, Byung Hwa; Na, Duk L

2017-01-01

Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness. © 2017 S. Karger AG, Basel.

Exposure to Smoking in Movies and Smoking Initiation Among Black Youth

PubMed Central

Dal Cin, Sonya; Stoolmiller, Mike; Sargent, James D.

2013-01-01

Background Black adolescents see more substance use in mainstream media but seem less responsive to it than other U.S. adolescents. Black-oriented media may be more personally relevant to them. Purpose To determine smoking exposure separately for black-oriented (BSME) and mainstream (MMSE) movies and assess their longitudinal relationships with smoking among black and other-race adolescents. Methods Two-wave (2007–2009) national cohort survey of 2341 nonsmoking (at baseline) U.S. adolescents (aged 13–19 years), analyzed in 2012. The surveys determined BMSE and MMSE based on respondents’ exposure to random subsets of 50 movies from a contemporary sample of 95 black-oriented and 288 mainstream movies previously content-coded for smoking. Outcome was smoking initiation. Results Black teens had significantly more BMSE and MMSE than other teens (p’s <0.001). At follow-up, 23.5% of black and 29.0% of nonblack respondents had tried smoking. Among black respondents, BMSE was related to smoking initiation at follow-up but MMSE was not. For other adolescents, both BMSE and MMSE were related to smoking initiation. Conclusions A prospective relationship was found between exposure to smoking in movies and smoking initiation. Among black adolescents in the U.S., this was only for black-oriented movies, suggesting the importance of personal relevance of the exposures. Parents, practitioners, and producers should be aware of these potential influences of media on black teen viewers. PMID:23498099

Adaptive Window Zero-Crossing-Based Instantaneous Frequency Estimation

NASA Astrophysics Data System (ADS)

Sekhar, S. Chandra; Sreenivas, TV

2004-12-01

We address the problem of estimating instantaneous frequency (IF) of a real-valued constant amplitude time-varying sinusoid. Estimation of polynomial IF is formulated using the zero-crossings of the signal. We propose an algorithm to estimate nonpolynomial IF by local approximation using a low-order polynomial, over a short segment of the signal. This involves the choice of window length to minimize the mean square error (MSE). The optimal window length found by directly minimizing the MSE is a function of the higher-order derivatives of the IF which are not available a priori. However, an optimum solution is formulated using an adaptive window technique based on the concept of intersection of confidence intervals. The adaptive algorithm enables minimum MSE-IF (MMSE-IF) estimation without requiring a priori information about the IF. Simulation results show that the adaptive window zero-crossing-based IF estimation method is superior to fixed window methods and is also better than adaptive spectrogram and adaptive Wigner-Ville distribution (WVD)-based IF estimators for different signal-to-noise ratio (SNR).

Architectural-level power estimation and experimentation

NASA Astrophysics Data System (ADS)

Ye, Wu

With the emergence of a plethora of embedded and portable applications and ever increasing integration levels, power dissipation of integrated circuits has moved to the forefront as a design constraint. Recent years have also seen a significant trend towards designs starting at the architectural (or RT) level. Those demand accurate yet fast RT level power estimation methodologies and tools. This thesis addresses issues and experiments associate with architectural level power estimation. An execution driven, cycle-accurate RT level power simulator, SimplePower, was developed using transition-sensitive energy models. It is based on the architecture of a five-stage pipelined RISC datapath for both 0.35mum and 0.8mum technology and can execute the integer subset of the instruction set of SimpleScalar . SimplePower measures the energy consumed in the datapath, memory and on-chip buses. During the development of SimplePower , a partitioning power modeling technique was proposed to model the energy consumed in complex functional units. The accuracy of this technique was validated with HSPICE simulation results for a register file and a shifter. A novel, selectively gated pipeline register optimization technique was proposed to reduce the datapath energy consumption. It uses the decoded control signals to selectively gate the data fields of the pipeline registers. Simulation results show that this technique can reduce the datapath energy consumption by 18--36% for a set of benchmarks. A low-level back-end compiler optimization, register relabeling, was applied to reduce the on-chip instruction cache data bus switch activities. Its impact was evaluated by SimplePower. Results show that it can reduce the energy consumed in the instruction data buses by 3.55--16.90%. A quantitative evaluation was conducted for the impact of six state-of-art high-level compilation techniques on both datapath and memory energy consumption. The experimental results provide a valuable insight for designers to develop future power-aware compilation frameworks for embedded systems.

Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients.

PubMed

Karamanli, Harun; Ilik, Faik; Kayhan, Fatih; Pazarli, Ahmet Cemal

2015-01-01

A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD) COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: <26 points) and MMSE (cutoff: ≤24 points) scores were compared between these two groups. The nonuser LTOTD-COPD group had a significantly lower MoCA score than that of the regular-user LTOTD-COPD group (19.38±2.99 vs 21.68±2.14, respectively) as well as a significantly lower MMSE score. Moreover, the absence of supplemental oxygen therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014), and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year. In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as continuous supplemental oxygen treatment, should be considered during the management of COPD in this population. In addition, the MoCA score was superior to the MMSE score for the determination of cognitive impairment in the nonuser LTOTD-COPD patients.

How Can We Best Screen for Cognitive Impairment in Malaysia? A Pilot of the IDEA Cognitive Screen and Picture-Based Memory Impairment Scale and Comparison of Criterion Validity with the Mini Mental State Examination.

PubMed

Rosli, Roshaslina; Tan, Maw Pin; Gray, William K; Subramanian, Pathmawathi; Mohd Hairi, Noran Naqiah; Chin, Ai-Vyrn

2017-01-01

To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference. The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7%; PMIS: ≤ 6, 97.3% and 69.0%; and MMSE: ≤ 23, 84.6% and 76.0%. Although the sample size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased. The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties. Study provides alternative screening tools for dementia for both non-specialists and specialists.

Prediction of acoustic feature parameters using myoelectric signals.

PubMed

Lee, Ki-Seung

2010-07-01

It is well-known that a clear relationship exists between human voices and myoelectric signals (MESs) from the area of the speaker's mouth. In this study, we utilized this information to implement a speech synthesis scheme in which MES alone was used to predict the parameters characterizing the vocal-tract transfer function of specific speech signals. Several feature parameters derived from MES were investigated to find the optimal feature for maximization of the mutual information between the acoustic and the MES features. After the optimal feature was determined, an estimation rule for the acoustic parameters was proposed, based on a minimum mean square error (MMSE) criterion. In a preliminary study, 60 isolated words were used for both objective and subjective evaluations. The results showed that the average Euclidean distance between the original and predicted acoustic parameters was reduced by about 30% compared with the average Euclidean distance of the original parameters. The intelligibility of the synthesized speech signals using the predicted features was also evaluated. A word-level identification ratio of 65.5% and a syllable-level identification ratio of 73% were obtained through a listening test.

LS Channel Estimation and Signal Separation for UHF RFID Tag Collision Recovery on the Physical Layer.

PubMed

Duan, Hanjun; Wu, Haifeng; Zeng, Yu; Chen, Yuebin

2016-03-26

In a passive ultra-high frequency (UHF) radio-frequency identification (RFID) system, tag collision is generally resolved on a medium access control (MAC) layer. However, some of collided tag signals could be recovered on a physical (PHY) layer and, thus, enhance the identification efficiency of the RFID system. For the recovery on the PHY layer, channel estimation is a critical issue. Good channel estimation will help to recover the collided signals. Existing channel estimates work well for two collided tags. When the number of collided tags is beyond two, however, the existing estimates have more estimation errors. In this paper, we propose a novel channel estimate for the UHF RFID system. It adopts an orthogonal matrix based on the information of preambles which is known for a reader and applies a minimum-mean-square-error (MMSE) criterion to estimate channels. From the estimated channel, we could accurately separate the collided signals and recover them. By means of numerical results, we show that the proposed estimate has lower estimation errors and higher separation efficiency than the existing estimates.

[The effect of disability of the aged patient on the level of caregiving burden by the family].

PubMed

Topinková, E; Neuwirth, J

1997-02-12

A growing number of dependent elderly people is cared for at home by family members. However, long-term caregiving may become an intolerable strain for some families and lead to failure of family care. The aim of the study was to examine if level of physical and mental disability of the patient influences the extent of perceived caregiver burden representing risk factor for negative outcome. 128 elderly patients with disability and dependency (37 men, 91 women, average age 79.9 +/- 6.9 yrs) and 128 their primary caregivers, mostly family members (28.9% men, 71.1% women) were evaluated. Functional status of care recipient was assessed by means of Barthel ADL Index (mean = 70.9 +/- 26.5), IADL Test (mean = 31.4 +/- 23.5) and Mini-Mental State Exam, MMSE (mean = 20.4 +/- 6.5). Average score of Caregiver Burden Interview (CBI) was 34.7 +/- 18.8. According to CBI, 40.6% of caregivers were found under high or even extremely hig level of stress. Level of perceived burden correlated significantly with physical and mental disability level, in decreasing order for IADL, ADL and MMSE (rs = 0.582-0.708, p < 0.001). Caregiver burden of family caregivers is significantly related to the level of functioning and cognitive impairment of care recipient, particularly to his/her ability to perform instrumental activities. Functional decline of elderly patient represents a risk factor which contributes to negative caregiving outcome and institutional placement.

Stability and Antioxidant Activity of Annatto (Bixa orellana L.) Tocotrienols During Frying and in Fried Tortilla Chips.

PubMed

Winkler-Moser, Jill K; Bakota, Erica L; Hwang, Hong-Sik

2018-02-01

Annatto tocotrienols (AnT3), which contain approximately 90% δ-tocotrienol (δ-T3), were added to mid-oleic sunflower oil used for frying tortilla chips over 3 d. The objectives were to evaluate their stability during frying, absorption by the fried food, and activity as antioxidants in frying oil and in tortilla chips during storage. AnT3 did not significantly affect the stability of the oil during frying or the sensory profiles of freshly fried chips. The naturally present α-tocopherol (α-T) in the oil degraded at a lower rate in the presence of AnT3, resulting in significantly higher α-T by the end of the frying study. Levels of tocopherols and tocotrienols in the chips mirrored oil levels. AnT3 did not affect the sensory profile of the chips after 1 wk of storage at 50 °C, but after 3 wk of storage, the control chips had higher levels of painty and rancid flavors compared to chips with AnT3. Headspace hexanal was also significantly higher in the control chips compared to the chips with AnT3 after 3 wk of storage. Annatto tocotrienols, containing primarily delta- and gamma-tocotrienols, were added to mid-oleic sunflower oil used for frying tortilla chips. The tocotrienols were absorbed by the chips along with the oil. They slowed the degradation of α tocopherol during frying, and reduced levels of painty and rancid flavor scores as well as headspace hexanal in chips that were stored for 3 wk at elevated temperatures. The results indicated that fried snack foods such as tortilla chips may be a suitable and convenient vehicle for enriching tocotrienols in the diet, and that tocotrienols may also enhance the shelf-life of fried foods. © 2018 Institute of Food Technologists®.

Network meta-analysis of diagnostic test accuracy studies identifies and ranks the optimal diagnostic tests and thresholds for health care policy and decision-making.

PubMed

Owen, Rhiannon K; Cooper, Nicola J; Quinn, Terence J; Lees, Rosalind; Sutton, Alex J

2018-07-01

Network meta-analyses (NMA) have extensively been used to compare the effectiveness of multiple interventions for health care policy and decision-making. However, methods for evaluating the performance of multiple diagnostic tests are less established. In a decision-making context, we are often interested in comparing and ranking the performance of multiple diagnostic tests, at varying levels of test thresholds, in one simultaneous analysis. Motivated by an example of cognitive impairment diagnosis following stroke, we synthesized data from 13 studies assessing the efficiency of two diagnostic tests: Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), at two test thresholds: MMSE <25/30 and <27/30, and MoCA <22/30 and <26/30. Using Markov chain Monte Carlo (MCMC) methods, we fitted a bivariate network meta-analysis model incorporating constraints on increasing test threshold, and accounting for the correlations between multiple test accuracy measures from the same study. We developed and successfully fitted a model comparing multiple tests/threshold combinations while imposing threshold constraints. Using this model, we found that MoCA at threshold <26/30 appeared to have the best true positive rate, whereas MMSE at threshold <25/30 appeared to have the best true negative rate. The combined analysis of multiple tests at multiple thresholds allowed for more rigorous comparisons between competing diagnostics tests for decision making. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Expression and significance of CHIP in canine mammary gland tumors

PubMed Central

WANG, Huanan; YANG, Xu; JIN, Yipeng; PEI, Shimin; ZHANG, Di; MA, Wen; HUANG, Jian; QIU, Hengbin; ZHANG, Xinke; JIANG, Qiuyue; SUN, Weidong; ZHANG, Hong; LIN, Degui

2015-01-01

CHIP (Carboxy terminus of Hsc70 Interacting Protein) is an E3 ubiquitin ligase that can induce ubiquitination and degradation of several oncogenic proteins. The expression of CHIP is frequently lower in human breast cancer than in normal breast tissue. However, the expression and role of CHIP in the canine mammary gland tumor (CMGT) remain unclear. We investigated the potential correlation between CHIP expression and mammary gland tumor prognosis in female dogs. CHIP expression was measured in 54 dogs by immunohistochemistry and real-time RT-PCR. CHIP protein expression was significantly correlated with the histopathological diagnosis, outcome of disease and tumor classification. The transcriptional level of CHIP was significantly higher in normal tissues (P=0.001) and benign tumors (P=0.009) than it in malignant tumors. CHIP protein expression was significantly correlated with the transcriptional level of CHIP (P=0.0102). The log-rank test survival curves indicated that patients with low expression of CHIP had shorter overall periods of survival than those with higher CHIP protein expression (P=0.050). Our data suggest that CHIP may play an important role in the formation and development of CMGTs and serve as a valuable prognostic marker and potential target for genetic therapy. PMID:26156079

Construct validation of two music-based assessments for people with dementia.

PubMed

Lipe, Anne W; York, Elizabeth; Jensen, Eric

2007-01-01

The purpose of this study was to substantiate the usefulness of the tasks on two music-based assessments in providing information about music cognition among people with dementia and to more fully understand the nature of this construct and its relationship to general cognition. Individuals with dementia (N = 50) received 3 evaluations: the Mini-Mental State Exam (MMSE), the MBECF, and the RMST. Results of the study revealed significant correlations between the MMSE and both music-based assessments. A pattern of correlations between the MMSE and the subsets of tasks contained in both music-based assessments showed that while there are strong relationships between music and general cognition, that there also is uniqueness to the melodic, singing and rhythmic aspects of music cognition.

Can increases in CHIP copayments reduce program expenditures on prescription drugs?

PubMed

Sen, Bisakha; Blackburn, Justin; Morrisey, Michael; Becker, David; Kilgore, Meredith; Caldwell, Cathy; Menachemi, Nir

2014-01-01

The primary aim is to explore whether prescription drug expenditures by enrollees changed in Alabama's CHIP program, ALL Kids, after copayment increases in fiscal year 2004. The subsidiary aim is to explore whether non-pharmaceutical expenditures also changed. Data on ALL Kids enrollees between 1999-2007, obtained from claims files and the state's administrative database. We used data on children who were enrolled between one and three years both before and after the changes to the copayment schedule, and estimate regression models with individual-level fixed effects to control for time-invariant heterogeneity at the child level. This allows an accurate estimate of how program expenditures change for the same individual following copayment changes. Primary outcomes of interest are expenditures for prescription drugs by class and brand-name and generic versions. We estimate models for the likelihood of any use of prescription drugs and expenditure level conditional on use. Following the copayment increase, the probability of any expenditure decline by 5.8%, brand name drugs by 6.9%, generic drugs by 7.4%. Conditional on any use, program expenditures decline by 7.9% for all drugs, by 9.6% for brand name drugs, and 6.2% for generic drugs. The largest declines are for antihistamine drugs; the least declines are for Central Nervous System agents. Declines are smaller and statistically weaker for children with chronic health conditions. Concurrent declines are also seen for non-pharmaceutical medical expenditures. Copayment increases appear to reduce program expenditures on prescription drugs per enrollee and may be a useful tool for controlling program costs.

Major depressive disorder with psychotic features may lead to misdiagnosis of dementia: a case report and review of the literature.

PubMed

Wagner, Gerhardt S; McClintock, Shawn M; Rosenquist, Peter B; McCall, W Vaughn; Kahn, David A

2011-11-01

Major depressive disorder (MDD) with psychotic features is relatively frequent in patients with greater depressive symptom severity and is associated with a poorer course of illness and greater functional impairment than MDD without psychotic features. Multiple studies have found that patients with psychotic mood disorders demonstrate significantly poorer cognitive performance in a variety of areas than those with nonpsychotic mood disorders. The Mini Mental State Examination (MMSE) and the Dementia Rating Scale, Second Edition (DRS-2) are widely used to measure cognitive functions in research on MDD with psychotic features. Established total raw score cut-offs of 24 on the MMSE and 137 on the DRS-2 in published manuals suggest possible global cognitive impairment and dementia, respectively. Limited research is available on these suggested cut-offs for patients with MDD with psychotic features. We document the therapeutic benefit of electroconvulsive therapy (ECT), which is usually associated with short-term cognitive impairment, in a 68-year-old woman with psychotic depression whose MMSE and DRS-2 scores initially suggested possible global cognitive impairment and dementia. Over the course of four ECT treatments, the patient's MMSE scores progressively increased. After the second ECT treatment, the patient no longer met criteria for global cognitive impairment. With each treatment, depression severity, measured by the 24-item Hamilton Rating Scale for Depression, improved sequentially. Thus, the suggested cut-off scores for the MMSE and the DRS-2 in patients with MDD with psychotic features may in some cases produce false-positive indications of dementia.

Finger displacement in Parkinson disease: up? down? sideways?

PubMed

Lieberman, Abraham; Dhall, Rohit; Salins, Naomi; Sadreddin, Arshia; Moguel-Cobos, Guillermo; Karis, John; Krishnamurthi, Narayanan

2014-05-01

We previously reported that patients with tremor preponderant Parkinson disease (PD) displayed upward or lateral displacement of their more tremulous finger when they pointed both their index fingers at a target and closed their eyes for 15 seconds. In this study, we examined the phenomenon in 104 PD patients: 72 patients without tremor and 32 with minimal tremor to see if the displacement is related to the disease or the tremor. Sixty-eight of the 72 patients without tremor, 94%, exhibited finger displacement suggesting the phenomenon is related to the disease. None of the 104 patients were demented: mini-mental status examination (MMSE) score 29.0 ± 0. 75. Ninety patients displayed upward displacement (56 patients) or lateral or medial displacement (34 patients). MMSE score of the 90 patients: 29.2 ± 0.74 with no score < 28. Eight patients (6 without tremor) displayed downward displacement. MMSE score of the 8 patients: 27.5 ± 0.35 with 5 having MMSE score of 27. Although not significant the results suggest that patients with downward displacement and lower MMSE score may be evolving a dementia. Upward displacement with eyes closed for 15 seconds requires an ability to "remember" the position of the finger in space and to alter tone to overcome gravity. Downward displacement implies an inability to "remember" the position of the finger in space an inability to overcome the effects of gravity. This may be more likely in patients who are evolving a dementia. Two patients, with PD-like symptoms, and specific anatomical abnormalities are also presented as they illustrate the anatomy of finger displacement.

Cognitive abilities screening instrument-short form, mini-mental state examination and functional activities questionnaire in the illiterate elderly.

PubMed

Rezende, Gabriela Pravatta; Cecato, Juliana; Martinelli, José Eduardo

2013-01-01

Dementia prevalence is increasing in developing countries due to population aging. Brief tests for assessing cognition and activities of daily living are very useful for the diagnosis of dementia by the clinician. Low education, particularly illiteracy, is a hindrance to the diagnosis of dementia in several regions of the world. To compare the Brazilian version of the Cognitive Abilities Screening Instrument-Short Form (CASI-S) with the Mini-Mental State Examination (MMSE) and Pfeffer Functional Activities Questionnaire (PFAQ) for the diagnosis of dementia in illiterate elderly. A cross-sectional study with illiterate elderly of both genders seen at the outpatient clinics of the Institute of Gerontology and Geriatrics Jundiaí, São Paulo state was performed. Spearman's correlation coefficient was used to correlate CASI-S, MMSE and PFAQ scores. The sample comprised 29 elderly over 57 years old whose mean scores on the CASI-S (scores ranging from 3 to 23) and the MMSE (scores ranging from 2 to 23) were 11.69 and 12.83, respectively. There was a strong significant correlation between the CASI-S and MMSE (r=0.75, p<0.001) and a moderate correlation coefficient that was significant and negative between the PFAQ and CASI-S (r= -0.53 p=0.003),similar to that between the MMSE and PFAQ (r= -0.41 p=0.025). The Brazilian version of the CASI-S demonstrates ease of application and correction in the illiterate elderly, and warrants further studies regarding its applicability for the diagnosis of dementia in populations with a heterogeneous educational background.

Neurogranin as a Cerebrospinal Fluid Biomarker for Synaptic Loss in Symptomatic Alzheimer Disease

PubMed Central

Kester, Maartje I.; Teunissen, Charlotte E.; Crimmins, Daniel L.; Herries, Elizabeth M.; Ladenson, Jack. H.; Scheltens, Philip; van der Flier, Wiesje M.; Morris, John C.; Holtzman, David M.; Fagan, Anne M.

2015-01-01

IMPORTANCE Neurogranin (NGRN) seems to be a promising novel cerebrospinal fluid (CSF) biomarker for synaptic loss; however, clinical, and especially longitudinal, data are sparse. OBJECTIVE To examine the utility of NGRN, with repeated CSF sampling, for diagnosis, prognosis, and monitoring of Alzheimer disease (AD). DESIGN, SETTING, AND PARTICIPANTS Longitudinal study of consecutive patients who underwent 2 lumbar punctures between the beginning of 1995 and the end of 2010 within the memory clinic–based Amsterdam Dementia Cohort. The study included 163 patients: 37 cognitively normal participants (mean [SE] age, 64 [2] years; 38% female; and mean [SE] Mini-Mental State Examination [MMSE] score, 28 [0.3]), 61 patients with mild cognitive impairment (MCI) (mean [SE] age, 68 [1] years; 38% female; and mean [SE] MMSE score, 27 [0.3]), and 65 patients with AD (mean [SE] age, 65 [1] years; 45% female; and mean [SE] MMSE score, 22 [0.7]). The mean (SE) interval between lumbar punctures was 2.0 (0.1) years, and the mean (SE) duration of cognitive follow-up was 3.8 (0.2) years. Measurements of CSF NGRN levels were obtained in January and February 2014. MAIN OUTCOME AND MEASURE Levels of NGRN in CSF samples. RESULTS Baseline CSF levels of NGRN in patients with AD (median level, 2381 pg/mL [interquartile range, 1651-3416 pg/mL]) were higher than in cognitively normal participants (median level, 1712 pg/mL [interquartile range, 1206-2724 pg/mL]) (P = .04). Baseline NGRN levels were highly correlated with total tau and tau phosphorylated at threonine 181 in all patient groups (all P < .001), but not with Aβ42. Baseline CSF levels of NGRN were also higher in patients with MCI who progressed to AD (median level, 2842 pg/mL [interquartile range, 1882-3950 pg/mL]) compared with those with stable MCI (median level, 1752 pg/mL [interquartile range, 1024-2438 pg/mL]) (P = .004), and they were predictive of progression from MCI to AD (hazard ratio, 1.8 [95% CI, 1.1-2.9]; stratified by tertiles). Linear mixed-model analyses demonstrated that within-person levels of NGRN increased over time in cognitively normal participants (mean [SE] level, 90 [45] pg/mL per year; P < .05) but not in patients with MCI or AD. CONCLUSIONS AND RELEVANCE Neurogranin is a promising biomarker for AD because levels were elevated in patients with AD compared with cognitively normal participants and predicted progression from MCI to AD. Within-person levels of NGRN increased in cognitively normal participants but not in patients with later stage MCI or AD, which suggests that NGRN may reflect presymptomatic synaptic dysfunction or loss. PMID:26366630

Characteristic differences in the mini-mental state examination used in Asian countries.

PubMed

Shim, Yong S; Yang, Dong Won; Kim, Hee-Jin; Park, Young Ho; Kim, SangYun

2017-07-21

The mini-mental state examination (MMSE) was adapted by individual countries according to their languages and cultures, though it has not been systematically compared. The objective of this study was to compare the linguistic and cultural variations of the MMSE used in various Asian countries. With this, we can analyze the strengths and weaknesses of the MMSE and consider using a common version in future international clinical studies in Asia. We collected the MMSEs used in 11 Asian nations. After translating those into English, we compared them to understand the differences in the questionnaires with regard to cultural aspects. Many items may be applicable or comparable with a little modification, for Asian countries. However, attention and calculation and repetition may be incomparable. There were some differences in the contents and the ways to administer. The lack of consideration of the cultural differences and their influences on the interpretation of the same cognitive test makes cross-cultural studies difficult. Some items of MMSE tasks need readjusting for, if any, multi-national studies. This study might serve as a first step in the development of a standardized cross-cultural cognitive instrument, especially in Asia.

A study on the achievable data rate in massive MIMO system

NASA Astrophysics Data System (ADS)

Salh, Adeeb; Audah, Lukman; Shah, Nor Shahida M.; Hamzah, Shipun A.

2017-09-01

The achievable high data rates depend on the ability of massive multi-input-multi-output (MIMO) for the fifth-generation (5G) cellular networks, where the massive MIMO systems can support very high energy and spectral efficiencies. A major challenge in mobile broadband networks is how to support the throughput in the future 5G, where the highlight of 5G expected to provide high speed internet for every user. The performance massive MIMO system increase with linear minimum mean square error (MMSE), zero forcing (ZF) and maximum ratio transmission (MRT) when the number of antennas increases to infinity, by deriving the closed-form approximation for achievable data rate expressions. Meanwhile, the high signal-to-noise ratio (SNR) can be mitigated by using MMSE, ZF and MRT, which are used to suppress the inter-cell interference signals between neighboring cells. The achievable sum rate for MMSE is improved based on the distributed users inside cell, mitigated the inter-cell interference caused when send the same signal by other cells. By contrast, MMSE is better than ZF in perfect channel state information (CSI) for approximately 20% of the achievable sum rate.

Tai Ji Quan and global cognitive function in older adults with cognitive impairment: a pilot study.

PubMed

Li, Fuzhong; Harmer, Peter; Liu, Yu; Chou, Li-Shan

2014-01-01

This study evaluated whether Tai Ji Quan: Moving for Better Balance (TJQMBB) could improve global cognitive function in older adults with cognitive impairment. Using a nonrandomized control group pretest-posttest design, participants aged ≥65 years who scored between 20 and 25 on the Mini-Mental State Examination (MMSE) were allocated into either a 14-week TJQMBB program (n=22) or a control group (n=24). The primary outcome was MMSE as a measure of global cognitive function with secondary outcomes of 50-ft speed walk, Timed Up&Go, and Activities-Specific Balance Confidence (ABC) scale. At 14 weeks, Tai Ji Quan participants showed significant improvement on MMSE (mean=2.26, p<0.001) compared to controls (mean=0.63, p=0.08). Similarly, Tai Ji Quan participants performed significantly better compared to the controls in both physical performance and balance efficacy measures (p<0.05). Improvement in cognition as measured by MMSE was related to improved physical performance and balance efficacy. These results provide preliminary evidence of the utility of the TJQMBB program to promote cognitive function in older adults in addition to physical benefits. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

'Yes' ifs, ands or buts: examining performance and correlates of the repetition task in the mini-mental state examination.

PubMed

Werner, P; Heinik, J; Lin, R; Bleich, A

1999-09-01

The aim of this study was to examine whether the type of sentence used in the repetition task included in the Mini-Mental State Examination (MMSE) affected performance in a group of 79 demented and 19 non-demented Hebrew-speaking elderly persons. The cognitive functioning of the participants was assessed using the MMSE and CAMCOG examinations. The performance of the repetition task was evaluated by using three sentences: the literal translation of the English language expression used in the original MMSE; a well-known Hebrew proverb consisting of monosyllabic words and rhythmic effects; and another well-known Hebrew proverb without such attributes. Only a third of the participants successfully repeated the literally translated expression. It showed low predictive value and was highly affected by education. The well-known Hebrew monosyllabic proverb showed moderate predictive value but no discriminatory ability. The other well-known Hebrew proverb performed the best. The translation of the repetition task in the MMSE to other languages is problematic. Strict adherence to the original language proved to be the least desirable choice. Copyright 1999 John Wiley & Sons, Ltd.

Trapping and Collection of Lymphocytes Using Microspot Array Chip and Magnetic Beads

NASA Astrophysics Data System (ADS)

Hashioka, Shingi; Obata, Tsutomu; Tokimitsu, Yoshiharu; Fujiki, Satoshi; Nakazato, Hiroyoshi; Muraguchi, Atsushi; Kishi, Hiroyuki; Tanino, Katsumi

2006-04-01

A microspot array chip, which has microspots of a magnetic thin film patterned on a glass substrate, was fabricated for trapping individual cells and for measuring their cellular response. The chip was easily fabricated by conventional semiconductor fabrication techniques on a mass production level as a disposable medical device. When a solution of lymphocyte-bound-magnetic beads was poured into the magnetized chip, each lymphocyte was trapped on each microspot of the magnetic thin film. The trapped cells were easily recovered from the chip using a micromanipulator. The micro-spot array chip can be utilized for arraying live cells and for measuring the response of each cell. The chip will be useful for preparing on array of different kinds of cells and for analyzing cellular response at the single cell level. The chip will be particularly useful for detecting antigen-specific B-lymphocytes and antigen-specific antibody complementary deoxyribonucleic acid (cDNA).

Multilevel, cross-sectional study on social capital with psychogeriatric health among older Japanese people dwelling in rural areas.

PubMed

Yuasa, Motoyuki; Ukawa, Shigekazu; Ikeno, Tamiko; Kawabata, Tomoko

2014-09-01

There has been increasing interest in the effect of social capital (SC) on health over the last decade both in Japan and internationally. This study elucidated whether components of SC are linked to the psychogeriatric health of older Japanese individuals. Data for 169 eligible older people living in three rural areas were collected. Multilevel analyses were performed to examine associations between general trust, informal social interaction and formal group participation with self-rated health, mini-mental state examination (MMSE), self-rated depression scale (SDS) and general self-efficacy scale (GSES). Our study revealed that MMSE, SDS and GSES were significantly associated with informal social interaction and formal group participation after adjusting for area-level SC. However, we observed no relationship between general trust and health outcomes. The findings suggest that the strategic enhancement of social cohesion and social networks for older people may promote their health and quality of later life. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Iterative MMSE Detection for MIMO/BLAST DS-CDMA Systems in Frequency Selective Fading Channels - Achieving High Performance in Fully Loaded Systems

NASA Astrophysics Data System (ADS)

Silva, João Carlos; Souto, Nuno; Cercas, Francisco; Dinis, Rui

A MMSE (Minimum Mean Square Error) DS-CDMA (Direct Sequence-Code Division Multiple Access) receiver coupled with a low-complexity iterative interference suppression algorithm was devised for a MIMO/BLAST (Multiple Input, Multiple Output / Bell Laboratories Layered Space Time) system in order to improve system performance, considering frequency selective fading channels. The scheme is compared against the simple MMSE receiver, for both QPSK and 16QAM modulations, under SISO (Single Input, Single Output) and MIMO systems, the latter with 2Tx by 2Rx and 4Tx by 4Rx (MIMO order 2 and 4 respectively) antennas. To assess its performance in an existing system, the uncoded UMTS HSDPA (High Speed Downlink Packet Access) standard was considered.

Carboxyl Terminus of HSC70-interacting Protein (CHIP) Down-regulates NF-κB-inducing Kinase (NIK) and Suppresses NIK-induced Liver Injury*

PubMed Central

Jiang, Bijie; Shen, Hong; Chen, Zheng; Yin, Lei; Zan, Linsen; Rui, Liangyou

2015-01-01

Ser/Thr kinase NIK (NF-κB-inducing kinase) mediates the activation of the noncanonical NF-κB2 pathway, and it plays an important role in regulating immune cell development and liver homeostasis. NIK levels are extremely low in quiescent cells due to ubiquitin/proteasome-mediated degradation, and cytokines stimulate NIK activation through increasing NIK stability; however, regulation of NIK stability is not fully understood. Here we identified CHIP (carboxyl terminus of HSC70-interacting protein) as a new negative regulator of NIK. CHIP contains three N-terminal tetratricopeptide repeats (TPRs), a middle dimerization domain, and a C-terminal U-box. The U-box domain contains ubiquitin E3 ligase activity that promotes ubiquitination of CHIP-bound partners. We observed that CHIP bound to NIK via its TPR domain. In both HEK293 and primary hepatocytes, overexpression of CHIP markedly decreased NIK levels at least in part through increasing ubiquitination and degradation of NIK. Accordingly, CHIP suppressed NIK-induced activation of the noncanonical NF-κB2 pathway. CHIP also bound to TRAF3, and CHIP and TRAF3 acted coordinately to efficiently promote NIK degradation. The TPR but not the U-box domain was required for CHIP to promote NIK degradation. In mice, hepatocyte-specific overexpression of NIK resulted in liver inflammation and injury, leading to death, and liver-specific expression of CHIP reversed the detrimental effects of hepatic NIK. Our data suggest that CHIP/TRAF3/NIK interactions recruit NIK to E3 ligase complexes for ubiquitination and degradation, thus maintaining NIK at low levels. Defects in CHIP regulation of NIK may result in aberrant NIK activation in the liver, contributing to live injury, inflammation, and disease. PMID:25792747

Association of GA/HbA1c ratio and cognitive impairment in subjects with type 2 diabetes mellitus.

PubMed

Kinoshita, Tomoe; Shimoda, Masashi; Sanada, Junpei; Fushimi, Yoshiro; Hirata, Yurie; Irie, Shintaro; Tanabe, Akihito; Obata, Atsushi; Kimura, Tomohiko; Hirukawa, Hidenori; Kohara, Kenji; Tatsumi, Fuminori; Kamei, Shinji; Nakanishi, Shuhei; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki

The aim of this study was to search for factors influencing cognitive impairment and to clarify the association between the fluctuation of blood glucose levels and cognitive impairment in elderly Japanese subjects with type 2 diabetes. We recruited 88 relatively elderly subjects (≥65years old) with type 2 diabetes who were hospitalized in Kawasaki Medical School from January 2014 to December 2015. We evaluated the fluctuation of blood glucose levels with glycoalbumin (GA)/hemoglobin A1c (HbA1c) ratio, and estimated cognitive impairment with Hasegawa dementia scale-revised (HDS-R) score and mini mental state examination (MMSE) score. Multivariate analyses showed that GA/HbA1c ratio and urinary albumin excretion, but not hypoglycemia, were independent determinant factors for cognitive impairment in elderly Japanese subjects with type 2 diabetes. The fluctuation of blood glucose levels per se is closely associated with cognitive impairment in elderly subjects with type 2 diabetes even when hypoglycemia is not accompanied. Since it is very easy to calculate GA/HbA1c ratio, we should check this ratio so that we can reduce the fluctuation of blood glucose levels especially in elderly subjects with type 2 diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.

The role and significance of Salix plantations for energy in Swedish agriculture

DOE Office of Scientific and Technical Information (OSTI.GOV)

Forsse, L.S.; Ledin, S.; Johansson, H.

1993-12-31

Fifteen years of research and development of energy forestry with Salix species has lead to a firm basis of knowledge concerning the basic biology, stand ecology and production systems of fast growing willows in Sweden. The biology research program continues to emphasize studies of plant biology and diseases as well as areas such as clone/site interactions, mixed clonal plantations and breeding. The technological research and development concentrates on functional and effective machinery for planting, harvesting, etc. Recently Salix plantations for energy production in Sweden have been commercialized. Plantations start with 18,000 cuttings of willow clones per hectare. During the firstmore » summer weed control is the most important treatment. Fertilizers are applied to keep a high production level. Crops are harvested during winter at 3--5 year intervals. The average annual production is about 10--12 tonnes DM per hectare. The life of Salix plantations is estimated as 25--30 years. An estimated potential of 300,000 hectares of Salix plantations would result 5% of the energy needs in Sweden. Wood fuel from the conventional forest equals 60 TWh today, with a potential of being doubled within 10--20 years. The economic outcome for the farmer of growing Salix mainly depends on the price of chips and the level of production. A fundamental requirement for establishing plantations is that there is a wood fuel market within a reasonable distance (about 50 km). In a calculation stretching over a period of 24 years with a production level of 12 tonnes DM per hectare and year, and at an interest rate of 6%, the net return is about 1,000--1,500 SEK/ha/yr (about 7 SEK/US$) if simultaneous chipping is used. With separate harvest and chipping and enterprise in this calculation breaks even. Interest in the utilization of sludge, ash, waste water and leakage water as nutrients for energy forests is increasing from local and regional authorities.« less

High dynamic range vision sensor for automotive applications

NASA Astrophysics Data System (ADS)

Grenet, Eric; Gyger, Steve; Heim, Pascal; Heitger, Friedrich; Kaess, Francois; Nussbaum, Pascal; Ruedi, Pierre-Francois

2005-02-01

A 128 x 128 pixels, 120 dB vision sensor extracting at the pixel level the contrast magnitude and direction of local image features is used to implement a lane tracking system. The contrast representation (relative change of illumination) delivered by the sensor is independent of the illumination level. Together with the high dynamic range of the sensor, it ensures a very stable image feature representation even with high spatial and temporal inhomogeneities of the illumination. Dispatching off chip image feature is done according to the contrast magnitude, prioritizing features with high contrast magnitude. This allows to reduce drastically the amount of data transmitted out of the chip, hence the processing power required for subsequent processing stages. To compensate for the low fill factor (9%) of the sensor, micro-lenses have been deposited which increase the sensitivity by a factor of 5, corresponding to an equivalent of 2000 ASA. An algorithm exploiting the contrast representation output by the vision sensor has been developed to estimate the position of a vehicle relative to the road markings. The algorithm first detects the road markings based on the contrast direction map. Then, it performs quadratic fits on selected kernel of 3 by 3 pixels to achieve sub-pixel accuracy on the estimation of the lane marking positions. The resulting precision on the estimation of the vehicle lateral position is 1 cm. The algorithm performs efficiently under a wide variety of environmental conditions, including night and rainy conditions.

Do Arterial Hemodynamic Parameters Predict Cognitive Decline Over a Period of 2 Years in Individuals Older Than 80 Years Living in Nursing Homes? The PARTAGE Study.

PubMed

Watfa, Ghassan; Benetos, Athanase; Kearney-Schwartz, Anna; Labat, Carlos; Gautier, Sylvie; Hanon, Olivier; Salvi, Paolo; Joly, Laure

2015-07-01

Several studies have highlighted a link between vascular alterations and cognitive decline. The PARTAGE study showed that arterial stiffness as evaluated by carotid-femoral pulse wave velocity (cfPWV) was associated with a more pronounced cognitive decline over a 1-year period in very old frail institutionalized individuals. The aim of the present analysis was to assess the role of hemodynamic parameters, such as blood pressure (BP), heart rate (HR), cfPWV, and central/peripheral pulse pressure amplification (PPA) on cognitive decline over 2 years in very old frail individuals. A total of 682 individuals from the PARTAGE study cohort, aged older than 80 years (mean age at inclusion: 87.5 ± 5.0 years) and living in French and Italian nursing homes, were analyzed. Mini-Mental State Examination (MMSE) score was assessed at baseline (BL) and at the end of the first and second year of follow-up (2y-FU). Those with a decrease in MMSE of 3 or more points between BL and 2y-FU were considered as "decliners." The cfPWV and PPA at baseline were assessed with an arterial tonometer. After adjustment for baseline MMSE, HR, body mass index, age, education level, and activities of daily living (ADLs), cfPWV was higher and PPA lower in "decliners" compared with "nondecliners," whereas BP did not differ between the 2 groups. Logistic multivariate analysis also revealed that high cfPWV, low PPA, high HR, and low ADLs were all determinants of MMSE decline. This 2-year longitudinal study in very old institutionalized individuals shows that arterial stiffness and high HR enabled us to identify subjects at higher risk of cognitive decline, whereas BP alone did not appear to have a significant predictive value. These findings highlight the contribution of vascular determinants in cognitive decline even in this very old population. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

BAG2 Interferes with CHIP-Mediated Ubiquitination of HSP72.

PubMed

Schönbühler, Bianca; Schmitt, Verena; Huesmann, Heike; Kern, Andreas; Gamerdinger, Martin; Behl, Christian

2016-12-30

The maintenance of cellular proteostasis is dependent on molecular chaperones and protein degradation pathways. Chaperones facilitate protein folding, maturation, and degradation, and the particular fate of a misfolded protein is determined by the interaction of chaperones with co-chaperones. The co-factor CHIP (C-terminus of HSP70-inteacting protein, STUB1) ubiquitinates chaperone substrates and directs proteins to the cellular degradation systems. The activity of CHIP is regulated by two co-chaperones, BAG2 and HSPBP1, which are potent inhibitors of the E3 ubiquitin ligase activity. Here, we examined the functional correlation of HSP72, CHIP, and BAG2, employing human primary fibroblasts. We showed that HSP72 is a substrate of CHIP and that BAG2 efficiently prevented the ubiquitination of HSP72 in young cells as well as aged cells. Aging is associated with a decline in proteostasis and we observed increased protein levels of CHIP as well as BAG2 in senescent cells. Interestingly, the ubiquitination of HSP72 was strongly reduced during aging, which revealed that BAG2 functionally counteracted the increased levels of CHIP. Interestingly, HSPBP1 protein levels were down-regulated during aging. The data presented here demonstrates that the co-chaperone BAG2 influences HSP72 protein levels and is an important modulator of the ubiquitination activity of CHIP in young as well as aged cells.

Evaluation of the efficacy of animal-assisted therapy based on the reality orientation therapy protocol in Alzheimer's disease patients: a pilot study.

PubMed

Menna, Lucia Francesca; Santaniello, Antonio; Gerardi, Federica; Di Maggio, Annamaria; Milan, Graziella

2016-07-01

The aim of this study was to evaluate the efficacy of animal-assisted therapy (AAT) in elderly patients affected by Alzheimer's disease based on the formal reality orientation therapy (ROT) protocol. Our study was carried out at an Alzheimer's centre for 6 months. A homogeneous sample (age, Mini-Mental State Examination (MMSE), 15-item Geriatric Depression Scale (GDS)) of 50 patients was selected at random and successively. Patients were divided into three groups: (i) 20 patients received a course of AAT (AAT group) based on the ROT protocol; (ii) 20 patients were engaged exclusively in activities based on the ROT group; and (iii) 10 patients (control group) participated in no stimulations. MMSE and GDS were administered at time 0 (T0 ) and time 1 (T1 ) to all three groups. Differences within groups between T0 and T1 for GDS and MMSE scores were analyzed by Student's t-test. Differences between group means were analyzed using an anova test with the Bonferroni-Dunn test for post-hoc comparisons. Both the AAT group and ROT group had improved GDS scores and showed a slight improvement in terms of mood. On the GDS, the AAT group improved from 11.5 (T0 ) to 9.5 (T1 ), and the ROT group improved from 11.6 (T0 ) to 10.5 (T1 ). At the same time, a slight improvement in cognitive function, as measured by the MMSE, was observed. In the AAT group, mean MMSE was 20.2 at T0 and 21.5 at T1 , and in the ROT group, it was 19.9 at T0 and 20.0 at T1 . In the control group, the average values of both the GDS and MMSE remained unchanged. The Bonferroni-Dunn results showed statistically significant differences between groups, particularly between the AAT group and the other two (P < 0.001). Pet therapy interventions based on the formal ROT protocol were effective and, compared to the ROT, provided encouraging and statistically significant results. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Elevated serum homocysteine level is not associated with serum C-reactive protein in patients with probable Alzheimer's disease.

PubMed

Lepara, Orhan; Alajbegovic, Azra; Zaciragic, Asija; Nakas-Icindic, Emina; Valjevac, Amina; Lepara, Dzenana; Hadzovic-Dzuvo, Almira; Fajkic, Almir; Kulo, Aida; Sofic, Emin

2009-12-01

Elevated plasma homocysteine (Hcy) levels have been associated with Alzheimer's disease (AD) and cognitive impairment. Studies have shown that Hcy may have direct and indirect neurotoxicity effects. The aim of the study was to investigate serum Hcy concentration in patients with probable AD with age-matched controls and to determine whether there was an association between serum Hcy and C-reactive protein concentration in patients with probable AD. We also aimed to determine whether there was an association between serum tHcy concentration and cognitive impairment in patients with probable AD. Serum concentration of total Hcy was determined by the fluorescence polarization immunoassay on the AxSYM system, and serum C-reactive protein (CRP) concentration was determined by means of particle-enhanced immunonephelometry with the use of BN II analyzer. Cognitive impairment was tested by the MMSE score. Body mass index (BMI) was calculated for each subject included in the study. Age, systolic and diastolic blood pressure and BMI did not differ significantly between the two groups. Mean serum tHcy concentration in the control group of subjects was 12.60 mumol/L, while in patients with probable AD the mean serum tHcy concentration was significantly higher than 16.15 mumol/L (p < 0.01). A significant negative association between serum tHcy concentration and cognitive impairment tested by the MMSE score in patients with probable AD was determined (r = -0.61634; p < 0.001). Positive, although not significant correlation between CRP and serum tHcy concentrations in patients with AD, was observed. Increased tHcy concentration in patients with probable AD, and the established negative correlation between serum tHcy concentration and cognitive damage tested by MMSE score in the same group of patients, suggests the possible independent role of Hcy in the pathogenesis of AD and cognitive impairment associated with this disease.

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

PubMed

Matrisch, M; Trampisch, U; Klaassen-Mielke, R; Pientka, L; Trampisch, H J; Thiem, U

2012-04-01

To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed. Participants were recruited in the offices of nine primary care physicians. Data from 197 participants (115 females, mean age 78.5±4.1 years) who were tested by telephone and in the office by means of the Mini-Mental State Examination (MMSE) were used for the evaluation. For assessing reliability, a group of 91 participants (55 females, mean age 78.1±4.1 years) was contacted twice during 30 days to be tested during a telephone interview by means of the TICS in its modified German version. The intraclass correlation coefficient (ICC), a measure of reliability, was 0.67 [95% confidence interval (CI): 0.53; 0.77]. The Bland-Altman plot did not reveal any relationship between the variability of the difference between repeated measures and the total amount of the measure. For the overall TICS score, no differences were found between repeated measurements. However, the tasks recall of the word list and counting backwards showed some improvement in the repeated tests. TICS and MMSE showed only moderate correlation, with a correlation coefficient of 0.48 (95% CI: 0.36; 0.58). TICS values were dependent on age and educational level of the person tested. The TICS in its modified German version appears to be of acceptable reliability for the assessment of cognitive impairment during a telephone interview. TICS values depend on age and educational level of the person tested. TICS and MMSE correlate only moderately.

Herbicide and antibiotic removal by woodchip denitrification filters: Sorption processes

USDA-ARS?s Scientific Manuscript database

Batch sorption and desorption experiments to evaluate the retention of the agrichemicals onto wood chips from an in situ wood chip denitrification wall were conducted for atrazine, enrofloxacin, monensin and sulfamethazine. Estimated Freundlich distribution coefficients (Kf) showed that the order of...

Herbicide and antibiotic removal by woodchip denitrification filters: Sorption processes

USDA-ARS?s Scientific Manuscript database

Batch sorption and desorption experiments to evaluate the retention of the agrichemicals onto wood chips from an in situ wood chip denitrification wall were conducted for atrazine, enrofloxacin, monensin, and sulfamethazine. Estimated Freundlich distribution coefficients (Kf) showed that the order o...

Test beam demonstration of silicon microstrip modules with transverse momentum discrimination for the future CMS tracking detector

NASA Astrophysics Data System (ADS)

Adam, W.; Bergauer, T.; Brondolin, E.; Dragicevic, M.; Friedl, M.; Frühwirth, R.; Hoch, M.; Hrubec, J.; König, A.; Steininger, H.; Treberspurg, W.; Waltenberger, W.; Alderweireldt, S.; Beaumont, W.; Janssen, X.; Lauwers, J.; Van Mechelen, P.; Van Remortel, N.; Van Spilbeeck, A.; Beghin, D.; Brun, H.; Clerbaux, B.; De Lentdecker, G.; Delannoy, H.; Fasanella, G.; Favart, L.; Goldouzian, R.; Grebenyuk, A.; Karapostoli, G.; Lenzi, T.; Léonard, A.; Luetic, J.; Maerschalk, T.; Marinov, A.; Postiau, N.; Randle-Conde, A.; Seva, T.; Vanlaer, P.; Vannerom, D.; Yonamine, R.; Wang, Q.; Yang, Y.; Zenoni, F.; Zhang, F.; Abu Zeid, S.; Blekman, F.; De Bruyn, I.; De Clercq, J.; D'Hondt, J.; Deroover, K.; Lowette, S.; Moortgat, S.; Moreels, L.; Python, Q.; Skovpen, K.; Van Mulders, P.; Van Parijs, I.; Bakhshiansohi, H.; Bondu, O.; Brochet, S.; Bruno, G.; Caudron, A.; Delaere, C.; Delcourt, M.; De Visscher, S.; Francois, B.; Giammanco, A.; Jafari, A.; Cabrera Jamoulle, J.; De Favereau De Jeneret, J.; Komm, M.; Krintiras, G.; Lemaitre, V.; Magitteri, A.; Mertens, A.; Michotte, D.; Musich, M.; Piotrzkowski, K.; Quertenmont, L.; Szilasi, N.; Vidal Marono, M.; Wertz, S.; Beliy, N.; Caebergs, T.; Daubie, E.; Hammad, G. H.; Härkönen, J.; Lampén, T.; Luukka, P.; Peltola, T.; Tuominen, E.; Tuovinen, E.; Eerola, P.; Baulieu, G.; Boudoul, G.; Caponetto, L.; Combaret, C.; Contardo, D.; Dupasquier, T.; Gallbit, G.; Lumb, N.; Mirabito, L.; Perries, S.; Vander Donckt, M.; Viret, S.; Agram, J.-L.; Andrea, J.; Bloch, D.; Bonnin, C.; Brom, J.-M.; Chabert, E.; Chanon, N.; Charles, L.; Conte, E.; Fontaine, J.-Ch.; Gross, L.; Hosselet, J.; Jansova, M.; Tromson, D.; Autermann, C.; Feld, L.; Karpinski, W.; Kiesel, K. M.; Klein, K.; Lipinski, M.; Ostapchuk, A.; Pierschel, G.; Preuten, M.; Rauch, M.; Schael, S.; Schomakers, C.; Schulz, J.; Schwering, G.; Wlochal, M.; Zhukov, V.; Pistone, C.; Fluegge, G.; Kuensken, A.; Pooth, O.; Stahl, A.; Aldaya, M.; Asawatangtrakuldee, C.; Beernaert, K.; Bertsche, D.; Contreras-Campana, C.; Eckerlin, G.; Eckstein, D.; Eichhorn, T.; Gallo, E.; Garay Garcia, J.; Hansen, K.; Haranko, M.; Harb, A.; Hauk, J.; Keaveney, J.; Kalogeropoulos, A.; Kleinwort, C.; Lohmann, W.; Mankel, R.; Maser, H.; Mittag, G.; Muhl, C.; Mussgiller, A.; Pitzl, D.; Reichelt, O.; Savitskyi, M.; Schuetze, P.; Walsh, R.; Zuber, A.; Biskop, H.; Buhmann, P.; Centis-Vignali, M.; Garutti, E.; Haller, J.; Hoffmann, M.; Klanner, R.; Matysek, M.; Perieanu, A.; Scharf, Ch.; Schleper, P.; Schmidt, A.; Schwandt, J.; Sonneveld, J.; Steinbrück, G.; Vormwald, B.; Wellhausen, J.; Abbas, M.; Amstutz, C.; Barvich, T.; Barth, Ch.; Boegelspacher, F.; De Boer, W.; Butz, E.; Casele, M.; Colombo, F.; Dierlamm, A.; Freund, B.; Hartmann, F.; Heindl, S.; Husemann, U.; Kornmeyer, A.; Kudella, S.; Muller, Th.; Printz, M.; Simonis, H. J.; Steck, P.; Weber, M.; Weiler, Th.; Anagnostou, G.; Asenov, P.; Assiouras, P.; Daskalakis, G.; Kyriakis, A.; Loukas, D.; Paspalaki, L.; Siklér, F.; Veszprémi, V.; Bhardwaj, A.; Dalal, R.; Jain, G.; Ranjan, K.; Dutta, S.; Chowdhury, S. Roy; Bakhshiansohl, H.; Behnamian, H.; Khakzad, M.; Naseri, M.; Cariola, P.; Creanza, D.; De Palma, M.; De Robertis, G.; Fiore, L.; Franco, M.; Loddo, F.; Sala, G.; Silvestris, L.; Maggi, G.; My, S.; Selvaggi, G.; Albergo, S.; Costa, S.; Di Mattia, A.; Giordano, F.; Potenza, R.; Saizu, M. A.; Tricomi, A.; Tuve, C.; Barbagli, G.; Brianzi, M.; Ciaranfi, R.; Ciulli, V.; Civinini, C.; D'Alessandro, R.; Focardi, E.; Latino, G.; Lenzi, P.; Meschini, M.; Paoletti, S.; Russo, L.; Scarlini, E.; Sguazzoni, G.; Strom, D.; Viliani, L.; Ferro, F.; Lo Vetere, M.; Robutti, E.; Dinardo, M. E.; Fiorendi, S.; Gennai, S.; Malvezzi, S.; Manzoni, R. A.; Menasce, D.; Moroni, L.; Pedrini, D.; Azzi, P.; Bacchetta, N.; Bisello, D.; Dall'Osso, M.; Pozzobon, N.; Tosi, M.; De Canio, F.; Gaioni, L.; Manghisoni, M.; Nodari, B.; Riceputi, E.; Re, V.; Traversi, G.; Comotti, D.; Ratti, L.; Alunni Solestizi, L.; Biasini, M.; Bilei, G. M.; Cecchi, C.; Checcucci, B.; Ciangottini, D.; Fanò, L.; Gentsos, C.; Ionica, M.; Leonardi, R.; Manoni, E.; Mantovani, G.; Marconi, S.; Mariani, V.; Menichelli, M.; Modak, A.; Morozzi, A.; Moscatelli, F.; Passeri, D.; Placidi, P.; Postolache, V.; Rossi, A.; Saha, A.; Santocchia, A.; Storchi, L.; Spiga, D.; Androsov, K.; Azzurri, P.; Arezzini, S.; Bagliesi, G.; Basti, A.; Boccali, T.; Borrello, L.; Bosi, F.; Castaldi, R.; Ciampa, A.; Ciocci, M. A.; Dell'Orso, R.; Donato, S.; Fedi, G.; Giassi, A.; Grippo, M. T.; Ligabue, F.; Lomtadze, T.; Magazzu, G.; Martini, L.; Mazzoni, E.; Messineo, A.; Moggi, A.; Morsani, F.; Palla, F.; Palmonari, F.; Raffaelli, F.; Rizzi, A.; Savoy-Navarro, A.; Spagnolo, P.; Tenchini, R.; Tonelli, G.; Venturi, A.; Verdini, P. G.; Bellan, R.; Costa, M.; Covarelli, R.; Da Rocha Rolo, M.; Demaria, N.; Rivetti, A.; Dellacasa, G.; Mazza, G.; Migliore, E.; Monteil, E.; Pacher, L.; Ravera, F.; Solano, A.; Fernandez, M.; Gomez, G.; Jaramillo Echeverria, R.; Moya, D.; Gonzalez Sanchez, F. J.; Vila, I.; Virto, A. L.; Abbaneo, D.; Ahmed, I.; Albert, E.; Auzinger, G.; Berruti, G.; Bianchi, G.; Blanchot, G.; Bonnaud, J.; Caratelli, A.; Ceresa, D.; Christiansen, J.; Cichy, K.; Daguin, J.; D'Auria, A.; Detraz, S.; Deyrail, D.; Dondelewski, O.; Faccio, F.; Frank, N.; Gadek, T.; Gill, K.; Honma, A.; Hugo, G.; Jara Casas, L. M.; Kaplon, J.; Kornmayer, A.; Kottelat, L.; Kovacs, M.; Krammer, M.; Lenoir, P.; Mannelli, M.; Marchioro, A.; Marconi, S.; Mersi, S.; Martina, S.; Michelis, S.; Moll, M.; Onnela, A.; Orfanelli, S.; Pavis, S.; Peisert, A.; Pernot, J.-F.; Petagna, P.; Petrucciani, G.; Postema, H.; Rose, P.; Tropea, P.; Troska, J.; Tsirou, A.; Vasey, F.; Vichoudis, P.; Verlaat, B.; Zwalinski, L.; Bachmair, F.; Becker, R.; di Calafiori, D.; Casal, B.; Berger, P.; Djambazov, L.; Donega, M.; Grab, C.; Hits, D.; Hoss, J.; Kasieczka, G.; Lustermann, W.; Mangano, B.; Marionneau, M.; Martinez Ruiz del Arbol, P.; Masciovecchio, M.; Meinhard, M.; Perozzi, L.; Roeser, U.; Starodumov, A.; Tavolaro, V.; Wallny, R.; Zhu, D.; Amsler, C.; Bösiger, K.; Caminada, L.; Canelli, F.; Chiochia, V.; de Cosa, A.; Galloni, C.; Hreus, T.; Kilminster, B.; Lange, C.; Maier, R.; Ngadiuba, J.; Pinna, D.; Robmann, P.; Taroni, S.; Yang, Y.; Bertl, W.; Deiters, K.; Erdmann, W.; Horisberger, R.; Kaestli, H.-C.; Kotlinski, D.; Langenegger, U.; Meier, B.; Rohe, T.; Streuli, S.; Chen, P.-H.; Dietz, C.; Grundler, U.; Hou, W.-S.; Lu, R.-S.; Moya, M.; Cussans, D.; Flacher, H.; Goldstein, J.; Grimes, M.; Jacob, J.; Seif El Nasr-Storey, S.; Cole, J.; Hoad, C.; Hobson, P.; Morton, A.; Reid, I. D.; Auzinger, G.; Bainbridge, R.; Dauncey, P.; Fulcher, J.; Hall, G.; James, T.; Magnan, A.-M.; Pesaresi, M.; Raymond, D. M.; Uchida, K.; Braga, D.; Coughlan, J. A.; Harder, K.; Jones, L.; Ilic, J.; Murray, P.; Prydderch, M.; Tomalin, I. R.; Garabedian, A.; Heintz, U.; Narain, M.; Nelson, J.; Sagir, S.; Speer, T.; Swanson, J.; Tersegno, D.; Watson-Daniels, J.; Chertok, M.; Conway, J.; Conway, R.; Flores, C.; Lander, R.; Pellett, D.; Ricci-Tam, F.; Squires, M.; Thomson, J.; Yohay, R.; Burt, K.; Ellison, J.; Hanson, G.; Olmedo, M.; Si, W.; Yates, B. R.; Gerosa, R.; Sharma, V.; Vartak, A.; Yagil, A.; Zevi Della Porta, G.; Dutta, V.; Gouskos, L.; Incandela, J.; Kyre, S.; Mullin, S.; Qu, H.; White, D.; Dominguez, A.; Bartek, R.; Cumalat, J. P.; Ford, W. T.; Jensen, F.; Johnson, A.; Krohn, M.; Leontsinis, S.; Mulholland, T.; Stenson, K.; Wagner, S. R.; Apresyan, A.; Bolla, G.; Burkett, K.; Butler, J. N.; Cheung, H. W. K.; Chramowicz, J.; Christian, D.; Cooper, W. E.; Deptuch, G.; Derylo, G.; Gingu, C.; Grünendahl, S.; Hasegawa, S.; Hoff, J.; Howell, J.; Hrycyk, M.; Jindariani, S.; Johnson, M.; Kahlid, F.; Lei, C. M.; Lipton, R.; Lopes De Sá, R.; Liu, T.; Los, S.; Matulik, M.; Merkel, P.; Nahn, S.; Prosser, A.; Rivera, R.; Schneider, B.; Sellberg, G.; Shenai, A.; Spiegel, L.; Tran, N.; Uplegger, L.; Voirin, E.; Berry, D. R.; Chen, X.; Ennesser, L.; Evdokimov, A.; Evdokimov, O.; Gerber, C. E.; Hofman, D. J.; Makauda, S.; Mills, C.; Sandoval Gonzalez, I. D.; Alimena, J.; Antonelli, L. J.; Francis, B.; Hart, A.; Hill, C. S.; Parashar, N.; Stupak, J.; Bortoletto, D.; Bubna, M.; Hinton, N.; Jones, M.; Miller, D. H.; Shi, X.; Tan, P.; Baringer, P.; Bean, A.; Khalil, S.; Kropivnitskaya, A.; Majumder, D.; Wilson, G.; Ivanov, A.; Mendis, R.; Mitchell, T.; Skhirtladze, N.; Taylor, R.; Anderson, I.; Fehling, D.; Gritsan, A.; Maksimovic, P.; Martin, C.; Nash, K.; Osherson, M.; Swartz, M.; Xiao, M.; Acosta, J. G.; Cremaldi, L. M.; Oliveros, S.; Perera, L.; Summers, D.; Bloom, K.; Claes, D. R.; Fangmeier, C.; Gonzalez Suarez, R.; Monroy, J.; Siado, J.; Hahn, K.; Sevova, S.; Sung, K.; Trovato, M.; Bartz, E.; Gershtein, Y.; Halkiadakis, E.; Kyriacou, S.; Lath, A.; Nash, K.; Osherson, M.; Schnetzer, S.; Stone, R.; Walker, M.; Malik, S.; Norberg, S.; Ramirez Vargas, J. E.; Alyari, M.; Dolen, J.; Godshalk, A.; Harrington, C.; Iashvili, I.; Kharchilava, A.; Nguyen, D.; Parker, A.; Rappoccio, S.; Roozbahani, B.; Alexander, J.; Chaves, J.; Chu, J.; Dittmer, S.; McDermott, K.; Mirman, N.; Rinkevicius, A.; Ryd, A.; Salvati, E.; Skinnari, L.; Soffi, L.; Tao, Z.; Thom, J.; Tucker, J.; Zientek, M.; Akgün, B.; Ecklund, K. M.; Kilpatrick, M.; Nussbaum, T.; Zabel, J.; Betchart, B.; Covarelli, R.; Demina, R.; Hindrichs, O.; Petrillo, G.; Eusebi, R.; Patel, R.; Perloff, A.; Ulmer, K. A.; Delannoy, A. G.; D'Angelo, P.; Johns, W.

2018-03-01

A new CMS Tracker is under development for operation at the High Luminosity LHC from 2026 onwards. It includes an outer tracker based on dedicated modules that will reconstruct short track segments, called stubs, using spatially coincident clusters in two closely spaced silicon sensor layers. These modules allow the rejection of low transverse momentum track hits and reduce the data volume before transmission to the first level trigger. The inclusion of tracking information in the trigger decision is essential to limit the first level trigger accept rate. A customized front-end readout chip, the CMS Binary Chip (CBC), containing stub finding logic has been designed for this purpose. A prototype module, equipped with the CBC chip, has been constructed and operated for the first time in a 4 GeemVem/emc positron beam at DESY. The behaviour of the stub finding was studied for different angles of beam incidence on a module, which allows an estimate of the sensitivity to transverse momentum within the future CMS detector. A sharp transverse momentum threshold around 2 emVem/emc was demonstrated, which meets the requirement to reject a large fraction of low momentum tracks present in the LHC environment on-detector. This is the first realistic demonstration of a silicon tracking module that is able to select data, based on the particle's transverse momentum, for use in a first level trigger at the LHC . The results from this test are described here.

Reconstruction of elasticity: a stochastic model-based approach in ultrasound elastography

PubMed Central

2013-01-01

Background The convectional strain-based algorithm has been widely utilized in clinical practice. It can only provide the information of relative information of tissue stiffness. However, the exact information of tissue stiffness should be valuable for clinical diagnosis and treatment. Methods In this study we propose a reconstruction strategy to recover the mechanical properties of the tissue. After the discrepancies between the biomechanical model and data are modeled as the process noise, and the biomechanical model constraint is transformed into a state space representation the reconstruction of elasticity can be accomplished through one filtering identification process, which is to recursively estimate the material properties and kinematic functions from ultrasound data according to the minimum mean square error (MMSE) criteria. In the implementation of this model-based algorithm, the linear isotropic elasticity is adopted as the biomechanical constraint. The estimation of kinematic functions (i.e., the full displacement and velocity field), and the distribution of Young’s modulus are computed simultaneously through an extended Kalman filter (EKF). Results In the following experiments the accuracy and robustness of this filtering framework is first evaluated on synthetic data in controlled conditions, and the performance of this framework is then evaluated in the real data collected from elastography phantom and patients using the ultrasound system. Quantitative analysis verifies that strain fields estimated by our filtering strategy are more closer to the ground truth. The distribution of Young’s modulus is also well estimated. Further, the effects of measurement noise and process noise have been investigated as well. Conclusions The advantage of this model-based algorithm over the conventional strain-based algorithm is its potential of providing the distribution of elasticity under a proper biomechanical model constraint. We address the model-data discrepancy and measurement noise by introducing process noise and measurement noise in our framework, and then the absolute values of Young’s modulus are estimated through the EFK in the MMSE sense. However, the initial conditions, and the mesh strategy will affect the performance, i.e., the convergence rate, and computational cost, etc. PMID:23937814

Reconstruction of elasticity: a stochastic model-based approach in ultrasound elastography.

PubMed

Lu, Minhua; Zhang, Heye; Wang, Jun; Yuan, Jinwei; Hu, Zhenghui; Liu, Huafeng

2013-08-10

The convectional strain-based algorithm has been widely utilized in clinical practice. It can only provide the information of relative information of tissue stiffness. However, the exact information of tissue stiffness should be valuable for clinical diagnosis and treatment. In this study we propose a reconstruction strategy to recover the mechanical properties of the tissue. After the discrepancies between the biomechanical model and data are modeled as the process noise, and the biomechanical model constraint is transformed into a state space representation the reconstruction of elasticity can be accomplished through one filtering identification process, which is to recursively estimate the material properties and kinematic functions from ultrasound data according to the minimum mean square error (MMSE) criteria. In the implementation of this model-based algorithm, the linear isotropic elasticity is adopted as the biomechanical constraint. The estimation of kinematic functions (i.e., the full displacement and velocity field), and the distribution of Young's modulus are computed simultaneously through an extended Kalman filter (EKF). In the following experiments the accuracy and robustness of this filtering framework is first evaluated on synthetic data in controlled conditions, and the performance of this framework is then evaluated in the real data collected from elastography phantom and patients using the ultrasound system. Quantitative analysis verifies that strain fields estimated by our filtering strategy are more closer to the ground truth. The distribution of Young's modulus is also well estimated. Further, the effects of measurement noise and process noise have been investigated as well. The advantage of this model-based algorithm over the conventional strain-based algorithm is its potential of providing the distribution of elasticity under a proper biomechanical model constraint. We address the model-data discrepancy and measurement noise by introducing process noise and measurement noise in our framework, and then the absolute values of Young's modulus are estimated through the EFK in the MMSE sense. However, the initial conditions, and the mesh strategy will affect the performance, i.e., the convergence rate, and computational cost, etc.

Enrichment of wheat chips with omega-3 fatty acid by flaxseed addition: textural and some physicochemical properties.

PubMed

Yuksel, Ferhat; Karaman, Safa; Kayacier, Ahmed

2014-02-15

In the present study, wheat chips enriched with flaxseed flour were produced and response surface methodology was used for the studying the simultaneous effects of flaxseed level (10-20%), frying temperature (160-180 °C) and frying time (40-60 s) on some physicochemical, textural and sensorial properties and fatty acid composition of wheat chips. Ridge analysis was conducted to determine the optimum levels of processing variables. Predictive regression equations with adequate coefficients of determination (R² ≥ 0.705) to explain the effect of processing variables were constructed. Addition of flaxseed flour increased the dry matter and protein content of samples and increase of frying temperature decreased the hardness values of wheat chips samples. Increment in flaxseed level provided an increase in unsaturated fatty acid content namely omega-3 fatty acids of wheat chips samples. Overall acceptability of chips increased with the increase of frying temperature. Ridge analysis showed that maximum taste score would be at flaxseed level = 10%, frying temperature = 180 °C and frying time = 50 s. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of dual task and frailty on gait parameters of older community-dwelling individuals

PubMed Central

Guedes, Rita C.; Dias, Rosângela C.; Pereira, Leani S. M.; Silva, Sílvia L. A.; Lustosa, Lygia P.; Dias, João M. D.

2014-01-01

Background: Gait parameters such as gait speed (GS) are important indicators of functional capacity. Frailty Syndrome is closely related to GS and is also capable of predicting adverse outcomes. The cognitive demand of gait control is usually explored with dual-task (DT) methodology. Objective: To investigate the effect of DT and frailty on the spatio-temporal parameters of gait in older people and identify which variables relate to GS. Method: The presence of frailty was verified by Fried's Frailty Criteria. Cognitive function was evaluated with the Mini-Mental State Exam (MMSE) and gait parameters were analyzed through the GAITRite(r) system in the single-task and DT conditions. The Kolmogorov-Smirnov, ANOVA, and Pearson's Correlation tests were administered. Results: The participants were assigned to the groups frail (FG), pre-frail (PFG), and non-frail (NFG). During the DT, the three groups showed a decrease in GS, cadence, and stride length and an increase in stride time (p<0.001). The reduction in the GS of the FG during the DT showed a positive correlation with the MMSE scores (r=730; p=0.001) and with grip strength (r=681; p=0.001). Conclusions: Gait parameters are more affected by the DT, especially in the frail older subjects. The reduction in GS in the FG is associated with lower grip strength and lower scores in the MMSE. The GS was able to discriminate the older adults in the three levels of frailty, being an important measure of the functional capacity in this population. PMID:25372007

Plasma Klotho and Cognitive Decline in Older Adults: Findings From the InCHIANTI Study

PubMed Central

Semba, Richard D.; Rosano, Caterina; Kalyani, Rita R.; Bandinelli, Stefania; Chia, Chee W.; Ferrucci, Luigi

2016-01-01

Background. The hormone klotho, encoded by the gene klotho, is primarily expressed in the kidney and choroid plexus of the brain. Higher klotho concentrations and certain genetic variants of klotho have been linked to better cognition; however, it is unknown whether klotho relates prospectively to slower cognitive decline in older adults. Methods: Plasma klotho was measured in 833 participants aged 55 or older without dementia enrolled in InCHIANTI, a prospective cohort study comprising Italian adults. Cognition was measured by Mini-Mental State Examination (MMSE) and Trail-Making Tests A and B (Trails A and Trails B) at enrollment and at 3 and 6 years after enrollment. We assessed whether klotho concentrations measured at the 3-year visit related to cognition and cognitive decline. Results: Each additional natural logarithm of klotho (pg/mL) was associated with 35% lower risk of meaningful decline in MMSE, defined as decline exceeding three points (relative risk = 0.65; 95% confidence interval 0.45, 0.95; p value = .02), and 0.75-point smaller average 3-year decline (baseline to 3-year visit) in MMSE (95% confidence interval 0.02, 1.48; p value = .04). No statistically significant associations were found between klotho and declining Trails A (relative risk = 0.99; 95% confidence interval 0.75, 1.32; p value = .97) and B (relative risk = 1.02; 95% confidence interval 0.84, 1.24; p value = .82). Conclusions: Higher plasma klotho concentrations were associated with lower risk of meaningful decline and smaller average decline in MMSE. We did not observe such findings with Trails A and B, perhaps because they test executive function and motor skills, whereas MMSE measures global cognition. Future studies should investigate mechanisms through which klotho may affect domain-specific cognitive changes. PMID:26297657

Screening cognitive impairment among institutionalized older Chinese men in Taiwan: a new minimum data set-based dementia screening tool is needed.

PubMed

Lin, Chu-Sheng; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Kung; Hwang, Shinn-Jang; Lan, Chung-Fu

2011-01-01

Dementia screening is of great importance in various health settings for older people, long-term care facilities are no exception. The need for an effective dementia screening tool being culture sensitive is important. Minimum data set (MDS) is a population instrument for health care management in the world, which also covers dementia screening. The main purpose of this study was to evaluate the effectiveness of the MDS-based dementia screening tools among older Chinese men in the Veteran Home in Taiwan. Overall, 576 participants (mean age: 80.9±5.3 years, all males, 92.7% physically independent), 18.6% had cognitive impairment according to the mini-mental state examination (MMSE) (mean score: 26.7±3.9). However, the prevalence of cognitive impairment was 5.5% by MDS cognitive performance scale (CPS) and 18.9% by MDS cognition scale (MDS-COGS). The screening results of CPS and MDS-COGS were highly interrelated (γ=0.93, p<0.001), and MMSE scores were also significantly associated with CPS and MDS-COGS status (γ=-0.50, p<0.001 and γ=-0.52, p<0.001, respectively). Although the prevalence of cognitive impairment by MMSE and MDS-COGS are similar, the results are significantly inconsistent (p<0.001). In conclusion, both MDS-COGS and CPS were significantly correlated with MMSE scores, but significant inconsistence was noted between screening results of MMSE, CPS and MDS-COGS. Further study is needed to develop MDS-based dementia screening tools for older Chinese men in Taiwan. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Drug Burden Index and change in cognition over time in community-dwelling older men: the CHAMP study.

PubMed

Jamsen, Kris M; Gnjidic, Danijela; Hilmer, Sarah N; Ilomäki, Jenni; Le Couteur, David G; Blyth, Fiona M; Handelsman, David J; Naganathan, Vasi; Waite, Louise M; Cumming, Robert G; Bell, J Simon

2017-03-01

Anticholinergic and sedative medications are associated with acute cognitive impairment, but the long-term impact on change in cognition is unclear. This study investigated the effect of anticholinergic and sedative medications, quantified using the Drug Burden Index (DBI), on change in cognition over time in community-dwelling older men. This was a prospective cohort study of men aged ≥70 years in Sydney, Australia. DBI was assessed at baseline, 2, and 5 years. Cognitive performance was assessed using the Mini-Mental State Exam (MMSE) at each wave. Logistic quantile mixed-effects modelling was used to assess the adjusted effect of DBI on the median MMSE-time profile. Analyses were restricted to men with English-speaking backgrounds (n = 1059, 862, and 611 at baseline, 2, and 5 years). Overall, 292 (27.7%), 258 (29.9%), and 189 (31.3%) men used anticholinergic or sedative medications at baseline, 2, and 5 years. There was a concave relationship between MMSE and time, where higher DBI corresponded to lower MMSE scores (coefficient: -0.161; 95% CI: -0.250 to -0.071) but not acceleration of declining MMSE over time. Exposure to anticholinergic and sedative medications is associated with a small impairment in cognitive performance but not decline in cognition over time. KEY MESSAGES Exposure to anticholinergic and sedative medications, quantified using the Drug Burden Index, is associated with small cross-sectional impairments in cognitive performance. There was no evidence that exposure to anticholinergic and sedative medications is associated with accelerating decline in cognitive performance over a 5-year follow-up. Older people taking anticholinergic and sedative medications may derive immediate but small benefits in cognitive performance from clinical medication reviews to minimize or cease prescribing of these medications.

The relationship of bilingualism to cognitive decline: The Australian Longitudinal Study of Ageing.

PubMed

Mukadam, Naaheed; Jichi, Fatima; Green, David; Livingston, Gill

2018-02-01

We wished to clarify the link between bilingualism and cognitive decline, and examine whether improved executive function due to bilingualism may be a factor in preventing cognitive decline. We used the Australian Longitudinal Study of Ageing which collected data on 2087 participants aged over 65 over 20 years. We compared baseline demographics, health, and social characteristics between bilingual and non-bilingual participants. We used linear mixed models analysis to explore the effect of bilingualism on MMSE score over time and linear regression to explore the effect of bilingualism on baseline MMSE scores, controlling for pre-specified potential confounders. Bilingual participants had lower baseline MMSE scores than the non-bilingual population (mean difference = -2.3 points; 95% confidence intervals = 1.56-2.90). This was fully explained by education and National Adult Reading Test scores (17.4; standard deviation [SD] =7.7 versus 28.1; SD = 8.2) which also partly explained baseline executive function test scores differences. Bilingual and non-bilingual participants did not differ in MMSE decline over time (-0.33 points, P = 0.31) nor on baseline tests of executive function (-0.26, P = 0.051). In this cohort, education rather than bilingualism was a predictor of MMSE score, and being bilingual did not protect from cognitive decline. We conclude that bilingualism is complex, and when it is not the result of greater educational attainment, it does not always protect from cognitive decline. Neuroprotective effects of bilingualism over time may be attributable to the precise patterns of language use but not to bilingualism per se. Copyright © 2017 John Wiley & Sons, Ltd.

Validation of the Chinese version of the NUCOG cognitive screening tool in patients with epilepsy, dementia and other neurological disorders.

PubMed

Gao, Lan; Li, Shu-Chuen; Xia, Li; Pan, Songqing; Velakoulis, Dennis; Walterfang, Mark

2014-06-01

We aimed to develop and validate a Chinese version of the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) for use in Chinese-speaking subjects internationally. Patients and healthy controls were recruited from two hospitals between July and October 2012. Receiver operating characteristic (ROC) curves were utilized to test criterion validity. Convergent validity was assessed via correlations between NUCOG and the Mini-Mental State Examination (MMSE). Reliability was measured by internal consistency (Cronbach's α). Patients with epilepsy (n=144), neurological diseases (n=81), dementia (n=44), and controls (n=260) completed the NUCOG and the MMSE. Overall, both NUCOG and MMSE scores differed significantly across the four groups with the highest scores in the control group and the lowest in the dementia group (p<0.0001). The NUCOG scores could differentiate between patients with certain seizure types, stroke and transient ischemic attack. Compared to the MMSE, the NUCOG exhibited a higher area under the ROC curve. The convergent validity was substantially correlated, and internal consistency was very high (0.922). The Chinese version of NUCOG was demonstrated to be a sensitive and reliable screening tool for cognitive impairment in a Chinese-speaking population not only in China, but also in countries where there is a sizeable population of ethnic Chinese. Additionally, our study also showed the NUCOG could better differentiate cognitive function in patients with certain seizure types, stroke and transient ischemic attack than the MMSE. This potentially expands the clinical usefulness of NUCOG, enabling clinicians to measure the cognitive profile of patients with epilepsy and ischemic cerebrovascular diseases. Copyright © 2013 Elsevier Ltd. All rights reserved.

Interaction Effects between HIV and Aging on Selective Neurocognitive Impairment.

PubMed

Ding, Yingying; Lin, Haijiang; Shen, Weiwei; Wu, Qionghai; Gao, Meiyang; He, Na

2017-12-01

HIV infection and aging are each associated with neurocognitive impairment (NCI). This study examined the combined effects of HIV infection and aging on NCI. We performed a cross-sectional survey among 345 HIV-infected and 345 HIV-uninfected participants aged at least 40 years. The International HIV Dementia Scale (IHDS) and Chinese version of Mini-mental State Examination (MMSE) were administered to screen for NCI. HIV-infected individuals had higher prevalence of NCI than uninfected individuals (46.7% vs 15.1% for IHDS using cut-off of ≤ 10; 17.1% vs 2.6% for MMSE). Significant main effects of HIV and age were observed on IHDS and MMSE composite scores and all domains except for HIV on attention and calculation. Significant interaction effects between HIV and age were observed on motor speed, orientation, registration and recall, and mainly attributed to the inferior performance of HIV-infected patients aged over 60 years. Among HIV-infected individuals, in multivariable logistic models, older age, depressive symptoms and history of nevirapine treatment were associated with NCI using both IHDS and MMSE, whereas lower education current smoker and current CD4 ≥ 800 cells/μL were associated only with NCI using IHDS, and hypertension was associated only with NCI using MMSE. Findings suggest that HIV and older age may confer interactive effects on cognitive function in several domains with older HIV-infected adults experiencing greater NCI, which requires further longitudinal investigation. Furthermore, HIV early diagnosis and treatment may prevent or reverse NCI, but extra attention should be given to adverse effects including metabolic changes associated with long-term treatment.

Mild cognitive impairment is associated with poor physical function but not bone structure or density in late adulthood: findings from the Hertfordshire cohort study.

PubMed

Patel, A; Jameson, K A; Edwards, M H; Ward, K; Gale, C R; Cooper, C; Dennison, Elaine M

2018-04-24

This study investigated the association between mild cognitive impairment (MCI) and physical function and bone health in older adults. MCI was associated with poor physical performance but not bone mineral density or bone microarchitecture. Cross-sectional study to investigate the association between mild cognitive impairment (MCI) and physical performance, and bone health, in a community-dwelling cohort of older adults. Cognitive function of 222 men and 221 women (mean age 75.5 and 75.8 years in men and women, respectively) was assessed by the Strawbridge questionnaire and Mini Mental State Exam (MMSE). Participants underwent dual-energy X-ray absorptiometry (DXA), peripheral-quantitative computed tomography (pQCT) and high-resolution peripheral-quantitative computed tomography (HR-pQCT) scans to assess their bone density, strength and microarchitecture. Their physical function was assessed and a physical performance (PP) score was recorded. In the study, 11.8% of women and 8.1% of men were cognitively impaired on the MMSE (score < 24). On the Strawbridge questionnaire, 24% of women were deemed cognitively impaired compared to 22.3% of men. Cognitive impairment on the Strawbridge questionnaire was associated with poorer physical performance score in men but not in women in the unadjusted analysis. MMSE < 24 was strongly associated with the risk of low physical performance in men (OR 12.9, 95% CI 1.67, 99.8, p = 0.01). Higher MMSE score was associated with better physical performance in both sexes. Poorer cognitive function, whether assessed by the Strawbridge questionnaire, or by MMSE score, was not associated with bone density, shape or microarchitecture, in either sex. MCI in older adults was associated with poor physical performance, but not bone density, shape or microarchitecture.

Cognitive impairment associated with locomotive syndrome in community-dwelling elderly women in Japan.

PubMed

Nakamura, Misa; Tazaki, Fumie; Nomura, Kazuki; Takano, Taeko; Hashimoto, Masashi; Hashizume, Hiroshi; Kamei, Ichiro

2017-01-01

In our worldwide aging society, elderly people should maintain cognitive and physical function to help avoid health problems. Dementia is a major brain disease among elderly people, and is caused by cognitive impairment. The locomotive syndrome (LS) refers to a condition in which people require healthcare services because of problems associated with locomotion. The purpose of this study was to determine the association between cognitive impairment and LS. Study participants were 142 healthy elderly female volunteers living in a rural area in Japan. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). A score of ≤26 points on the MMSE was used to indicate categorically defined poor cognitive performance (cognitive impairment). The LS was defined by a score ≥16 points, and non-LS as <16 points, on the 25-question Geriatric Locomotive Function Scale (GLFS-25). Twenty-one participants (14.8%) had an MMSE score ≤26, and 19.0% were found to have LS. Compared with the MMSE >26 group, the ≤26 group was significantly older, had a higher percentage of body fat, and a higher GLFS-25 score. Those with LS were significantly older, had a higher body mass index, a higher percentage of body fat, and a lower MMSE score. Participants in the LS group had higher odds of cognitive impairment than those without LS [odds ratio (OR) =3.08] by logistic regression analysis adjusted for age. Furthermore, participants with GLFS-25 scores ≥6 had higher odds of cognitive impairment than those with a GLFS-25 score <6 by logistic regression analysis adjusted for both age (OR =4.44), and age and percent body fat (OR =4.12). These findings suggest that a strong relationship exists between the early stage of decreased motor function and cognitive impairment.

Cognitive abilities screening instrument-short form, mini-mental state examination and functional activities questionnaire in the illiterate elderly

PubMed Central

Rezende, Gabriela Pravatta; Cecato, Juliana; Martinelli, José Eduardo

2013-01-01

Dementia prevalence is increasing in developing countries due to population aging. Brief tests for assessing cognition and activities of daily living are very useful for the diagnosis of dementia by the clinician. Low education, particularly illiteracy, is a hindrance to the diagnosis of dementia in several regions of the world. OBJECTIVES To compare the Brazilian version of the Cognitive Abilities Screening Instrument-Short Form (CASI-S) with the Mini-Mental State Examination (MMSE) and Pfeffer Functional Activities Questionnaire (PFAQ) for the diagnosis of dementia in illiterate elderly. METHODS A cross-sectional study with illiterate elderly of both genders seen at the outpatient clinics of the Institute of Gerontology and Geriatrics Jundiaí, São Paulo state was performed. Spearman's correlation coefficient was used to correlate CASI-S, MMSE and PFAQ scores. RESULTS The sample comprised 29 elderly over 57 years old whose mean scores on the CASI-S (scores ranging from 3 to 23) and the MMSE (scores ranging from 2 to 23) were 11.69 and 12.83, respectively. There was a strong significant correlation between the CASI-S and MMSE (r=0.75, p<0.001) and a moderate correlation coefficient that was significant and negative between the PFAQ and CASI-S (r= –0.53 p=0.003),similar to that between the MMSE and PFAQ (r= –0.41 p=0.025). CONCLUSION The Brazilian version of the CASI-S demonstrates ease of application and correction in the illiterate elderly, and warrants further studies regarding its applicability for the diagnosis of dementia in populations with a heterogeneous educational background. PMID:29213866

[Effects of physical activity on cognitive functions, balance and risk of falls in elderly patients with Alzheimer's dementia].

PubMed

Hernandez, Salma S S; Coelho, Flávia G M; Gobbi, Sebastião; Stella, Florindo

2010-01-01

To analyze the effects of regular, systematic and supervised activity on the cognitive functions, balance and risk of falls of elderly patients with Alzheimer's Dementia (AD). Sixteen elderly patients (mean age 78.5+/-6.8 years) were divided into two groups: intervention group (IG; n=9) and routine group (RG; n=7). The IG exercised systematically for six months, and both groups were submitted to the following tests: Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), Timed Up-and-Go (TUG) and the agility/dynamic balance (AGIBAL) item of the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) test battery. There was a statistically significant interaction (two-way ANOVA; F1,14=32.07; p=0.01) between groups and moments for the AGIBAL. The Mann Whitney U test indicated significant differences between groups (p=0.03), only at the post-intervention moment for the TUG measured in steps and for BBS. Therefore, no significant intergroup differences were found for the TUG, BBS and MMSE at the pre-intervention moment or at post-intervention moment for the TUG measured in seconds and MMSE. The intragroup analysis by means of the Wilcoxon test showed a significant decline in the TUG, BBS and MMSE for the RG, but not for the IG. Spearman's coefficient showed a significant correlation between the results of the MMSE and AGIBAL. Physical activity may be an important non-pharmacological approach that can benefit cognitive functions and balance and reduce the risk of falls. Moreover, agility and balance are associated with cognitive functions in elderly patients with AD.

Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial.

PubMed

Toots, Annika; Littbrand, Håkan; Boström, Gustaf; Hörnsten, Carl; Holmberg, Henrik; Lundin-Olsson, Lillemor; Lindelöf, Nina; Nordström, Peter; Gustafson, Yngve; Rosendahl, Erik

2017-01-01

Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. To investigate effects of exercise on cognitive function in people with dementia. The Umeå Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umeå, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean Mini-Mental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale - Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months. Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707). A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.

Carboxy terminus of heat shock protein (HSP) 70-interacting protein (CHIP) inhibits HSP70 in the heart.

PubMed

Zhao, Bijun; Sun, Guocheng; Feng, Guanli; Duan, Weixun; Zhu, Xiaoling; Chen, Shaoyang; Hou, Lichao; Jin, Zhenxiao; Yi, Dinghua

2012-12-01

Heat shock protein (HSP) 70 plays a critical role in protecting the heart from various stressor-induced cell injuries; the mechanism remains to be further understood. The present study aims to elucidate the effect of a probiotics-derived protein, LGG-derived protein p75 (LGP), in alleviating the ischemia/reperfusion (I/R)-induced heart injury. We treated rats with the I/R with or without preadministration with LGP. The levels of HSP70 and carboxy terminus of HSP70-interacting protein (CHIP) in the heart tissue were assessed by enzyme-linked immunosorbent assay (ELISA) and Western blotting. The effect of CHIP on suppression of HSP70 and the effect of LGP on suppression of CHIP were investigated with an I/R rat model and a cell culture model. The results showed that I/R-induced infarction in the heart could be alleviated by pretreatment with LGP. HSP70 was detected in naïve rat heart tissue extracts. I/R treatment significantly suppressed the level of HSP70 and increased the levels of CHIP in the heart. A complex of CHIP/HSP70 was detected in heart tissue extracts. The addition of recombinant CHIP to culture inhibited HSP70 in heart cells. LGP was bound CHIP in heart cells and prevented the CHIP from binding HSP70. In summary, I/R can suppress HSP70 and increase CHIP in heart cells. CHIP can suppress HSP70 that can be prevented by pretreatment with LGP. The results imply that CHIP may be a potential target in the prevention of I/R-induced heart cell injury.

E3 ligase CHIP and Hsc70 regulate Kv1.5 protein expression and function in mammalian cells.

PubMed

Li, Peili; Kurata, Yasutaka; Maharani, Nani; Mahati, Endang; Higaki, Katsumi; Hasegawa, Akira; Shirayoshi, Yasuaki; Yoshida, Akio; Kondo, Tatehito; Kurozawa, Youichi; Yamamoto, Kazuhiro; Ninomiya, Haruaki; Hisatome, Ichiro

2015-09-01

Kv1.5 confers ultra-rapid delayed-rectifier potassium channel current (IKur) which contributes to repolarization of the atrial action potential. Kv1.5 proteins, degraded via the ubiquitin-proteasome pathway, decreased in some atrial fibrillation patients. Carboxyl-terminus heat shock cognate 70-interacting protein (CHIP), an E3 ubiquitin ligase, is known to ubiquitinate short-lived proteins. Here, we investigated the roles of CHIP in Kv1.5 degradation to provide insights into the mechanisms of Kv1.5 decreases and treatments targeting Kv1.5 for atrial fibrillation. Coexpression of CHIP with Kv1.5 in HEK293 cells increased Kv1.5 protein ubiquitination and decreased the protein level. Immunofluorescence revealed decreases of Kv1.5 proteins in the endoplasmic reticulum and on the cell membrane. A siRNA against CHIP suppressed Kv1.5 protein ubiquitination and increased its protein level. CHIP mutants, lacking either the N-terminal tetratricopeptide region domain or the C-terminal U-box domain, failed to exert these effects on Kv1.5 proteins. Immunoprecipitation showed that CHIP formed complexes with Kv1.5 proteins and heat shock cognate protein 70 (Hsc70). Effects of Hsc70 on Kv1.5 were similar to CHIP by altering interaction of CHIP with Kv1.5 protein. Coexpression of CHIP and Hsc70 with Kv1.5 additionally enhanced Kv1.5 ubiquitination. Kv1.5 currents were decreased by overexpression of CHIP or Hsc70 but were increased by knockdown of CHIP or Hsc70 in HEK 293 cells stably expressing Kv1.5. These effects of CHIP and Hsc70 were also observed on endogenous Kv1.5 in HL-1 mouse cardiomyocytes, decreasing IKur and prolonging action potential duration. These results indicate that CHIP decreases the Kv1.5 protein level and functional channel by facilitating its degradation in concert with chaperone Hsc70. Copyright © 2015 Elsevier Ltd. All rights reserved.

Admission Norton scale scores (ANSS) correlate with rehabilitation outcome and length in elderly patients following hip arthroplasty.

PubMed

Justo, Dan; Vislapu, Natalia; Shvedov, Victor; Fickte, Marina; Danylesko, Alexander; Kimelman, Polina; Merdler, Charlotte; Lerman, Yaffa

2011-01-01

We sought to determine if ANSS used for evaluating pressure sore risk also correlate with rehabilitation outcome and length following hip arthroplasty in elderly patients. This was a retrospective study conducted in a geriatric rehabilitation department during 2009. ANSS, admission albumin serum levels, mini-mental state examination (MMSE) scores, discharge walking functional independence measure (FIM) scores, and rehabilitation length were studied. The final cohort included 201 patients: 160 (79.6%) females and 41 (20.4%) males. Mean age was 82.7±6.5 years. Mean discharge walking FIM score was 5.2±0.9. Mean length of rehabilitation was 19.9±7.8 days. ANSS correlated with discharge walking FIM scores (r=0.28; p=0.002), and with length of rehabilitation (r=-0.22; p=0.014) following adjustment for age, admission albumin serum levels, and MMSE scores. Linear regression analysis showed that ANSS were associated with the discharge walking FIM scores (p<0.0001) and rehabilitation length (p=0.027) independent of age, admission albumin serum levels, gender, type of hip surgery, and the appearance of pressure sores. We conclude that the Norton scoring system may be used for predicting the outcome and the duration of rehabilitation in elderly patients following hip arthroplasty. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Delbaere, Kim; Daylight, Gail; Cumming, Robert G; Bennett, Hayley; Broe, Gerald A

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

A modular microfluidic architecture for integrated biochemical analysis.

PubMed

Shaikh, Kashan A; Ryu, Kee Suk; Goluch, Edgar D; Nam, Jwa-Min; Liu, Juewen; Thaxton, C Shad; Chiesl, Thomas N; Barron, Annelise E; Lu, Yi; Mirkin, Chad A; Liu, Chang

2005-07-12

Microfluidic laboratory-on-a-chip (LOC) systems based on a modular architecture are presented. The architecture is conceptualized on two levels: a single-chip level and a multiple-chip module (MCM) system level. At the individual chip level, a multilayer approach segregates components belonging to two fundamental categories: passive fluidic components (channels and reaction chambers) and active electromechanical control structures (sensors and actuators). This distinction is explicitly made to simplify the development process and minimize cost. Components belonging to these two categories are built separately on different physical layers and can communicate fluidically via cross-layer interconnects. The chip that hosts the electromechanical control structures is called the microfluidic breadboard (FBB). A single LOC module is constructed by attaching a chip comprised of a custom arrangement of fluid routing channels and reactors (passive chip) to the FBB. Many different LOC functions can be achieved by using different passive chips on an FBB with a standard resource configuration. Multiple modules can be interconnected to form a larger LOC system (MCM level). We demonstrated the utility of this architecture by developing systems for two separate biochemical applications: one for detection of protein markers of cancer and another for detection of metal ions. In the first case, free prostate-specific antigen was detected at 500 aM concentration by using a nanoparticle-based bio-bar-code protocol on a parallel MCM system. In the second case, we used a DNAzyme-based biosensor to identify the presence of Pb(2+) (lead) at a sensitivity of 500 nM in <1 nl of solution.

C-terminus of HSC70-Interacting Protein (CHIP) Inhibits Adipocyte Differentiation via Ubiquitin- and Proteasome-Mediated Degradation of PPARγ

PubMed Central

Kim, Jung-Hoon; Shin, Soyeon; Seo, Jinho; Lee, Eun-Woo; Jeong, Manhyung; Lee, Min-sik; Han, Hyun-Ji; Song, Jaewhan

2017-01-01

PPARγ (Peroxisome proliferator-activated receptor γ) is a nuclear receptor involved in lipid homeostasis and related metabolic diseases. Acting as a transcription factor, PPARγ is a master regulator for adipocyte differentiation. Here, we reveal that CHIP (C-terminus of HSC70-interacting protein) suppresses adipocyte differentiation by functioning as an E3 ligase of PPARγ. CHIP directly binds to and induces ubiquitylation of the PPARγ protein, leading to proteasome-dependent degradation. Stable overexpression or knockdown of CHIP inhibited or promoted adipogenesis, respectively, in 3T3-L1 cells. On the other hand, a CHIP mutant defective in E3 ligase could neither regulate PPARγ protein levels nor suppress adipogenesis, indicating the importance of CHIP-mediated ubiquitylation of PPARγ in adipocyte differentiation. Lastly, a CHIP null embryo fibroblast exhibited augmented adipocyte differentiation with increases in PPARγ and its target protein levels. In conclusion, CHIP acts as an E3 ligase of PPARγ, suppressing PPARγ-mediated adipogenesis. PMID:28059128

A 1-channel 3-band wide dynamic range compression chip for vibration transducer of implantable hearing aids.

PubMed

Kim, Dongwook; Seong, Kiwoong; Kim, Myoungnam; Cho, Jinho; Lee, Jyunghyun

2014-01-01

In this paper, a digital audio processing chip which uses a wide dynamic range compression (WDRC) algorithm is designed and implemented for implantable hearing aids system. The designed chip operates at a single voltage of 3.3V and drives a 16 bit parallel input and output at 32 kHz sample. The designed chip has 1-channel 3-band WDRC composed of a FIR filter bank, a level detector, and a compression part. To verify the performance of the designed chip, we measured the frequency separations of bands and compression gain control to reflect the hearing threshold level.

Coplanar electrode microfluidic chip enabling accurate sheathless impedance cytometry.

PubMed

De Ninno, Adele; Errico, Vito; Bertani, Francesca Romana; Businaro, Luca; Bisegna, Paolo; Caselli, Federica

2017-03-14

Microfluidic impedance cytometry offers a simple non-invasive method for single-cell analysis. Coplanar electrode chips are especially attractive due to ease of fabrication, yielding miniaturized, reproducible, and ultimately low-cost devices. However, their accuracy is challenged by the dependence of the measured signal on particle trajectory within the interrogation volume, that manifests itself as an error in the estimated particle size, unless any kind of focusing system is used. In this paper, we present an original five-electrode coplanar chip enabling accurate particle sizing without the need for focusing. The chip layout is designed to provide a peculiar signal shape from which a new metric correlating with particle trajectory can be extracted. This metric is exploited to correct the estimated size of polystyrene beads of 5.2, 6 and 7 μm nominal diameter, reaching coefficient of variations lower than the manufacturers' quoted values. The potential impact of the proposed device in the field of life sciences is demonstrated with an application to Saccharomyces cerevisiae yeast.

Take-up of public insurance and crowd-out of private insurance under recent CHIP expansions to higher income children.

PubMed

Gresenz, Carole Roan; Edgington, Sarah E; Laugesen, Miriam; Escarce, José J

2012-10-01

To analyze the effects of states' expansions of Children's Health Insurance Program (CHIP) eligibility to children in higher income families on health insurance coverage outcomes. 2002-2009 Current Population Survey linked to multiple secondary data sources. Instrumental variables estimation of linear probability models. Outcomes are whether the child had any public insurance, any private insurance, or no insurance coverage during the year. Among children in families with incomes between two and four times the federal poverty line (FPL), four enrolled in CHIP for every 100 who became eligible. Roughly half of the newly eligible children who took up public insurance were previously uninsured. The upper bound "crowd-out" rate was estimated to be 46 percent. The CHIP expansions to children in higher income families were associated with limited uptake of public coverage. Our results additionally suggest that there was crowd-out of private insurance coverage. © Health Research and Educational Trust.

Junction-to-Case Thermal Resistance of a Silicon Carbide Bipolar Junction Transistor Measured

NASA Technical Reports Server (NTRS)

Niedra, Janis M.

2006-01-01

Junction temperature of a prototype SiC-based bipolar junction transistor (BJT) was estimated by using the base-emitter voltage (V(sub BE)) characteristic for thermometry. The V(sub BE) was measured as a function of the base current (I(sub B)) at selected temperatures (T), all at a fixed collector current (I(sub C)) and under very low duty cycle pulse conditions. Under such conditions, the average temperature of the chip was taken to be the same as that of the temperature-controlled case. At increased duty cycle such as to substantially heat the chip, but same I(sub C) pulse height, the chip temperature was identified by matching the V(sub BE) to the thermometry curves. From the measured average power, the chip-to-case thermal resistance could be estimated, giving a reasonable value. A tentative explanation for an observed bunching with increasing temperature of the calibration curves may relate to an increasing dopant atom ionization. A first-cut analysis, however, does not support this.

Integration of image capture and processing: beyond single-chip digital camera

NASA Astrophysics Data System (ADS)

Lim, SukHwan; El Gamal, Abbas

2001-05-01

An important trend in the design of digital cameras is the integration of capture and processing onto a single CMOS chip. Although integrating the components of a digital camera system onto a single chip significantly reduces system size and power, it does not fully exploit the potential advantages of integration. We argue that a key advantage of integration is the ability to exploit the high speed imaging capability of CMOS image senor to enable new applications such as multiple capture for enhancing dynamic range and to improve the performance of existing applications such as optical flow estimation. Conventional digital cameras operate at low frame rates and it would be too costly, if not infeasible, to operate their chips at high frame rates. Integration solves this problem. The idea is to capture images at much higher frame rates than he standard frame rate, process the high frame rate data on chip, and output the video sequence and the application specific data at standard frame rate. This idea is applied to optical flow estimation, where significant performance improvements are demonstrate over methods using standard frame rate sequences. We then investigate the constraints on memory size and processing power that can be integrated with a CMOS image sensor in a 0.18 micrometers process and below. We show that enough memory and processing power can be integrated to be able to not only perform the functions of a conventional camera system but also to perform applications such as real time optical flow estimation.

Chip-scale integrated optical interconnects: a key enabler for future high-performance computing

NASA Astrophysics Data System (ADS)

Haney, Michael; Nair, Rohit; Gu, Tian

2012-01-01

High Performance Computing (HPC) systems are putting ever-increasing demands on the throughput efficiency of their interconnection fabrics. In this paper, the limits of conventional metal trace-based inter-chip interconnect fabrics are examined in the context of state-of-the-art HPC systems, which currently operate near the 1 GFLOPS/W level. The analysis suggests that conventional metal trace interconnects will limit performance to approximately 6 GFLOPS/W in larger HPC systems that require many computer chips to be interconnected in parallel processing architectures. As the HPC communications bottlenecks push closer to the processing chips, integrated Optical Interconnect (OI) technology may provide the ultra-high bandwidths needed at the inter- and intra-chip levels. With inter-chip photonic link energies projected to be less than 1 pJ/bit, integrated OI is projected to enable HPC architecture scaling to the 50 GFLOPS/W level and beyond - providing a path to Peta-FLOPS-level HPC within a single rack, and potentially even Exa-FLOPSlevel HPC for large systems. A new hybrid integrated chip-scale OI approach is described and evaluated. The concept integrates a high-density polymer waveguide fabric directly on top of a multiple quantum well (MQW) modulator array that is area-bonded to the Silicon computing chip. Grayscale lithography is used to fabricate 5 μm x 5 μm polymer waveguides and associated novel small-footprint total internal reflection-based vertical input/output couplers directly onto a layer containing an array of GaAs MQW devices configured to be either absorption modulators or photodetectors. An external continuous wave optical "power supply" is coupled into the waveguide links. Contrast ratios were measured using a test rider chip in place of a Silicon processing chip. The results suggest that sub-pJ/b chip-scale communication is achievable with this concept. When integrated into high-density integrated optical interconnect fabrics, it could provide a seamless interconnect fabric spanning the intra-

COMPASS: A computational model to predict changes in MMSE scores 24-months after initial assessment of Alzheimer's disease.

PubMed

Zhu, Fan; Panwar, Bharat; Dodge, Hiroko H; Li, Hongdong; Hampstead, Benjamin M; Albin, Roger L; Paulson, Henry L; Guan, Yuanfang

2016-10-05

We present COMPASS, a COmputational Model to Predict the development of Alzheimer's diSease Spectrum, to model Alzheimer's disease (AD) progression. This was the best-performing method in recent crowdsourcing benchmark study, DREAM Alzheimer's Disease Big Data challenge to predict changes in Mini-Mental State Examination (MMSE) scores over 24-months using standardized data. In the present study, we conducted three additional analyses beyond the DREAM challenge question to improve the clinical contribution of our approach, including: (1) adding pre-validated baseline cognitive composite scores of ADNI-MEM and ADNI-EF, (2) identifying subjects with significant declines in MMSE scores, and (3) incorporating SNPs of top 10 genes connected to APOE identified from functional-relationship network. For (1) above, we significantly improved predictive accuracy, especially for the Mild Cognitive Impairment (MCI) group. For (2), we achieved an area under ROC of 0.814 in predicting significant MMSE decline: our model has 100% precision at 5% recall, and 91% accuracy at 10% recall. For (3), "genetic only" model has Pearson's correlation of 0.15 to predict progression in the MCI group. Even though addition of this limited genetic model to COMPASS did not improve prediction of progression of MCI group, the predictive ability of SNP information extended beyond well-known APOE allele.

[Cognitive disorders and falls: experience of the Lille multidisciplinary falls service].

PubMed

Maeker, E; Bombois, S; Pardessus, V; Tiberghien, F; Dipompeo, C; Thevenon, A; Dewailly, P; Puisieux, F

2005-04-01

Falls and dementia are two major public health problems which concern the elderly population. Cognitive impairment, as a result of Alzheimer's disease or non-Alzheimer dementia, is recognized as a risk factor for falling. Through the experience of the Multidisciplinary Falls Consultation, our aims were first, to evaluate the prevalence of a cognitive decline among outpatients who consult for falls, and second, to determine whether the cognitive impairment was known and diagnosed before the consultation or not. Data concerning the first 300 outpatients who completed the initial evaluation are reported. Each patient was assessed by a geriatrician, a neurologist, and a physiatrist, who visited him or her at home. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score<24. Of the 300 patients, 228 patients completed the initial evaluation. Among them, 97 (42.5 percent) had a MMSE score<24; 55 had mild stage dementia (MMSE score between 23 and 18) and 42 were at a moderate or severe stage (MMSE score< or =17/30). The cognitive decline was not diagnosed before the consultation in 80 of the 97 patients (82 percent). The findings show that a large proportion of old persons presenting with gait disturbance at the Multidisciplinary Falls Consultation have an underlying cognitive decline. Assessment of cognitive functions is required in every elderly faller.

Predicting the Rate of Cognitive Decline in Alzheimer Disease: Data From the ICTUS Study.

PubMed

Canevelli, Marco; Kelaiditi, Eirini; Del Campo, Natalia; Bruno, Giuseppe; Vellas, Bruno; Cesari, Matteo

2016-01-01

Different rates of cognitive progression have been observed among Alzheimer disease (AD) patients. The present study aimed at evaluating whether the rate of cognitive worsening in AD may be predicted by widely available and easy-to-assess factors. Mild to moderate AD patients were recruited in the ICTUS study. Multinomial logistic regression analysis was performed to measure the association between several sociodemographic and clinical variables and 3 different rates of cognitive decline defined by modifications (after 1 year of follow-up) of the Mini Mental State Examination (MMSE) score: (1) "slow" progression, as indicated by a decrease in the MMSE score ≤1 point; (2) "intermediate" progression, decrease in the MMSE score between 2 and 5 points; and (3) "rapid" progression, decrease in the MMSE score ≥6 points. A total of 1005 patients were considered for the present analyses. Overall, most of the study participants (52%) exhibited a slow cognitive course. Higher ADAS-Cog scores at baseline were significantly associated with both "intermediate" and "rapid" decline. Conversely, increasing age was negatively associated with "rapid" cognitive worsening. A slow progression of cognitive decline is common among AD patients. The influence of age and baseline cognitive impairment should always be carefully considered when designing AD trials and defining study populations.

Lower cognitive function in patients with age-related macular degeneration: a meta-analysis

PubMed Central

Zhou, Li-Xiao; Sun, Cheng-Lin; Wei, Li-Juan; Gu, Zhi-Min; Lv, Liang; Dang, Yalong

2016-01-01

Objective To investigate the cognitive impairment in patients with age-related macular degeneration (AMD). Methods Relevant articles were identified through a search of the following electronic databases through October 2015, without language restriction: 1) PubMed; 2) the Cochrane Library; 3) EMBASE; 4) ScienceDirect. Meta-analysis was conducted using STATA 12.0 software. Standardized mean differences with corresponding 95% confidence intervals were calculated. All of the included studies met the following four criteria: 1) the study design was a case–control or randomized controlled trial (RCT) study; 2) the study investigated cognitive function in the patient with AMD; 3) the diagnoses of AMD must be provided; 4) there were sufficient scores data to extract for evaluating cognitive function between cases and controls. The Newcastle–Ottawa Scale criteria were used to assess the methodological quality of the studies. Results Of the initial 278 literatures, only six case–control and one RCT studies met all of the inclusion criteria. A total of 794 AMD patients and 1,227 controls were included in this study. Five studies were performed with mini-mental state examination (MMSE), two studies with animal fluency, two studies with trail making test (TMT)-A and -B, one study with Mini-Cog. Results of the meta-analysis revealed lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test (P≤0.001 for all). The results also showed that differences in the TMT-A (except AMD [total] vs controls) and TMT-B test had no statistical significance (P>0.01). The Newcastle–Ottawa Scale score was ≥5 for all of the included studies. Based on the sensitivity analysis, no single study influenced the overall pooled estimates. Conclusion This meta-analysis suggests lower cognitive function test scores in patients with AMD, especially with MMSE and Mini-Cog test. The other cognitive impairment screening tests, such as animal fluency test and TMT, need more studies to assess. PMID:26966358

Chipping and grinding production rate calculator

Treesearch

Mathew Smidt; Dana Mitchell

2014-01-01

The data for individual chipper and grinder production estimates were recorded with all the attributes available. If a study provided more than one production estimate and there was sufficient detail to describe each estimate, we entered multiple production estimates.

Evaluation of hardware costs of implementing PSK signal detection circuit based on "system on chip"

NASA Astrophysics Data System (ADS)

Sokolovskiy, A. V.; Dmitriev, D. D.; Veisov, E. A.; Gladyshev, A. B.

2018-05-01

The article deals with the choice of the architecture of digital signal processing units for implementing the PSK signal detection scheme. As an assessment of the effectiveness of architectures, the required number of shift registers and computational processes are used when implementing the "system on a chip" on the chip. A statistical estimation of the normalized code sequence offset in the signal synchronization scheme for various hardware block architectures is used.

Estimation and partitioning of (co)heritability of inflammatory bowel disease from GWAS and immunochip data.

PubMed

Chen, Guo-Bo; Lee, Sang Hong; Brion, Marie-Jo A; Montgomery, Grant W; Wray, Naomi R; Radford-Smith, Graham L; Visscher, Peter M

2014-09-01

As custom arrays are cheaper than generic GWAS arrays, larger sample size is achievable for gene discovery. Custom arrays can tag more variants through denser genotyping of SNPs at associated loci, but at the cost of losing genome-wide coverage. Balancing this trade-off is important for maximizing experimental designs. We quantified both the gain in captured SNP-heritability at known candidate regions and the loss due to imperfect genome-wide coverage for inflammatory bowel disease using immunochip (iChip) and imputed GWAS data on 61,251 and 38.550 samples, respectively. For Crohn's disease (CD), the iChip and GWAS data explained 19 and 26% of variation in liability, respectively, and SNPs in the densely genotyped iChip regions explained 13% of the SNP-heritability for both the iChip and GWAS data. For ulcerative colitis (UC), the iChip and GWAS data explained 15 and 19% of variation in liability, respectively, and the dense iChip regions explained 10 and 9% of the SNP-heritability in the iChip and the GWAS data. From bivariate analyses, estimates of the genetic correlation in risk between CD and UC were 0.75 (SE 0.017) and 0.62 (SE 0.042) for the iChip and GWAS data, respectively. We also quantified the SNP-heritability of genomic regions that did or did not contain the previous 163 GWAS hits for CD and UC, and SNP-heritability of the overlapping loci between the densely genotyped iChip regions and the 163 GWAS hits. For both diseases, over different genomic partitioning, the densely genotyped regions on the iChip tagged at least as much variation in liability as in the corresponding regions in the GWAS data, however a certain amount of tagged SNP-heritability in the GWAS data was lost using the iChip due to the low coverage at unselected regions. These results imply that custom arrays with a GWAS backbone will facilitate more gene discovery, both at associated and novel loci. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Social Ties and Cognitive Recovery after Stroke: Does Social Integration Promote Cognitive Resilience?

PubMed Central

Glymour, M. Maria; Weuve, Jennifer; Fay, Martha E.; Glass, Thomas; Berkman, Lisa F.

2008-01-01

Background/Aims Little is known about the possible effects of social resources on stroke survivors’ level and change in cognitive outcomes. Understanding this association may help us identify strategies to improve stroke recovery and help elucidate the etiology of dementia. Methods We examined the relationship of social ties and social support to cognitive function and cognitive change 6 months after stroke. Participants in the Families in Recovery from Stroke Trial (FIRST) (n = 272) were interviewed approximately 17 days (baseline) and 6 months (follow-up) after stroke. Cognition was assessed with the Mini Mental State Examination (MMSE) and a summary battery of 7 neuropsychological tests. Median-based regression was used to model cognitive outcomes by level of baseline intimate, personal and organizational social ties and received emotional and instrumental support. Results Baseline social ties and emotional sup- port independently predicted 6-month Cognitive Summary Scores. Emotional support also predicted greater improvements in Cognitive Summary Scores from baseline to the 6-month follow-up. No other social exposures predicted improvements in the MMSE or the Cognitive Summary. Conclusions Our results suggest that emotional support may promote cognitive resilience while social ties provide cognitive reserve that protects against impaired cognition after stroke. Social ties did not predict cognitive recovery however, so reverse causation cannot be ruled out. PMID:18535395

Coverage and efficiency in current SNP chips

PubMed Central

Ha, Ngoc-Thuy; Freytag, Saskia; Bickeboeller, Heike

2014-01-01

To answer the question as to which commercial high-density SNP chip covers most of the human genome given a fixed budget, we compared the performance of 12 chips of different sizes released by Affymetrix and Illumina for the European, Asian, and African populations. These include Affymetrix' relatively new population-optimized arrays, whose SNP sets are each tailored toward a specific ethnicity. Our evaluation of the chips included the use of two measures, efficiency and cost–benefit ratio, which we developed as supplements to genetic coverage. Unlike coverage, these measures factor in the price of a chip or its substitute size (number of SNPs on chip), allowing comparisons to be drawn between differently priced chips. In this fashion, we identified the Affymetrix population-optimized arrays as offering the most cost-effective coverage for the Asian and African population. For the European population, we established the Illumina Human Omni 2.5-8 as the preferred choice. Interestingly, the Affymetrix chip tailored toward an Eastern Asian subpopulation performed well for all three populations investigated. However, our coverage estimates calculated for all chips proved much lower than those advertised by the producers. All our analyses were based on the 1000 Genome Project as reference population. PMID:24448550

Effect of cooking method (baking compared with frying) on acrylamide level of potato chips.

PubMed

Palazoğlu, T Koray; Savran, Derya; Gökmen, Vural

2010-01-01

The effect of cooking method (baking compared with frying) on acrylamide level of potato chips was investigated in this study. Baking and frying experiments were conducted at 170, 180, and 190 degrees C using potato slices with a thickness of 1.4 mm. Raw potatoes were analyzed for reducing sugars and asparagine. Surface and internal temperatures of potato slices were monitored during the experiments to better explain the results. Fried and baked chips were analyzed for acrylamide content using an LC-MS method. The results showed that acrylamide level of potato chips prepared by frying increased with frying temperature (19.6 ng/g at 170 degrees C, 39 ng/g at 180 degrees C, and 95 ng/g at 190 degrees C). In baking, however, the highest acrylamide level was observed in potato chips prepared at 170 degrees C (47.8 ng/g at 170 degrees C, 19.3 ng/g at 180 degrees C, and 29.7 ng/g at 190 degrees C). The results showed that baking at 170 degrees C more than doubled the acrylamide amount that formed upon frying at the same temperature, whereas at 180 and 190 degrees C, the acrylamide levels of chips prepared by baking were lower than their fried counterparts.

Analysis of the Production Cost for Various Grades of Biomass Thermal Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cherry, Robert S.; Wood, Rick A.; Westover, Tyler L.

2013-12-01

Process flow sheets were developed for the thermal treatment of southern pine wood chips at four temperatures (150, 180, 230, and 270 degrees C) and two different scales (20 and 100 ton/hour). The larger capacity processes had as their primary heat source hot gas assumed to be available in quantity from an adjacent biorefinery. Mass and energy balances for these flow sheets were developed using Aspen Plus process simulation software. The hot gas demands in the larger processes, up to 1.9 million lb/hour, were of questionable feasibility because of the volume to be moved. This heat was of low utilitymore » because the torrefaction process, especially at higher temperatures, is a net heat producer if the organic byproduct gases are burned. A thermal treatment flow sheet using wood chips dried in the biorefinery to 10% moisture content (rather than 30% for green chips) with transfer of high temperature steam from the thermal treatment depot to the biorefinery was also examined. The equipment size information from all of these cases was used in several different equipment cost estimating methods to estimate the major equipment costs for each process. From these, factored estimates of other plant costs were determined, leading to estimates (± 30% accuracy) of total plant capital cost. The 20 ton/hour processes were close to 25 million dollars except for the 230 degrees C case using dried wood chips which was only 15 million dollars because of its small furnace. The larger processes ranged from 64-120 million dollars. From these capital costs and projections of several categories of operating costs, the processing cost of thermally treated pine chips was found to be $28-33 per ton depending on the degree of treatment and without any credits for steam generation. If the excess energy output of the two 20 ton/hr depot cases at 270 degrees C can be sold for $10 per million BTU, the net processing cost dropped to $13/ton product starting with green wood chips or only $3 per ton if using dried chips from the biorefinery. Including a 12% return on invested capital raised all of the operating cost results by about $20/ton.« less

Postmortem endogenous ethanol production and diffusion from the lung due to aspiration of wood chip dust in the work place.

PubMed

Furumiya, Junichi; Nishimura, Hiroyuki; Nakanishi, Akinori; Hashimoto, Yoshiaki

2011-07-01

We report an autopsy case of postmortem ethanol diffusion into the cardiac blood after aspiration of wood chips, although antemortem ethanol consumption was not evident. A man in his twenties, who was loading a truck with small wood chips in a hot, humid storehouse, was accidentally buried in a heap of chips. At the time the body was discovered, 20 h after the accident, rectal temperature was 36°C. Autopsy showed the cause of death to be asphyxia due to obstruction of the airway by aspiration of wood chips. The ethanol and n-propanol levels were significantly higher in the lungs (left, 0.603 and 0.009 mg/g; right, 0.571 and 0.006 mg/g) than in other tissues. A significant difference in ethanol concentration was observed between the left cardiac blood (0.243 mg/g) and the right femoral blood (0.042 mg/g). Low levels of ethanol and n-propanol were detected in the stomach contents (0.105 and 0.001 mg/g, respectively). In order to determine whether aspiration of wood chips affects postmortem ethanol production in the lung, we measured the ethanol and n-propanol levels of homogenized rabbit lung tissue incubated with autoclaved or non-autoclaved wood chips. Levels of ethanol and n-propanol were significantly higher in the homogenates incubated with non-autoclaved chips for 24h. The results of this animal experiment suggested that the ethanol detected in the lung was produced by putrefactive bacteria within the wood chips. After death, the ethanol produced endogenously in the lung appears to have diffused and affected the ethanol concentration of the left cardiac blood. 2011 Elsevier Ireland Ltd. All rights reserved.

Open-systems Architecture of a Standardized Command Interface Chip-set for Switching and Control of a Spacecraft Power Bus

NASA Technical Reports Server (NTRS)

Ruiz, B. Ian; Burke, Gary R.; Lung, Gerald; Whitaker, William D.; Nowicki, Robert M.

2004-01-01

This viewgraph presentation reviews the architecture of the The CIA-AlA chip-set is a set of mixed-signal ASICs that provide a flexible high level interface between the spacecraft's command and data handling (C&DH) electronics and lower level functions in other spacecraft subsystems. Due to the open-systems architecture of the chip-set including an embedded micro-controller a variety of applications are possible. The chip-set was developed for the missions to the outer planets. The chips were developed to provide a single solution for both the switching and regulation of a spacecraft power bus. The Open-Systems Architecture allows for other powerful applications.

Electrochemical detection of methylated DNA on a microfluidic chip with nanoelectrokinetic pre-concentration.

PubMed

Hong, Sung A; Kim, Yong-June; Kim, Sung Jae; Yang, Sung

2018-06-01

DNA methylation is considered to be a promising marker for the early diagnosis and prognosis of cancer. However, direct detection of the methylated DNAs in clinically relevant samples is still challenging because of its extremely low concentration (~fM). Here, an integrated microfluidic chip is reported, which is capable of pre-concentrating the methylated DNAs using ion concentration polarization (ICP) and electrochemically detecting the pre-concentrated DNAs on a single chip. The proposed chip is the first demonstration of an electrochemical detection of both level and concentration of the methylated DNAs by integrating a DNA pre-concentration unit without gene amplification. Using the proposed chip, 500 fM to 500 nM of methylated DNAs is pre-concentrated by almost 100-fold in 10 min, resulting in a drastic improvement of the electrochemical detection threshold down to the fM level. The proposed chip is able to measure not only the DNA concentration, but also the level of methylation using human urine sample by performing a consecutive electrochemical sensing on a chip. For clinical application, the level as well as the concentration of methylation of glutathione-S transferase-P1 (GSTP1) and EGF-containing fibulin-like extracellular matrix protein 1 (EFEMP1), which are known to be closely associated with prostate cancer diagnosis, are electrochemically detected in human urine spiked with these genes. The developed chip shows a limit of detection (LoD) of 7.9 pM for GSTP1 and 11.8 pM for EFEMP1 and is able to detect the level of methylation in a wide range from 10% to 100% with the concentration variation from 50 pM to 500 nM. Copyright © 2018 Elsevier B.V. All rights reserved.

Chip level modeling of LSI devices

NASA Technical Reports Server (NTRS)

Armstrong, J. R.

1984-01-01

The advent of Very Large Scale Integration (VLSI) technology has rendered the gate level model impractical for many simulation activities critical to the design automation process. As an alternative, an approach to the modeling of VLSI devices at the chip level is described, including the specification of modeling language constructs important to the modeling process. A model structure is presented in which models of the LSI devices are constructed as single entities. The modeling structure is two layered. The functional layer in this structure is used to model the input/output response of the LSI chip. A second layer, the fault mapping layer, is added, if fault simulations are required, in order to map the effects of hardware faults onto the functional layer. Modeling examples for each layer are presented. Fault modeling at the chip level is described. Approaches to realistic functional fault selection and defining fault coverage for functional faults are given. Application of the modeling techniques to single chip and bit slice microprocessors is discussed.

Ultrahigh-speed Si-integrated on-chip laser with tailored dynamic characteristics

NASA Astrophysics Data System (ADS)

Park, Gyeong Cheol; Xue, Weiqi; Piels, Molly; Zibar, Darko; Mørk, Jesper; Semenova, Elizaveta; Chung, Il-Sug

2016-12-01

For on-chip interconnects, an ideal light source should have an ultralow energy consumption per bandwidth (operating en-ergy) as well as sufficient output power for error-free detection. Nanocavity lasers have been considered the most ideal for smaller operating energy. However, they have a challenge in obtaining a sufficient output power. Here, as an alternative, we propose an ultrahigh-speed microcavity laser structure, based on a vertical cavity with a high-contrast grating (HCG) mirror for transverse magnetic (TM) polarisation. By using the TM HCG, a very small mode volume and an un-pumped compact optical feedback structure can be realised, which together tailor the frequency response function for achieving a very high speed at low injection currents. Furthermore, light can be emitted laterally into a Si waveguide. From an 1.54-μm optically-pumped laser, a 3-dB frequency of 27 GHz was obtained at a pumping level corresponding to sub-mA. Using measured 3-dB frequen-cies and calculated equivalent currents, the modulation current efficiency factor (MCEF) is estimated to be 42.1 GHz/mA1/2, which is superior among microcavity lasers. This shows a high potential for a very high speed at low injection currents or avery small heat generation at high bitrates, which are highly desirable for both on-chip and off-chip applications.

Survival of emerald ash borer in chips

Treesearch

Deborah G. McCullough; Therese M. Poland; David L. Cappaert

2005-01-01

The ability of emerald ash borer (EAB), Agrilus planipennis Fairmaire, to survive following chipping or grinding of infested ash trees remains a critical question for regulatory officials. In October 2002, we felled eight infested ash trees and sampled sections of the trunk and large branches from each tree to estimate EAB density.

A Practical, Hardware Friendly MMSE Detector for MIMO-OFDM-Based Systems

NASA Astrophysics Data System (ADS)

Kim, Hun Seok; Zhu, Weijun; Bhatia, Jatin; Mohammed, Karim; Shah, Anish; Daneshrad, Babak

2008-12-01

Design and implementation of a highly optimized MIMO (multiple-input multiple-output) detector requires cooptimization of the algorithm with the underlying hardware architecture. Special attention must be paid to application requirements such as throughput, latency, and resource constraints. In this work, we focus on a highly optimized matrix inversion free [InlineEquation not available: see fulltext.] MMSE (minimum mean square error) MIMO detector implementation. The work has resulted in a real-time field-programmable gate array-based implementation (FPGA-) on a Xilinx Virtex-2 6000 using only 9003 logic slices, 66 multipliers, and 24 Block RAMs (less than 33% of the overall resources of this part). The design delivers over 420 Mbps sustained throughput with a small 2.77-microsecond latency. The designed [InlineEquation not available: see fulltext.] linear MMSE MIMO detector is capable of complying with the proposed IEEE 802.11n standard.

Relationship between dietary pattern and cognitive function in elderly patients with type 2 diabetes mellitus.

PubMed

Enomoto, Mari; Yoshii, Hidenori; Mita, Tomoya; Sanke, Haruna; Yokota, Ayako; Yamashiro, Keiko; Inagaki, Noriko; Gosho, Masahiko; Ohmura, Chie; Kudo, Kayo; Watada, Hirotaka; Onuma, Tomio

2015-08-01

To analyse the relationships between dietary patterns and cognitive function in elderly patients with type 2 diabetes mellitus (T2DM). Patients with T2DM completed a 3-day dietary record and Mini-mental State Examination (MMSE). Dietary patterns were identified by factor analysis. The study included 73 patients and identified five dietary patterns, one of which was characterized by high loading for vegetables and fish. A higher consumption of vegetables and fish was significantly associated with improved MMSE score (unadjusted model, model adjusted for age and sex, and model adjusted for age, sex, education, diabetic nephropathy and alcohol consumption), and decreased prevalence of suspected mild dementia (unadjusted model, model adjusted for age and sex). A high score in the vegetables and fish dietary pattern was associated with high MMSE score and low prevalence of suspected mild dementia in elderly patients with T2DM. © The Author(s) 2015.

Detection of solder bump defects on a flip chip using vibration analysis

NASA Astrophysics Data System (ADS)

Liu, Junchao; Shi, Tielin; Xia, Qi; Liao, Guanglan

2012-03-01

Flip chips are widely used in microelectronics packaging owing to the high demand of integration in IC fabrication. Solder bump defects on flip chips are difficult to detect, because the solder bumps are obscured by the chip and substrate. In this paper a nondestructive detection method combining ultrasonic excitation with vibration analysis is presented for detecting missing solder bumps, which is a typical defect in flip chip packaging. The flip chip analytical model is revised by considering the influence of spring mass on mechanical energy of the system. This revised model is then applied to estimate the flip chip resonance frequencies. We use an integrated signal generator and power amplifier together with an air-coupled ultrasonic transducer to excite the flip chips. The vibrations are measured by a laser scanning vibrometer to detect the resonance frequencies. A sensitivity coefficient is proposed to select the sensitive resonance frequency order for defect detection. Finite element simulation is also implemented for further investigation. The results of analytical computation, experiment, and simulation prove the efficacy of the revised flip chip analytical model and verify the effectiveness of this detection method. Therefore, it may provide a guide for the improvement and innovation of the flip chip on-line inspection systems.

Reduced-rank technique for joint channel estimation in TD-SCDMA systems

NASA Astrophysics Data System (ADS)

Kamil Marzook, Ali; Ismail, Alyani; Mohd Ali, Borhanuddin; Sali, Adawati; Khatun, Sabira

2013-02-01

In time division-synchronous code division multiple access systems, increasing the system capacity by exploiting the inserting of the largest number of users in one time slot (TS) requires adding more estimation processes to estimate the joint channel matrix for the whole system. The increase in the number of channel parameters due the increase in the number of users in one TS directly affects the precision of the estimator's performance. This article presents a novel channel estimation with low complexity, which relies on reducing the rank order of the total channel matrix H. The proposed method exploits the rank deficiency of H to reduce the number of parameters that characterise this matrix. The adopted reduced-rank technique is based on truncated singular value decomposition algorithm. The algorithms for reduced-rank joint channel estimation (JCE) are derived and compared against traditional full-rank JCEs: least squares (LS) or Steiner and enhanced (LS or MMSE) algorithms. Simulation results of the normalised mean square error showed the superiority of reduced-rank estimators. In addition, the channel impulse responses founded by reduced-rank estimator for all active users offers considerable performance improvement over the conventional estimator along the channel window length.

Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study

PubMed Central

Zhu, Runxiu; Yan, Zhongrui; Zheng, Shouhuan; Wang, Jingwei; Huo, Jia; Liu, Yunlin; Li, Xin; Ji, Yong

2016-01-01

To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE) at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale) score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05–2.11, p<0.001). Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery. PMID:26751070

VLSI research

NASA Astrophysics Data System (ADS)

Brodersen, R. W.

1984-04-01

A scaled version of the RISC II chip has been fabricated and tested and these new chips have a cycle time that would outperform a VAX 11/780 by about a factor of two on compiled integer C programs. The architectural work on a RISC chip designed for a Smalltalk implementation has been completed. This chip, called SOAR (Smalltalk On a RISC), should run program s4-15 times faster than the Xerox 1100 (Dolphin), a TTL minicomputer, and about as fast as the Xerox 1132 (Dorado), a $100,000 ECL minicomputer. The 1983 VLSI tools tape has been converted for use under the latest UNIX release (4.2). The Magic (formerly called Caddy) layout system will be a unified set of highly automated tools that cover all aspects of the layout process, including stretching, compaction, tiling and routing. A multiple window package and design rule checker for this system have just been completed and compaction and stretching are partially implemented. New slope-based timing models for the Crystal timing analyzer are now fully implemented and in regular use. In an accuracy test using a dozen critical paths from the RISC II processor and cache chips it was found that Crystal's estimates were within 5-10% of SPICE's estimates, while being a factor of 10,000 times faster.

CHIP involves in non-small cell lung cancer prognosis through VEGF pathway.

PubMed

Tingting, Qian; Jiao, Wang; Qingfeng, Wang; Yancheng, Liu; Shijun, Y U; Zhaoqi, Wang; Dongmei, Sun; ShiLong, Wang

2016-10-01

CHIP (c-terminal Hsp70-interacting protein) is an E3 ligase playing vital roles in various cancers. The VEGF pathway has become an important therapeutic target in non-small cell lung cancer (NSCLC). However, little is known about the role of CHIP and the relationship between CHIP and VEGF-VEGFR2 (VEGF receptor 2) pathway in NSCLC. In this study we aimed to investigate the clinical function of CHIP in NSCLC and explore the relevant regulatory mechanism. QRT-PCR was performed to detect CHIP expression in NSCLC tissues. The association of CHIP expression and clinical parameters was analyzed using the Chi-square test. Kaplan- Meier and Cox analyses were performed to identify the role of CHIP in the prognosis of NSCLC patients. ELISA test was used to detect the VEGF secretion of NSCLC cells and western blot were used to detected the protein expression of VEGFR2 in NSCLC cells. and the results revealed that CHIP expression was decreased in NSCLC tissues and significantly correlated with clinical stages, lymph node metastasis and distant metastasis (P<0.05). Moreover, Kaplan-Meier and Cox regression analyses showed that patients with negative expression of CHIP had a shorter survival time and CHIP could be an independent prognostic biomarker. In addition, ELISA tests showed that CHIP negatively regulated the secretion level of VEGF. Furthermore, western blot assay indicated that the VEGFR2 protein level was reduced after CHIP over-expression. Taken together, our findings demonstrate for the first time that CHIP may serve as a promising prognostic biomarker for NSCLC patients and it may be involved in NSCLC angiogenesis through regulating VEGF secretion and expression of VEGFR2. Copyright © 2016. Published by Elsevier Masson SAS.

Effect of music-based multitask training on cognition and mood in older adults.

PubMed

Hars, Mélany; Herrmann, Francois R; Gold, Gabriel; Rizzoli, René; Trombetti, Andrea

2014-03-01

in a secondary analysis of a randomised controlled trial, we investigated whether 6 months of music-based multitask training had beneficial effects on cognitive functioning and mood in older adults. 134 community-dwellers aged ≥65 years at increased risk for falling were randomly assigned to either an intervention group (n = 66) who attended once weekly 1-h supervised group classes of multitask exercises, executed to the rhythm of piano music, or a control group with delayed intervention (n = 68) who maintained usual lifestyle habits, for 6 months. A short neuropsychological test battery was administered by an intervention-blinded neuropsychologist at baseline and Month 6, including the mini-mental state examination (MMSE), the clock-drawing test, the frontal assessment battery (FAB) and the hospital anxiety (HADS-A) and depression scale. intention-to-treat analysis showed an improvement in the sensitivity to interference subtest of the FAB (adjusted between-group mean difference (AMD), 0.12; 95% CI, 0.00 to 0.25; P = 0.047) and a reduction in anxiety level (HADS-A; AMD, -0.88; 95% CI, -1.73 to -0.05; P = 0.039) in intervention participants, as compared with the controls. Within-group analysis revealed an increase in MMSE score (P = 0.004) and a reduction in the number of participants with impaired global cognitive performance (i.e., MMSE score ≤23; P = 0.003) with intervention. six months of once weekly music-based multitask training was associated with improved cognitive function and decreased anxiety in community-dwelling older adults, compared with non-exercising controls. Studies designed to further delineate whether training-induced changes in cognitive function could contribute to dual-task gait improvements and falls reduction, remain to be conducted.

The Citicholinage Study: Citicoline Plus Cholinesterase Inhibitors in Aged Patients Affected with Alzheimer's Disease Study.

PubMed

Gareri, Pietro; Castagna, Alberto; Cotroneo, Antonino Maria; Putignano, Daria; Conforti, Raffaele; Santamaria, Francesco; Marino, Saverio; Putignano, Salvatore

2017-01-01

Citicoline can have beneficial effects both in degenerative and in vascular cognitive decline in a variety of ways (apoptosis inhibition, neuroplasticity potentiation, phospholipid, and acetylcholine (ACh) synthesis). Acetylcholinesterase inhibitors (AChEIs) have been used for treatment of Alzheimer's disease (AD). When co-administered with cholinergic precursors, they are able to increase the intrasynaptic levels of ACh more than when the single drugs given alone. The aim of the present study was to show the effectiveness of oral citicoline plus AChEIs in patients affected with AD. This was a retrospective multi-centric case-control study, involving seven Centers for Cognitive Impairment and Dementia in Italy, on 448 consecutive patients aged 65 years old or older affected with AD. 197 patients were treated with an AChEI while 251 were treated with an AchEI + citicoline 1000 mg/day given orally. Cognitive functions were assessed by MMSE, daily life functions by ADL and IADL, behavioral symptoms by NPI, comorbidities by CIRS, and mood by GDS-short form. Tests were administered at baseline (T0), after 3 (T1), and 9 months (T2). The primary outcomes were effects of combined administration versus AChEIs given alone on cognitive functions assessed by MMSE. The secondary outcomes were possible side effects or adverse events of combination therapy versus AChEIs alone. Patients treated with citicoline plus an AChEI showed a statistically significant increase in MMSE between T0 and T1 (16.88±3.38 versus 17.62±3.64; p = 0.000) and between T1 and T2 (17.62±3.64 versus 17.89±3.54; p = 0.000). The present study encourages the role of combined administration in disease management by slowing disease progression.

Role of physical activity in reducing cognitive decline in older Mexican-American adults.

PubMed

Ottenbacher, Allison J; Snih, Soham Al; Bindawas, Saad M; Markides, Kyriakos S; Graham, James E; Samper-Ternent, Rafael; Raji, Mukaila; Ottenbacher, Kenneth J

2014-09-01

The effect of physical activity on cognitive function in older adults from minority and disadvantaged populations is not well understood. This study examined the longitudinal association between physical activity and cognition in older Mexican Americans. The study methodology included a prospective cohort with longitudinal analysis of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. General linear mixed models were used to assess the associations and interactions between physical activity and cognitive function over 14 years. Community-based assessments were performed in participants' homes. Physical activity was recorded for 1,669 older Mexican Americans using the Physical Activity Scale for the Elderly. Cognition was measured using the Mini-Mental State Examination (MMSE) and separated into memory and nonmemory components. A statistically significant positive association was observed between levels of physical activity and cognitive function after adjusting for age, sex, marital status, education, and comorbid health conditions. There was a statistically significant difference in MMSE scores over time between participants in the third (β = 0.11, standard error (SE) = 0.05) and fourth (β = 0.10, SE = 0.2) quartiles of physical activity and those in the first. The protective effect of physical activity on cognitive decline was evident for the memory component of the MMSE but not the nonmemory component after adjusting for covariates. Greater physical activity at baseline was associated with less cognitive decline over 14 years in older Mexican Americans. The reduction in cognitive decline appeared to be related to the memory components of cognitive function. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Cognition and screening for hearing loss in nursing home residents.

PubMed

Jupiter, Tina

2012-10-01

To compare hearing screening results using pure tones and distortion product otoacoustic emissions (DPOAEs) with nursing home residents who have dementia and explore the relationship of hearing impairment and cognitive function using the Mini- Mental Status Evaluation (MMSE). A correlational design was implemented to evaluate residents in a large inner city nursing home. One hundred one nursing home residents 65-108 years. DPOAEs and pure tone screenings were conducted at 30 dB HL and 40 dB HL at 1, 2, and 3 kHz. Pure tone thresholds at 1, 2, and 3 kHz were obtained. The MMSE was administered to all participants. Results showed that all residents failed the DPOAE screen, 97.1% failed at 30 dB HL, and 90.0% failed at 40 dB HL. Kendall's tau, phi correlation, linear by linear association, and χ(2) results indicated no significant relationship for any of the screening protocols and cognitive status other than a significant finding with left ear screening at 40 dB HL. Logistic regression analysis indicated that individuals who passed the screen had better MMSE scores. Results of the t test and Mann-Whitney U test revealed a significant difference in cognitive function for residents with a mild hearing loss compared with those with a more significant hearing loss. For screening nursing home residents, 40 dB HL screening level or DPOAEs can be used. The significant finding that residents with greater than a mild hearing loss have poorer cognitive function reinforces the importance of identifying residents with a hearing loss and providing rehabilitation and follow-up. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

A preliminary study of the Six-Item Screener in detecting cognitive impairment.

PubMed

Chen, Mei-Rong; Guo, Qi-Hao; Cao, Xin-Yi; Hong, Zhen; Liu, Xiao-Hong

2010-08-01

The present retrospective study was to explore the clinical value of Six-Item Screener (SIS), which is constituted by 6 items from mini-mental status examination (MMSE), to identify cognitive impairment. A total number of 1976 patients aged over 50 years, from the Memory Clinic of Huashan Hospital were employed in a battery of neuropsychological tests including MMSE. Subjects with severe conditions, unable to cooperate, or having been previously enrolled, were excluded from this study. The employed subjects were divided into 3 groups: subjective memory complaints (SMCs) (475 cases), patients with mild cognitive impairment (MCI) (440 cases), and patients with Alzheimer's disease (AD) (1061 cases, including 555 mild, 339 moderate, and 167 severe). A total score of MMSE and a score of SIS composed of date, month, year, three-word delayed recall from MMSE were calculated. Data were analyzed based on educational background. The cut-off of SIS score was <2 for illiterate, <3 for elementary, and <4 for junior high school or above. The sensitivity and specificity of SIS for detecting mild AD were 88.5% and 78.3%, respectively, with an overall accuracy of 83.8%, while for detecting MCI, the sensitivity and specificity were 34.3% and 90.1%, respectively, with an overall accuracy of 63.2%. SIS is an effective and reliable instrument for dementia detection in outpatient department. However, it has limited value for MCI identification.

Clinically insubstantial cognitive side effects of bitemporal electroconvulsive therapy at 0.5 msec pulse width.

PubMed

Warnell, Ronald L; Swartz, Conrad M; Thomson, Alice

2011-11-01

We measured cognitive side effects from bitemporal electroconvulsive therapy (ECT) using stimuli of 0.5 msec pulse width 900 milliamperes (mA). Mini-Mental State Exam (MMSE) and 21-item Hamilton Rating Scale for Depression (HRSD-21) were rated within 36 hours before and 36 hours after a series of 6 bitemporal ECT sessions on 15 patients age ≥45. MMSE remained high after ECT (pre-ECT mean 29, standard deviation [SD] 1.60, post-ECT mean 28.53, SD 1.36) with no significant change. The mean HRSD-21 fell from 27.5 to 16.3. Post-ECT MMSE was significantly and markedly higher than in previous studies of bitemporal ECT; all had used ECT stimuli of pulse width at least 1 msec. With stimuli of 0.5 msec pulse width and 900 mA, 6 bitemporal ECTs did not decrease MMSE score. This result leaves no opportunity for further decrease in basic cognitive side effects, and complements published reports of stronger physiological effects with stimuli of 0.5 msec pulse width and 900 mA. ECT stimuli of 0.5 msec pulse width and 900 mA are more desirable than wider pulse widths. Six bitemporal ECT sessions using these stimuli generally will not have more cognitive side effects than treatments with other placements, allowing maintenance of full efficacy with clinically insubstantial side effects.

Domain Specific Changes in Cognition at High Altitude and Its Correlation with Hyperhomocysteinemia

PubMed Central

Sharma, Vijay K.; Das, Saroj K.; Dhar, Priyanka; Hota, Kalpana B.; Mahapatra, Bidhu B.; Vashishtha, Vivek; Kumar, Ashish; Hota, Sunil K.; Norboo, Tsering; Srivastava, Ravi B.

2014-01-01

Though acute exposure to hypobaric hypoxia is reported to impair cognitive performance, the effects of prolonged exposure on different cognitive domains have been less studied. The present study aimed at investigating the time dependent changes in cognitive performance on prolonged stay at high altitude and its correlation with electroencephalogram (EEG) and plasma homocysteine. The study was conducted on 761 male volunteers of 25–35 years age who had never been to high altitude and baseline data pertaining to domain specific cognitive performance, EEG and homocysteine was acquired at altitude ≤240 m mean sea level (MSL). The volunteers were inducted to an altitude of 4200–4600 m MSL and longitudinal follow-ups were conducted at durations of 03, 12 and 18 months. Neuropsychological assessment was performed for mild cognitive impairment (MCI), attention, information processing rate, visuo-spatial cognition and executive functioning. Total homocysteine (tHcy), vitamin B12 and folic acid were estimated. Mini Mental State Examination (MMSE) showed temporal increase in the percentage prevalence of MCI from 8.17% on 03 months of stay at high altitude to 18.54% on 18 months of stay. Impairment in visuo-spatial executive, attention, delayed recall and procedural memory related cognitive domains were detected following prolonged stay in high altitude. Increase in alpha wave amplitude in the T3, T4 and C3 regions was observed during the follow-ups which was inversely correlated (r = −0.68) to MMSE scores. The tHcy increased proportionately with duration of stay at high altitude and was correlated with MCI. No change in vitamin B12 and folic acid was observed. Our findings suggest that cognitive impairment is progressively associated with duration of stay at high altitude and is correlated with elevated tHcy in the plasma. Moreover, progressive MCI at high altitude occurs despite acclimatization and is independent of vitamin B12 and folic acid. PMID:24988417

Interactive effects of diabetes and impaired kidney function on cognitive performance in old age: a population-based study.

PubMed

Yin, Zhaoxue; Yan, Zhongrui; Liang, Yajun; Jiang, Hui; Cai, Chuanzhu; Song, Aiqin; Feng, Lei; Qiu, Chengxuan

2016-01-12

The interactive effect between diabetes and impaired kidney function on cognitive impairment in older adults has not yet been reported. The aim of this study was to investigate the association of diabetes and impaired kidney function with cognitive impairment among Chinese older people living in a rural area. This cross-sectional study included 1,358 participants (age ≥60 years; 60.5% women) in the population-based Confucius Hometown Aging Project in Shandong, China. Data on demographics, lifestyle factors, health history, use of medications, global cognitive function, and kidney function were collected through structured interviews, clinical examinations, and blood tests. We defined diabetes as a fasting plasma glucose level ≥7.0 mmol/l or use of hypoglycemic agents, impaired kidney function as glomerular filtration rate estimated from cystatin C (eGFRcys) <60 ml/min/1.73 m(2). Cognitive impairment was defined using the education-based cut-off scores of Mini-Mental State Examination (MMSE). Data were analyzed using multiple general linear and logistic regression models. Cognitive impairment was defined in 197 (14.5%) persons. The multi-adjusted β coefficient of MMSE score associated with diabetes was -0.06 (95% confidence interval [CI], -0.16, 0.03); the corresponding figures associated with eGFRcys <60, 60-89.9, and ≥90 ml/min/1.73 m(2) were -0.15 (-0.28, -0.02), -0.01 (-0.10, 0.08), and 0 (reference) (Ptrend = 0.046), respectively. Diabetes and impaired kidney function showed an interactive effect on cognitive impairment ( interaction = 0.02). Compared with individuals having neither diabetes nor impaired kidney function, those with both conditions had a multi-adjusted odds ratio of 4.23 (95% CI, 2.10-8.49) for cognitive impairment. The relative excess risk due to interaction was 2.74. This study suggests that concurrent presence of diabetes and impaired kidney function is associated with a substantial likelihood for cognitive impairment in older adults.

The neuropsychological differentiation of patients with very mild Alzheimer's disease and/or major depression.

PubMed

desRosiers, G; Hodges, J R; Berrios, G

1995-11-01

To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. Controlled prospective clinicoexperimental design. Multidisciplinary Memory Clinic at Addenbroke's Hospital, Cambridge, England. Twenty-four patients with a clinical diagnosis of Alzheimer's disease (12 with major depression and 12 without), 12 patients with major depressive illness but without AD, and 12 healthy control subjects, all matched for age, sex, education levels, and estimates of premorbid intellectual potential. Mini-Mental State Examination (MMSE), Wechsler's Logical Memory (WLM) and Visual Reproduction (WVR), immediate and delayed reproduction, Wechsler's paired Associate Learning (WPAL), including the Easy and Hard subsets. Warrington's Recognition Memory for Faces (WRMF), Kendrick's Object Learning (KOLT) and Digit Copying (KDCT) Tests. Minimum 2-year follow-up diagnosis. Statistically, patients with very mild AD were distinguished clearly from those without AD on most tests of memory functions. Psychometrically, only KOLT and an index of retention on WLM and WVR were specific enough to avoid false positives, a requirement for second-stage tools. They also proved sensitive enough to suggest their role as first-stage instruments when screening for primary dementia in high-functioning patients scoring above the cut-point on MMSE. As efforts intensify to develop more powerful means to identify patients with Alzheimer's disease in its earliest stages, inclusion of specialist tests posing greater cognitive challenge than standard mental status scales has been one strategy. Our study explored how some of these neuropsychological tools behave psychometrically when analyzed on a single-case basis, and the results suggest a few are sensitive enough to boost detection above base rates alone while also being specific enough to reduce false alarms. Retention on Wechsler's Logical Memory and Visual Reproduction tasks and scores on Kendrick's Object Learning Test helped decrease the degree of ambiguity when cognitive profiles were used to distinguish depressed patients with Alzheimer disease from those without.

Three levels of neuroelectronic interfacing: silicon chips with ion channels, nerve cells, and brain tissue.

PubMed

Fromherz, Peter

2006-12-01

We consider the direct electrical interfacing of semiconductor chips with individual nerve cells and brain tissue. At first, the structure of the cell-chip contact is studied. Then we characterize the electrical coupling of ion channels--the electrical elements of nerve cells--with transistors and capacitors in silicon chips. On that basis it is possible to implement signal transmission between microelectronics and the microionics of nerve cells in both directions. Simple hybrid neuroelectronic systems are assembled with neuron pairs and with small neuronal networks. Finally, the interfacing with capacitors and transistors is extended to brain tissue cultured on silicon chips. The application of highly integrated silicon chips allows an imaging of neuronal activity with high spatiotemporal resolution. The goal of the work is an integration of neuronal network dynamics with digital electronics on a microscopic level with respect to experiments in brain research, medical prosthetics, and information technology.

Fermented non-digestible fraction from combined nixtamalized corn (Zea mays L.)/cooked common bean (Phaseolus vulgaris L.) chips modulate anti-inflammatory markers on RAW 264.7 macrophages.

PubMed

Luzardo-Ocampo, I; Campos-Vega, R; Cuellar-Nuñez, M L; Vázquez-Landaverde, P A; Mojica, L; Acosta-Gallegos, J A; Loarca-Piña, G

2018-09-01

Chronic non-communicable diseases (NCDs) are low-level inflammation processes affected by several factors including diet. It has been reported that mixed whole grain and legume consumption, e.g. corn and common bean, might be a beneficial combination due to its content of bioactive compounds. A considerable amount would be retained in the non-digestible fraction (NDF), reaching the colon, where microbiota produce short-chain fatty acids (SCFAs) and phenolic compounds (PC) with known anti-inflammatory effect. The aim of this study was to estimate the anti-inflammatory potential of fermented-NDF of corn-bean chips (FNDFC) in RAW 264.7 macrophages. After 24 h, FNDFC produced SCFAs (0.156-0.222 mmol/l), inhibited nitric oxide production > 80% and H 2 O 2  > 30%, up-regulated anti-inflammatory cytokines (I-TAC, TIMP-1) > 2-fold, and produced angiostatic and protective factors against vascular/tissue damage, and amelioration of tumor necrosis factor signalling and inflammatory bowel disease. These results confirm the anti-inflammatory potential derived from healthy corn-bean chips. Copyright © 2018. Published by Elsevier Ltd.

Low uric acid is a risk factor in mild cognitive impairment.

PubMed

Xue, LingLing; Liu, YongBing; Xue, HuiPing; Xue, Jin; Sun, KaiXuan; Wu, LinFeng; Hou, Ping

2017-01-01

Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia. Uric acid is a water-soluble antioxidant found in the body. Many recent studies have found that uric acid plays an important role in cognitive impairment, although the effects of uric acid on MCI are not clear. The objective of this study was to explore the relationship between uric acid and MCI. Using a random sampling method, this study investigated 58 patients with MCI and 57 healthy elderly from January 2016 to November 2016. Demographic information was collected, the subjects were evaluated using the Mini Mental Status Examination (MMSE), and uric acid was measured in fasting venous blood. A total of 57 (49.6%) participants are healthy and 58 (50.4%) participants had MCI. The uric acid level was significantly lower in the patients with MCI (292.28±63.71 μmol/L) than in the normal controls (322.49±78.70 μmol/L; P <0.05). There were significant positive correlations between the MMSE scores, for each dimension and the total score, and uric acid level (all P <0.05). Multivariate logistic regression models illustrated that uric acid was a protective factor for MCI (odds ratio =0.999, 95% CI =0.987-0.999). A low uric acid level is a risk factor for MCI, and an appropriate increase in uric acid can be used to slow down the occurrence and development of MCI.

Differences in levels of albumin, ALT, AST, γ-GT and creatinine in frail, moderately healthy and healthy elderly individuals.

PubMed

Edvardsson, Maria; Sund-Levander, Märtha; Milberg, Anna; Wressle, Ewa; Marcusson, Jan; Grodzinsky, Ewa

2018-02-23

Reference intervals are widely used as decision tools, providing the physician with information about whether the analyte values indicate ongoing disease process. Reference intervals are generally based on individuals without diagnosed diseases or use of medication, which often excludes elderly. The aim of the study was to assess levels of albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine and γ-glutamyl transferase (γ-GT) in frail, moderately healthy and healthy elderly indivuduals. Blood samples were collected from individuals >80 years old, nursing home residents, in the Elderly in Linköping Screening Assessment and Nordic Reference Interval Project, a total of 569 individuals. They were divided into three cohorts: frail, moderately healthy and healthy, depending on cognitive and physical function. Albumin, ALT, AST, creatinine and γ-GT were analyzed using routine methods. Linear regression predicted factors for 34% of the variance in albumin were activities of daily living (ADL), gender, stroke and cancer. ADLs, gender and weight explained 15% of changes in ALT. For AST levels, ADLs, cancer and analgesics explained 5% of changes. Kidney disease, gender, Mini Mental State Examination (MMSE) and chronic obstructive pulmonary disease explained 25% of the variation in creatinine levels and MMSE explained three per cent of γ-GT variation. Because a group of people are at the same age, they should not be assessed the same way. To interpret results of laboratory tests in elderly is a complex task, where reference intervals are one part, but far from the only one, to take into consideration.

Sorbic and benzoic acid in non-preservative-added food products in Turkey.

PubMed

Cakir, Ruziye; Cagri-Mehmetoglu, Arzu

2013-01-01

Sorbic acid (SA) and benzoic acid (BA) were determined in yoghurt, tomato and pepper paste, fruit juices, chocolates, soups and chips in Turkey by using high-pressure liquid chromatography (HPLC). Levels were compared with Turkish Food Codex limits. SA was detected only in 2 of 21 yoghurt samples, contrary to BA, which was found in all yoghurt samples but one, ranging from 10.5 to 159.9 mg/kg. Both SA and BA were detected also in 3 and 6 of 23 paste samples in a range of 18.1-526.4 and 21.7-1933.5 mg/kg, respectively. Only 1 of 23 fruit juices contained BA. SA was not detected in any chips, fruit juice, soup, or chocolate sample. Although 16.51% of the samples was not compliant with the Turkish Food Codex limits, estimated daily intake of BA or SA was below the acceptable daily intake.

The Internationalization of Industry. Annex B. Offshore Production in the International Semiconductor Industry,

DTIC Science & Technology

1981-11-01

essence of these arrangements is specialization based in international differentials in * 379 the costs of labor services. The availability of low...of electronic equipment vary with the complexity and cost of the equipment, a differentiated market for chips of varying densities, for use in...level of chip density, while more complex products will be most economically produced with higher levels of chip density. Thuse a differentiated

Effect of Compressive Stresses on Leakage Currents in Microchip Tantalum Capacitors

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander

2012-01-01

Microchip tantalum capacitors are manufactured using new technologies that allow for production of small size capacitors (down to EIA case size 0402) with volumetric efficiency much greater than for regular chip capacitors. Due to a small size of the parts and leadless design they might be more sensitive to mechanical stresses that develop after soldering onto printed wiring boards (PWB) compared to standard chip capacitors. In this work, the effect of compressive stresses on leakage currents in capacitors has been investigated in the range of stresses up to 200 MPa. Significant, up to three orders of magnitude, variations of currents were observed after the stress exceeds a certain critical level that varied from 10 MPa to 180 MPa for capacitors used in this study. A stress-induced generation of electron traps in tantalum pentoxide dielectric is suggested to explain reversible variations of leakage currents in tantalum capacitors. Thermo-mechanical characteristics of microchip capacitors have been studied to estimate the level of stresses caused by assembly onto PWB and assess the risk of stress-related degradation and failures. Keywords: tantalum capacitors, leakage current, soldering, reliability, mechanical stress.

Association of physical activity with the visuospatial/executive functions of the montreal cognitive assessment in patients with vascular cognitive impairment.

PubMed

Ihara, Masafumi; Okamoto, Yoko; Hase, Yoshiki; Takahashi, Ryosuke

2013-10-01

The Montreal Cognitive Assessment (MoCA) is more suitable than the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment. In this study, we performed a correlation analysis of MoCA/MMSE scores with daily physical activity in patients with subcortical ischemic white matter changes. Ten patients (average 75.9 ± 9.1 years old) with extensive leukoaraiosis detected on magnetic resonance imaging underwent cognitive testing, including the MMSE and the Japanese version of the MoCA (MoCA-J). Physical activity was monitored with the Kenz Lifecorder EX device (Suzuken, Nagoya, Japan) to assess daily physical activity in terms of caloric expenditure, motor activity, number of steps, and walking distance for 6 months. Correlations of individual physical activity with total and subscale scores of MMSE/MoCA-J or 6-month interval change of MoCA-J scores were assessed. The total or subscale scores of the MMSE did not correlate with any parameters of physical activity. However, the mean number of steps and walking distance significantly correlated with the total MoCA-J scores (r = .67 and .64, respectively) and its visuospatial/executive subscores (r = .66 and .66, respectively). The mean interval change of MoCA-J was + .6; those who improved number of steps (n = 4; 80.5 ± 3.0 years of age) had significantly preserved MoCA-J scores compared to those who did not (n = 6; 73.0 ± 11.6 years of age; +2.0 versus - .3; P = .016). These results suggest that MoCA is useful to detect a biologically determined specific relationship between physical activity and executive function. In addition, physical exercise, such as walking, may help enhance cognitive function in patients with vascular cognitive impairment of subcortical origin. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study

PubMed Central

Carotenuto, Anna; Rea, Raffaele; Ricci, Giovanna; Fasanaro, Angiola Maria; Amenta, Francesco

2018-01-01

Background Approximately 46.8 million people are living with dementia worldwide and their number will grow in the next years. Any potential treatment should be administered as early as possible because it is important to provide an early cognitive assessment and to regularly monitor the mental function of patients. Information and communication technologies can be helpful to reach and follow patients without displacing them, but there may be doubts about the reliability of cognitive tests performed by telemedicine. Objective The purpose of this study was to evaluate the reliability of the Mini Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale cognitive subscale (ADAS-cog) tests administered in hospital by videoconference to patients with mild to moderate Alzheimer's disease. Methods The tests were administered to 28 Alzheimer's disease outpatients (8 male, mean age 73.88, SD 7.45 years; 20 female mean age 76.00, SD 5.40 years) recruited and followed in the Alzheimer’s Unit of the A Cardarelli National Hospital (Naples, Italy) at baseline and after 6, 12, 18, and 24 months of observation. Patients were evaluated first face-to-face by a psychologist and then, after 2 weeks, by another psychologist via videoconference in hospital. Results This study showed no differences in the MMSE and ADAS-cog scores when the tests were administered face-to-face or by videoconference, except in patients with more pronounced cognitive deficits (MMSE<17), in which the assessment via videoconference overestimated the cognitive impairment (face to face, MMSE mean 13.9, SD 4.9 and ADAS-cog mean 9.0, SD 3.8; videoconference, MMSE mean 42.8, SD 12.5 and ADAS-cog mean 56.9, SD 5.5). Conclusions We found that videoconferencing is a reliable approach to document cognitive stability or decline, and to measure treatment effects in patients with mild to moderate dementia. A more extended study is needed to confirm these results. PMID:29752254

A 1-1/2-level on-chip-decoding bubble memory chip design

NASA Technical Reports Server (NTRS)

Chen, T. T.

1975-01-01

Design includes multi-channel replicator which can reduce chip-writing requirement, selective annihilating switch which can effectively annihilate bubbles with minimum delay, and modified transfer switch which can be used as selective steering-type decoder.

Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium.

PubMed

Yoon, Hyung-Jun; Park, Kyoung-Min; Choi, Won-Jung; Choi, Soo-Hee; Park, Jin-Young; Kim, Jae-Jin; Seok, Jeong-Ho

2013-09-30

Most previous studies on the efficacy of antipsychotic medication for the treatment of delirium have reported that there is no significant difference between typical and atypical antipsychotic medications. It is known, however, that older age might be a predictor of poor response to antipsychotics in the treatment of delirium. The objective of this study was to compare the efficacy and safety of haloperidol versus three atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) for the treatment of delirium with consideration of patient age. This study was a 6-day, prospective, comparative clinical observational study of haloperidol versus atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) in patients with delirium at a tertiary level hospital. The subjects were referred to the consultation-liaison psychiatric service for management of delirium and were screened before enrollment in this study. A total of 80 subjects were assigned to receive either haloperidol (N = 23), risperidone (N = 21), olanzapine (N = 18), or quetiapine (N = 18). The efficacy was evaluated using the Korean version of the Delirium Rating Scale-Revised-98 (DRS-K) and the Korean version of the Mini Mental Status Examination (K-MMSE). The safety was evaluated by the Udvalg Kliniske Undersogelser side effect rating scale. There were no significant differences in mean DRS-K severity or K-MMSE scores among the four groups at baseline. In all groups, the DRS-K severity score decreased and the K-MMSE score increased significantly over the study period. However, there were no significant differences in the improvement of DRS-K or K-MMSE scores among the four groups. Similarly, cognitive and non-cognitive subscale DRS-K scores decreased regardless of the treatment group. The treatment response rate was lower in patients over 75 years old than in patients under 75 years old. Particularly, the response rate to olanzapine was poorer in the older age group. Fifteen subjects experienced a few adverse events, but there were no significant differences in adverse event profiles among the four groups. Haloperidol, risperidone, olanzapine, and quetiapine were equally efficacious and safe in the treatment of delirium. However, age is a factor that needs to be considered when making a choice of antipsychotic medication for the treatment of delirium. Clinical Research Information Service, Republic of Korea, (http://cris.nih.go.kr/cris/en/search/basic_search.jsp, Registered Trial No. KCT0000632).

"Hook"-calibration of GeneChip-microarrays: theory and algorithm.

PubMed

Binder, Hans; Preibisch, Stephan

2008-08-29

: The improvement of microarray calibration methods is an essential prerequisite for quantitative expression analysis. This issue requires the formulation of an appropriate model describing the basic relationship between the probe intensity and the specific transcript concentration in a complex environment of competing interactions, the estimation of the magnitude these effects and their correction using the intensity information of a given chip and, finally the development of practicable algorithms which judge the quality of a particular hybridization and estimate the expression degree from the intensity values. : We present the so-called hook-calibration method which co-processes the log-difference (delta) and -sum (sigma) of the perfect match (PM) and mismatch (MM) probe-intensities. The MM probes are utilized as an internal reference which is subjected to the same hybridization law as the PM, however with modified characteristics. After sequence-specific affinity correction the method fits the Langmuir-adsorption model to the smoothed delta-versus-sigma plot. The geometrical dimensions of this so-called hook-curve characterize the particular hybridization in terms of simple geometric parameters which provide information about the mean non-specific background intensity, the saturation value, the mean PM/MM-sensitivity gain and the fraction of absent probes. This graphical summary spans a metrics system for expression estimates in natural units such as the mean binding constants and the occupancy of the probe spots. The method is single-chip based, i.e. it separately uses the intensities for each selected chip. : The hook-method corrects the raw intensities for the non-specific background hybridization in a sequence-specific manner, for the potential saturation of the probe-spots with bound transcripts and for the sequence-specific binding of specific transcripts. The obtained chip characteristics in combination with the sensitivity corrected probe-intensity values provide expression estimates scaled in natural units which are given by the binding constants of the particular hybridization.

Estimated Hardwood Volume Available for Wood Chipmills or Other Low Grade Uses

EPA Pesticide Factsheets

The potential of wood chip mills to influence the distribution of harvests and the dynamics of wood fiber utilization has become an issue of concern. Where wood chip mills are active in a timber market, they may increase the utilization of wood fiber derived from a given harvest; change the pattern and distribution of harvests on the landscape; and reduce production costs of fiber supply, thus increasing overall quantity supplied in a price-taking market. Wood chip mills have proliferated in the South in recent decades. This data layer was created to address the following question: If the Mid-Atlantic region behaves as the South, which areas are relatively more attractive as sources of low grade hardwood fiber, and therefore relatively more vulnerable to any negative stresses associated with wood chip harvests? The data layer simulates annual softwood wood chip volume (in tons) available to supply chip mills or other low grade uses, if timber supply in the Mid-Atlantic mirrors trends for the South.

Capillary-Driven Microfluidic Chips for Miniaturized Immunoassays: Efficient Fabrication and Sealing of Chips Using a "Chip-Olate" Process.

PubMed

Temiz, Yuksel; Delamarche, Emmanuel

2017-01-01

The fabrication of silicon-based microfluidic chips is invaluable in supporting the development of many microfluidic concepts for research in the life sciences and in vitro diagnostic applications such as the realization of miniaturized immunoassays using capillary-driven chips. While being extremely abundant, the literature covering microfluidic chip fabrication and assay development might not have addressed properly the challenge of fabricating microfluidic chips on a wafer level or the need for dicing wafers to release chips that need then to be further processed, cleaned, rinsed, and dried one by one. Here, we describe the "chip-olate" process wherein microfluidic structures are formed on a silicon wafer, followed by partial dicing, cleaning, and drying steps. Then, integration of reagents (if any) can be done, followed by lamination of a sealing cover. Breaking by hand the partially diced wafer yields individual chips ready for use.

Bio-inspired multi-mode optic flow sensors for micro air vehicles

NASA Astrophysics Data System (ADS)

Park, Seokjun; Choi, Jaehyuk; Cho, Jihyun; Yoon, Euisik

2013-06-01

Monitoring wide-field surrounding information is essential for vision-based autonomous navigation in micro-air-vehicles (MAV). Our image-cube (iCube) module, which consists of multiple sensors that are facing different angles in 3-D space, can be applied to the wide-field of view optic flows estimation (μ-Compound eyes) and to attitude control (μ- Ocelli) in the Micro Autonomous Systems and Technology (MAST) platforms. In this paper, we report an analog/digital (A/D) mixed-mode optic-flow sensor, which generates both optic flows and normal images in different modes for μ- Compound eyes and μ-Ocelli applications. The sensor employs a time-stamp based optic flow algorithm which is modified from the conventional EMD (Elementary Motion Detector) algorithm to give an optimum partitioning of hardware blocks in analog and digital domains as well as adequate allocation of pixel-level, column-parallel, and chip-level signal processing. Temporal filtering, which may require huge hardware resources if implemented in digital domain, is remained in a pixel-level analog processing unit. The rest of the blocks, including feature detection and timestamp latching, are implemented using digital circuits in a column-parallel processing unit. Finally, time-stamp information is decoded into velocity from look-up tables, multiplications, and simple subtraction circuits in a chip-level processing unit, thus significantly reducing core digital processing power consumption. In the normal image mode, the sensor generates 8-b digital images using single slope ADCs in the column unit. In the optic flow mode, the sensor estimates 8-b 1-D optic flows from the integrated mixed-mode algorithm core and 2-D optic flows with an external timestamp processing, respectively.

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans.

PubMed

Ahn, Jeong-Deok; Kang, Hyunsik

2015-12-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R(2) = -0.184, p = 0.029) and endurance (partial R(2) = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R(2) = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key pointsCognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging.In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans.The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates.

Physical Fitness and Serum Vitamin D and Cognition in Elderly Koreans

PubMed Central

Ahn, Jeong-Deok; Kang, Hyunsik

2015-01-01

Poor physical fitness and low serum vitamin D are known to be modifiable risk factors for cognitive declines with normal aging. We investigated the association of physical fitness and serum vitamin D levels with global cognitive function in older adults. In this cross-sectional study, a total of 412 older Korean adults (108 men aged 74.4 ± 6.0 years and 304 women aged 73.1 ± 5.4 years) completed the Korean version of Mini-Mental State Examination (MMSE) to assess global cognitive performance and the senior fitness test to assess strength, flexibility, agility, and endurance domains of physical fitness. Body mass index, percent body fat, serum vitamin D, geriatric depression scale (GDS), level of education, smoking, and history of cardiovascular or cerebrovascular disease were also assessed as covariates. Age, sex, GDS, and body fatness were negatively associated with MMSE-based cognitive performance. Serum vitamin D and physical fitness were positively associated with MMSE-based cognitive performance. Multivariate linear regression showed that agility (partial R2 = -0.184, p = 0.029) and endurance (partial R2 = 0.191, p = 0.022) domains of physical fitness along with serum vitamin D (partial R2 = 0.210, p = 0.012) were significant predictors for global cognitive performance after controlling for covariates (i.e., age, sex, education, GDS, body fatness, and comorbidity index). The current findings of the study suggest that promotion of physical fitness and vitamin D supplementation should be key components of interventions to prevent cognitive decline with normal aging. Key points Cognitive declines are associated with normal aging as well as modifiable lifestyle risk factors, and there is an increasing need to identify the modifiable risk factors for the onset of cognitive declines and to provide evidence-based strategies for healthy and successful aging. In Korea, little is known about the relationships of physical fitness and serum vitamin D with cognitive function in older adults, and we determined the associations between a) serum vitamin D levels and cognitive function and b) physical fitness and cognitive function among community-dwelling elderly Koreans. The current findings of the study suggest that agility and endurance domains of physical fitness along with serum vitamin D were significant predictors for global cognitive performance after controlling for covariates. PMID:26664270

Channel estimation in few mode fiber mode division multiplexing transmission system

NASA Astrophysics Data System (ADS)

Hei, Yongqiang; Li, Li; Li, Wentao; Li, Xiaohui; Shi, Guangming

2018-03-01

It is abundantly clear that obtaining the channel state information (CSI) is of great importance for the equalization and detection in coherence receivers. However, to the best of the authors' knowledge, in most of the existing literatures, CSI is assumed to be perfectly known at the receiver. So far, few literature discusses the effects of imperfect CSI on MDM system performance caused by channel estimation. Motivated by that, in this paper, the channel estimation in few mode fiber (FMF) mode division multiplexing (MDM) system is investigated, in which two classical channel estimation methods, i.e., least square (LS) method and minimum mean square error (MMSE) method, are discussed with the assumption of the spatially white noise lumped at the receiver side of MDM system. Both the capacity and BER performance of MDM system affected by mode-dependent gain or loss (MDL) with different channel estimation errors have been studied. Simulation results show that the capacity and BER performance can be further deteriorated in MDM system by the channel estimation, and an 1e-3 variance of channel estimation error is acceptable in MDM system with 0-6 dB MDL values.

Evaluation of Chipper-Forwarder Biomass Harvesting Concept

Treesearch

Bryce J. Stokes; D.L. Sirois

1986-01-01

A chipper-forwarder system offers an alternative for biomass harvesting. Components are a small feller buncher for felling and bunching, and a chipper-forwarder that chips at the pile and transports the chips to roadside. In a case study on a mixed pine and hardwood site in Georgia after conventional hawesting, production rates and cost estimates for a prototype...

Relationship of executive function and educational status with functional balance in older adults.

PubMed

Voos, Mariana Callil; Custódio, Elaine Bazilio; Malaquias, Joel

2011-01-01

The Berg Balance Scale (BBS) is frequently used to assess functional balance in older adults. The relationship of executive function and level of education with the BBS performance has not been described. The aim of this study was to determine whether (1) the performance on a task requiring executive function (part B of the Trail Making Test, TMT-B) influences results of motor and cognitive tests and (2) the number of years of formal education could be related to performance on BBS in older adults. We also explored whether there would be differences, based on performance on TMT-B (high vs low) in motor function (BBS, the timed up and go [TUG]) or cognitive function (TMT-A and TMTDELTA), the Mini Mental State Examination (MMSE), as well as years of education. Participants included 101 older adults (age range, 60-80 years) residing in São Paulo, Brazil. Functional balance was assessed using BBS and TUG. Executive function was assessed using the TMT and MMSE. Educational status was determined by self-report of participant's total number of years of formal education. The BBS scores were inversely related to TMT-A time (r = -0.63, r = 0.40, P < .001) and TMT-B time (r = -0.56, r = 0.31, P < .001). There was a similar relationship with TMTDELTA (r = -0.47, r = 0.22, P < .001). The BBS scores were positively correlated to years of formal education (r = 0.48, r = 0.23, P < .001). There was a ceiling effect on the TMT-B, with many individuals reaching maximum score of 300 seconds. Participants with high levels of executive function had higher BBS and MMSE scores, more education, and lower TMT-A, TMTDELTA and TUG scores (P < .001) than the lower functioning group. Individuals with higher capacity on tasks requiring visuospatial abilities, psychomotor speed, and executive function, such as the TMT, had better performance on BBS. Individuals with a high executive function, measured by TMT-B, also performed better on other motor and cognitive tests.

Differences in ABCA1 R219K Polymorphisms and Serum Indexes in Alzheimer and Parkinson Diseases in Northern China

PubMed Central

Ya, Lagai; Lu, Zuneng

2017-01-01

Background ABCA1 R219K single-nucleotide polymorphisms (SNPs) was related to Alzheimer disease (AD) but not Parkinson disease (PD). Here, we analyzed the associations among ABCA1 R219K distribution, serum biomarkers, AD, and PD in a population in northern China. Material/Methods We used the Mini-Mental State Examination (MMSE) and the Hoehn and Yahr scale (H-Y) to evaluate AD and PD progression, separately. ABCA1 R219K was analyzed by matrix-assisted laser desorption ionization time of flight time mass spectrometry (MALDI-TOF-MS). Serum indexes were determined by enzyme-linked immunosorbent assay (ELISA). Results ABCA1 R219K RR+RK genotype frequency in AD and PD patients was lower than that in normal controls (NC), while ABCA1 R219K KK genotype frequency was significantly higher. ABCA1 R219K RR genotype frequency in AD patients and NC was lower than that in PD patients, while ABCA1 R219K RK+KK genotype frequency was significantly higher. ABCA1 R219K RR genotype was positively correlated to MMSE value in AD patients, while ABCA1 R219K KK genotype was negatively correlated to H-Y value in PD patients. Serum factors were significantly different among AD and PD patients and NC. Serum ABCA1, ApoA1, ApoA2, ApoB, HDL, TC, IL-1β, IL-6, and TNF-α were significantly different between AD and PD patients. Conclusions ABCA1 R219K R allele was the risk factor inducing abnormal serum levels of ApoA2, LDL, and TG in AD patients, and abnormal levels of serum ABCA1, HDL, IL-1β, IL-6, and TNF-α in PD patients, while ABCA1 R219K K allele was the risk factor inducing lower ABCA1 in AD patients. IL-1β, IL-6, and TNF-α were negatively correlated to MMSE in AD patients but positively correlated to H-Y in PD patients, while HDL was positively related to H-Y in PD patients. PMID:28943632

Differences in ABCA1 R219K Polymorphisms and Serum Indexes in Alzheimer and Parkinson Diseases in Northern China.

PubMed

Ya, Lagai; Lu, Zuneng

2017-09-25

BACKGROUND ABCA1 R219K single-nucleotide polymorphisms (SNPs) was related to Alzheimer disease (AD) but not Parkinson disease (PD). Here, we analyzed the associations among ABCA1 R219K distribution, serum biomarkers, AD, and PD in a population in northern China. MATERIAL AND METHODS We used the Mini-Mental State Examination (MMSE) and the Hoehn and Yahr scale (H-Y) to evaluate AD and PD progression, separately. ABCA1 R219K was analyzed by matrix-assisted laser desorption ionization time of flight time mass spectrometry (MALDI-TOF-MS). Serum indexes were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS ABCA1 R219K RR+RK genotype frequency in AD and PD patients was lower than that in normal controls (NC), while ABCA1 R219K KK genotype frequency was significantly higher. ABCA1 R219K RR genotype frequency in AD patients and NC was lower than that in PD patients, while ABCA1 R219K RK+KK genotype frequency was significantly higher. ABCA1 R219K RR genotype was positively correlated to MMSE value in AD patients, while ABCA1 R219K KK genotype was negatively correlated to H-Y value in PD patients. Serum factors were significantly different among AD and PD patients and NC. Serum ABCA1, ApoA1, ApoA2, ApoB, HDL, TC, IL-1β, IL-6, and TNF-α were significantly different between AD and PD patients. CONCLUSIONS ABCA1 R219K R allele was the risk factor inducing abnormal serum levels of ApoA2, LDL, and TG in AD patients, and abnormal levels of serum ABCA1, HDL, IL-1b, IL-6, and TNF-α in PD patients, while ABCA1 R219K K allele was the risk factor inducing lower ABCA1 in AD patients. IL-1β, IL-6, and TNF-α were negatively correlated to MMSE in AD patients but positively correlated to H-Y in PD patients, while HDL was positively related to H-Y in PD patients.

Performance of the Automated Neuropsychological Assessment Metrics (ANAM) in detecting cognitive impairment in heart failure patients.

PubMed

Xie, Susan S; Goldstein, Carly M; Gathright, Emily C; Gunstad, John; Dolansky, Mary A; Redle, Joseph; Hughes, Joel W

2015-01-01

Evaluate capacity of the Automated Neuropsychological Assessment Metrics (ANAM) to detect cognitive impairment (CI) in heart failure (HF) patients. CI is a key prognostic marker in HF. Though the most widely used cognitive screen in HF, the Mini-Mental State Examination (MMSE) is insufficiently sensitive. The ANAM has demonstrated sensitivity to cognitive domains affected by HF, but has not been assessed in this population. Investigators administered the ANAM and MMSE to 57 HF patients, compared against a composite model of cognitive function. ANAM efficiency (p < .05) and accuracy scores (p < .001) successfully differentiated CI and non-CI. ANAM efficiency and accuracy scores classified 97.7% and 93.0% of non-CI patients, and 14.3% and 21.4% with CI, respectively. The ANAM is more effective than the MMSE for detecting CI, but further research is needed to develop a more optimal cognitive screen for routine use in HF patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Payload specialist station study: Volume 2, part 3: Program analysis and planning for phase C/D

NASA Technical Reports Server (NTRS)

1976-01-01

The controls and displays (C&D) required at the Orbiter aft-flight deck (AFD) and the core C&D required at the Payload Specialist Station (PSS) are identified in this document. The AFD C&D Concept consists of a multifunction display system (MFDS) and elements of multiuse mission support equipment (MMSE). The MFDS consists of two CRTs, a display electronics unit (DEU), and a keyboard. The MMSE consists of a manual pointing controller (MPC), five digit numeric displays, 10 character alphanumeric legends, event timers, analog meters, rotary and toggle switches. The MMSE may be hardwired to the experiment, or interface with a data bus at the PSS for signal processing. The MFDS has video capability, with alphanumeric and graphic overlay features, on one CRT and alphanumeric and graphic (tricolor) capability on a second CRT. The DEU will have the capability to communicate, via redundant data buses, with both the spacelab experiment and subsystem computers.

Cognitive impairment in patients with fibromyalgia syndrome as assessed by the mini-mental state examination.

PubMed

Rodríguez-Andreu, Jose; Ibáñez-Bosch, Rosario; Portero-Vázquez, Amparo; Masramon, Xavier; Rejas, Javier; Gálvez, Rafael

2009-12-21

This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS) using the Mini Mental State Examination (MMSE). We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP) or mixed pain (MP) selected from a larger prospective study. FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1) than either NeP (27.3; 95% CI 27.2-27.4) or MP (27.3; 27.2-27.5). The percentage of patients with congnitive impairment (adjusted MMSE

Is this the right normalization? A diagnostic tool for ChIP-seq normalization.

PubMed

Angelini, Claudia; Heller, Ruth; Volkinshtein, Rita; Yekutieli, Daniel

2015-05-09

Chip-seq experiments are becoming a standard approach for genome-wide profiling protein-DNA interactions, such as detecting transcription factor binding sites, histone modification marks and RNA Polymerase II occupancy. However, when comparing a ChIP sample versus a control sample, such as Input DNA, normalization procedures have to be applied in order to remove experimental source of biases. Despite the substantial impact that the choice of the normalization method can have on the results of a ChIP-seq data analysis, their assessment is not fully explored in the literature. In particular, there are no diagnostic tools that show whether the applied normalization is indeed appropriate for the data being analyzed. In this work we propose a novel diagnostic tool to examine the appropriateness of the estimated normalization procedure. By plotting the empirical densities of log relative risks in bins of equal read count, along with the estimated normalization constant, after logarithmic transformation, the researcher is able to assess the appropriateness of the estimated normalization constant. We use the diagnostic plot to evaluate the appropriateness of the estimates obtained by CisGenome, NCIS and CCAT on several real data examples. Moreover, we show the impact that the choice of the normalization constant can have on standard tools for peak calling such as MACS or SICER. Finally, we propose a novel procedure for controlling the FDR using sample swapping. This procedure makes use of the estimated normalization constant in order to gain power over the naive choice of constant (used in MACS and SICER), which is the ratio of the total number of reads in the ChIP and Input samples. Linear normalization approaches aim to estimate a scale factor, r, to adjust for different sequencing depths when comparing ChIP versus Input samples. The estimated scaling factor can easily be incorporated in many peak caller algorithms to improve the accuracy of the peak identification. The diagnostic plot proposed in this paper can be used to assess how adequate ChIP/Input normalization constants are, and thus it allows the user to choose the most adequate estimate for the analysis.

Narrative Organization Deficit in Lewy Body Disorders Is Related to Alzheimer Pathology

PubMed Central

Grossman, Murray; Irwin, David J.; Jester, Charles; Halpin, Amy; Ash, Sharon; Rascovsky, Katya; Weintraub, Daniel; McMillan, Corey T.

2017-01-01

Background: Day-to-day interactions depend on conversational narrative, and we examine here the neurobiological basis for difficulty organizing narrative discourse in patients with Lewy body disorders (LBD). Method: Narrative organization was examined in 56 non-aphasic LBD patients, including a non-demented cohort (n = 30) with Parkinson's disease (PD) or PD-Mild Cognitive Impairment PD-MCI,) and a cohort with mild dementia (n = 26) including PD-dementia (PDD) and dementia with Lewy bodies (DLB), with similar age and education but differing in MMSE (p < 0.001). We used a previously reported procedure that probes patients' judgments of the organization of brief, familiar narratives (e.g., going fishing, wrapping a present). A subgroup of 24 patients had MRI assessment of regional gray matter (GM) atrophy and cerebrospinal fluid (CSF) levels of biomarkers for Alzheimer's disease (AD) pathology, including beta amyloid (Aβ), total-tau (t-tau), and phosphorylated-tau (p-tau). Results: Mildly demented LBD patients had a significant deficit judging narratives compared to non-demented patients, but this deficit was not correlated with MMSE. Regression analyses instead related narrative organization to regions of frontal GM atrophy, and CSF levels of Aβ and t-tau associated with presumed AD pathology in these frontal regions. Conclusion: These findings are consistent with the hypothesis that CSF markers of AD pathology associated with frontal regions play a role in difficulty organizing narratives in LBD. PMID:28228714

Extremely low frequency electromagnetic field (ELF-EMF) reduces oxidative stress and improves functional and psychological status in ischemic stroke patients.

PubMed

Cichoń, Natalia; Bijak, Michał; Miller, Elżbieta; Saluk, Joanna

2017-07-01

As a result of ischaemia/reperfusion, massive generation of reactive oxygen species occurs, followed by decreased activity of antioxidant enzymes. Extremely low frequency electromagnetic fields (ELF-EMF) can modulate oxidative stress, but there are no clinical antioxidant studies in brain stroke patients. The aim of our study was to investigate the effect of ELF-EMF on clinical and antioxidant status in post-stroke patients. Fifty-seven patients were divided into two groups: ELF-EMF and non-ELF-EMF. Both groups underwent the same 4-week rehabilitation program. Additionally, the ELF-EMF group was exposed to an ELF-EMF field of 40 Hz, 7 mT for 15 min/day for 4 weeks (5 days a week). The activity of catalase and superoxide dismutase was measured in hemolysates, and total antioxidant status (TAS) determined in plasma. Functional status was assessed before and after the series of treatments using Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Applied ELF-EMF significantly increased enzymatic antioxidant activity; however, TAS levels did not change in either group. Results show that ELF-EMF induced a significant improvement in functional (ADL) and mental (MMSE, GDS) status. Clinical parameters had positive correlation with the level of enzymatic antioxidant protection. Bioelectromagnetics. 38:386-396, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Narrative Organization Deficit in Lewy Body Disorders Is Related to Alzheimer Pathology.

PubMed

Grossman, Murray; Irwin, David J; Jester, Charles; Halpin, Amy; Ash, Sharon; Rascovsky, Katya; Weintraub, Daniel; McMillan, Corey T

2017-01-01

Background: Day-to-day interactions depend on conversational narrative, and we examine here the neurobiological basis for difficulty organizing narrative discourse in patients with Lewy body disorders (LBD). Method: Narrative organization was examined in 56 non-aphasic LBD patients, including a non-demented cohort ( n = 30) with Parkinson's disease (PD) or PD-Mild Cognitive Impairment PD-MCI,) and a cohort with mild dementia ( n = 26) including PD-dementia (PDD) and dementia with Lewy bodies (DLB), with similar age and education but differing in MMSE ( p < 0.001). We used a previously reported procedure that probes patients' judgments of the organization of brief, familiar narratives (e.g., going fishing, wrapping a present). A subgroup of 24 patients had MRI assessment of regional gray matter (GM) atrophy and cerebrospinal fluid (CSF) levels of biomarkers for Alzheimer's disease (AD) pathology, including beta amyloid (Aβ), total-tau ( t -tau), and phosphorylated-tau ( p -tau). Results: Mildly demented LBD patients had a significant deficit judging narratives compared to non-demented patients, but this deficit was not correlated with MMSE. Regression analyses instead related narrative organization to regions of frontal GM atrophy, and CSF levels of Aβ and t -tau associated with presumed AD pathology in these frontal regions. Conclusion: These findings are consistent with the hypothesis that CSF markers of AD pathology associated with frontal regions play a role in difficulty organizing narratives in LBD.

Comparative Diagnostic Accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for Screening of Alzheimer Disease.

PubMed

Matías-Guiu, Jordi A; Valles-Salgado, María; Rognoni, Teresa; Hamre-Gil, Frank; Moreno-Ramos, Teresa; Matías-Guiu, Jorge

2017-01-01

Our aim was to evaluate and compare the diagnostic properties of 5 screening tests for the diagnosis of mild Alzheimer disease (AD). We conducted a prospective and cross-sectional study of 92 patients with mild AD and of 68 healthy controls from our Department of Neurology. The diagnostic properties of the following tests were compared: Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination III (ACE-III), Memory Impairment Screen (MIS), Montreal Cognitive Assessment (MoCA), and Rowland Universal Dementia Assessment Scale (RUDAS). All tests yielded high diagnostic accuracy, with the ACE-III achieving the best diagnostic properties. The area under the curve was 0.897 for the ACE-III, 0.889 for the RUDAS, 0.874 for the MMSE, 0.866 for the MIS, and 0.856 for the MoCA. The Mini-ACE score from the ACE-III showed the highest diagnostic capacity (area under the curve 0.939). Memory scores of the ACE-III and of the RUDAS showed a better diagnostic accuracy than those of the MMSE and of the MoCA. All tests, especially the ACE-III, conveyed a higher diagnostic accuracy in patients with full primary education than in the less educated group. Implementing normative data improved the diagnostic accuracy of the ACE-III but not that of the other tests. The ACE-III achieved the highest diagnostic accuracy. This better discrimination was more evident in the more educated group. © 2017 S. Karger AG, Basel.

A systematic review of cognitive decline in dementia with Lewy bodies versus Alzheimer’s disease

PubMed Central

2014-01-01

Introduction The aim of this review was to investigate whether there is a faster cognitive decline in dementia with Lewy bodies (DLB) than in Alzheimer’s disease (AD) over time. Methods PsycINFO and Medline were searched from 1946 to February 2013. A quality rating from 1 to 15 (best) was applied to the included studies. A quantitative meta-analysis was done on studies with mini mental state examination (MMSE) as the outcome measure. Results A total of 18 studies were included. Of these, six (36%) reported significant differences in the rate of cognitive decline. Three studies reported a faster cognitive decline on MMSE in patients with mixed DLB and AD compared to pure forms, whereas two studies reported a faster decline on delayed recall and recognition in AD and one in DLB on verbal fluency. Mean quality scores for studies that did or did not differ were not significantly different. Six studies reported MMSE scores and were included in the meta-analysis, which showed no significant difference in annual decline on MMSE between DLB (mean 3.4) and AD (mean 3.3). Conclusions Our findings do not support the hypothesis of a faster rate of cognitive decline in DLB compared to AD. Future studies should apply recent diagnostic criteria, as well as extensive diagnostic evaluation and ideally autopsy diagnosis. Studies with large enough samples, detailed cognitive tests, at least two years follow up and multivariate statistical analysis are also needed. PMID:25478024

Electroencephalographic characteristics of Iranian schizophrenia patients.

PubMed

Chaychi, Irman; Foroughipour, Mohsen; Haghir, Hossein; Talaei, Ali; Chaichi, Ashkan

2015-12-01

Schizophrenia is a prevalent psychiatric disease with heterogeneous causes that is diagnosed based on history and mental status examination. Applied electrophysiology is a non-invasive method to investigate the function of the involved brain areas. In a previously understudied population, we examined acute phase electroencephalography (EEG) records along with pertinent Positive and Negative Syndrome Scale (PANSS) and Mini Mental State Examination (MMSE) scores for each patient. Sixty-four hospitalized patients diagnosed to have schizophrenia in Ebn-e-Sina Hospital were included in this study. PANSS and MMSE were completed and EEG tracings for every patient were recorded. Also, EEG tracings were recorded for 64 matched individuals of the control group. Although the predominant wave pattern in both patients and controls was alpha, theta waves were almost exclusively found in eight (12.5 %) patients with schizophrenia. Pathological waves in schizophrenia patients were exclusively found in the frontal brain region, while identified pathological waves in controls were limited to the temporal region. No specific EEG finding supported laterality in schizophrenia patients. PANSS and MMSE scores were significantly correlated with specific EEG parameters (all P values <0.04). Patients with schizophrenia demonstrate specific EEG patterns and show a clear correlation between EEG parameters and PANSS and MMSE scores. These characteristics are not observed in all patients, which imply that despite an acceptable specificity, they are not applicable for the majority of schizophrenia patients. Any deduction drawn based on EEG and scoring systems is in need of larger studies incorporating more patients and using better functional imaging techniques for the brain.

End-stage dementia spark of life: reliability and validity of the "GATOS" questionnaire.

PubMed

Tsoucalas, Gregory; Bourelia, Stamati; Kalogirou, Vaso; Giatsiou, Styliani; Mavrogiannaki, Eirini; Gatos, Georgios; Galanos, Antonis; Repana, Olga; Iliadou, Eleni; Antoniou, Antonis; Sgantzos, Markos; Gatos, Konstantinos

2015-01-01

Fl oor effects are present in most dementia assessment tools as dementia progresses and the in-depth assessment of patients considered more or less on vegetative state is questionable. To develop a questionnaire (the "Gatos Clinical Test-GCT") for the assessment of end-stage demented patients. Five hundred patients with dementia of various causes and an MMSE score between 0 and 2 were enrolled in the study. The GCT consists of 14 closed type questions rated on a Likert scale. The total score is used to evaluate patient's dementia. Various aspects of validity and reliability (including face, content and structural validity as well as test-retest reliability) were examined. Three subscales "Autonomy/Alertness", "Gnosias" and "Somatokinetic function" were defined, with a Cronbach equal to 0.851, 0.756 and 0.598 respectively. The GCT subscales and total score were statistically significant higher in patients with MMSE score 1 or 2 compared with those with MMSE score 0 (p<0.0005). Patients with GCT total score less than 12.5 had 75% probability to have zero MMSE score. The "GATOS" questionnaire is a valid and reliable test for patients with severe dementia, aiming at identification of those patients who could sustain some quality of life. It is a relatively short and easy to administer tool. As dementia prevalence is expected to rise further worldwide we believe that GCT could offer valuable services to health professionals, caregivers and patients.

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients.

PubMed

Arsic, S; Konstantinovic, Lj; Eminovic, F; Pavlovic, D; Popovic, M B; Arsic, V

2015-01-01

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B) test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE) for cognitive status; Functional Ambulation Category (FAC) test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Changes in the Chemical Composition of Plum Distillate During Maturation with Oak Chips under Different Conditions

PubMed Central

2017-01-01

Summary This study investigates the effect of ageing on the qualitative and quantitative composition of plum distillate in contact with oak wood chips. Maturation was performed with lightly toasted French oak (Quercus sessiflora and Quercus robur) chips or oak chips made from fragments of empty barrels that had been used for ageing cognac. The effects of oak chip dose, process temperature, ageing system (static or circulatory) and ultrasound treatment were assessed. Maturation of plum distillate samples with oak chips resulted in higher levels of extractable organics (including tannins) and colour changes, which were correlated with the type and dose of oak chips, and the conditions of maturation. The content of sugars such as glucose, xylose and arabinose also increased, depending on the conditions and type of oak chips. Degradation of lignin resulted in liberation of sinapaldehyde, syringaldehyde, coniferaldehyde and vanillin, with intensities depending on the applied parameters. In terms of volatiles, decreases in the concentration of higher alcohols and aliphatic aldehydes were observed in the majority of maturation experiments, while concentrations of furanic aldehydes increased depending on the type and dose of oak chips, as well as on the conditions of maturation. The quantities of esters such as ethyl acetate decreased in the majority of experimental variants, whereas concentrations of ethyl caproate, ethyl caprylate and ethyl caprate increased gradually. Some phenols and lactones were detected in all matured samples, with the lowest levels found in the samples aged with oak chips made from cognac barrels. PMID:29089848

Changes in the Chemical Composition of Plum Distillate During Maturation with Oak Chips under Different Conditions.

PubMed

Balcerek, Maria; Pielech-Przybylska, Katarzyna; Dziekońska-Kubczak, Urszula; Patelski, Piotr; Strąk, Ewelina

2017-09-01

This study investigates the effect of ageing on the qualitative and quantitative composition of plum distillate in contact with oak wood chips. Maturation was performed with lightly toasted French oak ( Quercus sessiflora and Quercus robur ) chips or oak chips made from fragments of empty barrels that had been used for ageing cognac. The effects of oak chip dose, process temperature, ageing system (static or circulatory) and ultrasound treatment were assessed. Maturation of plum distillate samples with oak chips resulted in higher levels of extractable organics (including tannins) and colour changes, which were correlated with the type and dose of oak chips, and the conditions of maturation. The content of sugars such as glucose, xylose and arabinose also increased, depending on the conditions and type of oak chips. Degradation of lignin resulted in liberation of sinapaldehyde, syringaldehyde, coniferaldehyde and vanillin, with intensities depending on the applied parameters. In terms of volatiles, decreases in the concentration of higher alcohols and aliphatic aldehydes were observed in the majority of maturation experiments, while concentrations of furanic aldehydes increased depending on the type and dose of oak chips, as well as on the conditions of maturation. The quantities of esters such as ethyl acetate decreased in the majority of experimental variants, whereas concentrations of ethyl caproate, ethyl caprylate and ethyl caprate increased gradually. Some phenols and lactones were detected in all matured samples, with the lowest levels found in the samples aged with oak chips made from cognac barrels.

Probe-level linear model fitting and mixture modeling results in high accuracy detection of differential gene expression.

PubMed

Lemieux, Sébastien

2006-08-25

The identification of differentially expressed genes (DEGs) from Affymetrix GeneChips arrays is currently done by first computing expression levels from the low-level probe intensities, then deriving significance by comparing these expression levels between conditions. The proposed PL-LM (Probe-Level Linear Model) method implements a linear model applied on the probe-level data to directly estimate the treatment effect. A finite mixture of Gaussian components is then used to identify DEGs using the coefficients estimated by the linear model. This approach can readily be applied to experimental design with or without replication. On a wholly defined dataset, the PL-LM method was able to identify 75% of the differentially expressed genes within 10% of false positives. This accuracy was achieved both using the three replicates per conditions available in the dataset and using only one replicate per condition. The method achieves, on this dataset, a higher accuracy than the best set of tools identified by the authors of the dataset, and does so using only one replicate per condition.

The correlation of methylation levels measured using Illumina 450K and EPIC BeadChips in blood samples

PubMed Central

Logue, Mark W; Smith, Alicia K; Wolf, Erika J; Maniates, Hannah; Stone, Annjanette; Schichman, Steven A; McGlinchey, Regina E; Milberg, William; Miller, Mark W

2017-01-01

Aim: We examined concordance of methylation levels across the Illumina Infinium HumanMethylation450 BeadChip and the Infinium MethylationEPIC BeadChip. Methods: We computed the correlation for 145 whole blood DNA samples at each of the 422,524 CpG sites measured by both chips. Results: The correlation at some sites was high (up to r = 0.95), but many sites had low correlation (55% had r < 0.20). The low correspondence between 450K and EPIC measured methylation values at many loci was largely due to the low variability in methylation values for the majority of the CpG sites in blood. Conclusion: Filtering out probes based on the observed correlation or low variability may increase reproducibility of BeadChip-based epidemiological studies. PMID:28809127

The impact of CHIP premium increases on insurance outcomes among CHIP eligible children

PubMed Central

2014-01-01

Background Within the United States, public insurance premiums are used both to discourage private health policy holders from dropping coverage and to reduce state budget costs. Prior research suggests that the odds of having private coverage and being uninsured increase with increases in public insurance premiums. The aim of this paper is to test effects of Children’s Health Insurance Program (CHIP) premium increases on public insurance, private insurance, and uninsurance rates. Methods The fact that families just below and above a state-specific income cut-off are likely very similar in terms of observable and unobservable characteristics except the premium contribution provides a natural experiment for estimating the effect of premium increases. Using 2003 Medical Expenditure Panel Survey (MEPS) merged with CHIP premiums, we compare health insurance outcomes for CHIP eligible children as of January 2003 in states with a two-tier premium structure using a cross-sectional regression discontinuity methodology. We use difference-in-differences analysis to compare longitudinal insurance outcomes by December 2003. Results Higher CHIP premiums are associated with higher likelihood of private insurance. Disenrollment from CHIP in response to premium increases over time does not increase the uninsurance rate. Conclusions When faced with higher CHIP premiums, private health insurance may be a preferable alternative for CHIP eligible families with higher incomes. Therefore, competition in the insurance exchanges being formed under the Affordable Care Act could enhance choice. PMID:24589197

The impact of CHIP premium increases on insurance outcomes among CHIP eligible children.

PubMed

Nikolova, Silviya; Stearns, Sally

2014-03-03

Within the United States, public insurance premiums are used both to discourage private health policy holders from dropping coverage and to reduce state budget costs. Prior research suggests that the odds of having private coverage and being uninsured increase with increases in public insurance premiums. The aim of this paper is to test effects of Children's Health Insurance Program (CHIP) premium increases on public insurance, private insurance, and uninsurance rates. The fact that families just below and above a state-specific income cut-off are likely very similar in terms of observable and unobservable characteristics except the premium contribution provides a natural experiment for estimating the effect of premium increases. Using 2003 Medical Expenditure Panel Survey (MEPS) merged with CHIP premiums, we compare health insurance outcomes for CHIP eligible children as of January 2003 in states with a two-tier premium structure using a cross-sectional regression discontinuity methodology. We use difference-in-differences analysis to compare longitudinal insurance outcomes by December 2003. Higher CHIP premiums are associated with higher likelihood of private insurance. Disenrollment from CHIP in response to premium increases over time does not increase the uninsurance rate. When faced with higher CHIP premiums, private health insurance may be a preferable alternative for CHIP eligible families with higher incomes. Therefore, competition in the insurance exchanges being formed under the Affordable Care Act could enhance choice.

Mobile Phone Chips Reduce Increases in EEG Brain Activity Induced by Mobile Phone-Emitted Electromagnetic Fields.

PubMed

Henz, Diana; Schöllhorn, Wolfgang I; Poeggeler, Burkhard

2018-01-01

Recent neurophysiological studies indicate that exposure to electromagnetic fields (EMFs) generated by mobile phone radiation can exert effects on brain activity. One technical solution to reduce effects of EMFs in mobile phone use is provided in mobile phone chips that are applied to mobile phones or attached to their surfaces. To date, there are no systematical studies on the effects of mobile phone chip application on brain activity and the underlying neural mechanisms. The present study investigated whether mobile phone chips that are applied to mobile phones reduce effects of EMFs emitted by mobile phone radiation on electroencephalographic (EEG) brain activity in a laboratory study. Thirty participants volunteered in the present study. Experimental conditions (mobile phone chip, placebo chip, no chip) were set up in a randomized within-subjects design. Spontaneous EEG was recorded before and after mobile phone exposure for two 2-min sequences at resting conditions. During mobile phone exposure, spontaneous EEG was recorded for 30 min during resting conditions, and 5 min during performance of an attention test (d2-R). Results showed increased activity in the theta, alpha, beta and gamma bands during EMF exposure in the placebo and no chip conditions. Application of the mobile phone chip reduced effects of EMFs on EEG brain activity and attentional performance significantly. Attentional performance level was maintained regarding number of edited characters. Further, a dipole analysis revealed different underlying activation patterns in the chip condition compared to the placebo chip and no chip conditions. Finally, a correlational analysis for the EEG frequency bands and electromagnetic high-frequency (HF) emission showed significant correlations in the placebo chip and no chip condition for the theta, alpha, beta, and gamma bands. In the chip condition, a significant correlation of HF with the theta and alpha bands, but not with the beta and gamma bands was shown. We hypothesize that a reduction of EEG beta and gamma activation constitutes the key neural mechanism in mobile phone chip use that supports the brain to a degree in maintaining its natural activity and performance level during mobile phone use.

Mobile Phone Chips Reduce Increases in EEG Brain Activity Induced by Mobile Phone-Emitted Electromagnetic Fields

PubMed Central

Henz, Diana; Schöllhorn, Wolfgang I.; Poeggeler, Burkhard

2018-01-01

Recent neurophysiological studies indicate that exposure to electromagnetic fields (EMFs) generated by mobile phone radiation can exert effects on brain activity. One technical solution to reduce effects of EMFs in mobile phone use is provided in mobile phone chips that are applied to mobile phones or attached to their surfaces. To date, there are no systematical studies on the effects of mobile phone chip application on brain activity and the underlying neural mechanisms. The present study investigated whether mobile phone chips that are applied to mobile phones reduce effects of EMFs emitted by mobile phone radiation on electroencephalographic (EEG) brain activity in a laboratory study. Thirty participants volunteered in the present study. Experimental conditions (mobile phone chip, placebo chip, no chip) were set up in a randomized within-subjects design. Spontaneous EEG was recorded before and after mobile phone exposure for two 2-min sequences at resting conditions. During mobile phone exposure, spontaneous EEG was recorded for 30 min during resting conditions, and 5 min during performance of an attention test (d2-R). Results showed increased activity in the theta, alpha, beta and gamma bands during EMF exposure in the placebo and no chip conditions. Application of the mobile phone chip reduced effects of EMFs on EEG brain activity and attentional performance significantly. Attentional performance level was maintained regarding number of edited characters. Further, a dipole analysis revealed different underlying activation patterns in the chip condition compared to the placebo chip and no chip conditions. Finally, a correlational analysis for the EEG frequency bands and electromagnetic high-frequency (HF) emission showed significant correlations in the placebo chip and no chip condition for the theta, alpha, beta, and gamma bands. In the chip condition, a significant correlation of HF with the theta and alpha bands, but not with the beta and gamma bands was shown. We hypothesize that a reduction of EEG beta and gamma activation constitutes the key neural mechanism in mobile phone chip use that supports the brain to a degree in maintaining its natural activity and performance level during mobile phone use. PMID:29670503

Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey.

PubMed

Matchar, David B; Chei, Choy-Lye; Yin, Zhao-Xue; Koh, Victoria; Chakraborty, Bibhas; Shi, Xiao-Ming; Zeng, Yi

2016-10-01

Vitamin D has a neuroprotective function, potentially important for the prevention of cognitive decline. Prospective studies from Western countries support an association between lower vitamin D level and future cognitive decline in elderly people. No prospective study has examined this association in Asia. This community-based cohort study of elderly people in China follows 1,202 cognitively intact adults aged ≥60 years for a mean duration of 2 years. Plasma vitamin D level was measured at the baseline. Cognitive state of participants was assessed using the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score <18. Cognitive decline was defined as ≥3 points decline from baseline. Multivariable logistic regression models were used to examine the association between quartiles of vitamin D levels with cognitive decline and incidence of cognitive impairment. Participants with low vitamin D level had an increased risk of cognitive decline. Compared with the highest quartile of vitamin D levels, the multivariable odds ratios (ORs; 95% confidence interval) for cognitive decline were 2.1 (1.3-3.4) for the second highest quartile, 2.2 (1.4-3.6) for the third highest quartile, and 2.0 (1.2-3.3) for the lowest quartile. The multivariable ORs of incident cognitive impairment for the second highest, third highest, and lowest versus highest quartiles of vitamin D levels were 1.9 (0.9-4.1), 2.6 (1.2-5.6), and 3.2 (1.5-6.6), respectively. This first follow-up study of elderly people, including the oldest-old, in Asia shows that low vitamin D levels were associated with increased risk of subsequent cognitive decline and impairment. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparisons of Wet and Ovendry Analyses of Compression Debarking Tests on Wood Chips

Treesearch

Rodger A. Arola

1974-01-01

Compares the level of bark removal from chips and resultant wood losses when measured on both a wet and ovendry basis with several chip debarking trials for quaking aspen, jack pine, and sugar maple cut at different times of the year.

On-Chip Biomedical Imaging

PubMed Central

Göröcs, Zoltán; Ozcan, Aydogan

2012-01-01

Lab-on-a-chip systems have been rapidly emerging to pave the way toward ultra-compact, efficient, mass producible and cost-effective biomedical research and diagnostic tools. Although such microfluidic and micro electromechanical systems achieved high levels of integration, and are capable of performing various important tasks on the same chip, such as cell culturing, sorting and staining, they still rely on conventional microscopes for their imaging needs. Recently several alternative on-chip optical imaging techniques have been introduced, which have the potential to substitute conventional microscopes for various lab-on-a-chip applications. Here we present a critical review of these recently emerging on-chip biomedical imaging modalities, including contact shadow imaging, lensfree holographic microscopy, fluorescent on-chip microscopy and lensfree optical tomography. PMID:23558399

Change in content of sugars and free amino acids in potato tubers under short-term storage at low temperature and the effect on acrylamide level after frying.

PubMed

Ohara-Takada, Akiko; Matsuura-Endo, Chie; Chuda, Yoshihiro; Ono, Hiroshi; Yada, Hiroshi; Yoshida, Mitsuru; Kobayashi, Akira; Tsuda, Shogo; Takigawa, Shigenobu; Noda, Takahiro; Yamauchi, Hiroaki; Mori, Motoyuki

2005-07-01

Changes in the sugar and amino acid contents of potato tubers during short-term storage and the effect on the acrylamide level in chips after frying were investigated. The acrylamide content in chips began to increase after 3 days of storage at 2 degrees C in response to the increase of glucose and fructose contents in the tubers. There was strong correlation between the reducing sugar content and acrylamide level, R(2)=0.873 for fructose and R(2)=0.836 for glucose. The sucrose content had less correlation with the acrylamide content because of its decrease after 4 weeks of storage at 2 degrees C, while the reducing sugar in potato tubers and the acrylamide in chips continued to increase. The contents of the four amino acids, i.e., asparatic acid, asparagine, glutamic acid and glutamine, showed no significant correlation with the acrylamide level. These results suggest that the content of reducing sugars in potato tubers determined the degree of acrylamide formation in chips. The chip color, as evaluated by L* (lightness), was correlated well with the acrylamide content.

Development of a package-free transparent disposable biosensor chip for simultaneous measurements of blood constituents and investigation of its storage stability.

PubMed

Nakamura, Hideaki; Tohyama, Kana; Tanaka, Masanori; Shinohara, Shouji; Tokunaga, Yuichi; Kurusu, Fumiyo; Koide, Satoshi; Gotoh, Masao; Karube, Isao

2007-12-15

A package-free transparent disposable biosensor chip was developed by a screen-printing technique. The biosensor chip was fabricated by stacking a substrate with two carbon electrodes on its surface, a spacer consisting of a resist layer and an adhesive layer, and a cover. The structure of the chip keeps the interior of the reaction-detecting section airtight until use. The chip is equipped with double electrochemical measuring elements for the simultaneous measurement of multiple items, and the reagent layer was developed in sample-feeding path. The sample-inlet port and air-discharge port are simultaneously opened by longitudinally folding in two biosensor units with a notch as a boundary. Then the shape of the chip is changed to a V-shape. The reaction-detecting section of the chip has a 1.0 microl sample volume for one biosensor unit. Excellent results were obtained with the chip in initial simultaneous chronoamperometric measurements of both glucose (r=1.00) and lactate (r=0.998) in the same samples. The stability of the enzyme sensor signals of the chip was estimated at ambient atmosphere on 8 testing days during a 6-month period. The results were compared with those obtained for an unpackaged chip used as a control. The package-free chip proved to be twice as good as the control chip in terms of the reproducibility of slopes from 16 calibration curves (one calibration curve: 0, 100, 300, 500 mg dl(-1) glucose; n=3) and 4.6 times better in terms of the reproducibility of correlation coefficients from the 16 calibration curves.

How Well Is CHIP Addressing Health Care Access and Affordability for Children?

PubMed

Clemans-Cope, Lisa; Kenney, Genevieve; Waidmann, Timothy; Huntress, Michael; Anderson, Nathaniel

2015-01-01

We examine how access to care and care experiences under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states. We report on findings from a 2012 survey of CHIP enrollees in 10 states. We examined a range of health care access and use measures among CHIP enrollees. Comparisons of the experiences of established CHIP enrollees to the experiences of uninsured and privately insured children were used to estimate differences in children's health care. Children with CHIP coverage had substantially better access to care across a range of outcomes, other things being equal, particularly compared to those with no coverage. Compared to being uninsured, CHIP enrollees were more likely to have specialty and mental health visits and to receive prescription drugs; and their parents were much more likely to feel confident in meeting the child's health care needs and were less likely to have trouble finding providers. CHIP enrollees were less likely to have unmet needs, but 1 in 4 had at least 1 unmet need. Compared to being privately insured, CHIP enrollees had generally similar health care use and unmet needs. Additionally, CHIP enrollees had lower financial burden related to their health care needs. The findings were generally robust with respect to alternative specifications and subgroup analyses, and they corroborated findings of previous studies. Enrolling more of the uninsured children who are eligible for CHIP improved their access to a range of care, including specialty and mental health services, and reduced the financial burden of meeting their health care needs; however, we found room for improvement in CHIP enrollees' access to care. Copyright © 2015 Academic Pediatric Association. All rights reserved.

Acrylamide in Romanian food using HPLC-UV and a health risk assessment.

PubMed

Oroian, Mircea; Amariei, Sonia; Gutt, Gheorghe

2015-01-01

The aim of this study was to investigate the level of acrylamide from coffee, potato chips and French fries in Romanian food. According to the European Food Safety Authority, coffee beans, potato chips and French fries have the highest levels of acrylamide. For this survey, 50 samples of coffee beans, 50 samples of potato chips and 25 samples of French fries were purchased from different producers from the Romanian market. Acrylamide levels have been quantified using high-performance liquid chromatography with a diode array detector (HPLC-DAD) method, using water as mobile phase. Health risk assessment was achieved by computing the average daily intake, hazard quotient, cumulative risk, carcinogenic risk and cancer risk. For coffee, potato chips and French fries, acrylamide was not shown to pose a health risk in Romanian food.

A Space-Time Signal Decomposition Algorithm for Downlink MIMO DS-CDMA Receivers

NASA Astrophysics Data System (ADS)

Wang, Yung-Yi; Fang, Wen-Hsien; Chen, Jiunn-Tsair

We propose a dimension reduction algorithm for the receiver of the downlink of direct-sequence code-division multiple access (DS-CDMA) systems in which both the transmitters and the receivers employ antenna arrays of multiple elements. To estimate the high order channel parameters, we develop a layered architecture using dimension-reduced parameter estimation algorithms to estimate the frequency-selective multipath channels. In the proposed architecture, to exploit the space-time geometric characteristics of multipath channels, spatial beamformers and constrained (or unconstrained) temporal filters are adopted for clustered-multipath grouping and path isolation. In conjunction with the multiple access interference (MAI) suppression techniques, the proposed architecture jointly estimates the direction of arrivals, propagation delays, and fading amplitudes of the downlink fading multipaths. With the outputs of the proposed architecture, the signals of interest can then be naturally detected by using path-wise maximum ratio combining. Compared to the traditional techniques, such as the Joint-Angle-and-Delay-Estimation (JADE) algorithm for DOA-delay joint estimation and the space-time minimum mean square error (ST-MMSE) algorithm for signal detection, computer simulations show that the proposed algorithm substantially mitigate the computational complexity at the expense of only slight performance degradation.

Solar Particle Induced Upsets in the TDRS-1 Attitude Control System RAM During the October 1989 Solar Particle Events

NASA Technical Reports Server (NTRS)

Croley, D. R.; Garrett, H. B.; Murphy, G. B.; Garrard,T. L.

1995-01-01

The three large solar particle events, beginning on October 19, 1989 and lasting approximately six days, were characterized by high fluences of solar protons and heavy ions at 1 AU. During these events, an abnormally large number of upsets (243) were observed in the random access memory of the attitude control system (ACS) control processing electronics (CPE) on-board the geosynchronous TDRS-1 (Telemetry and Data Relay Satellite). The RAM unit affected was composed of eight Fairchild 93L422 memory chips. The Galileo spacecraft, launched on October 18, 1989 (one day prior to the solar particle events) observed the fluxes of heavy ions experienced by TDRS-1. Two solid-state detector telescopes on-board Galileo, designed to measure heavy ion species and energy, were turned on during time periods within each of the three separate events. The heavy ion data have been modeled and the time history of the events reconstructed to estimate heavy ion fluences. These fluences were converted to effective LET spectra after transport through the estimated shielding distribution around the TDRS-1 ACS system. The number of single event upsets (SEU) expected was calculated by integrating the measured cross section for the Fairchild 93L422 memory chip with average effective LET spectrum. The expected number of heavy ion induced SEU's calculated was 176. GOES-7 proton data, observed during the solar particle events, were used to estimate the number of proton-induced SEU's by integrating the proton fluence spectrum incident on the memory chips, with the two-parameter Bendel cross section for proton SEU'S. The proton fluence spectrum at the device level was gotten by transporting the protons through the estimated shielding distribution. The number of calculated proton-induced SEU's was 72, yielding a total of 248 predicted SEU'S, very dose to the 243 observed SEU'S. These calculations uniquely demonstrate the roles that solar heavy ions and protons played in the production of SEU's during the October 1989 solar particle events.

Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis

PubMed Central

Nüesch, Eveline; Dale, Caroline; Palmer, Tom M; White, Jon; Keating, Brendan J; van Iperen, Erik PA; Goel, Anuj; Padmanabhan, Sandosh; Asselbergs, Folkert W; Verschuren, WM; Wijmenga, C; Van der Schouw, YT; Onland-Moret, NC; Lange, Leslie A; Hovingh, GK; Sivapalaratnam, Suthesh; Morris, Richard W; Whincup, Peter H; Wannamethe, Goya S; Gaunt, Tom R; Ebrahim, Shah; Steel, Laura; Nair, Nikhil; Reiner, Alexander P; Kooperberg, Charles; Wilson, James F; Bolton, Jennifer L; McLachlan, Stela; Price, Jacqueline F; Strachan, Mark WJ; Robertson, Christine M; Kleber, Marcus E; Delgado, Graciela; März, Winfried; Melander, Olle; Dominiczak, Anna F; Farrall, Martin; Watkins, Hugh; Leusink, Maarten; Maitland-van der Zee, Anke H; de Groot, Mark CH; Dudbridge, Frank; Hingorani, Aroon; Ben-Shlomo, Yoav; Lawlor, Debbie A; Amuzu, A; Caufield, M; Cavadino, A; Cooper, J; Davies, TL; Drenos, F; Engmann, J; Finan, C; Giambartolomei, C; Hardy, R; Humphries, SE; Hypponen, E; Kivimaki, M; Kuh, D; Kumari, M; Ong, K; Plagnol, V; Power, C; Richards, M; Shah, S; Shah, T; Sofat, R; Talmud, PJ; Wareham, N; Warren, H; Whittaker, JC; Wong, A; Zabaneh, D; Davey Smith, George; Wells, Jonathan C; Leon, David A; Holmes, Michael V; Casas, Juan P

2016-01-01

Abstract Background: We investigated causal effect of completed growth, measured by adult height, on coronary heart disease (CHD), stroke and cardiovascular traits, using instrumental variable (IV) Mendelian randomization meta-analysis. Methods: We developed an allele score based on 69 single nucleotide polymorphisms (SNPs) associated with adult height, identified by the IBCCardioChip, and used it for IV analysis against cardiovascular risk factors and events in 21 studies and 60 028 participants. IV analysis on CHD was supplemented by summary data from 180 height-SNPs from the GIANT consortium and their corresponding CHD estimates derived from CARDIoGRAMplusC4D. Results: IV estimates from IBCCardioChip and GIANT-CARDIoGRAMplusC4D showed that a 6.5-cm increase in height reduced the odds of CHD by 10% [odds ratios 0.90; 95% confidence intervals (CIs): 0.78 to 1.03 and 0.85 to 0.95, respectively],which agrees with the estimate from the Emerging Risk Factors Collaboration (hazard ratio 0.93; 95% CI: 0.91 to 0.94). IV analysis revealed no association with stroke (odds ratio 0.97; 95% CI: 0.79 to 1.19). IV analysis showed that a 6.5-cm increase in height resulted in lower levels of body mass index (P < 0.001), triglycerides (P < 0.001), non high-density (non-HDL) cholesterol (P < 0.001), C-reactive protein (P = 0.042), and systolic blood pressure (P = 0.064) and higher levels of forced expiratory volume in 1 s and forced vital capacity (P < 0.001 for both). Conclusions: Taller individuals have a lower risk of CHD with potential explanations being that taller people have a better lung function and lower levels of body mass index, cholesterol and blood pressure. PMID:25979724

Transcranial Doppler assessment of cerebral vasomotor reactivity in evaluating the effects of vinpocetine in cerebral small vessel disease: a pilot study.

PubMed

Jovanović, Zagorka B; Pavlović, Aleksandra M; Pekmezović, Tatjana; Mijajlović, Milija; Covicković, Nadezda Sternić

2013-07-30

There are still dilemmas about the vasodilating effect of vinpocetine, a synthetic ethyl alkaloid vincamine. The method of measuring cerebral vasomotor reactivity (VMR) by transcranial Doppler (TCD) technique before and after administration of the medication was used to estimate the degree of arterioles vasodilatation. The aim of this study was to test of the vasodilating effect of vinpocetine in patients with cerebral small vessel disease (SVD) by measuring cerebral VMR. Thirty patients with SVD were on 3-month-long oral treatment with 15 mg vinpocetine daily. Cerebral VMR was determined by breath holding test. The breath holding index (BHI) was calculated in standard manner and values > 0.69 were considered normal. At the baseline, before treatment (I), BHI, modified Rankin scale (mRS) score, Mini Mental State Examination (MMSE) score were determined. One month later (II) BHI was assessed again, while after 3 months of treatment (III) we analyzed BHI, mRS score and MMSE score. The average age of patients was 61.4 +/- 11.5 years (range 40 to 77 years), 18 (60%) female and 12 (40%) males. Values of BHIs were increased during treatment at the right MCA (I) 1.18 +/- 0.53, (II) 1.26 +/- 0.54, (III) 1.37 +/- 0.41, with statistical significance between I and III measurement (p < 0.05). An increase was noted on the left MCA (I) 1.25 +/- 0.53, (II) 1.31 +/- 0.55 and (III) 1.32 +/- 0.42, but it did not reach statistical significance (p > 0.05). Mean MMSE score significantly increased from baseline 27.4 +/- 2.3 to 28.5 +/- 2.0 after three months of treatment (p < 0.001). Functional status showed a statistically significant improvement with mRS score increasing from 2.1 +/- 1.0 to 1.1 +/- 0.6 (p < 0.001). This pilot study showed that 3-month-long oral treatment with vinpocetine 15 mg daily had tendency to increase BHI, indicating improvement of cerebral VMR. It is possible that higher doses of vinpocetine are needed to achieve substantial increase of VMR.

Docking-dependent Ubiquitination of the Interferon Regulatory Factor-1 Tumor Suppressor Protein by the Ubiquitin Ligase CHIP*

PubMed Central

Narayan, Vikram; Pion, Emmanuelle; Landré, Vivien; Müller, Petr; Ball, Kathryn L.

2011-01-01

Characteristically for a regulatory protein, the IRF-1 tumor suppressor turns over rapidly with a half-life of between 20–40 min. This allows IRF-1 to reach new steady state protein levels swiftly in response to changing environmental conditions. Whereas CHIP (C terminus of Hsc70-interacting protein), appears to chaperone IRF-1 in unstressed cells, formation of a stable IRF-1·CHIP complex is seen under specific stress conditions. Complex formation, in heat- or heavy metal-treated cells, is accompanied by a decrease in IRF-1 steady state levels and an increase in IRF-1 ubiquitination. CHIP binds directly to an intrinsically disordered domain in the central region of IRF-1 (residues 106–140), and this site is sufficient to form a stable complex with CHIP in cells and to compete in trans with full-length IRF-1, leading to a reduction in its ubiquitination. The study reveals a complex relationship between CHIP and IRF-1 and highlights the role that direct binding or “docking” of CHIP to its substrate(s) can play in its mechanism of action as an E3 ligase. PMID:20947504

Bryostatin Effects on Cognitive Function and PKCɛ in Alzheimer's Disease Phase IIa and Expanded Access Trials.

PubMed

Nelson, Thomas J; Sun, Miao-Kun; Lim, Chol; Sen, Abhik; Khan, Tapan; Chirila, Florin V; Alkon, Daniel L

2017-01-01

Bryostatin 1, a potent activator of protein kinase C epsilon (PKCɛ), has been shown to reverse synaptic loss and facilitate synaptic maturation in animal models of Alzheimer's disease (AD), Fragile X, stroke, and other neurological disorders. In a single-dose (25 μg/m2) randomized double-blind Phase IIa clinical trial, bryostatin levels reached a maximum at 1-2 h after the start of infusion. In close parallel with peak blood levels of bryostatin, an increase of PBMC PKCɛ was measured (p = 0.0185) within 1 h from the onset of infusion. Of 9 patients with a clinical diagnosis of AD, of which 6 received drug and 3 received vehicle within a double-blind protocol, bryostatin increased the Mini-Mental State Examination (MMSE) score by +1.83±0.70 unit at 3 h versus -1.00±1.53 unit for placebo. Bryostatin was well tolerated in these AD patients and no drug-related adverse events were reported. The 25 μg/m2 administered dose was based on prior clinical experience with three Expanded Access advanced AD patients treated with bryostatin, in which return of major functions such as swallowing, vocalization, and word recognition were noted. In one Expanded Access patient trial, elevated PKCɛ levels closely tracked cognitive benefits in the first 24 weeks as measured by MMSE and ADCS-ADL psychometrics. Pre-clinical mouse studies showed effective activation of PKCɛ and increased levels of BDNF and PSD-95. Together, these Phase IIa, Expanded Access, and pre-clinical results provide initial encouragement for bryostatin 1 as a potential treatment for AD.

Clock drawing test in elderly individuals with different education levels: correlation with clinical dementia rating.

PubMed

Cecato, Juliana Francisca; Fiorese, Bruna; Montiel, José Maria; Bartholomeu, Daniel; Martinelli, José Eduardo

2012-12-01

The aim of this study was to describe the performance in Clock Drawing Test (CDT) of the elderly individuals assessed in a geriatric clinic, with at least 1 year of schooling, comparing with other groups with higher education and with Clinical Dementia Rating (CDR) levels. The study also aims to correlate the results of CDT and other used diagnostic tests for dementia by CDR levels, providing additional validity evidence to the CDT. Cross-sectional study with 426 elderly individuals, >60 years old and at least 1 year of education. All participants searched for medical assistance at Geriatric and Gerontology Ambulatory of Jundiaí city, in Brazil. The community-dwelling outpatients previously undergone a detailed clinical examination and neuropsychological evaluation: Cambrigde Cognitive Examination (CAMCOG), Mini-Mental State Examination (MMSE), andCDT. To differentiate data from diagnostic groups based on CDR, it Kruskal-Wallis test was used. Pearson statistics were calculated to compare data from CDT and CDR. The statistical analyses were 2-tailed and were considered significant when P < .05. Regarding CDT, groups with more years of schooling showed similar means in CDR = 0 and CDR = 0.5 and in CDR = 1 and CDR = 2. Shulman and Sunderland scale were high score in groups with more years of education and above of cutoff points in all CDT score. On the contrary, in Mendez scale we did not observed similar means. Otherwise, in the group with less years of schooling greater means differences in the CDT were observed. The CDT did not show a strong correlation with MMSE and CAMCOG, both important instruments in Brazilian population to investigate dementia. For elderly individuals with high education levels, the CDT did not seem to be a good test to detect cognitive impairment.

Combined measurement of plasma cystatin C and low-density lipoprotein cholesterol: A valuable tool for evaluating progressive supranuclear palsy.

PubMed

Weng, Ruihui; Wei, Xiaobo; Yu, Bin; Zhu, Shuzhen; Yang, Xiaohua; Xie, Fen; Zhang, Mahui; Jiang, Ying; Feng, Zhong-Ping; Sun, Hong-Shuo; Xia, Ying; Jin, Kunlin; Chan, Piu; Wang, Qing; Gao, Xiaoya

2018-07-01

Progressive supranuclear palsy (PSP) was previously thought as a cause of atypical Parkinsonism. Although Cystatin C (Cys C) and low-density cholesterol lipoprotein-C (LDL-C) are known to play critical roles in Parkinsonism, it is unknown whether they can be used as markers to distinguish PSP patients from healthy subjects and to determine disease severity. We conducted a cross-sectional study to determine plasma Cys C/HDL/LDL-C levels of 40 patients with PSP and 40 healthy age-matched controls. An extended battery of motor and neuropsychological tests, including the PSP-Rating Scale (PSPRS), the Non-Motor Symptoms Scale (NMSS), Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE), was used to evaluate the disease severity. Receiver operating characteristic (ROC) curves were adopted to assess the prognostic accuracy of Cys C/LDL-C levels in distinguishing PSP from healthy subjects. Patients with PSP exhibited significantly higher plasma levels of Cys C and lower LDL-C. The levels of plasma Cys C were positively and inversely correlated with the PSPRS/NMSS and MMSE scores, respectively. The LDL-C/HDL-C ratio was positively associated with PSPRS/NMSS and GDS scores. The ROC curve for the combination of Cys C and LDL-C yielded a better accuracy for distinguishing PSP from healthy subjects than the separate curves for each parameter. Plasma Cys C and LDL-C may be valuable screening tools for differentiating PSP from healthy subjects; while they could be useful for the PSP intensifies and severity evaluation. A better understanding of Cys C and LDL-C may yield insights into the pathogenesis of PSP. Copyright © 2018 Elsevier Ltd. All rights reserved.

Leisure activities, education, and cognitive impairment in Chinese older adults: a population-based longitudinal study.

PubMed

Zhu, Xinyi; Qiu, Chengxuan; Zeng, Yi; Li, Juan

2017-05-01

We examine the association between leisure-time activities and the risk of developing cognitive impairment among Chinese older people, and further investigate whether the association varies by educational level. This follow-up study included 6,586 participants (aged 79.5 ± 9.8 years, range 65-105 years, 51.7% female) of the Chinese Longitudinal Healthy Longevity Survey who were aged ≥65 years and were free of cognitive impairment in 2002. Incident cognitive impairment was defined at the 2005 or 2008/2009 survey following an education-based cut-off on the adapted Chinese version of Mini-Mental State Examination (MMSE). Participation in cognitive activities (e.g. reading) and non-exercise physical activity (e.g. housework) was assessed by a self-reported scale. Cox proportional hazard models were employed to examine the association of leisure activities with incident cognitive impairment while controlling for age, gender, education, occupation, residence, physical exercise, smoking, drinking, cardiovascular diseases and risk factors, negative well-being, and physical functioning, and baseline MMSE score. During a five-year follow-up, 1,448 participants developed incident cognitive impairment. Overall, a high level of participation in leisure activities was associated with a 41% decreased risk of cognitive impairment compared to low-level engagement in leisure activities after controlling for age, gender, education, and other confounders. Moreover, there was a significant interaction between leisure activity and educational level, such that the beneficial effect of leisure activities on cognitive function was larger in educated elderly than their uneducated counterparts, and only educated elderly benefited from cognitive activities. Late-life leisure activities protect against cognitive impairment among elderly Chinese people, and the protective effects are more profound for educated elderly.

Efficacy and Safety of 3 Different Anesthesia Techniques Used in Total Hip Arthroplasty

PubMed Central

Liang, Chengwei; Wei, Jionglin; Cai, Xiaoxi; Lin, Weilong; Fan, Yongqian; Yang, Fengjian

2017-01-01

Background This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). Material/Methods We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients. Results The CEA and SEA groups had lower rates of perioperative adverse effects than in the GA group. Patients in the GA group required significantly higher administration of analgesics after the surgery than those in CEA and SEA groups. Higher Aβ expression levels and VAS scores, as well as lower MMSE scores, were also seen in the GA group compared with the other 2 groups. Conclusions CEA and SEA were more effective than GA in THA, and CEA seemed to be a better anesthesia technique than SEA. PMID:28767640

Bi-level microelectronic device package with an integral window

DOEpatents

Peterson, Kenneth A.; Watson, Robert D.

2004-01-06

A package with an integral window for housing a microelectronic device. The integral window is bonded directly to the package without having a separate layer of adhesive material disposed in-between the window and the package. The device can be a semiconductor chip, CCD chip, CMOS chip, VCSEL chip, laser diode, MEMS device, or IMEMS device. The multilayered package can be formed of a LTCC or HTCC cofired ceramic material, with the integral window being simultaneously joined to the package during LTCC or HTCC processing. The microelectronic device can be flip-chip bonded so that the light-sensitive side is optically accessible through the window. The package has at least two levels of circuits for making electrical interconnections to a pair of microelectronic devices. The result is a compact, low-profile package having an integral window that is hermetically sealed to the package prior to mounting and interconnecting the microelectronic device(s).

Antioxidant Defence, Oxidative Stress and Oxidative Damage in Saliva, Plasma and Erythrocytes of Dementia Patients. Can Salivary AGE be a Marker of Dementia?

PubMed Central

Choromańska, Magdalena; Klimiuk, Anna; Kostecka-Sochoń, Paula; Wilczyńska, Karolina; Kwiatkowski, Mikołaj; Okuniewska, Natalia; Waszkiewicz, Napoleon; Zalewska, Anna

2017-01-01

Oxidative stress plays a crucial role in dementia pathogenesis; however, its impact on salivary secretion and salivary qualities is still unknown. This study included 80 patients with moderate dementia and 80 healthy age- and sex-matched individuals. Salivary flow, antioxidants (salivary peroxidase, catalase, superoxide dismutase, uric acid and total antioxidant capacity), and oxidative damage products (advanced oxidation protein products, advanced glycation end products (AGE), 8-isoprostanes, 8-hydroxy-2’-deoxyguanosine and total oxidant status) were estimated in non-stimulated and stimulated saliva, as well as in plasma and erythrocytes. We show that in dementia patients the concentration/activity of major salivary antioxidants changes, and the level of oxidative damage to DNA, proteins and lipids is increased compared to healthy controls. Non-stimulated and stimulated salivary secretions were significantly reduced in dementia patients. The deterioration in mini mental state examination (MMSE) score correlated with salivary AGE levels, which when considered with receiver operating characteristic (ROC) analysis, suggests their potential role in the non-invasive diagnosis of dementia. In conclusion, dementia is associated with disturbed salivary redox homeostasis and impaired secretory function of the salivary glands. Salivary AGE may be useful in the diagnosis of dementia. PMID:29053628

The influence of aging on the methylation status of brain-derived neurotrophic factor gene in blood.

PubMed

Ihara, Kazushige; Fuchikami, Manabu; Hashizume, Masahiro; Okada, Satoshi; Kawai, Hisashi; Obuchi, Shuichi; Hirano, Hirohiko; Fujiwara, Yoshinori; Hachisu, Mitsugu; Hongyong, Kim; Morinobu, Shigeru

2018-06-28

Brain-derived neurotrophic factor (BDNF) is involved in the pathophysiology of psychiatric disorders in adults and elderly individuals, and as a result, the DNA methylation (DNAm) of the BDNF gene in peripheral tissues including blood has been extensively examined to develop a useful biomarker for psychiatric disorders. However, studies to date have not previously investigated the effect of age on DNAm of the BDNF gene in blood. In this context, we measured DNAm of 39 CpG units in the CpG island at the promoter of exon I of the BDNF gene. We analyzed genomic DNA from peripheral blood of 105 health Japanese women 20 to 80 years of age to identify aging-associated change in DNAm of the BDNF gene. In addition, we examined the relationship between total MMSE scores, numbers of stressful life events, and serum BDNF levels on DNAm of the BDNF gene. The DNAm rate at each CpG unit was measured using a MassArray ® system (Agena Bioscience), and serum BDNF levels were measured by ELISA. There was a significant correlation between DNAm and age in 13 CpGs. However, there was no significant correlation between DNAm and total MMSE scores, numbers of life events, or serum BDNF levels. Despite the small number of subjects and the inclusion of only female subjects, our results suggest that DNAm of 13 CpGs of the BDNF gene may be an appropriate biomarker for aging and useful for predicting increased susceptibility to age-related psychiatric disorders. © 2018 John Wiley & Sons, Ltd.

Higher HDL cholesterol is associated with better cognitive function: the Maine-Syracuse study.

PubMed

Crichton, Georgina E; Elias, Merrill F; Davey, Adam; Sullivan, Kevin J; Robbins, Michael A

2014-11-01

Few studies have examined associations between different subcategories of cholesterol and cognitive function. We examined relationships between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride levels and cognitive performance in the Maine-Syracuse Longitudinal Study, a community-based study of cardiovascular risk factors. Cross-sectional analyses were undertaken on data from 540 participants, aged 60 to 98 years, free of dementia and stroke. TC, HDL, LDL, and triglyceride levels were obtained. Cognitive function was assessed using a thorough neuropsychological test battery, including domains of cognitive function indexed by multiple cognitive tests. The cognitive outcomes studied were as follows: Visual-Spatial Memory and Organization, Verbal and Working Memory, Scanning and Tracking, Abstract Reasoning, a Global Composite score, and the Mini-Mental State Examination (MMSE). Significant positive associations were observed between HDL-cholesterol and the Global Composite score, Working Memory, and the MMSE after adjustment for demographic and cardiovascular risk factors. Participants with desirable levels of HDL (≥60 mg/dL) had the highest scores on all cognitive outcomes. There were no significant associations observed between TC, LDL, or triglyceride concentrations and cognition. In older individuals, HDL-cholesterol was related to a composite of Working Memory tests and for general measures of cognitive ability when adjusted for cardiovascular variables. We speculate that persons over 60 are survivors and thus less likely to show cognitive deficit in relation to TC, LDL-cholesterol, and triglycerides. Longitudinal studies are needed to examine relations between specific cognitive abilities and the different subcategories of cholesterol.

Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort.

PubMed

Salem, L C; Vogel, A; Ebstrup, J; Linneberg, A; Waldemar, G

2015-12-01

Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet. In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score. We found that young patients with dementia have a significantly higher level and a different profile of subjective cognitive complaints as compared with elderly patients with dementia. Furthermore, young patients, diagnosed with an affective disorder, had the highest level of subjective cognitive complaints of all patients in a memory clinic. The age of the patients and MDI score (but not MMSE or ACE) had significant impact on the level of subjective cognitive complaints. We have established that young patients with dementia have a different profile of subjective cognitive complaints than elderly patients, and further studies are needed to clarify possible relation to specific subtypes of dementia. Altogether, a systematic interview on subjective cognitive complaints may contribute to the diagnostic evaluation of patients referred to a memory clinic. Copyright © 2015 John Wiley & Sons, Ltd.

Elevated NT-proBNP Levels are Associated with Poor Cognitive Function in Community-Dwelling Older Adults: Results from the Rancho Bernardo Study

PubMed Central

Daniels, Lori B.; Laughlin, Gail A.; Kritz-Silverstein, Donna; Clopton, Paul; Chen, Wei-Chung; Maisel, Alan S.; Barrett-Connor, Elizabeth

2011-01-01

Background Natriuretic peptides (NP’s) have prognostic value across a wide spectrum of cardiovascular diseases and may predict cognitive dysfunction in patients with cardiovascular disease even in the absence of prior stroke. Little is known about the association of NP’s with cognitive function in community-dwelling adults. We assessed the association between NT-proBNP levels and cognitive function in community-dwelling ambulatory older adults in the Rancho Bernardo Study. Methods We studied 950 men and women, aged 60 years and older, who attended a research clinic visit where a medical history and examination were performed, and blood for cardiovascular disease risk factors and NT-proBNP levels were obtained. Three cognitive function tests were administered: Mini Mental State Exam (MMSE), Trail-Making Test B (Trails B), and Category Fluency. Results Participants with high NT-proBNP levels (≥450 pg/mL, n=198) were older and had a higher prevalence of coronary heart disease (12% vs. 30%), and stroke (5% vs. 11%) (both p’s≤0.001). In unadjusted analyses, all three cognitive function test scores were significantly associated with NT-proBNP levels (p<0.001). After adjusting for age, sex, education, hypertension, body mass index, exercise, alcohol use, smoking, low density lipoprotein cholesterol, creatinine clearance, and prior cardiovascular disease, elevated NT-proBNP levels remained independently associated with poor cognitive performance on MMSE (odds ratio [95% confidence interval] 2.0 [1.1–3.6], p=0.02) and Trails B (1.7 [1.2–2.7], p=0.01), but not Category Fluency (1.4 [0.9–2.2], p=0.19). Results were unchanged after excluding the 6% of participants with a history of stroke. Conclusions NT-proBNP levels were strongly and independently associated with poor cognitive function in community-dwelling older adults. PMID:21683832

Physical-level synthesis for digital lab-on-a-chip considering variation, contamination, and defect.

PubMed

Liao, Chen; Hu, Shiyan

2014-03-01

Microfluidic lab-on-a-chips have been widely utilized in biochemical analysis and human health studies due to high detection accuracy, high timing efficiency, and low cost. The increasing design complexity of lab-on-a-chips necessitates the computer-aided design (CAD) methodology in contrast to the classical manual design methodology. A key part in lab-on-a-chip CAD is physical-level synthesis. It includes the lab-on-a-chip placement and routing, where placement is to determine the physical location and the starting time of each operation and routing is to transport each droplet from the source to the destination. In the lab-on-a-chip design, variation, contamination, and defect need to be considered. This work designs a physical-level synthesis flow which simultaneously considers variation, contamination, and defect of the lab-on-a-chip design. It proposes a maze routing based, variation, contamination, and defect aware droplet routing technique, which is seamlessly integrated into an existing placement technique. The proposed technique improves the placement solution for routing and achieves the placement and routing co-optimization to handle variation, contamination, and defect. The simulation results demonstrate that our technique does not use any defective/contaminated grids, while the technique without considering contamination and defect uses 17.0% of the defective/contaminated grids on average. In addition, our routing variation aware technique significantly improves the average routing yield by 51.2% with only 3.5% increase in completion time compared to a routing variation unaware technique.

Sulforaphane Upregulates the Heat Shock Protein Co-Chaperone CHIP and Clears Amyloid-β and Tau in a Mouse Model of Alzheimer's Disease.

PubMed

Lee, Siyoung; Choi, Bo-Ryoung; Kim, Jisung; LaFerla, Frank M; Park, Jung Han Yoon; Han, Jung-Soo; Lee, Ki Won; Kim, Jiyoung

2018-04-30

Sulforaphane is an herbal isothiocyanate enriched in cruciferous vegetables. Here, the authors investigate whether sulforaphane modulates the production of amyloid-β (Aβ) and tau, the two main pathological factors in Alzheimer's disease (AD). A triple transgenic mouse model of AD (3 × Tg-AD) is used to study the effect of sulforaphane. Oral gavage of sulforaphane reduces protein levels of monomeric and polymeric forms of Aβ as well as tau and phosphorylated tau in 3 × Tg-AD mice. However, sulforaphane treatment do not affect mRNA expression of amyloid precursor protein or tau. As previous studies show that Aβ and tau metabolism are influenced by a heat shock protein (HSP) co-chaperone, C-terminus of HSP70-interacting protein (CHIP), the authors examine whether sulforaphane can modulate CHIP. The authors find that sulforaphane treatment increase levels of CHIP and HSP70. Furthermore, observations of CHIP-deficient primary neurons derived from 3 × Tg-AD mice suggest that sulforaphane treatment increase CHIP level and clear the accumulation of Aβ and tau. Finally, sulforaphane ameliorated memory deficits in 3 × Tg-AD mice as reveal by novel object/location recognition tests and contextual fear conditioning tests. These results demonstrate that sulforaphane treatment upregulates CHIP and has the potential to decrease the accumulation of Aβ and tau in patients with AD. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study.

PubMed

Carotenuto, Anna; Rea, Raffaele; Traini, Enea; Ricci, Giovanna; Fasanaro, Angiola Maria; Amenta, Francesco

2018-05-11

Approximately 46.8 million people are living with dementia worldwide and their number will grow in the next years. Any potential treatment should be administered as early as possible because it is important to provide an early cognitive assessment and to regularly monitor the mental function of patients. Information and communication technologies can be helpful to reach and follow patients without displacing them, but there may be doubts about the reliability of cognitive tests performed by telemedicine. The purpose of this study was to evaluate the reliability of the Mini Mental State Examination (MMSE) and the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) tests administered in hospital by videoconference to patients with mild to moderate Alzheimer's disease. The tests were administered to 28 Alzheimer's disease outpatients (8 male, mean age 73.88, SD 7.45 years; 20 female mean age 76.00, SD 5.40 years) recruited and followed in the Alzheimer's Unit of the A Cardarelli National Hospital (Naples, Italy) at baseline and after 6, 12, 18, and 24 months of observation. Patients were evaluated first face-to-face by a psychologist and then, after 2 weeks, by another psychologist via videoconference in hospital. This study showed no differences in the MMSE and ADAS-cog scores when the tests were administered face-to-face or by videoconference, except in patients with more pronounced cognitive deficits (MMSE<17), in which the assessment via videoconference overestimated the cognitive impairment (face to face, MMSE mean 13.9, SD 4.9 and ADAS-cog mean 9.0, SD 3.8; videoconference, MMSE mean 42.8, SD 12.5 and ADAS-cog mean 56.9, SD 5.5). We found that videoconferencing is a reliable approach to document cognitive stability or decline, and to measure treatment effects in patients with mild to moderate dementia. A more extended study is needed to confirm these results. ©Anna Carotenuto, Raffaele Rea, Enea Traini, Giovanna Ricci, Angiola Maria Fasanaro, Francesco Amenta. Originally published in JMIR Mental Health (http://mental.jmir.org), 11.05.2018.

Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

PubMed

Hongisto, Markus T; Nuotio, Maria; Luukkaala, Tiina; Väistö, Olli; Pihlajamäki, Harri K

2016-10-22

Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture. Age-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37-35.86), IADL <5 (OR 12.96, 95 % CI 1.62-103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82-9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %-100 %) sensitivity and 38 % (95 % CI 33 %-43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %-91 %) sensitivity and 65 % (95 % CI 60 %-70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations. IADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.

Pest risk assessment of the importation into the United States of unprocessed Pinus logs and chips from Australia

Treesearch

John T Kliejunas; Harold H. Burdsall; Gregg A. DeNitto; Andris Eglitis; Dennis A. Haugen; Michael I. Haverty; Jessie A. Micales-Glaeser

2006-01-01

The unmitigated pest risk potential for the importation of unprocessed logs and chips of species of Pinus (Pinus radiata, P. elliottii Engelm. var. elliottii, P. taeda L., and P. caribaea var. hondurensis, principally) from Australia into the United States was assessed by estimating the likelihood and consequences of introduction of representative insects and pathogens...

Pest risk assessment of the importation into the United States of unprocessed Eucalyptus logs and chips from South America

Treesearch

John T. Kliejunas; Harold H. Burdsall; Gregg A. DeNitto; Andris Eglitis; Dennis A. Haugen; William E. Wallner

2001-01-01

In this report, we assess the unmitigated pest risk potential of importing Eucalyptus logs and chips from South America into the United States. To do this, we estimated the likelihood and consequences of introducing representative insects and pathogens of concern. Nineteen individual pest risk assessments were prepared, eleven dealing with insects and eight with...

Exploring the Role of Cognitive Factors in a New Instrument for Elders' Financial Capacity Assessment.

PubMed

Giannouli, Vaitsa; Stamovlasis, Dimitrios; Tsolaki, Magda

2018-01-01

The influence of cognitive factors on financial capacity across the dementia spectrum of cognitive aging, Alzheimer's disease (AD), and mild cognitive impairment (MCI) has been little investigated, while it has not been investigated at all in other types of dementia as well as in extended samples of elders in Greece. The aim of this study is to investigate financial capacity, to develop a tool, test its psychometric properties, validate, and then test the tool in groups of healthy controls compared to elders with dementia, while examining other facets of their cognitive performance. 719 elders from Greece including healthy participants and patients with different types of dementia were examined with Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) and a battery of neuropsychological tests concerning various cognitive functions. Significantly different profiles in the scores and subscores of LCPLTAS for all the groups of dementia patients were found, with a general incapacity finding for all the dementia groups including the MCI patients. Logistic regression showed that Mini-Mental State Examination (MMSE), Geriatric Depression Scale, and Trail Making Part B predicted competence on LCPLTAS for the dementia patients. Persons with MCI and dementia had lower financial knowledge scores than those without cognitive impairment, with MMSE scores below 27 suggestive as an indication of financial incapacity. The LCPLTAS provides information for a strong positive correlation with MMSE, while the use both of MMSE and LCPLTAS as adequate measures of financial (in)capacity is discussed for the Greek legal procedures regarding elder guardianship cases.

Going outdoors and cognitive function among community-dwelling older adults: Moderating role of physical function.

PubMed

Harada, Kazuhiro; Lee, Sangyoon; Park, Hyuntae; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Anan, Yuya; Uemura, Kazuki; Suzuki, Takao

2016-01-01

Identifying the risk factors of cognitive impairment is essential for implementing effective prevention strategies for dementia. Previous studies have shown that the frequency of going outdoors is inversely associated with cognitive decline. Little research has examined whether the relationship between going outdoors and cognitive decline varies with physical functioning in older adults. The aim of the present study was to examine the relationship between going outdoors and cognitive function in older adults with and without physical function limitations. The present study analyzed the data of 4450 individuals (aged 65 years or older) who participated in the Obu Study of Health Promotion for the Elderly. The measures were the Mini-Mental State Examination (MMSE), going outdoors (at least once a week or not), self-reported physical function limitations (with or without), and demographic and health-related factors as potential confounders. Analysis of covariance and post-hoc comparisons showed that although going outdoors at least once a week was associated with higher MMSE scores among older adults with limited physical function, it was not significantly associated with the MMSE scores among older adults without limited physical function. Similarly, logistic regression analyses, stratified by physical function, showed a significant association between going outdoors and MMSE (<24 points or not) among older adults with limited physical function. The results show that going outdoors less than once a week is associated with decreased cognitive function among older adults with limited physical function, but it is not associated with cognitive function among older adults without limited physical function. © 2015 Japan Geriatrics Society.

Correlation Between Vision and Cognitive Function in the Elderly

PubMed Central

Spierer, Oriel; Fischer, Naomi; Barak, Adiel; Belkin, Michael

2016-01-01

Abstract The correlation between vision and cognition is not fully understood. Visual impairment in the elderly has been associated with impaired cognitive function, dementia, and Alzheimer disease. The aim was to study the correlation between near visual acuity (VA), refraction, and cognitive state in an elderly population. Subjects ≥75 years were enrolled in this cross-sectional study. Refraction and near VA was tested. Cognitive function was evaluated with a version of the mini-mental state examination for the visually impaired (MMSE-blind). The eye with better VA and no cataract or refractive surgery was analyzed. One-hundred ninety subjects (81.6 ± 5.1 years, 69.5% female) were included. Good VA (≤J3) was associated with high MMSE-blind (>17) (OR = 3.18, 95% CI = 1.57–6.43, P = 0.001). This remained significant adjusting for sex, age, and years of education. Wearing reading glasses correlated significantly with high MMSE-blind after adjustment for sex and age (OR = 2.14, 95% CI = 1.16–3.97, P = 0.016), but reached borderline significance after adjustment for education. There was a trend toward correlation between myopia and better MMSE-blind (r = −0.123, P = 0.09, Pearson correlation). Good VA and wearing glasses seem to correlate with better cognitive function. Reading glasses can serve as a protective factor against cognitive deterioration associated with sensory (visual) deprivation in old age. The association between myopia and cognition requires further investigation. PMID:26817872

Validation of the Sinhala version of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS)

PubMed

Suraweera, Chathurie; Anandakumar, D; Dahanayake, D; Subendran, M; Perera, U T; Hanwella, Raveen; de Silva, Varuni

2016-12-30

Only the Mini mental state examination (MMSE) and Montreal Cognitive Assessment scale have been validated in a Sri Lankan population for the assessment of cognitive functions. Both tests are deficient in the number of domains assessed. Therefore validation of Repeatable Battery for Assessment of Neuropsychological Status is important as it assesses most of the cognitive domains. To culturally adapt RBANS and investigate the validity and reliability of culturally adapted RBANS (RBANS-S). Fifty four participants with major neurocognitive disorder and 60 normal controls aged >50 were administered with RBANS-S at the Cognitive Assessment Unit, Faculty of Medicine, Colombo and National Hospital of Sri Lanka. The participants were selected after a detailed clinical assessment according to Diagnostic and Statistical Manual – 5 criteria. Data were analysed using SPSS data package. The mean age of the sample was 69.5 years. RBANS-S total scale correlated highly with MMSE total score, (Pearson correlational coefficient = 0.793 p=0.01). Criterion validity was assessed using receiver operating curve characteristic analysis and the area under the curve was 0.937. RBANS-S showed strong concurrent validity us indicated by its significant correlations with the MMSE. All of the RBANS-S subtests demonstrated significant correlations with the MMSE subsets. The sensitivity and specificity for RBANS-S was 89% and 85% respectively at a totals score of 80.5. The RBANS-S yielded a reliability coefficient of 0.929. Culturally adapted RBANS-S is a valid and reliable instrument which can be used in assessment of cognitive functions.

Association between functional alterations of senescence and senility and disorders of gait and balance

PubMed Central

Teixeira-Leite, Homero; Manhães, Alex C.

2012-01-01

OBJECTIVES: Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil. METHODS: Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale. RESULTS: Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores. CONCLUSIONS: Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity. PMID:22892914

Association between functional alterations of senescence and senility and disorders of gait and balance.

PubMed

Teixeira-Leite, Homero; Manhães, Alex C

2012-07-01

Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil. Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale. Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores. Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity.

Efficacy of video-music therapy on quality of life improvement in a group of patients with Alzheimer's disease: a pre-post study.

PubMed

Rubbi, Ivan; Magnani, Daniela; Naldoni, Giada; Di Lorenzo, Rosaria; Cremonini, Valeria; Capucci, Patrizia; Artioli, Giovanna; Ferri, Paola

2016-11-22

Alzheimer's disease is the most common degenerative dementia with a predominantly senile onset. The difficult management of altered behaviour related to this disorder, poorly responsive to pharmacological treatments, has stimulated growth in non-pharmacological interventions, such as music therapy, whose effectiveness has not been supported by the literature up to now. The aim of this study was to evaluate the efficacy of video-music therapy on quality of life improvement in Patients affected by Alzheimer's Disease (AD). A pre-post study was conducted in a residential facility. 32 AD Patients, who attended this facility daily to participate in supportive and rehabilitative programs, were treated with 2 cycles of 6 video-music-therapy sessions, which consisted of folk music and video, recalling local traditions. In order to investigate their cognitive status, Mini Mental State Examination (MMSE) was administered and Patients were divided into stages according to MMSE scores. After each session of video-music-therapy, Quality of Life in Alzheimer's Disease Scale (QOL-AD) was administered to our Patients. 21 AD Patients completed the 2 cycles of video-music therapy. Among them, only the Patients with questionable, mild and moderate neurocognitive impairment (MMSE Stages 1, 2, 3) reported an improvement in their quality of life, whereas the Patients with severe deterioration (MMSE stage 4) did not report any change. Many items of QOL-AD improved, showing a statistically significantly correlation to each other. Video-music therapy was a valuable tool for improving the quality of life only in Patients affected by less severe neurocognitive impairment.

Mental status testing in the elderly nursing home population.

PubMed

Nadler, J D; Relkin, N R; Cohen, M S; Hodder, R A; Reingold, J; Plum, F

1995-07-01

The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old.

Effects of nutritional status and cognitive ability on olfactory function in geriatric patients.

PubMed

Jin, Sung-Yong; Jeong, Hye Seon; Lee, Jin Woo; Kwon, Ki Ryun; Rha, Ki-Sang; Kim, Yong Min

2016-02-01

The aim of this study was to investigate the prevalence of olfactory dysfunction and evaluate the relationship between olfactory function and nutritional status, comorbidity, and the results of a neurocognitive test in geriatric patients who do not suffer from neurodegenerative disease. A total of 45 patients who visited the Geriatric Health Center of Chungnam National University Hospital were enrolled in this study. Olfactory function was assessed using a Korean Version of Sniffin' Stick Test II. Cognitive status of all participants was assessed with the MMSE-K (Korean version of the Mini-Mental State Examination). Nutritional status was assessed with body mass index, Mini-Nutritional Assessment (MNA), and serum total protein and albumin. A total of 45 participants were enrolled in this study. Of these subjects, 28 were men and 17 were women, with a mean age of 71.7±5.16 years. Nine (20%) were normosmia, 13 (28.9%) were hyposmia, and 23 (51.1%) were anosmia. Thirty-six patients (80%) suffered from olfactory dysfunction (anosmia or hyposmia). MMSE score showed significant correlation with MNA score. There were significant negative correlations between age and total TDI (threshold, discrimination, and identification) score, discrimination score, identification score, and MMSE score. MMSE score showed significant correlation with discrimination score and identification score. However, MNA score did not show any significant correlation with olfactory function test results. Although olfactory function was not influenced by nutritional status, abilities of discrimination and identification of odors were associated with cognitive function in geriatric patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Atom chip microscopy: A novel probe for strongly correlated materials

NASA Astrophysics Data System (ADS)

Kasch, Brian; Naides, Matthew; Turner, Richard; Ray, Ushnish; Lev, Benjamin

2010-03-01

Atom chip technology---substrates supporting micron-sized current-carrying wires that create magnetic microtraps near surfaces for thermal or degenerate gases of neutral atoms---will enable single-shot, large area detection of magnetic flux below the 10-7 flux quantum level. By harnessing the extreme sensitivity of Bose-Einstein condensates (BECs) to external perturbations, cryogenic atom chips could provide a magnetic flux detection capability that surpasses all other techniques by a factor of 10^2--10^3. We describe the merits of atom chip microscopy, our Rb BEC and atom chip apparatus, and prospects for imaging strongly correlated condensed matter materials.

Three Dimensional Integration and On-Wafer Packaging for Heterogeneous Wafer-Scale Circuit Architectures

DTIC Science & Technology

2006-11-01

Chip Level CMOS Chip High resistivity Si Metal Interconnect 25μm 24GHz fully integrated receiver CMOS transimpedance Amplifier (13GHz BW, 52dBΩ...power of a high-resistivity SiGe power amplifier chip with the wide operating frequency range and compactness of a CMOS mixed signal chip operating...With good RF channel selectivity, system specifications such as the linearity of the low noise amplifier (LNA), the phase noise of the voltage

The influence of demographic, physical, behavioral, and dietary factors on hemoglobin adduct levels of acrylamide and glycidamide in the general U.S. population.

PubMed

Duke, Tina J; Ruestow, Peter S; Marsh, Gary M

2018-03-24

This study aims to better understand the individual characteristics and dietary factors that affect the relationship between estimated consumption of acrylamide and measured acrylamide hemoglobin adduct levels (HbAA) and glycidamide hemoglobin adduct levels (HbGA). Acrylamide levels in individual food items, estimated by the U.S. Food and Drug Administration, were linked to data collected in the 2003-2004 National Health and Nutrition Examination Survey. Multivariable linear regression was used to evaluate the relationship between estimated consumption of acrylamide and HbAA. A significant association between acrylamide intake and HbAA was observed, after adjustment for gender, race/ethnicity, smoking status, age, and BMI (R 2 = 0.34). Across quartiles of acrylamide consumption, HbAA and HbGA levels increased monotonically. Among nonsmokers, an evaluation of three heavily consumed, high AA concentration foods showed a positive trend between the consumed amount of fried potatoes and HbAA in children, adolescents, and adults. A significant positive trend between the consumed amount of potato chips or coffee was indicated in adolescents, adults, and seniors. Consumption of some individual foods affects HbAA concentrations more strongly and in an age-dependent manner. Our results suggest that effective dietary guidelines for controlling acrylamide intake should be subpopulation specific.

A scalable neural chip with synaptic electronics using CMOS integrated memristors.

PubMed

Cruz-Albrecht, Jose M; Derosier, Timothy; Srinivasa, Narayan

2013-09-27

The design and simulation of a scalable neural chip with synaptic electronics using nanoscale memristors fully integrated with complementary metal-oxide-semiconductor (CMOS) is presented. The circuit consists of integrate-and-fire neurons and synapses with spike-timing dependent plasticity (STDP). The synaptic conductance values can be stored in memristors with eight levels, and the topology of connections between neurons is reconfigurable. The circuit has been designed using a 90 nm CMOS process with via connections to on-chip post-processed memristor arrays. The design has about 16 million CMOS transistors and 73 728 integrated memristors. We provide circuit level simulations of the entire chip performing neuronal and synaptic computations that result in biologically realistic functional behavior.

The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination.

PubMed

Duff, Kevin; Tometich, Danielle; Dennett, Kathryn

2015-09-01

Although not as popular as the Mini-Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these 2 cognitive screening measures in their ability to predict performance on a memory composite (ie, delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after 1 year. Both the MMSE and the mTICS significantly correlated with the memory composite at baseline (r's of .41 and .62, respectively) and at 1 year (r's of .36 and .50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R (2) = .45, P < .001), and the MMSE and other demographic variables did not significantly improve the prediction. At 1 year, the results were very similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range. © The Author(s) 2015.

On the optimum signal constellation design for high-speed optical transport networks.

PubMed

Liu, Tao; Djordjevic, Ivan B

2012-08-27

In this paper, we first describe an optimum signal constellation design algorithm, which is optimum in MMSE-sense, called MMSE-OSCD, for channel capacity achieving source distribution. Secondly, we introduce a feedback channel capacity inspired optimum signal constellation design (FCC-OSCD) to further improve the performance of MMSE-OSCD, inspired by the fact that feedback channel capacity is higher than that of systems without feedback. The constellations obtained by FCC-OSCD are, however, OSNR dependent. The optimization is jointly performed together with regular quasi-cyclic low-density parity-check (LDPC) code design. Such obtained coded-modulation scheme, in combination with polarization-multiplexing, is suitable as both 400 Gb/s and multi-Tb/s optical transport enabling technology. Using large girth LDPC code, we demonstrate by Monte Carlo simulations that a 32-ary signal constellation, obtained by FCC-OSCD, outperforms previously proposed optimized 32-ary CIPQ signal constellation by 0.8 dB at BER of 10(-7). On the other hand, the LDPC-coded 16-ary FCC-OSCD outperforms 16-QAM by 1.15 dB at the same BER.

Gender, Resources Across the Life Course, and Cognitive Functioning in Egypt

PubMed Central

YOUNT, KATHRYN M.

2008-01-01

In this article, I evaluate the life-course determinants of cognitive functioning among 1,003 women and men aged 50 and older in Ismailia, Egypt. Three questions motivate this analysis: (1) Do older women have poorer cognitive functioning than do older men?; (2) Do cognitive resources accrued in childhood and adulthood have net positive associations with later-life cognitive functioning for women and men?; and (3) To what extent do differences in the amounts and effects of women’s and men’s cognitive resources account for gaps in their cognitive functioning? Compared with men, women have lower Modified-Mini Mental Status Exam (M-MMSE) scores for overall cognitive functioning. Cognitive resources in childhood and adulthood are jointly associated with the M-MMSE score. About 83% of the gender gap in mean M-MMSE scores is attributable to gaps in men’s and women’s attributes across the life course. Gender gaps in childhood cognitive resources—and especially schooling attainment—account for the largest share (18%) of the residual gender gap in cognitive functioning. PMID:19110904

Cognitive impairment in patients with Fibromyalgia syndrome as assessed by the Mini-Mental State Examination

PubMed Central

2009-01-01

Background This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS) using the Mini Mental State Examination (MMSE). Methods We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP) or mixed pain (MP) selected from a larger prospective study. Results FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1) than either NeP (27.3; 95% CI 27.2-27.4) or MP (27.3; 27.2-27.5). The percentage of patients with congnitive impairment (adjusted MMSE ≤ 26) was numerically higher in FMS (15%; 95% CI 6.3-29) compared with NeP (5%; 95% CI 1.8-12.2) or MP (5%; 95% CI 1.8-12.2) and higher than in the same age stratum of the general population (0.05%). Conclusions Compared with the population reference value, patients with FMS showed high frequency of cognitive impairment. PMID:20025750

Cultural adaptation, standardization and clinical validity of the test your memory dementia screening instrument in Greek.

PubMed

Iatraki, Eliza; Simos, Panagiotis G; Lionis, Christos; Zaganas, Ioannis; Symvoulakis, Emmanouil K; Papastefanakis, Emmanouil; Panagiotakis, Simeon; Pantelidakis, Heraklis; Papadopoulos, Konstantinos; Tziraki, Chariklia

2014-01-01

To adapt and standardize the Test Your Memory (TYM) dementia screening instrument in Greek. Normative data on the Greek version of the TYM were obtained from a community sample of 239 adults aged 21-92 years. Clinical validity was assessed in a cohort of 134 Neurology Clinic patients. Concurrent validity was examined through comparisons with the Mini-Mental State Examination (MMSE) and the Greek Everyday Function Scale. Correlations between the TYM and the MMSE were 0.73 and 0.82 in the community and patient samples, respectively. Scores on both tests were moderately associated with everyday functional capacity. Using age- and education-corrected cutoff scores ranging from 26/50 to 45/50 points, the sensitivity of the TYM for Alzheimer's disease detection was found to be higher than that of the MMSE (0.82 vs. 0.70), although its specificity was lower (0.71 vs. 0.90). Findings are consistent with previous reports in a variety of cultural settings supporting the potential utility of the TYM as a dementia screening tool.

An observational clinical study of the efficacy and tolerability of donepezil in the treatment of Alzheimer's disease.

PubMed

Hager, Klaus; Calabrese, Pasquale; Frölich, Lutz; Göbel, Claus; Berger, Frank M

2003-01-01

An open-label, observational Post-Marketing Surveillance (PMS) study was undertaken in Germany to examine the efficacy and tolerability of donepezil in routine clinical practice. Alzheimer's disease (AD) patients were treated with donepezil (5 or 10 mg once daily) and observed for a period of approximately 3 months. Study assessments included the Mini-Mental State Examination (MMSE), the Nurses' Observation Scale for Geriatric Patients (NOSGER), and adverse events (AEs). A total of 2,092 patients (mean age 73.0 years; mean +/- SD MMSE score 17.8 +/- 5.8) were included in the efficacy assessments. MMSE and NOSGER scores showed statistically significant improvements in the total patient population and in the subpopulations with severe AD or AD with concomitant Parkinsonian symptoms (ADPS cohort). AEs were reported in a total of 12% of patients and were mostly due to peripheral cholinergic effects. In this observational PMS study, donepezil was shown to be an effective and well-tolerated therapy in the overall patient population, in patients with severe AD, and in the ADPS cohort. Copyright 2003 S. Karger AG, Basel

Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial.

PubMed

Abbasinazari, Mohammad; Adib-Eshgh, Ladan; Rostami, Azin; Beyraghi, Narges; Dabir, Shideh; Jafari, Reyhaneh

2015-06-01

The purpose of this study was to evaluate the effect of memantine administration on the adverse cognitive effects of electroconvulsive therapy (ECT). Forty patients diagnosed with a major depressive disorder for which ECT was indicated as a treatment for their current episode were randomly allocated to either the memantine (5mg/day) group or the placebo group. All patients underwent the same protocol for anaesthesia and ECT procedures. The patients received memantine or the placebo for the whole period of ECT treatment, starting the day before ECT and continuing until the fourth session of ECT. The Modified Mental State Examination (MMSE) was used for the assessment of cognition before and after the trial. Regarding MMSE and item 3 MMSE (related to recent memory), the memantine group scored significantly higher at the end of ECT sessions than the control group (P=0.02, P<0.001, respectively). Our data support the hypothesis that memantine may reduce cognitive impairment following ECT. Memantine could be both a safe and well-tolerated treatment for use with ECT. Copyright © 2015 Elsevier B.V. All rights reserved.

On-chip detection of non-classical light by scalable integration of single-photon detectors

PubMed Central

Najafi, Faraz; Mower, Jacob; Harris, Nicholas C.; Bellei, Francesco; Dane, Andrew; Lee, Catherine; Hu, Xiaolong; Kharel, Prashanta; Marsili, Francesco; Assefa, Solomon; Berggren, Karl K.; Englund, Dirk

2015-01-01

Photonic-integrated circuits have emerged as a scalable platform for complex quantum systems. A central goal is to integrate single-photon detectors to reduce optical losses, latency and wiring complexity associated with off-chip detectors. Superconducting nanowire single-photon detectors (SNSPDs) are particularly attractive because of high detection efficiency, sub-50-ps jitter and nanosecond-scale reset time. However, while single detectors have been incorporated into individual waveguides, the system detection efficiency of multiple SNSPDs in one photonic circuit—required for scalable quantum photonic circuits—has been limited to <0.2%. Here we introduce a micrometer-scale flip-chip process that enables scalable integration of SNSPDs on a range of photonic circuits. Ten low-jitter detectors are integrated on one circuit with 100% device yield. With an average system detection efficiency beyond 10%, and estimated on-chip detection efficiency of 14–52% for four detectors operated simultaneously, we demonstrate, to the best of our knowledge, the first on-chip photon correlation measurements of non-classical light. PMID:25575346

Dynamically programmable cache

NASA Astrophysics Data System (ADS)

Nakkar, Mouna; Harding, John A.; Schwartz, David A.; Franzon, Paul D.; Conte, Thomas

1998-10-01

Reconfigurable machines have recently been used as co- processors to accelerate the execution of certain algorithms or program subroutines. The problems with the above approach include high reconfiguration time and limited partial reconfiguration. By far the most critical problems are: (1) the small on-chip memory which results in slower execution time, and (2) small FPGA areas that cannot implement large subroutines. Dynamically Programmable Cache (DPC) is a novel architecture for embedded processors which offers solutions to the above problems. To solve memory access problems, DPC processors merge reconfigurable arrays with the data cache at various cache levels to create a multi-level reconfigurable machines. As a result DPC machines have both higher data accessibility and FPGA memory bandwidth. To solve the limited FPGA resource problem, DPC processors implemented multi-context switching (Virtualization) concept. Virtualization allows implementation of large subroutines with fewer FPGA cells. Additionally, DPC processors can parallelize the execution of several operations resulting in faster execution time. In this paper, the speedup improvement for DPC machines are shown to be 5X faster than an Altera FLEX10K FPGA chip and 2X faster than a Sun Ultral SPARC station for two different algorithms (convolution and motion estimation).

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

PubMed Central

John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

2015-01-01

Introduction PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis. PMID:26155567

Feasibility of ultra-wideband SAW RFID tags meeting FCC rules.

PubMed

Härmä, Sanna; Plessky, Victor P; Li, Xianyi; Hartogh, Paul

2009-04-01

We discuss the feasibility of surface acoustic wave (SAW) radio-frequency identification (RFID) tags that rely on ultra-wideband (UWB) technology. We propose a design of a UWB SAW tag, carry out numerical experiments on the device performance, and study signal processing in the system. We also present experimental results for the proposed device and estimate the potentially achievable reading distance. UWB SAW tags will have an extremely small chip size (<0.5 x 1 mm(2)) and a low cost. They also can provide a large number of different codes. The estimated read range for UWB SAW tags is about 2 m with a reader radiating as low as <0.1 mW power levels with an extremely low duty factor.

A demonstration of CMOS VLSI circuit prototyping in support of the site facility using the 1.2 micron standard cell library developed by National Security Agency

NASA Technical Reports Server (NTRS)

Smith, Edwyn D.

1991-01-01

Two silicon CMOS application specific integrated circuits (ASICs), a data generation chip, and a data checker chip were designed. The conversion of the data generator circuitry into a pair of CMOS ASIC chips using the 1.2 micron standard cell library is documented. The logic design of the data checker is discussed. The functions of the control circuitry is described. An accurate estimate of timing relationships is essential to make sure that the logic design performs correctly under practical conditions. Timing and delay information are examined.

Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study.

PubMed

Cotroneo, Antonino Maria; Castagna, Alberto; Putignano, Salvatore; Lacava, Roberto; Fantò, Fausto; Monteleone, Francesco; Rocca, Filomena; Malara, Alba; Gareri, Pietro

2013-01-01

The studio di intervento nel decadimento vascolare lieve (IDEALE study) was an open multicenter Italian study, the aim of which was to assess the effectiveness and safety of oral citicoline in elderly people with mild vascular cognitive impairment. The study was performed in 349 patients. The active or citicoline group was composed of 265 patients and included 122 men and 143 women of mean age 79.9 ± 7.8 years selected from six Italian regions. Inclusion criteria were age ≥ 65 years, Mini-Mental State Examination (MMSE) score ≥ 21, subjective memory complaints but no evidence of deficits on MMSE, and evidence of vascular lesions on neuroradiology. Those with probable Alzheimer's disease were excluded. The control group consisted of 84 patients, including 36 men and 48 women of mean age 78.9 ± 7.01 (range 67-90) years. Patients included in the study underwent brain computed tomography or magnetic resonance imaging, and plasma dosage of vitamin B12, folate, and thyroid hormones. Functional dependence was investigated by scores on the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, mood was assessed by the Geriatric Depression Scale (GDS), and behavioral disorders using the Neuropsychiatric Inventory scale. Comorbidity was assessed using the Cumulative Illness Rating Scale. An assessment was made at baseline (T0), after 3 months (T1), and after 9 months (T2, ie, 6 months after T1). The main outcomes were an improvement in MMSE, ADL, and IADL scores in the study group compared with the control group. Side effects were also investigated. The study group was administered oral citicoline 500 mg twice a day throughout the study. MMSE scores remained unchanged over time (22.4 ± 4 at T0; 22.7 ± 4 at T1; 22.9 ± 4 at T2), whereas a significant difference was found between the study and control groups, both in T1 and in T2. No differences were found in ADL and IADL scores between the two groups. A slight but not statistically significant difference was found in GDS score between the study and control groups (P = 0.06). No adverse events were recorded. In this study, citicoline was effective and well tolerated in patients with mild vascular cognitive impairment. Citicoline activates biosynthesis of phospholipids in neuronal membranes, increases brain metabolism as well as norepinephrine and dopamine levels in the central nervous system, and has neuroprotective effects during hypoxia and ischemia. Therefore, citicoline may be recommended for patients with mild vascular cognitive impairment.

A Bayesian deconvolution strategy for immunoprecipitation-based DNA methylome analysis

PubMed Central

Down, Thomas A.; Rakyan, Vardhman K.; Turner, Daniel J.; Flicek, Paul; Li, Heng; Kulesha, Eugene; Gräf, Stefan; Johnson, Nathan; Herrero, Javier; Tomazou, Eleni M.; Thorne, Natalie P.; Bäckdahl, Liselotte; Herberth, Marlis; Howe, Kevin L.; Jackson, David K.; Miretti, Marcos M.; Marioni, John C.; Birney, Ewan; Hubbard, Tim J. P.; Durbin, Richard; Tavaré, Simon; Beck, Stephan

2009-01-01

DNA methylation is an indispensible epigenetic modification of mammalian genomes. Consequently there is great interest in strategies for genome-wide/whole-genome DNA methylation analysis, and immunoprecipitation-based methods have proven to be a powerful option. Such methods are rapidly shifting the bottleneck from data generation to data analysis, necessitating the development of better analytical tools. Until now, a major analytical difficulty associated with immunoprecipitation-based DNA methylation profiling has been the inability to estimate absolute methylation levels. Here we report the development of a novel cross-platform algorithm – Bayesian Tool for Methylation Analysis (Batman) – for analyzing Methylated DNA Immunoprecipitation (MeDIP) profiles generated using arrays (MeDIP-chip) or next-generation sequencing (MeDIP-seq). The latter is an approach we have developed to elucidate the first high-resolution whole-genome DNA methylation profile (DNA methylome) of any mammalian genome. MeDIP-seq/MeDIP-chip combined with Batman represent robust, quantitative, and cost-effective functional genomic strategies for elucidating the function of DNA methylation. PMID:18612301

Germanium ``hexa'' detector: production and testing

NASA Astrophysics Data System (ADS)

Sarajlić, M.; Pennicard, D.; Smoljanin, S.; Hirsemann, H.; Struth, B.; Fritzsch, T.; Rothermund, M.; Zuvic, M.; Lampert, M. O.; Askar, M.; Graafsma, H.

2017-01-01

Here we present new result on the testing of a Germanium sensor for X-ray radiation. The system is made of 3 × 2 Medipix3RX chips, bump-bonded to a monolithic sensor, and is called ``hexa''. Its dimensions are 45 × 30 mm2 and the sensor thickness was 1.5 mm. The total number of the pixels is 393216 in the matrix 768 × 512 with pixel pitch 55 μ m. Medipix3RX read-out chip provides photon counting read-out with single photon sensitivity. The sensor is cooled to -126°C and noise levels together with flat field response are measured. For -200 V polarization bias, leakage current was 4.4 mA (3.2 μ A/mm2). Due to higher leakage around 2.5% of all pixels stay non-responsive. More than 99% of all pixels are bump bonded correctly. In this paper we present the experimental set-up, threshold equalization procedure, image acquisition and the technique for bump bond quality estimate.

System on a chip with MPEG-4 capability

NASA Astrophysics Data System (ADS)

Yassa, Fathy; Schonfeld, Dan

2002-12-01

Current products supporting video communication applications rely on existing computer architectures. RISC processors have been used successfully in numerous applications over several decades. DSP processors have become ubiquitous in signal processing and communication applications. Real-time applications such as speech processing in cellular telephony rely extensively on the computational power of these processors. Video processors designed to implement the computationally intensive codec operations have also been used to address the high demands of video communication applications (e.g., cable set-top boxes and DVDs). This paper presents an overview of a system-on-chip (SOC) architecture used for real-time video in wireless communication applications. The SOC specifications answer to the system requirements imposed by the application environment. A CAM-based video processor is used to accelerate data intensive video compression tasks such as motion estimations and filtering. Other components are dedicated to system level data processing and audio processing. A rich set of I/Os allows the SOC to communicate with other system components such as baseband and memory subsystems.

Implementation of QoSS (Quality-of-Security Service) for NoC-Based SoC Protection

NASA Astrophysics Data System (ADS)

Sepúlveda, Johanna; Pires, Ricardo; Strum, Marius; Chau, Wang Jiang

Many of the current electronic systems embedded in a SoC (System-on-Chip) are used to capture, store, manipulate and access critical data, as well as to perform other key functions. In such a scenario, security is considered as an important issue. The Network-on-chip (NoC), as the foreseen communication structure of next-generation SoC devices, can be used to efficiently incorporate security. Our work proposes the implementation of QoSS (Quality of Security Service) to overcome present SoC vulnerabilities. QoSS is a novel concept for data protection that introduces security as a dimension of QoS. In this paper, we present the implementation of two security services (access control and authentication), that may be configured to assume one from several possible levels, the implementation of a technique to avoid denial-of-service (DoS) attacks, evaluate their effectiveness and estimate their impact on NoC performance.

Decreased levels of guanosine 3', 5'-monophosphate (cGMP) in cerebrospinal fluid (CSF) are associated with cognitive decline and amyloid pathology in Alzheimer's disease.

PubMed

Ugarte, Ana; Gil-Bea, Francisco; García-Barroso, Carolina; Cedazo-Minguez, Ángel; Ramírez, M Javier; Franco, Rafael; García-Osta, Ana; Oyarzabal, Julen; Cuadrado-Tejedor, Mar

2015-06-01

Levels of the cyclic nucleotides guanosine 3', 5'-monophosphate (cGMP) or adenosine 3', 5'-monophosphate (cAMP) that play important roles in memory processes are not characterized in Alzheimer's disease (AD). The aim of this study was to analyse the levels of these nucleotides in cerebrospinal fluid (CSF) samples from patients diagnosed with clinical and prodromal stages of AD and study the expression level of the enzymes that hydrolyzed them [phosphodiesterases (PDEs)] in the brain of AD patients vs. For cGMP and cAMP CSF analysis, the cohort (n = 79) included cognitively normal participants (subjective cognitive impairment), individuals with stable mild cognitive impairment or AD converters (sMCI and cMCI), and mild AD patients. A high throughput liquid chromatography-tandem mass spectrometry method was used. Interactions between CSF cGMP or cAMP with mini-mental state examination (MMSE) score, CSF Aβ(1-42) and CSF p-tau were analysed. For PDE4, 5, 9 and 10 expression analysis, brains of AD patients vs. controls (n = 7 and n = 8) were used. cGMP, and not cAMP levels, were significantly lower in the CSF of patients diagnosed with mild AD when compared with nondemented controls. CSF levels of cGMP showed a significant association with MMSE-diagnosed clinical dementia and with CSF biomarker Aβ42 in AD patients. Significant increase in PDE5 expression was detected in temporal cortex of AD patients compared with that of age-matched healthy control subjects. No changes in the expression of others PDEs were detected. These results support the potential involvement of cGMP in the pathological and clinical development of AD. The cGMP reduction in early stages of AD might participate in the aggravation of amyloid pathology and cognitive decline. © 2014 British Neuropathological Society.

Development and effect of a cognitive enhancement gymnastics program for elderly people with dementia

PubMed Central

Han, Yoon-Soo; Araki, Tatsuo; Lee, Pil-Young; Choi, Jung-Hyun; Kwon, In-Seon; Kwon, Ki-Nam; Kim, Ji-Youn

2016-01-01

The purpose of this study was to develop a cognitive enhancement gymnastics program for the elderly with dementia and to verify its effect. The study was conducted on 27 people with dementia being treated in a dementia day care center in Incheon city. No statistically significant differences were found in the measures Mini-Mental State Examination for Dementia Screening (MMSE-DS), Short Geriatric Depression Scale (SGDS), Seoul Activities of Daily Living (S-ADL), or rock-paper-scissors. However, the MMSE-DS and rock-paper-scissors showed improvement after 12 weeks. PMID:27656632

Underperception of Naps in Older Adults Referred for a Sleep Assessment: An Insomnia Trait and a Cognitive Problem?

PubMed

Nguyen-Michel, Vi-Huong; Lévy, Pierre-P; Pallanca, Olivier; Kinugawa, Kiyoka; Banica-Wolters, Raluca; Sebban, Claude; Mariani, Jean; Fournier, Emmanuel; Arnulf, Isabelle

2015-10-01

To examine the frequency and determinants of underperception of naps in older adults referred for a sleep assessment. Prospective study. Outpatient geriatric sleep clinic. Individuals aged 60 and older referred for insomnia complaints or suspected sleep apnea (N = 135). Tests included clinical interview, sleepiness scale, anxiety and depression scale, Insomnia Severity Index (ISI), Mini-Mental State Examination (MMSE), and overnight polysomnography, followed by multiple sleep latency tests. At the end of each of four nap opportunities, participants answered whether they had slept during the test. Nap underperception was defined as two or more unperceived naps. Of the 105 participants who napped at least twice, 42 (40%) did not perceive at least two naps. These participants had lower MMSE scores (P = .01) and were more likely to be taking benzodiazepines (P = .008) than the 63 participants who did not underperceive their naps but had similar demographic characteristics, sleep diagnoses, depression and anxiety scores, and polysomnography measures. Both groups had similarly short mean daytime sleep latencies (9.7 ± 4.5 minutes and 9.8 ± 3.7 minutes), but participants who underperceived their naps scored lower on the Epworth Sleepiness Scale (5.6 ± 4.0, vs 9.6 ± 4.8, P < .001). An ISI of 11 or greater, a MMSE score of 26 or less, and a sleepiness score of 8 or less were each independently associated with underperception of naps. The combination of these three factors yielded a positive predictive value of 93% and a negative predictive value of 71% for nap underperception. Older adults referred for sleep consultation with cognitive impairment and greater insomnia symptoms frequently underperceive naps, leading them to underestimate their level of sleepiness. In such cases, objective measures of daytime sleepiness would be better than the Epworth Sleepiness Scale. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Assessment of relationship on excess arsenic intake from drinking water and cognitive impairment in adults and elders in arsenicosis areas.

PubMed

Liu, Jiayong; Gao, Yanhui; Liu, Hongxu; Sun, Jing; Liu, Yang; Wu, Junhua; Li, Dandan; Sun, Dianjun

2017-04-01

In this study, the relationships between high water arsenic exposure and cognitive impairment were investigated. A total of 483 residents aged 40 or older were randomly recruited and were divided into four groups according to the concentrations of arsenic in their water. Consumption levels (̄x¯±s d ) of drinking water arsenic for normal, mild, moderate, and high exposure groups were 4±2μg/L, 25±11μg/L, 73±15μg/L, and 183±88μg/L, respectively. The average scores (̄x¯±s d ) of the Chinese version Mini-Mental State Examination (MMSE) for females in each group were 21.49±3.14, 19.04±5.87, 16.18±8.14, and 15.82±7.78, and the average scores (̄x¯±s d ) for males were 24.50±3.97, 23.16±4.45, 21.00±6.57, and 18.92±7.99, respectively. Significant differences among the average scores of MMSE for males or females in the four groups were found (p<0.05). The prevalence of cognitive impairment for females in each group was 10.86%, 29.63%, 53.48%, and 55.29%, and the prevalence of cognitive impairment for males was 10.71%, 12.00%, 35.71%, and 50.89%, respectively. Significant differences between all groups were observed (p<0.05). In the multivariable regress model, high water was closely associated with the MMSE score (Standardized Coefficient=-0.021) and cognitive impairment (arsenic ˃100 μg/L PR 4/1 =4.01). The findings of our research suggested a significant positive relationship between arsenic exposure from drinking water and cognitive impairment. Copyright © 2016 Elsevier GmbH. All rights reserved.

Cerebral glucose metabolism and cognition in newly diagnosed Parkinson's disease: ICICLE-PD study.

PubMed

Firbank, M J; Yarnall, A J; Lawson, R A; Duncan, G W; Khoo, T K; Petrides, G S; O'Brien, J T; Barker, R A; Maxwell, R J; Brooks, D J; Burn, D J

2017-04-01

To assess reductions of cerebral glucose metabolism in Parkinson's disease (PD) with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and their associations with cognitive decline. FDG-PET was performed on a cohort of 79 patients with newly diagnosed PD (mean disease duration 8 months) and 20 unrelated controls. PD participants were scanned while on their usual dopaminergic medication. Cognitive testing was performed at baseline, and after 18 months using the Cognitive Drug Research (CDR) and Cambridge Neuropsychological Test Automated Battery (CANTAB) computerised batteries, the Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). We used statistical parametric mapping (SPM V.12) software to compare groups and investigate voxelwise correlations between FDG metabolism and cognitive score at baseline. Linear regression was used to evaluate how levels of cortical FDG metabolism were predictive of subsequent cognitive decline rated with the MMSE and MoCA. PD participants showed reduced glucose metabolism in the occipital and inferior parietal lobes relative to controls. Low performance on memory-based tasks was associated with reduced FDG metabolism in posterior parietal and temporal regions, while attentional performance was associated with more frontal deficits. Baseline parietal to cerebellum FDG metabolism ratios predicted MMSE (β=0.38, p=0.001) and MoCA (β=0.3, p=0.002) at 18 months controlling for baseline score. Reductions in cortical FDG metabolism were present in newly diagnosed PD, and correlated with performance on neuropsychological tests. A reduced baseline parietal metabolism is associated with risk of cognitive decline and may represent a potential biomarker for this state and the development of PD dementia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Uncovering Molecular Biomarkers That Correlate Cognitive Decline with the Changes of Hippocampus' Gene Expression Profiles in Alzheimer's Disease

PubMed Central

Gómez Ravetti, Martín; Rosso, Osvaldo A.; Berretta, Regina; Moscato, Pablo

2010-01-01

Background Alzheimer's disease (AD) is characterized by a neurodegenerative progression that alters cognition. On a phenotypical level, cognition is evaluated by means of the MiniMental State Examination (MMSE) and the post-morten examination of Neurofibrillary Tangle count (NFT) helps to confirm an AD diagnostic. The MMSE evaluates different aspects of cognition including orientation, short-term memory (retention and recall), attention and language. As there is a normal cognitive decline with aging, and death is the final state on which NFT can be counted, the identification of brain gene expression biomarkers from these phenotypical measures has been elusive. Methodology/Principal Findings We have reanalysed a microarray dataset contributed in 2004 by Blalock et al. of 31 samples corresponding to hippocampus gene expression from 22 AD subjects of varying degree of severity and 9 controls. Instead of only relying on correlations of gene expression with the associated MMSE and NFT measures, and by using modern bioinformatics methods based on information theory and combinatorial optimization, we uncovered a 1,372-probe gene expression signature that presents a high-consensus with established markers of progression in AD. The signature reveals alterations in calcium, insulin, phosphatidylinositol and wnt-signalling. Among the most correlated gene probes with AD severity we found those linked to synaptic function, neurofilament bundle assembly and neuronal plasticity. Conclusions/Significance A transcription factors analysis of 1,372-probe signature reveals significant associations with the EGR/KROX family of proteins, MAZ, and E2F1. The gene homologous of EGR1, zif268, Egr-1 or Zenk, together with other members of the EGR family, are consolidating a key role in the neuronal plasticity in the brain. These results indicate a degree of commonality between putative genes involved in AD and prion-induced neurodegenerative processes that warrants further investigation. PMID:20405009

Subclinical hypothyroidism and cognitive function in people over 60 years: a systematic review and meta-analysis

PubMed Central

Akintola, Abimbola A.; Jansen, Steffy W.; van Bodegom, David; van der Grond, Jeroen; Westendorp, Rudi G.; de Craen, Anton J. M.; van Heemst, Diana

2015-01-01

Subclinical hypothyroidism (SCH), defined as elevated thyroid stimulating hormone (TSH) and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association between SCH and cognitive impairment are conflicting. This systematic review and meta-analysis was performed to assess available evidence on the association of SCH with cognition in community dwelling, relatively healthy older adults. PubMed, EMBASE, Web of Science, COCHRANE, CINAHL, PsycINFO, and Academic Search Premier (January 1966 to April 1, 2015) were searched without language restrictions, as were references of key articles, for studies on the association between SCH and cognition in older adults (>60 years). These studies were reviewed by two independent reviewers according to predefined criteria for eligibility and methodological quality, and data were extracted using standardized forms. Of the 844 reports initially identified, 270 remained after exclusion of duplicates. Of the 270, 15 studies comprising 19,944 subjects, of whom 1,199 had subclinical hypothyroidism were included. Data from the 15 studies was pooled, and meta-analyzed cross-sectionally for global cognition [assessed by Mini-Mental State Examination (MMSE)], executive function, and memory, using random effects models. Pooled effect size (ES) for MMSE was −0.01 (95% CI −0.09, 0.08), with heterogeneity (I2) of 55.1%. Pooled ES was < 0.001 (95% CI −0.10, 0.09) for executive function (I2 = 13.5%), and 0.01 (95% CI −0.12, 0.14) for memory (I2 = 46.9%). In addition, prospective analysis including four studies showed pooled ES of 0.033 (95% CI −0.001 − 0.067) for MMSE (I2 < 0.001%), indicating that subclinical hypothyroidism was not significantly associated with accelerated cognitive decline. This systematic review and meta-analysis provides no evidence that supports an association between SCH and cognitive impairment in relatively healthy older adults. PMID:26321946

A Novel Analog Integrated Circuit Design Course Covering Design, Layout, and Resulting Chip Measurement

ERIC Educational Resources Information Center

Lin, Wei-Liang; Cheng, Wang-Chuan; Wu, Chen-Hao; Wu, Hai-Ming; Wu, Chang-Yu; Ho, Kuan-Hsuan; Chan, Chueh-An

2010-01-01

This work describes a novel, first-year graduate-level analog integrated circuit (IC) design course. The course teaches students analog circuit design; an external manufacturer then produces their designs in three different silicon chips. The students, working in pairs, then test these chips to verify their success. All work is completed within…

Factors associated with cognitive impairment in patients with Parkinson disease: an urban study.

PubMed

Rosdinom, R; Fazli, A; Ruzyanei, N J Nik; Azlin, B; Srijit, D

2011-01-01

Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment. A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale. Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness. Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.

Factors affecting institutionalization in older Hong Kong Chinese patients after recovery from acute medical illnesses.

PubMed

Luk, James Ka Hay; Chiu, Patrick Ka Chun; Chu, Leung Wing

2009-01-01

Older patients with medical illnesses are at risk of institutionalization. The purpose of this study is to investigate the factors leading to institutionalization in older patients after recovery from medical illnesses. We studied 535 older patients in two convalescence hospitals in Hong Kong. Of them, 116 patients (21.7%) needed to move to nursing homes upon discharge. Univariate analysis showed that age, single/divorced/widowed status, longer length of stay, pressure sores, urinary incontinence, urinary catheterization, falls, dementia, diabetes mellitus, Barthel index (100), Elderly Mobility Score (EMS), Chinese version of the mini-mental state examination (C-MMSE) and albumin levels were significant factors associated with institutionalization. Multivariate analysis showed that being single/divorced/widowed (odds ratio=OR=2.74, 95% confidence interval=CI=1.36-5.53, p=0.0048), having urinary incontinence on discharge (OR=5.13, CI=2.66-10.6, p<0.001) and admission due to falls (OR=2.4, CI=1.03-5.57, p=0.04) were independent risk factors for nursing home admission. Higher admission EMS (OR=0.91, CI=0.84-0.97, p=0.009), admission C-MMSE (OR=0.93, CI=0.87-0.98, p=0.019), and discharge albumin levels (OR=0.93, CI=0.88-0.99, p=0.02) were independent protecting factors against nursing home admission. Knowledge of these factors can allow us to predict accommodation outcome and develop intervention strategy to reduce institutionalization in the older patients.

Impact of literacy and years of education on the diagnosis of dementia: A population-based study.

PubMed

Contador, Israel; Del Ser, Teodoro; Llamas, Sara; Villarejo, Alberto; Benito-León, Julián; Bermejo-Pareja, Félix

2017-03-01

The effect of different educational indices on clinical diagnosis of dementia requires more investigation. We compared the differential influence of two educational indices (EIs): years of schooling and level of education (i.e., null/low literacy, can read and write, primary school, and secondary school) on global cognition, functional performance, and the probability of having a dementia diagnosis. A total of 3,816 participants were selected from the population-based study of older adults "Neurological Disorders in Central Spain" (NEDICES). The 37-item version of the Mini-Mental State Examination (MMSE-37) and the Pfeffer's questionnaire were applied to assess cognitive and functional performance, respectively. The diagnosis of dementia was performed by expert neurologists according to Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria. Logistic regression models adjusted for potential confounders were carried out to test the association between the two EIs and dementia diagnosis. Both EIs were significantly associated with cognitive and functional scores, but individuals with null/low literacy performed significantly worse on MMSE-37 than literates when these groups were compared in terms of years of schooling. The two EIs were also related to an increased probability of dementia diagnosis in logistic models, but the association's strength was stronger for level of education than for years of schooling. Literacy predicted cognitive performance over and above the years of schooling. Lower education increases the probability of having a dementia diagnosis but the impact of different EIs is not uniform.

Grinding damage assessment for CAD-CAM restorative materials.

PubMed

Curran, Philippe; Cattani-Lorente, Maria; Anselm Wiskott, H W; Durual, Stéphane; Scherrer, Susanne S

2017-03-01

To assess surface/subsurface damage after grinding with diamond discs on five CAD-CAM restorative materials and to estimate potential losses in strength based on crack size measurements of the generated damage. The materials tested were: Lithium disilicate (LIT) glass-ceramic (e.max CAD), leucite glass-ceramic (LEU) (Empress CAD), feldspar ceramic (VM2) (Vita Mark II), feldspar ceramic-resin infiltrated (EN) (Enamic) and a composite reinforced with nano ceramics (LU) (Lava Ultimate). Specimens were cut from CAD-CAM blocs and pair-wise mirror polished for the bonded interface technique. Top surfaces were ground with diamond discs of respectively 75, 54 and 18μm. Chip damage was measured on the bonded interface using SEM. Fracture mechanics relationships were used to estimate fracture stresses based on average and maximum chip depths assuming these to represent strength limiting flaws subjected to tension and to calculate potential losses in strength compared to manufacturer's data. Grinding with a 75μm diamond disc induced on a bonded interface critical chips averaging 100μm with a potential strength loss estimated between 33% and 54% for all three glass-ceramics (LIT, LEU, VM2). The softer materials EN and LU were little damage susceptible with chips averaging respectively 26μm and 17μm with no loss in strength. Grinding with 18μm diamond discs was still quite detrimental for LIT with average chip sizes of 43μm and a potential strength loss of 42%. It is essential to understand that when grinding glass-ceramics or feldspar ceramics with diamond discs surface and subsurface damage are induced which have the potential of lowering the strength of the ceramic. Careful polishing steps should be carried out after grinding especially when dealing with glass-ceramics. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Estimated Softwood Volume Available for Wood Chipmills or other Low Grade Uses.

EPA Pesticide Factsheets

The potential of wood chip mills to influence the distribution of harvests and the dynamics of wood fiber utilization has become an issue of concern. Where wood chip mills are active in a timber market, they may increase the utilization of wood fiber derived from a given harvest; change the pattern and distribution of harvests on the landscape; and reduce production costs of fiber supply, thus increasing overall quantity supplied in a price-taking market. Wood chip mills have proliferated in the South in recent decades. This data layer was created to address the following question: If the Mid-Atlantic region behaves as the South, which areas are relatively more attractive as sources of low grade softwood fiber, and therefore relatively more vulnerable to any negative stresses associated with wood chip harvests? The data layer simulates annual softwood wood chip volume (in tons) available to supply chip mills or other low grade uses, if timber supply in the Mid-Atlantic mirrors trends for the South. More information about these resources, including the variables used in this study, may be found here: https://edg.epa.gov/data/Public/ORD/NERL/ReVA/ReVA_Data.zip.

Visual Impairment Screening at the Geriatric Frailty Clinic for Assessment of Frailty and Prevention of Disability at the Gérontopôle.

PubMed

Soler, V; Sourdet, S; Balardy, L; Abellan van Kan, G; Brechemier, D; Rougé-Bugat, M E; Tavassoli, N; Cassagne, M; Malecaze, F; Nourhashémi, F; Vellas, B

2016-01-01

To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. Retrospective, observational cross-sectional, single-centre study. Institutional practice. Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648). Collected medical records included sociodemographic data (including living environment and educational level), anthropometric data, and clinical data. The general evaluation included the patient's functional status using the Activities of Daily Living (ADL) scale and the Instrumental Activity of Daily Living (IADL) scale, the Mini-Mental State Examination (MMSE) for cognition testing, and the Short Physical Performance Battery (SPPB) for physical performance. We also examined Body Mass Index (BMI), the Mini-Nutritional Assessment (MNA), and the Hearing Handicap Inventory for the Elderly Screening (HHIE-S) tool. The ophthalmologic evaluation included assessing visual acuity using the Snellen decimal chart for distant vision, and the Parinaud chart for near vision. Patients were divided into groups based on normal distant/near vision (NDV and NNV groups) and abnormal distant/near vision (ADV and ANV groups). Abnormal distant or near vision was defined as visual acuity inferior to 20/40 or superior to a Parinaud score of 2, in at least one eye. Associations with frailty-associated factors were evaluated in both groups. The mean age of the population was 82.6 ± 6.2 years. The gender distribution was 1,061 females (64.4%) and 587 males (35.6%). According to the Fried criteria, 619 patients (41.1%) were pre-frail and 771 (51.1%) were frail. Distant and near vision data were available for 1425 and 1426 patients, respectively. Distant vision was abnormal for 437 patients (30.7%). Near vision was abnormal for 199 patients (14%). Multiple regression analysis showed that abnormal distant vision as well as abnormal near vision were independently associated with greater age (P < 0.01), lower educational level (P < 0.05), lower performance on the MMSE (P < 0.001), and lower autonomy (P < 0.02), after controlling for age, gender, educational level, Fried criteria, and MMSE score. The high prevalence of visual disorders observed in the study population and their association with lower autonomy and cognitive impairment emphasises the need for systematic screening of visual impairments in the elderly. Frailty was not found to be independently associated with abnormal vision.

Benefits of use, and tolerance of, medium-chain triglyceride medical food in the management of Japanese patients with Alzheimer's disease: a prospective, open-label pilot study.

PubMed

Ohnuma, Tohru; Toda, Aiko; Kimoto, Ayako; Takebayashi, Yuto; Higashiyama, Ryoko; Tagata, Yuko; Ito, Masanobu; Ota, Tsuneyoshi; Shibata, Nobuto; Arai, Heii

2016-01-01

This is the first clinical trial of this type in Japan, designed to analyze two important aspects of Alzheimer's disease (AD) management using medium-chain triglycerides. Axona was administered for 3 months (40 g of powder containing 20 g of caprylic triglycerides). We used an indurating, four-step dose-titration method (from 10 to 40 g per day) for 7 days before the trial, and examined the tolerance and adverse effects of this intervention. We also investigated its effect on cognitive function in mild-to-moderate AD patients. This was a clinical intervention in 22 Japanese patients with sporadic AD at a mild-to-moderate stage (ten females, 12 males), mean age (± standard deviation) 63.9 (±8.5) years, Mini-Mental State Examination (MMSE) score, 10-25, seven patients were ApoE4-positive. During Axona administration, we examined changes in cognitive function by obtaining MMSE and AD assessment-scale scores. Intolerance and serum ketone concentrations were also examined. The tolerance of Axona was good, without severe gastrointestinal adverse effects. Axona did not improve cognitive function in our sample of AD patients, even in those patients without the ApoE4 allele. However, some ApoE4-negative patients with baseline MMSE score ≥14 showed improvement in their cognitive functions. The modified dose-titration method, starting with a low dose of Axona, decreased gastrointestinal adverse effects in Japanese patients. Axona might be effective for some relatively mildly affected patients with AD (with cognitive function MMSE score of ≥14 and lacking the ApoE4 allele).

Diagnostic performance of short portable mental status questionnaire for screening dementia among patients attending cognitive assessment clinics in Singapore.

PubMed

Malhotra, Chetna; Chan, Angelique; Matchar, David; Seow, Dennis; Chuo, Adeline; Do, Young Kyung

2013-07-01

The Short Portable Mental Status Questionnaire (SPMSQ) is a brief cognitive screening instrument, which is easy to use by a healthcare worker with little training. However, the validity of this instrument has not been established in Singapore. Thus, the primary aim of this study was to determine the diagnostic performance of SPMSQ for screening dementia among patients attending outpatient cognitive assessment clinics and to assess whether the appropriate cut-off score varies by patient's age and education. A secondary aim of the study was to map the SPMSQ scores with Mini-Mental State Examination (MMSE) scores. SPMSQ and MMSE were administered by a trained interviewer to 127 patients visiting outpatient cognitive assessment clinics at the Singapore General Hospital, Changi General Hospital and Tan Tock Seng Hospital. The geriatricians at these clinics then diagnosed these patients with dementia or no dementia (reference standard). Sensitivity and specificity of SPMSQ with different cut-off points (number of errors) were calculated and compared to the reference standard using the Receiver Operator Characteristic (ROC) analysis. Correlation coefficient was also calculated between MMSE and SPMSQ scores. Based on the ROC analysis and a balance of sensitivity and specificity, the appropriate cut-off for SPMSQ was found to be 5 or more errors (sensitivity 78%, specificity 75%). The cut-off varied by education, but not by patient's age. There was a high correlation between SPMSQ and MMSE scores (r = 0.814, P <0.0001). Despite the advantage of being a brief screening instrument for dementia, the use of SPMSQ is limited by its low sensitivity and specificity, especially among patients with less than 6 years of education.

Migraine is associated with better cognition in the middle-aged and elderly: the Rotterdam Study.

PubMed

Wen, K; Nguyen, N T; Hofman, A; Ikram, M A; Franco, O H

2016-10-01

Converging evidence suggests that migraine has, in part, a vascular basis. In turn, vascular pathology is a strong risk factor for cognitive decline. In this population-based study, we studied cognition amongst individuals with and without migraine. In 6708 participants of the Rotterdam Study, migraine was assessed using a validated questionnaire. Cognition was assessed by the Mini Mental State Examination (MMSE) and a dedicated cognitive test battery. Participants were classified as non-migraineurs (n = 5399), migraineurs (n = 1021) or probable migraineurs (n = 288). Multivariable linear regression was used to cross-sectionally evaluate the association between migraine and cognition, adjusting for age, sex and cardiovascular risk factors. Additionally, we stratified the analysis by sex and by migraine subtype. Migraineurs had higher mean MMSE scores [unstandardized regression coefficient 0.21, (95% confidence interval, 0.08; 0.34)] and global cognition [0.10 (0.04; 0.15)] than non-migraineurs. This difference was particularly marked for migraineurs with aura [MMSE: 0.39 (0.13; 0.66); global cognition: 0.13 (0.01; 0.24)]. Migraineurs performed better on tests of executive function and fine motor skills amongst specific cognitive domains. The difference in MMSE between migraineurs and non-migraineurs was greater in women [0.25 (0.10; 0.40)] than in men [0.13 (-0.15; 0.40)], whereas the difference in global cognition was similar in men and women [0.15 (0.04; 0.27) and 0.09 (0.02; 0.15), respectively]. Migraineurs, particularly migraineurs with aura, tend to score higher in cognition tests than non-migraineurs. More studies are needed to corroborate these findings. © 2016 EAN.

Racial and sex differences in associations between activities of daily living and cognition in community-dwelling older adults.

PubMed

Garrett, Stephanie L; Sawyer, Patricia; Kennedy, Richard E; McGuire, Dawn; Simon, Roger P; Strothers, Harry S; Allman, Richard M

2013-12-01

To examine the association between function measured according to activities of daily living (ADLs), instrumental activ1ities of daily living (IADLs), and cognition assessed according to Mini-Mental State Examination (MMSE) scores of older African-American and non-Hispanic white community-dwelling men and women. Cross-sectional study assessing associations between self-reported ADL and IADL difficulty and MMSE scores for race- and sex-specific groups. Homes of community-dwelling older adults. A random sample of 974 African-American and non-Hispanic white Medicare beneficiaries aged 65 and older living in west-central Alabama and participating in the University of Alabama at Birmingham Study of Aging, excluding those with reported diagnoses of dementia or with missing data. Function, based on self-reported difficulty in performing ADLs and IADLs, and cognition, using the MMSE. Multivariable linear regression models were used to test the association between function and cognition in race- and sex-specific groups after adjusting for covariates. Mini-Mental State Examination scores were modestly correlated with ADL and IADL difficulty in all four race- and sex-specific groups, with Pearson correlation coefficients ranging from −0.189 for non-Hispanic white women to −0.429 for African-American men. Correlations between MMSE and ADL or IADL difficulty in any of the race- and sex-specific groups were no longer significant after controlling for sociodemographic factors and comorbidities. Mini-Mental State Examination was not significantly associated with functional difficulty in older African-American and non-Hispanic white men and women after adjusting for sociodemographic factors and comorbidities, suggesting a mediating role in the relationship between cognition and function. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Scenery Picture Memory Test: A new type of quick and effective screening test to detect early stage Alzheimer’s disease patients

PubMed Central

Takechi, Hajime; Dodge, Hiroko H

2010-01-01

Aim It is highly desirable to develop a neuropsychological screening test which is sensitive to the early stage of Alzheimer’s disease (AD), and is easy to administer at the primary care physician’s (PCP’s) office. Methods Participants were 128 AD patients and 54 healthy volunteers. Brief cognitive screening tests were administered to the participants including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), a Verbal Category Cued Memory test (CCMT) and the Scenery Picture Memory Test (SPMT). In the SPMT, a scenery picture of a living room containing 23 familiar objects was used. The administration of the SPMT comprised the first shallow memory session (Pict 1) and the second deep memory session (Pict 2). The area under the receiver–operator curve (AUC) was used to compare the efficacy of SPMT with other cognitive tests. Results Pict 1, which requires less than 2 min to complete, had the same AUC as Pict 2, and showed significantly larger AUC than MMSE, CDT and VFT for all (MMSE 19–23) and very mild (MMSE ≥ 24) AD patients. When we conducted the similar analysis separately for those younger than 75 years and those aged 75 years or older, we obtained the same results as above among the older age group. Pict 1 showed larger AUC than CCMT in overall sample and also in the older age group, although the difference was not statistically significant. Conclusion The SPMT could be useful for detection of mild and very mild AD in settings even where time is limited. PMID:20446933

Cognitive function and walking velocity in people with dementia; a comparison of backward and forward walking.

PubMed

Johansson, Hanna; Lundin-Olsson, Lillemor; Littbrand, Håkan; Gustafson, Yngve; Rosendahl, Erik; Toots, Annika

2017-10-01

How forward and backward walking, both central to everyday life, relate to cognition are relatively unexplored in people with dementia. This study aimed to investigate if forward and backward walking velocity respectively, associated with global cognition and executive function in people with dementia, and whether the association differed according to walking aid use or dementia type. Using a cross-sectional design, 161 participants (77% women), a mean Mini-Mental State Examination (MMSE) score of 15, and mean age of 85.5years and living in nursing homes were included. Self-paced forward walking (FW) and backward walking (BW) velocity over 2.4m was measured. Global cognitive outcome measurements included MMSE and Alzheimer Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Executive function was measured using Verbal Fluency (VF). In comprehensively adjusted multivariate linear regression analyses, FW was independently associated with VF (p=0.001), but not MMSE (p=0.126) or ADAS-Cog (p=0.818). BW was independently associated with VF (p=0.043) and MMSE (p=0.022), but not ADAS-Cog (p=0.519). Interaction analyses showed that the association between BW velocity and executive function were stronger in participants who walked without a walking aid. No associations differed according to dementia type. In conclusion, executive function appears important to walking velocity, both forward and backward, in people with dementia with mild to moderately severe cognitive impairment. Global cognitive function was associated with backward walking only, perhaps due to it being more challenging. The association between BW velocity and executive function differed according to use of walking aids, which appeared to attenuate the association. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors of cognitive impairment assessed by Mini Mental State Examination in community-dwelling older adults: relevance of the step test.

PubMed

Muscari, Antonio; Spiller, Ilaria; Bianchi, Giampaolo; Fabbri, Elisa; Forti, Paola; Magalotti, Donatella; Pandolfi, Paolo; Zoli, Marco

2018-07-15

Several predictors of cognitive impairment assessed by Mini Mental State Examination (MMSE) have previously been identified. However, which predictors are the most relevant and what is their effect on MMSE categories remains unclear. Cross-sectional and longitudinal study using data from 1116 older adults (72.6 ± 5.6 years, 579 female), 350 of whom were followed for 7 years. At baseline, the following variables were collected: personal data, marital status, occupation, anthropometric measures, risk factors, previous cardiovascular events, self-rated health and physical activity during the last week. Furthermore, routine laboratory tests, abdominal echography and a step test (with measurement of the time needed to ascend and descend two steps 20 times) were performed. The associations of these variables with cross-sectional cognitive deficit (MMSE < 24) and longitudinal cognitive decline (decrease of MMSE score over 7 years of follow-up) were investigated using logistic regression models. Cross-sectional cognitive deficit was independently associated with school education ≤ 5 years, prolonged step test duration, having been blue collar or housewife (P ≤ 0.0001 for all) and, with lower significance, with advanced age, previous stroke and poor recent physical activity (P < 0.05). Longitudinal cognitive decline was mainly associated with step test duration (P = 0.0001) and diastolic blood pressure (P = 0.0002). The MMSE categories mostly associated with step test duration were orientation, attention, calculation and language, while memory appeared to be poorly or not affected. In our cohort of older adults, step test duration was the most relevant predictor of cognitive impairment. Copyright © 2018 Elsevier Inc. All rights reserved.

Mental and physical activities delay cognitive decline in older persons with dementia.

PubMed

Cheng, Sheung-Tak; Chow, Pizza K; Song, You-Qiang; Yu, Edwin C S; Chan, Alfred C M; Lee, Tatia M C; Lam, John H M

2014-01-01

To examine the effects of cognitive stimulation (mahjong) and physical exercise (tai chi [TC]) on cognitive performance in persons with dementia. Cluster-randomized open-label controlled design. Nursing homes. One hundred ten residents, most of whom were cholinesterase-inhibitor naive. Inclusion criteria were Mini-Mental State Examination (MMSE) = 10-24 and suffering from at least very mild dementia (Clinical Dementia Rating ≥ 0.5). Exclusion criteria were being bedbound, audio/visual impairment, regular activity participation before study, or contraindications for physical or group activities. Homes were randomized into three conditions (mahjong, TC, and simple handicrafts [control]). Activities were conducted three times weekly for 12 weeks. Primary outcome was MMSE. Secondary outcomes were immediate/delayed recall, categorical fluency, and digit span. Various biological risk factors, including apolipoprotein E ε4 allele, were included as covariates. Measures were collected at 0 (baseline), 3 (posttreatment), 6, and 9 months. Intent-to-treat analyses were performed using mixed-effects regression. Mahjong's effect varied by time for MMSE, delayed recall, and forward digit span. TC had similar effects but not for delayed recall. The typical pattern was that control participants deteriorated while mahjong and TC participants maintained their abilities over time, leading to enlarged treatment effects as time progressed. By 9 months, mahjong and TC differed from control by 4.5 points (95% confidence interval: 2.0-6.9; d = 0.48) and 3.7 points (95% confidence interval: 1.4-6.0; d = 0.40), respectively, on MMSE. No treatment effects were observed for immediate recall and backward digit span. Mahjong and TC can preserve functioning or delay decline in certain cognitive domains, even in those with significant cognitive impairment. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Association between exercise habits and subcortical gray matter volumes in healthy elderly people: A population-based study in Japan.

PubMed

Yamamoto, Mikie; Wada-Isoe, Kenji; Yamashita, Fumio; Nakashita, Satoko; Kishi, Masafumi; Tanaka, Kenichiro; Yamawaki, Mika; Nakashima, Kenji

2017-06-01

The relationship between exercise and subcortical gray matter volume is not well understood in the elderly population, although reports indicate that exercise may prevent cortical gray matter atrophy. To elucidate this association in the elderly, we measured subcortical gray matter volume and correlated this with volumes to exercise habits in a community-based cohort study in Japan. Subjects without mild cognitive impairment or dementia (n = 280, 35% male, mean age 73.1 ± 5.9 years) were evaluated using the Mini-Mental State Examination (MMSE), an exercise habit questionnaire, and brain magnetic resonance imaging. Subcortical gray matter volume was compared between groups based on the presence/absence of exercise habits. The MMSE was re-administered 3 years after the baseline examination. Ninety-one subjects (32.5%) reported exercise habits (exercise group), and 189 subjects (67.5%) reported no exercise habits (non-exercise group). Volumetric analysis revealed that the volumes in the exercise group were greater in the left hippocampus (p = 0.042) and bilateral nucleus accumbens (left, p = 0.047; right, p = 0.007) compared to those of the non-exercise group. Among the 195 subjects who received a follow-up MMSE examination, the normalized intra-cranial volumes of the left nucleus accumbens (p = 0.004) and right amygdala (p = 0.014)showed significant association with a decline in the follow-up MMSE score. Subjects with exercise habits show larger subcortical gray matter volumes than subjects without exercise habits in community-dwelling elderly subjects in Japan. Specifically, the volume of the nucleus accumbens correlates with both exercise habits and cognitive preservation.

Detectable changes in physical performance measures in elderly African Americans.

PubMed

Mangione, Kathleen Kline; Craik, Rebecca L; McCormick, Alyson A; Blevins, Heather L; White, Meaghan B; Sullivan-Marx, Eileen M; Tomlinson, James D

2010-06-01

African American older adults have higher rates of self-reported disability and lower physical performance scores compared with white older adults. Measures of physical performance are used to predict future morbidity and to determine the effect of exercise. Characteristics of performance measures are not known for African American older adults. The purpose of this study was to estimate the standard error of measurement (SEM) and minimal detectable change (MDC) for the Short Physical Performance Battery (SPPB), Timed "Up & Go" Test (TUG) time, free gait speed, fast gait speed, and Six-Minute Walk Test (6MWT) distance in frail African American adults. This observational measurement study used a test-retest design. Individuals were tested 2 times over a 1-week period. Demographic data collected included height, weight, number of medications, assistive device use, and Mini-Mental Status Examination (MMSE) scores. Participants then completed the 5 physical performance tests. Fifty-two participants (mean age=78 years) completed the study. The average MMSE score was 25 points, and the average body mass index was 29.4 kg/m(2). On average, participants took 7 medications, and the majority used assistive devices. Intraclass correlation coefficients (ICC [2,1]) were greater than .90, except for the SPPB score (ICC=.81). The SEMs were 1.2 points for the SPPB, 1.7 seconds for the TUG, 0.08 m/s for free gait speed, 0.09 m/s for fast gait speed, and 28 m for 6MWT distance. The MDC values were 2.9 points for the SPPB, 4 seconds for the TUG, 0.19 m/s for free gait speed, 0.21 m/s for fast gait speed, and 65 m for 6MWT distance. The entire sample was from an urban area. The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

Brittleness index of machinable dental materials and its relation to the marginal chipping factor.

PubMed

Tsitrou, Effrosyni A; Northeast, Simon E; van Noort, Richard

2007-12-01

The machinability of a material can be measured with the calculation of its brittleness index (BI). It is possible that different materials with different BI could produce restorations with varied marginal integrity. The degree of marginal chipping of a milled restoration can be estimated by the calculation of the marginal chipping factor (CF). The aim of this study is to investigate any possible correlation between the BI of machinable dental materials and the CF of the final restorations. The CEREC system was used to mill a wide range of materials used with that system; namely the Paradigm MZ100 (3M/ESPE), Vita Mark II (VITA), ProCAD (Ivoclar-Vivadent) and IPS e.max CAD (Ivoclar-Vivadent). A Vickers Hardness Tester was used for the calculation of BI, while for the calculation of CF the percentage of marginal chipping of crowns prepared with bevelled marginal angulations was estimated. The results of this study showed that Paradigm MZ100 had the lowest BI and CF, while IPS e.max CAD demonstrated the highest BI and CF. Vita Mark II and ProCAD had similar BI and CF and were lying between the above materials. Statistical analysis of the results showed that there is a perfect positive correlation between BI and CF for all the materials. The BI and CF could be both regarded as indicators of a material's machinability. Within the limitations of this study it was shown that as the BI increases so does the potential for marginal chipping, indicating that the BI of a material can be used as a predictor of the CF.

Health Conditions and Memory Performance: a study with older adult women.

PubMed

Nespollo, Alice Milani; Marcon, Samira Reschetti; Lima, Nathalie Vilma Pollo de; Dias, Tatiane Lebre; Espinosa, Mariano Martínez

2017-01-01

to verify the correlation between health condition and memory performance of older adult women in the community. Analytical cross-sectional study developed with 28 older adult women living in Cuiabá-MT. They answered the Mini-Mental State Examination (MMSE), and a shortened Geriatric Depression Scale (GDS-15) to screen for dementia and depression symptoms. Memory skills were assessed through Rey Auditory Verbal Learning Test (RAVLT). The mean age was 66.36 years and 75% of the participants had educational level higher than 7 years. The MMSE mean score was 28.45. The correlations found were: educational level and immediate memory (r = 0.49; p = 0.008); delayed recall and immediate memory (r = 0.71; p < 0.001); memory recognition and immediate memory (r = 0.43; p = 0.021) and recognition memory with delayed recall (r = 0.47; p = 0.012). High scores in the MMSE and a satisfactory health perception among the participants were evident. There was no correlation between memory performance and health perception. Verificar a correlação entre condições de saúde e desempenho da memória de idosas da comunidade. Estudo transversal analítico, realizado com 28 idosas residentes em Cuiabá-MT. Essas foram submetidas a rastreio para demências e sintomas depressivos por meio do Miniexame do Estado Mental (MEEM) e Escala de Depressão Geriátrica Abreviada (GDS-15). A avaliação das habilidades de memória ocorreu por meio do Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT). A idade média foi de 66,36 anos e 75% possuíam escolaridade maior que sete anos. A média do MEEM foi 28,45. As correlações encontradas foram: escolaridade e memória imediata (r = 0,49; p = 0,008); evocação tardia e memória de reconhecimento com memória imediata (r = 0,71; p < 0,001 e r = 0,43; p = 0,021) e memória de reconhecimento com evocação tardia (r = 0,47; p = 0,012). Evidenciou-se escore elevado no MEEM e percepção de saúde satisfatória entre os participantes. Não houve correlação entre desempenho da memória e percepção de saúde.

A randomized placebo-controlled pilot trial of omega-3 fatty acids and alpha lipoic acid in Alzheimer's disease.

PubMed

Shinto, Lynne; Quinn, Joseph; Montine, Thomas; Dodge, Hiroko H; Woodward, William; Baldauf-Wagner, Sara; Waichunas, Dana; Bumgarner, Lauren; Bourdette, Dennis; Silbert, Lisa; Kaye, Jeffrey

2014-01-01

Oxidative stress, inflammation, and increased cholesterol levels are all mechanisms that have been associated with Alzheimer's disease (AD) pathology. Several epidemiologic studies have reported a decreased risk of AD with fish consumption. This pilot study was designed to evaluate the effects of supplementation with omega-3 fatty acids alone (ω-3) or omega-3 plus alpha lipoic acid (ω-3 + LA) compared to placebo on oxidative stress biomarkers in AD. The primary outcome measure was peripheral F2-isoprostane levels (oxidative stress measure). Secondary outcome measures included performance on: Mini-Mental State Examination (MMSE), Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL), and Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Thirty-nine AD subjects were randomized to one of three groups: 1) placebo, 2) ω-3, or 3) ω-3 + LA for a treatment duration of 12 months. Eighty seven percent (34/39) of the subjects completed the 12-month intervention. There was no difference between groups at 12 months in peripheral F2-isoprostane levels (p = 0.83). The ω-3 + LA and ω-3 were not significantly different than the placebo group in ADAS-cog (p = 0.98, p = 0.86) and in ADL (p = 0.15, p = 0.82). Compared to placebo, the ω-3 + LA showed less decline in MMSE (p < 0.01) and IADL (p = 0.01) and the ω-3 group showed less decline in IADL (p < 0.01). The combination of ω-3 + LA slowed cognitive and functional decline in AD over 12 months. Because the results were generated from a small sample size, further evaluation of the combination of omega-3 fatty acids plus alpha-lipoic acid as a potential treatment in AD is warranted.

A Randomized Placebo-Controlled Pilot Trial of Omega-3 Fatty Acids and Alpha Lipoic Acid in Alzheimer’s Disease

PubMed Central

Shinto, Lynne; Quinn, Joseph; Montine, Thomas; Dodge, Hiroko H.; Woodward, William; Baldauf-Wagner, Sara; Waichunas, Dana; Bumgarner, Lauren; Bourdette, Dennis; Silbert, Lisa; Kaye, Jeffrey

2013-01-01

Oxidative stress, inflammation, and increased cholesterol levels are all mechanisms that have been associated with Alzheimer’s disease (AD) pathology. Several epidemiologic studies have reported a decreased risk of AD with fish consumption. This pilot study was designed to evaluate the effects of supplementation with omega-3 fatty acids alone (ω-3) or omega-3 plus alpha lipoic acid (ω-3 +LA) compared to placebo on oxidative stress biomarkers in AD. The primary outcome measure was peripheral F2-isoprostane levels (oxidative stress measure). Secondary outcome measures included performance on: Mini-Mental State Examination (MMSE), Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL), and Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog). Thirty-nine AD subjects were randomized to one of three groups: 1) placebo, 2) ω-3, or 3) ω-3 + LA for a treatment duration of 12 months. Eighty seven percent (34/39) of the subjects completed the 12-month intervention. There was no difference between groups at 12 months in peripheral F2-isoprostane levels (p = 0.83). The ω-3 +LA and ω-3 were not significantly different than the placebo group in ADAS-cog (p = 0.98, p = 0.86) and in ADL (p = 0.15, p = 0.82). Compared to placebo, the ω-3+LA showed less decline in MMSE (p< 0.01) and IADL (p= 0.01) and the ω-3 group showed less decline in IADL (p < 0.01). The combination of ω-3+LA slowed cognitive and functional decline in AD over 12 months. Because the results were generated from a small sample size, further evaluation of the combination of omega-3 fatty acids plus alpha-lipoic acid as a potential treatment in AD is warranted. PMID:24077434