RLS Channel Estimation with Adaptive Forgetting Factor for DS-CDMA Frequency-Domain Equalization

NASA Astrophysics Data System (ADS)

Kojima, Yohei; Tomeba, Hiromichi; Takeda, Kazuaki; Adachi, Fumiyuki

Frequency-domain equalization (FDE) based on the minimum mean square error (MMSE) criterion can increase the downlink bit error rate (BER) performance of DS-CDMA beyond that possible with conventional rake combining in a frequency-selective fading channel. FDE requires accurate channel estimation. Recently, we proposed a pilot-assisted channel estimation (CE) based on the MMSE criterion. Using MMSE-CE, the channel estimation accuracy is almost insensitive to the pilot chip sequence, and a good BER performance is achieved. In this paper, we propose a channel estimation scheme using one-tap recursive least square (RLS) algorithm, where the forgetting factor is adapted to the changing channel condition by the least mean square (LMS)algorithm, for DS-CDMA with FDE. We evaluate the BER performance using RLS-CE with adaptive forgetting factor in a frequency-selective fast Rayleigh fading channel by computer simulation.

Distal transport of dissolved hydrothermal iron in the deep South Pacific Ocean

PubMed Central

Fitzsimmons, Jessica N.; Boyle, Edward A.; Jenkins, William J.

2014-01-01

Until recently, hydrothermal vents were not considered to be an important source to the marine dissolved Fe (dFe) inventory because hydrothermal Fe was believed to precipitate quantitatively near the vent site. Based on recent abyssal dFe enrichments near hydrothermal vents, however, the leaky vent hypothesis [Toner BM, et al. (2012) Oceanography 25(1):209–212] argues that some hydrothermal Fe persists in the dissolved phase and contributes a significant flux of dFe to the global ocean. We show here the first, to our knowledge, dFe (<0.4 µm) measurements from the abyssal southeast and southwest Pacific Ocean, where dFe of 1.0–1.5 nmol/kg near 2,000 m depth (0.4–0.9 nmol/kg above typical deep-sea dFe concentrations) was determined to be hydrothermally derived based on its correlation with primordial 3He and dissolved Mn (dFe:3He of 0.9–2.7 × 106). Given the known sites of hydrothermal venting in these regions, this dFe must have been transported thousands of kilometers away from its vent site to reach our sampling stations. Additionally, changes in the size partitioning of the hydrothermal dFe between soluble (<0.02 µm) and colloidal (0.02–0.4 µm) phases with increasing distance from the vents indicate that dFe transformations continue to occur far from the vent source. This study confirms that although the southern East Pacific Rise only leaks 0.02–1% of total Fe vented into the abyssal Pacific, this dFe persists thousands of kilometers away from the vent source with sufficient magnitude that hydrothermal vents can have far-field effects on global dFe distributions and inventories (≥3% of global aerosol dFe input). PMID:25349389

Cardiotoxic (Arrhythmogenic) Effects of 1,1-Difluoroethane Due to Electrolyte Imbalance and Cardiomyocyte Damage.

PubMed

Joshi, Kaushal; Barletta, Michael; Wurpel, John

2017-06-01

Inhalant abuse is the intentional inhalation of chemical vapors to attain euphoric effects. Many common household products are abused by inhalation and one is 1,1-difluoroethane (DFE), which is a halogenated hydrocarbon used in refrigeration, dust-off spray, and airbrush painting. Although many human DFE abuse cases have been studied, the etiology and mechanism of sudden death is still unknown. In this study, an animal model was used to simulate the human conditions of DFE inhalation abuse that results in sudden death.Current research targets mechanistic studies involving electrolyte changes and cardiomyocyte damage after DFE administration in vivo. To investigate these changes, Sprague Dawley rats (N = 6) were exposed to 30 seconds of 20 L/min of DFE in multiple doses. Isoflurane acted as a control. Two additional groups, epinephrine and epinephrine + DFE, were included to simulate the clinical condition of DFE abuse. Plasma sodium, potassium, calcium, and magnesium levels were measured, followed by lactate dehydrogenase, creatine kinase, and cardiac troponin I levels. In addition, oxidative stress markers were also evaluated in all animal groups. Electrolyte levels showed a significant rise in plasma potassium and magnesium levels for the treated groups. In addition, lactate dehydrogenase, creatine kinase, and cardiac troponin I levels in DFE and epinephrine + DFE administered rats were significantly elevated as compared with control. Some oxidative stress makers were also elevated significantly in treatment groups. Furthermore, histopathological analysis showed hyperemia/congestion in treated rats.These results support cardiotoxic effects indicating that DFE results in fatal arrhythmias, and the study can be important during clinical cases involving inhalant abuse.

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.

Dissolved iron and iron(II) distributions beneath the pack ice in the East Antarctic (120°E) during the winter/spring transition

NASA Astrophysics Data System (ADS)

Schallenberg, Christina; van der Merwe, Pier; Chever, Fanny; Cullen, Jay T.; Lannuzel, Delphine; Bowie, Andrew R.

2016-09-01

Distributions of dissolved iron (dFe) and its reduced form, Fe(II), to a depth of 1000 m were investigated under the seasonal pack ice off East Antarctica during the Sea Ice Physics and Ecosystem experiment (SIPEX-2) sea-ice voyage in September-October 2012. Concentrations of dFe were elevated up to five-fold relative to Southern Ocean background concentrations and were spatially variable. The mean dFe concentration was 0.44±0.4 nM, with a range from 0.09 to 3.05 nM. Profiles of dFe were more variable within and among stations than were macronutrients, suggesting that coupling between these biologically-essential elements was weak at the time of the study. Brine rejection and drainage from sea ice are estimated to be the dominant contributors to elevated dFe concentrations in the mixed layer, but mass budget considerations indicate that estimated dFe fluxes from brine input alone are insufficient to account for all observed dFe. Melting icebergs and shelf sediments are suspected to provide the additional dFe. Fe(II) was mostly below the detection limit but elevated at depth near the continental shelf, implying that benthic processes are a source of reduced Fe in bottom waters. The data indicate that dFe builds up under the seasonal sea-ice cover during winter and that reduction of Fe may be hampered in early spring by several factors such as lack of electron donors, low biological productivity and inadequate light below the sea ice. The accumulated dFe pool in the mixed layer is expected to contribute to the formation of the spring bloom as the ice retreats.

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.

Pathways and supply of dissolved iron in the Amundsen Sea (Antarctica)

NASA Astrophysics Data System (ADS)

St-Laurent, P.; Yager, P. L.; Sherrell, R. M.; Stammerjohn, S. E.; Dinniman, M. S.

2017-09-01

Numerous coastal polynyas fringe the Antarctic continent and strongly influence the productivity of Antarctic shelf systems. Of the 46 Antarctic coastal polynyas documented in a recent study, the Amundsen Sea Polynya (ASP) stands out as having the highest net primary production per unit area. Incubation experiments suggest that this productivity is partly controlled by the availability of dissolved iron (dFe). As a first step toward understanding the iron supply of the ASP, we introduce four plausible sources of dFe and simulate their steady spatial distribution using conservative numerical tracers. The modeled distributions replicate important features from observations including dFe maxima at the bottom of deep troughs and enhanced concentrations near the ice shelf fronts. A perturbation experiment with an idealized drawdown mimicking summertime biological uptake and subsequent resupply suggests that glacial meltwater and sediment-derived dFe are the main contributors to the prebloom dFe inventory in the top 100 m of the ASP. The sediment-derived dFe depends strongly on the buoyancy-driven overturning circulation associated with the melting ice shelves (the "meltwater pump") to add dFe to the upper 300 m of the water column. The results support the view that ice shelf melting plays an important direct and indirect role in the dFe supply and delivery to polynyas such as the ASP.

Dairy farm effluent effects on urine patch nitrous oxide and carbon dioxide emissions.

PubMed

Clough, Tim J; Kelliher, Francis M

2005-01-01

Dairy farm effluent (DFE) comprises animal feces, urine, and wash-down water collected at the milking shed. This is collected daily during the milking season and sprayed onto grazed dairy pastures. Urine patches in grazed pastures make a significant contribution to anthropogenic N(2)O emissions. The DFE could potentially mitigate N(2)O emissions by influencing the N(2)O to dinitrogen (N(2)) ratio, since it contains water-soluble carbon (WSC). Alternatively, DFE may enhance N(2)O emissions from urine patches. The application of DFE may also provide a substrate for the production of CO(2) in pasture soils. The effects of DFE on the CO(2) and N(2)O emissions from urine patches are unknown. Thus a laboratory experiment was performed where repeated DFE applications were made to repacked soil cores. Dairy farm effluent was applied at 0, 7, or 14 d after urine deposition. The urine was applied once on Day 0. Urine contained (15)N-enriched urea. Measurements of N(2)O, N(2), and carbon dioxide (CO(2)) fluxes, soil pH, and soil inorganic N concentrations were made. After 43 d the DFE had not mitigated N(2)O fluxes from urine patches. A small increase in the N(2)O flux occurred from the urine-treated soils where DFE was applied 1 wk after urine deposition. The amount of WSC applied in the DFE proved to be insignificant compared with the amount of soil C released as CO(2) following urine application. The priming of soil C in urine patches has implications for the understanding of soil C processes in grazed pasture ecosystems and the budgeting of C within these ecosystems.

Design for the Environment Products (Raw Data)

EPA Pesticide Factsheets

This dataset contains a list of products that carry the Design for the Environment (DfE) label. This mark enables consumers to quickly identify and choose products that can help protect the environment and are safer for families. When you see the DfE logo on a product it means that the DfE scientific review team has screened each ingredient for potential human health and environmental effects and that-based on currently available information, EPA predictive models, and expert judgment-the product contains only those ingredients that pose the least concern among chemicals in their class. Product manufacturers who become DfE partners, and earn the right to display the DfE logo on recognized products, have invested heavily in research, development and reformulation to ensure that their ingredients and finished product line up on the green end of the health and environmental spectrum while maintaining or improving product performance. EPA's Design for the Environment Program (DfE) has allowed use of their logo on over 2500 products. These products are formulated from the safest possible ingredients and have reduced the use of chemicals of concern by hundreds of millions of pounds. A Spanish version of this dataset is available for download at http://www.epa.gov/dfe/pubs/products/list_of_labeled_products.html

Inhibitory effects of Drynaria fortunei extract on house dust mite antigen-induced atopic dermatitis in NC/Nga mice.

PubMed

Sung, Yoon-Young; Kim, Dong-Seon; Yang, Won-Kyung; Nho, Kyoung Jin; Seo, Hyeong Seok; Kim, Young Sang; Kim, Ho Kyoung

2012-10-31

Drynaria fortunei (Kunze) J. Sm has been widely used in traditional medicine for the treatment of inflammation, hyperlipidemia, arteriosclerosis, rheumatism, and bone healing. We investigated the anti-inflammatory effects of a 70% ethanol extract of Drynaria fortunei (DFE). We evaluated the anti-inflammatory effects of topically applied DFE on house dust mite Dermatophargoides farinae-induced atopic dermatitis-like skin lesions in NC/Nga mice. Treatment of NC/Nga mice with DFE reduced the dermatitis score, ear thickness, and serum levels of IgE, IgG1, and IL-6. Histopathological analyses of ear and skin lesions showed inhibition of the thickening of the epidermis and reduced epidermal/dermal infiltration of inflammatory cells. In ear lesions, mRNA expression levels of IL-4, IL-6, and tumor necrosis factor-α were reduced by DFE treatment. DFE inhibited the development of dermatitis-like skin lesions in NC/Nga mice. These results suggest that DFE may be a therapeutic candidate for the treatment of AD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Fatal cardiac arrhythmia after repeated exposure to 1,1-difluoroethane (DFE).

PubMed

Avella, Joseph; Wilson, James C; Lehrer, Michael

2006-03-01

A 42-year-old man was found dead after repeated exposure to 1,1-difluoroethane (DFE, Freon 152a), a propellant found in CRC Duster, a product intended for the removal of dust and lint. Toxicologic analysis detected DFE in femoral blood 136.3 mg/L, brain 117.5 mg/kg, liver 87.6 mg/kg, lung 60.3 mg/kg, adipose 235.7 mg/kg, and vitreous fluid 25.1 mg/L. The cause of death was determined to be a fatal cardiac arrhythmia due to intoxication with 1,1-difluoroethane. After comparison to previously published cases involving DFE, we suggest that analysis of adipose tissue for DFE and similar compounds, along with blood and other tissues, may be useful in distinguishing between acute versus chronic exposure. Adipose may also be a valuable alternate specimen for detection in cases where loss or elimination from blood is likely to have occurred.

Frequency-Domain Channel Estimation and Equalization for Single Carrier Underwater Acoustic Communications

DTIC Science & Technology

2007-01-01

synchronization ; vm(k) white Gaussian noise with average power σ2. If the Doppler shift f m,k is significant, then it causes the received signal ym(k) to be time ...intersymbol interference (ISI) to extend over 20-300 symbols at a data rate of 2-10 kilosymbols per second. Another obstacle is the time -varying Doppler... synchronization that employs a phase-locked loop (PLL) or delay-locked loop (DLL). However, the DFE and PLL/DLL have to interact in a nonlinear fashion

78 FR 68056 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; EPA's...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... Request Submitted to OMB for Review and Approval; Comment Request; EPA's Design for the Environment (DfE... Environment (DfE) Logo Redesign Consultations'' (EPA ICR No. 2487.01, OMB Control No. 2070-NEW) to the Office... (EPA) will select a revised logo and messaging for its Design for the Environment (DfE) program. A key...

77 FR 65683 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... Activities; Submission to OMB for Review and Approval; Comment Request; EPA's Design for the Environment (DfE... Budget (OMB) for review and approval: EPA's Design for the Environment (DfE) Partner of the Year Awards... . Title: EPA's Design for the Environment (DfE) Partner of the Year Awards Program. ICR Status: This is a...

Design for the Environment Products (Online Search)

EPA Pesticide Factsheets

This dataset contains a list of products that carry the Design for the Environment (DfE) label. This mark enables consumers to quickly identify and choose products that can help protect the environment and are safer for families. When you see the DfE logo on a product it means that the DfE scientific review team has screened each ingredient for potential human health and environmental effects and that-based on currently available information, EPA predictive models, and expert judgment-the product contains only those ingredients that pose the least concern among chemicals in their class. Product manufacturers who become DfE partners, and earn the right to display the DfE logo on recognized products, have invested heavily in research, development and reformulation to ensure that their ingredients and finished product line up on the green end of the health and environmental spectrum while maintaining or improving product performance. EPA's Design for the Environment Program (DfE) has allowed use of their logo on over 2500 products. These products are formulated from the safest possible ingredients and have reduced the use of chemicals of concern by hundreds of millions of pounds.

Inference of the Distribution of Selection Coefficients for New Nonsynonymous Mutations Using Large Samples

PubMed Central

Kim, Bernard Y.; Huber, Christian D.; Lohmueller, Kirk E.

2017-01-01

The distribution of fitness effects (DFE) has considerable importance in population genetics. To date, estimates of the DFE come from studies using a small number of individuals. Thus, estimates of the proportion of moderately to strongly deleterious new mutations may be unreliable because such variants are unlikely to be segregating in the data. Additionally, the true functional form of the DFE is unknown, and estimates of the DFE differ significantly between studies. Here we present a flexible and computationally tractable method, called Fit∂a∂i, to estimate the DFE of new mutations using the site frequency spectrum from a large number of individuals. We apply our approach to the frequency spectrum of 1300 Europeans from the Exome Sequencing Project ESP6400 data set, 1298 Danes from the LuCamp data set, and 432 Europeans from the 1000 Genomes Project to estimate the DFE of deleterious nonsynonymous mutations. We infer significantly fewer (0.38–0.84 fold) strongly deleterious mutations with selection coefficient |s| > 0.01 and more (1.24–1.43 fold) weakly deleterious mutations with selection coefficient |s| < 0.001 compared to previous estimates. Furthermore, a DFE that is a mixture distribution of a point mass at neutrality plus a gamma distribution fits better than a gamma distribution in two of the three data sets. Our results suggest that nearly neutral forces play a larger role in human evolution than previously thought. PMID:28249985

The removal of arsenate from water using iron-modified diatomite (D-Fe): isotherm and column experiments.

PubMed

Pantoja, M L; Jones, H; Garelick, H; Mohamedbakr, H G; Burkitbayev, M

2014-01-01

Iron hydroxide supported onto porous diatomite (D-Fe) is a low-cost material with potential to remove arsenic from contaminated water due to its affinity for the arsenate ion. This affinity was tested under varying conditions of pH, contact time, iron content in D-Fe and the presence of competitive ions, silicate and phosphate. Batch and column experiments were conducted to derive adsorption isotherms and breakthrough behaviours (50 μg L(-1)) for an initial concentration of 1,000 μg L(-1). Maximum capacity at pH 4 and 17% iron was 18.12-40.82 mg of arsenic/g of D-Fe and at pH 4 and 10% iron was 18.48-29.07 mg of arsenic/g of D-Fe. Adsorption decreased in the presence of phosphate and silicate ions. The difference in column adsorption behaviour between 10% and 17% iron was very pronounced, outweighing the impact of all other measured parameters. There was insufficient evidence of a correlation between iron content and arsenic content in isotherm experiments, suggesting that ion exchange is a negligible process occurring in arsenate adsorption using D-Fe nor is there co-precipitation of arsenate by rising iron content of the solute above saturation.

Importance of Ekman transport and gyre circulation change on seasonal variation of surface dissolved iron in the western subarctic North Pacific

NASA Astrophysics Data System (ADS)

Nakanowatari, Takuya; Nakamura, Tomohiro; Uchimoto, Keisuke; Nishioka, Jun; Mitsudera, Humio; Wakatsuchi, Masaaki

2017-05-01

Iron (Fe) is an essential nutrient for marine phytoplankton and it constitutes an important element in the marine carbon cycle in the ocean. This study examined the mechanisms controlling seasonal variation of dissolved Fe (dFe) in the western subarctic North Pacific (WSNP), using an ocean general circulation model coupled with a simple biogeochemical model incorporating a dFe cycle fed by two major sources (atmospheric dust and continental shelf sediment). The model reproduced the seasonal cycle of observed concentrations of dFe and macronutrients at the surface in the Oyashio region with maxima in winter (February-March) and minima in summer (July-September), although the simulated seasonal amplitudes are a half of the observed values. Analysis of the mixed-layer dFe budget indicated that both local vertical entrainment and lateral advection are primary contributors to the wintertime increase in dFe concentration. In early winter, strengthened northwesterly winds excite southward Ekman transport and Ekman upwelling over the western subarctic gyre, transporting dFe-rich water southward. In mid to late winter, the southward western boundary current of the subarctic gyre and the outflow from the Sea of Okhotsk also bring dFe-rich water to the Oyashio region. The contribution of atmospheric dust to the dFe budget is several times smaller than these ocean transport processes in winter. These results suggest that the westerly wind-induced Ekman transport and gyre circulation systematically influence the seasonal cycle of WSNP surface dFe concentration.

A validated method for the quantitation of 1,1-difluoroethane using a gas in equilibrium method of calibration.

PubMed

Avella, Joseph; Lehrer, Michael; Zito, S William

2008-10-01

1,1-Difluoroethane (DFE), also known as Freon 152A, is a member of a class of compounds known as halogenated hydrocarbons. A number of these compounds have gained notoriety because of their ability to induce rapid onset of intoxication after inhalation exposure. Abuse of DFE has necessitated development of methods for its detection and quantitation in postmortem and human performance specimens. Furthermore, methodologies applicable to research studies are required as there have been limited toxicokinetic and toxicodynamic reports published on DFE. This paper describes a method for the quantitation of DFE using a gas chromatography-flame-ionization headspace technique that employs solventless standards for calibration. Two calibration curves using 0.5 mL whole blood calibrators which ranged from A: 0.225-1.350 to B: 9.0-180.0 mg/L were developed. These were evaluated for linearity (0.9992 and 0.9995), limit of detection of 0.018 mg/L, limit of quantitation of 0.099 mg/L (recovery 111.9%, CV 9.92%), and upper limit of linearity of 27,000.0 mg/L. Combined curve recovery results of a 98.0 mg/L DFE control that was prepared using an alternate technique was 102.2% with CV of 3.09%. No matrix interference was observed in DFE enriched blood, urine or brain specimens nor did analysis of variance detect any significant differences (alpha = 0.01) in the area under the curve of blood, urine or brain specimens at three identical DFE concentrations. The method is suitable for use in forensic laboratories because validation was performed on instrumentation routinely used in forensic labs and due to the ease with which the calibration range can be adjusted. Perhaps more importantly it is also useful for research oriented studies because the removal of solvent from standard preparation eliminates the possibility for solvent induced changes to the gas/liquid partitioning of DFE or chromatographic interference due to the presence of solvent in specimens.

Prospective randomized controlled trial comparing the outcomes and costs of two eyecare adherence interventions in diabetes patients.

PubMed

Pizzi, Laura T; Zangalli, Camila S; Murchison, Ann P; Hale, Nicole; Hark, Lisa; Dai, Yang; Leiby, Benjamin E; Haller, Julia A

2015-04-01

Diabetic retinopathy is one of the leading causes of vision impairment among adults in the USA. While it is suggested that diabetics receive annual dilated fundus examinations (DFE), many patients do not adhere to these recommendations. This paper investigates the outcomes and costs of an educational and telephone intervention on DFE follow-up adherence in patients with diabetes. In a prospective trial, 356 diabetic patients due for a DFE at an urban eye clinic were randomly assigned to usual care (UC; reference case), mailed intervention (MI), or telephone intervention (TI). UC patients (n = 119) received a standard form letter. MI patients (n = 117) received a personalized letter encouraging scheduling of an eye examination with an educational brochure about diabetic eye disease. TI patients (n = 120) received personal calls (up to three attempts) to schedule a follow-up with standard form letter. The primary outcome was obtaining a DFE within 90 days of suggested return. Costs (US$ 2013) included time costs for staff, phone charges, supplies, and postage. Since TI involved greater cost components compared to MI, univariate sensitivity analysis examined the impact of reducing phone costs. Patients were mostly female (66 %) and African American (70 %) with a mean age of 61 years. TI patients were more likely to schedule DFE [65 vs. 42 %; relative risk (RR) 1.54; CI 1.20-1.96; P < 0.001] versus UC patients. Obtaining a DFE within 90 days of suggested return was also significantly higher among TI patients compared to UC patients (51 vs. 36 %, RR 1.41; CI 1.05-1.89; P = 0.024). MI patients were slightly less likely to schedule DFE versus UC patients (38 vs. 42 %, RR 0.90; CI 0.66-1.22; P = NSS) and obtain a DFE (32 vs. 36 %; RR 0.90; CI 0.63-1.28; P = NSS). The total cost of TI was US$798.28 or US$6.65/patient and the cost/follow-up DFE was US$26.05. Sensitivity analyses revealed that the cost/follow-up can be greatly reduced but remains greater compared to UC (US$2.76 if US$0.25/call, US$11.13 if $1/call; US$22.29 if US$2/call). Personal phone assistance in scheduling DFE follow-up is more effective but also more costly. Follow-up research has been initiated to determine whether automated phone reminders can achieve similar effectiveness at a lower cost.

Cognitive function and dementia in six areas of England and Wales: the distribution of MMSE and prevalence of GMS organicity level in the MRC CFA Study. The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS).

PubMed

1998-03-01

This two-stage prevalence survey involved geographically delimited areas, four urban (Liverpool, Newcastle, Nottingham and Oxford) and two rural (Cambridgeshire and Gwynedd), including institutions. Stratified random population samples of people in their 65th year and above, from Family Health Service Authorities were studied. The sample was stratified (65-74 years and > or = 75) to provide equal numbers. In Liverpool equal numbers in 5 year age groups were taken. After an initial screening interview, approximately 20% were selected on the basis of age, AGECAT organicity confidence level and MMSE score to proceed to a detailed assessment interview from which the full AGECAT organicity confidence level could be derived. Major influences on MMSE were confirmed as age, sex, social class and educational level. Estimates of prevalence of AGECAT O3 and above for each centre and the entire sample according to age are given, based on 1991 Census population structure, and suggest that around half a million (543,400) people in England and Wales would be defined as case level by this method. The five centres employing the same methodology showed no heterogeneity in prevalence. Prevalence of cognitive impairment and dementia appear not to vary widely across the centres examined in this study, which provides stable estimates by age and sex for AGECAT O3 and above, and norms for MMSE. Using these estimates as an indication of the size of the population affected, around 550,000 individuals in England and Wales would be expected to be suffering from dementia of mild or greater severity.

Consistent force field modeling of matrix isolated molecules. V. Minimum energy path potential to the conformer conversion of 1,2-difluoroethane: Ar 364, ab initio calculation of electric multipole moments and electric polarization contribution to the conversion barrier

NASA Astrophysics Data System (ADS)

Gunde, R.; Ha, T.-K.; Günthard, H. H.

1990-08-01

In this paper results of consistent force field modeling (CFF) of the potential function to conversion of the gauche (g) to the trans (t) conformer of 1,2-difluoroethane (DFE) isolated in an argon matrix will be reported. Starting point are locally stable configurations gDFE:Ar 364 (defect GH1) and tDFE:Ar 364 (TH1) obtained in previous work from CFF modeling of a cube shaped Ar 364 fragment containing one DFE molecule in its center. Using the dihedral angle of DFE as an independent parameter the minimum energy path of the conversion process gDFE:Ar 364→tDFE:Ar 364 will be determined by CFF energy minimization. Determination of the minimum energy path is found to require large numbers of energy minimization steps and to lead to a rather complicated motion of the molecule with respect to the crystal fragment. Surprisingly the molecule-matrix interactions lead to a reduction of the g-t barrier by ≈500 cal/mol and to a stabilization of the trans species by ≈500 cal/mol. This finding is a consequence of a delicate interplay of matrix-molecule and matrix-matrix interactions. Calculation of the electric polarization energy (induced dipole-first-order polarization approximation) is based on extended ab initio calculations of dipole and quadrupole moments and a bond polarizability estimate of the first-order polarizability of DFE as a function of the internal rotation angle, on Fourier expansion of multipole components and use of symmetry for reduction of the order of the linear system defining the (self-consistent) induced dipole moments of all Ar atoms. Electric polarization is found to alter the potential function of the conversion process in a profound way: the g-t barrier and the t-g energy difference are increased to ≈3000 cal/mol and to ≈1500 cal/mol respectively (≈2500 and ≈530 cal/mol respectively for free DFE). Further applications of the technique developed in this work to related problems of matrix isolated molecules, e.g., vibrational matrix shifts will be discussed.

The 3D Distribution of Dissolved and Colloidal Fe, Mn, Zn, Cu, Ni, Cd and Pb in the Western Antarctic Peninsula Shelf Region; Implications for Natural Fe Fertilization

NASA Astrophysics Data System (ADS)

Sherrell, R. M.; Fitzsimmons, J. N.; Roccanova, J.; Schofield, O.; Meredith, M. P.

2016-02-01

The Western Antarctic Peninsula (WAP) shelf region is is a natural Fe fertilization zone where primary production exceeds that of the adjacent open Southern Ocean. Until recently, however, distributions of Fe and of other bioactive metals were completely lacking for the WAP, and the sources and delivery mechanisms of Fe to the euphotic zone were only speculated upon. We have previously presented surface water (2m) dissolved (dTM, <0.2µm) and particulate (pTM, >0.45µm) distributions for Fe and a suite of other bioactive metals over the WAP shelf, covering the Palmer LTER sampling grid for Jan. 2010, 2011 and 2012. We now report the first complete 3D distribution of dissolved and colloidal Fe (and Mn, Zn, Cu, Ni, Cd and Pb) over the LTER grid in Jan. 2015, allowing assessment of dFe size speciation, sources and transport pathways in this dynamic shelf system. Dissolved metals were analyzed by automated offline preconcentration (seaFAST-pico, ESI) followed by sector-field ICP-MS. We confirm previous findings of low ( 0.1nM) dFe in surface waters on the mid-outer shelf in the northern portion of the grid, and now find that concentrations at this level or below persist through the euphotic zone. However, dFe increases rapidly with depth, with low surface values underlain by substantially higher concentrations even at 50m. Inner shelf surface waters are generally substantially > 0.1nM, suggesting Fe replete conditions in this region. Vertical profiles reveal that dFe generally increases with depth, much moreso in the inner shelf (dFe up to 5.0nM) than the outer shelf. A general N-S gradient in dFe is also evident, with concentrations higher in the southern WAP, especially in Marguerite Bay. In addition, shelf stations often show a dFe maximum suggesting remineralization from sinking biogenic particles. These findings for dFe and for the other metals, will be used to help unravel the biogeochemical workings of natural Fe fertilization in this region.

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.

Aqueous Date Flesh or Pits Extract Attenuates Liver Fibrosis via Suppression of Hepatic Stellate Cell Activation and Reduction of Inflammatory Cytokines, Transforming Growth Factor-β1 and Angiogenic Markers in Carbon Tetrachloride-Intoxicated Rats

PubMed Central

Al-Rasheed, Nouf M.; Attia, Hala A.; Mohamad, Raeesa A.; Al-Rasheed, Nawal M.; Al-Amin, Maha A.; AL-Onazi, Asma

2015-01-01

Previous data indicated the protective effect of date fruit extract on oxidative damage in rat liver. However, the hepatoprotective effects via other mechanisms have not been investigated. This study was performed to evaluate the antifibrotic effect of date flesh extract (DFE) or date pits extract (DPE) via inactivation of hepatic stellate cells (HSCs), reducing the levels of inflammatory, fibrotic and angiogenic markers. Coffee was used as reference hepatoprotective agent. Liver fibrosis was induced by injection of CCl4 (0.4 mL/kg) three times weekly for 8 weeks. DFE, DPE (6 mL/kg), coffee (300 mg/kg), and combination of coffee + DFE and coffee + DPE were given to CCl4-intoxicated rats daily for 8 weeks. DFE, DPE, and their combination with coffee attenuated the elevated levels of inflammatory cytokines including tumor necrosis factor-α, interleukin-6, and interleukin-1β. The increased levels of transforming growth factor-β1 and collagen deposition in injured liver were alleviated by both extracts. CCl4-induced expression of α-smooth muscle actin was suppressed indicating HSCs inactivation. Increased angiogenesis was ameliorated as revealed by reduced levels and expression of vascular endothelial growth factor and CD31. We concluded that DFE or DPE could protect liver via different mechanisms. The combination of coffee with DFE or DPE may enhance its antifibrotic effects. PMID:25945106

Methane emissions and contaminant degradation rates at sites affected by accidental releases of denatured fuel-grade ethanol

NASA Astrophysics Data System (ADS)

Sihota, Natasha J.; Mayer, K. Ulrich; Toso, Mark A.; Atwater, Joel F.

2013-08-01

The recent increase in the use of denatured fuel-grade ethanol (DFE) has enhanced the probability of its environmental release. Due to the highly labile nature of ethanol (EtOH), it is expected to rapidly biodegrade, increasing the potential for inducing methanogenic conditions in the subsurface. As environmental releases of DFE can be expected to occur at the ground surface or in the vadose zone (e.g., due to surficial spills from rail lines or tanker trucks and leaking underground storage tanks), the potential for methane (CH4) generation at DFE spill sites requires evaluation. An assessment is needed because high CH4 generation rates may lead to CH4 fluxes towards the ground surface, which is of particular concern if spills are located close to human habitation—related to concerns of soil vapor intrusion (SVI). This work demonstrates, for the first time, the measurement of surficial gas release rates at large volume DFE spill sites. Two study sites, near Cambria and Balaton, in MN are investigated. Total carbon emissions at the ground surface (summing carbon dioxide (CO2) and CH4 emissions) are used to quantify depth-integrated DFE degradation rates. Results from both sites demonstrate that substantial CO2 and CH4 emissions do occur—even years after a spill. However, large total carbon fluxes, and CH4 emissions in particular, were restricted to a localized area within the DFE source zone. At the Balaton site, estimates of total DFE carbon losses in the source zone ranged between 5 and 174 μmol m- 2 s- 1, and CH4 effluxes ranged between non-detect and 9 μmol m- 2 s- 1. At the Cambria site estimates of total DFE carbon losses in the source zone ranged between 8 and 500 μmol m- 2 s- 1, and CH4 effluxes ranged between non-detect and 393 μmol m- 2 s- 1. Substantial CH4 accumulation, coupled with oxygen (O2) depletion, measured in samples collected from custom-designed gas collection chambers at the Cambria site suggests that the development of explosion or asphyxiation hazards is possible in confined spaces above a rapidly degrading DFE release. However, the results also indicate that the development of such hazards is locally constrained, will require a high degree of soil moisture, close proximity to the source zone, a good connection between the soil and the confined space, and poorly aerated conditions.

Methane emissions and contaminant degradation rates at sites affected by accidental releases of denatured fuel-grade ethanol.

PubMed

Sihota, Natasha J; Mayer, K Ulrich; Toso, Mark A; Atwater, Joel F

2013-08-01

The recent increase in the use of denatured fuel-grade ethanol (DFE) has enhanced the probability of its environmental release. Due to the highly labile nature of ethanol (EtOH), it is expected to rapidly biodegrade, increasing the potential for inducing methanogenic conditions in the subsurface. As environmental releases of DFE can be expected to occur at the ground surface or in the vadose zone (e.g., due to surficial spills from rail lines or tanker trucks and leaking underground storage tanks), the potential for methane (CH4) generation at DFE spill sites requires evaluation. An assessment is needed because high CH4 generation rates may lead to CH4 fluxes towards the ground surface, which is of particular concern if spills are located close to human habitation-related to concerns of soil vapor intrusion (SVI). This work demonstrates, for the first time, the measurement of surficial gas release rates at large volume DFE spill sites. Two study sites, near Cambria and Balaton, in MN are investigated. Total carbon emissions at the ground surface (summing carbon dioxide (CO2) and CH4 emissions) are used to quantify depth-integrated DFE degradation rates. Results from both sites demonstrate that substantial CO2 and CH4 emissions do occur-even years after a spill. However, large total carbon fluxes, and CH4 emissions in particular, were restricted to a localized area within the DFE source zone. At the Balaton site, estimates of total DFE carbon losses in the source zone ranged between 5 and 174 μmol m(-2) s(-1), and CH4 effluxes ranged between non-detect and 9 μmol m(-2) s(-1). At the Cambria site estimates of total DFE carbon losses in the source zone ranged between 8 and 500 μmol m(-2) s(-1), and CH4 effluxes ranged between non-detect and 393 μmol m(-2) s(-1). Substantial CH4 accumulation, coupled with oxygen (O2) depletion, measured in samples collected from custom-designed gas collection chambers at the Cambria site suggests that the development of explosion or asphyxiation hazards is possible in confined spaces above a rapidly degrading DFE release. However, the results also indicate that the development of such hazards is locally constrained, will require a high degree of soil moisture, close proximity to the source zone, a good connection between the soil and the confined space, and poorly aerated conditions. Copyright © 2013 Elsevier B.V. All rights reserved.

Capacity of humic substances to complex with iron at different salinities in the Yangtze River estuary and East China Sea.

PubMed

Yang, Rujun; Su, Han; Qu, Shenglu; Wang, Xuchen

2017-05-03

The iron binding capacities (IBC) of fulvic acid (FA) and humic acid (HA) were determined in the salinity range from 5 to 40. The results indicated that IBC decreased while salinity increased. In addition, dissolved iron (dFe), FA and HA were also determined along the Yangtze River estuary's increasing salinity gradient from 0.14 to 33. The loss rates of dFe, FA and HA in the Yangtze River estuary were up to 96%, 74%, and 67%, respectively. The decreases in dFe, FA and HA, as well as the change in IBC of humic substances (HS) along the salinity gradient in the Yangtze River estuary were all well described by a first-order exponential attenuation model: y(dFe/FA/HA, S) = a 0 × exp(kS) + y 0 . These results indicate that flocculation of FA and HA along the salinity gradient resulted in removal of dFe. Furthermore, the exponential attenuation model described in this paper can be applied in the major estuaries of the world where most of the removal of dFe and HS occurs where freshwater and seawater mix.

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

A motor vehicle accident fatality involving the inhalation of 1,1-difluoroethane.

PubMed

Hahn, Timothy; Avella, Joseph; Lehrer, Michael

2006-10-01

A 24-year-old female driver with a history of substance abuse was pronounced dead following a single car motor vehicle accident. A surviving front seat passenger witnessed the decedent inhaling "Dust Off" cleaner just prior to losing control of the vehicle. The propellant compound used in this product is the halogenated hydrocarbon 1,1-difluoroethane (DFE). Sealed autopsy specimens were examined for the presence and subsequent quantitation of DFE utilizing an Agilent 6850 gas chromatograph (GC)-flame-ionization detector. The levels of DFE obtained were as follows: 29.8 mg/L in femoral blood, 40.3 mg/L in pulmonary arterial blood, 85.6 mg/L in aortic blood, 79.9 mg/L in chest cavity blood, 21.2 mg/L in vitreous, 11.7 mg/kg in brain, 27.9 mg/kg in liver, 71.0 mg/L in urine, and 51.8 mg/total gastric contents. The presence of DFE was confirmed in the decedent's urine by injection on an Agilent 6890/5973 GC-mass spectrometer in full scan mode. This case presents a uniquely witnessed observation of the apparent impairing effects and consequences of the acute inhalation of halogenated hydrocarbons such as DFE and the operation of a motor vehicle. The proximity of time of death to inhalant use may also provide insight to postmortem distribution patterns of DFE in relation to normal physiologic blood flow. With further investigations, estimating the time of final use of an inhalant prior to death may be deciphered from such patterns, although a degree of caution should be applied in deaths resulting from severe trauma in which normal tissue structure is compromised because postmortem redistribution may result.

Hierarchically three-dimensional (3D) nanotubular sea urchin-shaped iron oxide and its application in heavy metal removal and solar-induced photocatalytic degradation.

PubMed

Lee, Soon Chang; Jeong, Yesul; Kim, Youn Jung; Kim, Hyeran; Lee, Hyun Uk; Lee, Young-Chul; Lee, Sang Moon; Kim, Hae Jin; An, Ha-Rim; Ha, Myoung Gyu; Lee, Go-Woon; Lee, Young-Seak; Lee, Gaehang

2018-04-23

In this study, hierarchically three-dimensional (3D) nanotubular sea urchin-shaped iron oxide nanostructures (3D-Fe 2 O 3 ) were synthesized by a facile and rapid ultrasound irradiation method. Additives, templates, inert gas atmosphere, pH regulation, and other complicated procedures were not required. Dense 3D-Fe 2 O 3 with a relatively large Brunauer-Emmett-Teller (BET) surface area of 129.4 m 2 /g was synthesized within 23 min, and the BET surface area was further improved to 282.7 m 2 /g by a post heat-treatment process. In addition, this post processing led to phase changes from maghemite (γ phase) to hematite (α phase) Fe 2 O 3 . Subsequent characterization suggested that the growth mechanism of the 3D-Fe 2 O 3 follows self-assembly and oriented attachment. The prepared 3D-Fe 2 O 3 was applied to wastewater purification. Ultrasound-irradiated 3D-Fe 2 O 3 can eliminate a As(V) and Cr(VI) from water with 25 times faster removal rate by using a one third smaller amount than commercial α-Fe 2 O 3 . This was attributed to the inter-particle pores and relatively positively charged surface of the nanostructure. In addition, post heat treatment on ultrasound-irradiated 3D-Fe 2 O 3 significantly influenced the photocatalytic degradation of methylene blue and phenol, with a 25 times higher removal efficiency than that of commercial α-Fe 2 O 3 , because of both high BET surface area and good crystallization of the prepared samples. Copyright © 2018 Elsevier B.V. All rights reserved.

Study of CNG/diesel dual fuel engine's emissions by means of RBF neural network.

PubMed

Liu, Zhen-tao; Fei, Shao-mei

2004-08-01

Great efforts have been made to resolve the serious environmental pollution and inevitable declining of energy resources. A review of Chinese fuel reserves and engine technology showed that compressed natural gas (CNG)/diesel dual fuel engine (DFE) was one of the best solutions for the above problems at present. In order to study and improve the emission performance of CNG/diesel DFE, an emission model for DFE based on radial basis function (RBF) neural network was developed which was a black-box input-output training data model not require priori knowledge. The RBF centers and the connected weights could be selected automatically according to the distribution of the training data in input-output space and the given approximating error. Studies showed that the predicted results accorded well with the experimental data over a large range of operating conditions from low load to high load. The developed emissions model based on the RBF neural network could be used to successfully predict and optimize the emissions performance of DFE. And the effect of the DFEmain performance parameters, such as rotation speed, load, pilot quantity and injection timing, were also predicted by means of this model. In resumé, an emission prediction model for CNG/diesel DFE based on RBF neural network was built for analyzing the effect of the main performance parameters on the CO, NOx, emissions of DFE. The predicted results agreed quite well with the traditional emissions model, which indicated that the model had certain application value, although it still has some limitations, because of its high dependence on the quantity of the experimental sample data.

Finite element modelling to assess the effect of surface mounted piezoelectric patch size on vibration response of a hybrid beam

NASA Astrophysics Data System (ADS)

Rahman, N.; Alam, M. N.

2018-02-01

Vibration response analysis of a hybrid beam with surface mounted patch piezoelectric layer is presented in this work. A one dimensional finite element (1D-FE) model based on efficient layerwise (zigzag) theory is used for the analysis. The beam element has eight mechanical and a variable number of electrical degrees of freedom. The beams are also modelled in 2D-FE (ABAQUS) using a plane stress piezoelectric quadrilateral element for piezo layers and a plane stress quadrilateral element for the elastic layers of hybrid beams. Results are presented to assess the effect of size of piezoelectric patch layer on the free and forced vibration responses of thin and moderately thick beams under clamped-free and clamped-clamped configurations. The beams are subjected to unit step loading and harmonic loading to obtain the forced vibration responses. The vibration control using in phase actuation potential on piezoelectric patches is also studied. The 1D-FE results are compared with the 2D-FE results.

The contribution of the mitochondrial genome to sex-specific fitness variance.

PubMed

Smith, Shane R T; Connallon, Tim

2017-05-01

Maternal inheritance of mitochondrial DNA (mtDNA) facilitates the evolutionary accumulation of mutations with sex-biased fitness effects. Whereas maternal inheritance closely aligns mtDNA evolution with natural selection in females, it makes it indifferent to evolutionary changes that exclusively benefit males. The constrained response of mtDNA to selection in males can lead to asymmetries in the relative contributions of mitochondrial genes to female versus male fitness variation. Here, we examine the impact of genetic drift and the distribution of fitness effects (DFE) among mutations-including the correlation of mutant fitness effects between the sexes-on mitochondrial genetic variation for fitness. We show how drift, genetic correlations, and skewness of the DFE determine the relative contributions of mitochondrial genes to male versus female fitness variance. When mutant fitness effects are weakly correlated between the sexes, and the effective population size is large, mitochondrial genes should contribute much more to male than to female fitness variance. In contrast, high fitness correlations and small population sizes tend to equalize the contributions of mitochondrial genes to female versus male variance. We discuss implications of these results for the evolution of mitochondrial genome diversity and the genetic architecture of female and male fitness. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

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.

Opposing authigenic controls on the isotopic signature of dissolved iron in hydrothermal plumes

NASA Astrophysics Data System (ADS)

Lough, A. J. M.; Klar, J. K.; Homoky, W. B.; Comer-Warner, S. A.; Milton, J. A.; Connelly, D. P.; James, R. H.; Mills, R. A.

2017-04-01

Iron is a scarce but essential micronutrient in the oceans that limits primary productivity in many regions of the surface ocean. The mechanisms and rates of Fe supply to the ocean interior are still poorly understood and quantified. Iron isotope ratios of different Fe pools can potentially be used to trace sources and sinks of the global Fe biogeochemical cycle if these boundary fluxes have distinct signatures. Seafloor hydrothermal vents emit metal rich fluids from mid-ocean ridges into the deep ocean. Iron isotope ratios have the potential to be used to trace the input of hydrothermal dissolved iron to the oceans if the local controls on the fractionation of Fe isotopes during plume dispersal in the deep ocean are understood. In this study we assess the behaviour of Fe isotopes in a Southern Ocean hydrothermal plume using a sampling program of Total Dissolvable Fe (TDFe), and dissolved Fe (dFe). We demonstrate that δ56Fe values of dFe (δ56dFe) within the hydrothermal plume change dramatically during early plume dispersal, ranging from -2.39 ± 0.05‰ to -0.13 ± 0.06‰ (2 SD). The isotopic composition of TDFe (δ56TDFe) was consistently heavier than dFe values, ranging from -0.31 ± 0.03‰ to 0.78 ± 0.05‰, consistent with Fe oxyhydroxide precipitation as the plume samples age. The dFe present in the hydrothermal plume includes stabilised dFe species with potential to be transported to the deep ocean. We estimate that stable dFe exported from the plume will have a δ56Fe of -0.28 ± 0.17‰. Further, we show that the proportion of authigenic iron-sulfide and iron-oxyhydroxide minerals precipitating in the buoyant plume exert opposing controls on the resultant isotope composition of dissolved Fe passed into the neutrally buoyant plume. We show that such controls yield variable dissolved Fe isotope signatures under the authigenic conditions reported from modern vent sites elsewhere, and so ought to be considered during iron isotope reconstructions of past hydrothermalism from ocean sediment records.

[Three-dimensional finite element analysis of three conjunctive methods of free iliac bone graft for established mandibular body defects].

PubMed

Wang, Dong; Yang, Zhuang-qun; Hu, Xiao-yi

2007-08-01

To analyze the stress and displacement distribution of 3D-FE models in three conjunctive methods of vascularized iliac bone graft for established mandibular body defects. Using computer image process technique, a series of spiral CT images were put into Ansys preprocess programe to establish three 3D-FE models of different conjunctions. The three 3D-FE models of established mandibular body defects by vascularized iliac bone graft were built up. The distribution of Von Mises stress and displacement around mandibular segment, grafted ilium, plates and screws was obtained. It may be determined successfully that the optimal conjunctive shape be the on-lay conjunction.

Monitoring propranolol treatment in periocular infantile haemangioma.

PubMed

Burne, R; Taylor, R

2014-11-01

To develop a tool for assessing amblyopic risk and monitoring the treatment effect of propranolol in periocular haemangioma management. We present a study of nine children with periocular haemangioma who underwent propranolol treatment at York Hospital between 2009 and 2013.A proposed measure of amblyogenic risk based on the induced anisometropia resulting from a periocular haemangioma was calculated in the form of a single quantitative value, measured in dioptres. This calculation used published work and developed it to produce a new function, termed the delta defocus equivalent (DFE-∂).Refraction measurements were retrospectively collected from patients' notes in order to measure the trend of DFE-∂ over the treatment period with propranolol. The average DFE-∂ at commencement of propranolol was 1.54 (±0.62) D. The average at the end of treatment was 0.39 (±0.38) D. This work presents a possible tool for assessing amblyopic risk in cases of periocular infantile haemangioma. The DFE-∂ gives a measure in dioptres, which may represent the true amblyopic risk, and so be useful in supporting treatment decisions in paediatric ophthalmology.

Iron from a submarine source impacts the productive layer of the Western Tropical South Pacific (WTSP).

PubMed

Guieu, Cécile; Bonnet, Sophie; Petrenko, Anne; Menkes, Christophe; Chavagnac, Valérie; Desboeufs, Karine; Maes, Christophe; Moutin, Thierry

2018-06-13

In the Western Tropical South Pacific, patches of high chlorophyll concentrations linked to the occurrence of N 2 -fixing organisms are found in the vicinity of volcanic islands. The survival of these organisms relies on a high bioavailable iron supply whose origin and fluxes remain unknown. Here, we measured high dissolved iron (DFe) concentrations (up to 66 nM) in the euphotic layer, extending zonally over 10 degrees longitude (174 E-175 W) at ∼20°S latitude. DFe atmospheric fluxes were at the lower end of reported values of the remote ocean and could not explain the high DFe concentrations measured in the water column in the vicinity of Tonga. We argue that the high DFe concentrations may be sustained by a submarine source, also characterized by freshwater input and recorded as salinity anomalies by Argo float in situ measurements and atlas data. The observed negative salinity anomalies are reproduced by simulations from a general ocean circulation model. Submarine iron sources reaching the euphotic layer may impact nitrogen fixation across the whole region.

The Distribution of Dissolved Iron in the West Atlantic Ocean

PubMed Central

Rijkenberg, Micha J. A.; Middag, Rob; Laan, Patrick; Gerringa, Loes J. A.; van Aken, Hendrik M.; Schoemann, Véronique; de Jong, Jeroen T. M.; de Baar, Hein J. W.

2014-01-01

Iron (Fe) is an essential trace element for marine life. Extremely low Fe concentrations limit primary production and nitrogen fixation in large parts of the oceans and consequently influence ocean ecosystem functioning. The importance of Fe for ocean ecosystems makes Fe one of the core chemical trace elements in the international GEOTRACES program. Despite the recognized importance of Fe, our present knowledge of its supply and biogeochemical cycle has been limited by mostly fragmentary datasets. Here, we present highly accurate dissolved Fe (DFe) values measured at an unprecedented high intensity (1407 samples) along the longest full ocean depth transect (17500 kilometers) covering the entire western Atlantic Ocean. DFe measurements along this transect unveiled details about the supply and cycling of Fe. External sources of Fe identified included off-shelf and river supply, hydrothermal vents and aeolian dust. Nevertheless, vertical processes such as the recycling of Fe resulting from the remineralization of sinking organic matter and the removal of Fe by scavenging still dominated the distribution of DFe. In the northern West Atlantic Ocean, Fe recycling and lateral transport from the eastern tropical North Atlantic Oxygen Minimum Zone (OMZ) dominated the DFe-distribution. Finally, our measurements showed that the North Atlantic Deep Water (NADW), the major driver of the so-called ocean conveyor belt, contains excess DFe relative to phosphate after full biological utilization and is therefore an important source of Fe for biological production in the global ocean. PMID:24978190

High Resolution Observations of Dissolved Iron Distribution Along a Coastal Offshore Transect in the Eastern North Atlantic.

NASA Astrophysics Data System (ADS)

Blain, S.; Laes, A.; Laan, P.; Achterberg, E.; de Baar, H.

2002-12-01

In order to better understand and quantify the inputs of iron from below in the water column a detailed section from the coast to offshore has been studied in the eastern North Atlantic. The section, extended from 47°36 58 N, 4°14 51 W (depth 96 m) to 46°00 00 N, 8°00 00 W (depth 4912 m). The cruise took place in March 2002, on board R/V Pelagia, as part of the European Union project IRONAGES. Fifteen stations have been sampled for dissolved iron (DFe) and nutrients analysis. Go Flo bottles mounted on a kevlar cable were used for clean seawater sampling in the water column. A torpedo fish and trace metal clean bellows pump were used for surface sampling. Sample were filtered on-line through an 0.2 μm cartridge. The DFe concentrations were measured onboard using a FIA method with on line preconcentration (8-HQ resin) and chemiluminescence detection (mean blank = 28 pM, mean limit of detection= 39 pM). The coastal stations over the shelf showed the highest concentrations of DFe. In this part of the transect, the concentration decreased from the surface to the bottom. Maxima (1-2.4 nM) were associated with increase in turbidity demonstrating the DFe inputs associated with re-suspended sediments and/or pore waters. In the eastern part of the transect, water of the Loire river has been identified has a source of iron. Close to the shelf break the two dimensional iron distribution became more complex. A tidal front, internal waves and slope currents created a patchy distribution of DFe. Evertheless the input from below was always observable at depth between 500 and 1200 m. Finally, in the western part of the transect, off the plateau, the concentration of DFe was strongly correlated with the occurrence of different water masses (see abstract by A. Laës).

Uptake and distribution of the abused inhalant 1,1-difluoroethane in the rat.

PubMed

Avella, Joseph; Kunaparaju, Naveen; Kumar, Sunil; Lehrer, Michael; Zito, S William; Barletta, Michael

2010-09-01

1,1-Difluoroethane (DFE) is a halogenated hydrocarbon used as a propellant in products designed for dusting electronic equipment and air brush painting. When abused, inhaled DFE produces intoxication and loss of muscular coordination. To investigate DFE toxicokinetics, groups (n = 3) of Sprague-Dawley rats were exposed to 30 s of 20 L/min DFE. The experimental model was designed to mimic exposure during abuse, a protocol which has not been conducted. Tissue collection (blood, brain, heart, liver, and kidney) occurred at 0, 10, 20, 30, 45, 60, 120, 240, 480, and 900 s. Average peak DFE levels were blood 352, brain 519, heart 338, liver 187, and kidney 364 mg/L or mg/kg. The total percent uptake of the administered dose was 4.0%. Uptake into individual compartments was 2.72, 0.38, 0.15, 0.41, and 0.32% for blood, brain, heart, liver, and kidney, respectively. All animals showed signs of intoxication within 20 s manifested as lethargy, prostration and loss of righting reflex. Marked intoxication continued for about 4 min when DFE averaged 21 mg/L in blood and 17 mg/kg in brain. Between 4 and 8 min, animals continued to show signs of sedation as evidenced by reduced aggression and excitement during handling. No discernable intoxication was evident after 8 min and blood and brain levels had fallen to 10 and 6 mg/L or kg, respectively. Plots of concentration (log) versus time were consistent with a two compartment model. Initial distribution was rapid with average half life (t((1/2))) during the alpha phase of 9 s for blood, 18 s for brain and 27 s in cardiac tissue. During beta slope elimination average t((1/2)) was 86 s in blood, 110 s in brain and 168 s in heart. Late elimination half lives were longer with blood gamma = 240 s, brain gamma = 340 s, and heart gamma = 231 s. Following acute exposure the Vd = 0.06 L, beta = 0.48 min(-1), AUC = 409.8 mg.min L(-1), and CL from blood was 0.03 L min(-1). The calculated toxicokinetic data may underestimate these parameters if DFE is abused chronically due to continued uptake into lowly perfused tissues with repeated dosing.

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.

77 FR 16562 - Solicitation for a Cooperative Agreement-Curriculum Development for MET, ECCP, and ICMS Training...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... designed to be delivered to staff at the SCA/DFE sites. The key elements from the ICMS approach that are... to design an MET approach appropriate for the SCA/DFE intervention which may differ from the... approaches, techniques, or design aspects proposed that will enhance the project? Organizational (35%) Does...

Adsorption induced modification of in-plane magnetic anisotropy in epitaxial Co and Fe/Co films on Fe(110)

NASA Astrophysics Data System (ADS)

Ślezak, M.; Ślezak, T.; Matlak, K.; DróŻdŻ, P.; Korecki, J.

2018-05-01

A study of in-plane magnetic anisotropy (MA) in epitaxial bcc Co films and Fe/Co bilayers on a Fe(110) surface is reported. Surface MA of as-deposited Co films and Fe/Co bilayers strongly depends on the Co (dCo) and Fe (dFe) thickness. Adsorption of residual gases drastically modifies in-plane MA of both Co films and Fe/Co bilayers. We present two dimensional MA maps in the (dCo, dFe) space for both as grown and adsorption-modified films. Our results indicate how to precisely engineer in-plane MA that can be controlled by dCo, dFe and is sensitive to the residual gas adsorption.

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.

MIMO equalization with adaptive step size for few-mode fiber transmission systems.

PubMed

van Uden, Roy G H; Okonkwo, Chigo M; Sleiffer, Vincent A J M; de Waardt, Hugo; Koonen, Antonius M J

2014-01-13

Optical multiple-input multiple-output (MIMO) transmission systems generally employ minimum mean squared error time or frequency domain equalizers. Using an experimental 3-mode dual polarization coherent transmission setup, we show that the convergence time of the MMSE time domain equalizer (TDE) and frequency domain equalizer (FDE) can be reduced by approximately 50% and 30%, respectively. The criterion used to estimate the system convergence time is the time it takes for the MIMO equalizer to reach an average output error which is within a margin of 5% of the average output error after 50,000 symbols. The convergence reduction difference between the TDE and FDE is attributed to the limited maximum step size for stable convergence of the frequency domain equalizer. The adaptive step size requires a small overhead in the form of a lookup table. It is highlighted that the convergence time reduction is achieved without sacrificing optical signal-to-noise ratio performance.

Behavioral assessment of adaptive feedback equalization in a digital hearing aid.

PubMed

French-St George, M; Wood, D J; Engebretson, A M

1993-01-01

An evaluation was made of the efficacy of a digital feedback equalization algorithm employed by the Central Institute for the Deaf Wearable Adaptive Digital Hearing Aid. Three questions were addressed: 1) Does acoustic feedback limit gain adjustments made by hearing aid users? 2) Does feedback equalization permit users with hearing-impairment to select more gain without feedback? and, 3) If more gain is used when feedback equalization is active, does word identification performance improve? Nine subjects with hearing impairment participated in the study. Results suggest that listeners with hearing impairment are indeed limited by acoustic feedback when listening to soft speech (55 dB A) in quiet. The average listener used an additional 4 dB gain when feedback equalization was active. This additional gain resulted in an average 10 rationalized arcsine units (RAU) improvement in word identification score.

Temporal variability of dissolved iron species in the mesopelagic zone at Ocean Station PAPA

NASA Astrophysics Data System (ADS)

Schallenberg, Christina; Ross, Andrew R. S.; Davidson, Ashley B.; Stewart, Gillian M.; Cullen, Jay T.

2017-08-01

Deposition of atmospheric aerosols to the surface ocean is considered an important mechanism for the supply of iron (Fe) to remote ocean regions, but direct observations of the oceanic response to aerosol deposition are sparse. In the high nutrient, low chlorophyll (HNLC) subarctic Pacific Ocean we observed a dissolved Fe and Fe(II) anomaly at depth that is best explained as the result of aerosol deposition from Siberian forest fires in May 2012. Interestingly, there was no evidence of enhanced dFe concentrations in surface waters, nor was there a detectable phytoplankton bloom in response to the suspected aerosol deposition. Dissolved Fe (dFe) and Fe(II) showed the strongest enhancement in the subsurface oxygen deficient zone (ODZ), where oxygen concentrations <50 μmol kg-1 are prevalent. In the upper 200 m, dFe concentrations were at or below historic background levels, consistent with a short residence time of aerosol particles in surface waters and possible scavenging loss of dFe. Aerosol toxicity and/or dominance of particle scavenging over dissolution of Fe in the upper water column may have contributed to the lack of a strong phytoplankton response.

Seasonal and spatial variabilities in northern Gulf of Alaska surface water iron concentrations driven by shelf sediment resuspension, glacial meltwater, a Yakutat eddy, and dust

NASA Astrophysics Data System (ADS)

Crusius, John; Schroth, Andrew W.; Resing, Joseph A.; Cullen, Jay; Campbell, Robert W.

2017-06-01

Phytoplankton growth in the Gulf of Alaska (GoA) is limited by iron (Fe), yet Fe sources are poorly constrained. We examine the temporal and spatial distributions of Fe, and its sources in the GoA, based on data from three cruises carried out in 2010 from the Copper River (AK) mouth to beyond the shelf break. April data are the first to describe late winter Fe behavior before surface water nitrate depletion began. Sediment resuspension during winter and spring storms generated high "total dissolvable Fe" (TDFe) concentrations of 1000 nmol kg-1 along the entire continental shelf, which decreased beyond the shelf break. In July, high TDFe concentrations were similar on the shelf, but more spatially variable, and driven by low-salinity glacial meltwater. Conversely, dissolved Fe (DFe) concentrations in surface waters were far lower and more seasonally consistent, ranging from 4 nmol kg-1 in nearshore waters to 0.6-1.5 nmol kg-1 seaward of the shelf break during April and July, despite dramatic depletion of nitrate over that period. The reasonably constant DFe concentrations are likely maintained during the year across the shelf by complexation by strong organic ligands, coupled with ample supply of labile particulate Fe. The April DFe data can be simulated using a simple numerical model that assumes a DFe flux from shelf sediments, horizontal transport by eddy diffusion, and removal by scavenging. Given how global change is altering many processes impacting the Fe cycle, additional studies are needed to examine controls on DFe in the Gulf of Alaska.

A normative inference approach for optimal sample sizes in decisions from experience

PubMed Central

Ostwald, Dirk; Starke, Ludger; Hertwig, Ralph

2015-01-01

“Decisions from experience” (DFE) refers to a body of work that emerged in research on behavioral decision making over the last decade. One of the major experimental paradigms employed to study experience-based choice is the “sampling paradigm,” which serves as a model of decision making under limited knowledge about the statistical structure of the world. In this paradigm respondents are presented with two payoff distributions, which, in contrast to standard approaches in behavioral economics, are specified not in terms of explicit outcome-probability information, but by the opportunity to sample outcomes from each distribution without economic consequences. Participants are encouraged to explore the distributions until they feel confident enough to decide from which they would prefer to draw from in a final trial involving real monetary payoffs. One commonly employed measure to characterize the behavior of participants in the sampling paradigm is the sample size, that is, the number of outcome draws which participants choose to obtain from each distribution prior to terminating sampling. A natural question that arises in this context concerns the “optimal” sample size, which could be used as a normative benchmark to evaluate human sampling behavior in DFE. In this theoretical study, we relate the DFE sampling paradigm to the classical statistical decision theoretic literature and, under a probabilistic inference assumption, evaluate optimal sample sizes for DFE. In our treatment we go beyond analytically established results by showing how the classical statistical decision theoretic framework can be used to derive optimal sample sizes under arbitrary, but numerically evaluable, constraints. Finally, we critically evaluate the value of deriving optimal sample sizes under this framework as testable predictions for the experimental study of sampling behavior in DFE. PMID:26441720

"It's All about Developing the Whole Child": An Examination of the "Legacy" Benefits of Youth Sport Trust's School-Based Inclusion Initiatives

ERIC Educational Resources Information Center

Black, Alison; Costello, Rebecca; Craft, Anna; Katene, Will

2015-01-01

Between 2011 and 2013, the Department for Education (DfE) in England made £3.3 million available to support the development of opportunities for young disabled people to access high-quality physical education and school sport. The DfE with the Youth Sport Trust (YST) developed a range of initiatives to help meet this aim, including Project…

Iron Biogeochemistry in the High Latitude North Atlantic Ocean.

PubMed

Achterberg, Eric P; Steigenberger, Sebastian; Marsay, Chris M; LeMoigne, Frédéric A C; Painter, Stuart C; Baker, Alex R; Connelly, Douglas P; Moore, C Mark; Tagliabue, Alessandro; Tanhua, Toste

2018-01-19

Iron (Fe) is an essential micronutrient for marine microbial organisms, and low supply controls productivity in large parts of the world's ocean. The high latitude North Atlantic is seasonally Fe limited, but Fe distributions and source strengths are poorly constrained. Surface ocean dissolved Fe (DFe) concentrations were low in the study region (<0.1 nM) in summer 2010, with significant perturbations during spring 2010 in the Iceland Basin as a result of an eruption of the Eyjafjallajökull volcano (up to 2.5 nM DFe near Iceland) with biogeochemical consequences. Deep water concentrations in the vicinity of the Reykjanes Ridge system were influenced by pronounced sediment resuspension, with indications for additional inputs by hydrothermal vents, with subsequent lateral transport of Fe and manganese plumes of up to 250-300 km. Particulate Fe formed the dominant pool, as evidenced by 4-17 fold higher total dissolvable Fe compared with DFe concentrations, and a dynamic exchange between the fractions appeared to buffer deep water DFe. Here we show that Fe supply associated with deep winter mixing (up to 103 nmol m -2 d -1 ) was at least ca. 4-10 times higher than atmospheric deposition, diffusive fluxes at the base of the summer mixed layer, and horizontal surface ocean fluxes.

Free-space optics mode-wavelength division multiplexing system using LG modes based on decision feedback equalization

NASA Astrophysics Data System (ADS)

Amphawan, Angela; Ghazi, Alaan; Al-dawoodi, Aras

2017-11-01

A free-space optics mode-wavelength division multiplexing (MWDM) system using Laguerre-Gaussian (LG) modes is designed using decision feedback equalization for controlling mode coupling and combating inter symbol interference so as to increase channel diversity. In this paper, a data rate of 24 Gbps is achieved for a FSO MWDM channel of 2.6 km in length using feedback equalization. Simulation results show significant improvement in eye diagrams and bit-error rates before and after decision feedback equalization.

The Montreal Cognitive Assessment and the mini-mental state examination as screening instruments for cognitive impairment: item analyses and threshold scores.

PubMed

Damian, Anne M; Jacobson, Sandra A; Hentz, Joseph G; Belden, Christine M; Shill, Holly A; Sabbagh, Marwan N; Caviness, John N; Adler, Charles H

2011-01-01

To perform an item analysis of the Montreal Cognitive Assessment (MoCA) versus the Mini-Mental State Examination (MMSE) in the prediction of cognitive impairment, and to examine the characteristics of different MoCA threshold scores. 135 subjects enrolled in a longitudinal clinicopathologic study were administered the MoCA by a single physician and the MMSE by a trained research assistant. Subjects were classified as cognitively impaired or cognitively normal based on independent neuropsychological testing. 89 subjects were found to be cognitively normal, and 46 cognitively impaired (20 with dementia, 26 with mild cognitive impairment). The MoCA was superior in both sensitivity and specificity to the MMSE, although not all MoCA tasks were of equal predictive value. A MoCA threshold score of 26 had a sensitivity of 98% and a specificity of 52% in this population. In a population with a 20% prevalence of cognitive impairment, a threshold of 24 was optimal (negative predictive value 96%, positive predictive value 47%). This analysis suggests the potential for creating an abbreviated MoCA. For screening in primary care, the MoCA threshold of 26 appears optimal. For testing in a memory disorders clinic, a lower threshold has better predictive value. Copyright © 2011 S. Karger AG, Basel.

Blind Channel Equalization with Colored Source Based on Constrained Optimization Methods

NASA Astrophysics Data System (ADS)

Wang, Yunhua; DeBrunner, Linda; DeBrunner, Victor; Zhou, Dayong

2008-12-01

Tsatsanis and Xu have applied the constrained minimum output variance (CMOV) principle to directly blind equalize a linear channel—a technique that has proven effective with white inputs. It is generally assumed in the literature that their CMOV method can also effectively equalize a linear channel with a colored source. In this paper, we prove that colored inputs will cause the equalizer to incorrectly converge due to inadequate constraints. We also introduce a new blind channel equalizer algorithm that is based on the CMOV principle, but with a different constraint that will correctly handle colored sources. Our proposed algorithm works for channels with either white or colored inputs and performs equivalently to the trained minimum mean-square error (MMSE) equalizer under high SNR. Thus, our proposed algorithm may be regarded as an extension of the CMOV algorithm proposed by Tsatsanis and Xu. We also introduce several methods to improve the performance of our introduced algorithm in the low SNR condition. Simulation results show the superior performance of our proposed methods.

Experimental Results and Issues on Equalization for Nonlinear Memory Channel: Pre-Cursor Enhanced Ram-DFE Canceler

NASA Technical Reports Server (NTRS)

Yuan, Lu; LeBlanc, James

1998-01-01

This thesis investigates the effects of the High Power Amplifier (HPA) and the filters over a satellite or telemetry channel. The Volterra series expression is presented for the nonlinear channel with memory, and the algorithm is based on the finite-state machine model. A RAM-based algorithm operating on the receiver side, Pre-cursor Enhanced RAM-FSE Canceler (PERC) is developed. A high order modulation scheme , 16-QAM is used for simulation, the results show that PERC provides an efficient and reliable method to transmit data on the bandlimited nonlinear channel. The contribution of PERC algorithm is that it includes both pre-cursors and post-cursors as the RAM address lines, and suggests a new way to make decision on the pre-addresses. Compared with the RAM-DFE structure that only includes post- addresses, the BER versus Eb/NO performance of PERC is substantially enhanced. Experiments are performed for PERC algorithms with different parameters on AWGN channels, and the results are compared and analyzed. The investigation of this thesis includes software simulation and hardware verification. Hardware is setup to collect actual TWT data. Simulation on both the software-generated data and the real-world data are performed. Practical limitations are considered for the hardware collected data. Simulation results verified the reliability of the PERC algorithm. This work was conducted at NMSU in the Center for Space Telemetering and Telecommunications Systems in the Klipsch School of Electrical and Computer Engineering Department.

Triggered Seismicity in Utah from the November 3, 2002, Denali Fault Earthquake

NASA Astrophysics Data System (ADS)

Pankow, K. L.; Nava, S. J.; Pechmann, J. C.; Arabasz, W. J.

2002-12-01

Coincident with the arrival of the surface waves from the November 3, 2002, Mw 7.9 Denali Fault, Alaska earthquake (DFE), the University of Utah Seismograph Stations (UUSS) regional seismic network detected a marked increase in seismicity along the Intermountain Seismic Belt (ISB) in central and north-central Utah. The number of earthquakes per day in Utah located automatically by the UUSS's Earthworm system in the week following the DFE was approximately double the long-term average during the preceding nine months. From these preliminary data, the increased seismicity appears to be characterized by small magnitude events (M = 3.2) and concentrated in five distinct spatial clusters within the ISB between 38.75°and 42.0° N. The first of these earthquakes was an M 2.2 event located ~20 km east of Salt Lake City, Utah, which occurred during the arrival of the Love waves from the DFE. The increase in Utah earthquake activity at the time of the arrival of the surface waves from the DFE suggests that these surface waves triggered earthquakes in Utah at distances of more than 3,000 km from the source. We estimated the peak dynamic shear stress caused by these surface waves from measurements of their peak vector velocities at 43 recording sites: 37 strong-motion stations of the Advanced National Seismic System and six broadband stations. (The records from six other broadband instruments in the region of interest were clipped.) The estimated peak stresses ranged from 1.2 bars to 3.5 bars with a mean of 2.3 bars, and generally occurred during the arrival of Love waves of ~15 sec period. These peak dynamic shear stress estimates are comparable to those obtained from recordings of the 1992 Mw 7.3 Landers, California, earthquake in regions where the Landers earthquake triggered increased seismicity. We plan to present more complete analyses of UUSS seismic network data, further testing our hypothesis that the DFE remotely triggered seismicity in Utah. This hypothesis is important to investigate because well-documented evidence for triggering of seismicity by distant earthquakes comes primarily from areas characterized by recent volcanic or geothermal activity. The regions of apparent triggered seismicity from the DFE in Utah fall into neither of these two categories.

Thermal and ion-induced surface reactions of 1,1-difluoroethylene on Si(111)7 x 7 and vitreous SiO2.

PubMed

He, Zhenhua; Leung, K T

2005-08-11

Thermal and ion-induced reactions of 1,1-difluoroethylene (1,1-C2H2F2 or iso-DFE) on Si(111)7 x 7 and vitreous SiO2 surfaces have been investigated by vibrational electron energy loss spectroscopy and thermal desorption spectrometry. Like ethylene, iso-DFE predominantly chemisorbs via a [2 + 2] cycloaddition mechanism onto the 7 x 7 surface as a di-sigma-bonded difluoroethane-1,2-diyl adstructure, which undergoes H abstraction and defluorination, producing hydrocarbon fragments and SiF(x) (x = 1-3) upon annealing to >700 K. Ion irradiation of Si(111)7 x 7 in iso-DFE at 50 eV impact energy appears to substantially enhance the production of hydrocarbon fragments and SiF(x)(), leading to stronger SiF4 desorption products over an extended temperature range (400-900 K). The observed SiC and SiF(x) produced on the 7 x 7 surface by ion irradiation in iso-DFE are found to be similar to those obtained by ion irradiation in the fluoromethane homologues, CF4 and CH2F2. The production of higher relative concentrations for the larger SiF(x) and C2-containing fragments is evidently favored on the 7 x 7 surface. On a vitreous SiO2 surface, ion irradiation in iso-DFE, unlike that in CF4 and CH2F2, appears to produce less SiF(x) than that on the 7 x 7 surface, which indicates that surface O does not interact strongly with the C2-containing fragments. The presence or absence of a C=C bond and the relative F-to-C ratio of the sputtering gas could therefore produce important effects on the resulting surface products obtained by low-energy ion irradiation.

High-accuracy determination of iron in seawater by isotope dilution multiple collector inductively coupled plasma mass spectrometry (ID-MC-ICP-MS) using nitrilotriacetic acid chelating resin for pre-concentration and matrix separation.

PubMed

de Jong, Jeroen; Schoemann, Véronique; Lannuzel, Delphine; Tison, Jean-Louis; Mattielli, Nadine

2008-08-15

In the present paper we describe a robust and simple method to measure dissolved iron (DFe) concentrations in seawater down to <0.1 nmol L(-1) level, by isotope dilution multiple collector inductively coupled plasma mass spectrometry (ID-MC-ICP-MS) using a (54)Fe spike and measuring the (57)Fe/(54)Fe ratio. The method provides for a pre-concentration step (100:1) by micro-columns filled with the resin NTA Superflow of 50 mL seawater samples acidified to pH 1.9. NTA Superflow is demonstrated to quantitatively extract Fe from acidified seawater samples at this pH. Blanks are kept low (grand mean 0.045+/-0.020 nmol L(-1), n=21, 3 x S.D. limit of detection per session 0.020-0.069 nmol L(-1) range), as no buffer is required to adjust the sample pH for optimal extraction, and no other reagents are needed than ultrapure nitric acid, 12 mM H(2)O(2), and acidified (pH 1.9) ultra-high purity (UHP) water. We measured SAFe (sampling and analysis of Fe) reference seawater samples Surface-1 (0.097+/-0.043 nmol L(-1)) and Deep-2 (0.91+/-0.17 nmol L(-1)) and obtained results that were in excellent agreement with their DFe consensus values: 0.118+/-0.028 nmol L(-1) (n=7) for Surface-1 and 0.932+/-0.059 nmol L(-1) (n=9) for Deep-2. We also present a vertical DFe profile from the western Weddell Sea collected during the Ice Station Polarstern (ISPOL) ice drift experiment (ANT XXII-2, RV Polarstern) in November 2004-January 2005. The profile shows near-surface DFe concentrations of approximately 0.6 nmol L(-1) and bottom water enrichment up to 23 nmol L(-1) DFe.

Theobroma cacao extract attenuates the development of Dermatophagoides farinae-induced atopic dermatitis-like symptoms in NC/Nga mice.

PubMed

Kang, Heerim; Lee, Chang Hyung; Kim, Jong Rhan; Kwon, Jung Yeon; Son, Myoung-Jin; Kim, Jong-Eun; Lee, Ki Won

2017-02-01

Cacao beans from Theobroma cacao are an abundant source of polyphenols, particularly flavonoids. Previous studies demonstrated that cacao flavanols decrease pro-inflammatory cytokines resulting in the alleviation of allergic symptoms. We sought to investigate the effects of cacao extract (CE) on Dermatophagoides farinae extract (DFE)-induced atopic dermatitis (AD)-like symptoms. CE attenuated DFE-induced AD-like symptoms as assessed by skin lesion analyses, dermatitis score, and skin thickness. Histopathological analysis revealed that CE suppressed DFE-induced immune cell infiltration into the skin. These observations occurred concomitantly with the downregulation of inflammatory markers including serum immunoglobulin (Ig) E, chemokine; thymus and activation-regulated chemokine and macrophage-derived chemokine as well as the skin-derived cytokines interleukin (IL)-4, IL-5, and interferon-γ. CE also significantly alleviated transepidermal water loss and increased skin hydration. These results suggest that CE, a natural phytochemical-rich food, has potential therapeutic efficacy for the treatment of AD. Copyright © 2016. Published by Elsevier Ltd.

Iron Supply and Demand in an Antarctic Shelf Ecosystem

NASA Astrophysics Data System (ADS)

McGillicuddy, D. J., Jr.; Sedwick, P.; Dinniman, M. S.; Arrigo, K. R.; Bibby, T. S.; Greenan, B. J. W.; Hofmann, E. E.; Klinck, J. M., II; Smith, W.; Mack, S. L.; Marsay, C. M.; Sohst, B. M.; van Dijken, G.

2016-02-01

The Ross Sea sustains a rich ecosystem and is the most productive sector of the Southern Ocean. Most of this production occurs within a polynya during the November-February period, when the availability of dissolved iron (dFe) is thought to exert the major control on phytoplankton growth. Here we combine new data on the distribution of dFe, high-resolution model simulations of ice melt and regional circulation, and satellite-based estimates of primary production to quantify iron supply and demand over the Ross Sea continental shelf. Our analysis suggests that the largest sources of dFe to the euphotic zone are wintertime mixing and melting sea ice, with a lesser input from intrusions of Circumpolar Deep Water, and a small amount from melting glacial ice. Together these sources are in approximate balance with the annual biological dFe demand inferred from satellite-based productivity algorithms, although both the supply and demand estimates have large uncertainties. Our findings illustrate the complexities of iron cycling in the Southern Ocean, highlighting the heterogeneity of the underlying processes along the Antarctic continental margin. Explicit representation of these complexities, and the temporal variability in both proximate and ultimate sources of iron, will be necessary to understand how a changing climate will affect this important ecosystem and its influence on biogeochemical cycles. Reduction of the present uncertainties in iron supply and demand will require coupled observational and modeling systems capable of resolving the wide range of physical, biological, and chemical processes involved.

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.

"3D fusion" echocardiography improves 3D left ventricular assessment: comparison with 2D contrast echocardiography.

PubMed

Augustine, Daniel; Yaqub, Mohammad; Szmigielski, Cezary; Lima, Eduardo; Petersen, Steffen E; Becher, Harald; Noble, J Alison; Leeson, Paul

2015-02-01

Three-dimensional fusion echocardiography (3DFE) is a novel postprocessing approach that utilizes imaging data acquired from multiple 3D acquisitions. We assessed image quality, endocardial border definition, and cardiac wall motion in patients using 3DFE compared to standard 3D images (3D) and results obtained with contrast echocardiography (2DC). Twenty-four patients (mean age 66.9 ± 13 years, 17 males, 7 females) undergoing 2DC had three, noncontrast, 3D apical volumes acquired at rest. Images were fused using an automated image fusion approach. Quality of the 3DFE was compared to both 3D and 2DC based on contrast-to-noise ratio (CNR) and endocardial border definition. We then compared clinical wall-motion score index (WMSI) calculated from 3DFE and 3D to those obtained from 2DC images. Fused 3D volumes had significantly improved CNR (8.92 ± 1.35 vs. 6.59 ± 1.19, P < 0.0005) and segmental image quality (2.42 ± 0.99 vs. 1.93 ± 1.18, P < 0.005) compared to unfused 3D acquisitions. Levels achieved were closer to scores for 2D contrast images (CNR: 9.04 ± 2.21, P = 0.6; segmental image quality: 2.91 ± 0.37, P < 0.005). WMSI calculated from fused 3D volumes did not differ significantly from those obtained from 2D contrast echocardiography (1.06 ± 0.09 vs. 1.07 ± 0.15, P = 0.69), whereas unfused images produced significantly more variable results (1.19 ± 0.30). This was confirmed by a better intraclass correlation coefficient (ICC 0.72; 95% CI 0.32-0.88) relative to comparisons with unfused images (ICC 0.56; 95% CI 0.02-0.81). 3DFE significantly improves left ventricular image quality compared to unfused 3D in a patient population and allows noncontrast assessment of wall motion that approaches that achieved with 2D contrast echocardiography. © 2014, Wiley Periodicals, Inc.

Solvent organization around the perfluoro group of coumarin 153 governs its photophysical properties: An experimental and simulation study of coumarin dyes in ethanol as well as fluorinated ethanol solvents.

PubMed

Mondal, Saptarsi; Halder, Ritaban; Biswas, Biswajit; Jana, Biman; Singh, Prashant Chandra

2016-05-14

The self-aggregation property of the perfluoro group containing molecules makes it important in the research fields of biology and polymer and organic synthesis. In the quest of understanding the role of the perfluoro group on the photophysical properties of perfluoro-containing molecules in biologically important fluoroethanol solvents, we have applied photophysical as well as molecular dynamics simulation techniques to explore the properties of perfluoro groups containing molecule coumarin-153 (C153) in ethanol (ETH), monofluoroethanol (MFE), difluoroethanol (DFE), and trifluoroethanol (TFE) and compared them with the molecules without perfluoro moiety, namely coumarin-6H (C6H) and coumarin-480 (C480). In contrast to C6H and C480, the excited state lifetime of C153 in fluorinated ETHs is not monotonic. The excited state lifetime of C153 decreases in MFE and DFE as compared to ETH, whereas in TFE, it increases as compared to MFE and DFE. Molecular dynamics simulation reveals that the carbon terminal away from the OH group of fluorinated ETHs has a preferential orientation near the perfluoro (CF3) group of C153. In MFE and DFE, the CF3 group of C153 prefers to have a CF2-F⋯H -(CHF) type of electrostatic interaction over CF2-F⋯F -(CH2) kind of dispersion interaction which increases the rate of nonradiative decay, probably due to the electrostatic nature of the CF2-F⋯H -(CHF) hydrogen bond. On the other hand, in TFE, C-F⋯ F-C type of dispersion interaction, also known as fluorous interaction, takes place between the CF3 groups of C153 and TFE which decreases the rate of nonradiative rate as compared to MFE and DFE, leading to the increased lifetime of C153 in TFE. Photophysical and MD simulation studies clearly depict that the structural organization of solvents and their interaction with the fluorocarbon group are crucial factors for the photophysical behavior of the fluorocarbon containing molecules.

Solvent organization around the perfluoro group of coumarin 153 governs its photophysical properties: An experimental and simulation study of coumarin dyes in ethanol as well as fluorinated ethanol solvents

NASA Astrophysics Data System (ADS)

Mondal, Saptarsi; Halder, Ritaban; Biswas, Biswajit; Jana, Biman; Singh, Prashant Chandra

2016-05-01

The self-aggregation property of the perfluoro group containing molecules makes it important in the research fields of biology and polymer and organic synthesis. In the quest of understanding the role of the perfluoro group on the photophysical properties of perfluoro-containing molecules in biologically important fluoroethanol solvents, we have applied photophysical as well as molecular dynamics simulation techniques to explore the properties of perfluoro groups containing molecule coumarin-153 (C153) in ethanol (ETH), monofluoroethanol (MFE), difluoroethanol (DFE), and trifluoroethanol (TFE) and compared them with the molecules without perfluoro moiety, namely coumarin-6H (C6H) and coumarin-480 (C480). In contrast to C6H and C480, the excited state lifetime of C153 in fluorinated ETHs is not monotonic. The excited state lifetime of C153 decreases in MFE and DFE as compared to ETH, whereas in TFE, it increases as compared to MFE and DFE. Molecular dynamics simulation reveals that the carbon terminal away from the OH group of fluorinated ETHs has a preferential orientation near the perfluoro (CF3) group of C153. In MFE and DFE, the CF3 group of C153 prefers to have a CF2—F⋯H —(CHF) type of electrostatic interaction over CF2—F⋯F —(CH2) kind of dispersion interaction which increases the rate of nonradiative decay, probably due to the electrostatic nature of the CF2—F⋯H —(CHF) hydrogen bond. On the other hand, in TFE, C—F⋯ F—C type of dispersion interaction, also known as fluorous interaction, takes place between the CF3 groups of C153 and TFE which decreases the rate of nonradiative rate as compared to MFE and DFE, leading to the increased lifetime of C153 in TFE. Photophysical and MD simulation studies clearly depict that the structural organization of solvents and their interaction with the fluorocarbon group are crucial factors for the photophysical behavior of the fluorocarbon containing molecules.

Properties of an adaptive feedback equalization algorithm.

PubMed

Engebretson, A M; French-St George, M

1993-01-01

This paper describes a new approach to feedback equalization for hearing aids. The method involves the use of an adaptive algorithm that estimates and tracks the characteristic of the hearing aid feedback path. The algorithm is described and the results of simulation studies and bench testing are presented.

Immunopotentiator from Pantoea agglomerans Prevents Atopic Dermatitis Induced by Dermatophagoides farinae Extract in NC/Nga Mouse.

PubMed

Wakame, Koji; Komatsu, Ken-Ichi; Inagawa, Hiroyuki; Nishizawa, Takashi

2015-08-01

Pantoea agglomerans LPS (immunopotentiator from Pantoea agglomerans 1: IP-PA1) has been reported to have anti-inflammatory effects in in vitro and in vivo models. The aim of the present study was to investigate the effects of orally-administered IP-PA1 on atopic dermatitis (AD) symptoms induced by Dermatophagoides farinae body extract (DFE) in NC/Nga mice. Using the NC/Nga AD murine model, mice were orally administered 0.1% (High) or 0.01% (Low) water-containing IP-PA1. Skin lesion assessment and blood collection from the caudal vein was performed on days 0, 7, 21 and 31. On day 31, all mice were sacrificed and blood, skin, spleen, as well as intestine samples, were obtained. Assessment score of the skin lesion and serum immunoglobulin E (IgE) level of both IP-PA1 groups were significantly lower than that of the DFE group on days 14 and 21. The serum periostin and thymus and activation-regulated chemokine (TARC) level of IP-PA1-Low group was significantly lower than that of the DFE group on day 31. On histological examination of the skin, hyperplasia of epidermal and dermal layers and infiltration of inflammatory cells were suppressed by IP-PA1 administration. Deposition of periostin was observed in the DFE group skin tissue. Moreover, the CD4(+)/CD8(+) ratio of splenic T-cells increased by IP-PA1 administration. IP-PA1 administration may have an inhibitory effect on AD skin lesions. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Characterizability of metabolic pathway systems from time series data.

PubMed

Voit, Eberhard O

2013-12-01

Over the past decade, the biomathematical community has devoted substantial effort to the complicated challenge of estimating parameter values for biological systems models. An even more difficult issue is the characterization of functional forms for the processes that govern these systems. Most parameter estimation approaches tacitly assume that these forms are known or can be assumed with some validity. However, this assumption is not always true. The recently proposed method of Dynamic Flux Estimation (DFE) addresses this problem in a genuinely novel fashion for metabolic pathway systems. Specifically, DFE allows the characterization of fluxes within such systems through an analysis of metabolic time series data. Its main drawback is the fact that DFE can only directly be applied if the pathway system contains as many metabolites as unknown fluxes. This situation is unfortunately rare. To overcome this roadblock, earlier work in this field had proposed strategies for augmenting the set of unknown fluxes with independent kinetic information, which however is not always available. Employing Moore-Penrose pseudo-inverse methods of linear algebra, the present article discusses an approach for characterizing fluxes from metabolic time series data that is applicable even if the pathway system is underdetermined and contains more fluxes than metabolites. Intriguingly, this approach is independent of a specific modeling framework and unaffected by noise in the experimental time series data. The results reveal whether any fluxes may be characterized and, if so, which subset is characterizable. They also help with the identification of fluxes that, if they could be determined independently, would allow the application of DFE. Copyright © 2013 Elsevier Inc. All rights reserved.

Characterizability of Metabolic Pathway Systems from Time Series Data

PubMed Central

Voit, Eberhard O.

2013-01-01

Over the past decade, the biomathematical community has devoted substantial effort to the complicated challenge of estimating parameter values for biological systems models. An even more difficult issue is the characterization of functional forms for the processes that govern these systems. Most parameter estimation approaches tacitly assume that these forms are known or can be assumed with some validity. However, this assumption is not always true. The recently proposed method of Dynamic Flux Estimation (DFE) addresses this problem in a genuinely novel fashion for metabolic pathway systems. Specifically, DFE allows the characterization of fluxes within such systems through an analysis of metabolic time series data. Its main drawback is the fact that DFE can only directly be applied if the pathway system contains as many metabolites as unknown fluxes. This situation is unfortunately rare. To overcome this roadblock, earlier work in this field had proposed strategies for augmenting the set of unknown fluxes with independent kinetic information, which however is not always available. Employing Moore-Penrose pseudo-inverse methods of linear algebra, the present article discusses an approach for characterizing fluxes from metabolic time series data that is applicable even if the pathway system is underdetermined and contains more fluxes than metabolites. Intriguingly, this approach is independent of a specific modeling framework and unaffected by noise in the experimental time series data. The results reveal whether any fluxes may be characterized and, if so, which subset is characterizable. They also help with the identification of fluxes that, if they could be determined independently, would allow the application of DFE. PMID:23391489

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

High resolution spectroscopy of 1,2-difluoroethane in a molecular beam: A case study of vibrational mode-coupling

NASA Astrophysics Data System (ADS)

Mork, Steven W.; Miller, C. Cameron; Philips, Laura A.

1992-09-01

The high resolution infrared spectrum of 1,2-difluoroethane (DFE) in a molecular beam has been obtained over the 2978-2996 cm-1 spectral region. This region corresponds to the symmetric combination of asymmetric C-H stretches in DFE. Observed rotational fine structure indicates that this C-H stretch is undergoing vibrational mode coupling to a single dark mode. The dark mode is split by approximately 19 cm-1 due to tunneling between the two identical gauche conformers. The mechanism of the coupling is largely anharmonic with a minor component of B/C plane Coriolis coupling. Effects of centrifugal distortion along the molecular A-axis are also observed. Analysis of the fine structure identifies the dark state as being composed of C-C torsion, CCF bend, and CH2 rock. Coupling between the C-H stretches and the C-C torsion is of particular interest because DFE has been observed to undergo vibrationally induced isomerization from the gauche to trans conformer upon excitation of the C-H stretch.

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.

Cardiomyopathy from 1,1-Difluoroethane Inhalation.

PubMed

Kumar, Suwen; Joginpally, Tejaswini; Kim, David; Yadava, Mrinal; Norgais, Konchok; Laird-Fick, Heather S

2016-10-01

Consumer aerosol products can be inhaled for their psychoactive effects, but with attendant adverse health effects including "sudden sniffing death." Cardiomyopathy has rarely been described in association with 1,1-difluoroethane (DFE), a common aerosol propellant. We report a 33-year-old male who developed acute myocardial injury and global hypokinesis along with rhabdomyolysis, acute kidney injury, and fulminant hepatitis after 2 days' nearly continuous huffing. Workup for other causes, including underlying coronary artery disease, was negative. His cardiac function improved over time. The exact mechanism of DFE's effects is uncertain but may include catecholamine-induced cardiomyopathy, coronary vasospasm, or direct cellular toxicity.

Application of neural network in the study of combustion rate of natural gas/diesel dual fuel engine.

PubMed

Yan, Zhao-Da; Zhou, Chong-Guang; Su, Shi-Chuan; Liu, Zhen-Tao; Wang, Xi-Zhen

2003-01-01

In order to predict and improve the performance of natural gas/diesel dual fuel engine (DFE), a combustion rate model based on forward neural network was built to study the combustion process of the DFE. The effect of the operating parameters on combustion rate was also studied by means of this model. The study showed that the predicted results were good agreement with the experimental data. It was proved that the developed combustion rate model could be used to successfully predict and optimize the combustion process of dual fuel engine.

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.

Influence of different acid and alkaline cleaning agents on the effects of irrigation of synthetic dairy factory effluent on soil quality, ryegrass growth and nutrient uptake.

PubMed

Liu, Y-Y; Haynes, R J

2013-01-01

The aim of this study was to examine the effects of replacement of phosphoric acid with nitric or acetic acid, and replacement of NaOH with KOH, as cleaning agents in dairy factories, on the effects that irrigation of dairy factory effluent (DFE) has on the soil-plant system. A 16-week greenhouse study was carried out in which the effects of addition of synthetic dairy factory effluent containing (a) milk residues alone or milk residues plus (b) H(3)PO(4)/NaOH, (c) H(3)PO(4)/HNO(3)/NaOH or (d) CH(3)COOH/KOH, on soil's chemical, physical and microbial properties and perennial ryegrass growth and nutrient uptake were investigated. The cumulative effect of DFE addition was to increase exchangeable Na, K, Ca, Mg, exchangeable sodium percentage, microbial biomass C and N and basal respiration in the soil. Dry matter yields of ryegrass were increased by additions of DFE other than that containing CH(3)COOH. Plant uptake of P, Ca and Mg was in the same order as their inputs in DFE but for Na; inputs were an order of magnitude greater than plant uptake. Replacement of NaOH by KOH resulted in increased accumulation of exchangeable K. The effects of added NaOH and KOH on promoting breakdown of soil aggregates during wet sieving (and formation of a < 0.25 mm size class) were similar. Replacement of H(2)PO(4) by HNO(3) is a viable but CH(3)COOH appears to have detrimental effects on plant growth. Replacement of NaOH by KOH lowers the likelihood of phytotoxic effects of Na, but K and Na have similar effects on disaggregation.

Time-dependent progression from the acute to chronic phases in atopic dermatitis induced by epicutaneous allergen stimulation in NC/Nga mice.

PubMed

Kim, Ji-Yun; Jeong, Mi Sook; Park, Mi Kyung; Lee, Mi-Kyung; Seo, Seong Jun

2014-01-01

Atopic dermatitis (AD) is a complicated skin condition influenced by genetic background and environmental factors. In this study, we applied Dermatophagoides farinae body extract (DfE) to the barrier-disrupted skin of NC/Nga mice twice a week for 8 weeks to identify the clinical and immunological factors in AD progression. Repeated application of the DfE to the skin of NC/Nga mice showed the similar consequences for the natural course of progression in human AD, histologically and immunologically. We confirmed that the AD-like skin lesions in NC/Nga mice did not last for the whole period of our experiment in spite of repeated topical applications of DfE twice a week. Topical DfE stimulation increased the skin mRNA expressions of Th1-, Th2- and Th17-related cytokines in the acute phase. The expression patterns of IL-4 and IL-13 in splenic T cells and skin lesions were consistent with the time course alterations of clinical features of AD-like skin symptoms. We also showed that there was a remission phase either just before or right after the chronic phase in this experimental model. Interestingly, splenic T-cell-derived IL-5 expression began to increase in the chronic phase, while skin-derived IL-5 mRNA expression increased in the acute phase. In conclusion, our results suggest that we should pay attention to the characteristics of each stage of AD progression and choose a suitable corresponding stage of animal model not only to elucidate the pathogenesis of AD but also to develop and evaluate therapeutic drugs for AD. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Accumulation of Fe oxyhydroxides in the Peruvian oxygen deficient zone implies non-oxygen dependent Fe oxidation

DOE PAGES

Heller, Maija I.; Lam, Phoebe J.; Moffett, James W.; ...

2017-05-19

Oxygen minimum zones (OMZs) have been proposed to be an important source of dissolved iron (Fe) into the interior ocean. However, previous studies in OMZs have shown a sharp decrease in total dissolved Fe (dFe) and/or dissolved Fe(II) (dFe(II)) concentrations at the shelf-break, despite constant temperature, salinity and continued lack of oxygen across the shelf-break. The loss of both total dFe and dFe(II) suggests a conversion of the dFe to particulate form, but studies that have coupled the reduction-oxidation (redox) speciation of both dissolved and particulate phases have not previously been done. Here in this work, we have measured themore » redox speciation and concentrations of both dissolved and particulate forms of Fe in samples collected during the U.S. GEOTRACES Eastern tropical Pacific Zonal Transect (EPZT) cruise in 2013 (GP16). This complete data set allows us to assess possible mechanisms for loss of dFe. We observed an offshore loss of dFe(II) within the oxygen deficient zone (ODZ), where dissolved oxygen is undetectable, accompanied by an increase in total particulate Fe (pFe). Total pFe concentrations were highest in the upper ODZ. X-ray absorption spectroscopy revealed that the pFe maximum was primarily in the Fe(III) form as Fe(III) oxyhydroxides. The remarkable similarity in the distributions of total particulate iron and nitrite suggests a role for nitrite in the oxidation of dFe(II) to pFe(III). Lastly, we present a conceptual model for the rapid redox cycling of Fe that occurs in ODZs, despite the absence of oxygen.« less

Accumulation of Fe oxyhydroxides in the Peruvian oxygen deficient zone implies non-oxygen dependent Fe oxidation

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

Heller, Maija I.; Lam, Phoebe J.; Moffett, James W.

Oxygen minimum zones (OMZs) have been proposed to be an important source of dissolved iron (Fe) into the interior ocean. However, previous studies in OMZs have shown a sharp decrease in total dissolved Fe (dFe) and/or dissolved Fe(II) (dFe(II)) concentrations at the shelf-break, despite constant temperature, salinity and continued lack of oxygen across the shelf-break. The loss of both total dFe and dFe(II) suggests a conversion of the dFe to particulate form, but studies that have coupled the reduction-oxidation (redox) speciation of both dissolved and particulate phases have not previously been done. Here in this work, we have measured themore » redox speciation and concentrations of both dissolved and particulate forms of Fe in samples collected during the U.S. GEOTRACES Eastern tropical Pacific Zonal Transect (EPZT) cruise in 2013 (GP16). This complete data set allows us to assess possible mechanisms for loss of dFe. We observed an offshore loss of dFe(II) within the oxygen deficient zone (ODZ), where dissolved oxygen is undetectable, accompanied by an increase in total particulate Fe (pFe). Total pFe concentrations were highest in the upper ODZ. X-ray absorption spectroscopy revealed that the pFe maximum was primarily in the Fe(III) form as Fe(III) oxyhydroxides. The remarkable similarity in the distributions of total particulate iron and nitrite suggests a role for nitrite in the oxidation of dFe(II) to pFe(III). Lastly, we present a conceptual model for the rapid redox cycling of Fe that occurs in ODZs, despite the absence of oxygen.« less

Accumulation of Fe oxyhydroxides in the Peruvian oxygen deficient zone implies non-oxygen dependent Fe oxidation

NASA Astrophysics Data System (ADS)

Heller, Maija I.; Lam, Phoebe J.; Moffett, James W.; Till, Claire P.; Lee, Jong-Mi; Toner, Brandy M.; Marcus, Matthew A.

2017-08-01

Oxygen minimum zones (OMZs) have been proposed to be an important source of dissolved iron (Fe) into the interior ocean. However, previous studies in OMZs have shown a sharp decrease in total dissolved Fe (dFe) and/or dissolved Fe(II) (dFe(II)) concentrations at the shelf-break, despite constant temperature, salinity and continued lack of oxygen across the shelf-break. The loss of both total dFe and dFe(II) suggests a conversion of the dFe to particulate form, but studies that have coupled the reduction-oxidation (redox) speciation of both dissolved and particulate phases have not previously been done. Here we have measured the redox speciation and concentrations of both dissolved and particulate forms of Fe in samples collected during the U.S. GEOTRACES Eastern tropical Pacific Zonal Transect (EPZT) cruise in 2013 (GP16). This complete data set allows us to assess possible mechanisms for loss of dFe. We observed an offshore loss of dFe(II) within the oxygen deficient zone (ODZ), where dissolved oxygen is undetectable, accompanied by an increase in total particulate Fe (pFe). Total pFe concentrations were highest in the upper ODZ. X-ray absorption spectroscopy revealed that the pFe maximum was primarily in the Fe(III) form as Fe(III) oxyhydroxides. The remarkable similarity in the distributions of total particulate iron and nitrite suggests a role for nitrite in the oxidation of dFe(II) to pFe(III). We present a conceptual model for the rapid redox cycling of Fe that occurs in ODZs, despite the absence of oxygen.

Kernel-based discriminant feature extraction using a representative dataset

NASA Astrophysics Data System (ADS)

Li, Honglin; Sancho Gomez, Jose-Luis; Ahalt, Stanley C.

2002-07-01

Discriminant Feature Extraction (DFE) is widely recognized as an important pre-processing step in classification applications. Most DFE algorithms are linear and thus can only explore the linear discriminant information among the different classes. Recently, there has been several promising attempts to develop nonlinear DFE algorithms, among which is Kernel-based Feature Extraction (KFE). The efficacy of KFE has been experimentally verified by both synthetic data and real problems. However, KFE has some known limitations. First, KFE does not work well for strongly overlapped data. Second, KFE employs all of the training set samples during the feature extraction phase, which can result in significant computation when applied to very large datasets. Finally, KFE can result in overfitting. In this paper, we propose a substantial improvement to KFE that overcomes the above limitations by using a representative dataset, which consists of critical points that are generated from data-editing techniques and centroid points that are determined by using the Frequency Sensitive Competitive Learning (FSCL) algorithm. Experiments show that this new KFE algorithm performs well on significantly overlapped datasets, and it also reduces computational complexity. Further, by controlling the number of centroids, the overfitting problem can be effectively alleviated.

Organic matter controls of iron incorporation in growing sea ice

NASA Astrophysics Data System (ADS)

Janssens, Julie; Meiners, Klaus M.; Townsend, Ashley T.; Lannuzel, Delphine

2018-03-01

This study presents the first laboratory-controlled sea-ice growth experiment conducted under trace metal clean conditions. The role played by organic matter, in the incorporation of iron (Fe) into sea ice was investigated by means of laboratory ice-growth experiments using a titanium cold-finger apparatus. Experiments were also conducted to understand the role of extracellular polymeric substances (EPS) in the enrichment of ammonium in sea ice. Sea ice was grown from several seawater solutions containing different quantities and qualities of particulate Fe (PFe), dissolved Fe (DFe) and organic matter. Sea ice and seawater were analyzed for particulate organic carbon and nitrogen, macro-nutrients, extracellular EPS, PFe and DFe, and particulate aluminium. The experiments showed that biogenic PFe is preferentially incorporated into sea ice compared to lithogenic PFe. Furthermore, sea ice grown from ultra-violet (UV) and non-UV treated seawaters exhibits contrasting incorporation rates of organic matter and Fe. Whereas the effects of UV-treatments were not always significant, we do find indications that the type or organic matter controls the enrichment of Fe in forming sea ice.. Specifically, we come to the conclusion that the incorporation of DFe is favored by the presence of organic ligands in the source solution.

A tale of two gyres: Contrasting distributions of dissolved cobalt and iron in the Atlantic Ocean during an Atlantic Meridional Transect (AMT-19)

NASA Astrophysics Data System (ADS)

Shelley, Rachel U.; Wyatt, Neil J.; Tarran, Glenn A.; Rees, Andrew P.; Worsfold, Paul J.; Lohan, Maeve C.

2017-11-01

Cobalt (Co) and iron (Fe) are essential for phytoplankton nutrition, and as such constitute a vital link in the marine biological carbon pump. Atmospheric deposition is an important, and in some places the dominant, source of trace elements (TEs) to the global ocean. Dissolved cobalt (dCo) and iron (dFe) were determined along an Atlantic Meridional Transect (AMT-19; Oct/Nov 2009) between 50°N and 40°S in the upper 150 m in order to investigate the behaviour and distribution of these two essential, bioactive TEs. During AMT-19, large differences in the distributions of dCo and dFe were observed. In the North Atlantic gyre provinces, extremely low mixed layer dCo concentrations (23 ± 9 pM) were observed, which contrasts with the relatively high mixed layer dFe concentrations (up to 1.0 nM) coincident with the band of highest atmospheric deposition (∼5-30°N). In the South Atlantic gyre, the opposite trend was observed, with relatively high dCo (55 ± 18 pM) observed throughout the water column, but low dFe concentrations (0.29 ± 0.08 nM). Given that annual dust supply is an order of magnitude greater in the North than the South Atlantic, the dCo distribution was somewhat unexpected. However, the distribution of dCo shows similarities with the distribution of phosphate (PO43-) in the euphotic zone of the Atlantic Ocean, where the North Atlantic gyre is characterised by chronically low PO4, and higher concentrations are observed in the South Atlantic gyre (Mather et al., 2008), suggesting the potential for a similar biological control of dCo distributions. Inverse correlations between dCo and Prochlorococcus abundance in the North Atlantic gyre provinces, combined with extremely low dCo where nitrogen fixation rates were highest (∼20-28°N), suggests the dominance of biological controls on dCo distributions. The contrasting dCo and dFe distributions in the North and South Atlantic gyres provides insights into the differences between the dominant controls on the distribution of these two bioactive trace metals in the central Atlantic Ocean.

[Cost relation between severity of Alzheimer's disease and cognitive and functional impairment].

PubMed

López-Pousa, Secundino; Garre-Olmo, Josep; Turon-Estrada, Antoni; Hernández, Francisco; Expósito, Inmaculada; Lozano-Gallego, Manoli; Hernández-Ferrándiz, Marta; Gelada-Batlle, Esther; Pericot-Nierga, Imma; Vilalta-Franch, Joan

2004-05-29

This study aims to identify the relationship between costs of medical and social attention in patients with dementia of Alzheimer disease (AD) type and clinical and sociodemographic data of patients and their caregivers. It was an analytic observational study in a cohort of patients diagnosed with Alzheimer's disease who received ambulatory attention. Information about the use of health-related resources was collected and costs were estimated from a societal perspective. Indirect costs were calculated using a replacement cost approach. Patients and caregivers were examined with the Mini-Mental State Examination (MMSE), the Rapid Disability Rating Scale (RDRS-2), the Neuropsychiatric Inventory (NPI), the Burden Interview (BI) and the Resource Utilization in Dementia (RUD). Patients were grouped taking into account the score obtained in the MMSE. A cohort of 417 patients, mean age (SD) 75.2 (6.6) years, 71% females, was studied. Disease severity levels were distributed as follows: MMSE, 26% for MMSE > 19, 66% for MMSE = 19-11, and 8% for MMSE < 11. 69% of caregivers were women, with a mean age of 57.1 (15.8) years. The cost per patient and per month was estimated to be 419.3 Euro for MMSE > 19, 641.9 Euro for MMSE = 19-11, and 1150.6 Euro for MMSE < 11. The societal cost of AD increases dramatically with increasing disease severity. Caregiver burden and sex as well as the marital status of patients are associated with the cost of the disease.

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.

Simple Form of MMSE Estimator for Super-Gaussian Prior Densities

NASA Astrophysics Data System (ADS)

Kittisuwan, Pichid

2015-04-01

The denoising method that become popular in recent years for additive white Gaussian noise (AWGN) are Bayesian estimation techniques e.g., maximum a posteriori (MAP) and minimum mean square error (MMSE). In super-Gaussian prior densities, it is well known that the MMSE estimator in such a case has a complicated form. In this work, we derive the MMSE estimation with Taylor series. We show that the proposed estimator also leads to a simple formula. An extension of this estimator to Pearson type VII prior density is also offered. The experimental result shows that the proposed estimator to the original MMSE nonlinearity is reasonably good.

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.

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.

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.

Equalizer design techniques for dispersive cables with application to the SPS wideband kicker

NASA Astrophysics Data System (ADS)

Platt, Jason; Hofle, Wolfgang; Pollock, Kristin; Fox, John

2017-10-01

A wide-band vertical instability feedback control system in development at CERN requires 1-1.5 GHz of bandwidth for the entire processing chain, from the beam pickups through the feedback signal digital processing to the back-end power amplifiers and kicker structures. Dispersive effects in cables, amplifiers, pickup and kicker elements can result in distortions in the time domain signal as it proceeds through the processing system, and deviations from linear phase response reduce the allowable bandwidth for the closed-loop feedback system. We have developed an equalizer analog circuit that compensates for these dispersive effects. Here we present a design technique for the construction of an analog equalizer that incorporates the effect of parasitic circuit elements in the equalizer to increase the fidelity of the implemented equalizer. Finally, we show results from the measurement of an assembled backend equalizer that corrects for dispersive elements in the cables over a bandwidth of 10-1000 MHz.

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

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.

[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.

Improving Bandwidth Utilization in a 1 Tbps Airborne MIMO Communications Downlink

DTIC Science & Technology

2013-03-21

number of transmitters). C = log2 ∣∣∣∣∣INr + EsNtN0 HHH ∣∣∣∣∣ (2.32) In the signal to noise ratio, Es represents the total energy from all transmitters...channel matrix pseudo-inverse is computed by (2.36) [6, p. 970] 31 H+ = ( HHH )−1HH. (2.36) 2.6.5 Minimum Mean-Squared Error Detection. Minimum Mean Squared...H† = ( HHH + Nt SNR I )−1 HH . (3.14) Equation (3.14) was defined in [2] as an implementation of a MMSE equalizer, and was applied to the received

A model of Fe speciation and biogeochemistry at the Tropical Eastern North Atlantic Time-Series Observatory site

NASA Astrophysics Data System (ADS)

Ye, Y.; Völker, C.; Wolf-Gladrow, D. A.

2009-10-01

A one-dimensional model of Fe speciation and biogeochemistry, coupled with the General Ocean Turbulence Model (GOTM) and a NPZD-type ecosystem model, is applied for the Tropical Eastern North Atlantic Time-Series Observatory (TENATSO) site. Among diverse processes affecting Fe speciation, this study is focusing on investigating the role of dust particles in removing dissolved iron (DFe) by a more complex description of particle aggregation and sinking, and explaining the abundance of organic Fe-binding ligands by modelling their origin and fate. The vertical distribution of different particle classes in the model shows high sensitivity to changing aggregation rates. Using the aggregation rates from the sensitivity study in this work, modelled particle fluxes are close to observations, with dust particles dominating near the surface and aggregates deeper in the water column. POC export at 1000 m is a little higher than regional sediment trap measurements, suggesting further improvement of modelling particle aggregation, sinking or remineralisation. Modelled strong ligands have a high abundance near the surface and decline rapidly below the deep chlorophyll maximum, showing qualitative similarity to observations. Without production of strong ligands, phytoplankton concentration falls to 0 within the first 2 years in the model integration, caused by strong Fe-limitation. A nudging of total weak ligands towards a constant value is required for reproducing the observed nutrient-like profiles, assuming a decay time of 7 years for weak ligands. This indicates that weak ligands have a longer decay time and therefore cannot be modelled adequately in a one-dimensional model. The modelled DFe profile is strongly influenced by particle concentration and vertical distribution, because the most important removal of DFe in deeper waters is colloid formation and aggregation. Redissolution of particulate iron is required to reproduce an observed DFe profile at TENATSO site. Assuming colloidal iron is mainly composed of inorganic colloids, the modelled colloidal to soluble iron ratio is lower that observations, indicating the importance of organic colloids.

Factors Influencing the Diversity of Iron Uptake Systems in Aquatic Microorganisms

PubMed Central

Desai, Dhwani K.; Desai, Falguni D.; LaRoche, Julie

2012-01-01

Iron (Fe) is an essential micronutrient for many processes in all living cells. Dissolved Fe (dFe) concentrations in the ocean are of the order of a few nM, and Fe is often a factor limiting primary production. Bioavailability of Fe in aquatic environments is believed to be primarily controlled through chelation by Fe-binding ligands. Marine microbes have evolved different mechanisms to cope with the scarcity of bioavailable dFe. Gradients in dFe concentrations and diversity of the Fe-ligand pool from coastal to open ocean waters have presumably imposed selection pressures that should be reflected in the genomes of microbial communities inhabiting the pelagic realm. We applied a hidden Markov model (HMM)-based search for proteins related to cellular iron metabolism, and in particular those involved in Fe uptake mechanisms in 164 microbial genomes belonging to diverse taxa and occupying different aquatic niches. A multivariate statistical approach demonstrated that in phototrophic organisms, there is a clear influence of the ecological niche on the diversity of Fe uptake systems. Extending the analyses to the metagenome database from the Global Ocean Sampling expedition, we demonstrated that the Fe uptake and homeostasis mechanisms differed significantly across marine niches defined by temperatures and dFe concentrations, and that this difference was linked to the distribution of microbial taxa in these niches. Using the dN/dS ratios (which signify the rate of non-synonymous mutations) of the nucleotide sequences, we identified that genes encoding for TonB, Ferritin, Ferric reductase, IdiA, ZupT, and Fe2+ transport proteins FeoA and FeoB were evolving at a faster rate (positive selection pressure) while genes encoding ferrisiderophore, heme and Vitamin B12 uptake systems, siderophore biosynthesis, and IsiA and IsiB were under purifying selection pressure (evolving slowly). PMID:23087680

Cost effectiveness of a telephone intervention to promote dilated fundus examination in adults with diabetes mellitus

PubMed Central

Schechter, Clyde B; Basch, Charles E; Caban, Arlene; Walker, Elizabeth A

2008-01-01

In a clinical trial, we have previously shown that a telephone intervention can significantly increase participation in dilated fundus examination (DFE) screening among low-income adults with diabetes. Here the costs and cost-effectiveness ratio of this intervention are calculated. Intervention effectiveness was estimated as the difference in DFE utilization between the telephone intervention and print groups from the clinical trial multiplied by the size of the telephone intervention group. A micro-costing approach was used. Personnel time was aggregated from logs kept during the clinical trial of the intervention. Wage rates were taken from a commercial compensation database. Telephone charges were estimated based on prevailing fees. The cost-effectiveness ratio was calculated as the ratio of total costs of the intervention to the number of DFEs gained by the intervention. A sensitivity analysis estimated the cost-effectiveness of a more limited telephone intervention. A probabilistic sensitivity analysis using bootstrap samples from the clinical trial results quantified the uncertainties in resource utilization and intervention effectiveness. Net intervention costs were US$18,676.06, with an associated gain of 43.7 DFEs and 16.4 new diagnoses of diabetic retinopathy. The cost-effectiveness ratio is US$427.37 per DFE gained. A restricted intervention limiting the number of calls to 5, as opposed to 7, would achieve the same results, but would cost approximately 17% less. In the probabilistic sensitivity analysis, the 5th and 95th percentiles of the cost-effectiveness ratio were US$304.05 and US$692.52 per DFE gained, respectively. Our telephone intervention is more expensive than simple mail or telephone reminders used in other settings to promote preventive care; it is, however, also considerably more effective, and is effective in a low-income minority population at greater risk for diabetes complications. The costs are dominated by labor costs, and may be substantially defrayed, without loss of effectiveness, by restricting the number of telephone calls to 5 per patient. PMID:19668428

Clinical efficacy of formula-based bifrontal versus right unilateral electroconvulsive therapy (ECT) in the treatment of major depression among elderly patients: a pragmatic, randomized, assessor-blinded, controlled trial.

PubMed

Bjølseth, Tor Magne; Engedal, Knut; Benth, Jūratė Šaltytė; Dybedal, Gro Strømnes; Gaarden, Torfinn Lødøen; Tanum, Lars

2015-04-01

No prior study has compared the efficacy of bifrontal (BF) vs right unilateral (RUL) electroconvulsive therapy (ECT) by including the subgroup that is most likely to receive it: only elderly patients with major depression (MD). This single-site, randomized, assessor-blinded, controlled trial was conducted from 2009 to 2013. Seventy-three elderly patients with MD, unipolar and bipolar, were treated with a course of formula-based BF ECT or RUL ECT. The 17-item Hamilton Rating Scale for Depression (HRSD17) was used to measure efficacy. Safety was assessed with the Mini Mental State Examination (MMSE). Both electrode placements resulted in highly significant downward trends in symptom severity (all p<0.001), with a non-significant difference between methods (p=0.703). At the end of the ECT course, response rates for the BF and RUL group were 63.9% and 67.6%, respectively. Short-term remission, defined as an HRSD17 score≤7, was achieved in 14 (38.9%) patients in the BF group and 19 (51.4%) patients in the RUL group. Global cognitive function, as measured by the MMSE, did not deteriorate in the two treatment groups. The small number of subjects may have led to reduced power to detect real differences. The MMSE is not sufficient to ascertain the negative effect of ECT on cognition. This study indicates that formula-based BF and RUL ECT are equally efficacious, and that remission rates of formula-based dosing are lower than those previously reported for titrated dosing, in a clinical sample of elderly patients with MD. ClinicalTrials.gov NCT01559324. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Providing Students with Formative Audio Feedback

ERIC Educational Resources Information Center

Brearley, Francis Q.; Cullen, W. Rod

2012-01-01

The provision of timely and constructive feedback is increasingly challenging for busy academics. Ensuring effective student engagement with feedback is equally difficult. Increasingly, studies have explored provision of audio recorded feedback to enhance effectiveness and engagement with feedback. Few, if any, of these focus on purely formative…

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.

Effects of installation of F101 DFE exhaust nozzles on the afterbody-nozzle characteristics of the F-14 airplane

NASA Technical Reports Server (NTRS)

Reubush, D. E.; Carlson, J. R.

1982-01-01

A wind-tunnel investigation was conducted to determine the effects of F101 DFE (derivative fighter engine) nozzle axial positioning on the afterbody-nozzle longitudinal aerodynamic characteristics of the F-14 airplane. The model was tested in the Langley 16-Foot Transonic Tunnel at Mach numbers from 0.7 to 1.25 and angles of attack from about -2 to 6 degrees. Compressed air was used to simulate nozzle exhaust flow at jet total-pressure ratios from 1 (jet off) to about 8. The results of the investigation show that for subsonic Mach numbers the intermediate cruise nozzle position of the three positions tested resulted in the lowest drag.

Rigorous study of low-complexity adaptive space-time block-coded MIMO receivers in high-speed mode multiplexed fiber-optic transmission links using few-mode fibers

NASA Astrophysics Data System (ADS)

Weng, Yi; He, Xuan; Wang, Junyi; Pan, Zhongqi

2017-01-01

Spatial-division multiplexing (SDM) techniques have been purposed to increase the capacity of optical fiber transmission links by utilizing multicore fibers or few-mode fibers (FMF). The most challenging impairments of SDMbased long-haul optical links mainly include modal dispersion and mode-dependent loss (MDL), whereas MDL arises from inline component imperfections, and breaks modal orthogonality thus degrading the capacity of multiple-inputmultiple- output (MIMO) receivers. To reduce MDL, optical approaches include mode scramblers and specialty fiber designs, yet these methods were burdened with high cost, yet cannot completely remove the accumulated MDL in the link. Besides, space-time trellis codes (STTC) were purposed to lessen MDL, but suffered from high complexity. In this work, we investigated the performance of space-time block-coding (STBC) scheme to mitigate MDL in SDM-based optical communication by exploiting space and delay diversity, whereas weight matrices of frequency-domain equalization (FDE) were updated heuristically using decision-directed recursive-least-squares (RLS) algorithm for convergence and channel estimation. The STBC was evaluated in a six-mode multiplexed system over 30-km FMF via 6×6 MIMO FDE, with modal gain offset 3 dB, core refractive index 1.49, numerical aperture 0.5. Results show that optical-signal-to-noise ratio (OSNR) tolerance can be improved via STBC by approximately 3.1, 4.9, 7.8 dB for QPSK, 16- and 64-QAM with respective bit-error-rates (BER) and minimum-mean-square-error (MMSE). Besides, we also evaluate the complexity optimization of STBC decoding scheme with zero-forcing decision feedback (ZFDF) equalizer by shortening the coding slot length, which is robust to frequency-selective fading channels, and can be scaled up for SDM systems with more dynamic channels.

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.

[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.

Combined magnetic vector-scalar potential finite element computation of 3D magnetic field and performance of modified Lundell alternators in Space Station applications. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Wang, Ren H.

1991-01-01

A method of combined use of magnetic vector potential (MVP) based finite element (FE) formulations and magnetic scalar potential (MSP) based FE formulations for computation of three-dimensional (3D) magnetostatic fields is developed. This combined MVP-MSP 3D-FE method leads to considerable reduction by nearly a factor of 3 in the number of unknowns in comparison to the number of unknowns which must be computed in global MVP based FE solutions. This method allows one to incorporate portions of iron cores sandwiched in between coils (conductors) in current-carrying regions. Thus, it greatly simplifies the geometries of current carrying regions (in comparison with the exclusive MSP based methods) in electric machinery applications. A unique feature of this approach is that the global MSP solution is single valued in nature, that is, no branch cut is needed. This is again a superiority over the exclusive MSP based methods. A Newton-Raphson procedure with a concept of an adaptive relaxation factor was developed and successfully used in solving the 3D-FE problem with magnetic material anisotropy and nonlinearity. Accordingly, this combined MVP-MSP 3D-FE method is most suited for solution of large scale global type magnetic field computations in rotating electric machinery with very complex magnetic circuit geometries, as well as nonlinear and anisotropic material properties.

Automotive Refinishing Industry: Isocyanates Profile

EPA Pesticide Factsheets

The isocyanates profile document is part of the DfE Auto Refinishing Shop Project and is intended to provide information on refinishing, control technologies, and regulatory status regarding isocyanate compounds

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.

Redox speciation of dissolved iron in the northeastern atlantic ocean.

NASA Astrophysics Data System (ADS)

Ussher, S. J.; Achterberg, E. P.; Worsfold, P. J.

2003-04-01

Dissolved iron (<0.2 micron) and iron(II) (<0.2 micron) distributions were determined during the Iron from Below and Iron from Above research cruises in the North Eastern Atlantic Ocean. The cruises were part of the EU Ironages project. Iron(II) was measured on-board ship using an iron(II) specific, automated flow injection analyser with luminol chemiluminescence detection [1]. Total dissolved iron (DFe) was determined in a land-based laboratory, using the same FI technique but with prior reduction of iron(III) to iron(II) [2]. The limits of detection for the methods were 5 -15 pM and 35 pM respectively, the analysis time was 8 - 10 minutes per sample (minimum of 3 replicates). The Iron from Below expedition took place over the European Continental Shelf, 200 km South West of Brittany (France) in March 2002. A transect between 47.61°N, 4.24°W and 46.00°N, 8.01°W was completed. Over the transect, the depth increased from 100 m to 5000 m. Iron(II) concentrations ranged between 10 and 100 pM and DFe between 0.2 and 1 nM, with the higher concentrations (Fe(II) ca. > 50 pM and DFe ca. > 0.8 nM) generally found in the shallow shelf waters. These observations imply that benthic inputs and sediment resuspension may form important inputs of dissolved iron and iron(II) in the shelf waters. Iron speciation measurements were also made for underway surface and shallow cast samples during the Iron from Above cruise October 2002. Fe(II) and DFe concentrations were typically 5 to 50 pM and 0.2 to 0.6 nM, respectively. Sampling was carried out within a grid in the Canary Basin around 5 degrees W of the Canary Islands, an area assumed to be strongly influenced by the Saharan dust plume. Observed Fe(II) concentrations are compared and ratioed to the DFe concentrations, and indicate that iron(II) forms an important fraction (between 5 and 15%) of the total dissolved iron concentration in the study areas. Data plots for surface samples are presented with the corresponding physical oceanographic and solar irradiance data. The concentrations of Fe(II) observed during our studies exceed the values predicted from thermodynamic equilibrium modelling. This indicates that there is a steady supply of Fe(II) (possibly from photoreduction and/or biological origins) and/or Fe(II) is prevented from oxidation through stabilisation mechanisms (possibly by organic ligands). [1] A. R. Bowie, E. P. Achterberg, P. N. Sedwick, S. Ussher, P. J. Worsfold, Environ. Sci. Technol., 36, (2002) 4600. [2] A. R. Bowie, E. P. Achterberg, R. F. C. Mantoura, P. J. Worsfold, Anal. Chim. Acta, 377, (1998) 113.

[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.

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.

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.

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).

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

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.

Physical activity and cognition in the northern Manhattan study.

PubMed

Willey, Joshua Z; Park Moon, Yeseon; Ruder, Rachel; Cheung, Yuen K; Sacco, Ralph L; Elkind, Mitchell S V; Wright, Clinton B

2014-01-01

To test the hypothesis that leisure time physical activity (PA) is associated with cognitive status. We assessed cognition using the Mini-Mental Status Examination (MMSE) at enrollment and using the modified Telephone Interview for Cognitive Status (TICS-m) administered annually since 2001 in the Northern Manhattan Study. Baseline measures of leisure time PA were collected via in-person questionnaires. Total PA was categorized into 3 groups based on the metabolic equivalent (MET) score, a composite of total reported intensity and time. We used linear regression models to examine the association of PA with MMSE, and generalized estimating equations for change in TICS-m over time. There were 3,298 stroke-free participants with MMSE data (mean MMSE 26.0 ± 3.8) and 2,279 with TICS-m scores available. Compared to no PA, those with the upper quartile of MET scores had greater baseline MMSE scores (adjusted β = 0.4, p = 0.01) but no association with change in TICS-m over time. There were interactions (p < 0.05) between PA and both insurance and education; compared to no PA, those in the upper quartile of MET scores had a greater MMSE score only among those with Medicaid/no insurance (adjusted β = 0.83, p = 0.0005) and those who did not complete high school (adjusted β = 0.68, p = 0.001). Increased levels of PA were associated with better baseline MMSE, particularly among those with socioeconomic disadvantages, but not with cognitive decline. © 2013 S. Karger AG, Basel.

Low-Bit Rate Feedback Strategies for Iterative IA-Precoded MIMO-OFDM-Based Systems

PubMed Central

Teodoro, Sara; Silva, Adão; Dinis, Rui; Gameiro, Atílio

2014-01-01

Interference alignment (IA) is a promising technique that allows high-capacity gains in interference channels, but which requires the knowledge of the channel state information (CSI) for all the system links. We design low-complexity and low-bit rate feedback strategies where a quantized version of some CSI parameters is fed back from the user terminal (UT) to the base station (BS), which shares it with the other BSs through a limited-capacity backhaul network. This information is then used by BSs to perform the overall IA design. With the proposed strategies, we only need to send part of the CSI information, and this can even be sent only once for a set of data blocks transmitted over time-varying channels. These strategies are applied to iterative MMSE-based IA techniques for the downlink of broadband wireless OFDM systems with limited feedback. A new robust iterative IA technique, where channel quantization errors are taken into account in IA design, is also proposed and evaluated. With our proposed strategies, we need a small number of quantization bits to transmit and share the CSI, when comparing with the techniques used in previous works, while allowing performance close to the one obtained with perfect channel knowledge. PMID:24678274

Low-bit rate feedback strategies for iterative IA-precoded MIMO-OFDM-based systems.

PubMed

Teodoro, Sara; Silva, Adão; Dinis, Rui; Gameiro, Atílio

2014-01-01

Interference alignment (IA) is a promising technique that allows high-capacity gains in interference channels, but which requires the knowledge of the channel state information (CSI) for all the system links. We design low-complexity and low-bit rate feedback strategies where a quantized version of some CSI parameters is fed back from the user terminal (UT) to the base station (BS), which shares it with the other BSs through a limited-capacity backhaul network. This information is then used by BSs to perform the overall IA design. With the proposed strategies, we only need to send part of the CSI information, and this can even be sent only once for a set of data blocks transmitted over time-varying channels. These strategies are applied to iterative MMSE-based IA techniques for the downlink of broadband wireless OFDM systems with limited feedback. A new robust iterative IA technique, where channel quantization errors are taken into account in IA design, is also proposed and evaluated. With our proposed strategies, we need a small number of quantization bits to transmit and share the CSI, when comparing with the techniques used in previous works, while allowing performance close to the one obtained with perfect channel knowledge.

a Study of Vibrational Mode Coupling in 2-FLUOROETHANOL and 1,2-DIFLUOROETHANE Using High-Resolution Infrared Spectroscopy.

NASA Astrophysics Data System (ADS)

Mork, Steven Wayne

High resolution infrared spectroscopy was used to examine intramolecular vibrational interactions in 2 -fluoroethanol (2FE) and 1,2-difluoroethane (DFE). A high resolution infrared spectrophotometer capable of better than 10 MHz spectral resolution was designed and constructed. The excitation source consists of three lasers: an argon-ion pumped dye laser which pumps a color -center laser. The infrared beam from the color-center laser is used to excite sample molecules which are rotationally and vibrationally cooled in a supersonic molecular beam. Rovibrational excitation of the sample molecules is detected by monitoring the kinetic energy of the molecular beam with a bolometer. The high resolution infrared spectrum of 2FE was collected and analyzed over the 2977-2990 cm^ {-1}^ectral region. This region contains the asymmetric CH stretch on the fluorinated carbon. The spectrum revealed extensive perturbations in the rotational fine structure. Analysis of these perturbations has provided a quantitative measure of selective vibrational mode coupling between the C-H stretch and its many neighboring dark vibrational modes. Interestingly, excitation of the C-H stretch is known to induce a photoisomerization reaction between 2FE's Gg^' and Tt conformers. Implications of the role of mode coupling in the reaction mechanism are also addressed. Similarly, the high resolution infrared spectrum of DFE was collected and analyzed over the 2978-2996 cm ^{-1}^ectral region. This region contains the symmetric combination of asymmetric C-H stretches in DFE. Perturbations in the rotational fine structure indicate vibrational mode coupling to a single dark vibrational state. The dark state is split by approximately 19 cm^{-1} due to tunneling between two identical gauche conformers. The coupling mechanism is largely anharmonic with a minor component of B/C-plane Coriolis coupling. Effects of centrifugal distortion along the molecular A-axis are also observed. The coupled vibrational mode has been identified as containing C-C torsion, CCF bend and CH_2 rock. As in 2FE, DFE undergoes an isomerization reaction upon excitation of the C-H stretch. Coupling between the C-H stretch and C-C torsion is addressed with respect to the reaction mechanism.

Implementing Cleaner Printed Wiring Board Technologies: Surface Finishes

EPA Pesticide Factsheets

This document describes the problems, solutions, and time and effort involved in implementing alternative surface finish technologies, and this guide is produced as part of the DfE Printed Wiring Board Project

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.

Item and scale differential functioning of the Mini-Mental State Exam assessed using the Differential Item and Test Functioning (DFIT) Framework.

PubMed

Morales, Leo S; Flowers, Claudia; Gutierrez, Peter; Kleinman, Marjorie; Teresi, Jeanne A

2006-11-01

To illustrate the application of the Differential Item and Test Functioning (DFIT) method using English and Spanish versions of the Mini-Mental State Examination (MMSE). Study participants were 65 years of age or older and lived in North Manhattan, New York. Of the 1578 study participants who were administered the MMSE 665 completed it in Spanish. : The MMSE contains 20 items that measure the degree of cognitive impairment in the areas of orientation, attention and calculation, registration, recall and language, as well as the ability to follow verbal and written commands. After assessing the dimensionality of the MMSE scale, item response theory person and item parameters were estimated separately for the English and Spanish sample using Samejima's 2-parameter graded response model. Then the DFIT framework was used to assess differential item functioning (DIF) and differential test functioning (DTF). Nine items were found to show DIF; these were items that ask the respondent to name the correct season, day of the month, city, state, and 2 nearby streets, recall 3 objects, repeat the phrase no ifs, no ands, no buts, follow the command, "close your eyes," and the command, "take the paper in your right hand, fold the paper in half with both hands, and put the paper down in your lap." At the scale level, however, the MMSE did not show differential functioning. Respondents to the English and Spanish versions of the MMSE are comparable on the basis of scale scores. However, assessments based on individual MMSE items may be misleading.

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.

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.

Feedback Valence Affects Auditory Perceptual Learning Independently of Feedback Probability

PubMed Central

Amitay, Sygal; Moore, David R.; Molloy, Katharine; Halliday, Lorna F.

2015-01-01

Previous studies have suggested that negative feedback is more effective in driving learning than positive feedback. We investigated the effect on learning of providing varying amounts of negative and positive feedback while listeners attempted to discriminate between three identical tones; an impossible task that nevertheless produces robust learning. Four feedback conditions were compared during training: 90% positive feedback or 10% negative feedback informed the participants that they were doing equally well, while 10% positive or 90% negative feedback informed them they were doing equally badly. In all conditions the feedback was random in relation to the listeners’ responses (because the task was to discriminate three identical tones), yet both the valence (negative vs. positive) and the probability of feedback (10% vs. 90%) affected learning. Feedback that informed listeners they were doing badly resulted in better post-training performance than feedback that informed them they were doing well, independent of valence. In addition, positive feedback during training resulted in better post-training performance than negative feedback, but only positive feedback indicating listeners were doing badly on the task resulted in learning. As we have previously speculated, feedback that better reflected the difficulty of the task was more effective in driving learning than feedback that suggested performance was better than it should have been given perceived task difficulty. But contrary to expectations, positive feedback was more effective than negative feedback in driving learning. Feedback thus had two separable effects on learning: feedback valence affected motivation on a subjectively difficult task, and learning occurred only when feedback probability reflected the subjective difficulty. To optimize learning, training programs need to take into consideration both feedback valence and probability. PMID:25946173

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.

Synthetic Aperture Sonar Processing with MMSE Estimation of Image Sample Values

DTIC Science & Technology

2016-12-01

UNCLASSIFIED/UNLIMITED 13. SUPPLEMENTARY NOTES 14. ABSTRACT MMSE (minimum mean- square error) target sample estimation using non-orthogonal basis...orthogonal, they can still be used in a minimum mean‐ square  error (MMSE)  estimator that models the object echo as a weighted sum of the multi‐aspect basis...problem.                     3    Introduction      Minimum mean‐ square  error (MMSE) estimation is applied to target imaging with synthetic aperture

Safer Choice Partner of the Year Awards Application Form

EPA Pesticide Factsheets

EPA's Design for the Environment program developed the Safer Product Labeling Program Partner of the Year Award program to recognize DfE stakeholders that have furthered the safer chemistry goals of the program

Iterative Overlap FDE for Multicode DS-CDMA

NASA Astrophysics Data System (ADS)

Takeda, Kazuaki; Tomeba, Hiromichi; Adachi, Fumiyuki

Recently, a new frequency-domain equalization (FDE) technique, called overlap FDE, that requires no GI insertion was proposed. However, the residual inter/intra-block interference (IBI) cannot completely be removed. In addition to this, for multicode direct sequence code division multiple access (DS-CDMA), the presence of residual interchip interference (ICI) after FDE distorts orthogonality among the spreading codes. In this paper, we propose an iterative overlap FDE for multicode DS-CDMA to suppress both the residual IBI and the residual ICI. In the iterative overlap FDE, joint minimum mean square error (MMSE)-FDE and ICI cancellation is repeated a sufficient number of times. The bit error rate (BER) performance with the iterative overlap FDE is evaluated by computer simulation.

The relationship between education level and Mini Mental State Examination domains among older Mexican Americans

PubMed Central

Matallana, Diana; de Santacruz, Cecilia; Cano, Carlos; Reyes, Pablo; Samper-Ternent, Rafael; Markides, Kyriakos S.; Ottenbacher, Kenneth J.; Reyes-Ortiz, Carlos A.

2011-01-01

To study the effect of education on the performance in the Mini-Mental State Examination (MMSE) domains, we included 2,861 Mexican Americans aged 65 and older from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (EPESE) followed from 1993–1994 until 2004–2005. The MMSE was examined as total score (0–30) or divided in two global domains: 1) no-memory (score 0–24): Orientation, attention, and language; and 2) memory (score 0–6): working and delayed memory. Mean age and total MMSE were 72.7 and 24.6 at wave 1, and 81.7 and 20.5 at wave 5. Spanish speaking subjects had lower years of education (4.1 vs. 7.4, p<.0001), they had significantly higher adjusted (by age, education, and gender) mean scores for memory, no-memory and the total MMSE compared with English speaking subjects across the five waves of follow-up. In multivariate longitudinal analyses over 11 years of follow-up, subjects with more years of education performed better than those less educated, especially in no-memory and the total MMSE. Spanish speaking subjects with 4–6 years of education had higher memory scores than those speaking English (estimate 0.40, standard error [SE] = 0.14, p<.001), 7–11 (estimate 0.27, SE= 0.13, p<.01) or 12+ (estimate 0.44, SE= 0.13, p<.001). This suggests that cultural factors and factors related to preferred language use may determine variations in MMSE performance. Since the memory domain of the MMSE is less affected by education, it may be used along with other cognitive tests in older populations with low education. PMID:20538969

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.

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.

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

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

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

Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies.

PubMed

Robitaille, Annie; van den Hout, Ardo; Machado, Robson J M; Bennett, David A; Čukić, Iva; Deary, Ian J; Hofer, Scott M; Hoogendijk, Emiel O; Huisman, Martijn; Johansson, Boo; Koval, Andriy V; van der Noordt, Maaike; Piccinin, Andrea M; Rijnhart, Judith J M; Singh-Manoux, Archana; Skoog, Johan; Skoog, Ingmar; Starr, John; Vermunt, Lisa; Clouston, Sean; Muniz Terrera, Graciela

2018-04-01

This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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.

Note: a novel vacuum ultraviolet light source assembly with aluminum-coated electrodes for enhancing the ionization efficiency of photoionization mass spectrometry.

PubMed

Zhu, Zhixiang; Wang, Jian; Qiu, Keqing; Liu, Chengyuan; Qi, Fei; Pan, Yang

2014-04-01

A novel vacuum ultraviolet (VUV) light source assembly (VUVLSA) for enhancing the ionization efficiency of photoionization mass spectrometer has been described. The VUVLSA composes of a Krypton lamp and a pair of disk electrodes with circular center cavities. The two interior surfaces that face the photoionization region were aluminum-coated. VUV light can be reflected back and forth in the photoionization region between the electrodes, thus the photoionization efficiency can be greatly enhanced. The performances of two different shaped electrodes, the coated double flat electrodes (DFE), and double conical electrodes, were studied. We showed that the signal amplification of coated DFE is around 4 times higher than that of uncoated electrodes without VUV light reflection. The relationship between the pressure of ionization chamber and mass signal enhancement has also been studied.

Afterslip, tremor, and the Denali fault earthquake

USGS Publications Warehouse

Gomberg, Joan; Prejean, Stephanie; Ruppert, Natalia

2012-01-01

We tested the hypothesis that afterslip should be accompanied by tremor using observations of seismic and aseismic deformation surrounding the 2002 M 7.9 Denali fault, Alaska, earthquake (DFE). Afterslip happens more frequently than spontaneous slow slip and has been observed in a wider range of tectonic environments, and thus the existence or absence of tremor accompanying afterslip may provide new clues about tremor generation. We also searched for precursory tremor, as a proxy for posited accelerating slip leading to rupture. Our search yielded no tremor during the five days prior to the DFE or in several intervals in the three months after. This negative result and an array of other observations all may be explained by rupture penetrating below the presumed locked zone into the frictional transition zone. While not unique, such an explanation corroborates previous models of megathrust and transform earthquake ruptures that extend well into the transition zone.

FN-DFE: Fuzzy-Neural Data Fusion Engine for Enhanced State-Awareness of Resilient Hybrid Energy System

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

Ondrej Linda; Dumidu Wijayasekara; Milos Manic

Resiliency and improved state-awareness of modern critical infrastructures, such as energy production and industrial systems, is becoming increasingly important. As control systems become increasingly complex, the number of inputs and outputs increase. Therefore, in order to maintain sufficient levels of state-awareness, a robust system state monitoring must be implemented that correctly identifies system behavior even when one or more sensors are faulty. Furthermore, as intelligent cyber adversaries become more capable, incorrect values may be fed to the operators. To address these needs, this paper proposes a Fuzzy-Neural Data Fusion Engine (FN-DFE) for resilient state-awareness of control systems. The designed FN-DFEmore » is composed of a three-layered system consisting of: 1) traditional threshold based alarms, 2) anomalous behavior detector using self-organizing fuzzy logic system, and 3) artificial neural network based system modeling and prediction. The improved control system state-awareness is achieved via fusing input data from multiple sources and combining them into robust anomaly indicators. In addition, the neural network based signal predictions are used to augment the resiliency of the system and provide coherent state-awareness despite temporary unavailability of sensory data. The proposed system was integrated and tested with a model of the Idaho National Laboratory’s (INL) hybrid energy system facility know as HYTEST. Experimental results demonstrate that the proposed FN-DFE provides timely plant performance monitoring and anomaly detection capabilities. It was shown that the system is capable of identifying intrusive behavior significantly earlier than conventional threshold based alarm systems.« less

Improved analysis tool for concrete pavement : [project summary].

DOT National Transportation Integrated Search

2017-10-01

University of Florida researchers developed 3D-FE models to more accurately predict the behavior of concrete slabs. They also followed up on a project to characterize strain gauge performance for a Florida Department of Transportation (FDOT) concrete...

Effect of Behavioral Intervention on Dilated Fundus Examination Rates in Older African American Individuals With Diabetes Mellitus: A Randomized Clinical Trial.

PubMed

Weiss, David M; Casten, Robin J; Leiby, Benjamin E; Hark, Lisa A; Murchison, Ann P; Johnson, Deiana; Stratford, Shayla; Henderer, Jeffrey; Rovner, Barry W; Haller, Julia A

2015-09-01

African American individuals are at high risk of diabetes mellitus and diabetic retinopathy but have suboptimal rates of dilated fundus examinations (DFEs). Early intervention is crucial for the prevention of diabetic retinopathy in this high-risk population. To test the efficacy of behavioral activation for diabetic retinopathy prevention on rates of DFEs in older African American individuals with diabetes mellitus. Masked randomized clinical trial at 2 urban medical centers from October 1, 2010, to May 31, 2014. Participants included 206 African American individuals 65 years and older with diabetes mellitus who had not obtained a DFE in the preceding 12 months. Participants were randomized to either behavioral activation for diabetic retinopathy prevention, a behavioral intervention designed to provide education, facilitate identifying and addressing health care barriers, and promote goal setting to improve rates of DFEs, or supportive therapy, a control condition. The primary outcome was medical documentation of a DFE at 6 months' follow-up. Secondary outcomes included the Risk Perceptions and Risk Knowledge Survey of Diabetes Mellitus, Diabetes Self-Care Inventory, Patient Health Questionnaire 9, and National Eye Institute Vision Function Questionnaire 25 scores and hemoglobin A1c levels. More participants in the behavioral activation for diabetic retinopathy prevention group (87.9%) obtained a DFE compared with those in the supportive therapy group (34.1%) by the 6-month follow-up assessment (P < .001). Overall, participants in the behavioral activation for diabetic retinopathy prevention group were 2.5 times more likely to obtain a DFE compared with those in the supportive therapy group (risk ratio = 2.58; 95% CI, 1.91-3.48; P < .001). The intervention had no short-term effect on secondary outcomes of hemoglobin A1c levels, depression, or the Risk Perceptions and Risk Knowledge Survey of Diabetes Mellitus or National Eye Institute Vision Function Questionnaire 25 composite scores; however, both groups had improved adherence to diabetes mellitus self-care behaviors from baseline to 6-month follow-up. Behavioral activation for diabetic retinopathy prevention significantly increased rates of DFEs in older African American individuals with diabetes mellitus. Behavioral interventions may have the potential to positively affect screening for diabetic retinopathy in at-risk populations. clinicaltrials.gov Identifier: NCT01179555.

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.

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

The Use of Objective Structured Self-Assessment and Peer-Feedback (OSSP) for Learning Communication Skills: Evaluation Using a Controlled Trial

ERIC Educational Resources Information Center

Perera, Jennifer; Mohamadou, Galy; Kaur, Satpal

2010-01-01

Feedback is essential to guide students towards expected performance goals. The usefulness of teacher feedback on improving communication skills (CS) has been well documented. It has been proposed that self-assessment and peer-feedback has an equally important role to play in enhancing learning. This is the focus of this study. Objectively…

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.

Locus of Control and Effects of Failure on Performance and Perceived Competence

ERIC Educational Resources Information Center

Shavit, Hana; Rabinowitz, Aaron

1978-01-01

Reactions to ego related performance feedback of 117 internal and external locus of control eighth-grade children were investigated. Both internals and externals were equally pleased by success feedback and displeased by failure, and their competence judgment was influenced by the feedback received. However, internals exhibited more effective…

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

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.

Performance analysis of passive time reversal communication technique for multipath interference in shallow sea acoustic channel

NASA Astrophysics Data System (ADS)

Kida, Yukihiro; Shimura, Takuya; Deguchi, Mitsuyasu; Watanabe, Yoshitaka; Ochi, Hiroshi; Meguro, Koji

2017-07-01

In this study, the performance of passive time reversal (PTR) communication techniques in multipath rich underwater acoustic environments is investigated. It is recognized empirically and qualitatively that a large number of multipath arrivals could generally raise the demodulation result of PTR. However, the relationship between multipath and the demodulation result is hardly evaluated quantitatively. In this study, the efficiency of the PTR acoustic communication techniques for multipath interference cancelation was investigated quantitatively by applying a PTR-DFE (decision feed-back filter) scheme to a synthetic dataset of a horizontal underwater acoustic channel. Mainly, in this study, we focused on the relationship between the signal-to-interference ratio (SIR) of datasets and the output signal-to-noise ratio (OSNR) of demodulation results by a parametric study approach. As a result, a proportional relation between SIR and OSNR is confirmed in low-SNR datasets. It was also found that PTR has a performance limitation, that is OSNR converges to a typical value depending on the number of receivers. In conclusion, results indicate that PTR could utilize the multipath efficiently and also withstand the negative effects of multipath interference at a given limitation.

Optimal estimation for discrete time jump processes

NASA Technical Reports Server (NTRS)

Vaca, M. V.; Tretter, S. A.

1977-01-01

Optimum estimates of nonobservable random variables or random processes which influence the rate functions of a discrete time jump process (DTJP) are obtained. The approach is based on the a posteriori probability of a nonobservable event expressed in terms of the a priori probability of that event and of the sample function probability of the DTJP. A general representation for optimum estimates and recursive equations for minimum mean squared error (MMSE) estimates are obtained. MMSE estimates are nonlinear functions of the observations. The problem of estimating the rate of a DTJP when the rate is a random variable with a probability density function of the form cx super K (l-x) super m and show that the MMSE estimates are linear in this case. This class of density functions explains why there are insignificant differences between optimum unconstrained and linear MMSE estimates in a variety of problems.

Optimal estimation for discrete time jump processes

NASA Technical Reports Server (NTRS)

Vaca, M. V.; Tretter, S. A.

1978-01-01

Optimum estimates of nonobservable random variables or random processes which influence the rate functions of a discrete time jump process (DTJP) are derived. The approach used is based on the a posteriori probability of a nonobservable event expressed in terms of the a priori probability of that event and of the sample function probability of the DTJP. Thus a general representation is obtained for optimum estimates, and recursive equations are derived for minimum mean-squared error (MMSE) estimates. In general, MMSE estimates are nonlinear functions of the observations. The problem is considered of estimating the rate of a DTJP when the rate is a random variable with a beta probability density function and the jump amplitudes are binomially distributed. It is shown that the MMSE estimates are linear. The class of beta density functions is rather rich and explains why there are insignificant differences between optimum unconstrained and linear MMSE estimates in a variety of problems.

Trade-Offs in a 1 Tbps Multiple-Input and Multiple-Output (MIMO) Communication System Between an Airship and Ground Receive Antennas

DTIC Science & Technology

2012-03-01

covariance PT T Ir, where R is the number of receive antennas. The capacity is given by B × log2 ∣ ∣Ir + PT T HHH ∣ ∣. From his theorem, Telatar stated that...Applying Telatar’s theorem to 2.9, the capacity for a MIMO system can be rewritten as C = B log2 ∣ ∣ ∣ ∣ I+ PT T HHH ∣ ∣ ∣ ∣ , (2.13) where I is the identity...as a MMSE equalizer and is modeled as H† = ( HHH + σ2 n I)−1HH, (2.39) where H is the channel gain matrix, σ2n is the SNR per transmit antenna, x H

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.

Describing the Sequence of Cognitive Decline in Alzheimer's Disease Patients: Results from an Observational Study.

PubMed

Henneges, Carsten; Reed, Catherine; Chen, Yun-Fei; Dell'Agnello, Grazia; Lebrec, Jeremie

2016-01-01

Improved understanding of the pattern of cognitive decline in Alzheimer's disease (AD) would be useful to assist primary care physicians in explaining AD progression to patients and caregivers. To identify the sequence in which cognitive abilities decline in community-dwelling patients with AD. Baseline data were analyzed from 1,495 patients diagnosed with probable AD and a Mini-Mental State Examination (MMSE) score ≤ 26 enrolled in the 18-month observational GERAS study. Proportional odds logistic regression models were applied to model MMSE subscores (orientation, registration, attention and concentration, recall, language, and drawing) and the corresponding subscores of the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), using MMSE total score as the index of disease progression. Probabilities of impairment start and full impairment were estimated at each MMSE total score level. From the estimated probabilities for each MMSE subscore as a function of the MMSE total score, the first aspect of cognition to start being impaired was recall, followed by orientation in time, attention and concentration, orientation in place, language, drawing, and registration. For full impairment in subscores, the sequence was recall, drawing, attention and concentration, orientation in time, orientation in place, registration, and language. The sequence of cognitive decline for the corresponding ADAS-cog subscores was remarkably consistent with this pattern. The sequence of cognitive decline in AD can be visualized in an animation using probability estimates for key aspects of cognition. This might be useful for clinicians to set expectations on disease progression for patients and caregivers.

Notification: Preliminary Research on EPA's Design for the Environment Product Labeling Program OIG

EPA Pesticide Factsheets

Project #OPE-FY14-4012, November 06, 2013. The Office of Inspector General (OIG) is starting preliminary research on the U.S. Environmental Protection Agency’s (EPA’s) Design for the Environment (DfE) Product Labeling Program.

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.

Flemish Primary Teachers' Use of School Performance Feedback and the Relationship with School Characteristics

ERIC Educational Resources Information Center

Vanhoof, Jan; Verhaeghe, Goedele; Van Petegem, Peter; Valcke, Martin

2012-01-01

Background: Schools are increasingly confronted with the challenges that information about school performance brings with it. It is common for schools' use of performance feedback to be limited. Equally, however, there are documented cases in which school performance feedback is meaningfully used. Purpose: This study looks at how Flemish primary…

Folate intake and the MTHFR C677T genotype influence choline status in young Mexican American women☆

PubMed Central

Abratte, Christian M.; Wang, Wei; Li, Rui; Moriarty, David J.; Caudill, Marie A.

2009-01-01

Numerous studies have reported a relationship between folate status, the methylenetetrahydrofolate reductase (MTHFR) 677C→T variant and disease risk. Although folate and choline metabolism are inter-related, only limited data are available on the relationship between choline and folate status in humans. This study sought to examine the influences of folate intake and the MTHFR 677C→T variant on choline status. Mexican-American women (n =43; 14 CC, 12 CT and 17 TT) consumed 135 μg/day as dietary folate equivalents (DFE) for 7 weeks followed by randomization to 400 or 800 μg DFE/day for 7 weeks. Throughout the study, total choline intake remained unchanged at ∼350 mg/day. Plasma concentrations of betaine, choline, glycerophosphocholine, phosphatidylcholine and sphingomyelin were measured via LC-MS/MS for Weeks 0, 7 and 14. Phosphatidylcholine and sphingomyelin declined ( P=.001, P=.009, respectively) in response to folate restriction and increased ( P=.08, P=.029, respectively) in response to folate treatment. The increase in phosphatidylcholine occurred in response to 800 ( P=.03) not 400 ( P=.85) μg DFE/day (week×folate interaction, P=.017). The response of phosphatidylcholine to folate intake appeared to be influenced by MTHFR C677T genotype. The decline in phosphatidylcholine during folate restriction occurred primarily in women with the CC or CT genotype and not in the TT genotype (week×genotype interaction, P=.089). Moreover, when examined independent of folate status, phosphatidylcholine was higher ( P <.05) in the TT genotype relative to the CT genotype. These data suggest that folate intake and the MTHFR C677T genotype influence choline status in humans. PMID:17588738

Meltwater Pathways and Iron Delivery to the Antarctic Coastal Ocean

NASA Astrophysics Data System (ADS)

Null, K. A.; Corbett, D. R.; Crenshaw, J.; Peterson, R. N.; Peterson, L.; Buck, C. S.; Lyons, W. B.

2016-02-01

Freshwater inputs to the Antarctic coastal ocean can occur through multiple pathways including calving, streams, and groundwater discharge. The impacts of submarine groundwater discharge on polar ecosystems are generally poorly understood and, until recently, had not been considered as an important physical process along the coast of the Antarctic continent. Here, we present a study utilizing multiple tracers (radium, radon, and stable water isotopes) to quantify freshwater inputs and chemical constituent fluxes associated with multiple discharge pathways, including submarine groundwater discharge, along the Western Antarctic Peninsula. Previous research has shown that primary production in iron-limited waters offshore of the Antarctic Peninsula is fueled in part by continentally-derived sediments, and our work demonstrates that subglacial/submarine groundwater discharge (SSGD) to continental shelf waters in the region is also an important source of dissolved iron (6.4 Gg yr-1; dFe). For reference, this flux equates to approximately 25 times the iron flux from calving in the study area. SSGD also contributed a significantly higher macronutrient flux than calving, although calving contributed more than twice as much freshwater. Thus, SSGD is likely a much more important source of macronutrients and dFe to the nearshore coastal ocean along the Western Antarctic Peninsula, and potentially to the continental shelf and offshore waters of the entire continent than previously recognized. If we assume similar discharge rates along the entire Antarctic coastline ( 45,000 km), the delivery of dFe via SSGD ( 216 Gg yr-1) is comparable to the other fluxes of Fe to the Southern Ocean via dust, icebergs, and glacial runoff from the Antarctic Ice Sheet, and should be considered in future geochemical budgets.

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.

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.

[Association between cerumen impaction, cognitive function and hearing in Japanese elderly].

PubMed

Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu; Nishita, Yukiko; Tange, Chikako; Ando, Fujiko; Shimokata, Hiroshi

2012-01-01

In this study we aimed to evaluate the frequency of cerumen impaction in Japanese elderly and clarify the associations between cerumen, cognitive function, and hearing impairment. The subjects enrolleded in this study were participants in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). The data of 792 community-dwelling participants aged 60 to 88 years old were collected. All had taken the Mini-Mental State Examination (MMSE) and had undergone pure tone audiometry (PTA) assessment and video recording of an otoscopic examination. We then analyzed associations between the incidence of the cerumen impaction of better-hearing ear, hearing level and MMSE scores using a general linear model. Cerumen impaction of the better-hearing ear was observed in 10.7% of all participants. In participants with an MMSE score of less than 24, the frequency of cerumen impaction was 23.3%. Cerumen was significant associated with poorer hearing after adjustment for sex and age (p=0.0001). Cerumen impaction also showed a significant association with a low MMSE score after adjustment for sex, age, hearing level and education (p=0.02). The frequency of cerumen impaction in Japanese elderly was estimated to be approximately 10%. The existence of cerumen impaction was associated with poorer hearing level and lower 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.

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

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.

40 CFR 80.1611 - Standards and requirements for certified ethanol denaturant.

Code of Federal Regulations, 2014 CFR

2014-07-01

... certified ethanol denaturant. 80.1611 Section 80.1611 Protection of Environment ENVIRONMENTAL PROTECTION....1611 Standards and requirements for certified ethanol denaturant. Producers and importers of ethanol denaturant that is suitable for the manufacture of denatured fuel ethanol (DFE) meeting federal quality...

Replacement of sugars to hydrogen production by Rhodobacter capsulatus using dark fermentation effluent as substrate.

PubMed

Silva, Felipe Thales Moreira; Moreira, Luiza Rojas; de Souza Ferreira, Juliana; Batista, Fabiana Regina Xavier; Cardoso, Vicelma Luiz

2016-01-01

Hydrogen is a promising alternative for the increased global energy demand since it has high energy density and is a clean fuel. The aim of this work was to evaluate the photo-fermentation by Rhodobacter capsulatus, using the dark fermentation effluent as substrate. Different systems were tested by changing the type of sugar in the dark fermentation, investigating the influence of supplementing DFE with sugar and adding alternate and periodically lactose and glucose throughout the process. The supplementation of the DFE with sugar resulted in higher H2 productivity and the replacement of the sugars repeatedly during the photo-fermentation process was important to maintain the cell culture active. By controlling the residual amount of sugar, bacteria inhibition was avoided; lactic acid, that was toxic to the biomass, was consumed and the metabolic route of butyric acid production was predominant. Under optimum conditions, the H2 productivity reached 208.40mmolH2/Ld in 52h. Copyright © 2015 Elsevier Ltd. All rights reserved.

Supporting Learners' Agentic Engagement with Feedback: A Systematic Review and a Taxonomy of Recipience Processes

ERIC Educational Resources Information Center

Winstone, Naomi E.; Nash, Robert A.; Parker, Michael; Rowntree, James

2017-01-01

Much has been written in the educational psychology literature about effective feedback and how to deliver it. However, it is equally important to understand how learners actively receive, engage with, and implement feedback. This article reports a systematic review of the research evidence pertaining to this issue. Through an analysis of 195…

The Timing of Feedback on Mathematics Problem Solving in a Classroom Setting

ERIC Educational Resources Information Center

Fyfe, Emily R.; Rittle-Johnson, Bethany

2015-01-01

Feedback is a ubiquitous learning tool that is theorized to help learners detect and correct their errors. The goal of this study was to examine the effects of feedback in a classroom context for children solving math equivalence problems (problems with operations on both sides of the equal sign). The authors worked with children in 7 second-grade…

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.

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.

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.

[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

Generation of GHS Scores from TEST and online sources

EPA Science Inventory

Alternatives assessment frameworks such as DfE (Design for the Environment) evaluate chemical alternatives in terms of human health effects, ecotoxicity, and fate. T.E.S.T. (Toxicity Estimation Software Tool) can be utilized to evaluate human health in terms of acute oral rat tox...

40 CFR 80.1600 - Additional definitions for subpart O.

Code of Federal Regulations, 2014 CFR

2014-07-01

... California. Certified ethanol denaturant means ethanol denaturant that meets the requirements of § 80.1611. Certified Sulfur-FRGAS has the meaning given in § 80.1666(a)(5). Denatured fuel ethanol (DFE) means an.... Ethanol denaturant means previously certified gasoline (including previously certified blendstocks for...

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.

Fe3+ partitioning during basalt differentiation on Mars: insights into the oxygen fugacity of the shergottite mantle source(s).

NASA Astrophysics Data System (ADS)

Medard, E.; Martin, A. M.; Collinet, M.; Righter, K.; Grove, T. L.; Newville, M.; Lanzirotti, A.

2014-12-01

The partitioning of Fe3+ between silicate melts and minerals is a key parameter to understand magmatic processes, as it is directly linked to oxygen fugacity (fO2). fO2 is, a priori, not a constant during magmatic processes, and its evolution depends on the compatibility of Fe3+. We have experimentally determined the partition coefficients of Fe3+ between augite, pigeonite, and silicate melt, and use them to constrain the fO2of the martian mantle and of differentiated martian basalts. A series of experiments on various martian basaltic compositions were performed under controlled fO2 in one-atmosphere gas-mixing furnaces. Fe3+/Fetotal ratios in silicate melts and pyroxenes were determined using synchrotron Fe K-edge XANES on the 13 IDE beamline at APS (Argonne). Fe3+ mineral/melt partition coefficients (DFe3+) for augite and pigeonite were obtained with a relative uncertainty of 10-15 %. Both are constant over a wide range of oxygen fugacity (FMQ-2.5 to FMQ+2.0). DFe3+ for augite and pigeonite are broadly consistent with previous data by [1], but DFe3+ for augite is significantly higher (by a factor of 2) than the indirect determinations of [2]. Since augites in [2] are extremely poor in iron compared to ours (0.18 wt% vs 13 wt% FeO), this strongly suggests that DFe3+ varies with Mg#, indicating that Fe3+is more compatible than previously thought in terrestrial mantle pyroxenes (3 wt% FeO) as well. Crystallization paths for shergottite parental melts have been calculated using the MELTS software, combined with our partition coefficients. fO2 in the residual melts is calculated from the models of [3] and [4]. It stays relatively constant at high temperatures, but increases very strongly during the latest stages of crystallization. These results explain the large range of fO2 determined in enriched shergottites. In order to estimate the fO2 of the martian mantle, only the highest temperature phases in the most primitive martian samples should be used. The most primitive shergottites record a mantle fO2 around FMQ-2.5, consistent with the lowest fO2estimated for surface basalts [5]. [1] McCanta et al. (2004) Am Min 89:1685-1693; [2] Mallmann and O'Neill (2009) J Petrol 50:1765-1794; [3] Righter et al. (2013) Am Min 98:616-628; [4] Kress and Carmichael (1991) CMP 108:82-92; [5] Schmidt ME et al. (2014) EPSL 384:198-208.

Lp-stability (1 less than or equal to p less than or equal to infinity) of multivariable nonlinear time-varying feedback systems that are open-loop unstable. [noting unstable convolution subsystem forward control and time varying nonlinear feedback

NASA Technical Reports Server (NTRS)

Callier, F. M.; Desoer, C. A.

1973-01-01

A class of multivariable, nonlinear time-varying feedback systems with an unstable convolution subsystem as feedforward and a time-varying nonlinear gain as feedback was considered. The impulse response of the convolution subsystem is the sum of a finite number of increasing exponentials multiplied by nonnegative powers of the time t, a term that is absolutely integrable and an infinite series of delayed impulses. The main result is a theorem. It essentially states that if the unstable convolution subsystem can be stabilized by a constant feedback gain F and if incremental gain of the difference between the nonlinear gain function and F is sufficiently small, then the nonlinear system is L(p)-stable for any p between one and infinity. Furthermore, the solutions of the nonlinear system depend continuously on the inputs in any L(p)-norm. The fixed point theorem is crucial in deriving the above theorem.

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.

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.

Space-time adaptive decision feedback neural receivers with data selection for high-data-rate users in DS-CDMA systems.

PubMed

de Lamare, Rodrigo C; Sampaio-Neto, Raimundo

2008-11-01

A space-time adaptive decision feedback (DF) receiver using recurrent neural networks (RNNs) is proposed for joint equalization and interference suppression in direct-sequence code-division multiple-access (DS-CDMA) systems equipped with antenna arrays. The proposed receiver structure employs dynamically driven RNNs in the feedforward section for equalization and multiaccess interference (MAI) suppression and a finite impulse response (FIR) linear filter in the feedback section for performing interference cancellation. A data selective gradient algorithm, based upon the set-membership (SM) design framework, is proposed for the estimation of the coefficients of RNN structures and is applied to the estimation of the parameters of the proposed neural receiver structure. Simulation results show that the proposed techniques achieve significant performance gains over existing schemes.

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.

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

Generation of Alternative Assessment Scores using TEST and online data sources

EPA Science Inventory

Alternatives assessment frameworks such as DfE (Design for the Environment) evaluate chemical alternatives in terms of human health effects, ecotoxicity, and fate. T.E.S.T. (Toxicity Estimation Software Tool) can be utilized to evaluate human health in terms of acute oral rat tox...

Chemistry within Molecular Clusters

DTIC Science & Technology

1992-05-29

within van der Waals clusters. 23 They include the generation of (C2H4F 2),,>4H+ ions from 1,1- difluoroethane clusters, 24 the generation of (CH 3...fragment ions, and identification of the molecule must be made by the characteristic fragmentation pattern. The mass spectrum of 1,1- difluoroethane (DFE

The Impact of "Achievement for All" on School Leadership

ERIC Educational Resources Information Center

Blandford, Sonia

2013-01-01

The "Achievement for All" (AfA) pilot initiative, delivered in partnership by the Department for Education (DfE), (formerly the Department for Children, Schools and Families [DCSF]), National Strategies and the National College (NCSL), aims to increase the attainment and progress of children in schools with special educational needs and…

77 FR 10573 - Meeting of the Department of Justice's (DOJ's) National Motor Vehicle Title Information System...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... Department of Justice's (DOJ's) National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... announcement of a meeting of DOJ's National Motor Vehicle Title Information System (NMVTIS) Federal Advisory.... FOR FURTHER INFORMATION CONTACT: Todd Brighton, Designated Federal Employee (DFE), Bureau of Justice...

78 FR 51747 - Meeting of the Department of Justice's (DOJ's) National Motor Vehicle Title Information System...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

... Department of Justice's (DOJ's) National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... announcement of a meeting of DOJ's National Motor Vehicle Title Information System (NMVTIS) Federal Advisory.... FOR FURTHER INFORMATION CONTACT: Todd Brighton, Designated Federal Employee (DFE), Bureau of Justice...

76 FR 38209 - Meeting of the Department of Justice's (DOJ's) National Motor Vehicle Title Information System...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... Department of Justice's (DOJ's) National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... announcement of a meeting of DOJ's National Motor Vehicle Title Information System (NMVTIS) Federal Advisory... FURTHER INFORMATION CONTACT: Alissa Huntoon, Designated Federal Employee (DFE), Bureau of Justice...

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…

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.

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.

Effects of education on very mild dementia among Chinese people in Hong Kong: potential mediators in the Cantonese Mini-Mental State Examination tasks.

PubMed

Tse, C S; Chang, J F; Leung, Grace T Y; Fung, Ada W T; Hau, K T; Chiu, Helen F K; Lam, Linda C W

2013-01-01

In Hong Kong, older Chinese adults generally have a low level of education. This study examined the effect of education on very mild Alzheimer's disease (AD), as quantified by Clinical Dementia Rating (CDR) scale (CDR 0.5 versus 0), in a Chinese community. The Cantonese version of the Mini-Mental State Examination (C-MMSE) was used to estimate cognitive abilities that were related to the level of education, and that in turn serve as protective factors for AD. A total of 788 community-dwelling older adults (383 CDR 0 and 405 CDR 0.5) were recruited in this cross-sectional study, which was derived from a population-based prevalence project. The participants' number of years of education and C-MMSE scores were used to predict their CDR scores using logistic regression and the mediation effects of C-MMSE scores were analyzed. Consistent with previous studies, the chance of being rated as having very mild AD increased with age, but decreased with years of education, among the older adult community of Hong Kong. The effect of education on very mild dementia was weakened substantially when C-MMSE scores were included as mediating variables. The findings indicate that the protective effects of education on dementia were mediated by an enhancement of older adults' performance on some C-MMSE items, including attention and orientation to time and place.

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.

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

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.

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.

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

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.

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.

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.

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.

[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.

Learner-Valued Interactions: Research into Practice

ERIC Educational Resources Information Center

Ley, Kathryn; Gannon-Cook, Ruth

2014-01-01

Online learners provide feedback that does not always match with the expectations of what university administration would expect from their feedback. Learners do not value all instructional features and conditions equally, nor do they view many of the instructional and technology features as being necessarily helpful. This paper presents research…

Identification of pilot-vehicle dynamics from simulation and flight test

NASA Technical Reports Server (NTRS)

Hess, Ronald A.

1990-01-01

The paper discusses an identification problem in which a basic feedback control structure, or pilot control strategy, is hypothesized. Identification algorithms are employed to determine the particular form of pilot equalization in each feedback loop. It was found that both frequency- and time-domain identification techniques provide useful information.

Language Trends 2010 Secondary (CILT, ALL, ISMLA) Data Report

ERIC Educational Resources Information Center

CILT, the National Centre for Languages, 2011

2011-01-01

This survey has been carried out annually since 2002 to track developments in language provision and take up in secondary schools. The following sections are included in this analysis of key results from the Secondary Language Trends survey: (1) Survey background, methodology and sample design; (2) DfE (Department for Education) data trends of…

Reframing the English Grammar Schools Debate

ERIC Educational Resources Information Center

Morris, Rebecca; Perry, Thomas

2017-01-01

In October 2015 the Department for Education (DfE) permitted a grammar school in Tonbridge, Kent, to open up an annexe in Sevenoaks, 10 miles away. Amidst claims that the annexe was essentially a new grammar school, the decision reignited an old debate about the value of academically-selective "grammar" schools in England. The intensity…

Using Space to Inspire and Engage Children

ERIC Educational Resources Information Center

Clements, Allan

2015-01-01

The European Space Education Resources Office (ESERO-UK) is a project of the European Space Agency (ESA) and national partners including the Department for Education (DfE), The UK Space Agency (UKSA) and the Science and Technology Facilities Council (STFC). The key objective of the project is to promote space as an exciting inspirational context…

Cereal Box Design: An Interdisciplinary Graphics Activity

ERIC Educational Resources Information Center

Fitzgerald, Mike; Tsosie, Teri

2004-01-01

This article describes cereal box design, an interdisciplinary graphics activity. The cereal box design activity is intriguing both for its simplicity and the resourcefulness that it can generate in young people. It lends itself to a variety of curriculums. It covers both consumerism and Design for the Environment (DfE) concepts broadly and in…

Too many chemicals, too little time: Rapid in silico methods to characterize and predict ADME properties for chemical toxicity and exposure potential

EPA Science Inventory

Evaluating proposed alternative chemical structures to support the design of safer chemicals and products is an important component of EPA's Green Chemistry and Design for the Environment (DfE) Programs. As such, science-based alternatives assessment is essential to support EPA's...

U.S. EPA, Pesticide Product Label, , 11/14/1991

EPA Pesticide Factsheets

2011-04-21

... 0. i~jS-"lu j~!:-;l.)licQt.ivl.1~ uat,.t;;;(.l nUSlUc.t. .:t~, .l~~l ilUu uctowr ~j, 1~~..L 4:"<.(H.iu(.:stih'.,;: dn I'\\lt~rr,~l~' O£lJuu L'id.fe u~nolin'::J ...

Action against Bullying.

ERIC Educational Resources Information Center

Smith, Peter K.; Madsen, Kirsten C.

This poster presentation outlines the work of the DFE Anti-bullying project. In the first part of the poster the results of a large scale survey in the United Kingdom are presented. The results show the extent and nature of bullying. The questionnaire survey was administered to students from 24 schools in and around Sheffield, a northern…

"Old Poems Have Heart": Teenage Students Reading Early Modern Poetry

ERIC Educational Resources Information Center

Naylor, Amanda

2013-01-01

The proposals for the revised National Curriculum in English suggest limiting the pre-twentieth century poetry that GCSE pupils read to "representative Romantic poetry" (Department for Education [DFE], 2013, p. 4). This paper argues that poetry of the early modern period is challenging and enriching study for adolescent pupils and that…

3D facial expression recognition using maximum relevance minimum redundancy geometrical features

NASA Astrophysics Data System (ADS)

Rabiu, Habibu; Saripan, M. Iqbal; Mashohor, Syamsiah; Marhaban, Mohd Hamiruce

2012-12-01

In recent years, facial expression recognition (FER) has become an attractive research area, which besides the fundamental challenges, it poses, finds application in areas, such as human-computer interaction, clinical psychology, lie detection, pain assessment, and neurology. Generally the approaches to FER consist of three main steps: face detection, feature extraction and expression recognition. The recognition accuracy of FER hinges immensely on the relevance of the selected features in representing the target expressions. In this article, we present a person and gender independent 3D facial expression recognition method, using maximum relevance minimum redundancy geometrical features. The aim is to detect a compact set of features that sufficiently represents the most discriminative features between the target classes. Multi-class one-against-one SVM classifier was employed to recognize the seven facial expressions; neutral, happy, sad, angry, fear, disgust, and surprise. The average recognition accuracy of 92.2% was recorded. Furthermore, inter database homogeneity was investigated between two independent databases the BU-3DFE and UPM-3DFE the results showed a strong homogeneity between the two databases.

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.

Sedimentary and atmospheric sources of iron around South Georgia, Southern Ocean: a modelling perspective

NASA Astrophysics Data System (ADS)

Borrione, I.; Aumont, O.; Nielsdóttir, M. C.; Schlitzer, R.

2013-07-01

In high-nutrient low-chlorophyll waters of the western Atlantic sector of the Southern Ocean, an intense phytoplankton bloom is observed annually north of South Georgia, most likely due to an enhanced supply of the limiting micronutrient iron. Shallow sediments and atmospheric dust deposition are believed to be the main iron sources. However, their relative importance is still unclear and in the South Georgia region have yet not been ascertained because iron measurements are very few. In this study, we use austral summer dissolved iron (dFe) data around South Georgia (January and February 2008) with a coupled regional hydrodynamic and biogeochemical model to investigate natural iron fertilization around the island. The biogeochemical component of the model includes an iron cycle, where sediments and dust deposition are the sources of iron to the ocean. The model captures the characteristic flow patterns around South Georgia, hence simulating a large phytoplankton bloom to the north, i.e., downstream, of the island. Modelled dFe concentrations agree well with observations (mean difference and root mean square errors of ~0.02 nM and ~0.81 nM) and form a large plume to the north of the island that extends eastwards for more than 800 km. In agreement with observations, highest dFe concentrations are located along the coast and decrease with distance from the island. Sensitivity tests indicate that most of the iron measured in the main bloom area originates from the coast and the very shallow shelf-sediments (depths < 20 m) while dust deposition plays a minor role, with almost no effects on surface chlorophyll a concentrations. Iron sources such as run-off not represented explicitly in the model, but that likely contribute to the iron plumes observed around South Georgia, are also discussed together with the potential effects their temporal variability may have on the system.

Jarzynski-Type Equalities in Gambling: Role of Information in Capital Growth

NASA Astrophysics Data System (ADS)

Hirono, Yuji; Hidaka, Yoshimasa

2015-11-01

We study the capital growth in gambling with (and without) side information and memory effects. We derive several equalities for gambling, which are of similar form to the Jarzynski equality and its extension to systems with feedback controls. Those relations provide us with new measures to quantify the effects of information on the statistics of capital growth in gambling. We discuss the implications of the equalities and show that they reproduce the known upper bounds of average capital growth rates.

Digital transceiver design for two-way AF-MIMO relay systems with imperfect CSI

NASA Astrophysics Data System (ADS)

Hu, Chia-Chang; Chou, Yu-Fei; Chen, Kui-He

2013-09-01

In the paper, combined optimization of the terminal precoders/equalizers and single-relay precoder is proposed for an amplify-and-forward (AF) multiple-input multiple-output (MIMO) two-way single-relay system with correlated channel uncertainties. Both terminal transceivers and relay precoding matrix are designed based on the minimum mean square error (MMSE) criterion when terminals are unable to erase completely self-interference due to imperfect correlated channel state information (CSI). This robust joint optimization problem of beamforming and precoding matrices under power constraints belongs to neither concave nor convex so that a nonlinear matrix-form conjugate gradient (MCG) algorithm is applied to explore local optimal solutions. Simulation results show that the robust transceiver design is able to overcome effectively the loss of bit-error-rate (BER) due to inclusion of correlated channel uncertainties and residual self-interference.

Application of the Social Marketing Model to Unemployment Counseling: A Theoretical Perspective

ERIC Educational Resources Information Center

Englert, Paul; Sommerville, Susannah; Guenole, Nigel

2009-01-01

A. R. Andreasen's (1995) social marketing model (SMM) is applied to structure feedback counseling for individuals who are unemployed. The authors discuss techniques used in commercial marketing and how they are equally applicable to solving societal problems; SMM and its application to social interventions; and structured feedback that moves a…

Silent Policy Feedback through School Choice

ERIC Educational Resources Information Center

Little-Hunt, Catherine Cecchini

2017-01-01

Increasing numbers of Florida parents are withdrawing their children from traditional public schools in highly-rated school districts to enroll them in tuition-free, startup, charter schools. Since not all parents have equal access or are as equally motivated to elect school choice alternatives, the fiscal sustainability of the traditional public…

[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.

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.

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…

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.

MMSE Estimator for Children’s Speech with Car and Weather Noise

NASA Astrophysics Data System (ADS)

Sayuthi, V.

2018-04-01

Previous research mentioned that most people need and use vehicles for various purposes, in this recent time and future, as a means of traveling. Many ways can be done in a vehicle, such as for enjoying entertainment, and doing work, so vehicles not just only as a means of traveling. In this study, we will examine the children’s speech from a girl in the vehicle that affected by noise disturbances from the sound source of car noise and the weather sound noise around it, in this case, the rainy weather noise. Vehicle sounds may be from car engine or car air conditioner. The minimum mean square error (MMSE) estimator is used as an attempt to obtain or detect the children’s clear speech by representing simulation research as random process signal that factored by the autocorrelation of both the child’s voice and the disturbance noise signal. This MMSE estimator can be considered as wiener filter as the clear sound are reconstructed again. We expected that the results of this study can help as the basis for development of entertainment or communication technology for passengers of vehicles in the future, particularly using MMSE estimators.

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.

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.

Evaluation of In Harmony: Year 1. Interim Report

ERIC Educational Resources Information Center

Lord, Pippa; Sharp, Caroline; Dawson, Anneka; Mehta, Palak; White, Richard; Jeffes, Jennifer

2013-01-01

Arts Council England (ACE) commissioned NFER to undertake the national evaluation of the In Harmony social and music education programme 2012-2015. In Harmony is funded by the Department for Education (DfE) and ACE, and is currently being piloted in six areas. The evaluation is investigating the range and extent of impacts on children, families,…

40 CFR 80.1642 - Sampling and testing requirements for producers and importers of denatured fuel ethanol and other...

Code of Federal Regulations, 2014 CFR

2014-07-01

... producers and importers of denatured fuel ethanol and other oxygenates for use by oxygenate blenders. 80... requirements for producers and importers of denatured fuel ethanol and other oxygenates for use by oxygenate blenders. Beginning January 1, 2017, producers and importers of denatured fuel ethanol (DFE) and other...

40 CFR 80.1610 - Standards and requirements for producers and importers of denatured fuel ethanol and other...

Code of Federal Regulations, 2014 CFR

2014-07-01

... producers and importers of denatured fuel ethanol and other oxygenates designated for use in transportation... requirements for producers and importers of denatured fuel ethanol and other oxygenates designated for use in transportation fuel. Beginning January 1, 2017, producers and importers of denatured fuel ethanol (DFE) or other...

Earth Science: It's All about the Processes

ERIC Educational Resources Information Center

King, Chris

2013-01-01

Readers of the draft new English primary science curriculum (DfE, 2012) might be concerned to see that there is much more detail on the Earth science content than previously in the United Kingdom. In this article, Chris King, a professor of Earth Science Education at Keele University and Director of the Earth Science Education Unit (ESEU),…

Cereal Box Design: An Interdisciplinary Graphics Activity

ERIC Educational Resources Information Center

Fitzgerald, Mike; Tsosie, Teri

2012-01-01

The cereal box design activity is intriguing both for its simplicity and the resourcefulness that it can generate in young people. Also, it lends itself to a variety of curriculums. It covers both consumerism and Design for the Environment (DfE) concepts broadly and in depth. The activity introduces a wide range of topics. They include graphic…

78 FR 38029 - Information Collection Request Submitted to OMB for Review and Approval; Comment Request; EPA's...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-25

... Submitted to OMB for Review and Approval; Comment Request; EPA's Design for the Environment Formulator... Environment Formulator Product Recognition Program'' (EPA ICR No. 2302.02, OMB Control No. 2070-0178), to the..., visit http://www.epa.gov/dockets . Abstract: EPA's Design for the Environment (DfE) Formulator Product...

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.

Analysis of the faster-than-Nyquist optimal linear multicarrier system

NASA Astrophysics Data System (ADS)

Marquet, Alexandre; Siclet, Cyrille; Roque, Damien

2017-02-01

Faster-than-Nyquist signalization enables a better spectral efficiency at the expense of an increased computational complexity. Regarding multicarrier communications, previous work mainly relied on the study of non-linear systems exploiting coding and/or equalization techniques, with no particular optimization of the linear part of the system. In this article, we analyze the performance of the optimal linear multicarrier system when used together with non-linear receiving structures (iterative decoding and direct feedback equalization), or in a standalone fashion. We also investigate the limits of the normality assumption of the interference, used for implementing such non-linear systems. The use of this optimal linear system leads to a closed-form expression of the bit-error probability that can be used to predict the performance and help the design of coded systems. Our work also highlights the great performance/complexity trade-off offered by decision feedback equalization in a faster-than-Nyquist context. xml:lang="fr"

Suppression of Spontaneous Gas Oscillations by Acoustic Self-Feedback

NASA Astrophysics Data System (ADS)

Biwa, Tetsushi; Sawada, Yoshiki; Hyodo, Hiroaki; Kato, Soichiro

2016-10-01

This paper demonstrates a method of acoustical self-feedback to suppress spontaneous gas oscillations such as those observed in combustors of gas-turbine engines. Whereas a conventional feedback system consists of electromechanical devices, the present method achieves acoustical self-feedback with a hollow tube that connects two positions of the oscillation system. A model oscillator of combustion-driven gas oscillations is designed and built to demonstrate the applicability of the self-feedback concept. Stability analysis through measurements of Q values (quality factor) of oscillations shows that the desired delay time and gain are obtained when the tube length is equal to the odd integer times half the wavelength of the anticipated acoustic oscillations.

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.

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.

Differential Effectiveness of Electromyograph Feedback, Verbal Relaxation Instructions, and Medication Placebo with Tension Headaches

ERIC Educational Resources Information Center

Cox, Daniel J.; And Others

1975-01-01

Adults with chronic tension headaches were assigned to auditory electromyograph (EMG) feedback (N=9), to progressive relaxation (N=9), and to placebo treatment (N=9). Data indicated that biofeedback and verbal relaxation instructions were equally superior to the medicine placebo on all measured variables in the direction of clinical improvement,…

A model-based investigation of manipulator characteristics and pilot/vehicle performance

NASA Technical Reports Server (NTRS)

Hess, R. A.

1983-01-01

Hess (1978, 1981) has introduced and discussed a structural model of the human pilot in which proprioceptive feedback plays a fundamental role in determining pilot equalization characteristics. It is pointed out that, on account of the feedback structure, this model may provide more insight into the effects of certain manipulator characteristics upon pilot equalization than would other modeling approaches. The model is briefly discussed, and an outline is presented concerning some of the implications of the model structure regarding the manipulator characteristics. Attention is given to some specific empirical examples of manipulator effects involving glide slope tracking in STOL aircraft, taking into account an employment of the model as a theoretical framework.

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

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

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.

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.

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.

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

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.

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.

Falls and cognitive decline in Mexican Americans 75 years and older

PubMed Central

Padubidri, Anokha; Al Snih, Soham; Samper-Ternent, Rafael; Markides, Kyriakos S; Ottenbacher, Kenneth J; Raji, Mukaila A

2014-01-01

Background Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls–cognition association among cognitively intact Hispanic Elders. Methods We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results At baseline, participants’ mean age was 80.8 years (range, 74–109), mean education was 6.3 years (range, 0–17), and mean MMSE was 25.2 (range, 21–30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =−0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =−0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls–cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls–cognition association. PMID:24790424

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.

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.

To Promote, or Not to Promote Fundamental British Values? Teachers' Standards, Diversity and Teacher Education

ERIC Educational Resources Information Center

Elton-Chalcraft, Sally; Lander, Vini; Revell, Lynn; Warner, Diane; Whitworth, Linda

2017-01-01

In this article we seek to problematize the presence of the requirement within the teachers' standards (DfE, 2012), that they "should not undermine fundamental British values" in the context of initial teacher education in England. The inclusion of this statement within the teachers' code of conduct has made its way from the…

More? Great? Childcare? A Discourse Analysis of Two Recent Social Policy Documents Relating to the Care and Education of Young Children in England

ERIC Educational Resources Information Center

Wild, Mary; Silberfeld, Carolyn; Nightingale, Beverley

2015-01-01

This paper considers the overt and covert discourses in two contemporary policy documents in England and Wales, "The Nutbrown Review: Foundations for Quality" ([DfE] Department for Education Department for Education. 2012. "The Nutbrown Review: Foundations for Quality: The Independent Review of Early Education and Childcare…

The Complex Learning Difficulties and Disabilities Research Project: Developing Meaningful Pathways to Personalised Learning. Executive Summary

ERIC Educational Resources Information Center

Schools Network, 2011

2011-01-01

The Specialist Schools and Academies Trust (SSAT) was commissioned by the Department for Education (DfE) to research ways to improve outcomes for children and young people with the most complex educational needs and disabilities through the development of evidence-based teaching and learning strategies. The programme of research brought together a…

Approaches to Increasing the Competence and Confidence of Student Teachers to Teach Music in Primary Schools

ERIC Educational Resources Information Center

Hennessy, Sarah

2017-01-01

The National Plan for Music (DfE (Department for Education). 2011. The "Importance of Music: a National Plan for Music Education." https://www.gov.uk/government/publications/the-importance-of-music-a-national-plan-for-music-education.) reflected the need for increasing the numbers of primary class teachers able to teach music and of…

"I Will Be 'Fighting' Even More for Pupils with SEN": SENCOs' Role Predictions in the Changing English Policy Context

ERIC Educational Resources Information Center

Pearson, Sue; Mitchell, Rafael; Rapti, Maria

2015-01-01

The Coalition Government's "Green Paper" (DfE 2011) proposes a systemic overhaul of services for pupils with special educational needs in England, with increased parental choice of provision and "sharper accountability" (p. 67) in schools. Deadlines for various stages of this reform have not been met, and its final nature…

Traditional Tales and Imaginary Contexts in Primary Design and Technology: A Case Study

ERIC Educational Resources Information Center

McLain, Matt; McLain, Mel; Tsai, Jess; Martin, Mike; Bell, Dawne; Wooff, David

2017-01-01

Working with contexts is a key component to design and technology activity and education. The most recent iteration of the national curriculum programme of study for design and technology, in England, sets out that children between the ages of 5 and 7 "should work in a range of relevant contexts" (DfE, 2013, p.193); suggested contexts…

Recruitment, Retention and the Workload Challenge: A Critique of the Government Response

ERIC Educational Resources Information Center

Quicke, John

2018-01-01

Various surveys have confirmed that there is a crisis of recruitment and retention of teachers in schools. This article examines the government response to this crisis, in particular to what is commonly cited as the main cause--unmanageable workloads. What it describes as the workload challenge has certainly not been ignored by the DfE, which in…

The use of third-party review to reduce health and environmental hazards from surfactants and cleaning products in the janitorial industry.

PubMed

Okumura, Kazuhiro

2009-05-01

The demand for environmentally preferable products is increasing in the area of Institutional and Industrial (I&I) cleaners. The GreenBlue Institute (GreenBlue) and U.S. Environmental Protection Agency's (U.S. EPA's) Design for Environment (DfE) launched two programs to review surfactant ingredients and final cleaning products, with the National Sanitation Foundation (NSF) conducting third-party reviews. The Local Hazardous Waste Management Program (LHWMP) in King County, Washington, has a strategic goal to reduce the risk of exposure of hazardous chemicals to vulnerable populations such as janitorial workers. This report summarizes the NSF partnership with GreenBlue, CleanGredients, and U.S. EPA's DfE to perform third-party reviews of cleaning product ingredients and its relevance to LHWMP's interest in reducing risks to workers in the janitorial industry. Due to information barriers, workers in the janitorial industry are at risk daily to these hazardous chemicals. The surfactant and formulator review program will make positive contributions towards the reduction of toxic chemical exposure to the employees of the janitorial industry. With proper communication and an increased use of less toxic cleaners, exposures to vulnerable populations can be reduced.

Food matrix and cooking process affect mineral bioaccessibility of enteral nutrition formulas.

PubMed

Galán, María Gimena; Drago, Silvina Rosa

2014-02-01

When enteral formulas (EF) are administered orally as a supplement to the normal diet, they are often mixed with conventional foods or included in recipes in order to seek new flavors and textures and avoid monotony. The aims of this work were to study the bioaccessibility of Fe, Zn and Ca from commercial EF and the impact upon their incorporation into sweet preparations. Twenty commercial EF, before and after inclusion in sweet food (rice pudding, RP; banana smoothie, BS; tea, T; chocolate dessert, CD) were evaluated regarding Fe, Zn and Ca dialyzability (%DFe , %DZn , %DCa ) as an estimator of mineral bioaccessibility. Fe, Zn and Ca dialyzability from EF was variable and generally low. Heating during EF-sweet food preparation (T and CD) lowered values to 44.1 %DFe , possibly due to degradation of vitamin C, and 52.7 %DZn and 25.3 %DCa , due to the interaction with food components. EF and EF-sweet foods did not represent a good supply of Fe, Zn and Ca as recommended. This study demonstrated how the bioaccessibility of these minerals is affected by the food matrix in which EF is included as well as heating during food preparation. © 2013 Society of Chemical Industry.

The Irony of Iron – Biogenic Iron Oxides as an Iron Source to the Ocean

PubMed Central

Emerson, David

2016-01-01

Primary productivity in at least a third of the sunlit open ocean is thought to be iron-limited. Primary sources of dissolved iron (dFe) to the ocean are hydrothermal venting, flux from the sediments along continental margins, and airborne dust. This article provides a general review of sources of hydrothermal and sedimentary iron to the ocean, and speculates upon the role that iron-cycling microbes play in controlling iron dynamics from these sources. Special attention is paid to iron-oxidizing bacteria (FeOB) that live by oxidizing iron and producing biogenic iron oxides as waste products. The presence and ubiquity of FeOB both at hydrothermal systems and in sediments is only beginning to be appreciated. The biogenic oxides they produce have unique properties that could contribute significantly to the dynamics of dFe in the ocean. Changes in the physical and chemical characteristics of the ocean due to climate change and ocean acidification will undoubtedly impact the microbial iron cycle. A better understanding of the contemporary role of microbes in the iron cycle will help in predicting how these changes could ultimately influence marine primary productivity. PMID:26779157

Effect of light-dark cycles on hydrogen and poly-β-hydroxybutyrate production by a photoheterotrophic culture and Rhodobacter capsulatus using a dark fermentation effluent as substrate.

PubMed

Montiel Corona, Virginia; Le Borgne, Sylvie; Revah, Sergio; Morales, Marcia

2017-02-01

A Rhodobacter capsulatus strain and a photoheterotrophic culture (IZT) were cultivated to produce hydrogen under different light-dark cycles. A dark fermentation effluent (DFE) was used as substrate. It was found that IZT culture had an average cumulative hydrogen production (Paccum H 2 ) of 1300±43mLH 2 L -1 under continuous illumination and light-dark cycles of 30 or 60min. In contrast, R. capsulatus reduced its Paccum H 2 by 20% under 30:30min light-dark cycles, but tripled its poly-β-hydroxybutyrate (PHB) content (308±2mgPHB gdw -1 ) compared to continuous illumination. The highest PHB content by IZT culture was 178±10mgPHB gdw -1 under 15:15min light-dark cycles. PCR-DGGE analysis revealed that the IZT culture was mainly composed of Rhodopseudomonas palustris identified with high nucleotide similarity (99%). The evaluated cultures might be used for hydrogen and PHB production. They might provide energy savings by using light-dark cycles and DFE valorization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Chlorella vulgaris Attenuates Dermatophagoides Farinae-Induced Atopic Dermatitis-Like Symptoms in NC/Nga Mice

PubMed Central

Kang, Heerim; Lee, Chang Hyung; Kim, Jong Rhan; Kwon, Jung Yeon; Seo, Sang Gwon; Han, Jae Gab; Kim, Byung Gon; Kim, Jong-Eun; Lee, Ki Won

2015-01-01

Atopic dermatitis (AD) is a chronic and inflammatory skin disease that can place a significant burden on quality of life for patients. AD most frequently appears under the age of six and although its prevalence is increasing worldwide, therapeutic treatment options are limited. Chlorella vulgaris (CV) is a species of the freshwater green algae genus chlorella, and has been reported to modulate allergy-inducible factors when ingested. Here, we examined the effect of CV supplementation on AD-like symptoms in NC/Nga mice. CV was orally administrated for six weeks while AD-like symptoms were induced via topical application of Dermatophagoides farinae extract (DFE). CV treatment reduced dermatitis scores, epidermal thickness, and skin hydration. Histological analysis also revealed that CV treatment reduced DFE-induced eosinophil and mast cell infiltration into the skin, while analysis of serum chemokine levels indicated that CV treatment downregulated thymus- and activation-regulated chemokine (TARC) and macrophage-derived chemokine (MDC) levels. In addition, CV treatment downregulated mRNA expression levels of IL-4 and IFN-γ. Taken together, these results suggest that CV extract may have potential as a nutraceutical ingredient for the prevention of AD. PMID:26404252

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.

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

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.

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.

[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.

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

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.

Investigation of adaptive filtering and MDL mitigation based on space-time block-coding for spatial division multiplexed coherent receivers

NASA Astrophysics Data System (ADS)

Weng, Yi; He, Xuan; Yao, Wang; Pacheco, Michelle C.; Wang, Junyi; Pan, Zhongqi

2017-07-01

In this paper, we explored the performance of space-time block-coding (STBC) assisted multiple-input multiple-output (MIMO) scheme for modal dispersion and mode-dependent loss (MDL) mitigation in spatial-division multiplexed optical communication systems, whereas the weight matrices of frequency-domain equalization (FDE) were updated heuristically using decision-directed recursive least squares (RLS) algorithm for convergence and channel estimation. The proposed STBC-RLS algorithm can achieve 43.6% enhancement on convergence rate over conventional least mean squares (LMS) for quadrature phase-shift keying (QPSK) signals with merely 16.2% increase in hardware complexity. The overall optical signal to noise ratio (OSNR) tolerance can be improved via STBC by approximately 3.1, 4.9, 7.8 dB for QPSK, 16-quadrature amplitude modulation (QAM) and 64-QAM with respective bit-error-rates (BER) and minimum-mean-square-error (MMSE).

Are Success and Failure Experiences Equally Motivational? An Investigation of Regulatory Focus and Feedback

ERIC Educational Resources Information Center

Shu, Tse-Mei; Lam, Shui-fong

2011-01-01

The present study extended regulatory focus theory (Idson & Higgins, 2000) to an educational setting and attempted to identify individuals with high motivation after both success and failure feedback. College students in Hong Kong (N = 180) participated in an experiment with a 2 promotion focus (high vs. low) x 2 prevention focus (high vs.…

Equalization for a page-oriented optical memory system

NASA Astrophysics Data System (ADS)

Trelewicz, Jennifer Q.; Capone, Jeffrey

1999-11-01

In this work, a method of decision-feedback equalization is developed for a digital holographic channel that experiences moderate-to-severe imaging errors. Decision feedback is utilized, not only where the channel is well-behaved, but also near the edges of the camera grid that are subject to a high degree of imaging error. In addition to these effects, the channel is worsened by typical problems of holographic channels, including non-uniform illumination, dropouts, and stuck bits. The approach described in this paper builds on established methods for performing trained and blind equalization on time-varying channels. The approach is tested on experimental data sets. On most of these data sets, the method of equalization described in this work delivers at least an order of magnitude improvement in bit-error rate (BER) before error-correction coding (ECC). When ECC is introduced, the approach is able to recover stored data with no errors for many of the tested data sets. Furthermore, a low BER was maintained even over a range of small alignment perturbations in the system. It is believed that this equalization method can allow cost reductions to be made in page-memory systems, by allowing for a larger image area per page or less complex imaging components, without sacrificing the low BER required by data storage applications.

[Early interventional group therapy for patients with incipient Alzheimer disease and their relatives].

PubMed

Scheurich, Armin; Schanz, Benno; Müller, Matthias J; Fellgiebel, Andreas

2008-06-01

Pilot study on an early-interventional group therapy for patients with incipient Alzheimer disease and their relatives. The present study investigates whether scientific progress in terms of earlier time of diagnostic certainty can be used for psychoeducation, maintenance of positive activities and prevention of comorbid depressive episodes. 12 patients (66.8 +/- 5.8 years, MMSE 24.0 +/- 4.0) together with 12 relatives have been treated with a bi-weekly group therapy program. For the patients treatment resulted in reduced anxiety, anergia and withdrawal, for their relatives reduced sleep disturbances, irascibility, and aggressiveness have been found. Only one of the patients suffered from a depressive episode. All participants expressed positive feedback and a high level of quality of life. By the straightforward psychosocial intervention it seems possible to use the earlier time of diagnostic certainty for early diagnosed patients suffering from incipient Alzheimer disease. However, results have to be replicated by a controlled, prospective study with larger sample sizes.

Log amplifier with pole-zero compensation

DOEpatents

Brookshier, William

1987-01-01

A logarithmic amplifier circuit provides pole-zero compensation for improved stability and response time over 6-8 decades of input signal frequency. The amplifier circuit includes a first operational amplifier with a first feedback loop which includes a second, inverting operational amplifier in a second feedback loop. The compensated output signal is provided by the second operational amplifier with the log elements, i.e., resistors, and the compensating capacitors in each of the feedback loops having equal values so that each break point or pole is offset by a compensating break point or zero.

Effect of Rayleigh-scattering distributed feedback on multiwavelength Raman fiber laser generation.

PubMed

El-Taher, A E; Harper, P; Babin, S A; Churkin, D V; Podivilov, E V; Ania-Castanon, J D; Turitsyn, S K

2011-01-15

We experimentally demonstrate a Raman fiber laser based on multiple point-action fiber Bragg grating reflectors and distributed feedback via Rayleigh scattering in an ~22-km-long optical fiber. Twenty-two lasing lines with spacing of ~100 GHz (close to International Telecommunication Union grid) in the C band are generated at the watt level. In contrast to the normal cavity with competition between laser lines, the random distributed feedback cavity exhibits highly stable multiwavelength generation with a power-equalized uniform distribution, which is almost independent on power.

Lossless Brownian Information Engine

NASA Astrophysics Data System (ADS)

Paneru, Govind; Lee, Dong Yun; Tlusty, Tsvi; Pak, Hyuk Kyu

2018-01-01

We report on a lossless information engine that converts nearly all available information from an error-free feedback protocol into mechanical work. Combining high-precision detection at a resolution of 1 nm with ultrafast feedback control, the engine is tuned to extract the maximum work from information on the position of a Brownian particle. We show that the work produced by the engine achieves a bound set by a generalized second law of thermodynamics, demonstrating for the first time the sharpness of this bound. We validate a generalized Jarzynski equality for error-free feedback-controlled information engines.

Lossless Brownian Information Engine.

PubMed

Paneru, Govind; Lee, Dong Yun; Tlusty, Tsvi; Pak, Hyuk Kyu

2018-01-12

We report on a lossless information engine that converts nearly all available information from an error-free feedback protocol into mechanical work. Combining high-precision detection at a resolution of 1 nm with ultrafast feedback control, the engine is tuned to extract the maximum work from information on the position of a Brownian particle. We show that the work produced by the engine achieves a bound set by a generalized second law of thermodynamics, demonstrating for the first time the sharpness of this bound. We validate a generalized Jarzynski equality for error-free feedback-controlled information engines.

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.

Analytically tractable climate-carbon cycle feedbacks under 21st century anthropogenic forcing

NASA Astrophysics Data System (ADS)

Lade, Steven J.; Donges, Jonathan F.; Fetzer, Ingo; Anderies, John M.; Beer, Christian; Cornell, Sarah E.; Gasser, Thomas; Norberg, Jon; Richardson, Katherine; Rockström, Johan; Steffen, Will

2018-05-01

Changes to climate-carbon cycle feedbacks may significantly affect the Earth system's response to greenhouse gas emissions. These feedbacks are usually analysed from numerical output of complex and arguably opaque Earth system models. Here, we construct a stylised global climate-carbon cycle model, test its output against comprehensive Earth system models, and investigate the strengths of its climate-carbon cycle feedbacks analytically. The analytical expressions we obtain aid understanding of carbon cycle feedbacks and the operation of the carbon cycle. Specific results include that different feedback formalisms measure fundamentally the same climate-carbon cycle processes; temperature dependence of the solubility pump, biological pump, and CO2 solubility all contribute approximately equally to the ocean climate-carbon feedback; and concentration-carbon feedbacks may be more sensitive to future climate change than climate-carbon feedbacks. Simple models such as that developed here also provide workbenches for simple but mechanistically based explorations of Earth system processes, such as interactions and feedbacks between the planetary boundaries, that are currently too uncertain to be included in comprehensive Earth system models.

Class Size and Education in England Evidence Report. Research Report. DFE-RR169

ERIC Educational Resources Information Center

Department for Education, 2011

2011-01-01

This report gives an overview of the existing evidence base on class size and education in England. In particular, it considers how class sizes have changed over time; the impact of the increase in birth rate on pupil numbers and how this could affect the teacher requirement and class sizes; and the impact of class size on educational outcomes.…

Are We Nearly There Yet? Progress, Issues, and Possible Next Steps for a Self-Improving School System. Inaugural Professorial Lecture

ERIC Educational Resources Information Center

Greany, Toby

2014-01-01

The DfE's 2010 white paper "The Importance of Teaching" set out the Coalition's aim to "create a school system which is self-improving". In this inaugural lecture, Toby Greany assesses progress to date and the Coalition Government's approach to developing a self-improving system. He argues that the Coalition is following at…

Educator Perceptions of Children Who Present with Social, Emotional and Behavioural Difficulties: A Literature Review with Implications for Recent Educational Policy in England and Internationally

ERIC Educational Resources Information Center

Armstrong, David

2014-01-01

In support of their recommendations, recent policy pronouncements in England on behaviour (DFE (Department for Education). 2010. "The Importance of Teaching-The Schools White Paper". London: TSO) and on reform of special educational needs and disabilities make reference, respectively, to educator perceptions of poor behaviour by children…

Review of the National Curriculum in England: Report on Subject Breadth in International Jurisdictions. Research Report. DFE-RR178a

ERIC Educational Resources Information Center

Department for Education, 2011

2011-01-01

To support the review of the National Curriculum, the National Foundation for Educational Research (NFER) was commissioned by the Department for Education in the spring of 2011 to produce a report detailing curricular arrangements in a number of high-performing educational jurisdictions. The principal source of information for this report has been…

Growing Musicians in English Secondary Schools at Key Stage 3 (Age 11-14)

ERIC Educational Resources Information Center

Dalladay, Christopher

2017-01-01

The National Curriculum for Music in England at Key Stage 3 (KS3; age 11-14) declares its purpose that pupils should be inspired to "develop a love of music and their talent as musicians" (DfE, 2013: KS3 Music). The Office for Standards in Education (Ofsted) have criticised secondary schools for a lack of progress in the musical…

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.

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.

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.

Enhancing the learning of sport skills through external-focus feedback.

PubMed

Wulf, Gabriele; McConnel, Nathan; Gärtner, Matthias; Schwarz, Andreas

2002-06-01

The authors examined how the effectiveness of feedback for the learning of complex motor skills is affected by the focus of attention it induces. The feedback referred specifically either to body movements (internal focus) or to movement effects (external focus). In Experiment 1, groups of novices and advanced volleyball players (N = 48) practiced "tennis" serves under internal-focus or external-focus feedback conditions in a 2 (expertise) x 2 (feedback type) design. Type of feedback did not differentially affect movement quality, but external-focus feedback resulted in greater accuracy of the serves than internal-focus feedback during both practice and retention, independent of the level of expertise. In Experiment 2, the effects of relative feedback frequency as a function of attentional focus were examined. A 2 (feedback frequency: 100% vs. 33%) x 2 (feedback type) design was used. Experienced soccer players (N = 52) were required to shoot lofted passes at a target. External-focus feedback resulted in greater accuracy than internal-focus feedback did. In addition, reduced feedback frequency was beneficial under internal-focus feedback conditions, whereas 100% and 33% feedback were equally effective under external-focus conditions. The results demonstrate the effectiveness of effect-related, as opposed to movement-related, feedback and also suggest that there is a need to revise current views regarding the role of feedback for motor learning.

Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.

PubMed

Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M

2017-09-01

Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.

[Mini Mental State Examination (MMSE): determination of cutoff scores according to age and educational level].

PubMed

Solias, A; Skapinakis, P; Degleris, N; Pantoleon, M; Katirtzoglou, E; Politis, A

2014-01-01

For the last 38 years, Mini Mental State Examination (MMSE) has been widely used as a dementia screening measure in everyday clinical practice as well as in both cohort and cross-sectional studies. Its validity and reliability for the Greek population has explicitly been documented. However, the effect of age and education on the subject's performance makes it necessary to reckon them in the estimation of the "cutoff score". The purpose of this study is to estimate the prevalence of dementia in Greek population and determine the "cutoff score" by age and education-corrected norms. Cross sectional study of 630 patients older than 55 years, who live independently in Ilion and Helioupolis Municipalities was conducted, 27.3% of the subjects tested in the study were diagnosed with memory disorder according to their MMSE scores and the validation for the Greek population. The effect of age and education to the subjects' performance was statistically significant (p=.000). The use of standard "cutoff score" was not proved to be useful for the personalized interpretation of the results, as documented by the fact that older individuals with lower education had a poorer performance relatively to younger, highly educated subjects. Comparatively to the group age of 55-60 years, the odds ratio after the age of 75 years varies from 2.58 to 4.91. Regarding the variable factor of education, the odds ratio for the first degree education graduates decreases from 1.43 to 3.19 for the third degree education graduates in comparison with the group of illiterates. In conclusion, the use of the "cutoff score" algorithm and the simultaneous estimation of age and education effect on MMSE score may prove useful for the proper evaluation of MMSE performance. According to the age and education of examine candidates in the community and the primary care, we propose the use of the 25th percentile as a more useful cutoff score in order to decrease the false positive results.

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.

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.

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

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.

Acceleration of Image Segmentation Algorithm for (Breast) Mammogram Images Using High-Performance Reconfigurable Dataflow Computers

PubMed Central

Filipovic, Nenad D.

2017-01-01

Image segmentation is one of the most common procedures in medical imaging applications. It is also a very important task in breast cancer detection. Breast cancer detection procedure based on mammography can be divided into several stages. The first stage is the extraction of the region of interest from a breast image, followed by the identification of suspicious mass regions, their classification, and comparison with the existing image database. It is often the case that already existing image databases have large sets of data whose processing requires a lot of time, and thus the acceleration of each of the processing stages in breast cancer detection is a very important issue. In this paper, the implementation of the already existing algorithm for region-of-interest based image segmentation for mammogram images on High-Performance Reconfigurable Dataflow Computers (HPRDCs) is proposed. As a dataflow engine (DFE) of such HPRDC, Maxeler's acceleration card is used. The experiments for examining the acceleration of that algorithm on the Reconfigurable Dataflow Computers (RDCs) are performed with two types of mammogram images with different resolutions. There were, also, several DFE configurations and each of them gave a different acceleration value of algorithm execution. Those acceleration values are presented and experimental results showed good acceleration. PMID:28611851

The Role of Inertia in Modeling Decisions from Experience with Instance-Based Learning

PubMed Central

Dutt, Varun; Gonzalez, Cleotilde

2012-01-01

One form of inertia is the tendency to repeat the last decision irrespective of the obtained outcomes while making decisions from experience (DFE). A number of computational models based upon the Instance-Based Learning Theory, a theory of DFE, have included different inertia implementations and have shown to simultaneously account for both risk-taking and alternations between alternatives. The role that inertia plays in these models, however, is unclear as the same model without inertia is also able to account for observed risk-taking quite well. This paper demonstrates the predictive benefits of incorporating one particular implementation of inertia in an existing IBL model. We use two large datasets, estimation and competition, from the Technion Prediction Tournament involving a repeated binary-choice task to show that incorporating an inertia mechanism in an IBL model enables it to account for the observed average risk-taking and alternations. Including inertia, however, does not help the model to account for the trends in risk-taking and alternations over trials compared to the IBL model without the inertia mechanism. We generalize the two IBL models, with and without inertia, to the competition set by using the parameters determined in the estimation set. The generalization process demonstrates both the advantages and disadvantages of including inertia in an IBL model. PMID:22685443

The role of inertia in modeling decisions from experience with instance-based learning.

PubMed

Dutt, Varun; Gonzalez, Cleotilde

2012-01-01

One form of inertia is the tendency to repeat the last decision irrespective of the obtained outcomes while making decisions from experience (DFE). A number of computational models based upon the Instance-Based Learning Theory, a theory of DFE, have included different inertia implementations and have shown to simultaneously account for both risk-taking and alternations between alternatives. The role that inertia plays in these models, however, is unclear as the same model without inertia is also able to account for observed risk-taking quite well. This paper demonstrates the predictive benefits of incorporating one particular implementation of inertia in an existing IBL model. We use two large datasets, estimation and competition, from the Technion Prediction Tournament involving a repeated binary-choice task to show that incorporating an inertia mechanism in an IBL model enables it to account for the observed average risk-taking and alternations. Including inertia, however, does not help the model to account for the trends in risk-taking and alternations over trials compared to the IBL model without the inertia mechanism. We generalize the two IBL models, with and without inertia, to the competition set by using the parameters determined in the estimation set. The generalization process demonstrates both the advantages and disadvantages of including inertia in an IBL model.

Acceleration of Image Segmentation Algorithm for (Breast) Mammogram Images Using High-Performance Reconfigurable Dataflow Computers.

PubMed

Milankovic, Ivan L; Mijailovic, Nikola V; Filipovic, Nenad D; Peulic, Aleksandar S

2017-01-01

Image segmentation is one of the most common procedures in medical imaging applications. It is also a very important task in breast cancer detection. Breast cancer detection procedure based on mammography can be divided into several stages. The first stage is the extraction of the region of interest from a breast image, followed by the identification of suspicious mass regions, their classification, and comparison with the existing image database. It is often the case that already existing image databases have large sets of data whose processing requires a lot of time, and thus the acceleration of each of the processing stages in breast cancer detection is a very important issue. In this paper, the implementation of the already existing algorithm for region-of-interest based image segmentation for mammogram images on High-Performance Reconfigurable Dataflow Computers (HPRDCs) is proposed. As a dataflow engine (DFE) of such HPRDC, Maxeler's acceleration card is used. The experiments for examining the acceleration of that algorithm on the Reconfigurable Dataflow Computers (RDCs) are performed with two types of mammogram images with different resolutions. There were, also, several DFE configurations and each of them gave a different acceleration value of algorithm execution. Those acceleration values are presented and experimental results showed good acceleration.

The sensitivity of primary productivity to intra-seasonal mixed layer variability in the sub-Antarctic Zone of the Atlantic Ocean

NASA Astrophysics Data System (ADS)

Joubert, W. R.; Swart, S.; Tagliabue, A.; Thomalla, S. J.; Monteiro, P. M. S.

2014-03-01

The seasonal cycle of primary productivity is impacted by seasonal and intra-seasonal dynamics of the mixed layer through the changing balance between mixing and buoyancy forcing, which regulates nutrient supply and light availability. Of particular recent interest is the role of synoptic scale events in supplying nutrients, particularly iron, to the euphotic zone in the Sub Antarctic Zone (SAZ), where phytoplankton blooms occur throughout summer. In this study, we present high resolution measurements of net community production (NCP) constrained by ΔO2/Ar ratios, and mixed layer depth (MLD) in the Atlantic SAZ. We found a non-linear relationship between NCP and MLD, with the highest and most variable NCP observed in shallow MLDs (< 45 m). We propose that NCP variability in the SAZ may be driven by alternating states of synoptic-scale deepening of the mixed layer, leading to the entrainment of iron (dFe), followed by restratification, allowing rapid growth in an iron replete, high light environment. Synoptic iron fluxes into the euphotic zone based on water column dFe profiles and high resolution glider MLD data, reveal a potentially significant contribution of "new iron" which could sustain NCP throughout summer. Future process studies will help elaborate these findings further.

A Constant Envelope OFDM Implementation on GNU Radio

DTIC Science & Technology

2015-02-02

more advanced schemes like Decision Feedback Equalization or Turbo Equalization must be implemented to avoid the noise enhancement that all linear...block is coded in C++, and uses the phase unwrapping algorithm similar to MATLABs unwrap() function. To avoid false wraps propagating throughout the...outperform the real-time GNU radio implementation at higher SNR’s. While the unequalized experiment with the Matlab processor usually stayed within 5

Adaptive Reception for Underwater Communications

DTIC Science & Technology

2011-06-01

Experimental results prove the effectiveness of the receiver. 14. SUBJECT TERMS Underwater acoustic communications, adaptive algorithms , Kalman filter...the update algorithm design and the value of the spatial diversity are addressed. In this research, an adaptive multichannel equalizer made up of a...for the time-varying nature of the channel is to use an Adaptive Decision Feedback Equalizer based on either the RLS or LMS algorithm . Although this

Diagnosis of Middle Atmosphere Climate Sensitivity by the Climate Feedback Response Analysis Method

NASA Technical Reports Server (NTRS)

Zhu, Xun; Yee, Jeng-Hwa; Cai, Ming; Swartz, William H.; Coy, Lawrence; Aquila, Valentina; Talaat, Elsayed R.

2014-01-01

We present a new method to diagnose the middle atmosphere climate sensitivity by extending the Climate Feedback-Response Analysis Method (CFRAM) for the coupled atmosphere-surface system to the middle atmosphere. The Middle atmosphere CFRAM (MCFRAM) is built on the atmospheric energy equation per unit mass with radiative heating and cooling rates as its major thermal energy sources. MCFRAM preserves the CFRAM unique feature of an additive property for which the sum of all partial temperature changes due to variations in external forcing and feedback processes equals the observed temperature change. In addition, MCFRAM establishes a physical relationship of radiative damping between the energy perturbations associated with various feedback processes and temperature perturbations associated with thermal responses. MCFRAM is applied to both measurements and model output fields to diagnose the middle atmosphere climate sensitivity. It is found that the largest component of the middle atmosphere temperature response to the 11-year solar cycle (solar maximum vs. solar minimum) is directly from the partial temperature change due to the variation of the input solar flux. Increasing CO2 always cools the middle atmosphere with time whereas partial temperature change due to O3 variation could be either positive or negative. The partial temperature changes due to different feedbacks show distinctly different spatial patterns. The thermally driven globally averaged partial temperature change due to all radiative processes is approximately equal to the observed temperature change, ranging from 0.5 K near 70 km from the near solar maximum to the solar minimum.

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

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.

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.

Time skewing and amplitude nonlinearity mitigation by feedback equalization for 56 Gbps VCSEL-based PAM-4 links

NASA Astrophysics Data System (ADS)

You, Yue; Zhang, Wenjia; Sun, Lin; Du, Jiangbing; Liang, Chenyu; Yang, Fan; He, Zuyuan

2018-03-01

The vertical cavity surface emitting laser (VCSEL)-based multimode optical transceivers enabled by pulse amplitude modulation (PAM)-4 will be commercialized in near future to meet the 400-Gbps standard short reach optical interconnects. It is still challenging to achieve over 56/112-Gbps with the multilevel signaling as the multimode property of the device and link would introduce the nonlinear temporal response for the different levels. In this work, we scrutinize the distortions that relates to the multilevel feature of PAM-4 modulation, and propose an effective feedback equalization scheme for 56-Gbps VCSEL-based PAM-4 optical interconnects system to mitigate the distortions caused by eye timing-skew and nonlinear power-dependent noise. Level redistribution at Tx side is theoretically modeled and constructed to achieve equivalent symbol error ratios (SERs) of four levels and improved BER performance. The cause of the eye skewing and the mitigation approach are also simulated at 100-Gbps and experimentally investigated at 56-Gbps. The results indicate more than 2-dB power penalty improvement has been achieved by using such a distortion aware equalizer.

Data Analysis for Rotationally Resolved Spectra: A Simulated Annealing Approach

DTIC Science & Technology

1992-05-29

Table V. Expe rimental Data PSA was used to analyze high resolution infrared spectra of 2- fluoroethanol (2FE) and difluoroethane (DFE). Although the...does not inhere in the model used to calculate spectra, so the match to the experimental spectrum is not ideal. 8. PSA optimization of Difluoroethane ...A) The experimental spectrum of Difluoroethane . B) The spectrum generated from the starting state given to PSA. C) The spectrum generated from the

Engineer Professional Development Study

DTIC Science & Technology

1980-05-01

the 1980’s. Although no specific data is available, sensings gathered during field interviews and through informal questionnaires at large gatherings...8C21 officers at six years of service for early 󈧭 introduction into the engineer environment. 27 • - ,,m•,•,•,•.e, ,•q•,_: ......... 2...reluctance of quality officers to seuk assig •ments there. 30 b. Increase the number of slots that must be filled in the DFE area at the captain and

How Important Is the Assessment of Practical Work? An Opinion Piece on the New Biology A-Level from BERG

ERIC Educational Resources Information Center

Journal of Biological Education, 2014

2014-01-01

As education in England emerges from a major curriculum review (DfE 2013), the next few years will see significant changes in what is taught in schools and how this is assessed. As a core subject, under the current proposals, all students, from the beginning of primary school until age 16, will study science in some detail. Biology is an exciting,…

Servo control booster system for minimizing following error

DOEpatents

Wise, W.L.

1979-07-26

A closed-loop feedback-controlled servo system is disclosed which reduces command-to-response error to the system's position feedback resolution least increment, ..delta..S/sub R/, on a continuous real-time basis, for all operational times of consequence and for all operating speeds. The servo system employs a second position feedback control loop on a by exception basis, when the command-to-response error greater than or equal to ..delta..S/sub R/, to produce precise position correction signals. When the command-to-response error is less than ..delta..S/sub R/, control automatically reverts to conventional control means as the second position feedback control loop is disconnected, becoming transparent to conventional servo control means. By operating the second unique position feedback control loop used herein at the appropriate clocking rate, command-to-response error may be reduced to the position feedback resolution least increment. The present system may be utilized in combination with a tachometer loop for increased stability.

Learning Rate Updating Methods Applied to Adaptive Fuzzy Equalizers for Broadband Power Line Communications

NASA Astrophysics Data System (ADS)

Ribeiro, Moisés V.

2004-12-01

This paper introduces adaptive fuzzy equalizers with variable step size for broadband power line (PL) communications. Based on delta-bar-delta and local Lipschitz estimation updating rules, feedforward, and decision feedback approaches, we propose singleton and nonsingleton fuzzy equalizers with variable step size to cope with the intersymbol interference (ISI) effects of PL channels and the hardness of the impulse noises generated by appliances and nonlinear loads connected to low-voltage power grids. The computed results show that the convergence rates of the proposed equalizers are higher than the ones attained by the traditional adaptive fuzzy equalizers introduced by J. M. Mendel and his students. Additionally, some interesting BER curves reveal that the proposed techniques are efficient for mitigating the above-mentioned impairments.

Modeling the Atmospheric Phase Effects of a Digital Antenna Array Communications System

NASA Technical Reports Server (NTRS)

Tkacenko, A.

2006-01-01

In an antenna array system such as that used in the Deep Space Network (DSN) for satellite communication, it is often necessary to account for the effects due to the atmosphere. Typically, the atmosphere induces amplitude and phase fluctuations on the transmitted downlink signal that invalidate the assumed stationarity of the signal model. The degree to which these perturbations affect the stationarity of the model depends both on parameters of the atmosphere, including wind speed and turbulence strength, and on parameters of the communication system, such as the sampling rate used. In this article, we focus on modeling the atmospheric phase fluctuations in a digital antenna array communications system. Based on a continuous-time statistical model for the atmospheric phase effects, we show how to obtain a related discrete-time model based on sampling the continuous-time process. The effects of the nonstationarity of the resulting signal model are investigated using the sample matrix inversion (SMI) algorithm for minimum mean-squared error (MMSE) equalization of the received signal

Precise measurement of Fe isotopes in marine samples by multi-collector inductively coupled plasma mass spectrometry (MC-ICP-MS).

PubMed

de Jong, Jeroen; Schoemann, Véronique; Tison, Jean-Louis; Becquevort, Sylvie; Masson, Florence; Lannuzel, Delphine; Petit, Jérôme; Chou, Lei; Weis, Dominique; Mattielli, Nadine

2007-04-18

A novel analytical technique for isotopic analysis of dissolved and particulate iron (Fe) from various marine environments is presented in this paper. It combines coprecipitation of dissolved Fe (DFe) samples with Mg(OH)(2), and acid digestion of particulate Fe (PFe) samples with double pass chromatographic separation. Isotopic data were obtained using a Nu Plasma MC-ICP-MS in dry plasma mode, applying a combination of standard-sample bracketing and external normalization by Cu doping. Argon interferences were determined prior to each analysis and automatically subtracted during analysis. Sample size can be varied between 200 and 600 ng of Fe per measurement and total procedural blanks are better than 10 ng of Fe. Typical external precision of replicate analyses (1S.D.) is +/-0.07 per thousand on delta(56)Fe and +/-0.09 per thousand on delta(57)Fe while typical internal precision of a measurement (1S.E.) is +/-0.03 per thousand on delta(56)Fe and +/-0.04 per thousand on delta(57)Fe. Accuracy and precision were assured by the analysis of reference material IRMM-014, an in-house pure Fe standard, an in-house rock standard, as well as by inter-laboratory comparison using a hematite standard from ETH (Zürich). The lowest amount of Fe (200 ng) at which a reliable isotopic measurement could still be performed corresponds to a DFe or PFe concentration of approximately 2 nmol L(-1) for a 2 L sample size. To show the versatility of the method, results are presented from contrasting environments characterized by a wide range of Fe concentrations as well as varying salt content: the Scheldt estuary, the North Sea, and Antarctic pack ice. The range of DFe and PFe concentrations encountered in this investigation falls between 2 and 2000 nmol L(-1) Fe. The distinct isotopic compositions detected in these environments cover the whole range reported in previous studies of natural Fe isotopic fractionation in the marine environment, i.e. delta(56)Fe varies between -3.5 per thousand and +1.5 per thousand. The largest fractionations were observed in environments characterized by redox changes and/or strong Fe cycling. This demonstrates the potential use of Fe isotopes as a tool to trace marine biogeochemical processes involving Fe.

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.

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.

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.

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.

[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).

Predictive factors for dementia and cognitive impairment among residents living in the veterans' retirement communities in Taiwan: Implications for cognitive health promotion activities.

PubMed

Chen, Liang-Yu; Wu, Yi-Hui; Huang, Chung-Yu; Liu, Li-Kuo; Hwang, An-Chun; Peng, Li-Ning; Lin, Ming-Hsieh; Chen, Liang-Kung

2017-04-01

To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five-item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline. The mean age of the participants was 85.7 ± 5.2 years, with a mean follow-up period of 41 ± 21.6 weeks. The prevalence of cognitive impairment (defined by MMSE <24) was 65.6%, whereas 34% of the study participants were positive for depressive symptoms. Approximately one-fifth of the study participants were using psychotropic agents, which was higher among participants with cognitive impairment (23.6% vs 15.6%, P < 0.05) than those without. In the generalized estimating equation model, physical function, nutritional status, depressive symptoms, ex-drinker, multimorbidity and stool incontinence were positively correlated with MMSE score; whereas advanced age, low educational level (<6 years), presence of communication difficulty and use of psychotropic agents were inversely associated with the MMSE score. Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans' retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7-13. © 2017 Japan Geriatrics Society.

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

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.

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.

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.

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.

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.

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

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

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.

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.

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

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.

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.

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.

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.

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.

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.

Prefrontal Neural Activity When Feedback Is Not Relevant to Adjust Performance

PubMed Central

Özyurt, Jale; Rietze, Mareike; Thiel, Christiane M.

2012-01-01

It has been shown that the rostral cingulate zone (RCZ) in humans uses both positive and negative feedback to evaluate performance and to flexibly adjust behaviour. Less is known on how the feedback types are processed by the RCZ and other prefrontal brain areas, when feedback can only be used to evaluate performance, but cannot be used to adjust behaviour. The present fMRI study aimed at investigating feedback that can only be used to evaluate performance in a word-learning paradigm. One group of volunteers (N = 17) received informative, performance-dependent positive or negative feedback after each trial. Since new words had to be learnt in each trial, the feedback could not be used for task-specific adaptations. The other group (N = 17) always received non-informative feedback, providing neither information about performance nor about possible task-specific adaptations. Effects of the informational value of feedback were assessed between-subjects, comparing trials with positive and negative informative feedback to non-informative feedback. Effects of feedback valence were assessed by comparing neural activity to positive and negative feedback within the informative-feedback group. Our results show that several prefrontal regions, including the pre-SMA, the inferior frontal cortex and the insula were sensitive to both, the informational value and the valence aspect of the feedback with stronger activations to informative as compared to non-informative feedback and to informative negative compared to informative positive feedback. The only exception was RCZ which was sensitive to the informational value of the feedback, but not to feedback valence. The findings indicate that outcome information per se is sufficient to activate prefrontal brain regions, with the RCZ being the only prefrontal brain region which is equally sensitive to positive and negative feedback. PMID:22615774

Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth.

PubMed

Ausiello, Pietro; Franciosa, Pasquale; Martorelli, Massimo; Watts, David C

2011-05-01

In restored teeth, stresses at the tooth-restoration interface during masticatory processes may fracture the teeth or the restoration and cracks may grow and propagate. The aim was to apply numerical methodologies to simulate the behavior of a restored tooth and to evaluate fatigue lifetimes before crack failure. Using a CAD-FEM procedure and fatigue mechanic laws, the fatigue damage of a restored molar was numerically estimated. Tessellated surfaces of enamel and dentin were extracted by applying segmentation and classification algorithms, to sets of 2D image data. A user-friendly GUI, which enables selection and visualization of 3D tessellated surfaces, was developed in a MatLab(®) environment. The tooth-boundary surfaces of enamel and dentin were then created by sweeping operations through cross-sections. A class II MOD cavity preparation was then added into the 3D model and tetrahedral mesh elements were generated. Fatigue simulation was performed by combining a preliminary static FEA simulation with classical fatigue mechanical laws. Regions with the shortest fatigue-life were located around the fillets of the class II MOD cavity, where the static stress was highest. The described method can be successfully adopted to generate detailed 3D-FE models of molar teeth, with different cavities and restorative materials. This method could be quickly implemented for other dental or biomechanical applications. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Assessing the Roles of Iron, Macronutrients and Wet deposition in Controlling Phytoplankton Growth in Seasonally Oligotrophic Waters of the Mid-Atlantic Bight

NASA Astrophysics Data System (ADS)

Sedwick, P.; Mulholland, M. R.; Najjar, R.; Bernhardt, P. W.; Price, L. M.; Sohst, B. M.; Sookhdeo, C.; Widner, B.

2016-02-01

The role of iron supply in regulating phytoplankton production in high-nutrient, low-chlorophyll ocean regions has been well established. Less clear, however, is the importance of iron for phytoplankton processes in other oceanic settings, such as coastal and oligotrophic waters, where differential changes in the supply and removal of dissolved iron (dFe) can result in limitation or co-limitation of growth due to iron deficiency. One such region of interest is the Mid-Atlantic Bight (MAB), where previous field experiments have provided some evidence of co-limitation of algal growth by nitrogen and iron. In summer 2014 we conducted field sampling and shipboard experiments to assess the role of iron and macronutrient availability in controlling primary production in seasonally oligotrophic waters over the MAB continental slope, with a focus on the the impacts of wet deposition. Our results indicate that nitrogen was the proximate limiting nutrient, with a secondary limitation imposed by availability of phosphorus; we found no evidence for a deficiency in dFe, which was present at concentrations in the range 0.3-0.9 nM. Phytoplankton growth was clearly stimulated by the addition of natural rainwater, suggesting that summer rain events stimulate primary production in the MAB by contributing new nitrogen (primarily as ammonium) and phosphorus, whilst maintaining iron-replete conditions.

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.

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.

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.

[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.

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

EMG Versus Torque Control of Human-Machine Systems: Equalizing Control Signal Variability Does not Equalize Error or Uncertainty.

PubMed

Johnson, Reva E; Kording, Konrad P; Hargrove, Levi J; Sensinger, Jonathon W

2017-06-01

In this paper we asked the question: if we artificially raise the variability of torque control signals to match that of EMG, do subjects make similar errors and have similar uncertainty about their movements? We answered this question using two experiments in which subjects used three different control signals: torque, torque+noise, and EMG. First, we measured error on a simple target-hitting task in which subjects received visual feedback only at the end of their movements. We found that even when the signal-to-noise ratio was equal across EMG and torque+noise control signals, EMG resulted in larger errors. Second, we quantified uncertainty by measuring the just-noticeable difference of a visual perturbation. We found that for equal errors, EMG resulted in higher movement uncertainty than both torque and torque+noise. The differences suggest that performance and confidence are influenced by more than just the noisiness of the control signal, and suggest that other factors, such as the user's ability to incorporate feedback and develop accurate internal models, also have significant impacts on the performance and confidence of a person's actions. We theorize that users have difficulty distinguishing between random and systematic errors for EMG control, and future work should examine in more detail the types of errors made with EMG control.

A parametric LQ approach to multiobjective control system design

NASA Technical Reports Server (NTRS)

Kyr, Douglas E.; Buchner, Marc

1988-01-01

The synthesis of a constant parameter output feedback control law of constrained structure is set in a multiple objective linear quadratic regulator (MOLQR) framework. The use of intuitive objective functions such as model-following ability and closed-loop trajectory sensitivity, allow multiple objective decision making techniques, such as the surrogate worth tradeoff method, to be applied. For the continuous-time deterministic problem with an infinite time horizon, dynamic compensators as well as static output feedback controllers can be synthesized using a descent Anderson-Moore algorithm modified to impose linear equality constraints on the feedback gains by moving in feasible directions. Results of three different examples are presented, including a unique reformulation of the sensitivity reduction problem.

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.

Feedback stabilization of resistive wall modes in a reversed-field pinch

NASA Astrophysics Data System (ADS)

Brunsell, P. R.; Yadikin, D.; Gregoratto, D.; Paccagnella, R.; Liu, Y. Q.; Cecconello, M.; Drake, J. R.; Manduchi, G.; Marchiori, G.

2005-09-01

An array of saddle coils having Nc=16 equally spaced positions along the toroidal direction has been installed for feedback control of resistive wall modes (RWMs) on the EXTRAP T2R reversed-field pinch [P. R. Brunsell, H. Bergsaker, M. Cecconello et al., Plasma Phys. Controlled Fusion 43, 1457 (2001)]. Using feedback, multiple nonresonant RWMs are simultaneously suppressed for three to four wall times. Feedback stabilization of RWMs results in a significant prolongation of the discharge duration. This is linked to a better sustainment of the plasma and tearing mode toroidal rotation with feedback. Due to the limited number of coils in the toroidal direction, pairs of modes with toroidal mode numbers n ,n' that fulfill the condition ∣n-n'∣=Nc are coupled by the feedback action from the discrete coil array. With only one unstable mode in a pair of coupled modes, the suppression of the unstable mode is successful. If two modes are unstable in a coupled pair, two possibilities exist: partial suppression of both modes or, alternatively, complete stabilization of one target mode while the other is left unstable.

Significance of auditory and kinesthetic feedback to singers' pitch control.

PubMed

Mürbe, Dirk; Pabst, Friedemann; Hofmann, Gert; Sundberg, Johan

2002-03-01

An accurate control of fundamental frequency (F0) is required from singers. This control relies on auditory and kinesthetic feedback. However, a loud accompaniment may mask the auditory feedback, leaving the singers to rely on kinesthetic feedback. The object of the present study was to estimate the significance of auditory and kinesthetic feedback to pitch control in 28 students beginning a professional solo singing education. The singers sang an ascending and descending triad pattern covering their entire pitch range with and without masking noise in legato and staccato and in a slow and a fast tempo. F0 was measured by means of a computer program. The interval sizes between adjacent tones were determined and their departures from equally tempered tuning were calculated. The deviations from this tuning were used as a measure of the accuracy of intonation. Statistical analysis showed a significant effect of masking that amounted to a mean impairment of pitch accuracy by 14 cent across all subjects. Furthermore, significant effects were found of tempo as well as of the staccato/legato conditions. The results indicate that auditory feedback contributes significantly to singers' control of pitch.

Study of aerodynamic technology for single-cruise-engine VSTOL fighter/attack aircraft, phase 1

NASA Technical Reports Server (NTRS)

Foley, W. H.; Sheridan, A. E.; Smith, C. W.

1982-01-01

A conceptual design and analysis on a single engine VSTOL fighter/attack aircraft is completed. The aircraft combines a NASA/deHavilland ejector with vectored thrust and is capable of accomplishing the mission and point performance of type Specification 169, and a flight demonstrator could be built with an existing F101/DFE engine. The aerodynamic, aero/propulsive, and propulsive uncertainties are identified, and a wind tunnel program is proposed to address those uncertainties associated with wing borne flight.

Better Communication Research Programme: Language and Literacy Attainment of Pupils during Early Years and through KS2: Does Teacher Assessment at Five Provide a Valid Measure of Children's Current and Future Educational Attainments? Research Brief. DFE-RB172a

ERIC Educational Resources Information Center

Snowling, Margaret J.; Hulme, Charles; Bailey, Alison M.; Stothard, Susan E.; Lindsay, Geoff

2011-01-01

It is well-established that language skills are amongst the best predictors of educational success. Consistent with this, findings from a population-based longitudinal study of parents and children in the UK indicate that language development at the age of two years predicts children's performance on entering primary school. Moreover, children who…

The Canadian Diving Symposium (2nd) Held at Defence and Civil Institute of Environmental Medicine, 31 October - 1 November 1977.

DTIC Science & Technology

1977-11-01

in oceanography, marine sL veying and marine engineering. The elective subjects cover such topics as hydrographic sur- veying, sounding , underwater...and Diving in Mr. J. Tomlinson D.F.E. Department of Fisheries and Marine Services L.Portable System for Ultrasonic Mr. B. EAtock, DCIEM Doppler...semi-tropical and temperate environments (1). As with all homeothermic mammals , the human body has a deep internal temperattre of approximately 37 0

[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.

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.

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).

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.

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.

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

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

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

[Significance of auditory and kinesthetic feedback in vocal training of young professional singers (students)].

PubMed

Ciochină, Al D; Ciochină, Paula; Cobzeanu, M D; Burlui, Ada; Zaharia, D

2004-01-01

The study was to estimate the significance of auditory and kinesthetic feedback to an accurate control of fundamental frequency (F0) in 18 students beginning a professional singing education. The students sing an ascending and descending triad pattern covering their entire pitch range with and without making noise in legato and staccato and in a slow and fast tempo. F0 was measured by a computer program. The interval sizes between adjacent tones were determined and their departures from equally tempered tuning were calculated, the deviation from this tuning were used as a measure of the accuracy of intonation. Intonation accuracy was reduced by masking noise, by staccato as opposed to legato singing, and by fast as opposed to slow performance. The contribution of the auditory feedback to pitch control was not significantly improved after education, whereas the kinesthetic feedback circuit was improved in slow legato and slow staccato tasks. The results support the assumption that the kinesthetic feedback contributes substantially to intonation accuracy.

Video Feedback in Key Word Signing Training for Preservice Direct Support Staff.

PubMed

Rombouts, Ellen; Meuris, Kristien; Maes, Bea; De Meyer, Anne-Marie; Zink, Inge

2016-04-01

Research has demonstrated that formal training is essential for professionals to learn key word signing. Yet, the particular didactic strategies have not been studied. Therefore, this study compared the effectiveness of verbal and video feedback in a key word signing training for future direct support staff. Forty-nine future direct support staff were randomly assigned to 1 of 3 key word signing training programs: modeling and verbal feedback (classical method [CM]), additional video feedback (+ViF), and additional video feedback and photo reminder (+ViF/R). Signing accuracy and training acceptability were measured 1 week after and 7 months after training. Participants from the +ViF/R program achieved significantly higher signing accuracy compared with the CM group. Acceptability ratings did not differ between any of the groups. Results suggest that at an equal time investment, the programs containing more training components were more effective. Research on the effect of rehearsal on signing maintenance is warranted.

Feedback increases benefits but not costs of retrieval practice: Retrieval-induced forgetting is strength independent.

PubMed

Tempel, Tobias; Frings, Christian

2018-04-01

We examined how the provision of feedback affected two separate effects of retrieval practice: strengthening of practiced information and forgetting of related, unpracticed information. Feedback substantially increased recall of retrieval-practiced items. This unsurprising result shows once again that restudy opportunities boost the benefits of testing. In contrast, retrieval-induced forgetting was unaffected by the manipulation and occurred in equal size with or without feedback. These findings demonstrate strength independence of retrieval-induced forgetting and thus support a theoretical account assuming that an inhibitory mechanism causes retrieval-induced forgetting. According to this theory, inhibition resolves competition that arises during retrieval attempts but is unrelated to the consequences of retrieval practice concerning practiced items. The present results match these assumptions and contradict the theoretical alternative that blocking by strengthened information might explain retrieval-induced forgetting. We discuss our findings against the background of previous studies.

Learning versus correct models: influence of model type on the learning of a free-weight squat lift.

PubMed

McCullagh, P; Meyer, K N

1997-03-01

It has been assumed that demonstrating the correct movement is the best way to impart task-relevant information. However, empirical verification with simple laboratory skills has shown that using a learning model (showing an individual in the process of acquiring the skill to be learned) may accelerate skill acquisition and increase retention more than using a correct model. The purpose of the present study was to compare the effectiveness of viewing correct versus learning models on the acquisition of a sport skill (free-weight squat lift). Forty female participants were assigned to four learning conditions: physical practice receiving feedback, learning model with model feedback, correct model with model feedback, and learning model without model feedback. Results indicated that viewing either a correct or learning model was equally effective in learning correct form in the squat lift.

Correlation between disease severity and brain electric LORETA tomography in Alzheimer's disease.

PubMed

Gianotti, Lorena R R; Künig, Gabriella; Lehmann, Dietrich; Faber, Pascal L; Pascual-Marqui, Roberto D; Kochi, Kieko; Schreiter-Gasser, Ursula

2007-01-01

To compare EEG power spectra and LORETA-computed intracortical activity between Alzheimer's disease (AD) patients and healthy controls, and to correlate the results with cognitive performance in the AD group. Nineteen channel resting EEG was recorded in 21 mild to moderate AD patients and in 23 controls. Power spectra and intracortical LORETA tomography were computed in seven frequency bands and compared between groups. In the AD patients, the EEG results were correlated with cognitive performance (Mini Mental State Examination, MMSE). AD patients showed increased power in EEG delta and theta frequency bands, and decreased power in alpha2, beta1, beta2 and beta3. LORETA specified that increases and decreases of power affected different cortical areas while largely sparing prefrontal cortex. Delta power correlated negatively and alpha1 power positively with the AD patients' MMSE scores; LORETA tomography localized these correlations in left temporo-parietal cortex. The non-invasive EEG method of LORETA localized pathological cortical activity in our mild to moderate AD patients in agreement with the literature, and yielded striking correlations between EEG delta and alpha1 activity and MMSE scores in left temporo-parietal cortex. The present data support the hypothesis of an asymmetrical progression of the Alzheimer's disease.

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.

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 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.

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.

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.

Changes in Tryptophan Catabolite (TRYCAT) Pathway Patterning Are Associated with Mild Impairments in Declarative Memory in Schizophrenia and Deficits in Semantic and Episodic Memory Coupled with Increased False-Memory Creation in Deficit Schizophrenia.

PubMed

Kanchanatawan, Buranee; Hemrungrojn, Solaphat; Thika, Supaksorn; Sirivichayakul, Sunee; Ruxrungtham, Kiat; Carvalho, André F; Geffard, Michel; Anderson, George; Maes, Michael

2018-06-01

Evidence indicates that schizophrenia and in particular negative symptoms and deficit schizophrenia are accompanied by neurocognitive impairments and changes in the patterning of the tryptophan catabolite (TRYCAT) pathway. This cross-sectional study was carried out to examine the associations between cognitive functions (as measured with Consortium to Establish a Registry for Alzheimer's disease (CERAD)) and TRYCAT pathway patterning in patients with (n = 40) and without (n = 40) deficit schizophrenia and normal controls (n = 40). Cognitive measures were assessed with the Verbal Fluency Test (VFT), Boston Naming Test (BNT), Mini-Mental State Examination (MMSE), Word List Memory (WLM), Constructional Praxis, Word List Recall (WLRecall), and Word List Recognition (WLRecognition), while TRYCAT measurements assessed the IgA/IgM responses to noxious TRYCATs, namely quinolinic acid (QA), 3-OH-kynurenine (3HK), picolinic acid (PA), and xanthurenic (XA) acid, and more protective (PRO) TRYCATs, including kynurenic acid (KA) and anthranilic acid (AA). IgA NOX/PRO, IgM KA/3HK, and IgA/IgM NOX/PRO ratios were computed. Schizophrenia was accompanied by lower VFT and WLM, while BNT (dysnomia) and MMSE are significantly lower in multiple- than first-episode schizophrenia. Deficit schizophrenia is strongly associated with worse outcomes on VFT, MMSE, WLM, WLRecall, WLRecognition, and delayed recall savings and increased false memories. Around 40-50% of the variance in negative symptoms' scores was explained by VFT, WLM, WLRecall, and MMSE. Increases in IgA NOX/PRO, IgM KA/3HK, and/or IgA/IgM NOX/PRO ratios were associated with impairments in VFT, BNT, MMSE, WLM, WLRecall, WLRecognition, and false-memory creation. In conclusion, nondeficit schizophrenia is accompanied by mild memory impairments, while disease progression is accompanied by broader cognitive impairments. Deficit schizophrenia and negative symptoms are strongly associated with deficits in working memory, delayed recall and recognition, and increased false-memory creation. These cognitive impairments and memory deficits are in part explained by increased production and/or attenuated regulation of TRYCATs with neurotoxic, excitotoxic, immune-inflammatory, oxidative, and nitrosative potential, which may contribute to neuroprogression.

Log amplifier with pole-zero compensation

DOEpatents

Brookshier, W.

1985-02-08

A logarithmic amplifier circuit provides pole-zero compensation for improved stability and response time over 6-8 decades of input signal frequency. The amplifer circuit includes a first operational amplifier with a first feedback loop which includes a second, inverting operational amplifier in a second feedstock loop. The compensated output signal is provided by the second operational amplifier with the log elements, i.e., resistors, and the compensating capacitors in each of the feedback loops having equal values so that each break point is offset by a compensating break point or zero.

Opto-electronic oscillators having optical resonators

NASA Technical Reports Server (NTRS)

Yao, Xiaotian Steve (Inventor); Maleki, Lutfollah (Inventor); Ilchenko, Vladimir (Inventor)

2003-01-01

Systems and techniques of incorporating an optical resonator in an optical part of a feedback loop in opto-electronic oscillators. This optical resonator provides a sufficiently long energy storage time and hence to produce an oscillation of a narrow linewidth and low phase noise. Certain mode matching conditions are required. For example, the mode spacing of the optical resonator is equal to one mode spacing, or a multiplicity of the mode spacing, of an opto-electronic feedback loop that receives a modulated optical signal and to produce an electrical oscillating signal.

Temporal prediction modulates the evaluative processing of "good" action feedback: An electrophysiological study.

PubMed

Kimura, Kenta; Kimura, Motohiro; Iwaki, Sunao

2016-10-01

The present study aimed to investigate whether or not the evaluative processing of action feedback can be modulated by temporal prediction. For this purpose, we examined the effects of the predictability of the timing of action feedback on an ERP effect that indexed the evaluative processing of action feedback, that is, an ERP effect that has been interpreted as a feedback-related negativity (FRN) elicited by "bad" action feedback or a reward positivity (RewP) elicited by "good" action feedback. In two types of experimental blocks, the participants performed a gambling task in which they chose one of two cards and received an action feedback that indicated monetary gain or loss. In fixed blocks, the time interval between the participant's choice and the onset of the action feedback was fixed at 0, 500, or 1,000 ms in separate blocks; thus, the timing of action feedback was predictable. In mixed blocks, the time interval was randomly chosen from the same three intervals with equal probability; thus, the timing was less predictable. The results showed that the FRN/RewP was smaller in mixed than fixed blocks for the 0-ms interval trial, whereas there was no difference between the two block types for the 500-ms and 1,000-ms interval trials. Interestingly, the smaller FRN/RewP was due to the modulation of gain ERPs rather than loss ERPs. These results suggest that temporal prediction can modulate the evaluative processing of action feedback, and particularly good feedback, such as that which indicates monetary gain. © 2016 Society for Psychophysiological Research.

Toxicity potentials from waste cellular phones, and a waste management policy integrating consumer, corporate, and government responsibilities

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

Lim, Seong-Rin; Schoenung, Julie M., E-mail: jmschoenung@ucdavis.ed

Cellular phones have high environmental impact potentials because of their heavy metal content and current consumer attitudes toward purchasing new phones with higher functionality and neglecting to return waste phones into proper take-back systems. This study evaluates human health and ecological toxicity potentials from waste cellular phones; highlights consumer, corporate, and government responsibilities for effective waste management; and identifies key elements needed for an effective waste management strategy. The toxicity potentials are evaluated by using heavy metal content, respective characterization factors, and a pathway and impact model for heavy metals that considers end-of-life disposal in landfills or by incineration. Cancermore » potentials derive primarily from Pb and As; non-cancer potentials primarily from Cu and Pb; and ecotoxicity potentials primarily from Cu and Hg. These results are not completely in agreement with previous work in which leachability thresholds were the metric used to establish priority, thereby indicating the need for multiple or revised metrics. The triple bottom line of consumer, corporate, and government responsibilities is emphasized in terms of consumer attitudes, design for environment (DfE), and establishment and implementation of waste management systems including recycling streams, respectively. The key strategic elements for effective waste management include environmental taxation and a deposit-refund system to motivate consumer responsibility, which is linked and integrated with corporate and government responsibilities. The results of this study can contribute to DfE and waste management policy for cellular phones.« less

Tannic acid modulates NFκB signaling pathway and skin inflammation in NC/Nga mice through PPARγ expression.

PubMed

Karuppagounder, Vengadeshprabhu; Arumugam, Somasundaram; Thandavarayan, Rajarajan Amirthalingam; Pitchaimani, Vigneshwaran; Sreedhar, Remya; Afrin, Rejina; Harima, Meilei; Suzuki, Hiroshi; Nomoto, Mayumi; Miyashita, Shizuka; Suzuki, Kenji; Nakamura, Masahiko; Ueno, Kazuyuki; Watanabe, Kenichi

2015-12-01

Polyphenolic compound tannic acid, which is mainly found in grapes and green tea, is a potent antioxidant with anticarcinogenic activities. In this present study, we hypothesized that tannic acid could inhibit nuclear factor (NF)κB signaling and inflammation in atopic dermatitis (AD) NC/Nga mice. We have analyzed the effects of tannic acid on dermatitis severity, histopathology and expression of inflammatory signaling proteins in house dust mite extract induced AD mouse skin. In addition, serum levels of T helper (Th) cytokines (interferon (IFN)γ, interleukin (IL)-4) were measured by enzyme-linked immunosorbent assay. Treatment with tannic acid ameliorated the development of AD-like clinical symptoms and effectively inhibited hyperkeratosis, parakeratosis, acanthosis, mast cells and infiltration of inflammatory cells in the AD mouse skin. Serum levels of IFNγ and IL-4 were significantly down-regulated by tannic acid. Furthermore, tannic acid treatment inhibited DfE induced tumor necrosis factor (TNF)α, high mobility group protein (HMG)B1, receptor for advanced glycation end products (RAGE), extracellular signal-regulated kinase (ERK)1/2, NFκB, cyclooxygenase (COX)2, IL-1β and increased the protein expression of peroxisome proliferator-activated receptor (PPAR)γ. Taken together, our results demonstrate that, DfE induced skin inflammation might be mediated through NFκB signaling and tannic acid may be a potential therapeutic agent for AD, which may possibly act via induction of PPARγ protein. Copyright © 2015 Elsevier Ltd. All rights reserved.

Toxicity potentials from waste cellular phones, and a waste management policy integrating consumer, corporate, and government responsibilities.

PubMed

Lim, Seong-Rin; Schoenung, Julie M

2010-01-01

Cellular phones have high environmental impact potentials because of their heavy metal content and current consumer attitudes toward purchasing new phones with higher functionality and neglecting to return waste phones into proper take-back systems. This study evaluates human health and ecological toxicity potentials from waste cellular phones; highlights consumer, corporate, and government responsibilities for effective waste management; and identifies key elements needed for an effective waste management strategy. The toxicity potentials are evaluated by using heavy metal content, respective characterization factors, and a pathway and impact model for heavy metals that considers end-of-life disposal in landfills or by incineration. Cancer potentials derive primarily from Pb and As; non-cancer potentials primarily from Cu and Pb; and ecotoxicity potentials primarily from Cu and Hg. These results are not completely in agreement with previous work in which leachability thresholds were the metric used to establish priority, thereby indicating the need for multiple or revised metrics. The triple bottom line of consumer, corporate, and government responsibilities is emphasized in terms of consumer attitudes, design for environment (DfE), and establishment and implementation of waste management systems including recycling streams, respectively. The key strategic elements for effective waste management include environmental taxation and a deposit-refund system to motivate consumer responsibility, which is linked and integrated with corporate and government responsibilities. The results of this study can contribute to DfE and waste management policy for cellular phones. 2010 Elsevier Ltd. All rights reserved.

An anti-barotrauma system for preventing barotrauma during hyperbaric oxygen therapy.

PubMed

Song, Moon; Hoon, Se Jeon; Shin, Tae Min

2018-01-01

In the present study, a tympanometry-based anti-barotrauma (ABT) device was designed using eardrum admittance measurements to develop an objective method of preventing barotrauma that occurs during hyperbaric oxygen (HBO₂) therapy. The middle ear space requires active equalization, and barotrauma of these tissues during HBO₂therapy constitutes the most common treatment-associated injury. Decongestant nasal sprays and nasal steroids are used, but their efficacy is questionable to prevent middle ear barotrauma (MEB) during HBO₂ treatment. Accordingly, a tympanometry-based ABT device was designed using eardrum admittance measurements to develop an objective method for preventing MEB, which causes pain and injury, and represents one of the principal reasons for patients to stop treatment. This study was conducted to test a novel technology that can be used to measure transmembrane pressures, and provide chamber attendants with real-time feedback regarding the patient's equalization status prior to the onset of pain or injury. Eardrum admittance values were measured according to pressure changes inside a hyperbaric oxygen chamber while the system was fitted to the subject. When the pressure increased to above 200 daPa, eardrum admittance decreased to 16.255% of prepressurization levels. After pressure equalization was achieved, eardrum admittance recovered to 95.595% of prepressurization levels. A one-way repeated measures analysis of variance contrast test was performed on eardrum admittance before pressurization versus during pressurization, and before pressurization versus after pressure equalization. The analysis revealed significant differences at all points during pressurization (P⟨0.001), but no significant difference after pressure equalization was achieved. This ABT device can provide objective feedback reflecting eardrum condition to the patient and the chamber operator during HBO₂ therapy. Copyright© Undersea and Hyperbaric Medical Society.

Coulomb stress transfer and tectonic loading preceding the 2002 Denali fault earthquake

USGS Publications Warehouse

Bufe, Charles G.

2006-01-01

Pre-2002 tectonic loading and Coulomb stress transfer are modeled along the rupture zone of the M 7.9 Denali fault earthquake (DFE) and on adjacent segments of the right-lateral Denali–Totschunda fault system in central Alaska, using a three-dimensional boundary-element program. The segments modeled closely follow, for about 95°, the arc of a circle of radius 375 km centered on an inferred asperity near the northeastern end of the intersection of the Patton Bay fault with the Alaskan megathrust under Prince William Sound. The loading model includes slip of 6 mm/yr below 12 km along the fault system, consistent with rotation of the Wrangell block about the asperity at a rate of about 1°/m.y. as well as slip of the Pacific plate at 5 cm/yr at depth along the Fairweather–Queen Charlotte transform fault system and on the Alaska megathrust. The model is consistent with most available pre-2002 Global Positioning System (GPS) displacement rate data. Coulomb stresses induced on the Denali–Totschunda fault system (locked above 12 km) by slip at depth and by transfer from the M 9.2 Prince William Sound earthquake of 1964 dominated the changing Coulomb stress distribution along the fault. The combination of loading (∼70–85%) and coseismic stress transfer from the great 1964 earthquake (∼15–30%) were the principal post-1900 stress factors building toward strike-slip failure of the northern Denali and Totschunda segments in the M 7.9 earthquake of November 2002. Postseismic stresses transferred from the 1964 earthquake may also have been a significant factor. The M 7.2–7.4 Delta River earthquake of 1912 (Carver et al., 2004) may have delayed or advanced the timing of the DFE, depending on the details and location of its rupture. The initial subevent of the 2002 DFE earthquake was on the 40-km Susitna Glacier thrust fault at the western end of the Denali fault rupture. The Coulomb stress transferred from the 1964 earthquake moved the Susitna Glacier thrust fault uniformly away from thrust failure by about 100 kPa. The initiation of the Denali fault earthquake was advanced by transfer of 30–50 kPa of positive Coulomb stress to the Susitna Glacier fault (Anderson and Ji, 2003) by the nearby M 6.7 Nenana Mountain foreshock of 23 October 2002. The regional tectonic loading model used here suggests that the Semidi (Alaska Peninsula) segment of the megathrust that ruptured in 1938 (M 8.2) may be reloaded and approaching failure.

Robust stabilization of the Space Station in the presence of inertia matrix uncertainty

NASA Technical Reports Server (NTRS)

Wie, Bong; Liu, Qiang; Sunkel, John

1993-01-01

This paper presents a robust H-infinity full-state feedback control synthesis method for uncertain systems with D11 not equal to 0. The method is applied to the robust stabilization problem of the Space Station in the face of inertia matrix uncertainty. The control design objective is to find a robust controller that yields the largest stable hypercube in uncertain parameter space, while satisfying the nominal performance requirements. The significance of employing an uncertain plant model with D11 not equal 0 is demonstrated.

TRADOC Union List of Periodicals.

DTIC Science & Technology

1988-08-01

Comp11t er Products TSO Nov 1987+ Compul er Rev iew TRQ 1980. Computer Security Journal TRADOC UNION LIST OF SERIALS P\\GE 103 TSO 1987+ Computer Shopper...c:urrcnrt monith onl.N TSP 1988+ TS( cu-rrenft year only TTF Ap1)r 21 , ŝ 86 + TT1T[’ rr-erit ,ear only De fvii <t - v ’P,’ort T s : 12+ Dfe r :iS 5...Executive Orders TTG 1948-1962. Executive Proclamations TTG 1955-1960. Executive Productivity TSR 0277-5298 current year only Executive Risk Assessment TRC V

High Resolution Spectroscopy of 1,2-Difluoroethane in a Molecular Beam: A Case Study of Vibrational Mode-Coupling

DTIC Science & Technology

1992-05-29

Spectroscopy of 1,2- Difluoroethane in a Molecular Beam: A Case Study of Vibrational Mode-Coupling by Steven W. Mork, C. Cameron Miller, and Laura A...and sale; its distribution is unlimited. 92-14657 l9lll l l l , II a HIGH RESOLUTION SPECTROSCOPY OF 1,2- DIFLUOROETHANE IN A MOLECULAR BEAM: A CASE...14853-1301 Abstract The high resolution infrared spectrum of 1,2- difluoroethane (DFE) in a molecular beam has been obtained over the 2978-2996 cm-1

Effectiveness of patient feedback as an educational intervention to improve medical student consultation (PTA Feedback Study): study protocol for a randomized controlled trial.

PubMed

Lai, Michelle Mei Yee; Roberts, Noel; Martin, Jenepher

2014-09-17

Oral feedback from clinical educators is the traditional teaching method for improving clinical consultation skills in medical students. New approaches are needed to enhance this teaching model. Multisource feedback is a commonly used assessment method for learning among practising clinicians, but this assessment has not been explored rigorously in medical student education. This study seeks to evaluate if additional feedback on patient satisfaction improves medical student performance. The Patient Teaching Associate (PTA) Feedback Study is a single site randomized controlled, double-blinded trial with two parallel groups.An after-hours general practitioner clinic in Victoria, Australia, is adapted as a teaching clinic during the day. Medical students from two universities in their first clinical year participate in six simulated clinical consultations with ambulatory patient volunteers living with chronic illness. Eligible students will be randomized in equal proportions to receive patient satisfaction score feedback with the usual multisource feedback and the usual multisource feedback alone as control. Block randomization will be performed. We will assess patient satisfaction and consultation performance outcomes at baseline and after one semester and will compare any change in mean scores at the last session from that at baseline. We will model data using regression analysis to determine any differences between intervention and control groups. Full ethical approval has been obtained for the study. This trial will comply with CONSORT guidelines and we will disseminate data at conferences and in peer-reviewed journals. This is the first proposed trial to determine whether consumer feedback enhances the use of multisource feedback in medical student education, and to assess the value of multisource feedback in teaching and learning about the management of ambulatory patients living with chronic conditions. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613001055796.

Factors influencing responsiveness to feedback: on the interplay between fear, confidence, and reasoning processes.

PubMed

Eva, Kevin W; Armson, Heather; Holmboe, Eric; Lockyer, Jocelyn; Loney, Elaine; Mann, Karen; Sargeant, Joan

2012-03-01

Self-appraisal has repeatedly been shown to be inadequate as a mechanism for performance improvement. This has placed greater emphasis on understanding the processes through which self-perception and external feedback interact to influence professional development. As feedback is inevitably interpreted through the lens of one's self-perceptions it is important to understand how learners interpret, accept, and use feedback (or not) and the factors that influence those interpretations. 134 participants from 8 health professional training/continuing competence programs were recruited to participate in focus groups. Analyses were designed to (a) elicit understandings of the processes used by learners and physicians to interpret, accept and use (or not) data to inform their perceptions of their clinical performance, and (b) further understand the factors (internal and external) believed to influence interpretation of feedback. Multiple influences appear to impact upon the interpretation and uptake of feedback. These include confidence, experience, and fear of not appearing knowledgeable. Importantly, however, each could have a paradoxical effect of both increasing and decreasing receptivity. Less prevalent but nonetheless important themes suggested mechanisms through which cognitive reasoning processes might impede growth from formative feedback. Many studies have examined the effectiveness of feedback through variable interventions focused on feedback delivery. This study suggests that it is equally important to consider feedback from the perspective of how it is received. The interplay observed between fear, confidence, and reasoning processes reinforces the notion that there is no simple recipe for the delivery of effective feedback. These factors should be taken into account when trying to understand (a) why self-appraisal can be flawed, (b) why appropriate external feedback is vital (yet can be ineffective), and (c) why we may need to disentangle the goals of performance improvement from the goals of improving self-assessment.

Calculation of Weapon Platform Attitude and Cant using Available Sensor Feedback

DTIC Science & Technology

2018-02-01

terrain presents challenges for firing large caliber weapons. When a weapon is fired, the forward momentum of the discharge is equally reflected to the...GIDEP Operations Center P.O. Box 8000 Corona , CA 91718-8000 gidep@gidep.org UNCLASSIFIED Approved for public release; distribution

24 CFR 203.255 - Insurance of mortgage.

Code of Federal Regulations, 2011 CFR

2011-04-01

... prescribed by the Secretary, stating that the underwriter has personally reviewed the appraisal report and..., reports and loan samples that enable FHA to evaluate program operation; (3) Not use TOTAL to direct... algorithm in TOTAL; (5) Not provide feedback messages that conflict with the Equal Credit Opportunity Act...

High-throughput, fully-automated volumetry for prediction of MMSE and CDR decline in mild cognitive impairment

PubMed Central

Kovacevic, Sanja; Rafii, Michael S.; Brewer, James B.

2008-01-01

Medial temporal lobe (MTL) atrophy is associated with increased risk for conversion to Alzheimer's disease (AD), but manual tracing techniques and even semi-automated techniques for volumetric assessment are not practical in the clinical setting. In addition, most studies that examined MTL atrophy in AD have focused only on the hippocampus. It is unknown the extent to which volumes of amygdala and temporal horn of the lateral ventricle predict subsequent clinical decline. This study examined whether measures of hippocampus, amygdala, and temporal horn volume predict clinical decline over the following 6-month period in patients with mild cognitive impairment (MCI). Fully-automated volume measurements were performed in 269 MCI patients. Baseline volumes of the hippocampus, amygdala, and temporal horn were evaluated as predictors of change in Mini-mental State Exam (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR SB) over a 6-month interval. Fully-automated measurements of baseline hippocampus and amygdala volumes correlated with baseline delayed recall scores. Patients with smaller baseline volumes of the hippocampus and amygdala or larger baseline volumes of the temporal horn had more rapid subsequent clinical decline on MMSE and CDR SB. Fully-automated and rapid measurement of segmental MTL volumes may help clinicians predict clinical decline in MCI patients. PMID:19474571

Response to rivastigmine transdermal patch or memantine plus rivastigmine patch is affected by apolipoprotein E genotype in Alzheimer patients.

PubMed

Han, Hyun Jeong; Kim, Byeong C; Lee, Jun-Young; Ryu, Seung-Ho; Na, Hae Ri; Yoon, Soo Jin; Park, Hyun Young; Shin, Joon Hyun; Cho, Soo-Jin; Yi, Hyon-Ah; Choi, Mun Seong; Heo, Jae-Hyeok; Park, Kyung Won; Kim, Kwang K; Choi, Seong Hye

2012-01-01

The apolipoprotein E (APOE) genotype in response to pharmacological treatments in patients with Alzheimer's disease (AD) remains a matter of controversy. This analysis investigated the effect of the APOE genotype on the clinical response to rivastigmine transdermal patch monotherapy or memantine plus rivastigmine patch in patients with mild to moderate AD. Two hundred and six (n = 206) patients with probable AD and Mini-Mental State Examination (MMSE) scores of 10-20 were randomized to rivastigmine patch monotherapy or memantine plus rivastigmine patch for 24 weeks. Of the 206 patients with probable AD, 146 patients who consented to genetic testing for APOE were included and assessed for this subgroup study. There were no significant differences on MMSE, NPI, ADAS-cog, ADCS-ADL, CDR-SB, NPI and FAB between rivastigmine patch monotherapy and memantine plus rivastigmine patch according to the APOE genotype. However, patients with moderately severe AD (MMSE ≤15) who were APOE ε4 carriers showed higher responder rates on ADCS-ADL with memantine plus rivastigmine patch compared to rivastigmine patch monotherapy. Moderately severe AD patients with the APOE ε4 allele may respond more favorably to memantine plus rivastigmine patch than ε4 noncarriers. Copyright © 2012 S. Karger AG, Basel.

Investigation of Genetic Variants Associated with Alzheimer Disease in Parkinson Disease Cognition.

PubMed

Barrett, Matthew J; Koeppel, Alexander F; Flanigan, Joseph L; Turner, Stephen D; Worrall, Bradford B

2016-01-01

Meta-analysis of genome-wide association studies have implicated multiple single nucleotide polymorphisms (SNPs) and associated genes with Alzheimer disease. The role of these SNPs in cognitive impairment in Parkinson disease (PD) remains incompletely evaluated. The objective of this study was to test alleles associated with risk of Alzheimer disease for association with cognitive impairment in Parkinson disease (PD). Two datasets with PD subjects accessed through the NIH database of Genotypes and Phenotypes contained both single nucleotide polymorphism (SNP) arrays and mini-mental state exam (MMSE) scores. Genetic data underwent rigorous quality control and we selected SNPs for genes associated with AD other than APOE. We constructed logistic regression and ordinal regression models, adjusted for sex, age at MMSE, and duration of PD, to assess the association between selected SNPs and MMSE score. In one dataset, PICALM rs3851179 was associated with cognitive impairment (MMSE <  24) in PD subjects > 70 years old (OR = 2.3; adjusted p-value = 0.017; n = 250) but not in PD subjects ≤ 70 years old. Our finding suggests that PICALM rs3851179 could contribute to cognitive impairment in older patients with PD. It is important that future studies consider the interaction of age and genetic risk factors in the development of cognitive impairment in PD.

The effect of shunt surgery on neuropsychological performance in normal pressure hydrocephalus: a systematic review and meta-analysis.

PubMed

Peterson, Katie A; Savulich, George; Jackson, Dan; Killikelly, Clare; Pickard, John D; Sahakian, Barbara J

2016-08-01

We conducted a systematic review of the literature and used meta-analytic techniques to evaluate the impact of shunt surgery on neuropsychological performance in patients with normal pressure hydrocephalus (NPH). Twenty-three studies with 1059 patients were identified for review using PubMed, Web of Science, Google scholar and manual searching. Inclusion criteria were prospective, within-subject investigations of cognitive outcome using neuropsychological assessment before and after shunt surgery in patients with NPH. There were statistically significant effects of shunt surgery on cognition (Mini-Mental State Examination; MMSE), learning and memory (Rey Auditory Verbal Learning Test; RAVLT, total and delayed subtests), executive function (backwards digit span, phonemic verbal fluency, trail making test B) and psychomotor speed (trail making test A) all in the direction of improvement following shunt surgery, but with considerable heterogeneity across all measures. A more detailed examination of the data suggested robust evidence for improved MMSE, RAVLT total, RAVLT delayed, phonemic verbal fluency and trail making test A only. Meta-regressions revealed no statistically significant effect of age, sex or follow-up interval on improvement in the MMSE. Our results suggest that shunt surgery is most sensitive for improving global cognition, learning and memory and psychomotor speed in patients with NPH.

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.

Medical Patients’ Treatment Decision Making Capacity: A Report from a General Hospital in Greece

PubMed Central

Bilanakis, Nikolaos; Vratsista, Aikaterini; Athanasiou, Eleni; Niakas, Dimitris; Peritogiannis, Vaios

2014-01-01

This study aimed to assess the decision-making capacity for treatment of patients hospitalized in an internal medicine ward of a General Hospital in Greece, and to examine the views of treating physicians regarding patients’ capacity. All consecutive admissions to an internal medicine ward within a month were evaluated. A total of 134 patients were approached and 78 patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Mini Mental State Examination (MMSE) questionnaire. Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment. The majority of them (n=56, 41.8%) were obviously incapable because they were unconscious, or had such marked impairment that they could not give their own names, and the rest (n=12, 8.9%) were rated as incompetent according to their performance in the MacCAT-T. Neurological disorders, old age and altered cognitive function according to MMSE were negatively correlated with decision making capacity. Physicians sometimes failed to recognize patients’ incapacity. Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians. Combined patient evaluation with the use of the MacCAT-T and MMSE, could be useful for the determination of incapable patients. PMID:25505489

Resistance Training Exercise Program for Intervention to Enhance Gait Function in Elderly Chronically Ill Patients: Multivariate Multiscale Entropy for Center of Pressure Signal Analysis

PubMed Central

Jiang, Bernard C.

2014-01-01

Falls are unpredictable accidents, and the resulting injuries can be serious in the elderly, particularly those with chronic diseases. Regular exercise is recommended to prevent and treat hypertension and other chronic diseases by reducing clinical blood pressure. The “complexity index” (CI), based on multiscale entropy (MSE) algorithm, has been applied in recent studies to show a person's adaptability to intrinsic and external perturbations and widely used measure of postural sway or stability. The multivariate multiscale entropy (MMSE) was advanced algorithm used to calculate the complexity index (CI) values of the center of pressure (COP) data. In this study, we applied the MSE & MMSE to analyze gait function of 24 elderly, chronically ill patients (44% female; 56% male; mean age, 67.56 ± 10.70 years) with either cardiovascular disease, diabetes mellitus, or osteoporosis. After a 12-week training program, postural stability measurements showed significant improvements. Our results showed beneficial effects of resistance training, which can be used to improve postural stability in the elderly and indicated that MMSE algorithms to calculate CI of the COP data were superior to the multiscale entropy (MSE) algorithm to identify the sense of balance in the elderly. PMID:25295070

Subclinical hypothyroidism and cognitive dysfunction in the elderly.

PubMed

Resta, F; Triggiani, V; Barile, G; Benigno, M; Suppressa, P; Giagulli, V A; Guastamacchia, E; Sabbà, C

2012-09-01

While overt hypothyroidism is associated with reversible dementia in the elderly, the relationship of subclinical hypothyroidism with cognition remains a controversial issue. Our aim was to investigate the correlation between subclinical hypothyroidism and cognition in the elderly, with particular reference to long term memory and selective attention. We selected 337 outpatients (177 men and 160 women), mean age 74.3 years, excluding the subjects with thyroid dysfunction and those treated with drugs influencing thyroid function. The score of Mini Mental State Examination (MMSE) was significantly lower in the group of patients with subclinical hypothyroidism than in euthyroid subjects (p<0.03). It was observed that patients with subclinical hypothyroidism had a probability about 2 times greater (RR = 2.028, p<0.05) of developing cognitive impairment. Prose Memory Test (PMT) score resulted significantly lower in subjects with subclinical hypothyroidism (p<0.04). Considering the Matrix Test (MT) score, the performance was slightly reduced in subclinical hypothyroidism (NS). Furthermore, TSH was negatively correlated with MMSE (p<0.04), PMT (p<0.05) and MT score (NS). No correlation was found between FT4 and FT3 and MMSE, PMT and MT score. In the elderly, subclinical hypothyroidism is associated with cognitive impairment, and its impact on specific aspects of cognition (long term memory and selective attention) is less evident.

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

Color discrimination performance in patients with Alzheimer's disease.

PubMed

Salamone, Giovanna; Di Lorenzo, Concetta; Mosti, Serena; Lupo, Federica; Cravello, Luca; Palmer, Katie; Musicco, Massimo; Caltagirone, Carlo

2009-01-01

Visual deficits are frequent in Alzheimer's disease (AD), yet little is known about the nature of these disturbances. The aim of the present study was to investigate color discrimination in patients with AD to determine whether impairment of this visual function is a cognitive or perceptive/sensory disturbance. A cross-sectional clinical study was conducted in a specialized dementia unit on 20 patients with mild/moderate AD and 21 age-matched normal controls. Color discrimination was measured by the Farnsworth-Munsell 100 hue test. Cognitive functioning was measured with the Mini-Mental State Examination (MMSE) and a comprehensive battery of neuropsychological tests. The scores obtained on the color discrimination test were compared between AD patients and controls adjusting for global and domain-specific cognitive performance. Color discrimination performance was inversely related to MMSE score. AD patients had a higher number of errors in color discrimination than controls (mean +/- SD total error score: 442.4 +/- 84.5 vs. 304.1 +/- 45.9). This trend persisted even after adjustment for MMSE score and cognitive performance on specific cognitive domains. A specific reduction of color discrimination capacity is present in AD patients. This deficit does not solely depend upon cognitive impairment, and involvement of the primary visual cortex and/or retinal ganglionar cells may be contributory.

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.

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

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.

DC attenuation meter

DOEpatents

Hargrove, Douglas L.

2004-09-14

A portable, hand-held meter used to measure direct current (DC) attenuation in low impedance electrical signal cables and signal attenuators. A DC voltage is applied to the signal input of the cable and feedback to the control circuit through the signal cable and attenuators. The control circuit adjusts the applied voltage to the cable until the feedback voltage equals the reference voltage. The "units" of applied voltage required at the cable input is the system attenuation value of the cable and attenuators, which makes this meter unique. The meter may be used to calibrate data signal cables, attenuators, and cable-attenuator assemblies.

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.

Predictors of cognitive impairment in an early stage Parkinson's disease cohort.

PubMed

Hu, Michele T M; Szewczyk-Królikowski, Konrad; Tomlinson, Paul; Nithi, Kannan; Rolinski, Michal; Murray, Clara; Talbot, Kevin; Ebmeier, Klaus P; Mackay, Clare E; Ben-Shlomo, Yoav

2014-03-01

The impact of Parkinson's disease (PD) dementia is substantial and has major functional and socioeconomic consequences. Early prediction of future cognitive impairment would help target future interventions. The Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and fluency tests were administered to 486 patients with PD within 3.5 years of diagnosis, and the results were compared with those from 141 controls correcting for age, sex, and educational years. Eighteen-month longitudinal assessments were performed in 155 patients with PD. The proportion of patients classified with normal cognition, mild cognitive impairment (MCI), and dementia varied considerably, depending on the MoCA and MMSE thresholds used. With the MoCA total score at screening threshold, 47.7%, 40.5%, and 11.7% of patients with PD were classified with normal cognition, MCI, and dementia, respectively; by comparison, 78.7% and 21.3% of controls had normal cognition and MCI, respectively. Cognitive impairment was predicted by lower education, increased age, male sex, and quantitative motor and non-motor (smell, depression, and anxiety) measures. Longitudinal data from 155 patients with PD over 18 months showed significant reductions in MoCA scores, but not in MMSE scores, with 21.3% of patients moving from normal cognition to MCI and 4.5% moving from MCI to dementia, although 13.5% moved from MCI to normal; however, none of the patients with dementia changed their classification. The MoCA may be more sensitive than the MMSE in detecting early baseline and longitudinal cognitive impairment in PD, because it identified 25.8% of those who experienced significant cognitive decline over 18 months. Cognitive decline was associated with worse motor and non-motor features, suggesting that this reflects a faster progressive phenotype. © 2014 The Authors. International Parkinson and Movement Disorder Society published by Wiley Periodicals, Inc.

First Spanish version of the Memorial Delirium Assessment Scale: psychometric properties, responsiveness, and factor loadings.

PubMed

Noguera, Antonio; Carvajal, Ana; Alonso-Babarro, Alberto; Chisholm, Gary; Bruera, Eduardo; Centeno, Carlos

2014-01-01

The Memorial Delirium Assessment Scale (MDAS) is a reliable and validated instrument with which to assess delirium. However, MDAS responsiveness has only been investigated in an indirect way. Also, neurobehavioral and global cognitive factors seem to be the MDAS main factor loads. The primary objective of this study was to evaluate MDAS responsiveness and analyze individual factors on this scale. The secondary objective was to confirm concurrent validity and reliability of the Spanish version of the MDAS. The translation-back translation method was used to obtain the Spanish version of the MDAS. Delirium diagnosis was determined by the clinical Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and with the Confusion Assessment Method. Responsiveness and factor loadings were determined with the Delirium Rating Scale-Revised-98, the Mini-Mental State Examination (MMSE), and the MDAS at baseline (0 hours) and at 72 hours. Variation in the scores of the Delirium Rating Scale-Revised-98 shows a correlation of r = 0.93, with variation in MDAS scores at P < 0.001. Variation in MMSE scores shows a correlation of r = -0.84, with variation in MDAS scores at P = 0.015. Factor I, neurobehavioral (reduced awareness, reduced attention, perceptual disturbance, delusions, altered psychomotor activity, and sleep-wake cycle disturbance), correlated moderately with the MMSE at -0.56. Factor II, global cognitive (disorientation, short-term memory impairment, impaired digit span, and disorganized thinking), correlated strongly with the MMSE at -0.81. Factor II was significantly more reliable than Factor I, rho = 0.7, P = 0.01. The high responsiveness confirms the value of the MDAS for ongoing delirium assessment. Two differentiated factor loadings point to a potential future need for MDAS subscales. Copyright © 2014 U.S. Cancer Pain Relief Committee. All rights reserved.

ApoE and SNAP-25 Polymorphisms Predict the Outcome of Multidimensional Stimulation Therapy Rehabilitation in Alzheimer's Disease.

PubMed

Guerini, Franca Rosa; Farina, Elisabetta; Costa, Andrea Saul; Baglio, Francesca; Saibene, Francesca Lea; Margaritella, Nicolò; Calabrese, Elena; Zanzottera, Milena; Bolognesi, Elisabetta; Nemni, Raffaello; Clerici, Mario

2016-10-01

Alzheimer's disease (AD) is a highly prevalent neurodegenerative disorder. Rate of decline and functional restoration in AD greatly depend on the capacity for neural plasticity within residual neural tissues; this is at least partially influenced by polymorphisms in genes that determine neural plasticity, including Apolipoprotein E4 (ApoE4) and synaptosomal-associated protein of 25 kDa (SNAP-25). We investigated whether correlations could be detected between polymorphisms of ApoE4 and SNAP-25 and the outcome of a multidimensional rehabilitative approach, based on cognitive stimulation, behavioral, and functional therapy (multidimensional stimulation therapy [MST]). Fifty-eight individuals with mild-to-moderate AD underwent MST for 10 weeks. Neuro-psychological functional and behavioral evaluations were performed blindly by a neuropsychologist at baseline and after 10 weeks of therapy using Mini-Mental State Examination (MMSE), Functional Living Skill Assessment (FLSA), and Neuropsychiatric Inventory (NPI) scales. Molecular genotyping of ApoE4 and SNAP-25 rs363050, rs363039, rs363043 was performed. Results were correlated with ΔMMSE, ΔNPI and ΔFLSA scores by multinomial logistic regression analysis. Polymorphisms in both genes correlated with the outcome of MST for MMSE and NPI scores. Thus, higher overall MMSE scores after rehabilitation were detected in ApoE4 negative compared to ApoE4 positive patients, whereas the SNAP-25 rs363050(G) and rs363039(A) alleles correlated with significant improvements in behavioural parameters. Polymorphisms in genes known to modulate neural plasticity might predict the outcome of a multistructured rehabilitation protocol in patients with AD. These data, although needing confirmation on larger case studies, could help optimizing the clinical management of individuals with AD, for example defining a more intensive treatment in those subjects with a lower likelihood of success. © The Author(s) 2016.

Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

PubMed Central

Takeuchi, Kenji; Izumi, Maya; Furuta, Michiko; Takeshita, Toru; Shibata, Yukie; Kageyama, Shinya; Ganaha, Seijun; Yamashita, Yoshihisa

2015-01-01

Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22–0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01–0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in Japan. Maintenance and restoration of posterior teeth occlusion may be a preventive factor against cognitive decline in aged populations. PMID:26512900

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.

Evaluating driving performance of outpatients with Alzheimer disease.

PubMed

Cox, D J; Quillian, W C; Thorndike, F P; Kovatchev, B P; Hanna, G

1998-01-01

Alzheimer disease (AD) is a progressive disease, with multiple physiologic, psychologic, and social implications. A critical issue in its management is when to recommend restrictions on autonomous functioning, such as driving an automobile. This study evaluates driving performance of patients with AD and its relation to patient scores on the Mini-Mental State Exam (MMSE). This study compared 29 outpatients with probable AD with 21 age-matched control participants on an interactive driving simulator to determine how the two groups differed and how such differences related to mental status. Patients with AD (1) were less likely to comprehend and operate the simulator cognitively, (2) drove off the road more often, (3) spent more time driving considerably slower than the posted speed limit, (4) spent less time driving faster than the speed limit, (5) applied less brake pressure in stop zones, (6) spent more time negotiating left turns, and (7) drove more poorly overall. There were no observed differences between AD patients and the control group in terms of crossing the midline and driving speed variability. Among the AD patients, those who could not drive the simulator because of confusion and disorientation (n = 10) had lower MMSE scores and drove fewer miles annually. Those AD patients who had stopped driving also scored lower on their MMSE but did not perform more poorly on the driving simulator. Factor analysis revealed five driving factors associated with AD, explaining 93 percent of the variance. These five factors correctly classified 27 (85 percent) of 32 AD patients compared with the control group. Of the 15 percent who were improperly classified, there were three false positives (control participants misclassified as AD patients) and two false negatives (AD patients misclassified as control participants). The computed total driving score correlated significantly with MMSE scores (r = -.403, P = 0.011). Driving simulators can provide an objective means of assessing driving safety.

Prevalence of depression in stroke patients with vascular dementia in universiti kebangsaan malaysia medical center.

PubMed

Khoo, K F; Tan, H J; R, Rosdinom; Raymond, A A; M I, Norlinah; A, Shamsul; W Y, Nafisah

2013-04-01

Depression among patients with vascular dementia is frequently overlooked and potentially causes significant morbidity. There is limited data in Malaysia on the subject and this study was conducted to determine the prevalence of depression in vascular dementia (VaD) in UKMMC. This was a cross-sectional study involving diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) criteria and who had a mini mental state examination (MMSE) score of less than 26. All patients were interviewed, examined clinically and their previous brain computer tomography (CT) were reviewed. The prevalence of depression was determined using the Cornell scale of depression. A total of 76 patients were recruited with a mean age of 70.5 ± 9.5 years. The median duration of illness was 2.0 (1.0-4.8) years. The prevalence of depression in the study population was 31.6%. The patients with depression had a significant older mean age (74.5±8.7 years old) compared to those without depression (68.6±9.4 years old). Patients with large artery stroke of less than 3 years had significant higher frequency of depression (53.6%) compared to patients with small artery stroke (23.8%) and patients with right sided large artery stroke had significantly higher frequency of depression compared to left (70% vs. 44.4%). Median MMSE score (17.0) for depressed patients was significantly lower compared with median MMSE score (22.5) for non depressed patients. Median Barthel Index (30.0) for depressed patients was significantly lower compared with median Barthel score for non depressed patients. Depression was prevalent among post stroke patients with VaD in UKMMC particularly for patients with older age, large artery stroke, right sided large artery stroke, low MMSE score and low Barthel Index. Early recognition of high risk patients is important in the holistic management of patients to prevent significant morbidity arising from depression.

Excessive variability in systolic blood pressure that is self-measured at home exacerbates the progression of brain white matter lesions and cognitive impairment in the oldest old.

PubMed

Liu, Zhendong; Zhao, Yingxin; Zhang, Hua; Chai, Qiang; Cui, Yi; Diao, Yutao; Xiu, Jianchao; Sun, Xiaolin; Jiang, Guosheng

2016-04-01

To investigate the effects of variability in self-measured systolic blood pressure at home on the progression of cognitive impairment and white matter lesions in the oldest old. Between April 2009 and October 2009, 248 oldest old aged 80 years or older were eligibly enrolled from geriatric practices and community-dwelling areas of Shandong, China. Self-measured blood pressure at home (HBP) was measured for 7 consecutive days at the baseline, and the Mini-Mental State Examination (MMSE) score and brain white matter hyperintensities (WMH) were assessed at the baseline and during the final follow-up visit. Variability in systolic HBP was evaluated using coefficient of variation (CV) in serial daily systolic HBP measurements of the last 6 consecutive days. After an average of 2.3 years of follow-up visits, 232 oldest old were included in and 16 were excluded from the analysis. The MMSE score declined -4.76 (interquartile ranges: -10.71, -0.83) %, the periventricular WMH, deep WMH, total WMH and WMH fraction increased 16.46 (s.d.: 6.72)%, 10.05 (s.d.: 6.40)%, 14.69 (s.d.: 6.07)% and 15.95 (s.d.: 6.32)%, respectively, in the total oldest old. A declined percentage of the MMSE score and increased percentages of the periventricular WMH, deep WMH, total WMH and WMH fraction in the high group divided by tertile of the CV of the systolic HBP at baseline were greater than those in the low group (P<0.05). The significant differences were retained after adjusting for covariates, including the MMSE score, periventricular WMH, deep WMH and WMH fraction at the baseline (P<0.05). Excessive variability in self-measured systolic HBP exacerbates the progression of cognitive impairment and brain white matter lesions in the oldest old.

[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.

Effect of concomitant use of memantine on mortality and efficacy outcomes of galantamine-treated patients with Alzheimer's disease: post-hoc analysis of a randomized placebo-controlled study.

PubMed

Hager, Klaus; Baseman, Alan S; Nye, Jeffrey S; Brashear, H Robert; Han, John; Sano, Mary; Davis, Bonnie; Richards, Henry M

2016-11-15

A large, prospective, 2-year, randomized study in patients with mild-to-moderate Alzheimer's disease or mixed dementia demonstrated reductions in mortality and cognitive/functional decline in galantamine-treated patients. A post-hoc analysis was conducted to study the effect of (the presence or absence of) concomitant memantine use on treatment outcome. Randomized patients (N = 2045) were divided into subgroups based on memantine use. Analyses included demographic and clinical characteristics (age, nursing home placement, Mini-Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD) scores) and mortality endpoints. Overall, 496 (24.3 %) patients were memantine users and were older (mean (SD), 74.0 (8.76) vs 72.8 (8.76), p = 0.008), with lower MMSE scores (18.2 (4.16) vs 19.2 (4.02), p < 0.0001) and DAD scores (58.0 (23.49) vs 62.5 (20.52), p < 0.0001) than nonusers. Mortality rates (per 100 patient-years) in memantine nonusers (n = 1549) were lower for galantamine (1.39) vs placebo-treated patients (4.15). In memantine users, mortality rates were similar for placebo-treated (4.49) and galantamine-treated patients (5.57). In memantine nonusers at 24 months, the decline in MMSE scores (effect size (95 % CI) 0.25 (0.14; 0.36)) and DAD scores (0.17 (0.06; 0.28)) from baseline was lower in galantamine patients vs placebo patients. The absence of these benefits in memantine users could not be explained by baseline age, MMSE, or DAD scores. This post-hoc analysis shows that the beneficial effects of galantamine at 2 years post treatment were not observed in patients who had been placed on background memantine. The reasons for memantine treatment and the possibility of interaction between memantine and galantamine merit further investigation. ClinicalTrials.gov NCT00679627 . Registered 15 May 2008.

Time-domain digital pre-equalization for band-limited signals based on receiver-side adaptive equalizers.

PubMed

Zhang, Junwen; Yu, Jianjun; Chi, Nan; Chien, Hung-Chang

2014-08-25

We theoretically and experimentally investigate a time-domain digital pre-equalization (DPEQ) scheme for bandwidth-limited optical coherent communication systems, which is based on feedback of channel characteristics from the receiver-side blind and adaptive equalizers, such as least-mean-squares (LMS) algorithm and constant or multi- modulus algorithms (CMA, MMA). Based on the proposed DPEQ scheme, we theoretically and experimentally study its performance in terms of various channel conditions as well as resolutions for channel estimation, such as filtering bandwidth, taps length, and OSNR. Using a high speed 64-GSa/s DAC in cooperation with the proposed DPEQ technique, we successfully synthesized band-limited 40-Gbaud signals in modulation formats of polarization-diversion multiplexed (PDM) quadrature phase shift keying (QPSK), 8-quadrature amplitude modulation (QAM) and 16-QAM, and significant improvement in both back-to-back and transmission BER performances are also demonstrated.

Phase inverter provides variable reference push-pull output

NASA Technical Reports Server (NTRS)

1966-01-01

Dual-transistor difference amplifier provides a push-pull output referenced to a dc potential which can be varied without affecting the signal levels. The amplifier is coupled with a feedback circuit which can vary the operating points of the transistors by equal amounts to provide the variable reference potentials.

Negative Reinforcement Impairs Overnight Memory Consolidation

ERIC Educational Resources Information Center

Stamm, Andrew W.; Nguyen, Nam D.; Seicol, Benjamin J.; Fagan, Abigail; Oh, Angela; Drumm, Michael; Lundt, Maureen; Stickgold, Robert; Wamsley, Erin J.

2014-01-01

Post-learning sleep is beneficial for human memory. However, it may be that not all memories benefit equally from sleep. Here, we manipulated a spatial learning task using monetary reward and performance feedback, asking whether enhancing the salience of the task would augment overnight memory consolidation and alter its incorporation into…

The impact of immediate or delayed feedback on driving behaviour in a simulated Pay-As-You-Drive system.

PubMed

Dijksterhuis, Chris; Lewis-Evans, Ben; Jelijs, Bart; de Waard, Dick; Brookhuis, Karel; Tucha, Oliver

2015-02-01

Pay-As-You-Drive (PAYD) insurance links an individual's driving behaviour to the insurance fee that they pay, making car insurance more actuarially accurate. The best known PAYD insurance format is purely mileage based and is estimated to reduce accidents by about 15% (Litman, 2011). However, these benefits could be further enhanced by incorporating a wider range of driving behaviours, such as lateral and longitudinal accelerations and speeding behaviour, thereby stimulating not only a safe but also an eco-friendly driving style. Currently, feedback on rewards and driver behaviour is mostly provided through a web-based interface, which is presented temporally separated from driving. However, providing immediate feedback within the vehicle itself could elicit more effect. To investigate this hypothesis, two groups of 20 participants drove with a behavioural based PAYD system in a driving simulator and were provided with either delayed feedback through a website, or immediate feedback through an in-car interface, allowing them to earn up to €6 extra. To be clear, every participant in the web group did actually view their feedback during the one week between sessions. Results indicate clear driving behaviour improvements for both PAYD groups as compared to baseline rides and an equal sized control group. After both PAYD groups had received feedback, the initial advantage of the in-car group was reduced substantially. Taken together with usability ratings and driving behaviours in specific situations these results show a moderate advantage of using immediate in-car feedback. However, the study also showed that under conditions of feedback certainty, the effectiveness of delayed feedback approaches that of immediate feedback as compared to a naïve control group. Copyright © 2014 Elsevier Ltd. All rights reserved.

Asymmetries in Climate Change Feedbacks: Why the Future may be Hotter Than you Think

NASA Astrophysics Data System (ADS)

Torn, M. S.; Harte, J.

2006-12-01

Feedbacks in the climate system are major sources of uncertainty, and climate predictions do not yet include one key set of feedbacks, namely biospheric greenhouse gas (GhG) feedbacks. Historical evidence shows that atmospheric GhG concentrations increase during periods of warming, implying a positive feedback to future climate change. We quantify this feedback for carbon dioxide (CO2) and methane (CH4) by combining the mathematics of feedback with both empirical ice-core information and general circulation model climate sensitivity. We find that a warming of 1.7-5.8°C predicted for the year 2100 is amplified to a warming commitment of 1.9-7.7°C, with the range deriving from different GCM simulations and paleo temperature records. Thus, anthropogenic emissions result in higher final GhG concentrations, and therefore more warming, than would be predicted in the absence of this feedback. Uncertainty in climate change predictions have been used as a rationale for inaction against the threat of global warming, based on a prevailing view that the uncertainties are symmetric, giving equal support to climate "optimists" (who think it will be a small problem) and "pessimists," (it will be a big problem). Our results show that even a symmetrical uncertainty in any component of feedback, whether positive or negative, produces an asymmetrical distribution of expected temperatures skewed towards higher temperature. For both reasons, the omission of key positive feedbacks and asymmetrical uncertainty from feedbacks, it is likely that the future will be hotter than we think, which implies more severe climate change impacts. Thus, these results suggest that a conservative policy approach would employ lower emission targets and tighter stabilization time horizons than would otherwise be required.

Power optimization of digital baseband WCDMA receiver components on algorithmic and architectural level

NASA Astrophysics Data System (ADS)

Schämann, M.; Bücker, M.; Hessel, S.; Langmann, U.

2008-05-01

High data rates combined with high mobility represent a challenge for the design of cellular devices. Advanced algorithms are required which result in higher complexity, more chip area and increased power consumption. However, this contrasts to the limited power supply of mobile devices. This presentation discusses the application of an HSDPA receiver which has been optimized regarding power consumption with the focus on the algorithmic and architectural level. On algorithmic level the Rake combiner, Prefilter-Rake equalizer and MMSE equalizer are compared regarding their BER performance. Both equalizer approaches provide a significant increase of performance for high data rates compared to the Rake combiner which is commonly used for lower data rates. For both equalizer approaches several adaptive algorithms are available which differ in complexity and convergence properties. To identify the algorithm which achieves the required performance with the lowest power consumption the algorithms have been investigated using SystemC models regarding their performance and arithmetic complexity. Additionally, for the Prefilter Rake equalizer the power estimations of a modified Griffith (LMS) and a Levinson (RLS) algorithm have been compared with the tool ORINOCO supplied by ChipVision. The accuracy of this tool has been verified with a scalable architecture of the UMTS channel estimation described both in SystemC and VHDL targeting a 130 nm CMOS standard cell library. An architecture combining all three approaches combined with an adaptive control unit is presented. The control unit monitors the current condition of the propagation channel and adjusts parameters for the receiver like filter size and oversampling ratio to minimize the power consumption while maintaining the required performance. The optimization strategies result in a reduction of the number of arithmetic operations up to 70% for single components which leads to an estimated power reduction of up to 40% while the BER performance is not affected. This work utilizes SystemC and ORINOCO for the first estimation of power consumption in an early step of the design flow. Thereby algorithms can be compared in different operating modes including the effects of control units. Here an algorithm having higher peak complexity and power consumption but providing more flexibility showed less consumption for normal operating modes compared to the algorithm which is optimized for peak performance.

Suppressive effect of an aqueous extract of Diospyros kaki calyx on dust mite extract/2,4-dinitrochlorobenzene-induced atopic dermatitis-like skin lesions.

PubMed

Yu, Ju-Hee; Jin, Meiling; Choi, Young-Ae; Jeong, Na-Hee; Park, Jeong-Sook; Shin, Tae-Yong; Kim, Sang-Hyun

2017-08-01

Atopic dermatitis (AD) is a common chronic inflammatory skin disease, affecting 10-20% of individuals worldwide. Therefore, the discovery of drugs for treating AD is an attractive subject and important to human health. Diospyros kaki and Diospyros kaki (D. kaki) folium exert beneficial effects on allergic inflammation. However, the effect of D. kaki calyx on AD remains elusive. The present study evaluated the effects of an aqueous extract of D. kaki calyx (AEDKC) on AD-like skin lesions using mouse and keratinocyte models. We used a mouse AD model by the repeated skin exposure of house dust mite extract [Dermatophagoides farinae extract (DFE)] and 2,4-dinitrochlorobenzene (DNCB) to the ears. In addition, to determine the underlying mechanism of its operation, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ)-activated keratinocytes (HaCaT) were used. Oral administration of AEDKC decreased AD-like skin lesions, as demonstrated by the reduced ear thickness, serum immunoglobulin E (IgE), DFE-specific IgE, IgG2a, histamine level and inflammatory cell infiltration. AEDKC inhibited the expression of pro-inflammatory cytokines and a chemokine via downregulation of nuclear factor-κB and signal transducer and activator of transcription 1 in HaCaT cells. On examination of the AD-related factors in vivo and in vitro, it was confirmed that AEDKC decreased AD-like skin lesions. Taken together, the results suggest that AEDKC is a potential drug candidate for the treatment of AD.

Esculetin from Fraxinus rhynchophylla attenuates atopic skin inflammation by inhibiting the expression of inflammatory cytokines.

PubMed

Jeong, Na-Hee; Yang, Eun-Ju; Jin, Meiling; Lee, Jong Yeong; Choi, Young-Ae; Park, Pil-Hoon; Lee, Sang-Rae; Kim, Sun-Uk; Shin, Tae-Yong; Kwon, Taeg Kyu; Jang, Yong Hyun; Song, Kyung-Sik; Kim, Sang-Hyun

2018-06-01

Atopic dermatitis (AD) is a common chronic inflammatory skin disorder afflicting from infancy to adults with itching, scratching, and lichenification. We aimed to investigate the effects of esculetin from Fraxinus rhynchophylla on atopic skin inflammation. For induction of atopic skin inflammation, we exposed the ears of female BALB/c mice to house dust mite (Dermatophagoides farinae extract, DFE) and 2,4-dinitrochlorobenzene (DNCB) for 4 weeks. Oral administration of esculetin reduced the symptoms of DFE/DNCB-induced atopic skin inflammation, which were evaluated based on ear swelling and number of scratch bouts. The immunoglobulin (Ig) E, IgG2a, and histamine levels in serum were decreased and inflammatory cell infiltration in skin tissue was reduced by the esculetin. It suppressed production of Th1, Th2 and Th17-related cytokines such as tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-4, IL-13, IL-31 and IL-17 in the ear tissue. Furthermore, we investigated the effects of esculetin on activated keratinocytes, which are representative cells used for studying the pathogenesis of acute and chronic atopic skin inflammation. As results, esculetin suppressed gene expression of Th1, Th2 and Th17 cytokines and the activation of nuclear factor-κB and signal transducer and activator of transcription 1 in TNF-α/IFN-γ-stimulated keratinocytes. Taken together, these results imply that esculetin attenuated atopic skin inflammation, suggesting that esculetin could be a potential therapeutic candidate for the treatment of AD. Copyright © 2018 Elsevier B.V. All rights reserved.

The effect of donepezil on increased regional cerebral blood flow in the posterior cingulate cortex of a patient with Parkinson's disease dementia.

PubMed

Imamura, Keiko; Wada-Isoe, Kenji; Kowa, Hisanori; Tanabe, Yoshio; Nakashima, Kenji

2008-01-01

It has been reported that the cholinesterase inhibitor, donepezil, improves cognitive decline in patients with Parkinson's disease dementia (PDD). However, this improvement was dominant for frontal lobe dysfunction, and the increase in the Mini-Mental State Examination (MMSE) score was minimal. We report a PDD patient with a decline of regional cerebral blood flow (rCBF) in the posterior cingulate cortex, precunei, and bilateral parietotemporal association cortex, as determined by single-photon emission computed tomography (SPECT) using the easy Z-scores imaging system (e-ZIS). Upon administration of donepezil, both the rCBF and MMSE score increased. The effectiveness of donepezil may vary based on the rCBF pattern in PDD.

Negative Feedback Enables Fast and Flexible Collective Decision-Making in Ants

PubMed Central

Grüter, Christoph; Schürch, Roger; Czaczkes, Tomer J.; Taylor, Keeley; Durance, Thomas; Jones, Sam M.; Ratnieks, Francis L. W.

2012-01-01

Positive feedback plays a major role in the emergence of many collective animal behaviours. In many ants pheromone trails recruit and direct nestmate foragers to food sources. The strong positive feedback caused by trail pheromones allows fast collective responses but can compromise flexibility. Previous laboratory experiments have shown that when the environment changes, colonies are often unable to reallocate their foragers to a more rewarding food source. Here we show both experimentally, using colonies of Lasius niger, and with an agent-based simulation model, that negative feedback caused by crowding at feeding sites allows ant colonies to maintain foraging flexibility even with strong recruitment to food sources. In a constant environment, negative feedback prevents the frequently found bias towards one feeder (symmetry breaking) and leads to equal distribution of foragers. In a changing environment, negative feedback allows a colony to quickly reallocate the majority of its foragers to a superior food patch that becomes available when foraging at an inferior patch is already well underway. The model confirms these experimental findings and shows that the ability of colonies to switch to a superior food source does not require the decay of trail pheromones. Our results help to resolve inconsistencies between collective foraging patterns seen in laboratory studies and observations in the wild, and show that the simultaneous action of negative and positive feedback is important for efficient foraging in mass-recruiting insect colonies. PMID:22984518