Visual Dysfunction and Occupational Performance in Persons With Parkinson's Disease

IMPORTANCE

Visual function is critical to support occupational performance for persons with Parkinson's disease (PwP), yet it can be adversely affected by the disease.

OBJECTIVE

To evaluate the prevalence and general awareness of visual dysfunction and identify the association between visual dysfunction and occupational performance in PwP.

DESIGN

Self-reported cross-sectional electronic survey.

PARTICIPANTS

PwP, identified from a registered database at a neurological institute, were invited to complete the survey through emails and newsletters.

OUTCOMES AND MEASURES

The survey contained items of self-reported visual difficulties, diagnosed eye conditions, and about general awareness about disease-related visual dysfunction. Ophthalmological symptoms and occupational performance were measured with the Visual Impairment Parkinson's disease Questionnaire and the Revised Self-Reported Functional Visual Performance Scale, respectively.

RESULTS

Data from PwP (n = 92; Mage = 69 yr) were analyzed. Nearly half were unaware that their disease could affect vision. Awareness was not associated with disease duration. Individuals reporting awareness tended to report difficulties with vision. Functional activities requiring vision were mildly impaired, and the frequency of ophthalmologic symptoms (commonly related to ocular surface disorder) was low. Nevertheless, a higher frequency of ophthalmologic symptoms was positively associated with a higher degree of disability in activities of daily living (Spearman's ρ = .49, p < .01).

CONCLUSIONS AND RELEVANCE

Visual dysfunction related to Parkinson's disease may affect occupational performance. Screening for changes in vision in these individuals may aid occupational therapists in addressing functional independence and activity engagement. What This Article Adds: People with Parkinson's disease may not have a general awareness that the disease can adversely affect visual function. Those individuals with awareness tend to notice changes in vision, and this disease-related visual dysfunction may limit engagement and participation in everyday activities. Active evaluation of visual function in people with Parkinson's disease is recommended. Occupational therapists could play a key role by screening for visual dysfunction and providing patient education in the clinic.

Practice Patterns and Responses to the Patient-Driven Groupings Model and Coronavirus Disease 2019 Pandemic in Home Health Occupational Therapy: A Pilot Survey Study

The purpose of the pilot survey was to understand current practice patterns and responses to the Patient-Driven Groupings Model and the coronavirus disease 2019 (COVID-19) pandemic in home health occupational therapy care. Fifty home health occupational therapy practitioners from 27 states in the United States completed the survey. Descriptive analysis was used to organize and summarize survey responses. The survey items on practice patterns included assessment tools, treatment approaches, and care coordination with physical therapy colleagues. The most reported assessment of occupational performance was the Barthel Index. The common treatment approaches included activities of daily living retraining, energy conservation, and functional mobility and transfer. The majority of respondents (n = 44) communicated with their physical therapy colleagues at least once a week. The communications were often related to scheduling and changes in a patient's condition. Seventy percent of practitioners experienced a reduction in home visits during the recent Medicare payment reform and the pandemic. These practitioners perceived that some patients might have been discharged from home health care prematurely. Additional studies to investigate the impact of policy changes and the pandemic on therapy intensity and patients' functional outcomes are warranted.

Loneliness and Activity Engagement Among Rural Homebound Older Adults With and Without Self-Reported Depression

IMPORTANCE

Rural homebound older adults are a vulnerable population at risk for depression, loneliness, and limited participation, but studies that examine these factors in this population are scarce.

OBJECTIVE

To describe the degree of depression, loneliness, and activity engagement among rural homebound older adults and determine differences in loneliness and activity engagement between those with and those without self-reported depression.

DESIGN

Cross-sectional survey.

SETTING

Two rural counties in south central Indiana.

PARTICIPANTS

Homebound adults ages 60 yr and older who received nutritional or companionship services from a local Area Agency on Aging. Outcomes and Measures: Depression was measured with an item on the self-report questionnaire and the Geriatric Depression Scale-15. Loneliness was measured with an item on the self-report questionnaire and the UCLA Loneliness Scale. Activity engagement was measured with the Engagement in Meaningful Activities Survey and the Meaningful Activity Participation Assessment.

RESULTS

Ninety-one participants returned surveys, of which 78 were analyzed. Regarding depression, 40% of participants reported having it, but results for the Geriatric Depression Scale-15 showed that 63% were in the indicative or suggestive range for depression. Participants in general reported moderate loneliness and low to moderate engagement in meaningful activities. Those with self-reported depression had significantly higher loneliness and lower activity engagement, particularly in self-care, leisure, and socializing activities.

CONCLUSIONS AND RELEVANCE

A high proportion of this sample of rural homebound older adults had depression. Those who did tended to have a higher degree of loneliness and lower engagement in meaningful activities. What This Article Adds: Depression was associated with greater loneliness and lower activity engagement in rural homebound older adults. Occupational therapy practitioners serving rural homebound older adults with depression should consider providing interventions to address loneliness and facilitate activity engagement.

Predicting Improvement in Self-Care Among Medicare Beneficiaries With an Orthopedic Hip Condition Discharged to Home From Skilled-Nursing Facilities

Date Presented 04/200/21

The study examined Medicare claims data to determine the amount of rehabilitation services needed (e.g., therapy intensity and length of stay) to maximize the improvement in self-care skills for older adults with an orthopedic hip condition in skilled-nursing facilities. Findings of the study provide reference data for OTs to plan intervention and justify resources necessary to increase clients' independence.

Primary Author and Speaker: Chiung-Ju Liu

Additional Authors and Speakers: Loriana Harkey, Sadie Jung, and Elizabeth Newton

The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review

BACKGROUND AND OBJECTIVES

The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults.

RESEARCH DESIGN AND METHODS

Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living.

RESULTS

The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific.

DISCUSSION AND IMPLICATIONS

Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.

[Risk factors for mortality in pediatric acute respiratory distress syndrome requiring extracorporeal membrane oxygenation support]

Objective: To explore the risk factors for mortality in pediatric acute respiratory distress syndrome (PARDS) requiring extracorporeal membrane oxygenation (ECMO) support. Methods: Clinical data of 109 patients with severe PARDS supported by ECMO, who were hospitalized in 6 ECMO centers in China from September 2012 to February 2020, were retrospectively analyzed. They were divided into survival group and death group according to the prognosis. Chi-square test and rank sum test were used to compare the variables between the two groups, including the demographic data, laboratory examination results, clinical data before and after ECMO, and other supportive treatment. Univariate and multivariate Logistic regression models were used to analyze the prognostic risk factors. Results: In these 109 cases, 54 died and 55 survived. Compared with the survival group, the death group had higher incidences of acute kidney injury (AKI) (48.1% (26/54) vs. 21.8% (12/55), χ²=8.318, P=0.004) and coagulation dysfunction (22.2% (12/54) vs. 7.3% (4/55), χ²=4.862, P=0.027), and higher rate of renal replacement therapy (48.1% (26/54) vs. 21.8% (12/55), χ²=9.694, P=0.008) during ECMO support. Logistic regression analysis showed that continuous renal replacement therapy (CRRT) and AKI were independent risk factors for death in patients with severe PARDS requiring ECMO support (HR=3.88,95%CI 1.04-14.52, HR=4.84,95%CI 1.21-19.46, both P<0.05). Conclusion: AKI and CRRT are independent risk factors for predicting mortality in patients with severe PARDS requiring ECMO support.

Interventions Within the Scope of Occupational Therapy Practice to Improve Performance of Daily Activities for Older Adults With Low Vision: A Systematic Review

IMPORTANCE

The prevalence of low vision increases with age. Low vision has detrimental effects on older adults' independence.

OBJECTIVE

To identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities for older adults with low vision.

DATA SOURCES

Literature published between 2010 and 2017 was searched in CINAHL, Cochrane Databases, MEDLINE, OTseeker, and PsycINFO.

STUDY SELECTION AND DATA COLLECTION

The authors screened and appraised studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Studies were eligible if the participants' mean age was 55 yr or older, the level of evidence was Level III or higher, the intervention was within the scope of occupational therapy practice, and the outcome measures assessed the performance of daily activities.

FINDINGS

Fourteen studies met the review criteria. Three intervention themes were identified: low vision rehabilitation services (n = 6), self-management approach (n = 6), and tango (n = 2). Moderate evidence was found for low vision rehabilitation services. Low evidence was found for using the self-management approach or adding the self-management approach to existing low vision rehabilitation services. Low evidence was found for tango.

CONCLUSION AND RELEVANCE

This systematic review supports the use of low vision rehabilitation services as an effective approach. Occupational therapy practitioners are encouraged to be part of multidisciplinary teams that offer comprehensive low vision evaluations and multicomponent services.

WHAT THIS ARTICLE ADDS

Low vision rehabilitation that offers multidisciplinary services, including occupational therapy, is effective in promoting independence among older adults with low vision.

Feasibility of staff-led 3-Step Workout for Life to reduce late-life activities of daily living disability: a community-based translational study

Translating and implementing research exercise programs that fit into the context of community service provisions could become part of the effort to reduce late-life disability. The purpose of this study was to examine the feasibility of a staff-led 3-Step Workout for Life program by applying a logic model in a local senior living community. The academic investigator and community fitness staff worked together to modify and implement the program protocol following the logic model. The community staff recruited residents and delivered the program. Residents were eligible if they were sedentary, showed muscle weakness, and experienced difficulty in performing activities of daily living. Feasibility was evaluated with program completion and attendance rates, adverse events, physical performance, and activities of daily living. Seventeen residents (mean age = 80 years) enrolled and 13 completed the program with an average attendance rate of 95%. No severe adverse events were reported. After program completion, participants' muscle strength and gross motor coordination of the upper extremity, as well as performance and satisfaction of activities of daily living were improved. This study supported the feasibility of the staff-led 3-Step Workout for Life program to promote independence for residents at risk of late-life disability in a senior living community.

Occupational Therapy Interventions to Improve Activities of Daily Living for Community-Dwelling Older Adults: A Systematic Review

OBJECTIVE

This systematic review aimed to synthesize the effects of interventions within the scope of occupational therapy to improve performance of activities of daily living (ADLs) in community-dwelling older adults.

METHOD

Searches were conducted in CINAHL, the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, and OTseeker. Empirical studies published between 1995 and 2015 were individually screened and appraised by two reviewers.

RESULTS

Forty-three studies met the review inclusion and exclusion criteria. Physical exercise was the most common intervention approach. Physical exercise interventions for frail older adults showed a moderate benefit, but no benefits were found for older adults without noticeable difficulty in ADLs. For older adults with difficulty in ADLs, there was a high benefit of using home-based intervention.

CONCLUSION

The findings of this systematic review highlight the importance of addressing older adults' living environment in intervention to promote independence in ADLs.

[Application and prospect of three-dimentional printing in stomatology]

Three dimentional printing is a new rapid prototyping technology based on digital model files, which developed through a combination of multi-disciplines such as information technology, precision machinery and materials science. With rapid development in recent years, three dimentional printing technology has been widely used in the medical fields, stomatology especially. It gradually penetrates into various parts of stomatology, such as education, practice and innovation, making stomatology clinical medicine more and more efficient, accurate and minimally invasive. Combined with basic research and clinical cases, this article describes the application and developent prospects of three dimentional printing technology in stomatology.

Whole-exome sequencing of cell-free DNA and circulating tumor cells in multiple myeloma

Liquid biopsies including circulating tumor cells (CTCs) and cell-free DNA (cfDNA) have enabled minimally invasive characterization of many cancers, but are rarely analyzed together. Understanding the detectability and genomic concordance of CTCs and cfDNA may inform their use in guiding cancer precision medicine. Here, we report the detectability of cfDNA and CTCs in blood samples from 107 and 56 patients with multiple myeloma (MM), respectively. Using ultra-low pass whole-genome sequencing, we find both tumor fractions correlate with disease progression. Applying whole-exome sequencing (WES) to cfDNA, CTCs, and matched tumor biopsies, we find concordance in clonal somatic mutations (~99%) and copy number alterations (~81%) between liquid and tumor biopsies. Importantly, analyzing CTCs and cfDNA together enables cross-validation of mutations, uncovers mutations exclusive to either CTCs or cfDNA, and allows blood-based tumor profiling in a greater fraction of patients. Our study demonstrates the utility of analyzing both CTCs and cfDNA in MM.

Circulating tumor cells (CTCs) and cell-free DNA (cfDNA) enables characterization of a patient’s cancer. Here, the authors analyse CTCs, cfDNA, and tumor biopsies from multiple myeloma patients to show these approaches are complementary for mutation detection, together enabling a greater fraction of patient tumors to be profiled.

[Radiological analysis of coronal and sagittal spinopelvic parameters in patients with degenerative lumbar kyphoscoliosis]

Objective: To review and compare radiological parameters between degenerative lumbar kyphoscoliosis (DLKS) and degenerative lumbar kyphosis (DLK), and analyze the relationships between coronal and sagittal deformities and compensatory mechanisms of sagittal balance. Methods: A total of 82 patients with lumbar degenerative deformities were enrolled for our radiographic study at Department of Spinal Surgery, Peking University People's Hospital from January 2016 to May 2017. These patients were divided into two groups: DLKS group (39 patients) with lumbar coronal and sagittal deformities, and DLK group (43 patients) just with lumbar sagittal deformity. Complete spinopelvic radiographic parameters were compared. Results: The Cobb angle and lumbar lordosis of DLKS group were (23.0±11.8)° and (18.2±12.1)°, while the lumbar lordosis of DLK group was (20.4±10.2)°. In DLKS group, Cobb angle had correlations with lumbar lordosis(r=-0.338, P=0.035), and central sacral vertical line distance had significant correlations with thoracolumbar junctional angle (r=0.488, P=0.002) . Moreover, no significant differences of all sagittal spinopelvic parameters were found between two groups (P>0.05). In DLKS group, significant correlations between lumbar lordosis and sacral slope (r=0.617, P=0.000), and correlations between lumbar lordosis and thoracic kyphosis(r=-0.363, P=0.023) were observed. In DLK group, lumbar lordosis showed significant correlations with thoracic kyphosis(r=-0.341, P=0.025) and sacral slope (r=0.772, P=0.000). According to Nash-Moe grading scale of apical vertebral rotation, 10 patients were with Ⅰ-Ⅱ grade while 29 patients with Ⅲ-Ⅴ grade in DLKS group. Conclusions: Both as typical lumbar degenerative deformities, there are some correlations between scoliosis and kyphosis. However, coronal scoliosis may not influent sagittal morphological parameters for DLKS patients. Thoracic curve changes and pelvic backtilt are both important for maintaining the sagittal balance in patients with degenerative lumbar kyphoscoliosis.

Predicting hand function in older adults: evaluations of grip strength, arm curl strength, and manual dexterity

BACKGROUND

Hand function is critical for independence in activities of daily living for older adults.

AIMS

The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults.

METHODS

Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively.

RESULTS

Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = -.25, p < .01) and manual dexterous coordination (β = -.52, p < .01) performed better on the time-based hand function test. In comparison, older adults with better grip strength (β = .40, p < .01), arm curl strength (β = .23, p < .05), and manual dexterous coordination (β = .23, p < .05) were associated with better self-report of upper extremity function.

CONCLUSIONS

The relationship between grip strength and hand function may be test-specific. Grip strength becomes a significant factor when the test requires grip strength to successfully complete the test tasks. Arm curl strength independently contributed to hand function in both time-based and self-report assessments, indicating that strength of extrinsic muscles of the hand are essential for hand function.

Promoting ADL independence in vulnerable, community-dwelling older adults: a pilot RCT comparing 3-Step Workout for Life versus resistance exercise

Background

Resistance exercise is effective to increase muscle strength for older adults; however, its effect on the outcome of activities of daily living is often limited. The purpose of this study was to examine whether 3-Step Workout for Life (which combines resistance exercise, functional exercise, and activities of daily living exercise) would be more beneficial than resistance exercise alone.

Methods

A single-blind randomized controlled trial was conducted. Fifty-two inactive, community-dwelling older adults (mean age =73 years) with muscle weakness and difficulty in activities of daily living were randomized to receive 3-Step Workout for Life or resistance exercise only. Participants in the 3-Step Workout for Life Group performed functional movements and selected activities of daily living at home in addition to resistance exercise. Participants in the Resistance Exercise Only Group performed resistance exercise only. Both groups were comparable in exercise intensity (moderate), duration (50–60 minutes each time for 10 weeks), and frequency (three times a week). Assessment of Motor and Process Skills, a standard performance test on activities of daily living, was administered at baseline, postintervention, and 6 months after intervention completion.

Results

At postintervention, the 3-Step Workout for Life Group showed improvement on the outcome measure (mean change from baseline =0.29, P=0.02), but the improvement was not greater than the Resistance Exercise Only Group (group mean difference =0.24, P=0.13). However, the Resistance Exercise Only Group showed a significant decline (mean change from baseline =−0.25, P=0.01) 6 months after the intervention completion. Meanwhile, the superior effect of 3-Step Workout for Life was observed (group mean difference =0.37, P<0.01).

Conclusion

Compared to resistance exercise alone, 3-Step Workout for Life improves the performance of activities of daily living and attenuates the disablement process in older adults.

[Application of improved regional citrate anticoagulation in continuous hemofiltration in children]

Objective: To investigate the application of regional citrate anticoagulation with calcium hemofiltration basic solution in continuous hemofiltration in children. Method: The clinical data of 18 patients with citrate anticoagulation in continuous hemofiltration in children, excluding the hepatic failure and septic shock cases, were analyzed retrospectively, from September 2015 to August 2016 in Intensive Care Unit of the Children's Hospital of Chongqing Medical University.The commercial calcium hemofiltration basic solution was used as displacement liquid . The blood gas analysis, electrolyte, four coagulation tests during the treatment and the corresponding relations of quantity of blood flow(QB), quantity of citrate flow(QCi), quantity of sodium bicarbonate flow(QSB), quantity of calcium flow(QCa), quantity of filtered solution flow (Qf) were monitored. Meanwhile, the blood gas analysis, electrolyte, four coagulation tests, useful life of filter, bleeding and clotting events internal and external before, during and after the treatments were monitored, too. And the common complications of citrate anticoagulation, such as hypocalcaemia, metabolic alkalosis, citrate accumulation and hypernatremia were observed. Result: Continuous hemofiltration was applied in 18 patients for 734.5 hours, and the average useful life of filter was (25±11)h.There was no obvious clotting event. There were 168 groups of datum of the blood gas analysis, electrolyte, four coagulation tests during the treatment and the relationships of QB, QCi, QSB, QCa, Qf had been collected. The relationships of the initial parameter settings of QB, QCi, QSB, QCa and Qf were concluded as QCi=1.8×QB, QCa=0.12×QB, QSB=0.01×Qf . There were 150 times(89.3%)of extracorporeal ionized calcium(iCa(E)(2+)) and 162 times(96.4%) of intracorporal ionized calcium(iCa(I)(2+)) reached the anticoagulation target. Although all the comparisons of Na(+) ((136.2±4.1)vs.(138.2±2.4)vs.(138.5±3.9)mmol/L), iCa(2+) ((1.07±0.11)vs.(1.21±0.12)vs.(1.17±0.09)mmol/L), HCO(3)(-) ((22±4)vs.(28±5)vs. (26±4)mmol/L) among before, during and after treatment had significant difference(F=6.414, 18.950, 19.151; P=0.002, 0.000, 0.000). Each mean parameter was within the nearly normal range, except that the HCO(3)(-) increased slightly. High HCO(3)(-) was the most common complications, which happened 87 times (51.8%) during the treatment and 11 cases(37.9%) after the treatment. There was none with refractory hypocalcemia and total ionized calcium(TCa(2+) )/iCa(2+) above 2.5, which hints the accumulation of citrate. Conclusion: The commercialized displacement liquid containing calcium can be used in RCA-CHF in children safely and simply.

[The imaging analysis of the age-related changes on maxillary sinus]

Objective:The aim of this study is to investigate the age-related changes rules of maxillary sinus.Method:The 540 patients (1 080 sides) with normal data of deputy sinus in spiral CT were enrolled,including 270 cases of male and female,age from 7 to 81 years old.They are divided into 9 groups according to the age:Group A at the age of 7-12 years old,Group B at the age of 13-17,Group C at the age of 18-20 years old,Group D at the age of 21-24 years old,Group E at the age of 25-28 years,Group F at the age of 29-35 years old,Group G at the age of 36-40 years old,Group H at the age of 41-65 years old,and Group I is more than 65 years old.By the gender,the patients in each group was divided into male and female groups.There are 30 cases in each group(60 sides).The volumes and the three-dimensional diameters of the maxillary sinus were measured,and the coefficient of gasification of them were calculated.Result:The maxillary sinus volume and 3 D lines have almost the same change trend along with the age between the male and female group;From 7 to 20 ages,they are increased linearly,13 to 17 fastest-growing;18 to 20 years old reached to peak;declined slightly in 21-28 years old,29-35 a second growth peak,and 36 to 40 years old have fallen sharply,to reaching a steady state after 41 years old;The gasification coefficient has no difference among all groups.Conclusion:The volume changes with the age-related on maxillary sinus is in the adolescent stage.It reaches a steady state in the middle and old age stage,and gasification coefficient on maxillary sinus has no age-related changes among all groups.

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

Age Differences in the Association Between Body Mass Index Class and Annualized Medicare Expenditures

OBJECTIVE

The aim of the study is to assess the relationship between body mass index (BMI) class and Medicare claims among young-old (65-69), old (70-74), and old-old (75+) adults over a 10-year period.

METHOD

We assessed costs by BMI class and age group among 9,300 respondents to the 1998 Health and Retirement Study (HRS) with linked 1998-2008 Medicare claims data. BMI was classified as normal (18.5-24.9), overweight (25-29.9), mild obesity (30-34.9), or severe obesity (35 or above).

RESULTS

Annualized total Medicare claims adjusted for age, gender, ethnicity, education, and smoking history were 109% greater for severely obese young-old adults in comparison with normal weight young-old adults (US$9,751 vs. US$4,663). Total annualized claim differences between the normal weight and severely obese in the old and old-old groups were not statistically significant.

DISCUSSION

Excess Medicare expenditures related to obesity may be concentrated among severely obese young-old adults. Preventing severe obesity among middle and older aged adults may have large cost implications for society.

Clinicopathological features of thirty patients with primary breast lymphoma and review of the literature

Primary breast lymphoma (PBL) is a rare disease accounting for 0.4-0.5 % of all breast malignancies. Accumulating evidence indicates that the diagnosis, prognostic factors, and optimal management of PBL are difficult. The present study aims to investigate the clinicopathological features and optimal treatment of PBL and to evaluate the institutional experience in this patient population. A total of 30 patients with PBL from January 2002 to December 2012 treated in He'nan Province Tumor Hospital were selected. The patients' clinical and pathological characteristics, treatment and response data, patterns of recurrence, and outcomes were retrospectively analyzed, and the relevant literatures were reviewed. All the cases were female, and the median age was 45. Diffuse large B cell lymphoma was the most common histological subtype seen in 23 of 30 patients. With a median follow-up time 32 months, median OS was 42 months (95 % CI 25-58 months), with 5-year OS rates 48 % (95 % CI 36-59 %). The median PFS was 14 months (95 % CI 6-30 months), with 5-year PFS rates 32 % (95 % CI 20-45 %). The prognostic factors that retained statistical significance for OS were IPI (P < 0.001), age (P = 0.04), and stage (P < 0.001). For PFS, significant prognostic factors were IPI (P = 0.01), radiotherapy given (P = 0.02) and stage (P = 0.02). PBL appears to have a worse prognosis. The present treatment method for PBL is a comprehensive way of diagnostic surgery together with radiotherapy and chemotherapy.

Multiband signal reconstruction for random equivalent sampling

The random equivalent sampling (RES) is a sampling approach that can be applied to capture high speed repetitive signals with a sampling rate that is much lower than the Nyquist rate. However, the uneven random distribution of the time interval between the excitation pulse and the signal degrades the signal reconstruction performance. For sparse multiband signal sampling, the compressed sensing (CS) based signal reconstruction algorithm can tease out the band supports with overwhelming probability and reduce the impact of uneven random distribution in RES. In this paper, the mathematical model of RES behavior is constructed in the frequency domain. Based on the constructed mathematical model, the band supports of signal can be determined. Experimental results demonstrate that, for a signal with unknown sparse multiband, the proposed CS-based signal reconstruction algorithm is feasible, and the CS reconstruction algorithm outperforms the traditional RES signal reconstruction method.

Effect of the IkBα mutant gene delivery to mesenchymal stem cells on rat chronic pancreatitis

This study aimed to investigate the effect of inhibitors of the NF-kΒ alpha mutant gene (IkBaM) delivery to mensenchymal stem cells (MSCs) on rat chronic pancreatitis (CP). A total of 120 Sprague-Dawley rats were randomly divided into 6 groups of 20: Group A was injected with sterile saline solution, Group B was injected with allogenic MSCs, Group C1 was injected with allogenic IkBαM-MSCs cultured in vitro 4 h before CP modeling, Group C2 was injected with allogenic IkBαM-MSCs cultured in vitro during CP modeling, Group C3 was cultured with allogenic IkBαM-MSCs cultured in vitro 4 h after CP modeling, and Group D was injected with rAAV2-MSCs. Cytokine levels of ICAM-1, CTGF, IL-1, IL-6, IL-8, TNF-α, TIMP-1, TIMP-2, IL-10, FN, MMP-1, MMP-2, MMP-3, and MMP-9 were examined. The results indicated that allogenic IκBαM-MSCs could reduce pro-inflammatory cytokine levels and increase anti-inflammatory cytokine levels in CP. The allogenic IkBαM-MSCs reduced the activation and promoted the apoptosis of pancreatic stellate cells in the rat model of CP. IkBαM-MSCs influenced the proliferation and apoptosis of pancreatic stellate cells by regulating the activation of the PPAR, MAPK, mTOR, TGF-β, NOD-like receptor, Notch, WNT, TGF-β1-SMAD-2/3, and P53 signal transduction pathways.

Improving yield and quality traits of durum wheat by introgressing chromosome segments from hexaploid wheat

Durum wheat (Triticum turgidum durum; 2n = 4x = 28; genome AABB) has long been an important food resource for human diets. The projected increase of the world's population to 9.1 billion by 2050 has highlighted the importance and urgency for improving the yield and quality performance of durum wheat. A backcrossed population, which was derived from the durum wheat variety 'Bellaroi' (recurrent parent) and the hexaploid genotype 'CSCR6' (donor parent), was used to investigate the feasibility of improving yield- and quality-related traits of durum wheat by introgressing chromosome fragments from hexaploid wheat. The population means for grain protein content, gluten content, spike length, and spikelet number were improved compared with those of the recurrent parent 'Bellaroi'. A small proportion of the backcross population lines showed significant improvements in spike length and spikelet number compared with the recurrent parent 'Bellaroi'. Some loci with significant effects for plant height, spike length, spikelet number, and thousand-grain weight were identified. Several of these loci affected more than one trait. These results showed that the introgression of chromosome fragments from 'CSCR6' into the durum genetic background could be an effective method for improving yield and quality traits of durum wheat. In addition, the loci showing significant effects on desired traits in this study could be fine mapped using an F2 population obtained by backcrossing the lines that carry the positive allele(s) with the recurrent parent.

Occupational therapy interventions to improve performance of daily activities at home for older adults with low vision: a systematic review

The impact of age-related vision loss on older adults' independence at home is profound. The purpose of this systematic review was to identify the effectiveness of interventions within the scope of occupational therapy practice to maintain, restore, and improve performance in daily activities at home for older adults with low vision. We searched and screened abstracts from multiple electronic databases and identified 17 studies that fulfilled our inclusion and exclusion criteria. Three themes in intervention approaches emerged: multicomponent intervention, single-component intervention, and multidisciplinary intervention. Strong evidence of effectiveness was found in studies that applied a multicomponent approach; these interventions involved teaching knowledge and skills that older adults with low vision need to help overcome the disablement process. Evidence also suggests that multiple sessions of training with low vision devices and special viewing skills to compensate for vision loss are necessary to have a positive effect on daily activities. Finally, multidisciplinary intervention that focused on personal goals yielded greater positive outcomes than interventions that were not personalized.

Major QTL for Fusarium crown rot resistance in a barley landrace

Fusarium crown rot (FCR) is a serious cereal disease in semi-arid regions worldwide. In assisting the effort of breeding cultivars with enhanced resistance, we identified several barley genotypes with high levels of FCR resistance. One of these genotypes, AWCS079 which is a barley landrace originating from Japan, was investigated by developing and assessing three populations of recombinant inbred lines. Two QTL, one located on the long arm of chromosome 1H (designated as Qcrs.cpi-1H) and the other on 3HL (designated as Qcrs.cpi-3H), were found to be responsible for the FCR resistance of this genotype. Qcrs.cpi-1H is novel as no other FCR loci have been reported on this chromosome arm. Qcrs.cpi-3H co-located with a reduced height (Rht) locus and the effectiveness of the former was significantly affected by the latter. The total phenotypic variance explained by these two QTL was over 60 %. Significant effects were detected for each of the QTL in each of the three populations assessed. The existence of these loci with major effects should not only facilitate breeding and exploitation of FCR-resistant barley cultivars but also their further characterization based on fine mapping and map-based gene cloning.

C-Src/Jak2/PDGFR/PKCδ-dependent MMP-9 induction is required for thrombin-stimulated rat brain astrocytes migration

Among matrix metalloproteinases (MMPs), MMP-9 has been observed in patients with brain inflammatory diseases and may contribute to the pathology of brain diseases. Thrombin has been known as a regulator of MMP-9 expression and cells migration. However, the mechanisms underlying thrombin-induced MMP-9 expression in rat brain astrocytes (RBA-1 cells) were not completely understood. Here, we demonstrated that thrombin induced the expression of pro-form MMP-9 in RBA-1 cells and cells migration which were attenuated by pretreatment with the inhibitor of receptor tyrosine kinase (Genistein), c-Src (PP1), Jak2 (AG490), PDGFR (AG1296), PI3K (LY294002), Akt (SH-5), PKCs (Ro318220), PKCδ (Rottlerin), or NF-κB (Bay11-7082) and transfection with siRNA of c-Src, PDGFR, Akt, PKCδ, ATF2, p65, IKKα, or IKKβ. In addition, thrombin-stimulated c-Src, Jak2, or PDGFR phosphorylation was inhibited by a thrombin inhibitor (PPACK), PP1, AG490, or AG1296. Thrombin further stimulated c-Src and PDGFR complex formation in RBA-1 cells. Thrombin also stimulated Akt and PKCδ phosphorylation and PKCδ translocation which were reduced by PPACK, PP1, AG490, AG1296, or LY294002. We further observed that thrombin markedly stimulated ATF2 or IκBα phosphorylation and NF-κB p65 translocation which were inhibited by Rottlerin or LY294002. Finally, thrombin stimulated in vivo binding of p65 to the MMP-9 promoter, which was reduced by pretreatment with Rottlerin or LY294002. These results concluded that in RBA-1 cells, thrombin activated a c-Src/Jak2/PDGFR/PI3K/Akt/PKCδ pathway, which in turn triggered ATF2 and NF-κB activation and ultimately induced MMP-9 expression associated with cell migration.

Mst1 overexpression inhibited the growth of human non-small cell lung cancer in vitro and in vivo

Mammalian STE20-like kinase 1 (Mst1) ubiquitously encodes serine threonine kinase, which is a 59-kDa class II GC kinase that shares 76% identity in amino-acid sequence with MST2, and is the closest mammalian homolog of Drosophila Hippo protein kinase, a major inhibitor of cell proliferation in Drosophila. Recent studies have shown that Mst1 and Mst2 perform tumor-suppressor function in a redundant manner and were originally identified as pro-apoptotic cytoplasmic kinases important for controlling cell growth, proliferation, apoptosis and organ size. We used recombinant eukaryotic expression vector containing human wild-type Mst1 gene to transfect human non-small cell lung cancer (NSCLC) A549 cells in vitro and in vivo. The results showed that Mst1 overexpression inhibited cell proliferation and induced apoptosis of A549 cells, promoted Yes-associated protein (YAP) (Ser127) phosphorylation and downregulated the transcriptional level of Cystein-rich protein connective tissue growth factor (CTGF), amphiregulin (AREG) and Survivin. In human NSCLC-cell-A549-xenograft models, Mst1 gene or cisplatin alone suppressed the growth of tumors and increased the cytoplasm-positive expression levels of YAP and Phospho-YAP (Ser127) proteins; however, their combination had the strongest anticancer effects. Overall, Mst1 has an important role in inhibiting the growth of NSCLC in vitro and in vivo; its antiproliferative effect is associated with induction of apoptosis through promotion of the cytoplasmic localization and phosphorylation of YAP protein at Ser127 site, indicating that Mst1 may be developed as a promising therapeutic target for NSCLC.

A new approach to kinetics study of the anhydrite crystallization at 373 K using a diamond anvil cell with Raman spectroscopy

A new approach to the kinetics study of anhydrite (CaSO4) crystallization has been performed in situ using a hydrothermal diamond anvil cell with Raman spectroscopy in the pressure range 896-1322 MPa and a constant temperature of 373 K. Transformed volume fraction X(t) was determined from Raman peak intensity of the sulfate ion in aqueous solution. The transformation-time plots display a sigmoidal shape with time, which indicates that the reaction rate is different at each stage of anhydrite crystallization. At 373 K, the rate constant k increases from 1.14 × 10(-4) s(-1) to 1.86 × 10(-3) s(-1), demonstrating a positive effect of pressure on the overall rate at isothermal condition. We first achieved the molar volume change (ΔVm) equal to -1.82 × 10(-5) m(3)∕mol in the course of anhydrite crystallization through Avrami kinetic theory, showing a process of reduction in volume at high pressure and high temperature. According to the exponent n derived from our experiments, a grain-boundary nucleation and diffusion-controlled growth kinetically dominates the crystallization of anhydrite.

Sonographic demonstration of human small intestinal migrating motor complex phase III

BACKGROUND

Migrating motor complex phase III (MMC phase III) of intestine is an important physiological mechanism traditionally recognized by myoelectric recordings or pressure tracings. Direct imaging is difficult and sonographic visualization in human has not been reported.

METHODS

We have demonstrated this unique phenomenon in three patients who underwent abdominal sonographic examinations. Characteristic images were recorded by videotape and both spatial and temporal features were analyzed.

KEY RESULTS

Occurrences of multiple equally spaced, rhythmic intestinal contractions were observed. Parameters including wave frequency, propagation velocity, and duration of the events agreed with those of the well-known phase III. The presence of distinct cyclic patterns observed in two and abolition by meal in the other patient further support our conclusion.

CONCLUSIONS & INFERENCES

We conclude that the migrating waves observed in our study represent the human MMC phase III. This unique finding in human subjects merits further investigation.

Effects of replacing dietary starch with neutral detergent-soluble fibre on ruminal fermentation, microbial synthesis and populations of ruminal cellulolytic bacteria using the rumen simulation technique (RUSITEC)

A rumen simulation technique (RUSITEC) apparatus with eight 800 ml fermenters was used to investigate the effects of replacing dietary starch with neutral detergent-soluble fibre (NDSF) by inclusion of sugar beet pulp in diets on ruminal fermentation, microbial synthesis and populations of ruminal cellulolytic bacteria. Experimental diets contained 12.7, 16.4, 20.1 or 23.8% NDSF substituted for starch on a dry matter basis. The experiment was conducted over two independent 15-day incubation periods with the last 8 days used for data collection. There was a tendency that 16.4% NDSF in the diet increased the apparent disappearance of organic matter (OM) and neutral detergent fibre (NDF). Increasing dietary NDSF level increased carboxymethylcellulase and xylanase activity in the solid fraction and apparent disappearance of acid detergent fibre (ADF) but reduced the 16S rDNA copy numbers of Ruminococcus albus in both liquid and solid fractions and R. flavefaciens in the solid fraction. The apparent disappearance of dietary nitrogen (N) was reduced by 29.6% with increased dietary NDSF. Substituting NDSF for starch appeared to increase the ratios of acetate/propionate and methane/volatile fatty acids (VFA) (mol/mol). Replacing dietary starch with NDSF reduced the daily production of ammonia-N and increased the growth of the solid-associated microbial pellets (SAM). Total microbial N flow and efficiency of microbial synthesis (EMS), expressed as g microbial N/kg OM fermented, tended to increase with increased dietary NDSF, but the numerical increase did not continue as dietary NDSF exceeded 20.1% of diet DM. Results suggested that substituting NDSF for starch up to 16.4% of diet DM increased digestion of nutrients (except for N) and microbial synthesis, and further increases (from 16.4% to 23.8%) in dietary NDSF did not repress microbial synthesis but did significantly reduce digestion of dietary N.

Characterization of a QTL affecting spike morphology on the long arm of chromosome 3H in barley (Hordeum vulgare L.) based on near isogenic lines and a NIL-derived population

Traits related to spike morphology (SM), including grain density (GD), spike length (SL) and awn length (AL), are of central importance in cereal improvement. A recent study based on a two-row landrace of barley, TX9425, detected QTL controlling all of the three traits in a similar region on the long arm of chromosome 3H. To further characterize this chromosomal region, 12 pairs of near isogenic lines (NILs) for GD were generated from two populations between TX9425 and two different commercial cultivars. A population consisting of 1,028 lines segregating primarily for the target region was also developed using materials generated during the production of these NILs. Results from the analysis of the NILs and the NIL-derived population showed that these three traits were likely controlled by a single-locus which was mapped to a 2.84 cM interval between two SSR markers, GBM1495 and HVM33. Across the 12 pairs of NILs, the presence of the 3HL locus increased GD by 53.4 %, reduced SL and AL by 38.8 % and 62.7 %, respectively. In the NIL-derived population, the presence of the 3HL locus increased GD by 64.6 %, reduced SL and AL by 33.7 % and 62.6 %, respectively. An interesting question arising from this research is why some loci such as the one reported here affect several SM-related traits while others appear to affect one of these traits only. The NILs and the NIL-derived population generated in this study will help answer such questions by providing the germplasm to enable cloning and comparative analysis of the genes responsible for these SM-related traits.

Rank regression for analyzing ordinal qualitative data for treatment comparison

ABSTRACT Ordinal qualitative data are often collected for phenotypical measurements in plant pathology and other biological sciences. Statistical methods, such as t tests or analysis of variance, are usually used to analyze ordinal data when comparing two groups or multiple groups. However, the underlying assumptions such as normality and homogeneous variances are often violated for qualitative data. To this end, we investigated an alternative methodology, rank regression, for analyzing the ordinal data. The rank-based methods are essentially based on pairwise comparisons and, therefore, can deal with qualitative data naturally. They require neither normality assumption nor data transformation. Apart from robustness against outliers and high efficiency, the rank regression can also incorporate covariate effects in the same way as the ordinary regression. By reanalyzing a data set from a wheat Fusarium crown rot study, we illustrated the use of the rank regression methodology and demonstrated that the rank regression models appear to be more appropriate and sensible for analyzing nonnormal data and data with outliers.

Gene expression analysis of host spleen responses to Marek's disease virus infection at late tumor transformation phase

Marek's disease is a viral neoplastic disease of chickens caused by Marek's disease virus (MDV). Gene expression patterns have been investigated at different MDV infection stages, but there is limited research about the late tumor transformation phase. In this experiment, 44K Agilent chicken genome-wide expression microarrays were used to profile differential expression in tumorous spleens (TS) from severely morbid chickens and apparently normal spleens from survivors (SS) after MDV infection and expression in noninfected spleens (NS) from controls. There were 4,317 differentially expressed (DE) genes in TS versus NS. However, no DE genes were detected in SS versus NS, suggesting that maintenance of, or return to, homeostasis of gene activity in survivor spleens. Downregulated genes in tumorous spleens mainly enriched in the cytokine-cytokine receptor interaction pathway, and commonly investigated genes in Marek's disease study, IL6, IL18, IFNA, and IFNG were nondifferentially expressed, which indicates host inflammatory response was impaired. The IL10 and TNFRSF8 genes were upregulated in tumorous spleens. We speculated that IL10 might be exploited by MDV to escape from host immune surveillance, as reported for Epstein-Barr virus, which stimulated T cells secreting IL10 to subvert immune response. Previous study reported that transcription from TNFRSF8 promoter could be enhanced by MDV oncogene Meq. In this study, the increased expression of TNFRSF8 indicated interaction between MDV and TNFRSF8, which might facilitate pathogenesis and tumor transformation. The expression of many members in IGF system was changed in tumorous compared with noninfected spleens. The downregulation of IGFBP7 was considered to be associated with MD lymphoma transformation. Gene expression change of multiple regulatory pathways indicated their involvements in facilitating tumor transformation.

Detection of interchromosomal translocations within the Triticeae by RFLP analysis

Twenty-three wheat/alien addition or substitution lines were screened using restriction fragment length polymorphisms for the presence or absence of 4/5 and 4/7 reciprocal translocations in the alien chromosomes. Such translocations have previously been identified in wheat and rye. Group 4 and group 5 Aegilops umbellulata, Triticum urartu, and Thinopyrum bessarabicum chromosomes were found to carry 4/5 translocations. Evidence for a 4/7 translocation was also found in Secale montanum. The presence of the 4/5 translocations in T. urartu indicates that the translocation predates the polyploidization of wheat. The implications of these results are discussed.

Effects of text cohesion on comprehension and retention of colorectal cancer screening information: a preliminary study

Increasing readability of written cancer prevention information is a fundamental step to increasing awareness and knowledge of cancer screening. Instead of readability formulas, the present study focused on text cohesion, which is the degree to which the text content ties together. The purpose of this study was to examine the effect of text cohesion on reading times, comprehension, and retention of colorectal cancer prevention information. English-speaking adults (50 years of age or older) were recruited from local communities. Participants were randomly assigned to read colorectal cancer prevention subtopics presented at 2 levels of text cohesion: from higher cohesion to lower cohesion, or vice versa. Reading times, word recognition, text comprehension, and recall were assessed after reading. Two weeks later, text comprehension and recall were reassessed. Forty-two adults completed the study, but five were lost to follow up. Higher text cohesion showed a significant effect on reading times and text comprehension but not on word recognition and recall. The effect of text cohesion was not found on text comprehension and recall after 2 weeks. Increasing text cohesion facilitates reading speed and comprehension of colorectal cancer prevention information. Further research on the effect of text cohesion is warranted.

Attitudes to colorectal cancer screening after reading the prevention information

Some of the biggest barriers to increase colorectal cancer screening are negative attitudes to screening tests. These negative attitudes might be evoked through reading cancer prevention information and impede the decision to get screened. Forty-two adults aged ≥50 years completed a 12-item attitude questionnaire after reading colorectal cancer prevention information. African-Americans perceived that others had higher cancer risk than themselves whereas Caucasians did not show the difference. Regardless of ethnicity and adherence to screening guidelines, no participants had strong feelings of fear and embarrassment. However, non-adherent Caucasians had higher anxiety than adherent Caucasians. The degree of negativity was not associated with intention to get screened in non-adherent participants. Adequate health literacy of participants may account for flat responses in negative attitudes. Further research in individuals with limited health literacy is recommended. Moreover, additional education about self-relevance of cancer risk is considered necessary to increase cancer awareness in African-Americans.

Identification and validation of quantitative trait loci conferring tan spot resistance in the bread wheat variety Ernie

Tan spot, caused by Pyrenophora tritici-repentis, is a foliar disease of wheat, and it can inflict serious reduction in grain yield and quality. The bread wheat variety Ernie was found to be immune to this disease in Australia, and its genetic control was investigated by quantitative trait loci (QTL) analysis using a doubled haploid population. Eight QTL were identified in this population from three independent trials, and four of them were derived from the parent Ernie. The most significant QTL was located on chromosome arm 2BS, explaining 38.2, 29.8 and 36.2% of the phenotypic variance, respectively, in these trials. The effects of the 2BS QTL were further validated in four additional populations. The presence of this single QTL reduced disease severity by between 29.2 and 67.1% with an average of 50.5%. The significant effects of this QTL and its consistent detection across all the trials with different genetic backgrounds make it an ideal target for breeding programmes as well as for its further characterization. Data from this study also showed that neither plant height nor heading date significantly affects tan spot resistance.

Plant height affects Fusarium crown rot severity in wheat

Effects of plant height on Fusarium crown rot (FCR) disease severity were investigated using 12 pairs of near-isogenic lines (NILs) for six different reduced height (Rht) genes in wheat. The dwarf isolines all gave better FCR resistance when compared with their respective tall counterparts, although the Rht genes involved in these NILs are located on several different chromosomes. Treating plants with exogenous gibberellin increased FCR severity as well as seedling lengths in all of the isolines tested. Analysis of the expression of several defense genes with known correlation with resistance to FCR pathogens between the Rht isolines following FCR inoculation indicated that the better resistance of the dwarf isolines was not due to enhanced defense gene induction. These results suggested that the difference in FCR severity between the tall and dwarf isolines is likely due to their height difference per se or to some physiological and structural consequences of reduced height. Thus, caution should be taken when considering to exploit any FCR locus located near a height gene.

Purification and characterization of an intracellular beta-glucosidase from the protoplast fusant of Aspergillus oryzae and Aspergillus niger

Protoplasts of Aspergillus oryzae 3.481 and Aspergillus niger 3.316 were prepared using cellulose and snail enzyme with 0.6 M NaCl as osmotic stabilizer. Protoplast fusion has been performed using 35% polyethylene glycol 4.000 with 0.01 mM CaCl2. The fused protoplasts have been regenerated on regeneration medium and fusants were selected for further studies. An intracellular beta-glucosidase (EC 3.2.1.21) was purified from the protoplast fusant of Aspergillus oryzae 3.481 and Aspergillus niger 3.316 and characterized. The enzyme was purified 138.85-fold by ammonium sulphate precipitation, DE-22 ion exchange and Sephadex G-150 gel filtration chromatography with a specific activity of 297.14 U/mg of protein. The molecular mass of the purified enzyme was determined to be about 125 kDa by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. The enzyme had an optimum pH of 5.4 and temperature of 65 degrees C, respectively. This enzyme showed relatively high stability against pH and temperature and was stable in the pH range of 3.0-6.6. Na+, K+, Ca2+, Mg2+ and EDTA completely inhibited the enzyme activity at a concentration of 10 mM. The enzyme activity was accelerated by Fe3+. The enzyme activity was strongly inhibited by glucose, the end product ofglucoside hydrolysis. The K(m) and V(max) values against salicin as substrate were 0.035 mM and 1.7215 micromol min(-1), respectively.

Adverse events reported in progressive resistance strength training trials in older adults: 2 sides of a coin

OBJECTIVES

To summarize adverse events reported in randomized controlled trials that applied progressive resistance strength training in older adults and to examine factors that might be associated with these events.

DESIGN

After systematic searches of databases, 2 reviewers independently screened and extracted adverse event-related information from identified trials.

SETTING

Not applicable.

PARTICIPANTS

Older adults 60 years of age and above (N = 6700).

INTERVENTION

Muscle strength training exercise that increases load gradually.

MAIN OUTCOME MEASURES

Adverse events and reasons for dropout. Adverse events include any undesirable outcomes that may be directly related or unrelated to the intervention.

RESULTS

Among 121 trials identified, 53 trials provided no comments about adverse events, 25 trials reported no adverse events occurred, and 43 trials reported some types of adverse events. Most adverse events reported were musculoskeletal problems such as muscle strain or joint pain. Adverse events were reported more often in trials that recruited participants with certain health conditions, functional limitations, or sedentary lifestyle; in trials that applied high intensity; and in trials that were published after the 2001 Consolidated Standards of Reporting Trials statement had been published. Reasons reported for dropout in 58 trials might be related to adverse events. The most frequent reasons for dropout were illness or medical problems.

CONCLUSIONS

Adverse events may be underreported because there is no consensus on the definition. Reporting adverse events associated with progressive resistance strength training in older adults is informative for practitioners to translate clinical research to clinical practice by knowing both the benefits and risks. Future trials should clearly define adverse events and report them in the published article.

Identification and validation of a major QTL conferring crown rot resistance in hexaploid wheat

Crown rot (CR), caused by various Fusarium species, is a chronic wheat disease in Australia. As part of our objective of improving the efficiency of breeding CR resistant wheat varieties, we have been searching for novel sources of resistance. This paper reports on the genetic control of one of these newly identified resistant genotypes, 'CSCR6'. A population derived from a cross between CSCR6 and an Australian variety 'Lang' was analyzed using two Fusarium isolates belonging to two different species, one Fusarium pseudograminearum and the other Fusarium graminearum. The two isolates detected QTL with the same chromosomal locations and comparable magnitudes, indicating that CR resistance is not species-specific. The resistant allele of one of the QTL was derived from 'CSCR6'. This QTL, designated as Qcrs.cpi-3B, was located on the long arm of chromosome 3B and explains up to 48.8% of the phenotypic variance based on interval mapping analysis. Another QTL, with resistant allele from the variety 'Lang', was located on chromosome 4B. This QTL explained up to 22.8% of the phenotypic variance. A strong interaction between Qcsr.cpi-3B and Qcsr.cpi-4B was detected, reducing the maximum effect of Qcrs.cpi-3B to 43.1%. The effects of Qcrs.cpi-3B were further validated in four additional populations and the presence of this single QTL reduced CR severity by up to 42.1%. The fact that significant effects of Qcrs.cpi-3B were detected across all trials with different genetic backgrounds and with the use of isolates belonging to two different Fusarium species make it an ideal target for breeding programs as well as for further characterization of the gene(s) involved in its resistance.

Elucidating therapeutic effects on patients with hepatocellular carcinoma and main portal vein thrombosis

BACKGROUND/AIMS

The survival duration for patients diagnosed with hepatocellular carcinoma (HCC) with main portal vein thrombosis (MPVT) was usually less than 3 months. The aim of this study is to elucidate whether treatment can prolong the survival for such patients.

METHODOLOGY

Retrospectively we analyzed the clinical features and outcomes of 63 patients with HCC and MPVT over a 7-year period. Three therapeutic modalities--transcatheter arterial chemotherapy (TAC) with or without radiotherapy (RT), and systemic chemotherapy--were applied.

RESULTS

The patients were divided into two groups: 34 (54%) patients were treated, while the remaining 29 (46%) were not. Multivariate analysis revealed that Child-Pugh class, Okuda stage for HCC and the presence of treatment were the principal factors to predict survival. The survival was significantly longer in treated patients than those untreated both in the Child-Pugh class A or B patients. Significantly longer survival is evident in patients treated by TAC combing RT compared to those underwent TAC alone, systemic chemotherapy or no treatment.

CONCLUSIONS

The survival of Child-Pugh class A or B patients can be extended by the use of an appropriate therapeutic modality. TAC combined with RT did the best benefit to prolong survival in such patients.

The p200 family protein p204 as a modulator of cell proliferation and differentiation: a brief survey

The expression of the murine p200 family protein p204 in numerous tissues can be activated by a variety of distinct, tissue-specific transcription factors. p204 modulates cell proliferation, cell cycling, and the differentiation of various tissues, including skeletal muscle myotubes, beating cardiac myocytes, osteoblasts, chondrocytes, and macrophages. This protein modulates these processes in various ways, such as by (1) blocking ribosomal RNA synthesis in the nucleolus, (2) inhibiting Ras signaling in the cytoplasm, (3) promoting the activity of particular transcription factors in the nucleus by forming complexes with them, and (4) overcoming the block of the activity of other transcription factors by inhibitor of differentiation (Id) proteins. Much remains to be learned about p204, particularly with respect to its expected involvement in the differentiation of several as yet unexplored tissues.

Combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma

AIMS

To compare the long-term efficacy and safety of combined trabeculectomy and cataract extraction versus trabeculectomy alone in primary angle-closure glaucoma (PACG).

METHODS

Hospital files were retrospectively examined for 99 Chinese PACG patients; 75 patients underwent combined surgery and 24 underwent trabeculectomy alone. Success rates were assessed with the Kaplan-Meier survival analysis. The main outcome was the complete success rate defined as either a >20% reduction in intraocular pressure (IOP) or an IOP that remained below 15 mm Hg, with no medications required.

RESULTS

Patients in the combined group and trabeculectomy group had a mean follow-up period of 25.8 (SD 10.8) months and 31.4 (8.9) months, respectively. Survival analysis showed that the complete success rate at 3 years was 56% in the combined group and 54% in the trabeculectomy group (p = 0.903). There were no significant differences between groups in either IOP or the number of glaucoma medications throughout the 3-year follow-up. The incidences of postoperative complications were similar between groups (p = 0.232). No additional IOP-lowering surgical procedures were required in the combined group, while 13 (54%) eyes in the trabeculectomy group required either cataract extraction or further IOP-lowering surgical procedures (p <0.001).

CONCLUSION

In patients with PACG, the long-term IOP-lowering effect and surgical complications of combined trabeculectomy and cataract extraction are comparable with those of trabeculectomy alone. However, the combined surgery incurred fewer subsequent surgical interventions.

Regulation of chondrocyte differentiation by ADAMTS-12 metalloproteinase depends on its enzymatic activity

ADAMTS-12, a metalloproteinase that belongs to ADAMTS family, is strongly upregulated during chondrogenesis and demonstrates prominent expression in the growth plate chondrocytes. ADAMTS-12 potently inhibits chondrocyte differentiation, as revealed by altered expression of both early and later genes critical for chondrogenesis. In addition, ADAMTS-12-mediated inhibition of chondrogenesis depends on its enzymatic activity, since its point mutant lacking enzymatic activity completely loses this activity. Furthermore, the C-terminal four thrombospondin motifs known to bind COMP substrate is necessary for its full proteolytic activity and inhibition of chondrocyte differentiation. Mechanism studies demonstrate that ADAMTS-12 induces PTHrP, whereas it inhibits IHH during chondrogenesis. Furthermore, PTHrP induces ADAMTS-12 and ADAMTS-12 is hardly detectable in PTHrP-/-growth plate chondrocytes. Importantly, knocking down ADAMTS-12 mRNA levels or blocking ADAMTS-12 activity almost abolishes the PTHrP-mediated inhibition of type X collagen expression. Collectively, these findings demonstrate that ADAMTS-12, a downstream molecule of PTHrP signaling, is a novel regulator of chondrogenesis.

A major QTL conferring crown rot resistance in barley and its association with plant height

Crown rot (CR) is one of the most destructive diseases of barley and wheat. Fusarium species causing CR survive in crop residue and a growing acceptance of stubble retention practices has exacerbated disease severity and yield loss. Growing resistant cultivars has long been recognised as the most effective way to reduce CR damage but these are not available in barley. In a routine screening of germplasm, a barley landrace from China gave the best CR resistance among the genotypes tested. Using a doubled haploid population derived from this landrace crossed to Franklin, we demonstrate that the CR resistance of TX9425 was conditioned by a major QTL. The QTL, designated as Qcrs.cpi-3H, was mapped near the centromere on the long arm of chromosome 3H. Its effect is highly significant, accounting for up to 63.3% of the phenotypic variation with a LOD value of 14.8. The location of Qcrs.cpi-3H was coincident with a major QTL conferring plant height (PH) and the effect of PH on CR reaction was also highly significant. When the effect of PH was accounted for by covariance analysis, the Qcrs.cpi-3H QTL remained highly significant, accounting for over 40% of the phenotypic variation. The existence of such a major QTL implies that breeding barley cultivars with enhanced CR resistance should be feasible.