Showing papers by "Dalhousie University published in 2000"
TL;DR: In more complex organisms more complex systems have evolved to orient the various receptors either towards or away from signal sources in the environment and to prepare the organism to select from arepertoire of behavioral actions as discussed by the authors.
1,783 citations
TL;DR: In this article, the authors compare the results with those for lithium insertion in graphitic carbon anode materials and demonstrate the presence of similar alkali metal insertion mechanisms in both cases.
Abstract: Electrochemical techniques have been used to study the reversible insertion of sodium into hard‐carbon host structures at room temperature. In this paper we compare these results with those for lithium insertion in the same materials and demonstrate the presence of similar alkali metal insertion mechanisms in both cases. Despite the gravimetric capacities being lower for sodium than lithium insertion, we have achieved a reversible sodium capacity of 300 mAh/g, close to that for lithium insertion in graphitic carbon anode materials. Such materials may therefore be useful as anodes in rechargeable sodium‐ion batteries. © 2000 The Electrochemical Society. All rights reserved.
1,297 citations
TL;DR: It is shown that there is very little evidence for rapid recovery from prolonged declines, in contrast to the perception that marine fishes are highly resilient to large population reductions.
Abstract: Overexploitation and subsequent collapse of marine fishes has focused attention on the ability of affected populations to recover to former abundance levels and on the degree to which their persistence is threatened by extinction Although potential for recovery has been assessed indirectly, actual changes in population size following long-term declines have not been examined empirically Here I show that there is very little evidence for rapid recovery from prolonged declines, in contrast to the perception that marine fishes are highly resilient to large population reductions With the possible exception of herring and related species that mature early in life and are fished with highly selective equipment, my analysis of 90 stocks reveals that many gadids (for example, cod, haddock) and other non-clupeids (for example, flatfishes) have experienced little, if any, recovery as much as 15 years after 45-99% reductions in reproductive biomass Although the effects of overfishing on single species may generally be reversible, the actual time required for recovery appears to be considerable To exempt marine fishes from existing criteria used to assign extinction risk would be inconsistent with precautionary approaches to fisheries management and the conservation of marine biodiversity
924 citations
TL;DR: A synopsis of the current understanding of how condensations are initiated and grown, how their boundaries and sizes are set, how condensation ceases, and how overt differentiation begins is presented.
Abstract: Condensation is the pivotal stage in the development of skeletal and other mesenchymal tissues. It occurs when a previously dispersed population of cells gathers together to differentiate into a single cell/tissue type such as cartilage, bone, muscle, tendon, kidney, and lung and is the earliest stage during organ formation when tissue-specific genes are upregulated. We present a synopsis of our current understanding of how condensations are initiated and grown, how their boundaries and sizes are set, how condensation ceases, and how overt differentiation begins. Extracellular matrix molecules, cell surface receptors and cell adhesion molecules, such as fibronectin, tenascin, syndecan, and N-CAM, initiate condensation formation and set condensation boundaries. Hox genes (Hoxd-11-13) and other transcription factors (CFKH-1, MFH-1, osf-2), modulate the proliferation of cells within condensations. Cell adhesion is ensured indirectly through Hox genes (Hoxa-2, Hoxd-13), and directly via cell adhesion molecules (N-CAM and N-cadherin). Subsequent growth of condensations is regulated by BMPs, which activate Pax-2, Hoxa-2 and Hoxd-11 among other genes. Growth of a condensation ceases when Noggin inhibits BMP signalling, setting the stage for transition to the next stage of skeletal development, namely overt cell differentiation. BioEssays 22:138-147, 2000.
900 citations
TL;DR: Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful.
Abstract: Background and Purpose. Development of gross motor function in children with cerebral palsy (CP) has not been documented. The purposes of this study were to examine a model of gross motor function in children with CP and to apply the model to construct gross motor function curves for each of the 5 levels of the Gross Motor Function Classification System (GMFCS). Subjects. A stratified sample of 586 children with CP, 1 to 12 years of age, who reside in Ontario, Canada, and are known to rehabilitation centers participated. Methods. Subjects were classified using the GMFCS, and gross motor function was measured with the Gross Motor Function Measure (GMFM). Four models were examined to construct curves that described the nonlinear relationship between age and gross motor function. Results. The model in which both the limit parameter (maximum GMFM score) and the rate parameter (rate at which the maximum GMFM score is approached) vary for each GMFCS level explained 83% of the variation in GMFM scores. The predicted maximum GMFM scores differed among the 5 curves (level I=96.8, level II=89.3, level III=61.3, level IV=36.1, and level V=12.9). The rate at which children at level II approached their maximum GMFM score was slower than the rates for levels I and III. The correlation between GMFCS levels and GMFM scores was −.91. Logistic regression, used to estimate the probability that children with CP are able to achieve gross motor milestones based on their GMFM total scores, suggests that distinctions between GMFCS levels are clinically meaningful. Conclusion and Discussion. Classification of children with CP based on functional abilities and limitations is predictive of gross motor function, whereas age alone is a poor predictor. Evaluation of gross motor function of children with CP by comparison with children of the same age and GMFCS level has implications for decision making and interpretation of intervention outcomes.
844 citations
TL;DR: Indonesia has no direct equivalent in Indonesia's national legal system, nor are there reservations or officially recognized tribal territories as mentioned in this paper, and it was the official line of Suharto's regime that Indonesia is a nation which has no indigenous people, or that all Indonesians are equally indigenous.
Abstract: It was the official line of Suharto’s regime that Indonesia is a nation which has no indigenous people, or that all Indonesians are equally indigenous.1 The internationally recognized category “indigenous and tribal peoples” (as defined in International Labour Organization convention 169) has no direct equivalent in Indonesia’s national legal system, nor are there reservations or officially recognized tribal territories. Under Suharto the national motto “unity in diversity” and the displays of Jakarta’s theme park, Taman Mini, presented the acceptable limits of Indonesia’s cultural difference, while development efforts were directed at improving the lot of “vulnerable population groups,” including those deemed remote or especially backwards. Expressions of the desire for development made through bottom up planning processes and supplications to visiting officials were the approved format through which rural citizens communicated with the state. National activists and international donors who argued for the rights of indigenous people were dismissed as romantics imposing their primitivist fantasies upon poor folk who want, or should want, to progress like “ordinary” Indonesians. Nevertheless, a discourse on indigenous people took hold in activist circles in the final years of Suharto’s rule, and it has increasing currency in the Indonesian countryside. With the new political possibilities opened up in the post-Suharto era, it seems an appropriate time to reflect on how Indonesia’s indigenous or tribal slot is being envisioned, who might occupy it, and with what effects.
700 citations
TL;DR: The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA, and catastrophizing mediated the relationship between gender and pain‐related outcomes.
Abstract: One hundred and sixty-eight patients with osteoarthritis (OA) of the knees participated in this study. Of the participants, 72 were men and 96 were women. All participants completed the Arthritis Impact Measurement Scales (AIMS), underwent a 10 min standardized observation session to assess their pain behavior, and completed the Catastrophizing Scale of the Coping Strategies Questionnaire (CSQ) and the Depression Scale of the Symptom Checklist 90 Revised (SCL-90R). The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA. Women had significantly higher levels of pain and physical disability, and exhibited more pain behavior during an observation session than men. Further analyses revealed that catastrophizing mediated the relationship between gender and pain-related outcomes. Once catastrophizing was entered into the analyses, the previously significant effects of gender were no longer found. Interestingly, catastrophizing still mediated the gender-pain relationship even after controlling for depression. These findings underscore the importance of both gender and catastrophizing in understanding the OA pain experience and may have important implications for pain assessment and treatment.
698 citations
TL;DR: In this article, a class of new three-step approximation schemes for general variational inequalities for general inequalities are proposed and considered. And the convergence criteria of these schemes are studied.
659 citations
TL;DR: In this article, an unconditionally stable three-dimensional (3-D) finite-difference time-method (FDTD) is presented where the time step used is no longer restricted by stability but by accuracy.
Abstract: In this paper, an unconditionally stable three-dimensional (3-D) finite-difference time-method (FDTD) is presented where the time step used is no longer restricted by stability but by accuracy. The principle of the alternating direction implicit (ADI) technique that has been used in formulating an unconditionally stable two-dimensional FDTD is applied. Unlike the conventional ADI algorithms, however, the alternation is performed in respect to mixed coordinates rather than to each respective coordinate direction, Consequently, only two alternations in solution marching are required in the 3-D formulations. Theoretical proof of the unconditional stability is shown and numerical results are presented to demonstrate the effectiveness and efficiency of the method. It is found that the number of iterations with the proposed FDTD can be at least four times less than that with the conventional FDTD at the same level of accuracy.
622 citations
TL;DR: The GMFCS can validly predict motor function for children with CP and the results are discussed in terms of their implications for clinical practice and future research.
Abstract: Children with cerebral palsy (CP) experience a change in motor function with age and development. It is important to consider this expected change in offering a prognosis, or in assessing differences in motor function after an intervention. The Gross Motor Function Classification System for CP (GMFCS) has been developed for these purposes. This study was based on a retrospective chart review of 85 children with CP followed from [les ]2 to [ges ]12 years of age. The GMFCS was applied to clinical notes by two blinded raters four times throughout the study. Interrater reliability was high (G=0.93). Test–retest reliability was high (G=0.79). The positive predictive value of the GMFCS at 1 to 2 years of age to predict walking by age 12 years was 0.74. The negative predictive value was 0.90. The GMFCS can validly predict motor function for children with CP. The results are discussed in terms of their implications for clinical practice and future research.
604 citations
TL;DR: A recent series of invasions by euryhaline organisms from the Black and Caspian Seas region signals a new phase in the transformation of the Great Lakes - one that supports the concept of an 'invasional meltdown'.
Abstract: The North American Great Lakes have been invaded and dramatically altered by more than 145 alien species. Many invasions have occurred during the past few decades because of the release of Eurasian ballast water from transoceanic ships. Current regulations require ships to exchange foreign ballast with highly saline water before entering the Great Lakes; this procedure should prevent colonization by strictly freshwater species, but species with broad salinity tolerance might survive transport in exchanged water. A recent series of invasions by euryhaline organisms from the Black and Caspian Seas region signals a new phase in the transformation of the Great Lakes - one that supports the concept of an 'invasional meltdown'.
TL;DR: In this paper, a modification of the NINDS-AIREN criteria was proposed for subcortical vascular dementia (VaD), which includes small vessel disease as the primary vascular etiology, lacunar infarct(s) and ischaemic white matter lesions as primary type of brain lesions.
Abstract: Vascular dementia (VaD) incorporate different vascular mechanisms and changes in the brain, and have different causes and clinical manifestations. Variation in defining the cognitive syndrome, in vascular etiologies, and allowable brain changes in current clinical definitions of VaD have resulted in variable estimates of prevalence, of groups of subjects, and of the types and distribution of putative causal brain lesions. Thus current criteria for VaD select an etiologically and clinically heterogeneous group. This definitional heterogeneity may have been a factor in “negative” clinical trials. An alternative for clinical drug trials is to focus on a more homogenous group, such as those with subcortical (ischemic) VaD. This designation incorporates two small vessel clinical entities “Binswanger’s disease” and “the lacunar state”. It comprises small vessel disease as the primary vascular etiology, lacunar infarct(s) and ischaemic white matter lesions as the primary type of brain lesions, and subcortical location as the primary location of lesions. The subcortical clinical syndrome is the primary clinical manifestation, a definition which still requires additional empirical data. We expect that subcortical VaD show a more predictable clinical picture, natural history, outcome, and treatment responses. We propose a modification of the NINDS-AIREN criteria as a new research criteria for subcortical VaD.
TL;DR: A discrete time delay is introduced to the model to describe the time between infection of a CD4(+) T-cell and the emission of viral particles on a cellular level and criteria are given to ensure that the infected equilibrium is asymptotically stable for all delay.
Abstract: A.S. Perelson, D.E. Kirschner and R. De Boer (Math. Biosci. 114 (1993) 81) proposed an ODE model of cell-free viral spread of human immunodeficiency virus (HIV) in a well-mixed compartment such as the bloodstream. Their model consists of four components: uninfected healthy CD4(+) T-cells, latently infected CD4(+) T-cells, actively infected CD4(+) T-cells, and free virus. This model has been important in the field of mathematical modeling of HIV infection and many other models have been proposed which take the model of Perelson, Kirschner and De Boer as their inspiration, so to speak (see a recent survey paper by A.S. Perelson and P.W. Nelson (SIAM Rev. 41 (1999) 3-44)). We first simplify their model into one consisting of only three components: the healthy CD4(+) T-cells, infected CD4(+) T-cells, and free virus and discuss the existence and stability of the infected steady state. Then, we introduce a discrete time delay to the model to describe the time between infection of a CD4(+) T-cell and the emission of viral particles on a cellular level (see A.V.M. Herz, S. Bonhoeffer, R.M. Anderson, R.M. May, M.A. Nowak [Proc. Nat. Acad. Sci. USA 93 (1996) 7247]). We study the effect of the time delay on the stability of the endemically infected equilibrium, criteria are given to ensure that the infected equilibrium is asymptotically stable for all delay. Numerical simulations are presented to illustrate the results.
TL;DR: In this paper, the authors developed and validated short measures of peer pressure, peer conformity, and popularity in a sample (n = 148) of adolescent boys and girls in grades 11 to 13.
Abstract: Existing measures of peer pressure and conformity may not be suitable for screening large numbers of adolescents efficiently, and few studies have differentiated peer pressure from theoretically related constructs, such as conformity or wanting to be popular. We developed and validated short measures of peer pressure, peer conformity, and popularity in a sample (n = 148) of adolescent boys and girls in grades 11 to 13. Results showed that all measures constructed for the study were internally consistent. Although all measures of peer pressure, conformity, and popularity were intercorrelated, peer pressure and peer conformity were stronger predictors of risk behaviors than measures assessing popularity, general conformity, or dysphoria. Despite a simplified scoring format, peer conformity vignettes were equal to if not better than the peer pressure measures in predicting risk behavior. Findings suggest that peer pressure and peer conformity are potentially greater risk factors than a need to be popular, and that both peer pressure and peer conformity can be measured with short scales suitable for large-scale testing.
TL;DR: These studies demonstrate that pseudouridylation of RNA confers an important selective advantage in a natural biological context.
Abstract: Pseudouridine (5-ribosyluracil) is a ubiquitous yet enigmatic constituent of structural RNAs (transfer, ribosomal, small nuclear, and small nucleolar). Although pseudouridine (psi) was the first modified nucleoside to be discovered in RNA, and is the most abundant, its biosynthesis and biological roles have remained poorly understood since its identification as a "fifth nucleoside" in RNA. Recently, a combination of biochemical, biophysical, and genetic approaches has helped to illuminate the structural consequences of psi in polyribonucleotides, the biochemical mechanism of U-->psi isomerization in RNA, and the role of modification enzymes (psi synthases) and box H/ACA snoRNAs, a class of eukaryotic small nucleolar RNAs, in the site-specific biosynthesis of psi. Through its unique ability to coordinate a structural water molecule via its free N1-H, psi exerts a subtle but significant "rigidifying" influence on the nearby sugar-phosphate backbone and also enhances base stacking. These effects may underlie the biological role of most (but perhaps not all) of the psi residues in RNA. Certain genetic mutants lacking specific psi residues in tRNA or rRNA exhibit difficulties in translation, display slow growth rates, and fail to compete effectively with wild-type strains in mixed culture. In particular, normal growth is severely compromised in an Escherichia coli mutant deficient in a pseudouridine synthase responsible for the formation of three closely spaced psi residues in the mRNA decoding region of the 23S rRNA. Such studies demonstrate that pseudouridylation of RNA confers an important selective advantage in a natural biological context.
01 Jan 2000
TL;DR: It is shown experimentally that, at least in the case of connectionist systems, class imbalances hinder the performance of standard classifiers and several approaches previously proposed to deal with the problem are compared.
Abstract: Although the majority of concept-learning systems previously designed usually assume that their training sets are well-balanced, this assumption is not necessarily correct. Indeed, there exists many domains for which one class is represented by a large number of examples while the other is represented by only a few. The purpose of this paper is 1) to demonstrate experimentally that, at least in the case of connectionist systems, class imbalances hinder the performance of standard classifiers and 2) to compare the performance of several approaches previously proposed to deal with the problem.
TL;DR: Significant variation in NICU practices and outcomes was observed despite Canada's universal health insurance system and is provided for planning research, allocating resources, designing health and public policy, and serving as a basis for longitudinal studies of NICU care in Canada.
Abstract: Background. Previous reports of variations in outcomes among neonatal intensive care units (NICUs) examined only specific subpopulations of interest (eg, very low birth weight [VLBW] infants Objectives. We report on current practice and outcomes variations in a population-based national study of Canadian NICUs from January 8, 1996 to October 31, 1997. Method. Information on 20 488 admissions to 17 tertiary level NICUs across Canada was prospectively collected by trained abstractors using a standard manual of operations and definitions. Data were verified and analyzed in concert with a steering committee comprising experienced researchers and neonatologists. Patient information included demographic information, antenatal history, mode of delivery, problems at delivery, status of infant and problems at birth, illness severity (Clinical Risk Index for Babies, Score for Neonatal Acute Physiology, Score for Neonatal Acute Physiology-Version II), therapeutic intensity (Neonatal Therapeutic Intensity Scoring System [NTISS]), selected NICU practices and procedures, use of technology and resources, and selected patient outcomes. Patients were tracked until death or discharge home. Results. The mean number of annual admissions to an NICU was 657, with 26% outborn infants. Fifty-three percent were Conclusion. This study provides population-based information about NICU outcomes. Significant variation in NICU practices and outcomes was observed despite Canada9s universal health insurance system. This national database provides valuable information for planning research, allocating resources, designing health and public policy, and serving as a basis for longitudinal studies of NICU care in Canada.
Journal Article•
TL;DR: The SLICC/ACR DI is a valid measure for damage in SLE and was documented in patients who went on to die, and whether initial DI scores were related to outcome.
Abstract: Objective. To compare patients with systemic lupus erythematosus ISLE) from different centers with respect to demographics and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR Dl) scores, and to assess whether the SLICC/ACR DI changed over time, and whether initial DI scores were related to outcome. Methods. Members of SLICC completed DI scores and patient demographics on patients followed in their centers. Information was provided at 2, 5-10, and > 10 years of followup. Data were entered on computer and analyzed on SPSS/PC+ and SAS using descriptive statistics and analysis of variance. Results. Information for 1297 patients within 2 years of first clinic visit was submitted from 8 centers. There were 1187 women and 110 ten with a mean age at diagnosis of SLE of 32 years. Seven hundred sixty-two were Caucasian, 423 were black, and the remainder were of other races. There were more blacks in the American centers than in Canadian or European centers. Five centers provided information for the 3 time periods. The DI increased over time. Ninety-nine patients had died. Higher SLICC/ACR DI scores were documented in patients who went on to die. Conclusion. The SLICC/ACR DI is a valid measure for damage in SLE.
TL;DR: Subcutaneous treatment with rhuIL-10 over 28 days induced a fully reversible, dose-dependent decrease in hemoglobin and thrombocyte counts but no clinically significant side effects and up to 8 μg/kg of rhu IL-10 was well tolerated.
TL;DR: It is concluded that inhibition of viral replication with lamivudine results in a significant improvement of liver function in patients with decompensated HBV cirrhosis, but the long‐term benefits remain uncertain.
TL;DR: The authors investigated the role of the supplementary eye field in the control of eye movements in macaque monkeys trained to perform an eye movement counter-manding task and found that different groups of neurons were active after errors, after successful withholding of a partially prepared movement, or in association with reinforcement.
Abstract: Intelligent behaviour requires self-control based on the consequences of actions The countermanding task is designed to study self-control; it requires subjects to withhold planned movements in response to an imperative stop signal, which they can do with varying success In humans, the medial frontal cortex has been implicated in the supervisory control of action1,2,3 In monkeys, the supplementary eye field in the dorsomedial frontal cortex is involved in producing eye movements, but its precise function has not been clarified4 To investigate the role of the supplementary eye field in the control of eye movements, we recorded neural activity in macaque monkeys trained to perform an eye movement countermanding task Distinct groups of neurons were active after errors, after successful withholding of a partially prepared movement, or in association with reinforcement These three forms of activation could not be explained by sensory or motor factors Our results lead us to put forward the hypothesis that the supplementary eye field contributes to monitoring the context and consequences of eye movements
TL;DR: The North Atlantic Oscillation (NAO) is the most important mode of variability in the northern hemisphere atmospheric circulation as mentioned in this paper, which measures the strength of the westerly winds blowing across the North Atlantic Ocean between 40°N and 60°N.
Abstract: The North Atlantic Oscillation (NAO) is the most important mode of variability in the northern hemisphere (NH) atmospheric circulation. Put simply, the NAO measures the strength of the westerly winds blowing across the North Atlantic Ocean between 40°N and 60°N. The NAO is not a regional, North Atlantic phenomenon, however, but rather is hemispheric in extent. Based on 60 years of data from 1935 to 1995, Hurrell (1996) estimates that the NAO accounts for 31% of the variance in hemispheric winter surface air temperature north of 20°N. The present article provides an overview of the NAO, its role in the atmospheric circulation, its close relationship to the Arctic Oscillation of Thompson and Wallace (1998), and its influence on the underlying North Atlantic Ocean. Some discussion is also given on the dynamics of the NAO, the possible role of ocean surface temperature, and recent evidence that the stratosphere plays an important role in modulating the NAO.
TL;DR: In this paper, a series of staged phases of graphite intercalation has been studied using Li/graphite test cells and in situ X-ray diffraction, and it has been shown that intercalated graphite exists in a seriesof staged phases.
Abstract: Nonaqueous electrochemical cells using carbon as both the negative and positive electrodes have been proposed in the literature. In such "dual graphite" cells, lithium intercalates into the negative electrode, and the anion intercalates into the positive electrode when the cells are charged, depleting the electrolyte of salt. Here, the origin of the cell potential is considered first. Then, using Li/graphite test cells, intercalation into graphite is studied using electrochemical methods and in situ X‐ray diffraction. We prove that intercalated graphite exists in a series of staged phases. Differential capacity vs. voltage measurements are used to determine the voltages of the staging transitions and the compositions of the staged phases. The cell potential during anion intercalation rises to over 5 V, and we have learned that cells with electrolytes using ethyl methyl sulfone solvent can give reliable results up to 5.5 V under these highly oxidizing conditions. By contrast, ethylene carbonate based electrolytes are strongly oxidized above about 5.2 V, preventing complete loading of graphite with . © 2000 The Electrochemical Society. All rights reserved.
TL;DR: The results support extrapolation from metabolic rates at incremented swimming speeds to zero activity as the best way to measure standard metabolic rate in cod and imply a potential trade-off in individual cod between stamina and the ability to use glycolytic-based locomotion.
Abstract: Individual Atlantic cod (Gadus morhua) were exercised using three different measures of swimming performance. (1) An endurance test (critical swimming speed, U(crit), protocol) designed to assess predominantly aerobic endurance swimming (duration hours). (2) An acceleration test (U(burst)), in which the fish were required to swim against a rapidly increasing current until exhausted (duration minutes). This test was designed to assess predominantly glycolytic-based swimming capacity. (3) A sprint test that examined the animals' ability to swim away from a sudden stimulus (duration seconds). Rates of oxygen consumption ( mdot (O2)) during the endurance test and various morphological variables of the individual fish were also measured. Both aerobic and anaerobic swimming performance of individual cod were found to be significantly repeatable over a 3 month period. mdot (O2) during the U(crit) protocol was also significantly repeatable at intermediate to high swimming speeds, but not at low speeds. Our results support extrapolation from metabolic rates at incremented swimming speeds to zero activity as the best way to measure standard metabolic rate in cod. While performance in the U(crit) test and the sprint test were positively correlated, there was a negative correlation between performance in the U(crit) test and performance in the U(burst) test. This implies a potential trade-off in individual cod between stamina and the ability to use glycolytic-based locomotion. Inter-individual variation in swimming performance during these protocols, while substantial, was not correlated with individual variation in fin surface areas, age or morphology. However, U(burst) performance was dependent upon the sex of the animals, while performance during the U(crit) protocol was significantly correlated with their aerobic scope for activity.
TL;DR: Vascular cognitive impairment without dementia was the most prevalent form of vascular cognitive impairment among those aged 65 to 84 years, and rates of institutionalization and mortality for those with cognitive impairment were significantly higher than those of people who had no cognitive impairment, and the mortality rate for patients with vascular Cognitive impairment was similar to that of patients with AD.
Abstract: Objective: To assess the importance of vascular cognitive impairment and its three subgroups (cognitive impairment, no dementia; vascular dementia; and AD with a vascular component) to the prevalence and burden of cognitive impairment in elderly people. Background: Vascular lesions may produce a spectrum of cognitive changes. Omitting elderly patients whose cognitive impairment falls short of dementia (vascular cognitive impairment, no dementia) may give a falsely low indication of the prevalence and burden of disease. To test this proposition, we compared the rates of adverse outcomes for patients with no cognitive impairment, vascular cognitive impairment (and its subgroups), and probable AD. Methods: The Canadian Study of Health and Aging is a prospective cohort study of 10,253 randomly selected community-dwelling and institution-dwelling respondents aged 65 years or older. In the community, all participants (n = 9,008) were screened for cognitive impairment; those who screened positive and a sample of those who screened negative received a clinical assessment (n = 1,659). All patients living in institutions received a clinical assessment (n = 1,255). Participants were reassessed 5 years after the original survey. Results: Vascular cognitive impairment without dementia was the most prevalent form of vascular cognitive impairment among those aged 65 to 84 years. Rates of institutionalization and mortality for those with vascular cognitive impairment were significantly higher than those of people who had no cognitive impairment, and the mortality rate for patients with vascular cognitive impairment was similar to that of patients with AD. Conclusions: Failure to consider vascular cognitive impairment without dementia underestimates the prevalence of impairment and the risk for adverse outcomes associated with vascular cognitive impairment.
TL;DR: In this article, beeswax or a 1:1 blend of stearic-palmitic acids (S-P) were incorporated into gellan films through emulsification to form Gellan/lipid composite films.
TL;DR: Pertussis in secondary case patients was less severe than in index case patients but presented with classic symptoms, and the burden of disease appears to increase with age, with smoking, and with asthma.
Abstract: The effect of age on the clinical presentation of pertussis was assessed in 664 adolescent and adult cases. Complications were more frequent in adults than in adolescents (28% vs. 16%). Pneumonia occurred in 2% of patients /=50 years old. Duration of cough, risk of sinusitis, and number of nights with disturbed sleep increased with smoking and asthma. The secondary attack rate in other household members >/=12 years was 11%. Pertussis in secondary case patients was less severe than in index case patients but presented with classic symptoms. The main source of infection in adolescents was schoolmates or friends; in adults it was workplace or their children. Teachers and health care workers had a greater risk of pertussis than did the general population. The burden of disease appears to increase with age, with smoking, and with asthma.
TL;DR: Sequential treatment of osteoporosis with PTH and alendronate results in an increase in vertebral bone density that is considerably more than has been reported with alendronsate or estrogens alone.
Abstract: Treatment of osteoporosis with PTH causes a marked increase in vertebral bone mineral density (BMD). However, this effect is rapidly reversed when the treatment is stopped. The purpose of the present study was to determine whether the bisphosphonate alendronate could preserve or enhance bone density in patients previously treated with PTH. Sixty-six postmenopausal osteoporotic women were treated for 1 yr with 50, 75, or 100 microg recombinant human PTH-(1-84) or placebo, and then were given 10 mg alendronate daily for an additional year. BMD was measured in the femoral neck, lumbar spine, and whole body. Markers of bone turnover included skeletal alkaline phosphatase, osteocalcin, and N-telopeptide. During the first year, changes in BMD (mean +/- SD) in women receiving PTH (all doses combined) were 7.1 +/- 5.6% (spine), 0.3 +/- 6.2% (femoral neck), and -2.3 +/- 3.3% (total body). After switching to alendronate for 1 yr in women who previously had received PTH, mean changes in BMD were 13.4 +/- 6.4% (spine), 4.4 +/- 7.2% (femoral neck), and 2.6 +/- 3.1% (whole body). In the subgroup of patients who had received the highest dose of PTH, the mean increase in vertebral BMD was 14.6 +/- 7.9%. All markers of bone turnover increased during treatment with PTH and decreased to below baseline after 1 yr of alendronate. In conclusion, sequential treatment of osteoporosis with PTH and alendronate results in an increase in vertebral bone density that is considerably more than has been reported with alendronate or estrogens alone. This combination of drugs may be a useful approach to maximizing bone density in women with vertebral osteoporosis.
TL;DR: In this paper, a series of integrations using the ocean component of the coupled model are performed to assess whether those fluctuations can be viewed as a coupled air-sea mode (in the sense of ENSO), or as an oceanic response to forcing from the atmosphere model, in which large-scale feedbacks from the ocean to the atmospheric circulation are not critical.
Abstract: Previous analyses of an extended integration of the Geophysical Fluid Dynamics Laboratory coupled climate model have revealed pronounced multidecadal variations of the thermohaline circulation (THC) in the North Atlantic. The purpose of the current work is to assess whether those fluctuations can be viewed as a coupled air‐sea mode (in the sense of ENSO), or as an oceanic response to forcing from the atmosphere model, in which large-scale feedbacks from the ocean to the atmospheric circulation are not critical. A series of integrations using the ocean component of the coupled model are performed to address the above question. The ocean model is forced by suitably chosen time series of surface fluxes from either the coupled model or a companion integration of an atmosphere-only model run with a prescribed seasonal cycle of SSTs and sea-ice thickness. These experiments reveal that 1) the previously identified multidecadal THC variations can be largely viewed as an oceanic response to surface flux forcing from the atmosphere model, although air‐ sea coupling through the thermodynamics appears to modify the amplitude of the variability, and 2) variations in heat flux are the dominant term (relative to the freshwater and momentum fluxes) in driving the THC variability. Experiments driving the ocean model using either high- or low-pass-filtered heat fluxes, with a cutoff period of 20 yr, show that the multidecadal THC variability is driven by the low-frequency portion of the spectrum of atmospheric flux forcing. Analyses have also revealed that the multidecadal THC fluctuations are driven by a spatial pattern of surface heat flux variations that bears a strong resemblance to the North Atlantic oscillation. No conclusive evidence is found that the THC variability is part of a dynamically coupled mode of the atmosphere and ocean models.
TL;DR: For instance, accountability is a cornerstone of public governance and management because it constitutes the principle that informs the processes whereby those who hold and exercise public authority are held to account as mentioned in this paper.
Abstract: Introduction Accountability is a cornerstone of public governance and management because it constitutes the principle that informs the processes whereby those who hold and exercise public authority are held to account. Although accountability regimes vary in important respects among political systems, taken collectively they encompass processes whereby citizens hold their governors to account for their behaviour and performance directly through elections; the representatives of citizens in legislative assemblies hold political executives and public servants accountable through mechanisms of public scrutiny and audit; political executives hold their subordinate officials accountable through hierarchical structures of authority and responsibility; and, among other things, courts and various administrative tribunals and commissions hold legislatures, executives or administrative officers accountable to the law (Cooper, 1995; Stone, 1995; Mulgan, 1997). The purposes that accountability are meant to serve are essentially threefold, although they overlap in several ways. The first is to control for the abuse and misuse of public authority. The second is to provide assurancein respect to the use of public resources and adherence to the law and public service values. The third is to encourage and promote learning in pursuit of continuous improvement in governance and public management. Because accountability is an integral dimension of governance and public management it cannot be affected by the extent to which governance and public management are subject to ever increasing complexity (Thomas, 1998). Governments everywhere are under increasing pressures to be both more productive and more effective — to achieve not only the greatest degree of economy and efficiency possible but also to secure desired outcomes in respect to economic