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Background: Eye movements reveal neurodegenerative disease processes due to overlap between oculomotor circuitry and disease-affected areas. Characterizing oculomotor behaviour in context of cognitive function may enhance disease diagnosis and monitoring. We therefore aimed to quantify cognitive impairment in neurodegenerative disease using saccade behaviour and neuropsychology. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with neurodegenerative disease: one of Alzheimer’s disease, mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia, Parkinson’s disease, or cerebrovascular disease. Patients (n=450, age 40-87) and healthy controls (n=149, age 42-87) completed a randomly interleaved pro- and anti-saccade task (IPAST) while their eyes were tracked. We explored the relationships of saccade parameters (e.g. task errors, reaction times) to one another and to cognitive domain-specific neuropsychological test scores (e.g. executive function, memory). Results: Task performance worsened with cognitive impairment across multiple diseases. Subsets of saccade parameters were interrelated and also differentially related to neuropsychology-based cognitive domain scores (e.g. antisaccade errors and reaction time associated with executive function). Conclusions: IPAST detects global cognitive impairment across neurodegenerative diseases. Subsets of parameters associate with one another, suggesting disparate underlying circuitry, and with different cognitive domains. This may have implications for use of IPAST as a cognitive screening tool in neurodegenerative disease.
Vascular cognitive impairment (VCI) post-stroke is frequent but may go undetected, which highlights the need to better screen cognitive functioning following a stroke.
Aim:
We examined the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairment against a gold-standard neuropsychological battery.
Methods:
We assessed cognitive status with a comprehensive battery of neuropsychological tests in 161 individuals who were at least 3-months post-stroke. We used receiver operating characteristic (ROC) curves to identify two cut points for the MoCA to maximize sensitivity and specificity at a minimum 90% threshold. We examined the utility of the Symbol Digit Modalities Test, a processing speed measure, to determine whether this additional metric would improve classification relative to the MoCA total score alone.
Results:
Using two cut points, 27% of participants scored ≤ 23 and were classified as high probability of cognitive impairment (sensitivity 92%), and 24% of participants scored ≥ 28 and were classified as low probability of cognitive impairment (specificity 91%). The remaining 48% of participants scored from 24 to 27 and were classified as indeterminate probability of cognitive impairment. The addition of a processing speed measure improved classification for the indeterminate group by correctly identifying 65% of these individuals, for an overall classification accuracy of 79%.
Conclusions:
The utility of the MoCA in detecting cognitive impairment post-stroke is improved when using a three-category approach. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome while minimally extending the screening routine for VCI.
Primitive reflexes and parkinsonian signs are used by clinicians to differentiate among dementias. We reviewed our clinical sample to determine whether primitive reflexes were more prevalent in frontally-based dementias and whether parkinsonian signs were more common in dementia with Lewy bodies (DLB) than in other types of dementia.
Design:
We retrospectively reviewed charts from 204 patients with dementia who presented for consultation at Baycrest's Ross Memory Clinic between April, 2003, to December, 2007.
Results:
A greater proportion of subjects with DLB and dementia of the Alzheimer type with cardiovascular disease had primitive reflexes than subjects with frontotemporal dementia (FTD). Primitive reflexes were not positively predictive of FTD or vascular dementia (VaD). Dementia with Lewy bodies subjects were more likely to have parkinsonian signs than the other dementias, and bradykinesia and rigidity were positively predictive of FTD. The palmomental reflex was the most common primitive reflex in the sample, and cogwheeling was the most common parkinsonian sign. There was no significant difference between early- and late-stage groups in presence of primitive reflexes or parkinsonian signs.
Conclusions:
Primitive reflexes appear not to be clinically discriminative of frontally-based dementias such as FTD and VaD.
To explore factors associated with self-reported food poisoning among Western Australian adults between 1998 and 2009.
Design
Data were pooled from four Nutrition Monitoring Surveys Series which included information on suspected food poisoning among Western Australian adults. Descriptive statistics and multinomial regression analyses were used to describe factors associated with self-reported food poisoning, food safety knowledge and behaviours.
Setting
Population of Western Australia estimated to be 2·5 million in 2009.
Subjects
A representative sample of 4494 adults aged between 18 and 64 years.
Results
There was no significant change in self-reported food poisoning over time, with about 18 % saying they had suspected food poisoning in the last 6 months. Overall, 2·1 % said they had confirmed their food-borne illness with a nurse of doctor. People less than 34 years old, those with a university degree and people who ate meals out on the day prior to the survey (one meal: OR = 1·30, 95 % CI 1·04, 1·62; two meals: OR = 2·21, 95 % CI 1·30, 3·76) were the most likely to report food poisoning. Younger people were also more likely to have their food poisoning confirmed by a health professional. Use of refrigerator thermometers and cool bags for storing food increased significantly between 2004 and 2009.
Conclusions
Findings support the inclusion of food safety advice in dietary recommendations. Food safety and handling education and training is recommended for food businesses, particularly the takeaway food sector, and for consumers. Because food poisoning is reported more often by younger people, food safety education should begin during childhood.
Fifteen life tables were compiled from population and mortality data collected in the Quinte area of eastern Ontario during the 5-year period, 1972–76, that spanned the rise and fall of an outbreak of the alfalfa weevil, Hypera postica (Gyll.).
Components analysis of the data showed that a disease of the feeding larvae caused by Entomophthora phytonomi Arthur, a fungus new to the insect in North America, was the principal determinant of intrageneration survival. Multivariate analysis of the separate mortalities, expressed as k-values, confirmed that this agent was the key factor governing population trends of the weevil and was mainly responsible for its population decline.
Examination of the properties of the various mortality factors showed that E. phytonomi was density dependent but overcompensating. Other agents, including the parasitoids Bathyplectes curculionis (Thom.) and Tetrastichus incertus (Ratz.) acted in a density independent manner and contributed little to population trend.
During 1977, a detailed study was undertaken to develop efficient sampling procedures for estimating egg and larval populations of the alfalfa blotch leafminer, Agromyza frontella (Rond.), in Vernal alfalfa. Distributions of the stages within and between stems were contagious and stem totals tended to follow negative binomial distributions. Within stems, the density of eggs and larval mines increased exponentially from base to tip. Taking these patterns and the costs of sampling into account, and using the relevant components of variance, four leaves taken systematically from a single stem is proposed as the appropriate sample unit for both eggs and mines. On this basis, 200 stems per field will give adequate precision (less than 10% of the mean with confidence probability 90%) for population estimates. However, the propensity of the leafminer to prefer the middle leaflet to the basal leaflets in the approximate ratio 3:4:3 suggests that sampling costs may be further reduced by restricting counts to the middle leaflet and raising them by a factor of 2.5.
The primary purpose of the present review was to determine if the scientific evidence available for potential human health benefits of conjugated linoleic acid (CLA) is sufficient to support health claims on foods based on milk naturally enriched with cis-9, trans-11-CLA (c9, t11-CLA). A search of the scientific literature was conducted and showed that almost all the promising research results that have emerged in relation to cancer, heart health, obesity, diabetes and bone health have been in animal models or in vitro. Most human intervention studies have utilised synthetic CLA supplements, usually a 50:50 blend of c9, t11-CLA and trans-10, cis-12-CLA (t10, c12-CLA). Of these studies, the only evidence that is broadly consistent is an effect on body fat and weight reduction. A previous review of the relevant studies found that 3.2 g CLA/d resulted in a modest body fat loss in human subjects of about 0.09 kg/week, but this effect was attributed to the t10, c12-CLA isomer. There is no evidence of a consistent benefit of c9, t11-CLA on any health conditions; and in fact both synthetic isomers, particularly t10, c12-CLA, have been suspected of having pro-diabetic effects in individuals who are already at risk of developing diabetes. Four published intervention studies using naturally enriched CLA products were identified; however, the results were inconclusive. This may be partly due to the differences in the concentration of CLA administered in animal and human studies. In conclusion, further substantiation of the scientific evidence relating to CLA and human health benefits are required before health claims can be confirmed.
Short-term randomised, controlled trials have found that dietary protein relative to carbohydrate can reduce blood pressure. Our objective was to investigate the effects on blood pressure of an increase in protein intake from whey over 2 years in women aged over 70 years. From the general population, 219 women aged between 70 and 80 years were recruited to a 2-year randomised, double-blind, placebo-controlled parallel-design trial: 181 women completed the trial to the end of year 2. Participants were randomly assigned to consume a daily whey protein-based beverage (protein) or an energy-matched low-protein high-carbohydrate beverage (control). Blood pressure measurements were performed at baseline, year 1 and year 2. For protein relative to control, the estimated mean net differences in protein and carbohydrate intakes were 18 (95 % CI 13, 23) and − 22 (95 % CI − 9, − 35) g/d at year 1, and 22 (95 % CI 17, 28) and − 18 (95 % CI − 6, − 31) g/d at year 2. Intention-to-treat analysis found no overall differences between groups in blood pressure (P>0·5). Net differences in systolic and diastolic blood pressure were − 2·3 (95 % CI − 5·3, 0·7) and − 1·5 (95 % CI − 3·6, 0·6) mmHg at year 1, and 1·6 (95 % CI − 1·5, 4·7) and 0·3 (95 % CI − 1·9, 2·4) mmHg at year 2. Similar differences in systolic and diastolic blood pressure at years 1 and 2 were observed with per-protocol analysis. Therefore, the present study did not provide evidence that a higher whey protein intake in older women can have prolonged effects on blood pressure.
To assess consumer understanding of fruit and vegetable serving sizes.
Design
The Western Australian Health Department launched the Go for 2&5® campaign to promote fruit and vegetables in March 2002. The Health & Wellbeing Surveillance System surveyed 1108 adults, aged 16 years and over, between September and November 2002 about what constituted a serving of fruit and of vegetables, their usual daily fruit and vegetables intake, and their recall of the campaign.
Setting
The study was undertaken as a part of a public health intervention – social marketing campaign in Western Australia, which had a population of 1 927 000 in 2002.
Results
Forty-two per cent of respondents knew that the fruit serving size was one piece and only 14·5 % reported the ½ cup vegetable serving size. The mean fruit intake was 1·8 (95 % CI 1·7, 1·8) servings/d and the mean vegetable intake was 2·8 (95 % CI 2·7, 3·0) servings/d. Vegetable intake was associated with being female (P = 0·006), increasing age (P < 0·0001), awareness of the campaign (P = 0·031) and knowledge of standard serving size (P = 0·006). Fruit consumption was associated with being female (P = 0·007). Fruit and vegetable intakes were not associated with educational attainment or household income.
Conclusions
The Go for 2&5® campaign uses a prescriptive message to promote increased consumption of fruit and vegetables. Respondent’s knowledge of the standard of serving sizes for fruit and vegetables suggests there is value in separating fruit and vegetable recommendations in messages to encourage increased consumption.
Working rules for determining plot size and number of plots within a block in field experiments are proposed based on the value of the intrablock correlation (ρ), which can be obtained from the analysis of variance of a randomized-block experiment. The method uses Binns' (1982) equation to relate this correlation to Smith's (1938) empirical law. The rules are: (1) if ρ is greater than 0·5, use an incomplete block design or reduce the plot size in order to increase the number of replications; (2) if ρ is less than 0·1, an increase in plot size is effective; (3) if ρ is between 0·1 and 0·5, an increase in plot size and a decrease in the number of plots per block may be helpful in combination.
The Western Australian Health Department’s Go for 2&5® campaign aimed to increase adults’ awareness of the need to eat more fruit and vegetables and encourage increased consumption of one serving over five years.
Design
The multi-strategy fruit and vegetable social marketing campaign, conducted from 2002 to 2005, included mass media advertising (television, radio, press and point-of-sale), public relations events, publications, a website (www.gofor2and5.com), and school and community activities. Campaign development and the evaluation framework were designed using health promotion theory, and assessed values, beliefs, knowledge and behaviour. Two independent telephone surveys evaluated the campaign: the Campaign Tracking Survey interviewed 5032 adults monitoring fruit and vegetable attitudes, beliefs and consumption prior to, during and 12 months after the campaign; and the Health & Wellbeing Surveillance System surveyed 17 993 adults between 2001 and 2006, continuously monitoring consumption.
Setting
Population public health intervention–social marketing campaign in Western Australia, population of 2 010 113 in 2005.
Subjects
Adults in the Perth metropolitan area.
Results
The campaign reached the target audience, increasing awareness of the recommended servings of fruit and vegetables. There was a population net increase of 0.8 in the mean number of servings of fruit and vegetables per day over three years (0.2 for fruit (1.6 in 2002 to 1.8 in 2005) and 0.6 for vegetables (2.6 in 2002 to 3.2 in 2005), significant at P < 0.05).
Conclusion
Sustained, well-executed social marketing is effective in improving nutrition knowledge, attitudes and consumption behaviour. The Go for 2&5® campaign provides guidance to future nutrition promotion through social marketing.
To identify the prevalence of breast-feeding at discharge and the determinants of breast-feeding initiation amongst Aboriginal women.
Design:
A prospective cohort study using a self-administered baseline questionnaire and telephone-administered follow-up interviews.
Setting:
Six hospitals with maternity wards in Perth, Western Australia.
Subjects:
Four hundred and twenty-five Aboriginal mothers of newborn infants.
Results:
At discharge, 89.4% of Aboriginal mothers were breast-feeding. Breast-feeding at discharge was most positively associated with perceived paternal support of breast-feeding, with an adjusted odds ratio (OR) of 6.65 (95% confidence interval (CI) 2.81–15.74), and with maternal age (OR 1.12, 95% CI 1.03–1.22), but negatively associated with parity and having delivered vaginally.
Conclusion:
The factors independently associated with breast-feeding at discharge were similar to those previously identified for a group of non-Aboriginal Perth women, suggesting that separate breast-feeding interventions specially targeted at Aboriginal women are not warranted. The findings do, however, highlight the importance of including the father in the breast-feeding discussions.
During the past eight years a comprehensive genetic linkage map for the horse has been generated in Newmarket, through a fruitful collaboration between the Genetics section at the AHT and Professor Twink Allen at the TBA Equine Fertility Unit (Swinburne et al., 2000). In order to assess whether the map was adequate to start mapping disease traits in which we are interested, it was decided to attempt to map a clear, easily scoreable trait such as grey coat colour in the Thoroughbred horse. Grey coat colour is inherited as an autosomal dominant trait. Thoroughbred horses are fairly inbred, and as such they represent one of the more difficult horse breeds for genetic mapping. The majority of grey Thoroughbreds trace their ancestry back to Allcock's Arabian who was born in 1700, and horsemen have long noted an association between grey coat colour and the incidence of melanomas. It is hoped that characterizing the mechanism of grey coat colour formation might also lead to an improved understanding of the molecular basis of melanoma formation.
A collection (164) of isolates of Bordetella bronchiseptica
made predominantly from cats (132)
but also from dogs (15), pigs (12) and other species was examined by pulsed
field gel
electrophoresis following macrorestriction digestion with XbaI.
Each
isolate was analysed twice
and the patterns were entirely reproducible. The isolates fell into 17
different strains (>3 bands different) and within strains there were
numerous subtypes. Feline isolates fell into 12 of
the 17 strains. In general, cats housed together had similar or identical
strains and subtypes of
B. bronchiseptica. There was no difference in the PFGE patterns
of isolates made from carrier
cats and those from cats with respiratory disease. Isolates from pigs and
dogs were in general
similar to the feline isolates and there was no great evidence for
species specificity. The PFGE
pattern of feline and canine isolates were more related to whether the
animals were housed
together rather than whether they came from dogs or cats.
During a survey of foal diarrhoea between 1991 and 1994,
Clostridium perfringens was
significantly associated with disease with 56% of cases infected [1].
The contribution of
enterotoxigenic C. perfringens to this association, was assessed
by
use of the reverse passive
latex agglutination test for enterotoxin (RPLA; Oxoid Unipath) and vero
cell toxicity
neutralized by antitoxin on stored faecal samples and sporulated faecal
isolates of C.
perfringens. Polymerase chain reaction (PCR1) based on the DNA sequence
for the whole
enterotoxin gene [2] yielded a fragment from an equine
isolate of the anticipated size which,
cloned into plasmid M13 phage, had a sequence essentially identical to
the published sequence.
Consequently, all faecal isolates were also tested by PCR1 and for a part
of the enterotoxin
gene (PCR2).
Significant association with diarrhoea (controls not in contact with
cases) was found with
positive RPLA tests on faeces (OR=13, P=0·002) and isolates
(OR=4·57, P=<0·0001),
vero cell toxicity of isolates (OR=1·78, P=0·026),
and PCR1 (OR=nd, P=0·029) but not
PCR2 or vero cell toxicity of faeces. Significant association with diarrhoea
was also found for
isolates negative by RPLA (OR=3·91; CI 2·05–7·57;
P<0·0001) or PCR1 (OR=4·81; CI
2·84–8·20; P<0·0001). Many of
the isolates from RPLA positive faeces and verotoxic isolates
were PCR negative and no evidence could be found for the presence of the
enterotoxin gene in
a random selection of RPLA positive/PCR negative isolates by gene probe
on chromosomal
DNA and PCR reaction product or vero cell toxicity neutralized by specific
antiserum. Failure
of the vero cell toxicity on faeces to be associated with diarrhoea or
for cytotoxicity of cultures
and RPLA on cultures to agree with the PCRs was believed to be related
to the presence of
other cytotoxins, the inherent cytotoxicity of equine faeces and to the
poor specificity of the commercial antiserum used in the test.
Enterotoxigenic C. perfringens could not account for the
overall association of C. perfringens
with foal diarrhoea because (a) cultures positive by PCR, RPLA or cytotoxicity
were not
significantly more common amongst isolates from cases than controls; and
(b) the proportion
of isolates from cases positive by PCR (PCR1 or PCR2) was too small at
9·7%.
The 16S-23S RNA gene intergenic spacers of isolates of Streptococcus
equi (n=5), S.
zooepidemicus (n=5), S. equisimilis (n=3)
and
S. dysgalactiae (n=2) were sequenced and
compared. There were distinct regions within the spacer, arranged in the
order
1–9 for all S.
equi and one S. zooepidemicus isolate and 1,2 and 4–9
for
the remaining isolates. Region 4 was identical to the tRNAala
gene found in the 16S-23S intergenic spacers of other streptococci.
Regions 1, 5, 6 and 7 had distinct variations, each conserved in different
isolates. However,
amongst the intergenic spacers there were different combinations of variant
regions,
suggesting
a role for DNA recombination in their evolution. The intergenic spacer
of all
isolates of S.
equi and one S. zooepidemicus isolate were almost identical.
Primers derived from the variant
sequences of regions 1 and 5 to 6 were used to group all S. zooepidemicus
(n=17) and S. equi
(n=5) into 1 of 8 types by polymerase chain reaction; three S.
zooepidemicus isolates typed
the same as S. equi. S. equi and S. zooepidemicus
were
clearly distinguishable from
S. equisimilis and S. dysgalactiae which had shorter
regions
5 and 6 and no region 7. Most
homology for the group C sequences was found in previously published sequences
for the
16S-23S intergenic spacers of S. anginosis, S. constellatus,
S. intermedius, S. salivarius and
S. agalactiae. A 75-90 nucleotide length shared with S. anginosus
and S. intermedius in opposite
orientations in the two main variants of region 6 supported the role for
DNA
recombination
in the evolution of the spacer. The 16S-23S intergenic spacers indicate
that
S. zooepidemicus
was the archetypal species for S. equi and that both are genetically
more distant from
S. equisimilis and S. dysgalactiae. The intergenic spacer
can be used to identify specifically
the group C. streptococci and as an epidemiological marker for
S.
zooepidemicus.
The Coppergate helmet, found in central York in 1982 and of Anglo-Saxon date, bears a Latin inscription. A new reading of the inscription is offered, and a different view consequently taken of its significance.
The third High Energy Astronomical Observatory, HEAO-3 was launched on the 20th Sept., 1979 into a 496 km, 43.6° orbit, and has since been successfully returning data from all three experiments on board. One of these experiments, that intended to study the heavy and ultra heavy nuclei in the cosmic radiation, is described here.