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OBJECTIVE: Describe the incidence of delirium and associated outcomes among hospitalized, non-critically ill older people. DESIGN: Single-center, retrospective chart review. SETTING: A 217-bed academic teaching hospital in Cambridge, Massachusetts affiliated with Harvard Medical School. PATIENTS: People 65 years of age or older, admitted to a general medicine unit between January 1 and August 31, 2021, who were prescribed one or more deliriogenic medications prior to or during admission. INTERVENTIONS: Patient electronic medical records were reviewed for deliriogenic medications prescribed and administered during admission and associated clinical outcomes. RESULTS: The percentage of patients who developed delirium was 13% overall. The most implicated deliriogenic medications were benzodiazepines, antipsychotics, and histamine-2 receptor antagonists (H2RAs). Seventy-three percent of deliriogenic home medications were continued upon admission. Subgroup analyses of those with delirium had a mean length-ofstay of 20 days compared with 6 days in those who did not develop delirium. Those with delirium tended to have more deliriogenic medications used during admission. CONCLUSION: This review describes the incidence of delirium for non-critically ill older people who were prescribed at least one deliriogenic medication. Of all the deliriogenic agents reviewed, moderate quality clinical evidence supports the association between use and development of delirium except for H2RAs, which have low-quality evidence. Pharmacist-driven efforts to deprescribe deliriogenic medications in at-risk patient populations may be better focused on agents with higher-quality evidence. [ABSTRACT FROM AUTHOR]

Objectives: Histopathologic evaluation of bile biopsies for biliary strictures is frequently challenging and is affected by interobserver disagreement. Reliable ancillary tests that can help differentiate benign from malignant are not available. This study aimed to evaluate whether DNA content abnormalities detected by flow cytometry on formalin-fixed, paraffin-embedded (FFPE) tissue can help differentiate benign/reactive, dysplastic from malignant cell populations in bile duct biopsies.Methods: We performed DNA flow cytometry on 30 FFPE bile duct biopsies in 5 well-defined diagnostic categories: (1) negative for dysplasia (NED), (2) low-grade dysplasia (LGD), (3) high-grade dysplasia (HGD), (4) carcinoma (CA), and (5) indefinite for dysplasia (IND).Results: Abnormal DNA content was detected in 0 NED, 5 LGD (62.5%), 2 HGD (33.3%), 3 CA (60%), and 4 IND (80%) samples. As a diagnostic marker, the estimated sensitivity, specificity, positive predictive value, and negative predictive value were 63%, 100%, 100%, and 50%, respectively, for diagnosing HGD or CA.Conclusions: DNA flow cytometry analysis is a useful ancillary test for the interpretation of bile duct biopsies. DNA content abnormalities, when correlated with histologic findings, will not only help confirm the morphologic impression but also identify patients who are at a higher risk of developing malignancy. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) at midlife increases dementia risk. Metabolic factors contribute more to Alzheimer's disease (AD) risk in Mexican Americans (MA) than in non‐Hispanic Whites (NHW). However, most work relating T2DM to brain structure in older adults has been performed in NHWs. We evaluated how T2DM related to regional cortical thickness in cognitively intact older MA or NHW adults. We hypothesized that T2DM would relate more to regional cortical thickness in MA. Method: We assessed 819 cognitively intact controls (344 MA, mean age=62.2; 475 NHW, mean age =68.8) in the Health and Aging Brain‐Health Disparities (HABS‐HD) cohort who had 1) a T1‐weighted structural brain MRI (3T Siemens Magnatom Skyra) 2) type 2 diabetes diagnostic assessment and 3) successful FreeSurfer (v5.3.0) cortical segmentations (34 cortical regions on the right and left). Regions that failed visual quality checks were imputed using MICE (R studio). We related mean bilateral regional cortical thickness to T2DM diagnosis, covarying for age and sex and controlling for multiple comparisons (Bonferroni correction.) For regions significantly associated with T2DM diagnosis, we evaluated the relationship of HbA1c and fasting blood insulin to cortical thickness, controlling for age and sex. Result: T2DM was significantly associated with cortical thickness in bilateral gyri: supramarginal, precuneus, superior and middle temporal, banks of the superior temporal sulcus, transverse temporal, temporal pole, lingual, pericalcarine, and left lateral occipital (Table 1). HbA1c levels, but not fasting insulin, were significantly correlated with cortical thickness in all identified regions after Bonferroni correction (p<0.0012). There was a significant effect of ethnicity in most of these regions, after controlling for education and household income (Table 2). Supramarginal gyrus, precuneus, transverse temporal gyrus, and left lateral occipital thickness showed a nominally significant interaction (p<0.05) between ethnicity and T2DM, with stronger T2DM effects in MA. Ethnicity interaction effects were diminished in all regions when HbA1c was added to the model. Conclusion: T2DM is associated with cortical thickness in temporal, parietal, and occipital regions. Those effects are stronger in MA than NHW, independent of age, sex, and economic status, but may be partly explained by differences in blood glucose level control. [ABSTRACT FROM AUTHOR]

Abstract Background Our research sought to understand how falls risk, cognitive function, and daily function are associated with health related quality of life (using the EuroQol-5D) and quality of life (using the ICECAP-O) among older adults with mobility impairments. Methods The EQ-5D and ICECAP-O were administered at 12 months post first clinic attendance at the Vancouver Falls Prevention Clinic. We report descriptive statistics for all baseline characteristics collected at first clinic visit and primary outcomes of interest. Using multivariate stepwise linear regression, we assessed the construct validity of the EQ-5D and ICECAP-O using three dependent measures that are recognized indicators of “impaired mobility” – physiological falls risk, general balance and mobility, and cognitive status among older adults. Results We report data on 215 seniors who attended the Vancouver Falls Prevention Clinic and received their first clinic assessment. Patients had a mean age of 79.3 (6.2) years. After accounting for known covariates (i.e., age and sex), the ICECAP-O domains explained a greater amount of variation in each of the three dependent measures compared with the EQ-5D domains. Conclusion Both the EQ-5D and ICECAP-O demonstrate associations with falls risk and general balance and mobility; however, only the ICECAP-O was associated with cognitive status among older adults with mobility impairments. Trial registration ClinicalTrials.gov Identifier: NCT01022866

Abstract Background Perception of neighborhood social environment can influence an individual’s susceptibility to drug dependence. However, this has never been examined with a jailed sample, where frequent transitions between local jails and disadvantaged neighborhoods are common. Understanding these associations could aid in the design of targeted programs to decrease drug dependence and recidivism among the incarcerated. Methods For this study, 596 women and men from three Kansas City jails were surveyed over the course of six months in 2010. Drug dependence was assessed with DSM-IV criteria. Independent variables included fear of one’s neighborhood, perceived level of neighborhood violence, and social capital. All data were self-reported and were analyzed using logistic regression. Results Controlling for gender and age, fear of neighborhood violence was associated with increased odds of having drug dependence (OR = 1.27, CI 1.02, 1.58) and a higher level of social capital prior to incarceration was associated with lower odds of drug dependence (OR = 0.65, CI 0.44, 0.96). Mental health problem diagnosis and past year intimate partner violence were significant mediating factors. Gender and race/ethnicity were significant moderating factors between neighborhood disadvantage and drug dependence. Conclusions Our study suggests that drug dependence programs for women and men who cycle between jails and communities require both individual- and community-level interventions. To be most effective, programs at the community-level should focus on helping specific groups navigate their communities, as well as address individual health needs associated with drug dependence.

Polyethylene glycols (PEGs) and polypropylene glycols (PPGs) are frequently used in hydraulic fracturing fluids and have been detected in water returning to the surface from hydraulically fractured oil and gas wells in multiple basins. We identified degradation pathways and kinetics for PEGs and PPGs under conditions simulating a spill of produced water to shallow groundwater. Sediment-groundwater microcosm experiments were conducted using four produced water samples from two Denver-Julesburg Basin wells at early and late production. High-resolution mass spectrometry was used to identify the formation of mono- and di-carboxylated PEGs and mono-carboxylated PPGs, which are products of PEG and PPG biodegradation, respectively. Under oxic conditions, first-order half-lives were more rapid for PEGs (＜0.4–1.1 d) compared to PPGs (2.5–14 d). PEG and PPG degradation corresponded to increased relative abundance of primary alcohol dehydrogenase genes predicted from metagenome analysis of the 16S rRNA gene. Further degradation was not observed under anoxic conditions. Our results provide insight into the differences between the degradation rates and pathways of PEGs and PPGs, which may be utilized to better characterize shallow groundwater contamination following a release of produced water. [ABSTRACT FROM AUTHOR]

The rapid expansion of unconventional oil and gas development has raised concerns about the potential contamination of aquifers; however, the groundwater fate and transport of hydraulic fracturing fluid compounds and mixtures remains a significant data gap. Degradation kinetics of five hydraulic fracturing compounds (2-propanol, ethylene glycol, propargyl alcohol, 2-butoxyethanol, and 2-ethylhexanol) in the absence and presence of the biocide glutaraldehyde were investigated under a range of redox conditions using sediment-groundwater microcosms and flow-through columns. Microcosms were used to elucidate biodegradation inhibition at varying glutaraldehyde concentrations. In the absence of glutaraldehyde, half-lives ranged from 13 d to >93 d. Accurate mass spectrometry indicated that a trimer was the dominant aqueous-phase glutaraldehyde species. Microbial inhibition was observed at glutaraldehyde trimer concentrations as low as 5 mg L-1, which demonstrated that the trimer retained some biocidal activity. For most of the compounds, biodegradation rates slowed with increasing glutaraldehyde concentrations. For many of the compounds, degradation was faster in the columns than the microcosms. Four compounds (2-propanol, ethylene glycol, propargyl alcohol, and 2-butoxyethanol) were found to be both mobile and persistent in groundwater under a range of redox conditions. The glutaraldehyde trimer and 2-ethylhexanol were more rapidly degraded, particularly under oxic conditions. [ABSTRACT FROM AUTHOR]

Social media is an omnipresent part of everyday life. It provides users with an easy way to engage and connect with others without meeting face-to-face. This form of communication provides a lot of opportunity for companies and individuals to reach a massive audience. What is the purpose of social media, and how does it tie into science? Well, you see, it all depends on who you know and how active your social media presence is. Is there a benefit for sharing research across social media? The benefits of social media stem from active participation and the generation of new attractive content from an individual. Research is about producing new information, and social media offers unique opportunities to present new content. [ABSTRACT FROM AUTHOR]

There is clear evidence that spatial attention increases neural responses to attended stimuli in extrastriate visual areas and, to a lesser degree, in earlier visual areas. Other evidence shows that neurons representing unattended locations can also be suppressed. However, the extent to which enhancement and suppression is observed, their stimulus dependence, and the stages of the visual system at which they are expressed remains poorly understood. Using fMRI we set out to characterize both the task and stimulus dependence of neural responses in the lateral geniculate nucleus (LGN), primary visual cortex (V1), and visual motion area (V5) in humans to determine where suppressive and facilitatory effects of spatial attention are expressed. Subjects viewed a lateralized drifting grating stimulus, presented at multiple stimulus contrasts, and performed one of three tasks designed to alter the spatial location of their attention. In retinotopic representations of the stimulus location, we observed increasing attention-dependent facilitation and decreasing dependence on stimulus contrast moving up the visual hierarchy from theLGNto V5. However, in the representations of unattended locations of theLGNand V1, we observed suppression, which was not significantly dependent on the attended stimulus contrast. These suppressive effects were also found in the pulvinar, which has been frequently associated with attention. We provide evidence, therefore, for a spatially selective suppressive mechanism that acts at a subcortical level. [ABSTRACT FROM AUTHOR]

Background/Aims: Data on the prevalence, treatment and control of hypertension in patients with advanced chronic kidney disease (CKD) are limited. This study aimed to examine the above factors in a cohort of predialysis patients. Methods: During a period of 4 months, we recorded information on blood pressure (BP), comorbidities, medications and related parameters of patients followed up in the Low-Clearance Clinic of our Department. Control rates of hypertension were calculated at two thresholds: <130/80 and <140/90 mm Hg. Univariate and multiple linear regression analyses were employed to assess factors associated with BP control. Results: In the population studied [n = 238, males 58.4%, age 66.21 ± 4.2 years (mean ± SD), estimated glomerular filtration rate 14.5 ± 4.8 ml/min/1.73 m2], the prevalence of hypertension was 95.0%. Treatment rate among hypertensives was at 99.1%. On average, 3.04 ± 1.32 antihypertensive drugs were used, ranging from 1 to 7 agents. BP control rates at the <130/80 and <140/90 mm Hg thresholds were 26.5% and 48.2%, respectively. The systolic goal was achieved in 31.0% and 50.4%, whereas the diastolic goal was achieved in 67.7% and 91.2% of patients, respectively. In multivariate analysis, only black race was independently and inversely related with hypertension control (β = -0.187, p = 0.030). No specific antihypertensive class showed independent associations with control. Conclusions: Hypertension is highly prevalent in predialysis CKD patients. An almost universal treatment, employing a multi-agent regime, can help towards improved rates of control. Systolic BP is the main barrier to successful control and black race is associated with poorer control rates. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article focuses on the paper that evaluates lake morphometry and their spatial distribution on the coastal margin of the south-western Greenland north of Kangerlussuaq. It states that their shapes are influenced by the fundamental geological structure and processes of glacial sediment deposition or erosion. The distribution of lakes can show the intensity of glacial erosional or depositional processes and their spatial extent. It cites that it used Landsat imagery to obtain lake outlines and geographic information system (GIS) tools for spatial analysis. It explains that the widespread distribution of modeled kettle lake features across the area of study suggests that the last deglaciation process was followed by melting of blocks stagnant ice.

The article review was completed as an assignment for a Gallaudet University Counseling graduate course, "Psychosocial Aspects of Deafness," reviewing MJ Bienvenu's (1991) article entitled "Can Deaf People Survive 'deafness?'" In the review, main points in Bienvenu's article are discussed and the author's reasons for reviewing this particular article are elaborated. Comparisons are made between issues within the Deaf community in 1991 and issues found today for the purpose of advocating Bienvenu's point; additionally, another article is presented to assist in Bienvenu's position. The author discusses the relevance of Bienvenu's article to her developing profession as a counselor for Deaf children. [ABSTRACT FROM AUTHOR]

Determines the nuclear magnetic resonance (NMR) solution structure of the smallest known alpha-conotoxin, ImI, a 12-amino acid peptide that binds specifically to neuronal alpha7-containing nicotinic acetylcholine receptors in mammals. Characterization of the structure of the ImI by two compact loops, defined by two disulfide bridges.

Examines the adsorption of different DNA sequences to mercaptoethanol-capped cadmium sulfide quantum dots, as a minimalist model for nonspecific protein-DNA interactions. Binding for `straight' and A-tract oligonucleotide and crystallographically `kinked' sequence; Monitoring of kinetics of binding; Comparison with nonspecific protein-DNA interactions.

Describes a novel method for probing DNA structure in dilute solution, the adsorption of oligonucleotides of defined sequence to protein-sized particles. Discrimination between `straight', `bent', and `kinked' oligonucleotides in dilute solution.

Abstract: Objective: To estimate the absorbed organ dose and effective dose for a wide range of cone beam computed tomography scanners, using different exposure protocols and geometries. Materials and methods: Two Alderson Radiation Therapy anthropomorphic phantoms were loaded with LiF detectors (TLD-100 and TLD-100H) which were evenly distributed throughout the head and neck, covering all radiosensitive organs. Measurements were performed on 14 CBCT devices: 3D Accuitomo 170, Galileos Comfort, i-CAT Next Generation, Iluma Elite, Kodak 9000 3D, Kodak 9500, NewTom VG, NewTom VGi, Pax-Uni3D, Picasso Trio, ProMax 3D, Scanora 3D, SkyView, Veraviewepocs 3D. Effective dose was calculated using the ICRP 103 (2007) tissue weighting factors. Results: Effective dose ranged between 19 and 368μSv. The largest contributions to the effective dose were from the remainder tissues (37%), salivary glands (24%), and thyroid gland (21%). For all organs, there was a wide range of measured values apparent, due to differences in exposure factors, diameter and height of the primary beam, and positioning of the beam relative to the radiosensitive organs. Conclusions: The effective dose for different CBCT devices showed a 20-fold range. The results show that a distinction is needed between small-, medium-, and large-field CBCT scanners and protocols, as they are applied to different indication groups, the dose received being strongly related to field size. Furthermore, the dose should always be considered relative to technical and diagnostic image quality, seeing that image quality requirements also differ for patient groups. The results from the current study indicate that the optimisation of dose should be performed by an appropriate selection of exposure parameters and field size, depending on the diagnostic requirements. [Copyright &y& Elsevier]