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AD is a public health epidemic, which seriously impacts cognition, mood and daily activities; however, one type of activity, exercise, has been shown to alter these states. Accordingly, we sought to investigate the relationship between exercise and mood, in early-stage AD patients (N=104) from California, over a 1-year period. Patients completed the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Blessed-Roth Dementia Rating Scale (BRDRS), while their caregivers completed the Yale Physical Activity Survey (YALE), Profile of Mood States (POMS), the Neuropsychiatric Inventory (NPI) and Functional Abilities Questionnaire (FAQ). Approximately half of the participants were female, from a variety of ethnic groups (Caucasian=69.8%; Latino/Hispanic Americans=20.1%). Our results demonstrated that the patients spent little time engaged in physical activity in general, their overall activity levels decreased over time, and this was paired with a change in global cognition (e.g., MMSE total score) and affect/mood (e.g., POMS score). Patients were parsed into Active and Sedentary groups based on their Yale profiles, with Active participants engaged in walking activities, weekly, over 1 year. Here, Sedentary patients had a significant decline in MMSE scores, while the Active patients had an attenuation in global cognitive decline. Importantly, among the Active AD patients, those individuals who engaged in walking for more than 2 h/week had a significant improvement in MMSE scores. Structured clinical trials which seek to increase the amount of time AD patients were engaged in walking activities and evaluate the nature and scope of beneficial effects in the brain are warranted.

Vertebral fracture assessment (VFA) is a new method for imaging thoracolumbar spine on bone densitometer. Among patients referred for bone densitometry, the selection of patients for VFA testing can be optimized using an index derived from clinical risk factors and bone density measurement.VFA, a method for imaging thoracolumbar spine on bone densitometer, was developed because vertebral fractures, although common and predictive of future fractures, are often not clinically diagnosed. The study objective was to develop a strategy for selecting patients for VFA.A convenience sample from a university hospital bone densitometry center included 892 subjects (795 women) referred for bone mineral density (BMD) testing. We used questionnaires to capture clinical risk factors and dual-energy X-ray absorptiometry to obtain BMD and VFA.Prevalence of vertebral fractures was 18% in women and 31% in men (p = 0.003 for gender difference). In women, age, height loss, glucocorticoid use, history of vertebral and other fractures, and BMD T-score were significantly and independently associated with vertebral fractures. A multivariate model which included above predictors had an area under the receiver operating curve of 0.85 with 95% confidence interval (CI) of 0.81 to 0.89. A risk factor index was derived from the above multivariate model. Using a level of 2 as a cut-off yielded 93% sensitivity (95% CI 87, 96) and 48% specificity (95% CI 69, 83). Assuming a 15% prevalence of vertebral fractures, this cut-off value had a 24% positive and 97% negative predictive value and required VFA scanning of three women at a cost of $60 (assuming a $20 cost/VFA scan) to detect one with vertebral fracture(s).Selecting patients for VFA can be optimized using an index derived from BMD measurement and easily obtained clinical risk factors.

Individual-based simulations are an important class of applications where a complex system is modeled as a collection of autonomous entities, each having its own identify and behavior in the underlying simulated space. The main drawback of such simulations is that they are extremely compute-intensive. We consider the class of individual-based simulations where the simulated entities interact with one another indirectly through the underlying simulated space, significant performance improvement is attainable through parallelism on a network of machines. We present a data distribution and an approach to reduce the communication overhead, which leads to significant performance improvements while preserving the accuracy of the simulation. © 2009 Springer.

ObjectiveThe prevalence of adverse respiratory outcomes among children has been frequently associated with measurements of traffic-related exposures, and other data suggest asthma severity is worsened with residence near heavy traffic. We examined the association between neighbourhood traffic burden and repeated acute respiratory illnesses that required emergency department visits and/or hospitalisation for children with a primary or secondary diagnosis of asthma (89% acute bronchitis or pneumonia).MethodsThis is a hospital-based longitudinal study of a southern California urban catchment area around two adjacent children's hospitals. Subjects' home addresses were geocoded and linked to nearby traffic data. Recurrent event proportional hazard analysis was used to estimate the hazard of repeated hospital encounters.ResultsWe found living within 300 metres of arterial roads or freeways increased risk of repeated hospital encounters in 3297 children age 18 years or less. At highest risk were children in the top quintile of traffic density (HR = 1.21; 95% CL 0.99 to 1.49) and those who had 750 metres or more of arterial road and freeway length within 300 metres of their residence (HR = 1.18; 95% CL 0.99 to 1.41). Associations between repeated hospital encounters and residence near heavy traffic were stronger in females than males and in children without insurance or who required government sponsored insurance than children with private insurance. The gender disparity was most notable among infants (age 0) and children ages 6-18 years.ConclusionsResults suggest exposure to traffic-related air pollution increases asthma severity as indicated by hospital utilisation. The finding in infants suggests this is an especially vulnerable population, although the validity of asthma diagnosis at this age is unknown. Females and children who do not have private insurance may also be more vulnerable to air pollution from traffic.

New approaches are required to successfully justify and implement advanced manufacturing technology (AMT). This paper offers such a new approach by proposing an operational framework for measuring the impact of AMT on productivity gains at the firm level. The approach is a complement to the conventional input/output analysis and is based on the realization that any attempt to capture the benefits of AMT should emphasize the 'outcome' or effectiveness of the operation rather than only to accentuate its 'output' or efficiency. The framework presented is sufficiently general that it can be used in assessing any form of new technology and its introduction into the firm. [ABSTRACT FROM AUTHOR]

Introduction: Early endoscopy is recommended for investigating dyspeptic patients when sinister symptoms (i.e. weight loss, dysphagia, persistent vomiting, family history of gastric cancer or history of gastric surgery) are present. [...]

Dept of Medicine & Therapeutics, Western Infirmary, Glasgow, Scotland, UK Introduction: We have previously reported that there is significant rebound basal and GRP-stimulated acid hypersecretion after ranitidine treatment. GRP stimulates [...]

Western Infirmary, Scotland, UK Introduction: There is interest in using non-invasive H. pylori (H.P.) testing in place of endoscopy for investigating dyspepsia. Aim: To compare by prospective randomised trial HP [...]

Dept of Medicine & Therapeutics, Western Infirmary, Glasgow, Scotland, UK Introduction: We have previously reported that there is significant rebound maximal acid hypersecretion in H. pylon negative healthy subjects at [...]