a total of 112 patients with dementia , diagnosed according to dsm - iv criteria , from six centres providing care for persons with dementia in spain participated in the study . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 19 centres 0 ###LEFT-WALL### 32 . 1 a 2 total 2 total 3 of 2 total 19 centres 3 of 5 patients 4 112 5 patients 5 patients 6 with 5 patients 17 from 6 with 7 dementia 7 dementia 9 diagnosed 8 , 9 diagnosed 9 diagnosed 11 to 9 diagnosed 16 , 10 according 11 to 11 to 12 dsm 12 dsm 15 criteria 13 - 15 criteria 14 iv 15 criteria 15 criteria 16 , 17 from 18 six 19 centres 20 providing 19 centres 29 in 20 providing 21 care 20 providing 28 participated 21 care 22 for 21 care 28 participated 22 for 23 persons 23 persons 24 with 24 with 25 dementia 25 dementia 26 in 26 in 27 spain 29 in 31 study 30 the 31 study results : the spanish version of the dqol showed acceptable psychometric properties . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 version 2 : 9 showed 2 : 13 . 3 the 5 version 4 spanish 5 version 5 version 6 of 5 version 9 showed 6 of 8 dqol 7 the 8 dqol 9 showed 12 properties 10 acceptable 12 properties 11 psychometric 12 properties internal consistency ( cronbach 's alpha ) was acceptable for most of the dqol scales . 0 ###LEFT-WALL### 2 consistency 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 16 . 1 internal 2 consistency 2 consistency 6 alpha 2 consistency 8 was 3 ( 6 alpha 4 cronbach 5 's 5 's 6 alpha 6 alpha 7 ) 8 was 9 acceptable 9 acceptable 10 for 10 for 15 scales 11 most 12 of 11 most 15 scales 12 of 15 scales 13 the 15 scales 14 dqol 15 scales as expected , associations were found between dqol scales and the whoqol - bref psychological domain and the gds - 15 , indicating good validity . 0 ###LEFT-WALL### 4 associations 0 ###LEFT-WALL### 6 found 1 as 2 expected 1 as 3 , 1 as 4 associations 2 expected 3 , 4 associations 5 were 5 were 6 found 6 found 7 between 6 found 23 indicating 7 between 17 and 8 dqol 9 scales 9 scales 10 and 10 and 16 domain 10 and 17 and 11 the 16 domain 12 whoqol 14 bref 13 - 14 bref 14 bref 16 domain 15 psychological 16 domain 17 and 19 gds 17 and 21 15 18 the 19 gds 20 - 21 15 21 15 22 , 22 , 23 indicating 23 indicating 25 validity 23 indicating 26 . 24 good 25 validity neither functional status nor severity of dementia was associated with qol ; but depressive symptoms and self - reported feeling ill had a negative association on qol . 0 ###LEFT-WALL### 4 nor 0 ###LEFT-WALL### 9 associated 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 28 . 1 neither 4 nor 2 functional 3 status 3 status 4 nor 4 nor 5 severity 4 nor 8 was 5 severity 6 of 6 of 7 dementia 8 was 9 associated 9 associated 10 with 10 with 11 qol 12 ; 13 but 13 but 16 and 13 but 22 had 14 depressive 15 symptoms 15 symptoms 16 and 16 and 17 self 16 and 22 had 18 - 19 reported 19 reported 20 feeling 19 reported 22 had 20 feeling 21 ill 22 had 25 association 22 had 26 on 23 a 25 association 24 negative 25 association 26 on 27 qol conclusions : the results showed that the spanish version of the dqol has comparable psychometric properties to the us version . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 showed 2 : 21 . 3 the 4 results 4 results 5 showed 5 showed 6 that 6 that 9 version 6 that 13 has 7 the 9 version 8 spanish 9 version 9 version 10 of 9 version 13 has 10 of 12 dqol 11 the 12 dqol 13 has 16 properties 13 has 17 to 14 comparable 16 properties 15 psychometric 16 properties 17 to 20 version 18 the 20 version 19 us 20 version the dqol appears to be a reliable and valid instrument intended to be administered to patients with mild/moderate dementia who are living at home . 0 ###LEFT-WALL### 13 be 0 ###LEFT-WALL### 25 . 1 the 2 dqol 2 dqol 3 appears 3 appears 4 to 3 appears 5 be 4 to 5 be 5 be 10 instrument 5 be 12 to 6 a 10 instrument 7 reliable 8 and 8 and 9 valid 8 and 10 instrument 10 instrument 11 intended 12 to 13 be 13 be 14 administered 14 administered 15 to 14 administered 23 at 15 to 16 patients 16 patients 17 with 16 patients 20 who 16 patients 21 are 17 with 19 dementia 18 mild/moderate 19 dementia 20 who 21 are 21 are 22 living 23 at 24 home objectives : to describe factors that support and [inhibit] recruitment and participation of people with dementia living in care homes . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 describe 2 : 21 . 3 to 4 describe 4 describe 20 homes 5 factors 20 homes 6 that 7 support 7 support 8 and 8 and 10 recruitment 8 and 11 and 11 and 12 participation 11 and 13 of 11 and 20 homes 13 of 14 people 14 people 15 with 15 with 16 dementia 16 dementia 17 living 17 living 18 in 18 in 19 care method : this article focuses on the methods used to recruit people with dementia to a longitudinal study that employed a mixed [-] method design to track events and care that older people with dementia experienced over two years in six care homes . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 44 . 1 method 2 : 2 : 4 article 2 : 37 over 3 this 4 article 4 article 5 focuses 4 article 12 people 5 focuses 6 on 5 focuses 12 people 6 on 8 methods 7 the 8 methods 8 methods 9 used 9 used 10 to 10 to 11 recruit 12 people 13 with 12 people 34 with 13 with 14 dementia 13 with 15 to 15 to 18 study 16 a 17 longitudinal 16 a 18 study 17 longitudinal 18 study 18 study 19 that 18 study 20 employed 19 that 20 employed 20 employed 25 design 20 employed 26 to 20 employed 29 and 21 a 25 design 22 mixed 24 method 24 method 25 design 26 to 29 and 27 track 28 events 27 track 29 and 29 and 30 care 29 and 33 people 31 that 33 people 32 older 33 people 34 with 35 dementia 34 with 36 experienced 37 over 39 years 38 two 39 years 39 years 40 in 40 in 43 homes 41 six 43 homes 42 care 43 homes a staged approach [to] recruitment was [adopted] involving separate meetings with staff , residents and relatives . 0 ###LEFT-WALL### 5 recruitment 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 17 . 1 a 5 recruitment 2 staged 3 approach 3 approach 5 recruitment 5 recruitment 6 was 6 was 8 involving 8 involving 10 meetings 8 involving 11 with 9 separate 10 meetings 11 with 15 and 12 staff 13 , 13 , 14 residents 13 , 15 and 15 and 16 relatives individual consent was secured with residents with dementia who could consent in the moment and for those without capacity [,] through mail and follow - up telephone contact with consultees . 0 ###LEFT-WALL### 2 consent 0 ###LEFT-WALL### 4 secured 0 ###LEFT-WALL### 25 - 0 ###LEFT-WALL### 31 . 1 individual 2 consent 2 consent 3 was 3 was 4 secured 4 secured 5 with 5 with 6 residents 5 with 7 with 7 with 8 dementia 8 dementia 9 who 8 dementia 10 could 9 who 10 could 10 could 23 and 11 consent 15 and 11 consent 18 without 11 consent 23 and 12 in 14 moment 12 in 15 and 13 the 14 moment 15 and 16 for 16 for 17 those 18 without 19 capacity 19 capacity 21 through 21 through 22 mail 23 and 24 follow 25 - 26 up 26 up 28 contact 26 up 29 with 27 telephone 28 contact 29 with 30 consultees data were collected on the frequency of meetings , issues raised by staff , consultees and people with dementia as well as the overall time taken to complete recruitment . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 30 . 1 data 2 were 2 were 3 collected 3 collected 4 on 4 on 6 frequency 5 the 6 frequency 6 frequency 7 of 6 frequency 10 issues 7 of 8 meetings 9 , 10 issues 10 issues 11 raised 10 issues 14 , 11 raised 12 by 12 by 13 staff 14 , 29 recruitment 15 consultees 16 and 16 and 17 people 16 and 18 with 16 and 22 as 16 and 29 recruitment 18 with 19 dementia 20 as 21 well 21 well 22 as 22 as 25 time 23 the 25 time 24 overall 25 time 25 time 26 taken 25 time 27 to 25 time 28 complete 27 to 28 complete results : over five months , 133 older people with dementia were recruited ( 62 % of sampling [frame] ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 results 2 : 2 : 3 over 3 over 5 months 4 five 5 months 5 months 7 133 6 , 7 133 7 133 9 people 7 133 12 were 7 133 13 recruited 7 133 16 % 7 133 20 ) 8 older 9 people 9 people 10 with 9 people 12 were 10 with 11 dementia 14 ( 16 % 15 62 16 % 16 % 17 of 16 % 20 ) 17 of 18 sampling the recruitment process was supported or hindered by the number of individuals and organisations that needed to be consulted , the care home culture , staff 's understanding of how people with dementia can be involved in research , and how they interpreted their role as mediators , protectors and gatekeepers . 0 ###LEFT-WALL### 3 process 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 6 or 0 ###LEFT-WALL### 52 . 1 the 3 process 2 recruitment 3 process 3 process 4 was 4 was 5 supported 6 or 26 staff 6 or 27 's 7 hindered 8 by 7 hindered 25 , 7 hindered 26 staff 8 by 13 and 9 the 10 number 10 number 11 of 10 number 13 and 11 of 12 individuals 13 and 14 organisations 13 and 15 that 13 and 16 needed 13 and 24 culture 15 that 16 needed 16 needed 17 to 16 needed 19 consulted 17 to 18 be 20 , 24 culture 21 the 24 culture 22 care 24 culture 23 home 24 culture 24 culture 25 , 26 staff 27 's 27 's 28 understanding 28 understanding 42 they 28 understanding 43 interpreted 29 of 30 how 29 of 42 they 30 how 31 people 30 how 36 involved 31 people 32 with 31 people 34 can 32 with 33 dementia 34 can 35 be 35 be 36 involved 37 in 40 and 37 in 42 they 38 research 40 and 39 , 40 and 40 and 41 how 42 they 43 interpreted 43 interpreted 45 role 43 interpreted 46 as 44 their 45 role 46 as 50 and 47 mediators 48 , 48 , 49 protectors 48 , 50 and 50 and 51 gatekeepers conclusions : care homes are isolated communities of care . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 homes 2 : 5 are 2 : 10 . 3 care 4 homes 4 homes 5 are 5 are 7 communities 6 isolated 7 communities 7 communities 8 of 8 of 9 care to achieve the research objectives , researchers in the initial stages need to consider the philosophical underpinnings of individual care homes , and the politics of hierarchy both within the care home and between it , and health professionals . 0 ###LEFT-WALL### 7 researchers 0 ###LEFT-WALL### 12 need 0 ###LEFT-WALL### 40 . 1 to 2 achieve 1 to 6 , 1 to 7 researchers 2 achieve 5 objectives 3 the 5 objectives 4 research 5 objectives 7 researchers 8 in 7 researchers 12 need 8 in 11 stages 9 the 11 stages 10 initial 11 stages 12 need 13 to 12 need 14 consider 13 to 14 consider 14 consider 17 underpinnings 15 the 17 underpinnings 16 philosophical 17 underpinnings 17 underpinnings 18 of 17 underpinnings 26 of 18 of 23 and 19 individual 21 homes 20 care 21 homes 21 homes 23 and 22 , 23 and 23 and 25 politics 24 the 25 politics 26 of 39 professionals 27 hierarchy 39 professionals 28 both 33 and 28 both 37 and 29 within 32 home 29 within 33 and 30 the 32 home 31 care 32 home 33 and 34 between 34 between 35 it 36 , 37 and 37 and 38 health 37 and 39 professionals there is a need to develop credible infrastructures of support that enable people with dementia to participate in research . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 20 . 1 there 2 is 2 is 4 need 3 a 4 need 4 need 5 to 4 need 6 develop 5 to 6 develop 6 develop 8 infrastructures 7 credible 8 infrastructures 8 infrastructures 9 of 8 infrastructures 11 that 8 infrastructures 12 enable 9 of 10 support 11 that 12 enable 12 enable 13 people 12 enable 14 with 12 enable 16 to 12 enable 17 participate 14 with 15 dementia 16 to 17 participate 17 participate 18 in 18 in 19 research objective : the aim of this study was to evaluate the association between vision and hearing impairment and depressive - anxiety syndrome in a large population participating in the faenza project , northern italy . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 10 evaluate 0 ###LEFT-WALL### 32 , 0 ###LEFT-WALL### 35 . 1 objective 2 : 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 10 evaluate 5 of 6 this 7 study 8 was 8 was 9 to 8 was 10 evaluate 9 to 10 evaluate 10 evaluate 12 association 10 evaluate 13 between 10 evaluate 23 in 11 the 12 association 13 between 18 and 14 vision 15 and 15 and 17 impairment 15 and 18 and 16 hearing 17 impairment 18 and 22 syndrome 19 depressive 20 - 19 depressive 21 anxiety 21 anxiety 22 syndrome 23 in 26 population 24 a 25 large 24 a 26 population 25 large 26 population 26 population 27 participating 26 population 28 in 28 in 31 project 29 the 31 project 30 faenza 31 project 32 , 34 italy 33 northern 34 italy method : the study population consisted of 7389 participants not affected by dementia , 4408 ( 59.7 % ) , [of] [whom] were women , mean age ± standard deviation ( [±sd] [ )(71.9 ( ±7.7 ) years . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 5 population 2 : 6 consisted 2 : 20 , 2 : 23 were 3 the 5 population 4 study 5 population 5 population 6 consisted 6 consisted 7 of 7 of 9 participants 8 7389 9 participants 9 participants 10 not 9 participants 15 4408 10 not 11 affected 11 affected 12 by 12 by 13 dementia 14 , 15 4408 15 4408 18 % 15 4408 20 , 16 ( 18 % 17 59.7 18 % 18 % 19 ) 20 , 23 were 23 were 24 women 23 were 38 years 24 women 30 deviation 25 , 30 deviation 26 mean 30 deviation 27 age 30 deviation 28 ± 29 standard 29 standard 30 deviation 30 deviation 34 )(71.9 30 deviation 37 ) 31 ( 34 )(71.9 34 )(71.9 36 ±7.7 34 )(71.9 37 ) 35 ( 36 ±7.7 36 ±7.7 37 ) information about previous [or] current psychiatric symptoms , including sleeping and eating habits , [non] - verbal language and ability in activity of daily living was used to investigate depressive and anxiety syndrome . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 16 - 1 information 2 about 1 information 8 , 2 about 7 symptoms 3 previous 7 symptoms 5 current 7 symptoms 6 psychiatric 7 symptoms 8 , 9 including 8 , 11 and 9 including 10 sleeping 11 and 13 habits 11 and 14 , 12 eating 13 habits 16 - 18 language 16 - 19 and 16 - 34 . 17 verbal 18 language 19 and 20 ability 19 and 27 used 20 ability 21 in 20 ability 23 of 20 ability 26 was 21 in 22 activity 23 of 25 living 24 daily 25 living 26 was 27 used 27 used 28 to 27 used 29 investigate 28 to 29 investigate 29 investigate 31 and 30 depressive 31 and 31 and 33 syndrome 32 anxiety 33 syndrome a semi - structured interview was administered to survey the presence of sensory impairment . 0 ###LEFT-WALL### 5 interview 0 ###LEFT-WALL### 7 administered 0 ###LEFT-WALL### 15 . 1 a 2 semi 1 a 5 interview 2 semi 3 - 2 semi 5 interview 4 structured 5 interview 5 interview 6 was 6 was 7 administered 7 administered 8 to 8 to 9 survey 9 survey 11 presence 10 the 11 presence 11 presence 12 of 12 of 14 impairment 13 sensory 14 impairment logistic regression analyses were used to evaluate the association between sensory impairment and depressive - anxiety syndrome estimating odds ratio ( or ) and 95 % confidence interval ( 95 % ci ) . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 34 . 1 logistic 3 analyses 2 regression 3 analyses 3 analyses 4 were 4 were 5 used 5 used 6 to 5 used 7 evaluate 6 to 7 evaluate 7 evaluate 9 association 7 evaluate 10 between 8 the 9 association 10 between 24 and 11 sensory 12 impairment 12 impairment 13 and 13 and 20 ratio 13 and 22 or 13 and 24 and 14 depressive 15 - 14 depressive 16 anxiety 16 anxiety 20 ratio 17 syndrome 20 ratio 18 estimating 20 ratio 19 odds 20 ratio 21 ( 22 or 22 or 23 ) 24 and 28 interval 24 and 32 ci 25 95 26 % 26 % 27 confidence 27 confidence 28 interval 29 ( 32 ci 30 95 32 ci 31 % 32 ci 32 ci 33 ) results : the prevalence of vision and hearing impairment was 1.4 [%] and 0.2 % , respectively , with an increasing trend in people aged 75+ years ( p < 0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 33 . 1 results 2 : 2 : 4 prevalence 3 the 4 prevalence 4 prevalence 5 of 5 of 6 vision 7 and 8 hearing 7 and 25 aged 8 hearing 9 impairment 8 hearing 10 was 8 hearing 25 aged 9 impairment 10 was 10 was 15 % 10 was 17 respectively 10 was 19 with 10 was 23 in 11 1.4 13 and 13 and 14 0.2 13 and 15 % 16 , 17 respectively 17 respectively 18 , 19 with 22 trend 20 an 22 trend 21 increasing 22 trend 23 in 24 people 25 aged 27 years 25 aged 30 < 26 75+ 27 years 28 ( 30 < 29 p 30 < 30 < 31 0.001 30 < 32 ) the prevalence [of] depressive syndrome was higher among vision - impaired participants ( 20.2 % vs [.] 9.3 % , p < 0.001 ) , especially women ( 22.9 % ) and persons aged 75+ years ( 22.1 % ) . 0 ###LEFT-WALL### 5 syndrome 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 41 . 1 the 5 syndrome 2 prevalence 5 syndrome 4 depressive 5 syndrome 5 syndrome 6 was 6 was 7 higher 7 higher 8 among 8 among 9 vision 9 vision 12 participants 10 - 12 participants 11 impaired 12 participants 12 participants 15 % 12 participants 27 women 12 participants 31 ) 13 ( 15 % 14 20.2 15 % 15 % 16 vs 15 % 25 , 16 vs 19 % 18 9.3 19 % 19 % 22 < 20 , 22 < 21 p 22 < 22 < 23 0.001 22 < 24 ) 25 , 26 especially 25 , 27 women 27 women 30 % 27 women 31 ) 28 ( 30 % 29 22.9 30 % 30 % 31 ) 32 and 33 persons 32 and 34 aged 33 persons 34 aged 34 aged 36 years 35 75+ 36 years 36 years 39 % 37 ( 39 % 38 22.1 39 % 39 % 40 ) the prevalence of anxiety [syndrome] was higher in the hearing [-] impaired group ( 25.0 % vs [.] 11.0 % , p = 0.09 ) . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 26 . 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 6 was 3 of 4 anxiety 6 was 7 higher 7 higher 8 in 7 higher 23 = 8 in 13 group 9 the 13 group 10 hearing 12 impaired 12 impaired 13 group 13 group 16 % 14 ( 16 % 15 25.0 16 % 16 % 17 vs 16 % 21 , 17 vs 20 % 19 11.0 20 % 21 , 23 = 22 p 23 = 23 = 24 0.09 23 = 25 ) vision - impaired participants , especially women and participants aged 75+ years had have a twofold higher probability to have depressive syndrome ( or [=] 2.03 , 95 [%] ci = 1.21 - 3.38 ) , [and] hearing - impaired individuals showed an increased probability of presenting anxiety syndrome [(] or = 2.71 , 95 % ci = 0.86 - 8.55 ) , although these results were not statistically significant . 0 ###LEFT-WALL### 1 vision 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 10 aged 2 - 4 participants 2 - 5 , 3 impaired 4 participants 5 , 8 and 6 especially 8 and 7 women 8 and 8 and 9 participants 8 and 10 aged 10 aged 11 75+ 10 aged 19 to 11 75+ 12 years 11 75+ 13 had 12 years 13 had 13 had 14 have 14 have 18 probability 15 a 18 probability 16 twofold 17 higher 17 higher 18 probability 19 to 20 have 20 have 30 ci 21 depressive 27 , 21 depressive 30 ci 22 syndrome 24 or 23 ( 24 or 24 or 26 2.03 24 or 27 , 28 95 30 ci 30 ci 32 1.21 30 ci 42 showed 31 = 32 1.21 32 1.21 34 3.38 32 1.21 39 - 32 1.21 42 showed 33 - 34 3.38 34 3.38 35 ) 36 , 39 - 38 hearing 39 - 39 - 41 individuals 40 impaired 41 individuals 42 showed 45 probability 42 showed 52 = 43 an 45 probability 44 increased 45 probability 45 probability 46 of 45 probability 52 = 46 of 47 presenting 47 presenting 51 or 48 anxiety 51 or 49 syndrome 51 or 52 = 53 2.71 52 = 64 although 53 2.71 57 ci 54 , 57 ci 55 95 57 ci 56 % 57 ci 57 ci 60 - 57 ci 62 ) 58 = 59 0.86 59 0.86 60 - 60 - 61 8.55 63 , 64 although 64 although 66 results 64 although 67 were 64 although 71 . 65 these 66 results 66 results 67 were 67 were 68 not 67 were 69 statistically 67 were 70 significant conclusion : this study 's findings suggest that sensory impairment in older adults can increase their probability of experiencing depressive and anxiety syndrome . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 6 findings 2 : 7 suggest 2 : 24 . 3 this 4 study 4 study 5 's 5 's 6 findings 6 findings 7 suggest 7 suggest 8 that 8 that 10 impairment 8 that 15 increase 9 sensory 10 impairment 10 impairment 11 in 10 impairment 14 can 11 in 13 adults 12 older 13 adults 14 can 15 increase 15 increase 17 probability 16 their 17 probability 17 probability 18 of 18 of 19 experiencing 19 experiencing 21 and 20 depressive 21 and 21 and 23 syndrome 22 anxiety 23 syndrome correction of these deficits could improve the quality of life in this population . 0 ###LEFT-WALL### 1 correction 0 ###LEFT-WALL### 6 improve 0 ###LEFT-WALL### 14 . 1 correction 2 of 1 correction 5 could 2 of 4 deficits 3 these 4 deficits 5 could 6 improve 6 improve 8 quality 6 improve 11 in 7 the 8 quality 8 quality 9 of 9 of 10 life 11 in 13 population 12 this 13 population objective : social isolation is a common problem in older people who move into care that has negative consequences for well - being . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 isolation 2 : 5 is 2 : 22 - 2 : 24 . 3 social 4 isolation 4 isolation 5 is 5 is 8 problem 6 a 8 problem 7 common 8 problem 8 problem 9 in 8 problem 14 into 8 problem 20 for 9 in 11 people 10 older 11 people 11 people 12 who 11 people 13 move 12 who 13 move 14 into 15 care 15 care 16 that 15 care 17 has 16 that 17 has 17 has 19 consequences 18 negative 19 consequences 20 for 21 well 22 - 23 being this is of particular concern for men , who are marginalised in long - term care settings as a result of their reduced numbers and greater difficulty in accessing effective social support , relative to women . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 1 this 2 is 2 is 3 of 3 of 5 concern 4 particular 5 concern 5 concern 6 for 6 for 7 men 7 men 9 who 8 , 9 who 9 who 10 are 9 who 37 . 10 are 11 marginalised 11 marginalised 12 in 11 marginalised 18 as 12 in 17 settings 13 long 14 - 13 long 15 term 15 term 17 settings 16 care 17 settings 18 as 20 result 19 a 20 result 20 result 21 of 20 result 28 in 21 of 25 and 22 their 24 numbers 23 reduced 24 numbers 24 numbers 25 and 25 and 27 difficulty 26 greater 27 difficulty 28 in 29 accessing 29 accessing 32 support 30 effective 31 social 31 social 32 support 32 support 34 relative 33 , 34 relative 34 relative 35 to 34 relative 37 . 35 to 36 women however , researchers in the social identity tradition argue that developing social group memberships can counteract the effects of isolation . 0 ###LEFT-WALL### 3 researchers 0 ###LEFT-WALL### 9 argue 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 3 researchers 3 researchers 4 in 3 researchers 9 argue 4 in 8 tradition 5 the 8 tradition 6 social 7 identity 7 identity 8 tradition 9 argue 10 that 10 that 11 developing 10 that 16 counteract 11 developing 14 memberships 11 developing 15 can 12 social 13 group 13 group 14 memberships 15 can 16 counteract 16 counteract 18 effects 17 the 18 effects 18 effects 19 of 19 of 20 isolation we test this account in this study by examining whether increased socialisation with others of the same gender enhances social identification , well - being [(] e.g . life satisfaction , mood [ )(, and cognitive ability . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 24 - 0 ###LEFT-WALL### 28 . 1 we 2 test 2 test 4 account 2 test 8 by 3 this 4 account 4 account 5 in 5 in 7 study 6 this 7 study 8 by 9 examining 9 examining 10 whether 10 whether 12 socialisation 10 whether 19 enhances 11 increased 12 socialisation 12 socialisation 13 with 12 socialisation 15 of 12 socialisation 19 enhances 13 with 14 others 15 of 18 gender 16 the 17 same 16 the 18 gender 19 enhances 21 identification 19 enhances 23 well 20 social 21 identification 22 , 23 well 23 well 24 - 24 - 27 e.g 25 being 27 e.g 28 . 35 and 28 . 38 . 29 life 30 satisfaction 30 satisfaction 31 , 31 , 32 mood 31 , 35 and 34 )(, 35 and 35 and 37 ability 36 cognitive 37 ability method : care home residents were invited to join gender - based groups ( i.e [.] ladies and gentlemen 's clubs ) . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 5 residents 2 : 7 invited 2 : 23 . 3 care 4 home 4 home 5 residents 5 residents 6 were 6 were 7 invited 7 invited 8 to 8 to 10 gender 9 join 10 gender 10 gender 13 groups 11 - 13 groups 12 based 13 groups 13 groups 18 and 13 groups 22 ) 14 ( 18 and 15 i.e 17 ladies 17 ladies 18 and 18 and 21 clubs 18 and 22 ) 19 gentlemen 20 's 20 's 21 clubs nine groups were examined [(] five male groups , four female groups [ )(comprising 26 participants [(] 12 male , 14 female [ )(, who took part in fortnightly social activities . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 32 . 1 nine 2 groups 2 groups 3 were 3 were 8 groups 4 examined 8 groups 6 five 8 groups 7 male 8 groups 9 , 19 male 9 , 20 , 10 four 16 participants 11 female 16 participants 12 groups 16 participants 14 )(comprising 16 participants 15 26 16 participants 16 participants 19 male 18 12 19 male 20 , 22 female 20 , 24 )(, 21 14 22 female 24 )(, 25 who 24 )(, 27 part 25 who 27 part 26 took 27 part 27 part 28 in 28 in 31 activities 29 fortnightly 31 activities 30 social 31 activities social identification , personal identity strength , cognitive ability and well - being were measured at the commencement of the intervention and 12 weeks later . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 26 . 1 social 2 identification 2 identification 3 , 3 , 6 strength 3 , 7 , 4 personal 5 identity 5 identity 6 strength 7 , 9 ability 7 , 10 and 8 cognitive 9 ability 10 and 11 well 12 - 13 being 12 - 15 measured 13 being 14 were 14 were 15 measured 15 measured 16 at 16 at 22 and 17 the 18 commencement 18 commencement 19 of 18 commencement 22 and 19 of 21 intervention 20 the 21 intervention 22 and 24 weeks 22 and 25 later 23 12 24 weeks results : a clear gender effect was found . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 . 1 results 2 : 2 : 5 gender 3 a 4 clear 3 a 5 gender 4 clear 5 gender 5 gender 6 effect 5 gender 8 found 6 effect 7 was 7 was 8 found for women , there was evidence of maintained well - being and identification over time . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 10 - 1 for 2 women 1 for 3 , 1 for 4 there 4 there 5 was 5 was 6 evidence 6 evidence 7 of 7 of 9 well 8 maintained 9 well 10 - 12 and 10 - 16 . 11 being 12 and 12 and 13 identification 12 and 14 over 14 over 15 time for men , there was a significant reduction in depression and anxiety , and an increased sense of social identification with others . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 23 . 1 for 2 men 1 for 3 , 1 for 4 there 4 there 5 was 5 was 8 reduction 6 a 8 reduction 7 significant 8 reduction 8 reduction 9 in 9 in 14 and 10 depression 11 and 11 and 12 anxiety 11 and 14 and 13 , 14 and 14 and 17 sense 14 and 18 of 14 and 21 with 15 an 17 sense 16 increased 17 sense 18 of 20 identification 19 social 20 identification 21 with 22 others conclusion : while decreasing well - being tends to be the norm in long - term residential care , building new social group memberships in the form of gender clubs can counteract this decline , particularly among men . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 7 being 2 : 8 tends 3 while 4 decreasing 3 while 6 - 3 while 7 being 4 decreasing 5 well 7 being 8 tends 8 tends 9 to 8 tends 10 be 9 to 10 be 10 be 12 norm 10 be 36 particularly 11 the 12 norm 12 norm 13 in 12 norm 24 memberships 13 in 18 care 14 long 15 - 14 long 16 term 16 term 18 care 17 residential 18 care 19 , 24 memberships 20 building 24 memberships 21 new 22 social 22 social 24 memberships 23 group 24 memberships 24 memberships 25 in 24 memberships 30 clubs 24 memberships 32 counteract 24 memberships 35 , 25 in 27 form 26 the 27 form 27 form 28 of 28 of 29 gender 30 clubs 31 can 31 can 32 counteract 32 counteract 34 decline 33 this 34 decline 36 particularly 37 among 37 among 38 men background : the role [of] adherence to an intervention is examined to further understand the relationship between performing new challenging activities ( either mental or physical ones ) and their putative cognitive benefits . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 6 adherence 2 : 11 examined 3 the 6 adherence 4 role 6 adherence 6 adherence 7 to 6 adherence 10 is 7 to 9 intervention 8 an 9 intervention 10 is 11 examined 11 examined 12 to 11 examined 17 between 12 to 14 understand 13 further 14 understand 14 understand 16 relationship 15 the 16 relationship 17 between 18 performing 18 performing 29 and 19 new 20 challenging 19 new 29 and 20 challenging 21 activities 21 activities 27 ones 22 ( 27 ones 23 either 25 or 24 mental 25 or 25 or 26 physical 25 or 27 ones 27 ones 28 ) 29 and 33 benefits 30 their 33 benefits 31 putative 33 benefits 32 cognitive 33 benefits they completed five tests , measuring episodic and working memory pre - and post - intervention . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 17 . 1 they 13 and 2 completed 4 tests 2 completed 6 measuring 2 completed 13 and 3 five 4 tests 5 , 6 measuring 6 measuring 8 and 6 measuring 12 - 7 episodic 8 and 8 and 11 pre 9 working 10 memory 10 memory 11 pre 13 and 14 post 15 - 16 intervention a moderated mediation model was specified to test the strength of the indirect effect of the activity mode ( i.e [.] physical [vs] [.] mental ) through adherence [(] i.e [.] time spent on course attendance ) on levels of baseline cognitive performance . 0 ###LEFT-WALL### 4 model 0 ###LEFT-WALL### 44 . 1 a 4 model 2 moderated 4 model 3 mediation 4 model 4 model 5 was 5 was 6 specified 6 specified 7 to 7 to 8 test 8 test 10 strength 8 test 38 on 9 the 10 strength 10 strength 11 of 10 strength 20 i.e 11 of 14 effect 12 the 14 effect 13 indirect 14 effect 14 effect 15 of 15 of 18 mode 16 the 18 mode 17 activity 18 mode 19 ( 20 i.e 20 i.e 22 physical 20 i.e 37 ) 22 physical 32 time 22 physical 34 on 25 mental 26 ) 25 mental 28 adherence 27 through 28 adherence 28 adherence 32 time 30 i.e 32 time 32 time 33 spent 34 on 36 attendance 35 course 36 attendance 38 on 39 levels 39 levels 40 of 40 of 43 performance 41 baseline 43 performance 42 cognitive 43 performance results : both physical and mental activity groups performed better over time than the control group ( p < 0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 results 2 : 2 : 8 groups 3 both 8 groups 4 physical 5 and 5 and 6 mental 5 and 8 groups 7 activity 8 groups 8 groups 9 performed 8 groups 19 < 9 performed 10 better 9 performed 11 over 9 performed 13 than 11 over 12 time 13 than 16 group 14 the 16 group 15 control 16 group 17 ( 19 < 18 p 19 < 19 < 20 0.001 19 < 21 ) adherence predicted cognitive performance ( p = 0.011 ) . 0 ###LEFT-WALL### 1 adherence 0 ###LEFT-WALL### 2 predicted 0 ###LEFT-WALL### 10 . 1 adherence 2 predicted 2 predicted 4 performance 3 cognitive 4 performance 4 performance 7 = 5 ( 7 = 6 p 7 = 7 = 8 0.011 7 = 9 ) the indirect effect of the activity mode [on] cognitive performance through adherence was especially seen when levels of baseline composite scores were low ( p = 0.023 ) . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 15 seen 0 ###LEFT-WALL### 29 . 1 the 3 effect 2 indirect 3 effect 3 effect 4 of 3 effect 13 was 4 of 12 adherence 5 the 12 adherence 6 activity 12 adherence 7 mode 12 adherence 9 cognitive 10 performance 10 performance 12 adherence 11 through 12 adherence 13 was 15 seen 14 especially 15 seen 15 seen 16 when 16 when 17 levels 16 when 22 were 17 levels 18 of 17 levels 22 were 18 of 21 scores 19 baseline 21 scores 20 composite 21 scores 22 were 23 low 23 low 26 = 24 ( 26 = 25 p 26 = 26 = 27 0.023 26 = 28 ) conclusion : older healthy women can improve episodic and working memory through spending time on a challenging physical or mental activity . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 5 women 2 : 7 improve 3 older 5 women 4 healthy 5 women 5 women 6 can 6 can 7 improve 7 improve 14 time 7 improve 15 on 8 episodic 9 and 9 and 11 memory 9 and 12 through 9 and 14 time 10 working 11 memory 12 through 13 spending 15 on 21 activity 16 a 17 challenging 16 a 21 activity 17 challenging 21 activity 18 physical 19 or 19 or 20 mental 19 or 21 activity results are most promising for cognitively less fit women . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 . 1 results 2 are 2 are 4 promising 3 most 4 promising 4 promising 5 for 5 for 9 women 6 cognitively 8 fit 7 less 8 fit 8 fit 9 women time spent on course attendance can be interpreted as an adherence indicator that makes a difference for various cognitive outcomes of the intervention . 0 ###LEFT-WALL### 1 time 0 ###LEFT-WALL### 8 interpreted 0 ###LEFT-WALL### 24 . 1 time 2 spent 1 time 5 attendance 1 time 7 be 1 time 8 interpreted 2 spent 4 course 3 on 4 course 5 attendance 6 can 6 can 7 be 8 interpreted 9 as 9 as 12 indicator 10 an 12 indicator 11 adherence 12 indicator 12 indicator 13 that 12 indicator 14 makes 13 that 14 makes 14 makes 16 difference 15 a 16 difference 16 difference 17 for 16 difference 21 of 17 for 20 outcomes 18 various 20 outcomes 19 cognitive 20 outcomes 21 of 23 intervention 22 the 23 intervention background and objective : psychological well - being as one of the most important indicators of successful aging has received substantial attention in the gerontological literature . 0 ###LEFT-WALL### 3 objective 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 7 - 1 background 2 and 2 and 3 objective 3 objective 4 : 4 : 5 psychological 5 psychological 6 well 7 - 8 being 7 - 20 received 7 - 27 . 8 being 9 as 8 being 11 of 8 being 19 has 9 as 10 one 11 of 15 indicators 12 the 13 most 13 most 15 indicators 14 important 15 indicators 15 indicators 16 of 16 of 18 aging 17 successful 18 aging 19 has 20 received 20 received 22 attention 20 received 23 in 21 substantial 22 attention 23 in 26 literature 24 the 26 literature 25 gerontological 26 literature prior studies show that sociodemographic factors influencing elderly ['s] psychological well [-] being are multiple and differ across cultures . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 20 . 1 prior 2 studies 2 studies 16 and 3 show 4 that 3 show 6 factors 3 show 14 are 3 show 16 and 5 sociodemographic 6 factors 6 factors 7 influencing 6 factors 14 are 7 influencing 13 being 8 elderly 13 being 10 psychological 13 being 11 well 13 being 14 are 15 multiple 16 and 17 differ 17 differ 18 across 18 across 19 cultures the aim of this study was to identify significant sociodemographic predictors of psychological well - being among malay elders . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 identify 7 to 8 identify 8 identify 11 predictors 9 significant 11 predictors 10 sociodemographic 11 predictors 11 predictors 12 of 12 of 14 well 13 psychological 14 well 14 well 16 being 15 - 16 being 16 being 17 among 16 being 20 . 17 among 19 elders 18 malay 19 elders methodology : the study included 1415 older malays ( 60 - 100 years , 722 women ) , randomly selected through a multistage stratified random method from peninsular malaysia . 0 ###LEFT-WALL### 1 methodology 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 1 methodology 2 : 2 : 4 study 3 the 4 study 4 study 5 included 4 study 8 malays 4 study 20 selected 6 1415 8 malays 7 older 8 malays 8 malays 13 years 8 malays 20 selected 9 ( 13 years 10 60 11 - 11 - 12 100 11 - 13 years 13 years 16 women 13 years 18 , 14 , 16 women 15 722 16 women 16 women 17 ) 19 randomly 20 selected 20 selected 21 through 20 selected 27 from 21 through 26 method 22 a 26 method 23 multistage 26 method 24 stratified 26 method 25 random 26 method 27 from 29 malaysia 28 peninsular 29 malaysia who - five well [-] being index was used to measure psychological well - being . 0 ###LEFT-WALL### 1 who 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 14 - 1 who 3 five 1 who 7 index 1 who 8 was 2 - 3 five 3 five 6 being 3 five 7 index 4 well 6 being 8 was 9 used 9 used 10 to 9 used 11 measure 10 to 11 measure 11 measure 13 well 12 psychological 13 well 14 - 15 being 14 - 16 . data analysis was conducted using the statistical package for social sciences ( spss ) version 13.0 . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 17 . 1 data 2 analysis 2 analysis 3 was 3 was 4 conducted 4 conducted 5 using 5 using 8 package 6 the 8 package 7 statistical 8 package 8 package 9 for 9 for 15 version 10 social 11 sciences 11 sciences 13 spss 12 ( 13 spss 13 spss 14 ) 13 spss 15 version 15 version 16 13.0 however , level of education , employment status , and place of residence failed to predict psychological well - being . 0 ###LEFT-WALL### 3 level 0 ###LEFT-WALL### 14 failed 0 ###LEFT-WALL### 19 - 1 however 2 , 1 however 3 level 3 level 4 of 3 level 14 failed 4 of 10 and 5 education 6 , 6 , 8 status 6 , 10 and 7 employment 8 status 9 , 10 and 10 and 11 place 10 and 12 of 12 of 13 residence 14 failed 15 to 14 failed 16 predict 15 to 16 predict 16 predict 18 well 17 psychological 18 well 19 - 20 being 19 - 21 . conclusion : this study showed that the oldest old , elderly women , unmarried , and the poor elderly people are at risk for experiencing low psychological well - being . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 showed 2 : 10 , 2 : 13 , 3 this 4 study 4 study 5 showed 5 showed 6 that 5 showed 9 old 7 the 8 oldest 7 the 9 old 10 , 12 women 11 elderly 12 women 13 , 20 people 13 , 21 are 13 , 29 - 14 unmarried 16 and 15 , 16 and 16 and 18 poor 16 and 20 people 17 the 18 poor 19 elderly 20 people 20 people 21 are 21 are 22 at 21 are 24 for 22 at 23 risk 24 for 28 well 25 experiencing 28 well 26 low 28 well 27 psychological 28 well 29 - 30 being 29 - 31 . therefore , they need special attention from family , policy makers , and those who work with elderly people . 0 ###LEFT-WALL### 3 they 0 ###LEFT-WALL### 4 need 0 ###LEFT-WALL### 20 . 1 therefore 2 , 1 therefore 3 they 3 they 4 need 4 need 6 attention 5 special 6 attention 6 attention 7 from 7 from 13 and 8 family 9 , 9 , 11 makers 9 , 13 and 10 policy 11 makers 12 , 13 and 13 and 14 those 13 and 15 who 13 and 16 work 15 who 16 work 16 work 17 with 17 with 19 people 18 elderly 19 people objective : perceiving oneself as younger than one's actual age functions as a self - enhancing positive illusion that promotes life satisfaction . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 perceiving 2 : 11 functions 3 perceiving 4 oneself 3 perceiving 5 as 3 perceiving 11 functions 5 as 10 age 6 younger 10 age 7 than 9 actual 8 one's 9 actual 9 actual 10 age 11 functions 12 as 12 as 14 self 13 a 14 self 14 self 16 enhancing 15 - 16 enhancing 16 enhancing 18 illusion 16 enhancing 23 . 17 positive 18 illusion 18 illusion 19 that 18 illusion 20 promotes 19 that 20 promotes 20 promotes 22 satisfaction 21 life 22 satisfaction however , no research has yet focused on the mechanisms through which a youthful subjective age could be related to higher life satisfaction . 0 ###LEFT-WALL### 4 research 0 ###LEFT-WALL### 24 . 1 however 2 , 1 however 4 research 3 no 4 research 4 research 5 has 5 has 7 focused 6 yet 7 focused 7 focused 8 on 7 focused 20 to 7 focused 23 satisfaction 8 on 10 mechanisms 9 the 10 mechanisms 10 mechanisms 11 through 11 through 12 which 11 through 16 age 11 through 19 related 13 a 16 age 14 youthful 16 age 15 subjective 16 age 16 age 17 could 17 could 18 be 18 be 19 related 20 to 22 life 21 higher 22 life the purpose of this study was to identify the mediating role of resources , such as subjective health and memory self - efficacy , in the relation between subjective age and life satisfaction among older adults . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 37 . 1 the 2 purpose 2 purpose 3 of 2 purpose 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 identify 7 to 8 identify 8 identify 11 role 8 identify 28 between 8 identify 34 among 9 the 11 role 10 mediating 11 role 11 role 12 of 11 role 25 in 12 of 19 and 13 resources 14 , 14 , 18 health 14 , 19 and 15 such 18 health 16 as 17 subjective 17 subjective 18 health 19 and 21 self 19 and 23 efficacy 20 memory 21 self 22 - 23 efficacy 23 efficacy 24 , 25 in 27 relation 26 the 27 relation 28 between 31 and 29 subjective 30 age 30 age 31 and 31 and 33 satisfaction 32 life 33 satisfaction 34 among 36 adults 35 older 36 adults method : a cross - sectional study was conducted with 250 older individuals aged from 60 to 77 years who completed measures of subjective age , subjective health , memory self - efficacy , and life satisfaction . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 1 method 2 : 2 : 4 cross 3 a 4 cross 5 - 7 study 5 - 9 conducted 5 - 26 , 5 - 38 . 6 sectional 7 study 7 study 8 was 8 was 9 conducted 9 conducted 10 with 9 conducted 14 aged 10 with 13 individuals 11 250 13 individuals 12 older 13 individuals 14 aged 15 from 15 from 19 years 16 60 17 to 17 to 18 77 17 to 19 years 19 years 20 who 19 years 21 completed 20 who 21 completed 21 completed 22 measures 22 measures 23 of 23 of 25 age 24 subjective 25 age 26 , 28 health 26 , 29 , 27 subjective 28 health 29 , 31 self 29 , 32 - 30 memory 31 self 32 - 35 and 33 efficacy 35 and 34 , 35 and 35 and 37 satisfaction 36 life 37 satisfaction results : path analysis revealed that subjective age was positively related to both subjective health and memory self - efficacy , and that subjective health and memory self - efficacy were both positively related to life satisfaction . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 related 0 ###LEFT-WALL### 29 - 1 results 2 : 3 path 8 age 3 path 9 was 3 path 11 related 4 analysis 5 revealed 5 revealed 8 age 6 that 7 subjective 7 subjective 8 age 8 age 9 was 9 was 10 positively 11 related 12 to 12 to 22 and 13 both 22 and 14 subjective 15 health 15 health 16 and 16 and 18 self 16 and 20 efficacy 16 and 22 and 17 memory 18 self 19 - 20 efficacy 20 efficacy 21 , 22 and 28 self 23 that 24 subjective 24 subjective 28 self 25 health 26 and 26 and 27 memory 26 and 28 self 29 - 30 efficacy 29 - 31 were 29 - 38 . 30 efficacy 31 were 31 were 32 both 32 both 34 related 33 positively 34 related 34 related 35 to 35 to 37 satisfaction 36 life 37 satisfaction [bootstrap] procedures further indicated that subjective age has significant total and specific indirect contribution to life satisfaction through subjective health and memory self - efficacy . 0 ###LEFT-WALL### 2 procedures 0 ###LEFT-WALL### 4 indicated 2 procedures 4 indicated 3 further 4 indicated 4 indicated 7 age 4 indicated 8 has 5 that 6 subjective 6 subjective 7 age 7 age 8 has 8 has 17 satisfaction 8 has 18 through 9 significant 17 satisfaction 10 total 11 and 11 and 14 contribution 11 and 15 to 11 and 17 satisfaction 12 specific 14 contribution 13 indirect 14 contribution 15 to 16 life 18 through 21 and 19 subjective 20 health 20 health 21 and 21 and 23 self 21 and 25 efficacy 22 memory 23 self 24 - 25 efficacy 25 efficacy 26 . discussion : this study fills a gap in existing literature and suggests that a youthful subjective age is associated with higher life satisfaction because it is related to higher evaluation of health and memory self - efficacy . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 1 discussion 2 : 2 : 37 efficacy 3 this 4 study 4 study 11 and 4 study 33 and 5 fills 7 gap 5 fills 8 in 5 fills 11 and 6 a 7 gap 8 in 10 literature 9 existing 10 literature 11 and 12 suggests 11 and 30 evaluation 12 suggests 13 that 14 a 15 youthful 14 a 30 evaluation 15 youthful 17 age 16 subjective 17 age 17 age 18 is 18 is 19 associated 19 associated 20 with 20 with 23 satisfaction 21 higher 22 life 22 life 23 satisfaction 23 satisfaction 24 because 23 satisfaction 28 to 24 because 25 it 25 it 26 is 26 is 27 related 27 related 28 to 29 higher 30 evaluation 30 evaluation 31 of 31 of 32 health 33 and 35 self 33 and 36 - 33 and 37 efficacy 34 memory 35 self it provides an initial support for a resource - based explanation of the relation between subjective age and life satisfaction . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 provides 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 21 . 1 it 2 provides 2 provides 5 support 3 an 4 initial 3 an 5 support 4 initial 5 support 5 support 6 for 6 for 8 resource 7 a 8 resource 9 - 11 explanation 10 based 11 explanation 11 explanation 12 of 12 of 14 relation 13 the 14 relation 14 relation 15 between 15 between 18 and 16 subjective 17 age 17 age 18 and 18 and 20 satisfaction 19 life 20 satisfaction objectives : this article provides an overview of the international literature on the most important ethical considerations in the field of assistive technology ( at ) in the care for community [-] dwelling elderly people , focused on dementia . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 article 2 : 36 , 2 : 40 . 3 this 4 article 4 article 36 , 5 provides 7 overview 5 provides 12 on 5 provides 18 in 5 provides 36 , 6 an 7 overview 7 overview 8 of 8 of 11 literature 9 the 11 literature 10 international 11 literature 12 on 17 considerations 13 the 17 considerations 14 most 15 important 15 important 17 considerations 16 ethical 17 considerations 18 in 20 field 19 the 20 field 20 field 21 of 20 field 27 in 20 field 30 for 21 of 23 technology 22 assistive 23 technology 23 technology 25 at 24 ( 25 at 25 at 26 ) 27 in 29 care 28 the 29 care 30 for 35 people 31 community 33 dwelling 33 dwelling 35 people 34 elderly 35 people 36 , 37 focused 36 , 38 on 38 on 39 dementia method : a systematic literature review was performed . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 6 review 2 : 8 performed 2 : 9 . 3 a 4 systematic 3 a 6 review 4 systematic 5 literature 5 literature 6 review 6 review 7 was 7 was 8 performed results : a total of 46 papers met the inclusion criteria . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 total 2 : 8 met 2 : 12 . 3 a 4 total 4 total 5 of 4 total 8 met 5 of 7 papers 6 46 7 papers 8 met 11 criteria 9 the 11 criteria 10 inclusion 11 criteria three main themes were found . 0 ###LEFT-WALL### 3 themes 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 6 . 1 three 3 themes 2 main 3 themes 3 themes 4 were 4 were 5 found the first theme , personal living environment , [involves] the subthemes privacy , autonomy and obtrusiveness . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 17 . 1 the 3 theme 2 first 3 theme 3 theme 4 , 4 , 7 environment 4 , 8 , 5 personal 6 living 6 living 7 environment 8 , 12 privacy 8 , 13 , 10 the 12 privacy 11 subthemes 12 privacy 13 , 14 autonomy 13 , 15 and 15 and 16 obtrusiveness the second theme , the outside world , involves the subthemes stigma and human contact . 0 ###LEFT-WALL### 3 theme 0 ###LEFT-WALL### 9 involves 0 ###LEFT-WALL### 16 . 1 the 3 theme 2 second 3 theme 3 theme 7 world 3 theme 9 involves 4 , 7 world 5 the 7 world 6 outside 7 world 7 world 8 , 9 involves 13 and 10 the 12 stigma 11 subthemes 12 stigma 12 stigma 13 and 13 and 15 contact 14 human 15 contact the third theme , the design of at devices , involves the subthemes individual approach , affordability and safety . 0 ###LEFT-WALL### 3 theme 0 ###LEFT-WALL### 11 involves 0 ###LEFT-WALL### 20 . 1 the 3 theme 2 third 3 theme 3 theme 6 design 3 theme 11 involves 4 , 6 design 5 the 6 design 6 design 7 of 6 design 10 , 7 of 9 devices 8 at 9 devices 11 involves 18 and 12 the 15 approach 13 subthemes 15 approach 14 individual 15 approach 15 approach 16 , 16 , 17 affordability 16 , 18 and 18 and 19 safety the often referred [to] umbrella term of ['] obtrusiveness ['] is frequently used by many authors in the discussion , while a clear description of the concept is mostly absent . 0 ###LEFT-WALL### 6 term 0 ###LEFT-WALL### 13 used 1 the 6 term 2 often 3 referred 3 referred 5 umbrella 5 umbrella 6 term 6 term 7 of 6 term 11 is 7 of 9 obtrusiveness 11 is 13 used 12 frequently 13 used 13 used 14 by 13 used 17 in 13 used 21 while 14 by 16 authors 15 many 16 authors 17 in 19 discussion 18 the 19 discussion 20 , 21 while 21 while 24 description 21 while 28 is 21 while 31 . 22 a 23 clear 22 a 24 description 23 clear 24 description 24 description 25 of 24 description 28 is 25 of 27 concept 26 the 27 concept 28 is 29 mostly 28 is 30 absent conclusion : when it comes to at use in the care for elderly people living at home , ethical debate appears not to be a priority . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 be 0 ###LEFT-WALL### 27 . 2 : 20 debate 2 : 21 appears 3 when 4 it 3 when 5 comes 3 when 18 , 3 when 20 debate 4 it 5 comes 5 comes 6 to 5 comes 16 at 6 to 8 use 7 at 8 use 8 use 9 in 8 use 15 living 9 in 11 care 10 the 11 care 11 care 12 for 12 for 14 people 13 elderly 14 people 16 at 17 home 19 ethical 20 debate 20 debate 21 appears 21 appears 23 to 22 not 23 to 23 to 24 be 24 be 26 priority 25 a 26 priority the little discussion there relies heavily on thick concepts such as autonomy and obtrusiveness which seem to complicate the debate rather than clarify it , because they contain many underlying ambiguous concepts and assumptions . 0 ###LEFT-WALL### 3 discussion 0 ###LEFT-WALL### 5 relies 1 the 3 discussion 2 little 3 discussion 3 discussion 4 there 3 discussion 5 relies 5 relies 6 heavily 5 relies 7 on 5 relies 11 as 7 on 9 concepts 8 thick 9 concepts 10 such 11 as 11 as 13 and 12 autonomy 13 and 13 and 14 obtrusiveness 13 and 15 which 13 and 16 seem 15 which 16 seem 16 seem 17 to 16 seem 23 clarify 17 to 18 complicate 18 complicate 20 debate 18 complicate 22 than 19 the 20 debate 21 rather 22 than 22 than 23 clarify 23 clarify 24 it 23 clarify 26 because 25 , 26 because 26 because 27 they 26 because 28 contain 26 because 35 . 27 they 28 contain 28 contain 29 many 29 many 30 underlying 30 underlying 33 and 31 ambiguous 32 concepts 32 concepts 33 and 33 and 34 assumptions most encountered ethical objections originate from the view that people are , or should be , independent and self - determinant . 0 ###LEFT-WALL### 4 objections 0 ###LEFT-WALL### 13 or 0 ###LEFT-WALL### 16 , 1 most 2 encountered 2 encountered 4 objections 3 ethical 4 objections 4 objections 13 or 5 originate 6 from 5 originate 13 or 6 from 8 view 7 the 8 view 8 view 9 that 8 view 11 are 9 that 10 people 9 that 11 are 10 people 11 are 12 , 13 or 13 or 14 should 14 should 15 be 16 , 18 and 16 , 20 - 17 independent 18 and 18 and 19 self 20 - 21 determinant 20 - 22 . it is questionable whether the view is correct and helpful in the debate on at use in the care for [(] frail ) elderly people . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 26 . 1 it 2 is 2 is 3 questionable 3 questionable 4 whether 4 whether 6 view 4 whether 7 is 5 the 6 view 6 view 7 is 7 is 16 use 7 is 17 in 7 is 20 for 8 correct 9 and 9 and 10 helpful 9 and 16 use 10 helpful 11 in 10 helpful 14 on 11 in 13 debate 12 the 13 debate 14 on 15 at 17 in 19 care 18 the 19 care 20 for 25 people 22 frail 23 ) 22 frail 25 people 24 elderly 25 people other ethical approaches that view people as social and reciprocal might be more applicable and shed a different light on the ethical aspects of at use . 0 ###LEFT-WALL### 3 approaches 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 27 . 1 other 3 approaches 2 ethical 3 approaches 3 approaches 4 that 3 approaches 5 view 3 approaches 11 might 4 that 5 view 5 view 6 people 5 view 7 as 7 as 9 and 8 social 9 and 9 and 10 reciprocal 11 might 15 and 12 be 14 applicable 12 be 15 and 13 more 14 applicable 15 and 16 shed 16 shed 19 light 16 shed 20 on 17 a 19 light 18 different 19 light 20 on 23 aspects 21 the 23 aspects 22 ethical 23 aspects 23 aspects 24 of 24 of 26 use 25 at 26 use data were reported by median and range or incidence . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 reported 0 ###LEFT-WALL### 10 . 1 data 2 were 2 were 3 reported 3 reported 4 by 4 by 8 or 5 median 6 and 6 and 7 range 6 and 8 or 8 or 9 incidence characteristics in elbw neonates with raised peak scr ( >p75 ) were compared to controls ( [<] p75 ) . 0 ###LEFT-WALL### 4 neonates 0 ###LEFT-WALL### 13 compared 0 ###LEFT-WALL### 20 . 1 characteristics 2 in 1 characteristics 4 neonates 2 in 3 elbw 4 neonates 5 with 4 neonates 12 were 5 with 8 scr 6 raised 7 peak 7 peak 8 scr 8 scr 10 >p75 9 ( 10 >p75 10 >p75 11 ) 12 were 13 compared 13 compared 14 to 14 to 15 controls 15 controls 18 p75 16 ( 18 p75 18 p75 19 ) in 151 elbw neonates , an initial increase in scr was observed , resulting in a peak [scr] on day 3 or 4 of 99.9 ( 46.8 - 221.8 ) μmol/l with subsequent decrease . 0 ###LEFT-WALL### 8 increase 0 ###LEFT-WALL### 12 observed 1 in 2 151 1 in 5 , 1 in 8 increase 2 151 3 elbw 2 151 4 neonates 3 elbw 4 neonates 6 an 7 initial 6 an 8 increase 7 initial 8 increase 8 increase 9 in 8 increase 11 was 9 in 10 scr 11 was 12 observed 12 observed 14 resulting 13 , 14 resulting 14 resulting 15 in 14 resulting 19 on 14 resulting 35 . 15 in 17 peak 16 a 17 peak 19 on 20 day 20 day 22 or 20 day 24 of 21 3 22 or 22 or 23 4 24 of 31 μmol/l 25 99.9 31 μmol/l 26 ( 28 - 27 46.8 28 - 28 - 29 221.8 28 - 30 ) 28 - 31 μmol/l 31 μmol/l 32 with 32 with 34 decrease 33 subsequent 34 decrease in cases ( n = 37 ) with a peak scr >p75 ( 112.3 μmol/l ) , scr remained elevated until day 28 . 0 ###LEFT-WALL### 18 scr 0 ###LEFT-WALL### 19 remained 0 ###LEFT-WALL### 24 . 1 in 2 cases 1 in 18 scr 2 cases 5 = 3 ( 5 = 4 n 5 = 5 = 6 37 5 = 7 ) 8 with 12 >p75 8 with 17 , 8 with 18 scr 9 a 12 >p75 10 peak 12 >p75 11 scr 12 >p75 12 >p75 15 μmol/l 13 ( 15 μmol/l 14 112.3 15 μmol/l 15 μmol/l 16 ) 18 scr 19 remained 19 remained 20 elevated 20 elevated 21 until 21 until 22 day 22 day 23 28 mothers of cases received less betamethasone , neonates had a lower ga , lower bw , lower apgar , and needed more often intubation . 0 ###LEFT-WALL### 1 mothers 0 ###LEFT-WALL### 4 received 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 25 . 1 mothers 2 of 1 mothers 4 received 2 of 3 cases 4 received 6 betamethasone 5 less 6 betamethasone 7 , 8 neonates 7 , 9 had 8 neonates 9 had 9 had 12 ga 9 had 20 and 10 a 12 ga 11 lower 12 ga 12 ga 15 bw 13 , 15 bw 14 lower 15 bw 15 bw 16 , 17 lower 18 apgar 17 lower 20 and 19 , 20 and 20 and 21 needed 20 and 23 often 20 and 24 intubation 22 more 23 often postnatal ventilation , oxygen , parenteral nutrition , ibuprofen , steroids , rop , and intraventricular hemorrhage were different . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 18 were 0 ###LEFT-WALL### 20 . 1 postnatal 2 ventilation 2 ventilation 3 , 3 , 4 oxygen 3 , 5 , 5 , 7 nutrition 5 , 8 , 6 parenteral 7 nutrition 8 , 9 ibuprofen 8 , 10 , 10 , 11 steroids 10 , 12 , 12 , 13 rop 12 , 15 and 14 , 15 and 15 and 17 hemorrhage 15 and 18 were 16 intraventricular 17 hemorrhage 18 were 19 different ga and ventilation or apgar were independent factors for raised peak scr . 0 ###LEFT-WALL### 4 or 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 13 . 1 ga 2 and 2 and 3 ventilation 2 and 4 or 4 or 5 apgar 4 or 6 were 6 were 8 factors 7 independent 8 factors 8 factors 9 for 9 for 12 scr 10 raised 11 peak 11 peak 12 scr elbw neonates display trends similar to heavier neonates , [but] peak scr is higher , and the subsequent decrease slower . 0 ###LEFT-WALL### 2 neonates 0 ###LEFT-WALL### 3 display 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 21 . 1 elbw 2 neonates 2 neonates 3 display 3 display 4 trends 4 trends 5 similar 5 similar 6 to 6 to 8 neonates 7 heavier 8 neonates 9 , 12 scr 9 , 13 is 9 , 16 and 11 peak 12 scr 12 scr 13 is 13 is 14 higher 15 , 16 and 16 and 18 subsequent 16 and 19 decrease 17 the 18 subsequent 18 subsequent 19 decrease 19 decrease 20 slower raised creatinemia in elbw neonates reflects immaturity ( ga [ )(and morbidity ( ventilation , apgar ) . 0 ###LEFT-WALL### 2 creatinemia 0 ###LEFT-WALL### 6 reflects 0 ###LEFT-WALL### 18 . 1 raised 2 creatinemia 2 creatinemia 3 in 2 creatinemia 6 reflects 3 in 5 neonates 4 elbw 5 neonates 6 reflects 7 immaturity 7 immaturity 11 )(and 8 ( 11 )(and 9 ga 11 )(and 11 )(and 12 morbidity 11 )(and 14 ventilation 11 )(and 16 apgar 11 )(and 17 ) 13 ( 14 ventilation 14 ventilation 15 , 15 , 16 apgar 16 apgar 17 ) this study investigated maturational differences of selective auditory attention effects on transient evoked responses and 40 [-] hz auditory steady - state responses between children and adults . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 28 . 1 this 2 study 2 study 3 investigated 3 investigated 5 differences 4 maturational 5 differences 5 differences 6 of 6 of 10 effects 7 selective 9 attention 8 auditory 9 attention 9 attention 10 effects 10 effects 11 on 11 on 26 and 12 transient 13 evoked 13 evoked 14 responses 14 responses 15 and 15 and 23 responses 15 and 24 between 15 and 26 and 16 40 18 hz 18 hz 23 responses 19 auditory 22 state 20 steady 21 - 20 steady 22 state 22 state 23 responses 24 between 25 children 26 and 27 adults magnetoencephalography ( meg ) was recorded from children and adults performing a task where they attended to 40 [-] hz amplitude [-] modulated ( am ) tones of 1,200 hz while ignoring 40 [-] hz am tones of 800 hz . 0 ###LEFT-WALL### 3 meg 0 ###LEFT-WALL### 6 recorded 0 ###LEFT-WALL### 41 . 1 magnetoencephalography 3 meg 2 ( 3 meg 3 meg 4 ) 3 meg 5 was 5 was 6 recorded 6 recorded 7 from 6 recorded 14 where 7 from 9 and 8 children 9 and 9 and 10 adults 9 and 11 performing 11 performing 13 task 12 a 13 task 14 where 15 they 14 where 16 attended 15 they 16 attended 16 attended 17 to 16 attended 27 tones 16 attended 31 while 17 to 21 amplitude 18 40 20 hz 20 hz 21 amplitude 21 amplitude 23 modulated 21 amplitude 25 am 24 ( 25 am 25 am 26 ) 27 tones 28 of 28 of 30 hz 29 1,200 30 hz 31 while 32 ignoring 32 ignoring 37 tones 33 40 35 hz 35 hz 37 tones 36 am 37 tones 37 tones 38 of 38 of 40 hz 39 800 40 hz by using standard [dipole] - modeling procedures , the n1m of the transient evoked fields and [the] 40 - [hz] assrs were localized to secondary and primary auditory cortices , respectively . 0 ###LEFT-WALL### 10 n1m 0 ###LEFT-WALL### 15 fields 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 23 localized 0 ###LEFT-WALL### 32 . 1 by 2 using 1 by 8 , 1 by 10 n1m 2 using 7 procedures 3 standard 5 - 3 standard 6 modeling 6 modeling 7 procedures 9 the 10 n1m 10 n1m 11 of 10 n1m 14 evoked 10 n1m 15 fields 11 of 13 transient 12 the 13 transient 16 and 18 40 16 and 19 - 18 40 19 - 19 - 21 assrs 21 assrs 22 were 22 were 23 localized 23 localized 24 to 23 localized 31 respectively 24 to 26 and 25 secondary 26 and 26 and 29 cortices 26 and 30 , 27 primary 29 cortices 28 auditory 29 cortices source waveforms for the transient evoked fields and assrs were reconstructed at these locations and compared between attended and unattended tones . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 22 . 1 source 2 waveforms 2 waveforms 3 for 2 waveforms 18 attended 2 waveforms 19 and 3 for 5 transient 4 the 5 transient 5 transient 6 evoked 5 transient 8 and 5 transient 17 between 7 fields 8 and 8 and 9 assrs 8 and 15 and 10 were 11 reconstructed 10 were 15 and 11 reconstructed 12 at 12 at 14 locations 13 these 14 locations 15 and 16 compared 15 and 17 between 19 and 21 tones 20 unattended 21 tones source waveforms revealed attention enhances the sustained negativity of the transient evoked responses in both adults and children around 250 and 400 [m] s . 0 ###LEFT-WALL### 2 waveforms 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 25 . 1 source 2 waveforms 2 waveforms 3 revealed 3 revealed 4 attention 3 revealed 5 enhances 4 attention 5 enhances 5 enhances 8 negativity 5 enhances 14 in 5 enhances 19 around 6 the 8 negativity 7 sustained 8 negativity 8 negativity 9 of 9 of 13 responses 10 the 13 responses 11 transient 12 evoked 12 evoked 13 responses 14 in 17 and 15 both 17 and 16 adults 17 and 17 and 18 children 19 around 24 s 20 250 21 and 21 and 22 400 21 and 24 s assrs were also found to be enhanced within this time range but only for adults . 0 ###LEFT-WALL### 1 assrs 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 . 1 assrs 2 were 2 were 4 found 3 also 4 found 4 found 5 to 5 to 6 be 6 be 7 enhanced 7 enhanced 12 but 8 within 11 range 8 within 12 but 9 this 11 range 10 time 11 range 12 but 13 only 12 but 14 for 14 for 15 adults the results provide evidence for a limited role of attention modification of the 40 - [hz] assrs in children around the age of 12 years old . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 27 . 1 the 2 results 2 results 3 provide 3 provide 4 evidence 3 provide 5 for 5 for 8 role 6 a 7 limited 6 a 8 role 7 limited 8 role 8 role 9 of 8 role 12 of 9 of 11 modification 10 attention 11 modification 12 of 14 40 13 the 14 40 15 - 17 assrs 17 assrs 18 in 18 in 19 children 19 children 20 around 19 children 23 of 20 around 22 age 21 the 22 age 23 of 24 12 24 12 26 old 25 years 26 old because assrs are generated in a lower auditory processing stage as compared to the transient auditory evoked responses , findings from the present study could indicate that the maturation of attention progresses in top [-] [to] - bottom manner . 0 ###LEFT-WALL### 20 findings 0 ###LEFT-WALL### 40 . 1 because 2 assrs 1 because 4 generated 1 because 20 findings 2 assrs 3 are 3 are 4 generated 4 generated 5 in 4 generated 12 compared 5 in 10 stage 6 a 10 stage 7 lower 10 stage 8 auditory 10 stage 9 processing 10 stage 11 as 12 compared 13 to 18 responses 13 to 19 , 13 to 20 findings 14 the 18 responses 15 transient 18 responses 16 auditory 18 responses 17 evoked 18 responses 20 findings 21 from 20 findings 25 could 21 from 24 study 22 the 24 study 23 present 24 study 25 could 26 indicate 26 indicate 27 that 27 that 29 maturation 27 that 32 progresses 28 the 29 maturation 29 maturation 30 of 29 maturation 32 progresses 30 of 31 attention 32 progresses 33 in 33 in 39 manner 34 top 37 - 34 top 38 bottom 38 bottom 39 manner these findings fit with the notion that as a person gains sensory experience selective gating of [relevant] from irrelevant information likely occurs at earlier and earlier processing levels in order to become more automatic and efficient . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 fit 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 37 . 1 these 2 findings 2 findings 3 fit 3 fit 4 with 3 fit 7 that 3 fit 8 as 4 with 6 notion 5 the 6 notion 8 as 13 experience 8 as 24 earlier 9 a 13 experience 10 person 13 experience 11 gains 13 experience 12 sensory 13 experience 13 experience 15 gating 13 experience 23 at 14 selective 15 gating 15 gating 16 of 15 gating 22 occurs 16 of 18 from 18 from 20 information 19 irrelevant 20 information 21 likely 22 occurs 22 occurs 23 at 25 and 27 processing 25 and 28 levels 26 earlier 27 processing 27 processing 28 levels 28 levels 29 in 28 levels 31 to 29 in 30 order 31 to 32 become 32 become 33 more 32 become 35 and 34 automatic 35 and 35 and 36 efficient populations [are] becoming progressively older thus presenting symptoms of diminished organ function due to degenerative processes . 0 ###LEFT-WALL### 1 populations 0 ###LEFT-WALL### 12 function 0 ###LEFT-WALL### 17 . 1 populations 3 becoming 1 populations 7 presenting 1 populations 12 function 3 becoming 5 older 4 progressively 5 older 6 thus 7 presenting 7 presenting 8 symptoms 8 symptoms 9 of 9 of 11 organ 10 diminished 11 organ 12 function 14 to 13 due 14 to 14 to 16 processes 15 degenerative 16 processes these may be physiological or caused by additional factors damaging the organ . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 5 or 0 ###LEFT-WALL### 13 . 1 these 5 or 2 may 3 be 2 may 5 or 3 be 4 physiological 5 or 6 caused 5 or 7 by 7 by 9 factors 8 additional 9 factors 9 factors 10 damaging 10 damaging 12 organ 11 the 12 organ presbyacusis refers to the physiological age - related changes of the peripheral and central auditory system leading to hearing impairment and difficulty understanding spoken language . 0 ###LEFT-WALL### 1 presbyacusis 0 ###LEFT-WALL### 2 refers 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 26 . 1 presbyacusis 2 refers 2 refers 3 to 3 to 6 age 4 the 6 age 5 physiological 6 age 7 - 8 related 8 related 13 and 8 related 18 to 9 changes 10 of 9 changes 13 and 10 of 12 peripheral 11 the 12 peripheral 13 and 16 system 13 and 17 leading 14 central 16 system 15 auditory 16 system 18 to 19 hearing 19 hearing 21 and 19 hearing 23 understanding 20 impairment 21 and 21 and 22 difficulty 23 understanding 25 language 24 spoken 25 language in contrast to epidemiological data of other continents , the prevalence of age - related hearing loss ( arhl ) in europe is not well defined , due in part to the use of different classification systems . 0 ###LEFT-WALL### 16 hearing 0 ###LEFT-WALL### 23 is 0 ###LEFT-WALL### 38 . 1 in 2 contrast 1 in 16 hearing 2 contrast 3 to 3 to 5 data 4 epidemiological 5 data 5 data 6 of 5 data 15 related 6 of 8 continents 7 other 8 continents 8 continents 11 prevalence 9 , 11 prevalence 10 the 11 prevalence 11 prevalence 12 of 11 prevalence 14 - 12 of 13 age 16 hearing 17 loss 16 hearing 21 in 16 hearing 23 is 17 loss 19 arhl 18 ( 19 arhl 19 arhl 20 ) 21 in 22 europe 23 is 24 not 23 is 25 well 25 well 26 defined 26 defined 27 , 26 defined 28 due 28 due 30 part 29 in 30 part 30 part 31 to 31 to 33 use 32 the 33 use 33 use 34 of 34 of 37 systems 35 different 36 classification 36 classification 37 systems we performed a systematic literature review with the aim of gaining a picture of the prevalence of arhl in europe . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 performed 0 ###LEFT-WALL### 21 . 1 we 2 performed 2 performed 6 review 2 performed 7 with 2 performed 19 in 3 a 4 systematic 3 a 6 review 4 systematic 5 literature 5 literature 6 review 7 with 9 aim 8 the 9 aim 9 aim 10 of 9 aim 17 of 10 of 11 gaining 11 gaining 13 picture 12 a 13 picture 13 picture 14 of 14 of 16 prevalence 15 the 16 prevalence 17 of 18 arhl 19 in 20 europe the review included only population and epidemiological studies in english since 1970 with samples in european countries with subjects aged 60 years and above . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 25 . 1 the 2 review 2 review 3 included 3 included 4 only 3 included 6 and 3 included 9 in 3 included 11 since 3 included 13 with 5 population 6 and 6 and 8 studies 7 epidemiological 8 studies 9 in 10 english 11 since 12 1970 13 with 14 samples 14 samples 15 in 15 in 17 countries 16 european 17 countries 17 countries 23 and 18 with 22 years 18 with 23 and 19 subjects 20 aged 20 aged 22 years 21 60 22 years 23 and 24 above nineteen studies met our selection criteria and additional five studies reported self - reported hearing impairment . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 met 0 ###LEFT-WALL### 14 reported 0 ###LEFT-WALL### 17 . 1 nineteen 2 studies 2 studies 3 met 3 met 12 self 4 our 12 self 5 selection 12 self 6 criteria 7 and 7 and 10 studies 7 and 11 reported 7 and 12 self 8 additional 10 studies 9 five 10 studies 13 - 14 reported 14 reported 15 hearing 15 hearing 16 impairment when these data were crudely averaged and interpolated , roughly 30 % of men and 20 % of women in europe were found to have a hearing loss of 30 db hl or more by age 70 years , [and] 55 % of men and 45 % of women by age 80 years . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 9 , 1 when 3 data 1 when 4 were 1 when 7 and 2 these 3 data 3 data 4 were 4 were 5 crudely 6 averaged 7 and 7 and 8 interpolated 9 , 17 % 10 roughly 17 % 11 30 12 % 11 30 15 and 12 % 13 of 13 of 14 men 15 and 16 20 15 and 17 % 17 % 18 of 17 % 20 in 17 % 22 were 18 of 19 women 20 in 21 europe 22 were 23 found 23 found 24 to 24 to 25 have 25 have 27 hearing 25 have 33 or 25 have 35 by 26 a 27 hearing 28 loss 29 of 28 loss 33 or 29 of 32 hl 30 30 31 db 31 db 32 hl 33 or 34 more 35 by 38 years 36 age 38 years 37 70 38 years 38 years 47 % 39 , 47 % 41 55 42 % 41 55 45 and 42 % 43 of 43 of 44 men 45 and 46 45 45 and 47 % 47 % 48 of 47 % 50 by 47 % 54 . 48 of 49 women 50 by 53 years 51 age 53 years 52 80 53 years apparent problems in comparing the available data were the heterogeneity of measures and cut - offs for grades of hearing impairment . 0 ###LEFT-WALL### 2 problems 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 22 . 1 apparent 2 problems 2 problems 3 in 2 problems 8 were 3 in 4 comparing 4 comparing 7 data 5 the 7 data 6 available 7 data 8 were 10 heterogeneity 9 the 10 heterogeneity 10 heterogeneity 11 of 11 of 13 and 12 measures 13 and 13 and 14 cut 15 - 16 offs 16 offs 17 for 16 offs 19 of 17 for 18 grades 19 of 20 hearing 20 hearing 21 impairment our systematic review of epidemiological data revealed more information gaps than information that would allow gaining a meaningful picture of prevalence of arhl . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 7 revealed 0 ###LEFT-WALL### 24 . 1 our 3 review 2 systematic 3 review 3 review 4 of 3 review 7 revealed 4 of 6 data 5 epidemiological 6 data 7 revealed 10 gaps 7 revealed 11 than 8 more 10 gaps 9 information 10 gaps 11 than 12 information 11 than 20 of 12 information 13 that 12 information 15 allow 12 information 16 gaining 13 that 14 would 14 would 15 allow 16 gaining 19 picture 17 a 18 meaningful 17 a 19 picture 18 meaningful 19 picture 20 of 21 prevalence 21 prevalence 22 of 22 of 23 arhl the need [for] standardized procedures when collecting and reporting epidemiological data on hearing loss has become evident . 0 ###LEFT-WALL### 2 need 0 ###LEFT-WALL### 4 standardized 0 ###LEFT-WALL### 18 . 1 the 2 need 2 need 4 standardized 4 standardized 5 procedures 5 procedures 6 when 6 when 11 data 6 when 16 become 7 collecting 8 and 8 and 9 reporting 8 and 11 data 10 epidemiological 11 data 11 data 12 on 11 data 15 has 12 on 13 hearing 13 hearing 14 loss 15 has 16 become 16 become 17 evident development of hearing loss over time in conjunction with the increase in life expectancy is a major factor determining strategies of detection and correction of arhl . 0 ###LEFT-WALL### 1 development 0 ###LEFT-WALL### 15 is 0 ###LEFT-WALL### 27 . 1 development 2 of 1 development 15 is 2 of 3 hearing 3 hearing 4 loss 4 loss 5 over 4 loss 9 with 5 over 6 time 7 in 8 conjunction 8 conjunction 9 with 9 with 11 increase 10 the 11 increase 11 increase 12 in 12 in 14 expectancy 13 life 14 expectancy 15 is 18 factor 16 a 17 major 16 a 18 factor 17 major 18 factor 18 factor 19 determining 18 factor 21 of 18 factor 25 of 19 determining 20 strategies 21 of 23 and 22 detection 23 and 23 and 24 correction 25 of 26 arhl thus , we recommend using the who classification of hearing loss strictly [and] including standard audiometric measures in population - based health surveys . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 recommend 1 thus 2 , 1 thus 3 we 3 we 4 recommend 4 recommend 5 using 4 recommend 14 including 5 using 8 classification 6 the 8 classification 7 who 8 classification 8 classification 9 of 9 of 10 hearing 10 hearing 11 loss 12 strictly 14 including 14 including 17 measures 15 standard 17 measures 16 audiometric 17 measures 17 measures 18 in 18 in 19 population 19 population 23 surveys 20 - 23 surveys 21 based 22 health 22 health 23 surveys 23 surveys 24 . none unlabelled : in this population [-] based study of more than 2,600 elderly , people with dementia received less preventive treatment for osteoporosis compared to people without dementia , although osteoporotic fractures were more common in patients with dementia . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 8 based 1 none 2 unlabelled 1 none 3 : 1 none 8 based 2 unlabelled 3 : 3 : 4 in 4 in 6 population 5 this 6 population 8 based 9 study 9 study 10 of 9 study 25 compared 10 of 16 people 11 more 12 than 12 than 13 2,600 13 2,600 16 people 14 elderly 15 , 14 elderly 16 people 16 people 17 with 17 with 22 treatment 18 dementia 19 received 19 received 22 treatment 20 less 21 preventive 21 preventive 22 treatment 22 treatment 23 for 23 for 24 osteoporosis 25 compared 26 to 25 compared 28 without 25 compared 31 although 26 to 27 people 28 without 29 dementia 30 , 31 although 31 although 33 fractures 31 although 34 were 31 although 41 . 32 osteoporotic 33 fractures 33 fractures 34 were 34 were 36 common 35 more 36 common 36 common 37 in 36 common 39 with 37 in 38 patients 39 with 40 dementia thus , our results indicate an undertreatment of osteoporosis in dementia . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 indicate 0 ###LEFT-WALL### 12 . 1 thus 2 , 1 thus 4 results 3 our 4 results 4 results 5 indicate 5 indicate 7 undertreatment 5 indicate 10 in 6 an 7 undertreatment 7 undertreatment 8 of 8 of 9 osteoporosis 10 in 11 dementia introduction : this study compares the use of osteoporosis drugs in elderly [with] and [without] dementia , taking into account osteoporotic fractures and type of housing . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 compares 2 : 27 . 3 this 4 study 4 study 5 compares 5 compares 23 and 6 the 7 use 7 use 8 of 7 use 23 and 8 of 10 drugs 9 osteoporosis 10 drugs 10 drugs 11 in 10 drugs 18 taking 11 in 14 and 12 elderly 14 and 14 and 16 dementia 14 and 17 , 18 taking 19 into 19 into 22 fractures 20 account 22 fractures 21 osteoporotic 22 fractures 23 and 25 of 24 type 25 of 25 of 26 housing methods : we analyzed data from the baseline examination ( 2001 - 2004 ) of the swedish national study on aging and care - kungsholmen ( snac - k ) , stockholm , sweden . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 analyzed 2 : 31 , 2 : 35 . 3 we 4 analyzed 4 analyzed 5 data 4 analyzed 6 from 4 analyzed 20 on 6 from 9 examination 7 the 9 examination 8 baseline 9 examination 9 examination 12 - 9 examination 15 of 10 ( 12 - 11 2001 12 - 12 - 13 2004 12 - 14 ) 15 of 19 study 16 the 19 study 17 swedish 19 study 18 national 19 study 20 on 22 and 21 aging 22 and 22 and 23 care 23 care 27 snac 24 - 27 snac 25 kungsholmen 27 snac 26 ( 27 snac 27 snac 28 - 27 snac 29 k 27 snac 31 , 28 - 29 k 29 k 30 ) 31 , 32 stockholm 31 , 33 , 33 , 34 sweden participants were aged ≥ 66 years ( n = 2610 ) . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 12 . 1 participants 2 were 2 were 4 ≥ 3 aged 4 ≥ 4 ≥ 9 = 5 66 6 years 6 years 9 = 7 ( 9 = 8 n 9 = 9 = 10 2610 9 = 11 ) we analysed the use of bisphosphonates , raloxifene , and calcium/vitamin d combinations in relation to clinically based dementia diagnosis . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 analysed 0 ###LEFT-WALL### 21 . 1 we 2 analysed 2 analysed 10 and 2 analysed 16 to 3 the 4 use 4 use 5 of 4 use 10 and 5 of 6 bisphosphonates 6 bisphosphonates 8 raloxifene 7 , 8 raloxifene 8 raloxifene 9 , 9 , 10 and 10 and 13 combinations 11 calcium/vitamin 12 d 11 calcium/vitamin 13 combinations 14 in 15 relation 15 relation 16 to 16 to 20 diagnosis 17 clinically 18 based 18 based 19 dementia 19 dementia 20 diagnosis information about osteoporotic fractures during the previous 4 years was obtained from the swedish national patient register . 0 ###LEFT-WALL### 1 information 0 ###LEFT-WALL### 11 obtained 0 ###LEFT-WALL### 18 . 1 information 2 about 1 information 10 was 2 about 4 fractures 3 osteoporotic 4 fractures 4 fractures 5 during 5 during 9 years 6 the 7 previous 6 the 8 4 8 4 9 years 10 was 11 obtained 11 obtained 12 from 12 from 17 register 13 the 14 swedish 14 swedish 17 register 15 national 16 patient 16 patient 17 register we used logistic regression to analyze the association between dementia status and use of osteoporosis drugs . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 0 ###LEFT-WALL### 17 . 1 we 2 used 2 used 4 regression 2 used 5 to 2 used 6 analyze 3 logistic 4 regression 5 to 6 analyze 6 analyze 8 association 6 analyze 9 between 7 the 8 association 9 between 12 and 10 dementia 11 status 11 status 12 and 12 and 13 use 12 and 14 of 14 of 16 drugs 15 osteoporosis 16 drugs results : osteoporosis drugs ( mainly calcium/vitamin d combinations ) were used by 5 % of the persons with dementia [and] 12 % of the persons without dementia . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 drugs 2 : 12 used 2 : 29 . 3 osteoporosis 4 drugs 4 drugs 9 combinations 4 drugs 11 were 5 ( 6 mainly 5 ( 9 combinations 7 calcium/vitamin 8 d 7 calcium/vitamin 9 combinations 9 combinations 10 ) 11 were 12 used 12 used 13 by 12 used 19 with 12 used 27 without 13 by 15 % 14 5 15 % 15 % 16 of 16 of 18 persons 17 the 18 persons 19 with 20 dementia 19 with 23 % 22 12 23 % 23 % 24 of 24 of 26 persons 25 the 26 persons 27 without 28 dementia furthermore , 25 % of the persons with dementia [and] 7 % of the persons without dementia had had at least one osteoporotic fracture during the past 4 years . 0 ###LEFT-WALL### 4 % 0 ###LEFT-WALL### 19 had 0 ###LEFT-WALL### 30 . 1 furthermore 2 , 1 furthermore 4 % 3 25 4 % 4 % 5 of 4 % 19 had 5 of 7 persons 6 the 7 persons 7 persons 8 with 8 with 9 dementia 9 dementia 12 % 9 dementia 18 had 11 7 12 % 12 % 13 of 12 % 18 had 13 of 15 persons 14 the 15 persons 15 persons 16 without 16 without 17 dementia 19 had 24 fracture 19 had 25 during 20 at 21 least 21 least 22 one 22 one 24 fracture 23 osteoporotic 24 fracture 25 during 29 years 26 the 27 past 26 the 28 4 28 4 29 years after controlling for age , sex , osteoporotic fractures , and type of housing ( [own] home or institution ) , persons with dementia were less likely to use osteoporosis drugs than persons without dementia ( or [=] 0.34 [;] 95 % ci , 0.19 - 0.59 ) . 0 ###LEFT-WALL### 22 persons 0 ###LEFT-WALL### 25 were 1 after 2 controlling 1 after 21 , 1 after 22 persons 2 controlling 3 for 2 controlling 11 and 3 for 4 age 4 age 6 sex 5 , 6 sex 6 sex 7 , 8 osteoporotic 9 fractures 9 fractures 11 and 10 , 11 and 11 and 12 type 11 and 13 of 11 and 18 or 13 of 14 housing 15 ( 18 or 17 home 18 or 18 or 19 institution 18 or 20 ) 22 persons 23 with 22 persons 25 were 23 with 24 dementia 25 were 26 less 25 were 28 to 25 were 32 than 27 likely 28 to 28 to 29 use 29 use 31 drugs 30 osteoporosis 31 drugs 32 than 33 persons 33 persons 34 without 33 persons 43 ci 34 without 35 dementia 36 ( 43 ci 37 or 43 ci 39 0.34 43 ci 41 95 43 ci 42 % 43 ci 43 ci 45 0.19 43 ci 49 . 44 , 45 0.19 45 0.19 47 0.59 45 0.19 49 . 46 - 47 0.59 47 0.59 48 ) conclusions : our results indicate an undertreatment of osteoporosis in persons with dementia , although osteoporotic fractures are common among these patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 are 0 ###LEFT-WALL### 23 . 2 : 4 results 2 : 5 indicate 3 our 4 results 4 results 5 indicate 5 indicate 7 undertreatment 5 indicate 10 in 5 indicate 12 with 5 indicate 15 although 6 an 7 undertreatment 7 undertreatment 8 of 8 of 9 osteoporosis 10 in 11 persons 12 with 13 dementia 14 , 15 although 15 although 17 fractures 16 osteoporotic 17 fractures 17 fractures 18 are 18 are 19 common 19 common 20 among 20 among 22 patients 21 these 22 patients degenerative disorders of the musculoskeletal system , in particular osteoarthritis , are among the most common diseases of the elderly and their importance in an aging society is continuously increasing . 0 ###LEFT-WALL### 1 degenerative 0 ###LEFT-WALL### 28 is 0 ###LEFT-WALL### 31 . 1 degenerative 2 disorders 1 degenerative 12 are 1 degenerative 28 is 2 disorders 3 of 2 disorders 12 are 3 of 6 system 4 the 6 system 5 musculoskeletal 6 system 6 system 8 in 7 , 8 in 8 in 10 osteoarthritis 8 in 11 , 9 particular 10 osteoarthritis 12 are 13 among 12 are 24 in 13 among 17 diseases 14 the 15 most 15 most 17 diseases 16 common 17 diseases 17 diseases 18 of 18 of 21 and 19 the 20 elderly 20 elderly 21 and 21 and 23 importance 22 their 23 importance 24 in 27 society 25 an 27 society 26 aging 27 society 28 is 30 increasing 29 continuously 30 increasing correspondingly , many surgical interventions are undertaken and pathological specimens submitted for histopathologic workup . 0 ###LEFT-WALL### 5 interventions 0 ###LEFT-WALL### 7 undertaken 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 15 . 1 correspondingly 2 , 1 correspondingly 5 interventions 3 many 5 interventions 4 surgical 5 interventions 5 interventions 6 are 6 are 7 undertaken 8 and 10 specimens 8 and 11 submitted 9 pathological 10 specimens 10 specimens 11 submitted 11 submitted 12 for 12 for 14 workup 13 histopathologic 14 workup the pathophysiology of osteoarthritis , which ultimately leads to joint destruction , is still poorly understood . 0 ###LEFT-WALL### 2 pathophysiology 0 ###LEFT-WALL### 16 understood 0 ###LEFT-WALL### 17 . 1 the 2 pathophysiology 2 pathophysiology 3 of 2 pathophysiology 6 which 2 pathophysiology 13 is 3 of 4 osteoarthritis 5 , 6 which 6 which 8 leads 6 which 12 , 7 ultimately 8 leads 8 leads 9 to 9 to 10 joint 10 joint 11 destruction 13 is 16 understood 14 still 16 understood 15 poorly 16 understood the question remains as to whether the cause lies [(] mainly [ )(within the chondrocytes themselves [(] e.g . cellular aging/senescence [ )(or whether the synovial membrane or the subchondral bone are equally or even more important factors . 0 ###LEFT-WALL### 2 question 0 ###LEFT-WALL### 3 remains 0 ###LEFT-WALL### 19 . 1 the 2 question 2 question 3 remains 3 remains 5 to 3 remains 18 e.g 4 as 5 to 5 to 6 whether 6 whether 8 cause 6 whether 9 lies 7 the 8 cause 8 cause 9 lies 9 lies 11 mainly 9 lies 16 themselves 11 mainly 13 )(within 13 )(within 15 chondrocytes 14 the 15 chondrocytes 19 . 34 or 19 . 39 . 20 cellular 21 aging/senescence 21 aging/senescence 23 )(or 23 )(or 24 whether 23 )(or 28 or 23 )(or 32 are 23 )(or 34 or 25 the 27 membrane 26 synovial 27 membrane 27 membrane 28 or 28 or 31 bone 28 or 32 are 29 the 31 bone 30 subchondral 31 bone 32 are 33 equally 34 or 38 factors 35 even 36 more 36 more 37 important 37 important 38 factors the process of joint destruction can be evaluated in terms of pathogenesis ( typing ) , extent ( staging ) and degree of the most extensive focal damage [(] grading [ )( 0 ###LEFT-WALL### 2 process 0 ###LEFT-WALL### 8 evaluated 0 ###LEFT-WALL### 32 )( 1 the 2 process 2 process 3 of 2 process 6 can 3 of 5 destruction 4 joint 5 destruction 6 can 7 be 7 be 8 evaluated 8 evaluated 9 in 9 in 21 and 10 terms 11 of 10 terms 21 and 11 of 12 pathogenesis 12 pathogenesis 14 typing 12 pathogenesis 17 extent 13 ( 14 typing 14 typing 15 ) 16 , 17 extent 17 extent 19 staging 17 extent 20 ) 18 ( 19 staging 19 staging 20 ) 21 and 22 degree 21 and 23 of 23 of 30 grading 24 the 25 most 25 most 30 grading 26 extensive 28 damage 27 focal 28 damage 28 damage 30 grading because of the heterogeneity of the disease and substantial individual differences in progression , classification and grading of cartilage degeneration represents a complex task . 0 ###LEFT-WALL### 20 degeneration 0 ###LEFT-WALL### 21 represents 0 ###LEFT-WALL### 25 . 1 because 2 of 1 because 20 degeneration 2 of 8 and 3 the 4 heterogeneity 4 heterogeneity 5 of 4 heterogeneity 8 and 5 of 7 disease 6 the 7 disease 8 and 11 differences 9 substantial 10 individual 10 individual 11 differences 11 differences 12 in 12 in 16 and 13 progression 14 , 14 , 15 classification 14 , 16 and 16 and 17 grading 16 and 18 of 18 of 19 cartilage 20 degeneration 21 represents 21 represents 24 task 22 a 24 task 23 complex 24 task any pathology report should be concise and delineate only the essential features . 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 13 . 1 any 3 report 2 pathology 3 report 3 report 4 should 4 should 7 and 5 be 6 concise 5 be 7 and 7 and 8 delineate 8 delineate 9 only 8 delineate 12 features 10 the 12 features 11 essential 12 features differentiating between primary osteoarthritis and secondary degenerative changes , e.g [.] , due to previously unknown rheumatoid disease , bone necrosis or an infection of the joint , is of particular clinical interest . 0 ###LEFT-WALL### 10 e.g 0 ###LEFT-WALL### 29 is 0 ###LEFT-WALL### 34 . 1 differentiating 2 between 1 differentiating 9 , 1 differentiating 10 e.g 2 between 5 and 3 primary 4 osteoarthritis 4 osteoarthritis 5 and 5 and 8 changes 5 and 9 , 6 secondary 8 changes 7 degenerative 8 changes 10 e.g 13 due 10 e.g 22 or 10 e.g 29 is 12 , 13 due 13 due 14 to 13 due 19 , 14 to 18 disease 15 previously 16 unknown 16 unknown 18 disease 17 rheumatoid 18 disease 19 , 22 or 20 bone 21 necrosis 21 necrosis 22 or 22 or 24 infection 22 or 25 of 22 or 28 , 23 an 24 infection 25 of 27 joint 26 the 27 joint 29 is 30 of 30 of 33 interest 31 particular 33 interest 32 clinical 33 interest purpose : to establish preliminary normative data for macular thickness ( mt ) and macular volume ( mv ) by cirrus high - definition optical coherence tomography ( carl zeiss meditec , dublin , ca ) . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 3 to 2 : 4 establish 3 to 4 establish 4 establish 14 and 4 establish 20 by 5 preliminary 7 data 6 normative 7 data 7 data 8 for 7 data 14 and 8 for 10 thickness 9 macular 10 thickness 10 thickness 12 mt 11 ( 12 mt 12 mt 13 ) 14 and 16 volume 14 and 18 mv 15 macular 16 volume 17 ( 18 mv 18 mv 19 ) 20 by 27 tomography 21 cirrus 27 tomography 22 high 23 - 22 high 24 definition 24 definition 27 tomography 25 optical 26 coherence 26 coherence 27 tomography 27 tomography 31 meditec 27 tomography 33 dublin 27 tomography 35 ca 28 ( 31 meditec 29 carl 30 zeiss 30 zeiss 31 meditec 31 meditec 32 , 32 , 33 dublin 33 dublin 34 , 34 , 35 ca 35 ca 36 ) retinal thicknesses in nine early treatment diabetic retinopathy study subfields ( including central subfield thickness [[] [cst] ] [ )(, mt , and mv were measured with cirrus high - definition optical coherence tomography . 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 26 measured 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 35 . 1 retinal 2 thicknesses 2 thicknesses 3 in 2 thicknesses 23 and 3 in 10 subfields 4 nine 10 subfields 5 early 6 treatment 6 treatment 7 diabetic 7 diabetic 8 retinopathy 8 retinopathy 10 subfields 9 study 10 subfields 10 subfields 12 including 10 subfields 21 mt 11 ( 12 including 12 including 15 thickness 12 including 18 ] 13 central 15 thickness 14 subfield 15 thickness 20 )(, 21 mt 21 mt 22 , 23 and 24 mv 23 and 25 were 25 were 26 measured 26 measured 27 with 26 measured 29 high 27 with 28 cirrus 30 - 34 tomography 31 definition 34 tomography 32 optical 33 coherence 33 coherence 34 tomography effects of age , gender , lens status , and diabetic status on these measurements were analyzed . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 analyzed 0 ###LEFT-WALL### 18 . 1 effects 2 of 1 effects 4 , 2 of 3 age 4 , 5 gender 4 , 6 , 6 , 8 status 6 , 10 and 7 lens 8 status 9 , 10 and 10 and 12 status 10 and 13 on 10 and 16 were 11 diabetic 12 status 13 on 15 measurements 14 these 15 measurements 16 were 17 analyzed results : the mean ± sd [cst] , mt , and mv were 262.4 ± 22.8 μm , 281.3 ± 14.5 μm , and 10.1 ± 0.6 mm3 , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 mean 2 : 5 ± 2 : 11 and 2 : 24 and 3 the 4 mean 4 mean 5 ± 5 ± 6 sd 6 sd 9 mt 8 , 9 mt 9 mt 10 , 11 and 19 281.3 11 and 20 ± 12 mv 19 281.3 13 were 14 262.4 13 were 15 ± 13 were 18 , 13 were 19 281.3 15 ± 17 μm 16 22.8 17 μm 19 281.3 20 ± 20 ± 22 μm 21 14.5 22 μm 23 , 24 and 24 and 25 10.1 24 and 26 ± 25 10.1 26 ± 26 ± 28 mm3 26 ± 30 respectively 27 0.6 28 mm3 29 , 30 respectively 30 respectively 31 . although [cst] [and] age were not associated ( p = 0.45 ) , both mean mt and mean mv declined with age ( p < 0.0001 ) . 0 ###LEFT-WALL### 14 both 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 28 . 1 although 4 age 1 although 7 associated 1 although 13 , 1 although 14 both 4 age 5 were 5 were 6 not 5 were 7 associated 7 associated 10 = 8 ( 10 = 9 p 10 = 10 = 11 0.45 10 = 12 ) 14 both 17 and 15 mean 16 mt 15 mean 17 and 17 and 18 mean 18 mean 19 mv 18 mean 20 declined 19 mv 20 declined 20 declined 21 with 21 with 22 age 22 age 25 < 23 ( 25 < 24 p 25 < 25 < 26 0.0001 25 < 27 ) [central] subfield thickness ( p = 0.002 ) , mean mt ( p = 0.021 ) , and mv ( p = 0.041 ) were higher in men compared with women . 0 ###LEFT-WALL### 2 subfield 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 32 . 2 subfield 3 thickness 3 thickness 6 = 4 ( 6 = 5 p 6 = 6 = 7 0.002 6 = 8 ) 9 , 10 mean 10 mean 18 and 10 mean 25 were 11 mt 14 = 11 mt 18 and 12 ( 14 = 13 p 14 = 14 = 15 0.021 14 = 16 ) 17 , 18 and 18 and 19 mv 18 and 25 were 19 mv 22 = 20 ( 22 = 21 p 22 = 22 = 23 0.041 22 = 24 ) 25 were 26 higher 26 higher 27 in 27 in 28 men 28 men 29 compared 29 compared 30 with 30 with 31 women neither lens status nor diabetic status affected [cst] , mt , or mv . 0 ###LEFT-WALL### 12 or 0 ###LEFT-WALL### 14 . 1 neither 4 nor 2 lens 3 status 3 status 4 nor 4 nor 6 status 4 nor 9 , 5 diabetic 6 status 6 status 7 affected 9 , 10 mt 9 , 12 or 11 , 12 or 12 or 13 mv conclusion : a pilot study showed that preliminary normative [cst] , mt , and mv values were obtained by cirrus high - definition optical coherence tomography . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 5 study 2 : 6 showed 3 a 5 study 4 pilot 5 study 5 study 6 showed 6 showed 7 that 6 showed 12 mt 6 showed 14 and 6 showed 19 by 8 preliminary 12 mt 9 normative 11 , 9 normative 12 mt 13 , 14 and 14 and 15 mv 15 mv 16 values 15 mv 17 were 15 mv 18 obtained 16 values 17 were 19 by 26 tomography 20 cirrus 26 tomography 21 high 22 - 21 high 23 definition 23 definition 26 tomography 24 optical 25 coherence 25 coherence 26 tomography the authors propose that [cst] ranges from 216.8 μm to 308 μm in normal eyes . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 propose 0 ###LEFT-WALL### 16 . 1 the 2 authors 2 authors 3 propose 3 propose 4 that 3 propose 6 ranges 4 that 6 ranges 6 ranges 7 from 6 ranges 13 in 7 from 10 to 8 216.8 9 μm 9 μm 10 to 10 to 12 μm 11 308 12 μm 13 in 15 eyes 14 normal 15 eyes older age and female gender were associated with thinner mt . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 11 . 1 older 2 age 2 age 3 and 3 and 5 gender 3 and 6 were 4 female 5 gender 6 were 7 associated 7 associated 8 with 8 with 10 mt 9 thinner 10 mt background and aims : the aim of the present study was to determine whether age and gender affect the imbalance between oxidant production and antioxidant levels in age - related macular degeneration ( armd ) patients . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aims 4 : 36 patients 4 : 37 . 5 the 6 aim 6 aim 7 of 6 aim 21 between 6 aim 24 and 7 of 9 present 8 the 9 present 9 present 10 study 9 present 13 determine 10 study 11 was 11 was 12 to 11 was 13 determine 12 to 13 determine 13 determine 14 whether 14 whether 16 and 14 whether 18 affect 15 age 16 and 16 and 17 gender 16 and 18 affect 18 affect 20 imbalance 19 the 20 imbalance 21 between 23 production 22 oxidant 23 production 24 and 26 levels 24 and 27 in 24 and 36 patients 25 antioxidant 26 levels 27 in 28 age 28 age 32 degeneration 29 - 32 degeneration 30 related 32 degeneration 31 macular 32 degeneration 32 degeneration 34 armd 32 degeneration 35 ) 33 ( 34 armd 34 armd 35 ) methods : total superoxide dismutase ( t - sod ) , total glutathione peroxidase ( t - gshpx ) , and [catalase] ( cat ) activities [,] [as] well as malondialdehyde ( mda ) , protein carbonyl ( pc ) , 8 - hydroxy - 29 - deoxyguanosine ( 8 - ohdg ) and total oxidation status ( tos ) levels , were measured in the following groups subdivided by age and gender [:] 156 early - armd patients [;] 80 wet - late armd patients [;] 72 dry - late armd patients [;] and 207 healthy controls . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 11 , 1 methods 2 : 2 : 5 dismutase 3 total 5 dismutase 4 superoxide 5 dismutase 5 dismutase 7 t 5 dismutase 9 sod 6 ( 7 t 7 t 8 - 8 - 9 sod 9 sod 10 ) 11 , 12 total 11 , 20 , 12 total 14 peroxidase 13 glutathione 14 peroxidase 14 peroxidase 16 t 14 peroxidase 18 gshpx 15 ( 16 t 16 t 17 - 17 - 18 gshpx 18 gshpx 19 ) 20 , 21 and 21 and 26 activities 21 and 29 well 23 ( 24 cat 24 cat 25 ) 24 cat 26 activities 26 activities 29 well 29 well 30 as 29 well 37 carbonyl 30 as 36 protein 31 malondialdehyde 33 mda 31 malondialdehyde 35 , 31 malondialdehyde 36 protein 32 ( 33 mda 33 mda 34 ) 37 carbonyl 39 pc 37 carbonyl 43 - 38 ( 39 pc 39 pc 40 ) 41 , 43 - 42 8 43 - 43 - 54 and 44 hydroxy 47 - 44 hydroxy 54 and 45 - 47 - 46 29 47 - 47 - 48 deoxyguanosine 47 - 53 ) 48 deoxyguanosine 51 - 49 ( 51 - 50 8 51 - 51 - 52 ohdg 51 - 53 ) 54 and 56 oxidation 54 and 57 status 54 and 62 , 55 total 56 oxidation 57 status 59 tos 57 status 62 , 58 ( 59 tos 59 tos 60 ) 61 levels 62 , 62 , 63 were 62 , 65 in 62 , 69 subdivided 63 were 64 measured 65 in 67 following 66 the 67 following 68 groups 69 subdivided 69 subdivided 70 by 70 by 78 armd 71 age 72 and 72 and 73 gender 72 and 78 armd 73 gender 75 156 76 early 77 - 76 early 78 armd 78 armd 79 patients 78 armd 82 wet 78 armd 90 - 79 patients 81 80 79 patients 82 wet 83 - 90 - 84 late 86 patients 85 armd 86 patients 86 patients 88 72 86 patients 89 dry 86 patients 90 - 88 72 89 dry 90 - 95 and 90 - 99 . 91 late 93 patients 92 armd 93 patients 93 patients 95 and 95 and 98 controls 96 207 98 controls 97 healthy 98 controls results : among all study participants , women aged 50 - 54 [had] higher t - sod and t - gshpx activities and lower mda , pc , tos and 8 - ohdg levels than age - matched men ( p<0.05 ) , whereas older women were not significantly different from agematched older men . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 - 0 ###LEFT-WALL### 34 levels 1 results 2 : 2 : 3 among 3 among 6 participants 4 all 6 participants 5 study 6 participants 6 participants 8 women 7 , 8 women 8 women 9 aged 8 women 15 t 8 women 16 - 9 aged 10 50 11 - 15 t 12 54 15 t 14 higher 15 t 15 t 16 - 16 - 29 tos 16 - 30 and 17 sod 18 and 18 and 19 t 18 and 20 - 18 and 22 activities 21 gshpx 22 activities 22 activities 23 and 23 and 24 lower 23 and 29 tos 25 mda 27 pc 25 mda 29 tos 26 , 27 pc 27 pc 28 , 30 and 31 8 30 and 32 - 31 8 32 - 32 - 33 ohdg 33 ohdg 34 levels 34 levels 35 than 34 levels 36 age 34 levels 44 whereas 36 age 39 men 37 - 39 men 38 matched 39 men 39 men 41 p<0.05 39 men 43 , 40 ( 41 p<0.05 41 p<0.05 42 ) 43 , 44 whereas 44 whereas 46 women 44 whereas 47 were 44 whereas 55 . 45 older 46 women 46 women 47 were 47 were 48 not 47 were 49 significantly 47 were 50 different 50 different 51 from 51 from 54 men 52 agematched 54 men 53 older 54 men significantly increased oxidative damage was associated with armd patients >60 years of age in both sexes compared with controls ( p<0.01 for 60 - 64 and 65 - 69 - year [-] old armd subgroups ; p<0.001 for 70 - 74 and 75 - 80 - year [-] old armd subgroups ) . 0 ###LEFT-WALL### 2 increased 0 ###LEFT-WALL### 17 compared 0 ###LEFT-WALL### 28 - 0 ###LEFT-WALL### 37 p<0.001 1 significantly 2 increased 2 increased 5 was 2 increased 7 with 3 oxidative 4 damage 4 damage 5 was 5 was 6 associated 7 with 11 years 7 with 17 compared 8 armd 11 years 9 patients 11 years 10 >60 11 years 11 years 12 of 12 of 13 age 13 age 14 in 14 in 16 sexes 15 both 16 sexes 17 compared 18 with 18 with 19 controls 18 with 26 and 19 controls 21 p<0.01 20 ( 21 p<0.01 21 p<0.01 22 for 21 p<0.01 24 - 22 for 23 60 25 64 26 and 26 and 27 65 28 - 29 69 28 - 30 - 28 - 36 ; 30 - 35 subgroups 31 year 33 old 33 old 35 subgroups 34 armd 35 subgroups 36 ; 37 p<0.001 37 p<0.001 38 for 38 for 39 70 39 70 42 and 39 70 45 80 40 - 42 and 41 74 42 and 42 and 43 75 42 and 44 - 44 - 45 80 45 80 51 subgroups 45 80 53 . 46 - 51 subgroups 47 year 51 subgroups 49 old 51 subgroups 50 armd 51 subgroups 51 subgroups 52 ) multiple regression analysis demonstrates that age significantly affects antioxidant status and oxidative damage in armd patients compared with controls ( controls , p<0.05 [;] armd patients , p<0.001 ) . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 4 demonstrates 0 ###LEFT-WALL### 11 and 1 multiple 2 regression 2 regression 3 analysis 3 analysis 4 demonstrates 4 demonstrates 5 that 5 that 6 age 5 that 8 affects 6 age 8 affects 7 significantly 8 affects 8 affects 10 status 9 antioxidant 10 status 11 and 13 damage 11 and 17 compared 12 oxidative 13 damage 13 damage 14 in 13 damage 17 compared 14 in 16 patients 15 armd 16 patients 17 compared 18 with 18 with 19 controls 19 controls 21 controls 19 controls 26 patients 20 ( 21 controls 21 controls 22 , 22 , 26 patients 23 p<0.05 26 patients 25 armd 26 patients 26 patients 28 p<0.001 26 patients 30 . 27 , 28 p<0.001 28 p<0.001 29 ) a direct correlation with antioxidant enzyme activities and an inverse correlation with oxidative dna , protein and lipid damage were also observed in premenopausal women ( controls , p<0.05 ; armd patients , plt;0.001 [ )( 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 22 observed 0 ###LEFT-WALL### 30 ; 0 ###LEFT-WALL### 34 plt;0.001 0 ###LEFT-WALL### 36 )( 1 a 3 correlation 2 direct 3 correlation 3 correlation 4 with 3 correlation 12 with 3 correlation 15 , 4 with 8 and 5 antioxidant 6 enzyme 6 enzyme 7 activities 7 activities 8 and 8 and 11 correlation 9 an 10 inverse 9 an 11 correlation 10 inverse 11 correlation 12 with 14 dna 13 oxidative 14 dna 15 , 16 protein 15 , 17 and 17 and 19 damage 17 and 20 were 18 lipid 19 damage 20 were 22 observed 21 also 22 observed 22 observed 23 in 23 in 25 women 24 premenopausal 25 women 25 women 27 controls 26 ( 27 controls 27 controls 29 p<0.05 27 controls 30 ; 28 , 29 p<0.05 29 p<0.05 30 ; 30 ; 32 patients 30 ; 33 , 31 armd 32 patients 33 , 34 plt;0.001 conclusions : aging and postmenopausal status may be aggravating factors contributing to redox imbalance and oxidative damage in armd patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 21 . 1 conclusions 2 : 2 : 3 aging 4 and 6 status 4 and 8 be 5 postmenopausal 6 status 6 status 7 may 7 may 8 be 8 be 10 factors 8 be 12 to 8 be 18 in 9 aggravating 10 factors 10 factors 11 contributing 12 to 15 and 13 redox 14 imbalance 14 imbalance 15 and 15 and 17 damage 16 oxidative 17 damage 18 in 20 patients 19 armd 20 patients aim : to evaluate habitual macronutrient intake and its association with common cardiovascular risk factors in brazilian elderly women . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 8 and 2 : 20 . 3 to 4 evaluate 4 evaluate 7 intake 5 habitual 7 intake 6 macronutrient 7 intake 8 and 10 association 8 and 15 factors 9 its 10 association 10 association 11 with 10 association 15 factors 11 with 14 risk 12 common 14 risk 13 cardiovascular 14 risk 15 factors 16 in 15 factors 19 women 17 brazilian 19 women 18 elderly 19 women methods : analytical cross - sectional study with 293 subjects . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 cross 2 : 5 - 2 : 11 . 3 analytical 4 cross 5 - 7 study 6 sectional 7 study 7 study 8 with 8 with 10 subjects 9 293 10 subjects carbohydrate , protein and lipid intakes were determined based on a [non] [-] consecutive [three] - day dietary record . 0 ###LEFT-WALL### 1 carbohydrate 0 ###LEFT-WALL### 9 based 0 ###LEFT-WALL### 20 . 1 carbohydrate 9 based 2 , 8 determined 3 protein 4 and 4 and 5 lipid 4 and 6 intakes 4 and 7 were 4 and 8 determined 6 intakes 7 were 8 determined 9 based 9 based 10 on 9 based 19 record 10 on 17 day 11 a 17 day 14 consecutive 16 - 14 consecutive 17 day 18 dietary 19 record the following conditions were evaluated : dyslipidemia , systemic arterial hypertension , and type 2 diabetes . 0 ###LEFT-WALL### 3 conditions 0 ###LEFT-WALL### 5 evaluated 0 ###LEFT-WALL### 6 : 1 the 2 following 1 the 3 conditions 3 conditions 4 were 4 were 5 evaluated 6 : 13 and 6 : 17 . 7 dyslipidemia 8 , 8 , 11 hypertension 8 , 13 and 9 systemic 11 hypertension 10 arterial 11 hypertension 12 , 13 and 13 and 16 diabetes 14 type 16 diabetes 15 2 16 diabetes results : anthropometric , clinical and biochemical data revealed an elevated prevalence of classic cardiovascular risk factors in the sample . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 21 . 1 results 2 : 2 : 3 anthropometric 4 , 8 data 4 , 9 revealed 5 clinical 6 and 6 and 7 biochemical 6 and 8 data 8 data 9 revealed 9 revealed 12 prevalence 9 revealed 17 factors 10 an 12 prevalence 11 elevated 12 prevalence 12 prevalence 13 of 12 prevalence 17 factors 13 of 16 risk 14 classic 16 risk 15 cardiovascular 16 risk 17 factors 18 in 17 factors 20 sample 19 the 20 sample higher energy intake from omega - 3 fatty acid was associated with elevated levels of high - density lipoprotein cholesterol ( p<0.05 ) , whereas a diet pattern with a relatively lower energy content from monounsaturated fatty acids was associated with the presence of type 2 diabetes ( p<0.05 ) . 0 ###LEFT-WALL### 3 intake 0 ###LEFT-WALL### 13 elevated 0 ###LEFT-WALL### 51 . 1 higher 2 energy 2 energy 3 intake 3 intake 4 from 3 intake 13 elevated 4 from 5 omega 5 omega 7 3 5 omega 12 with 6 - 7 3 7 3 9 acid 7 3 10 was 7 3 11 associated 8 fatty 9 acid 9 acid 10 was 11 associated 12 with 13 elevated 14 levels 13 elevated 25 whereas 14 levels 15 of 15 of 20 cholesterol 16 high 17 - 16 high 18 density 18 density 20 cholesterol 19 lipoprotein 20 cholesterol 20 cholesterol 22 p<0.05 21 ( 22 p<0.05 22 p<0.05 23 ) 24 , 25 whereas 25 whereas 28 pattern 25 whereas 40 associated 25 whereas 50 ) 26 a 28 pattern 27 diet 28 pattern 28 pattern 29 with 28 pattern 35 from 28 pattern 39 was 29 with 34 content 30 a 34 content 31 relatively 32 lower 32 lower 33 energy 33 energy 34 content 35 from 38 acids 36 monounsaturated 38 acids 37 fatty 38 acids 39 was 40 associated 40 associated 41 with 41 with 43 presence 42 the 43 presence 43 presence 44 of 43 presence 49 p<0.05 44 of 47 diabetes 45 type 47 diabetes 46 2 47 diabetes 48 ( 49 p<0.05 49 p<0.05 50 ) conclusions : results corroborate experimental reports and contribute by suggesting that the usual diet , independently of supplementation , may be valuable in promoting health and preventing chronic diseases of aging . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 results 2 : 7 and 2 : 32 . 3 results 7 and 4 corroborate 6 reports 4 corroborate 7 and 5 experimental 6 reports 7 and 8 contribute 7 and 23 in 7 and 29 diseases 8 contribute 9 by 9 by 10 suggesting 10 suggesting 11 that 10 suggesting 21 be 11 that 13 usual 11 that 14 diet 11 that 20 may 12 the 13 usual 13 usual 14 diet 14 diet 16 independently 15 , 16 independently 16 independently 17 of 16 independently 19 , 17 of 18 supplementation 20 may 21 be 21 be 22 valuable 23 in 24 promoting 24 promoting 26 and 25 health 26 and 26 and 27 preventing 28 chronic 29 diseases 29 diseases 30 of 30 of 31 aging none background and aims : growing interest in understanding the relationship between subjective memory complaints ( smcs ) and objective measures of memory abilities emphasizes the importance of smc assessment for diagnostic purposes . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 25 emphasizes 0 ###LEFT-WALL### 34 . 1 none 4 aims 1 none 9 understanding 1 none 25 emphasizes 2 background 3 and 3 and 4 aims 4 aims 5 : 5 : 6 growing 6 growing 7 interest 6 growing 8 in 8 in 9 understanding 9 understanding 19 and 10 the 11 relationship 11 relationship 12 between 11 relationship 19 and 12 between 15 complaints 13 subjective 14 memory 14 memory 15 complaints 15 complaints 17 smcs 16 ( 17 smcs 17 smcs 18 ) 19 and 21 measures 19 and 22 of 20 objective 21 measures 22 of 24 abilities 23 memory 24 abilities 25 emphasizes 27 importance 25 emphasizes 31 for 26 the 27 importance 27 importance 28 of 28 of 30 assessment 29 smc 30 assessment 31 for 33 purposes 32 diagnostic 33 purposes the present study investigated the relationship between smcs and objective memory deficits in elderly adults by analysis of the factor structure of the everyday memory questionnaire ( emq ) . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 30 . 1 the 3 study 2 present 3 study 3 study 4 investigated 4 investigated 6 relationship 4 investigated 7 between 4 investigated 13 in 4 investigated 16 by 5 the 6 relationship 7 between 9 and 8 smcs 9 and 9 and 12 deficits 10 objective 11 memory 11 memory 12 deficits 13 in 15 adults 14 elderly 15 adults 16 by 17 analysis 17 analysis 18 of 17 analysis 22 of 17 analysis 28 emq 18 of 21 structure 19 the 21 structure 20 factor 21 structure 22 of 26 questionnaire 23 the 26 questionnaire 24 everyday 25 memory 25 memory 26 questionnaire 27 ( 28 emq 28 emq 29 ) methods : objective and subjective assessment of memory [function] was carried out in 112 elderly adults . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 assessment 2 : 11 carried 2 : 17 . 3 objective 4 and 4 and 5 subjective 4 and 6 assessment 6 assessment 7 of 6 assessment 10 was 7 of 8 memory 10 was 11 carried 11 carried 12 out 11 carried 13 in 13 in 16 adults 14 112 16 adults 15 elderly 16 adults principal component analysis was then performed to study the factor structure of the emq in relation to the assessment . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 6 performed 0 ###LEFT-WALL### 20 . 1 principal 3 analysis 2 component 3 analysis 3 analysis 4 was 4 was 6 performed 5 then 6 performed 6 performed 7 to 6 performed 17 to 7 to 8 study 8 study 11 structure 9 the 11 structure 10 factor 11 structure 11 structure 12 of 12 of 14 emq 13 the 14 emq 15 in 16 relation 16 relation 17 to 17 to 19 assessment 18 the 19 assessment results : objective memory impairment was evident in 8.9 % of elderly adults . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 impairment 2 : 6 was 2 : 14 . 3 objective 4 memory 4 memory 5 impairment 5 impairment 6 was 6 was 7 evident 7 evident 8 in 8 in 10 % 9 8.9 10 % 10 % 11 of 11 of 13 adults 12 elderly 13 adults the factor analysis showed that the most interpretable solution to detect objective changes with the emq comprised only 20 out of 28 items of the original list , with three factors explaining 48 % of total variance . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 4 showed 1 the 3 analysis 2 factor 3 analysis 3 analysis 4 showed 4 showed 5 that 4 showed 9 solution 4 showed 10 to 4 showed 14 with 6 the 9 solution 7 most 8 interpretable 8 interpretable 9 solution 10 to 11 detect 11 detect 13 changes 12 objective 13 changes 14 with 16 emq 14 with 18 only 14 with 19 20 15 the 16 emq 16 emq 17 comprised 19 20 21 of 19 20 24 of 19 20 29 with 20 out 21 of 21 of 23 items 22 28 23 items 24 of 27 list 25 the 27 list 26 original 27 list 28 , 29 with 29 with 31 factors 29 with 38 . 30 three 31 factors 31 factors 32 explaining 31 factors 35 of 32 explaining 34 % 33 48 34 % 35 of 37 variance 36 total 37 variance this version was more sensitive for detecting smcs in elderly adults , since one out of the three factors was able to differentiate subjects with objective memory deficits from those [without] . 0 ###LEFT-WALL### 2 version 0 ###LEFT-WALL### 3 was 1 this 2 version 2 version 3 was 3 was 5 sensitive 4 more 5 sensitive 5 sensitive 6 for 5 sensitive 13 since 6 for 7 detecting 7 detecting 8 smcs 8 smcs 9 in 9 in 11 adults 10 elderly 11 adults 12 , 13 since 13 since 14 one 13 since 23 differentiate 13 since 32 . 14 one 16 of 14 one 20 was 15 out 16 of 16 of 19 factors 17 the 18 three 18 three 19 factors 20 was 21 able 21 able 22 to 22 to 23 differentiate 23 differentiate 24 subjects 23 differentiate 25 with 25 with 28 deficits 26 objective 28 deficits 27 memory 28 deficits 28 deficits 29 from 29 from 30 those background and aims : the relative weight of various etiologies of dementia and mild cognitive impairment ( mci ) as predictors [of] [intra] - hospital , short - and long - term mortality in very old acutely ill patients suffering from multiple comorbid conditions remains unclear . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 47 . 1 background 2 and 2 and 3 aims 4 : 7 weight 4 : 24 - 5 the 7 weight 6 relative 7 weight 7 weight 8 of 8 of 10 etiologies 9 various 10 etiologies 10 etiologies 11 of 10 etiologies 20 as 11 of 13 and 12 dementia 13 and 13 and 16 impairment 13 and 18 mci 14 mild 16 impairment 15 cognitive 16 impairment 17 ( 18 mci 18 mci 19 ) 20 as 21 predictors 24 - 25 hospital 24 - 26 , 26 , 27 short 26 , 29 and 28 - 29 and 29 and 33 mortality 29 and 45 remains 30 long 31 - 30 long 33 mortality 32 term 33 mortality 33 mortality 34 in 33 mortality 40 suffering 33 mortality 44 conditions 33 mortality 45 remains 34 in 39 patients 35 very 36 old 36 old 39 patients 37 acutely 38 ill 38 ill 39 patients 40 suffering 41 from 40 suffering 44 conditions 41 from 43 comorbid 42 multiple 43 comorbid 45 remains 46 unclear we investigated [intra] - hospital , 1 - and 5 - year mortality risk associated with dementia and its various etiologies in a very old population after discharge from acute care . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 15 associated 0 ###LEFT-WALL### 32 . 1 we 2 investigated 4 - 5 hospital 4 - 6 , 6 , 7 1 6 , 8 - 7 1 8 - 8 - 9 and 9 and 10 5 9 and 11 - 10 5 11 - 11 - 14 risk 12 year 14 risk 13 mortality 14 risk 14 risk 15 associated 15 associated 16 with 15 associated 27 after 16 with 18 and 17 dementia 18 and 18 and 21 etiologies 18 and 22 in 19 its 21 etiologies 20 various 21 etiologies 22 in 26 population 23 a 24 very 23 a 26 population 24 very 25 old 25 old 26 population 27 after 28 discharge 28 discharge 29 from 29 from 31 care 30 acute 31 care methods : prospective cohort study of 444 patients ( mean age 85 years ; 74 % [female] [ )(discharged from the acute geriatric unit of geneva university hospital . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 5 study 2 : 14 ; 3 prospective 5 study 4 cohort 5 study 5 study 6 of 5 study 13 years 6 of 8 patients 7 444 8 patients 9 ( 13 years 10 mean 11 age 11 age 13 years 12 85 13 years 13 years 14 ; 14 ; 16 % 14 ; 19 )(discharged 15 74 16 % 16 % 19 )(discharged 19 )(discharged 20 from 20 from 24 unit 21 the 24 unit 22 acute 24 unit 23 geriatric 24 unit 24 unit 25 of 25 of 28 hospital 26 geneva 27 university 27 university 28 hospital on admission , each subject underwent standardized evaluation [of] cognitive and comorbid conditions . 0 ###LEFT-WALL### 5 subject 0 ###LEFT-WALL### 6 underwent 0 ###LEFT-WALL### 14 . 1 on 2 admission 1 on 3 , 1 on 5 subject 4 each 5 subject 5 subject 6 underwent 6 underwent 13 conditions 7 standardized 8 evaluation 8 evaluation 13 conditions 10 cognitive 11 and 11 and 12 comorbid 11 and 13 conditions patients were followed yearly by the same team . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 3 followed 0 ###LEFT-WALL### 9 . 1 patients 2 were 2 were 3 followed 3 followed 4 yearly 3 followed 5 by 5 by 8 team 6 the 7 same 7 same 8 team predictive variables were age , sex , cognitive diagnosis , dementia etiology and severity . 0 ###LEFT-WALL### 2 variables 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 15 . 1 predictive 2 variables 2 variables 3 were 3 were 13 and 4 age 5 , 5 , 6 sex 5 , 7 , 7 , 9 diagnosis 7 , 10 , 8 cognitive 9 diagnosis 10 , 12 etiology 10 , 13 and 11 dementia 12 etiology 13 and 14 severity survival during hospitalization , at 1 [-] and 5 [-] year follow - ups [was] the outcome of interest evaluated with cox proportional hazard models . 0 ###LEFT-WALL### 1 survival 0 ###LEFT-WALL### 14 ups 0 ###LEFT-WALL### 26 . 1 survival 2 during 1 survival 5 at 1 survival 14 ups 2 during 3 hospitalization 4 , 5 at 5 at 8 and 5 at 13 - 6 1 8 and 8 and 9 5 9 5 11 year 11 year 12 follow 14 ups 17 outcome 16 the 17 outcome 17 outcome 18 of 17 outcome 20 evaluated 18 of 19 interest 20 evaluated 21 with 21 with 25 models 22 cox 25 models 23 proportional 24 hazard 24 hazard 25 models results : two hundred and six patients were cognitively normal , 48 had mci , and 190 had dementia : of these , there were 75 cases of alzheimer 's disease ( ad ) , 20 of vascular dementia ( vad ) , 82 of mixed dementia ( md ) and 13 [of] other types of dementia . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 58 . 2 : 7 patients 2 : 8 were 2 : 11 , 2 : 20 : 3 two 4 hundred 4 hundred 5 and 5 and 6 six 6 six 7 patients 7 patients 8 were 8 were 9 cognitively 8 were 10 normal 11 , 12 48 11 , 13 had 11 , 16 and 12 48 13 had 13 had 14 mci 15 , 16 and 16 and 17 190 16 and 18 had 17 190 18 had 18 had 19 dementia 20 : 24 there 20 : 25 were 21 of 22 these 21 of 23 , 21 of 24 there 24 there 25 were 25 were 51 and 26 75 27 cases 27 cases 28 of 27 cases 51 and 28 of 31 disease 29 alzheimer 30 's 30 's 31 disease 31 disease 33 ad 31 disease 36 20 31 disease 44 82 32 ( 33 ad 33 ad 34 ) 35 , 36 20 36 20 37 of 36 20 43 , 37 of 39 dementia 38 vascular 39 dementia 39 dementia 41 vad 40 ( 41 vad 41 vad 42 ) 43 , 44 82 44 82 45 of 44 82 49 md 44 82 50 ) 45 of 47 dementia 46 mixed 47 dementia 48 ( 49 md 49 md 50 ) 51 and 55 types 51 and 56 of 52 13 54 other 54 other 55 types 56 of 57 dementia the groups compared were statistically similar in age , sex , education level and comorbidity score . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 17 . 1 the 2 groups 2 groups 3 compared 2 groups 4 were 4 were 5 statistically 4 were 6 similar 6 similar 7 in 7 in 14 and 8 age 9 , 9 , 10 sex 9 , 11 , 11 , 13 level 11 , 14 and 12 education 13 level 14 and 16 score 15 comorbidity 16 score after 5 years [of] follow - up , 60 % of the patients had died . 0 ###LEFT-WALL### 10 % 0 ###LEFT-WALL### 15 died 0 ###LEFT-WALL### 16 . 1 after 3 years 1 after 5 follow 1 after 8 , 1 after 10 % 2 5 3 years 3 years 5 follow 5 follow 7 up 6 - 7 up 7 up 8 , 9 60 10 % 10 % 11 of 10 % 14 had 11 of 13 patients 12 the 13 patients 14 had 15 died regarding [intra] [-] hospital mortality , none of the predictive variables was associated with mortality . 0 ###LEFT-WALL### 7 none 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 16 . 1 regarding 5 mortality 1 regarding 6 , 1 regarding 7 none 4 hospital 5 mortality 7 none 8 of 7 none 12 was 8 of 11 variables 9 the 11 variables 10 predictive 11 variables 12 was 13 associated 13 associated 14 with 14 with 15 mortality [mci] [,] ad and md were not predictive of short - or long - term mortality . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 17 . 3 ad 4 and 4 and 5 md 4 and 6 were 6 were 7 not 6 were 9 of 7 not 8 predictive 9 of 12 or 10 short 12 or 11 - 12 or 12 or 16 mortality 13 long 14 - 13 long 15 term 15 term 16 mortality features significantly associated with reduced survival at 1 and 5 years were being older , male , and having vascular or severe dementia . 0 ###LEFT-WALL### 11 years 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 24 . 1 features 3 associated 2 significantly 3 associated 3 associated 4 with 3 associated 7 at 4 with 6 survival 5 reduced 6 survival 7 at 9 and 8 1 9 and 9 and 10 5 10 5 11 years 11 years 12 were 12 were 13 being 13 being 23 dementia 14 older 15 , 14 older 23 dementia 16 male 18 and 17 , 18 and 18 and 19 having 18 and 23 dementia 20 vascular 21 or 21 or 22 severe 21 or 23 dementia when all the variables were added in the multiple model , the dementia effect completely disappeared . 0 ###LEFT-WALL### 14 effect 0 ###LEFT-WALL### 16 disappeared 0 ###LEFT-WALL### 17 . 1 when 2 all 1 when 6 added 1 when 11 , 1 when 14 effect 2 all 3 the 2 all 4 variables 2 all 5 were 3 the 4 variables 5 were 6 added 6 added 7 in 7 in 10 model 8 the 10 model 9 multiple 10 model 12 the 14 effect 13 dementia 14 effect 14 effect 16 disappeared 15 completely 16 disappeared conclusions : dementia ( all etiologies ) is not predictive of mortality . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 dementia 2 : 8 is 2 : 13 . 3 dementia 6 etiologies 3 dementia 8 is 4 ( 6 etiologies 5 all 6 etiologies 6 etiologies 7 ) 8 is 9 not 8 is 11 of 9 not 10 predictive 11 of 12 mortality the observed vad effect is probably linked to cardiovascular risk comorbidities : hypertension , stroke [and] hyperlipidemia . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 7 linked 0 ###LEFT-WALL### 12 : 1 the 4 effect 2 observed 4 effect 3 vad 4 effect 4 effect 5 is 5 is 7 linked 6 probably 7 linked 7 linked 8 to 8 to 11 comorbidities 9 cardiovascular 11 comorbidities 10 risk 11 comorbidities 12 : 13 hypertension 12 : 14 , 12 : 18 . 14 , 15 stroke 15 stroke 17 hyperlipidemia background and aims : a large body of research has demonstrated that , although specific memory activities can enhance the memory performance of healthy older adults , the extent of the increment is negatively associated with age . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aims 4 : 7 body 4 : 11 demonstrated 4 : 38 . 5 a 6 large 5 a 7 body 6 large 7 body 7 body 8 of 7 body 10 has 8 of 9 research 10 has 11 demonstrated 11 demonstrated 12 that 12 that 29 extent 12 that 35 associated 13 , 14 although 14 although 17 activities 14 although 19 enhance 14 although 27 , 14 although 29 extent 15 specific 16 memory 16 memory 17 activities 17 activities 18 can 18 can 19 enhance 19 enhance 22 performance 20 the 22 performance 21 memory 22 performance 22 performance 23 of 23 of 26 adults 24 healthy 26 adults 25 older 26 adults 28 the 29 extent 29 extent 30 of 29 extent 33 is 30 of 32 increment 31 the 32 increment 33 is 34 negatively 33 is 35 associated 35 associated 36 with 36 with 37 age conversely , few studies have examined the case of healthy elderly people not living alone . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 examined 0 ###LEFT-WALL### 16 . 1 conversely 2 , 1 conversely 4 studies 3 few 4 studies 4 studies 5 have 5 have 6 examined 6 examined 8 case 7 the 8 case 8 case 9 of 9 of 12 people 10 healthy 12 people 11 elderly 12 people 12 people 13 not 13 not 14 living 14 living 15 alone this study has two mains goals : to understand whether older adults with limited autonomy can benefit from activities devoted to increasing their episodic memory performance , and to test the efficacy of a memory training program based on autobiographical memories , in terms of transfer and maintenance effect . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 has 0 ###LEFT-WALL### 7 : 1 this 2 study 2 study 3 has 3 has 6 goals 4 two 6 goals 5 mains 6 goals 7 : 8 to 7 : 9 understand 8 to 9 understand 9 understand 10 whether 10 whether 12 adults 10 whether 28 and 11 older 12 adults 12 adults 13 with 12 adults 16 can 13 with 15 autonomy 14 limited 15 autonomy 16 can 28 and 17 benefit 18 from 17 benefit 21 to 17 benefit 28 and 18 from 19 activities 19 activities 20 devoted 21 to 22 increasing 22 increasing 26 performance 23 their 26 performance 24 episodic 25 memory 25 memory 26 performance 27 , 28 and 28 and 29 to 28 and 30 test 29 to 30 test 30 test 32 efficacy 30 test 39 on 30 test 43 in 31 the 32 efficacy 32 efficacy 33 of 32 efficacy 38 based 33 of 37 program 34 a 35 memory 34 a 37 program 35 memory 36 training 36 training 37 program 39 on 41 memories 40 autobiographical 41 memories 42 , 43 in 43 in 47 and 43 in 50 . 44 terms 45 of 44 terms 47 and 45 of 46 transfer 47 and 49 effect 48 maintenance 49 effect we postulated that being able to rely on stable autobiographical memories ( intrinsically associated with emotions ) would be a valuable memory aid . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 postulated 0 ###LEFT-WALL### 24 . 1 we 2 postulated 2 postulated 3 that 3 that 4 being 3 that 19 be 4 being 5 able 4 being 18 would 5 able 6 to 5 able 7 rely 6 to 7 rely 7 rely 8 on 7 rely 14 associated 8 on 11 memories 9 stable 11 memories 10 autobiographical 11 memories 12 ( 14 associated 13 intrinsically 14 associated 14 associated 15 with 14 associated 17 ) 15 with 16 emotions 18 would 19 be 19 be 23 aid 20 a 21 valuable 20 a 23 aid 21 valuable 22 memory 22 memory 23 aid methods : memory training was given to healthy older adults ( aged 75 - 85 ) living in a retirement home . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 methods 2 : 2 : 3 memory 3 memory 4 training 3 memory 6 given 3 memory 17 living 4 training 5 was 5 was 6 given 6 given 7 to 6 given 12 aged 7 to 10 adults 8 healthy 10 adults 9 older 10 adults 11 ( 12 aged 12 aged 14 - 12 aged 16 ) 13 75 14 - 14 - 15 85 17 living 18 in 18 in 21 home 19 a 21 home 20 retirement 21 home results : both groups improved their performance from pre - to post - test . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 groups 2 : 5 improved 2 : 13 - 3 both 4 groups 4 groups 5 improved 5 improved 7 performance 6 their 7 performance 7 performance 8 from 8 from 9 pre 9 pre 11 to 10 - 11 to 11 to 12 post 11 to 13 - 13 - 14 test 13 - 15 . however , the experimental group reported a greater feeling of well - being after the training , and maintained the training gains relating to episodic performance after three months . 0 ###LEFT-WALL### 5 group 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 5 group 3 the 5 group 4 experimental 5 group 5 group 18 and 6 reported 9 feeling 6 reported 18 and 7 a 9 feeling 8 greater 9 feeling 9 feeling 10 of 9 feeling 13 being 10 of 11 well 12 - 13 being 13 being 14 after 13 being 17 , 14 after 16 training 15 the 16 training 17 , 18 and 18 and 19 maintained 19 maintained 22 gains 19 maintained 24 to 19 maintained 27 after 20 the 22 gains 21 training 22 gains 22 gains 23 relating 24 to 26 performance 25 episodic 26 performance 27 after 29 months 28 three 29 months conclusions : our findings suggest that specific memory activities are beneficial to elderly people living in a retirement home context . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 5 suggest 2 : 21 . 3 our 4 findings 4 findings 5 suggest 5 suggest 6 that 6 that 9 activities 6 that 10 are 7 specific 8 memory 8 memory 9 activities 9 activities 10 are 10 are 11 beneficial 11 beneficial 12 to 11 beneficial 16 in 12 to 14 people 13 elderly 14 people 14 people 15 living 16 in 20 context 17 a 18 retirement 17 a 20 context 18 retirement 20 context 19 home 20 context in addition , training based on reactivation of autobiographical memories is shown to produce a long - lasting effect on memory performance . 0 ###LEFT-WALL### 4 training 0 ###LEFT-WALL### 12 shown 0 ###LEFT-WALL### 23 . 1 in 2 addition 1 in 3 , 1 in 4 training 4 training 5 based 4 training 11 is 5 based 6 on 6 on 7 reactivation 7 reactivation 8 of 8 of 10 memories 9 autobiographical 10 memories 11 is 12 shown 12 shown 13 to 12 shown 20 on 13 to 14 produce 14 produce 19 effect 15 a 16 long 15 a 19 effect 16 long 17 - 16 long 19 effect 18 lasting 19 effect 20 on 22 performance 21 memory 22 performance background and aims : the effectiveness of community [-] based fall assessment programs in older people is unclear . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 19 . 1 background 2 and 2 and 3 aims 4 : 6 effectiveness 4 : 17 is 5 the 6 effectiveness 6 effectiveness 7 of 6 effectiveness 14 in 6 effectiveness 17 is 7 of 13 programs 8 community 10 based 10 based 13 programs 11 fall 13 programs 12 assessment 13 programs 14 in 16 people 15 older 16 people 17 is 18 unclear in this study , we examined the effectiveness of community [-] based fall assessment compared with hospital [-] based assessment . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 examined 0 ###LEFT-WALL### 21 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 examined 6 examined 8 effectiveness 6 examined 16 with 7 the 8 effectiveness 8 effectiveness 9 of 9 of 14 assessment 10 community 12 based 12 based 14 assessment 13 fall 14 assessment 14 assessment 15 compared 16 with 20 assessment 17 hospital 19 based 19 based 20 assessment methods : [a] randomized [un] - blind study was conducted in 369 older adults aged 65 years and over at high risk of falling . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 4 randomized 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 25 . 1 methods 2 : 2 : 4 randomized 6 - 8 study 6 - 10 conducted 7 blind 8 study 8 study 9 was 9 was 10 conducted 10 conducted 18 and 11 in 17 years 11 in 18 and 12 369 17 years 13 older 14 adults 14 adults 15 aged 15 aged 17 years 16 65 17 years 18 and 19 over 19 over 20 at 20 at 22 risk 21 high 22 risk 22 risk 23 of 23 of 24 falling participants were drawn from a larger cohort of community [-] dwelling older people . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 drawn 0 ###LEFT-WALL### 14 . 1 participants 2 were 2 were 3 drawn 3 drawn 4 from 4 from 7 cohort 5 a 7 cohort 6 larger 7 cohort 7 cohort 8 of 8 of 13 people 9 community 11 dwelling 11 dwelling 13 people 12 older 13 people eligible participants were identified by means of a simple [five] - item screening tool . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 4 identified 0 ###LEFT-WALL### 15 . 1 eligible 2 participants 2 participants 3 were 3 were 4 identified 4 identified 5 by 5 by 6 means 6 means 7 of 7 of 14 tool 8 a 9 simple 8 a 14 tool 9 simple 11 - 9 simple 12 item 12 item 14 tool 13 screening 14 tool a randomly chosen subset population of people at high risk of falling was then randomized into two arms , community - [based] and hospital - based fall assessments . 0 ###LEFT-WALL### 5 population 0 ###LEFT-WALL### 15 randomized 0 ###LEFT-WALL### 25 - 1 a 2 randomly 1 a 5 population 2 randomly 3 chosen 4 subset 5 population 5 population 6 of 5 population 8 at 5 population 11 of 5 population 13 was 6 of 7 people 8 at 10 risk 9 high 10 risk 11 of 12 falling 13 was 15 randomized 14 then 15 randomized 15 randomized 16 into 16 into 23 and 17 two 18 arms 18 arms 19 , 19 , 20 community 19 , 23 and 21 - 23 and 23 and 24 hospital 25 - 28 assessments 25 - 29 . 26 based 28 assessments 27 fall 28 assessments the total number of [falls] in both groups was recorded by following up subjects ' diaries and telephone interviews at 3 , 6 and 12 months . 0 ###LEFT-WALL### 3 number 0 ###LEFT-WALL### 10 recorded 1 the 3 number 2 total 3 number 3 number 4 of 3 number 9 was 4 of 6 in 6 in 8 groups 7 both 8 groups 9 was 10 recorded 10 recorded 11 by 10 recorded 20 at 11 by 12 following 12 following 13 up 13 up 17 and 14 subjects 15 ' 15 ' 16 diaries 16 diaries 17 and 17 and 19 interviews 18 telephone 19 interviews 20 at 21 3 21 3 26 months 22 , 26 months 23 6 24 and 24 and 25 12 24 and 26 months 26 months 27 . incidence rate ratios ( irr ) for the rate of [falls] at 12 months [between] [community] - and hospital - based assessments were analysed as primary [outcome] , by intention - to [-] treat analysis . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 36 . 1 incidence 2 rate 2 rate 3 ratios 3 ratios 5 irr 4 ( 5 irr 5 irr 6 ) 5 irr 7 for 5 irr 18 and 7 for 9 rate 8 the 9 rate 9 rate 10 of 10 of 12 at 12 at 14 months 13 12 14 months 17 - 18 and 18 and 19 hospital 18 and 20 - 18 and 21 based 18 and 22 assessments 18 and 23 were 18 and 24 analysed 18 and 26 primary 22 assessments 23 were 25 as 26 primary 26 primary 29 by 26 primary 32 to 28 , 29 by 29 by 30 intention 29 by 31 - 32 to 34 treat 34 treat 35 analysis results : a total of 349 participants completed the study . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 total 2 : 8 completed 2 : 11 . 3 a 4 total 4 total 5 of 4 total 8 completed 5 of 7 participants 6 349 7 participants 8 completed 10 study 9 the 10 study attendance to community [-] based assessment was significantly higher compared with hospital [-] based assessment in this older population ( p=0.012 ) . 0 ###LEFT-WALL### 1 attendance 0 ###LEFT-WALL### 10 compared 0 ###LEFT-WALL### 23 . 1 attendance 2 to 1 attendance 7 was 2 to 6 assessment 3 community 5 based 5 based 6 assessment 7 was 9 higher 7 was 10 compared 8 significantly 9 higher 10 compared 11 with 10 compared 16 in 11 with 15 assessment 12 hospital 14 based 14 based 15 assessment 16 in 19 population 17 this 19 population 18 older 19 population 19 population 21 p=0.012 20 ( 21 p=0.012 21 p=0.012 22 ) there were no statistically significant differences between the two groups in total number of [falls] at the 12 month [follow] - up . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 21 - 1 there 2 were 2 were 6 differences 3 no 6 differences 4 statistically 5 significant 5 significant 6 differences 6 differences 7 between 6 differences 14 of 7 between 9 two 8 the 9 two 9 two 10 groups 9 two 13 number 10 groups 13 number 11 in 12 total 12 total 13 number 14 of 16 at 16 at 19 month 17 the 19 month 18 12 19 month 21 - 22 up 21 - 23 . according to negative binomial regression , the adjusted irr of [falls] in the community based arm was not significantly different from the hospital - based one ( irr 0.95 [;] 95 % ci 0.58 - 1.45 , p=0.83 ) . 0 ###LEFT-WALL### 5 regression 0 ###LEFT-WALL### 25 based 0 ###LEFT-WALL### 40 . 1 according 2 to 2 to 4 binomial 2 to 5 regression 3 negative 4 binomial 5 regression 20 different 5 regression 25 based 6 , 20 different 7 the 9 irr 8 adjusted 9 irr 9 irr 10 of 9 irr 17 was 10 of 12 in 12 in 16 arm 13 the 16 arm 14 community 15 based 15 based 16 arm 17 was 18 not 18 not 19 significantly 19 significantly 20 different 20 different 21 from 20 different 24 - 21 from 23 hospital 22 the 23 hospital 25 based 26 one 26 one 33 ci 26 one 38 p=0.83 27 ( 33 ci 28 irr 29 0.95 28 irr 33 ci 31 95 33 ci 32 % 33 ci 33 ci 35 - 33 ci 37 , 34 0.58 35 - 35 - 36 1.45 37 , 38 p=0.83 38 p=0.83 39 ) conclusion : this study showed the increased risk of falling according to community [-] based fall assessment program [with] respect to a traditional hospital - based one in community - dwelling older adults at high risk of falling . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 showed 2 : 25 - 2 : 39 . 3 this 4 study 4 study 5 showed 5 showed 8 risk 6 the 8 risk 7 increased 8 risk 8 risk 9 of 8 risk 12 to 9 of 11 according 10 falling 11 according 12 to 20 respect 13 community 16 fall 15 based 16 fall 16 fall 20 respect 17 assessment 20 respect 18 program 20 respect 20 respect 21 to 21 to 24 hospital 22 a 23 traditional 22 a 24 hospital 23 traditional 24 hospital 25 - 29 community 25 - 30 - 26 based 29 community 27 one 28 in 28 in 29 community 30 - 33 adults 31 dwelling 33 adults 32 older 33 adults 33 adults 34 at 33 adults 37 of 34 at 36 risk 35 high 36 risk 37 of 38 falling background and aims : metabolic syndrome and osteoporosis are recognized as major public health problems in many countries . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aims 4 : 6 syndrome 4 : 7 and 4 : 19 . 5 metabolic 6 syndrome 7 and 8 osteoporosis 7 and 10 recognized 8 osteoporosis 9 are 9 are 10 recognized 10 recognized 11 as 11 as 15 problems 12 major 13 public 13 public 15 problems 14 health 15 problems 15 problems 16 in 16 in 18 countries 17 many 18 countries this study investigated the association between bone quality and components [of] metabolic syndrome in an elderly population . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 18 . 1 this 2 study 2 study 3 investigated 3 investigated 5 association 3 investigated 6 between 3 investigated 14 in 4 the 5 association 6 between 9 and 7 bone 8 quality 8 quality 9 and 9 and 13 syndrome 10 components 13 syndrome 12 metabolic 13 syndrome 14 in 17 population 15 an 16 elderly 15 an 17 population 16 elderly 17 population methods : the study included a population sample of 211 men and women , of mean age 77.9 ± 4.5 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 study 2 : 5 included 2 : 14 , 3 the 4 study 4 study 5 included 5 included 8 sample 6 a 7 population 6 a 8 sample 7 population 8 sample 8 sample 9 of 9 of 12 and 10 211 11 men 11 men 12 and 12 and 13 women 14 , 18 77.9 14 , 19 ± 15 of 17 age 15 of 18 77.9 16 mean 17 age 18 77.9 19 ± 19 ± 21 years 20 4.5 21 years anthropometry , blood pressure , serum levels of lipoproteins ( hdl and ldl ) , triglycerides and glucose were measured , and ultrasound bone densitometry was performed in all subjects . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 19 were 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 31 . 1 anthropometry 4 pressure 1 anthropometry 15 , 2 , 4 pressure 3 blood 4 pressure 4 pressure 7 levels 4 pressure 14 ) 5 , 7 levels 6 serum 7 levels 7 levels 8 of 7 levels 14 ) 8 of 9 lipoproteins 9 lipoproteins 13 ldl 10 ( 13 ldl 11 hdl 12 and 12 and 13 ldl 13 ldl 14 ) 15 , 16 triglycerides 15 , 17 and 17 and 18 glucose 17 and 19 were 19 were 20 measured 21 , 22 and 22 and 25 densitometry 22 and 27 performed 23 ultrasound 25 densitometry 24 bone 25 densitometry 25 densitometry 26 was 26 was 27 performed 27 performed 28 in 28 in 30 subjects 29 all 30 subjects information on lifestyle habits , including physical activity , smoking and alcohol consumption , were obtained by a questionnaire . 0 ###LEFT-WALL### 1 information 0 ###LEFT-WALL### 16 obtained 0 ###LEFT-WALL### 20 . 1 information 2 on 1 information 11 and 1 information 15 were 2 on 4 habits 3 lifestyle 4 habits 4 habits 6 including 5 , 6 including 6 including 8 activity 6 including 9 , 7 physical 8 activity 9 , 11 and 10 smoking 11 and 11 and 13 consumption 11 and 14 , 12 alcohol 13 consumption 15 were 16 obtained 16 obtained 17 by 17 by 19 questionnaire 18 a 19 questionnaire results : metabolic syndrome , defined by the criteria of the international diabetes federation , was determined in 59 % of men and 65 % [of] women . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 4 syndrome 2 : 5 , 3 metabolic 4 syndrome 5 , 15 , 6 defined 7 by 6 defined 14 federation 6 defined 15 , 7 by 9 criteria 8 the 9 criteria 9 criteria 10 of 10 of 12 international 11 the 12 international 13 diabetes 14 federation 15 , 16 was 16 was 17 determined 17 determined 18 in 18 in 20 % 19 59 20 % 20 % 21 of 21 of 23 and 22 men 23 and 23 and 27 women 24 65 27 women 25 % 27 women the quantitative ultrasound index ( qui ) was significantly correlated with serum glucose in men ( r= - 0.31 [;] p=0.005 ) and [with] body mass index ( bmi ) in women ( r=0.39 [;] p<0.0001 ) . 0 ###LEFT-WALL### 4 index 0 ###LEFT-WALL### 10 correlated 0 ###LEFT-WALL### 38 . 1 the 4 index 2 quantitative 4 index 3 ultrasound 4 index 4 index 6 qui 4 index 8 was 5 ( 6 qui 6 qui 7 ) 8 was 10 correlated 9 significantly 10 correlated 10 correlated 11 with 10 correlated 31 in 11 with 23 and 12 serum 13 glucose 13 glucose 14 in 13 glucose 23 and 14 in 15 men 15 men 17 r= 15 men 21 p=0.005 16 ( 17 r= 17 r= 18 - 18 - 21 p=0.005 19 0.31 21 p=0.005 21 p=0.005 22 ) 23 and 27 index 23 and 29 bmi 25 body 27 index 26 mass 27 index 28 ( 29 bmi 29 bmi 30 ) 31 in 32 women 32 women 36 p<0.0001 33 ( 36 p<0.0001 34 r=0.39 36 p<0.0001 36 p<0.0001 37 ) qui was significantly lower in men with metabolic syndrome [(] f=7.57 [;] p<0.007 [ )(and significantly higher in women with it ( f=6.47 ; p=0.012 [ )(compared with controls . 0 ###LEFT-WALL### 1 qui 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 24 ; 0 ###LEFT-WALL### 30 . 1 qui 2 was 2 was 4 lower 3 significantly 4 lower 4 lower 5 in 4 lower 7 with 4 lower 15 )(and 5 in 6 men 7 with 11 f=7.57 8 metabolic 9 syndrome 9 syndrome 11 f=7.57 13 p<0.007 15 )(and 15 )(and 17 higher 16 significantly 17 higher 17 higher 18 in 18 in 19 women 19 women 20 with 19 women 23 f=6.47 20 with 21 it 22 ( 23 f=6.47 23 f=6.47 24 ; 24 ; 25 p=0.012 24 ; 27 )(compared 25 p=0.012 27 )(compared 27 )(compared 28 with 28 with 29 controls when qui was adjusted for body mass index [in] women and for serum glucose in men , it was no longer significantly different from values for controls . 0 ###LEFT-WALL### 18 it 0 ###LEFT-WALL### 19 was 0 ###LEFT-WALL### 28 . 1 when 2 qui 1 when 4 adjusted 1 when 17 , 1 when 18 it 2 qui 3 was 3 was 4 adjusted 4 adjusted 11 and 4 adjusted 15 in 5 for 10 women 5 for 11 and 6 body 10 women 7 mass 10 women 8 index 10 women 11 and 12 for 12 for 14 glucose 13 serum 14 glucose 15 in 16 men 18 it 19 was 19 was 21 longer 19 was 23 different 20 no 21 longer 22 significantly 23 different 23 different 24 from 24 from 25 values 25 values 26 for 26 for 27 controls other covariates such as cholesterol , blood pressure , smoking , alcohol , and physical activity did not change the difference in qui between patients with metabolic syndrome and controls . 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 31 . 1 other 2 covariates 2 covariates 4 as 2 covariates 6 , 3 such 4 as 4 as 5 cholesterol 6 , 8 pressure 6 , 9 , 7 blood 8 pressure 9 , 28 syndrome 9 , 29 and 10 smoking 11 , 11 , 12 alcohol 11 , 14 and 13 , 14 and 14 and 15 physical 14 and 16 activity 14 and 26 with 14 and 28 syndrome 16 activity 17 did 17 did 18 not 17 did 19 change 19 change 21 difference 19 change 22 in 19 change 24 between 19 change 26 with 20 the 21 difference 22 in 23 qui 24 between 25 patients 27 metabolic 28 syndrome 29 and 30 controls diabetes in men ( p=0.005 ) and obesity and waist circumference in women ( p<0.05 ) were also significant predictors of qui in regression analysis . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 26 . 1 diabetes 2 in 1 diabetes 7 and 2 in 3 men 3 men 5 p=0.005 4 ( 5 p=0.005 5 p=0.005 6 ) 7 and 8 obesity 7 and 9 and 9 and 11 circumference 9 and 12 in 9 and 17 were 10 waist 11 circumference 12 in 13 women 13 women 15 p<0.05 14 ( 15 p<0.05 15 p<0.05 16 ) 17 were 18 also 17 were 20 predictors 19 significant 20 predictors 20 predictors 21 of 21 of 22 qui 22 qui 23 in 23 in 25 analysis 24 regression 25 analysis conclusions : the association [between] metabolic syndrome and bone stiffness in elderly people may be explained by increased bmi in women and high serum glucose in men . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 28 . 1 conclusions 2 : 2 : 7 syndrome 3 the 7 syndrome 4 association 7 syndrome 6 metabolic 7 syndrome 8 and 10 stiffness 8 and 16 explained 9 bone 10 stiffness 10 stiffness 11 in 10 stiffness 14 may 11 in 13 people 12 elderly 13 people 14 may 15 be 15 be 16 explained 16 explained 17 by 16 explained 20 in 16 explained 26 in 17 by 19 bmi 18 increased 19 bmi 20 in 22 and 21 women 22 and 22 and 25 glucose 23 high 24 serum 24 serum 25 glucose 26 in 27 men background and aims : the telomere length of peripheral blood leukocytes has been reported to be inversely correlated with many kinds of pathophysiological conditions . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 25 . 1 background 2 and 2 and 3 aims 4 : 7 length 4 : 14 reported 5 the 7 length 6 telomere 7 length 7 length 8 of 7 length 12 has 8 of 11 leukocytes 9 peripheral 10 blood 10 blood 11 leukocytes 12 has 13 been 13 been 14 reported 14 reported 15 to 14 reported 19 with 15 to 16 be 16 be 17 inversely 16 be 18 correlated 19 with 24 conditions 20 many 21 kinds 21 kinds 22 of 21 kinds 24 conditions 22 of 24 conditions 23 pathophysiological 24 conditions however , correlations between telomere length in peripheral blood leukocytes and patients ' physical ability are not known . 0 ###LEFT-WALL### 3 correlations 0 ###LEFT-WALL### 18 known 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 3 correlations 3 correlations 4 between 3 correlations 7 in 3 correlations 16 are 4 between 6 length 5 telomere 6 length 7 in 11 and 8 peripheral 9 blood 9 blood 10 leukocytes 10 leukocytes 11 and 11 and 15 ability 12 patients 13 ' 13 ' 15 ability 14 physical 15 ability 16 are 17 not 16 are 18 known methods : to address this problem , the physical ability of patients with cerebrovascular disease admitted to the chronic disease ward of kyushu university hospital was assessed with the barthel index ( bi ) and the telomere length of their peripheral blood leukocytes was determined . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 46 . 2 : 3 to 2 : 4 address 2 : 7 , 2 : 35 and 3 to 4 address 4 address 6 problem 5 this 6 problem 7 , 10 ability 7 , 16 admitted 8 the 10 ability 9 physical 10 ability 10 ability 11 of 10 ability 13 with 10 ability 16 admitted 11 of 12 patients 13 with 15 disease 14 cerebrovascular 15 disease 16 admitted 17 to 16 admitted 25 hospital 16 admitted 27 assessed 17 to 21 ward 18 the 21 ward 19 chronic 20 disease 20 disease 21 ward 22 of 23 kyushu 22 of 25 hospital 24 university 25 hospital 25 hospital 26 was 26 was 27 assessed 27 assessed 28 with 28 with 31 index 29 the 31 index 30 barthel 31 index 31 index 33 bi 32 ( 33 bi 33 bi 34 ) 35 and 38 length 35 and 44 was 36 the 38 length 37 telomere 38 length 38 length 39 of 38 length 44 was 39 of 43 leukocytes 40 their 43 leukocytes 41 peripheral 42 blood 42 blood 43 leukocytes 44 was 45 determined results and conclusions : women exhibited a significant correlation between the barthel score and the expression of long telomeres ( >9.4 kb ) , in contrast with men who revealed no such correlation . 0 ###LEFT-WALL### 3 conclusions 0 ###LEFT-WALL### 4 : 1 results 2 and 2 and 3 conclusions 4 : 5 women 4 : 6 exhibited 5 women 6 exhibited 6 exhibited 9 correlation 6 exhibited 10 between 7 a 8 significant 7 a 9 correlation 8 significant 9 correlation 10 between 14 and 11 the 13 score 12 barthel 13 score 13 score 14 and 14 and 16 expression 14 and 17 of 14 and 25 in 15 the 16 expression 17 of 19 telomeres 18 long 19 telomeres 19 telomeres 22 kb 20 ( 22 kb 21 >9.4 22 kb 22 kb 23 ) 24 , 25 in 25 in 26 contrast 25 in 34 . 26 contrast 27 with 27 with 28 men 28 men 29 who 28 men 30 revealed 29 who 30 revealed 30 revealed 33 correlation 31 no 32 such 32 such 33 correlation the physical ability of older women was positively correlated with the lengths of their somatic telomeres . 0 ###LEFT-WALL### 3 ability 0 ###LEFT-WALL### 9 correlated 0 ###LEFT-WALL### 17 . 1 the 3 ability 2 physical 3 ability 3 ability 4 of 3 ability 7 was 4 of 6 women 5 older 6 women 7 was 9 correlated 8 positively 9 correlated 9 correlated 10 with 10 with 12 lengths 11 the 12 lengths 12 lengths 13 of 13 of 16 telomeres 14 their 16 telomeres 15 somatic 16 telomeres among the bi items , the scores of more difficult physical performances tended to correlate with the presence of terminal restriction fragments longer than 9.4 kb . 0 ###LEFT-WALL### 12 performances 0 ###LEFT-WALL### 13 tended 0 ###LEFT-WALL### 27 . 1 among 4 items 1 among 5 , 1 among 12 performances 2 the 4 items 3 bi 4 items 6 the 7 scores 7 scores 8 of 7 scores 12 performances 8 of 12 performances 9 more 10 difficult 10 difficult 12 performances 11 physical 12 performances 12 performances 13 tended 13 tended 14 to 13 tended 15 correlate 14 to 15 correlate 15 correlate 16 with 16 with 18 presence 17 the 18 presence 18 presence 19 of 19 of 22 fragments 20 terminal 22 fragments 21 restriction 22 fragments 22 fragments 23 longer 23 longer 24 than 24 than 26 kb 25 9.4 26 kb background : jak2v617f mutation occurs in 90 % of polycythemia vera ( [pv] [ )(and in 50 % of essential thrombocythemia ( et ) patients . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 mutation 2 : 5 occurs 2 : 26 . 3 jak2v617f 4 mutation 4 mutation 5 occurs 5 occurs 15 )(and 6 in 8 % 6 in 15 )(and 7 90 8 % 8 % 9 of 9 of 11 vera 10 polycythemia 11 vera 12 ( 15 )(and 15 )(and 16 in 16 in 18 % 17 50 18 % 18 % 19 of 19 of 25 patients 20 essential 25 patients 21 thrombocythemia 23 et 21 thrombocythemia 25 patients 22 ( 23 et 23 et 24 ) materials and methods : 253 consecutive patients affected by myeloproliferative disorders ( mpd , 121 pv , 132 et ) were evaluated and stratified in 4 age groups : 18 - 39 , 40 - 59 , 60 - 75 and over 75 years ( >75 ) . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 48 . 1 materials 2 and 2 and 3 methods 4 : 7 patients 4 : 23 and 4 : 29 : 5 253 7 patients 6 consecutive 7 patients 7 patients 8 affected 7 patients 16 pv 7 patients 19 et 7 patients 23 and 8 affected 9 by 9 by 11 disorders 10 myeloproliferative 11 disorders 11 disorders 13 mpd 12 ( 13 mpd 13 mpd 14 , 14 , 16 pv 15 121 16 pv 16 pv 17 , 17 , 19 et 18 132 19 et 19 et 20 ) 21 were 22 evaluated 21 were 23 and 23 and 24 stratified 23 and 25 in 23 and 28 groups 25 in 26 4 27 age 28 groups 29 : 30 18 29 : 31 - 29 : 33 , 30 18 31 - 31 - 32 39 33 , 34 40 33 , 35 - 35 - 36 59 35 - 37 , 35 - 39 - 37 , 38 60 39 - 44 years 40 75 41 and 41 and 43 75 41 and 44 years 42 over 43 75 44 years 46 >75 45 ( 46 >75 46 >75 47 ) the jak2v617f mutation was searched and its allele burden was evaluated . 0 ###LEFT-WALL### 3 mutation 0 ###LEFT-WALL### 5 searched 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 12 . 1 the 3 mutation 2 jak2v617f 3 mutation 3 mutation 4 was 4 was 5 searched 6 and 9 burden 6 and 11 evaluated 7 its 9 burden 8 allele 9 burden 9 burden 10 was 10 was 11 evaluated results : the percentage of mutated patients increased progressively with age mainly in patients >75 ( p=0.0015 vs 18 - 39 , p=0.0021 vs 40 - 59 and p=0.012 vs 60 - 75 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 1 results 2 : 2 : 4 percentage 3 the 4 percentage 4 percentage 5 of 5 of 7 patients 6 mutated 7 patients 7 patients 8 increased 7 patients 17 p=0.0015 8 increased 9 progressively 8 increased 10 with 8 increased 12 mainly 8 increased 15 >75 10 with 11 age 12 mainly 13 in 13 in 14 patients 16 ( 17 p=0.0015 17 p=0.0015 18 vs 17 p=0.0015 34 ) 18 vs 20 - 19 18 20 - 20 - 21 39 20 - 28 and 22 , 28 and 23 p=0.0021 24 vs 23 p=0.0021 28 and 24 vs 26 - 25 40 26 - 26 - 27 59 28 and 29 p=0.012 28 and 30 vs 28 and 33 75 28 and 34 ) 30 vs 31 60 32 - 33 75 33 75 34 ) we also found a progressive increase in allele burden with age ( r2=0.042 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 15 . 1 we 3 found 2 also 3 found 3 found 6 increase 3 found 7 in 3 found 10 with 4 a 5 progressive 4 a 6 increase 5 progressive 6 increase 7 in 9 burden 8 allele 9 burden 10 with 11 age 11 age 13 r2=0.042 12 ( 13 r2=0.042 13 r2=0.042 14 ) thrombotic events were more common in patients carrying the mutation in comparison with wild [type] ( wt ) [(] p=0.006 , coefficient risk [1.94] ) . 0 ###LEFT-WALL### 2 events 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 26 . 1 thrombotic 2 events 2 events 3 were 3 were 5 common 4 more 5 common 5 common 6 in 5 common 11 in 5 common 13 with 6 in 7 patients 7 patients 8 carrying 8 carrying 10 mutation 9 the 10 mutation 11 in 12 comparison 13 with 20 p=0.006 14 wild 17 wt 14 wild 18 ) 14 wild 20 p=0.006 16 ( 17 wt 17 wt 18 ) 20 p=0.006 23 risk 21 , 23 risk 22 coefficient 23 risk 23 risk 25 ) no differences in the percentage of patients carrying the jak2v617f mutation were found , in spite of different [follow] - up durations ( < 5 yrs , 5 - 10 yrs , 10 - 15 yrs , >15 [yrs] ) . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 13 found 0 ###LEFT-WALL### 41 . 1 no 2 differences 2 differences 3 in 2 differences 6 of 2 differences 12 were 3 in 5 percentage 4 the 5 percentage 6 of 7 patients 7 patients 8 carrying 8 carrying 11 mutation 9 the 11 mutation 10 jak2v617f 11 mutation 12 were 13 found 13 found 15 in 14 , 15 in 15 in 16 spite 15 in 40 ) 16 spite 17 of 16 spite 29 - 17 of 22 durations 18 different 20 - 18 different 22 durations 21 up 22 durations 22 durations 26 yrs 23 ( 26 yrs 24 < 25 5 25 5 26 yrs 26 yrs 27 , 27 , 29 - 28 5 29 - 29 - 38 >15 29 - 40 ) 30 10 31 yrs 31 yrs 38 >15 32 , 34 - 33 10 34 - 34 - 36 yrs 34 - 37 , 34 - 38 >15 35 15 36 yrs the jak2v617f allele burden was similar in patients [with] ( 57 ± 31 [%] ) and without [(] 45 ± 26 % [ )(long - term hydroxyurea treatment . 0 ###LEFT-WALL### 4 burden 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 29 . 1 the 4 burden 2 jak2v617f 4 burden 3 allele 4 burden 4 burden 5 was 5 was 6 similar 6 similar 16 and 7 in 8 patients 7 in 16 and 8 patients 12 ± 10 ( 12 ± 11 57 12 ± 12 ± 13 31 12 ± 15 ) 16 and 17 without 17 without 28 treatment 19 45 20 ± 20 ± 28 treatment 21 26 22 % 22 % 28 treatment 24 )(long 25 - 24 )(long 26 term 26 term 28 treatment 27 hydroxyurea 28 treatment conclusions : jak2v617f mutation is more common in old than in young patients with mpd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 1 conclusions 2 : 2 : 3 jak2v617f 3 jak2v617f 4 mutation 3 jak2v617f 8 in 3 jak2v617f 9 old 4 mutation 5 is 5 is 7 common 6 more 7 common 7 common 8 in 9 old 10 than 9 old 11 in 9 old 14 with 11 in 13 patients 12 young 13 patients 14 with 15 mpd older patients have an higher allele burden . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 8 . 1 older 2 patients 2 patients 3 have 3 have 7 burden 4 an 7 burden 5 higher 7 burden 6 allele 7 burden age - related hearing impairment ( arhi ) , or presbycusis , is a complex disease with multifactorial etiology . 0 ###LEFT-WALL### 10 or 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 20 . 1 age 5 impairment 1 age 10 or 2 - 5 impairment 3 related 4 hearing 4 hearing 5 impairment 5 impairment 7 arhi 5 impairment 8 ) 6 ( 7 arhi 7 arhi 8 ) 9 , 10 or 10 or 11 presbycusis 12 , 13 is 13 is 16 disease 13 is 17 with 14 a 15 complex 14 a 16 disease 15 complex 16 disease 17 with 19 etiology 18 multifactorial 19 etiology it is the most prevalent sensory impairment in the elderly , and may have detrimental effects on their quality of life and psychological well - being . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 25 - 1 it 12 and 2 is 7 impairment 2 is 12 and 3 the 4 most 4 most 7 impairment 5 prevalent 7 impairment 6 sensory 7 impairment 7 impairment 8 in 8 in 10 elderly 9 the 10 elderly 11 , 12 and 12 and 13 may 13 may 14 have 14 have 16 effects 14 have 17 on 15 detrimental 16 effects 17 on 19 quality 18 their 19 quality 19 quality 20 of 20 of 22 and 21 life 22 and 22 and 24 well 23 psychological 24 well 25 - 26 being 25 - 27 . the aim of this paper is to give an overview of the current data on arhi , focusing mainly on environmental agents and genetic predisposition in animal models and in humans . 1 the 2 aim 2 aim 3 of 2 aim 6 is 3 of 5 paper 4 this 5 paper 6 is 7 to 6 is 8 give 7 to 8 give 8 give 10 overview 8 give 15 on 9 an 10 overview 10 overview 11 of 11 of 14 data 12 the 14 data 13 current 14 data 15 on 16 arhi 16 arhi 18 focusing 17 , 18 focusing 18 focusing 19 mainly 18 focusing 32 . 19 mainly 20 on 20 on 23 and 21 environmental 22 agents 22 agents 23 and 23 and 25 predisposition 23 and 29 and 24 genetic 25 predisposition 26 in 28 models 26 in 29 and 27 animal 28 models 29 and 30 in 30 in 31 humans with improvement of our understanding of arhi , treatment [other] [than] with amplification will be hopefully possible in the long term . 0 ###LEFT-WALL### 9 treatment 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 22 . 1 with 2 improvement 1 with 8 , 1 with 9 treatment 2 improvement 3 of 3 of 5 understanding 4 our 5 understanding 5 understanding 6 of 6 of 7 arhi 9 treatment 12 with 9 treatment 14 will 12 with 13 amplification 14 will 15 be 15 be 16 hopefully 15 be 17 possible 17 possible 18 in 18 in 21 term 19 the 21 term 20 long 21 term none larger animal models , [such] as porcine , have been validated as appropriate models of the human disc with respect to biomechanics and biochemistry . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 12 validated 0 ###LEFT-WALL### 26 . 1 none 4 models 1 none 11 been 1 none 12 validated 2 larger 4 models 3 animal 4 models 4 models 8 porcine 4 models 10 have 5 , 8 porcine 7 as 8 porcine 8 porcine 9 , 10 have 11 been 12 validated 15 models 12 validated 20 with 12 validated 22 to 13 as 14 appropriate 14 appropriate 15 models 15 models 16 of 16 of 19 disc 17 the 19 disc 18 human 19 disc 20 with 21 respect 22 to 24 and 23 biomechanics 24 and 24 and 25 biochemistry they are advantageous for research as the models [are] relatively straightforward to prepare and easily obtainable for research to perform surgical techniques . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 23 . 1 they 2 are 2 are 14 and 3 advantageous 4 for 3 advantageous 6 as 3 advantageous 14 and 4 for 5 research 6 as 8 models 7 the 8 models 8 models 11 straightforward 10 relatively 11 straightforward 11 straightforward 12 to 11 straightforward 13 prepare 12 to 13 prepare 14 and 16 obtainable 15 easily 16 obtainable 16 obtainable 17 for 16 obtainable 19 to 17 for 18 research 19 to 20 perform 20 perform 22 techniques 21 surgical 22 techniques the intention of this study was to quantitatively analyze gene expression for collagen and proteoglycan components of the extracellular matrix and for collagenase ( mmp - 1 ) in porcine discs of varying ages ( newborn ; 2 - 3weeks , mature ; 6 - 9 month , older ; 2 - 3 years [ )( 0 ###LEFT-WALL### 2 intention 0 ###LEFT-WALL### 37 ; 0 ###LEFT-WALL### 56 )( 1 the 2 intention 2 intention 3 of 2 intention 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 9 analyze 7 to 9 analyze 8 quantitatively 9 analyze 9 analyze 11 expression 9 analyze 29 in 10 gene 11 expression 11 expression 21 and 12 for 14 and 12 for 21 and 13 collagen 14 and 14 and 16 components 14 and 17 of 15 proteoglycan 16 components 17 of 20 matrix 18 the 20 matrix 19 extracellular 20 matrix 21 and 22 for 22 for 23 collagenase 23 collagenase 26 - 24 ( 26 - 25 mmp 26 - 26 - 27 1 26 - 28 ) 29 in 31 discs 30 porcine 31 discs 31 discs 32 of 32 of 33 varying 33 varying 34 ages 34 ages 36 newborn 35 ( 36 newborn 36 newborn 37 ; 37 ; 38 2 37 ; 39 - 39 - 40 3weeks 39 - 43 ; 40 3weeks 42 mature 41 , 42 mature 42 mature 43 ; 43 ; 44 6 43 ; 48 , 44 6 47 month 45 - 46 9 46 9 47 month 48 , 49 older 48 , 50 ; 50 ; 51 2 51 2 54 years 52 - 53 3 53 3 54 years in this study , we observed that the cell number and gag ( glycosaminoglycan ) formation dramatically decreased with aging . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 21 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 observed 6 observed 7 that 7 that 11 and 7 that 18 decreased 8 the 10 number 9 cell 10 number 10 number 11 and 11 and 16 formation 11 and 18 decreased 12 gag 14 glycosaminoglycan 12 gag 16 formation 13 ( 14 glycosaminoglycan 14 glycosaminoglycan 15 ) 17 dramatically 18 decreased 18 decreased 19 with 19 with 20 aging also , gene expression in the annulus fibrosus ( af ) and nucleus pulposus ( np ) cells changed with aging . 0 ###LEFT-WALL### 18 cells 0 ###LEFT-WALL### 19 changed 0 ###LEFT-WALL### 22 . 1 also 2 , 1 also 18 cells 3 gene 18 cells 4 expression 5 in 4 expression 12 and 5 in 8 fibrosus 6 the 8 fibrosus 7 annulus 8 fibrosus 8 fibrosus 10 af 9 ( 10 af 10 af 11 ) 12 and 14 pulposus 12 and 16 np 12 and 18 cells 13 nucleus 14 pulposus 15 ( 16 np 16 np 17 ) 18 cells 19 changed 19 changed 20 with 20 with 21 aging the level of mmp - 1 mrna increased with age and both type i , ii collagens decreased with age . 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 18 decreased 0 ###LEFT-WALL### 21 . 1 the 2 level 2 level 3 of 2 level 16 ii 2 level 17 collagens 2 level 18 decreased 3 of 4 mmp 4 mmp 7 mrna 5 - 7 mrna 6 1 7 mrna 7 mrna 8 increased 7 mrna 15 , 8 increased 9 with 9 with 11 and 9 with 13 type 10 age 11 and 11 and 12 both 13 type 14 i 16 ii 17 collagens 18 decreased 19 with 19 with 20 age the level of aggrecan mrna was [highest] in the mature group and decreased significantly with aging . 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 17 . 1 the 2 level 2 level 3 of 2 level 12 and 3 of 5 mrna 4 aggrecan 5 mrna 6 was 8 in 6 was 12 and 8 in 11 group 9 the 11 group 10 mature 11 group 12 and 13 decreased 12 and 14 significantly 12 and 15 with 15 with 16 aging in the mature group , mmp - 1 expression was minimal [compared] to the newborn group . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 17 . 1 in 4 group 1 in 10 was 2 the 4 group 3 mature 4 group 4 group 6 mmp 5 , 6 mmp 6 mmp 7 - 8 1 9 expression 9 expression 10 was 10 was 11 minimal 11 minimal 13 to 13 to 16 group 14 the 16 group 15 newborn 16 group in af cells , type ii collagen was expressed at a high level in the mature group with a higher level of aggrecan , when aged np showed a decrease in type ii collagen . 0 ###LEFT-WALL### 5 type 0 ###LEFT-WALL### 9 expressed 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 35 . 1 in 3 cells 1 in 4 , 1 in 5 type 2 af 3 cells 5 type 6 ii 5 type 7 collagen 5 type 8 was 5 type 9 expressed 7 collagen 8 was 9 expressed 10 at 9 expressed 18 with 10 at 13 level 11 a 13 level 12 high 13 level 13 level 14 in 14 in 17 group 15 the 17 group 16 mature 17 group 18 with 21 level 19 a 21 level 20 higher 21 level 21 level 22 of 22 of 23 aggrecan 24 , 27 np 24 , 28 showed 25 when 26 aged 25 when 27 np 27 np 28 showed 28 showed 30 decrease 28 showed 34 collagen 29 a 30 decrease 30 decrease 31 in 31 in 32 type 32 type 33 ii the model of ivd degeneration in the porcine disc shows many changes in gene expression with age that have been previously documented for human and [may] serve as a model for studying changes in ivd metabolism with age . 0 ###LEFT-WALL### 2 model 0 ###LEFT-WALL### 10 shows 0 ###LEFT-WALL### 39 . 1 the 2 model 2 model 3 of 2 model 10 shows 3 of 5 degeneration 4 ivd 5 degeneration 5 degeneration 6 in 6 in 9 disc 7 the 9 disc 8 porcine 9 disc 10 shows 12 changes 10 shows 33 changes 11 many 12 changes 12 changes 13 in 12 changes 16 with 12 changes 18 that 12 changes 19 have 13 in 15 expression 14 gene 15 expression 16 with 17 age 18 that 19 have 19 have 20 been 20 been 22 documented 21 previously 22 documented 22 documented 23 for 22 documented 31 for 23 for 25 and 24 human 25 and 25 and 27 serve 25 and 28 as 28 as 30 model 29 a 30 model 31 for 32 studying 33 changes 34 in 33 changes 37 with 34 in 36 metabolism 35 ivd 36 metabolism 37 with 38 age we concluded that the porcine model is excellent to test hypotheses related to disc degeneration while permitting time - course study in biologically active systems . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 concluded 0 ###LEFT-WALL### 12 related 0 ###LEFT-WALL### 19 - 1 we 2 concluded 2 concluded 3 that 3 that 6 model 3 that 12 related 4 the 6 model 5 porcine 6 model 6 model 7 is 7 is 8 excellent 8 excellent 9 to 8 excellent 10 test 9 to 10 test 11 hypotheses 12 related 12 related 13 to 12 related 16 while 12 related 19 - 13 to 15 degeneration 14 disc 15 degeneration 16 while 17 permitting 17 permitting 18 time 19 - 20 course 19 - 26 . 20 course 21 study 20 course 22 in 22 in 25 systems 23 biologically 24 active 24 active 25 systems preclinical alzheimer 's disease [(] [pad] [ )(reflects neuropathological findings of ad in cognitively normal subjects . 0 ###LEFT-WALL### 4 disease 0 ###LEFT-WALL### 8 )(reflects 0 ###LEFT-WALL### 17 . 1 preclinical 2 alzheimer 2 alzheimer 3 's 3 's 4 disease 4 disease 8 )(reflects 8 )(reflects 10 findings 8 )(reflects 13 in 9 neuropathological 10 findings 10 findings 11 of 11 of 12 ad 13 in 16 subjects 14 cognitively 15 normal 15 normal 16 subjects the present study represents an effort to determine if differences could be identified in the longitudinal patterns of cognitive performance in persons classified as [pad] compared to those who did not meet criteria for ad [at] [autopsy] . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 represents 0 ###LEFT-WALL### 8 determine 1 the 3 study 2 present 3 study 3 study 4 represents 4 represents 6 effort 5 an 6 effort 6 effort 7 to 6 effort 8 determine 7 to 8 determine 8 determine 9 if 8 determine 27 to 8 determine 38 . 9 if 10 differences 9 if 26 compared 10 differences 11 could 11 could 12 be 12 be 13 identified 13 identified 14 in 14 in 17 patterns 15 the 17 patterns 16 longitudinal 17 patterns 17 patterns 18 of 18 of 20 performance 19 cognitive 20 performance 20 performance 21 in 21 in 22 persons 22 persons 23 classified 23 classified 24 as 24 as 26 compared 27 to 28 those 28 those 29 who 28 those 30 did 29 who 30 did 30 did 31 not 30 did 32 meet 32 meet 33 criteria 33 criteria 34 for 34 for 35 ad we included 121 subjects who were cognitively normal from baseline through their last assessment before death and who underwent [autopsy] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 21 . 1 we 2 included 2 included 4 subjects 2 included 11 through 2 included 15 before 3 121 4 subjects 4 subjects 5 who 4 subjects 6 were 5 who 6 were 6 were 7 cognitively 6 were 8 normal 8 normal 9 from 9 from 10 baseline 11 through 14 assessment 12 their 14 assessment 13 last 14 assessment 15 before 17 and 15 before 19 underwent 16 death 17 and 17 and 18 who 17 and 19 underwent participants were classified into two groups : pathologically normal [(] pn ; nia - reagan low or no [-] likelihood of ad , n = 89 ) and preclinical ad ( [pad] [;] nia - reagan criteria of intermediate or high - likelihood of ad in the absence of clinical dementia symptoms , n = 32 ) followed for a mean 7.5 years prior to death [.] 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 classified 0 ###LEFT-WALL### 7 : 1 participants 2 were 2 were 3 classified 3 classified 4 into 4 into 6 groups 5 two 6 groups 7 : 11 pn 7 : 12 ; 8 pathologically 9 normal 9 normal 11 pn 12 ; 13 nia 12 ; 14 - 14 - 17 or 15 reagan 16 low 16 low 17 or 17 or 20 likelihood 18 no 20 likelihood 20 likelihood 21 of 21 of 28 and 22 ad 25 = 22 ad 28 and 23 , 25 = 24 n 25 = 25 = 26 89 25 = 27 ) 28 and 37 criteria 28 and 38 of 29 preclinical 37 criteria 30 ad 34 nia 31 ( 34 nia 34 nia 35 - 34 nia 37 criteria 36 reagan 37 criteria 38 of 43 likelihood 39 intermediate 40 or 40 or 41 high 40 or 42 - 40 or 43 likelihood 43 likelihood 44 of 43 likelihood 49 of 44 of 45 ad 45 ad 46 in 46 in 48 absence 47 the 48 absence 49 of 51 dementia 50 clinical 51 dementia 51 dementia 52 symptoms 51 dementia 58 followed 52 symptoms 55 = 52 symptoms 58 followed 53 , 55 = 54 n 55 = 55 = 56 32 55 = 57 ) 58 followed 59 for 59 for 64 prior 60 a 64 prior 61 mean 64 prior 62 7.5 63 years 63 years 64 prior 64 prior 65 to 65 to 66 death longitudinal rates and patterns of change in scores on a standard cognitive battery were compared between these two groups . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 20 . 1 longitudinal 2 rates 3 and 4 patterns 3 and 15 compared 4 patterns 5 of 4 patterns 14 were 5 of 6 change 6 change 7 in 6 change 9 on 7 in 8 scores 9 on 13 battery 10 a 11 standard 10 a 13 battery 11 standard 13 battery 12 cognitive 13 battery 14 were 15 compared 15 compared 16 between 16 between 19 groups 17 these 18 two 18 two 19 groups while cognitive results at baseline and last evaluations revealed no clear cross sectional group differences after adjustment for age , apoe status , education , and gender [,] statistically significant differences between the [pad] [and] pn groups in slope of decline were seen on a composite score of cognitive function [.] 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 9 revealed 1 while 2 cognitive 1 while 3 results 3 results 4 at 3 results 9 revealed 4 at 6 and 5 baseline 6 and 6 and 8 evaluations 7 last 8 evaluations 9 revealed 15 differences 9 revealed 16 after 9 revealed 18 for 10 no 15 differences 11 clear 15 differences 12 cross 15 differences 13 sectional 14 group 14 group 15 differences 16 after 17 adjustment 18 for 26 and 19 age 20 , 20 , 22 status 20 , 23 , 21 apoe 22 status 23 , 24 education 23 , 26 and 25 , 26 and 26 and 31 differences 27 gender 31 differences 29 statistically 30 significant 30 significant 31 differences 31 differences 32 between 32 between 36 pn 33 the 36 pn 36 pn 37 groups 36 pn 42 were 36 pn 43 seen 37 groups 38 in 37 groups 40 of 37 groups 42 were 38 in 39 slope 40 of 41 decline 43 seen 44 on 44 on 47 score 45 a 47 score 46 composite 47 score 47 score 48 of 48 of 50 function 49 cognitive 50 function further analyses showed three components of this score reached significance : constructional praxis , delayed recall of a word list , and category verbal fluency . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 11 : 0 ###LEFT-WALL### 26 . 1 further 2 analyses 2 analyses 3 showed 3 showed 5 components 4 three 5 components 5 components 6 of 6 of 10 significance 7 this 10 significance 8 score 9 reached 9 reached 10 significance 11 : 13 praxis 11 : 14 , 12 constructional 13 praxis 14 , 22 and 15 delayed 16 recall 16 recall 17 of 16 recall 22 and 17 of 20 list 18 a 20 list 19 word 20 list 21 , 22 and 22 and 25 fluency 23 category 25 fluency 24 verbal 25 fluency [despite] being clinically viewed as normal [at] enrollment and at the final exam , there are significant differences in rates of cognitive decline [in] participants classified as [pad] compared to those without this pathology . 0 ###LEFT-WALL### 8 enrollment 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 35 . 2 being 8 enrollment 3 clinically 4 viewed 4 viewed 8 enrollment 5 as 6 normal 6 normal 8 enrollment 9 and 15 there 9 and 16 are 10 at 13 exam 10 at 14 , 10 at 15 there 11 the 13 exam 12 final 13 exam 15 there 16 are 16 are 18 differences 17 significant 18 differences 18 differences 19 in 18 differences 21 of 18 differences 30 to 19 in 20 rates 21 of 25 participants 22 cognitive 23 decline 23 decline 25 participants 25 participants 26 classified 26 classified 29 compared 27 as 29 compared 30 to 31 those 31 those 32 without 32 without 34 pathology 33 this 34 pathology longitudinal changes in slope of [decline] in specific cognitive test measures can serve as [non] [-] invasive methods for the detection [of] [pad] . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 13 serve 0 ###LEFT-WALL### 24 . 1 longitudinal 2 changes 2 changes 3 in 2 changes 5 of 2 changes 12 can 3 in 4 slope 5 of 7 in 7 in 11 measures 8 specific 10 test 9 cognitive 10 test 10 test 11 measures 12 can 13 serve 13 serve 14 as 13 serve 19 for 14 as 18 methods 17 invasive 18 methods 19 for 21 detection 20 the 21 detection objectives : the sources of age differences in short - term memory for spatial locations were explored in 2 experiments that examined factors related to input , to maintenance , and to output . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 4 sources 2 : 22 examined 2 : 24 related 3 the 4 sources 4 sources 5 of 4 sources 8 in 4 sources 13 for 4 sources 16 were 5 of 7 differences 6 age 7 differences 8 in 12 memory 9 short 10 - 9 short 11 term 11 term 12 memory 13 for 15 locations 14 spatial 15 locations 16 were 17 explored 17 explored 18 in 18 in 20 experiments 19 2 20 experiments 21 that 22 examined 22 examined 23 factors 22 examined 24 related 23 factors 24 related 24 related 31 and 25 to 26 input 25 to 31 and 26 input 28 to 27 , 28 to 28 to 29 maintenance 28 to 30 , 30 , 31 and 31 and 32 to 32 to 33 output method : in each experiment , 4 dots were presented briefly , followed after a retention interval by a probe dot , which was judged to either match or [not] match one of the 4 memory - set dots . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 8 dots 2 : 12 , 3 in 5 experiment 3 in 6 , 3 in 8 dots 4 each 5 experiment 7 4 8 dots 8 dots 12 , 9 were 10 presented 9 were 12 , 10 presented 11 briefly 12 , 13 followed 12 , 14 after 12 , 39 dots 14 after 17 interval 14 after 38 set 15 a 16 retention 15 a 17 interval 16 retention 17 interval 17 interval 18 by 17 interval 38 set 18 by 21 dot 19 a 21 dot 20 probe 21 dot 21 dot 23 which 22 , 23 which 23 which 24 was 23 which 37 - 24 was 29 or 25 judged 26 to 25 judged 29 or 26 to 28 match 27 either 28 match 29 or 31 match 31 match 32 one 32 one 33 of 33 of 36 memory 34 the 36 memory 35 4 36 memory results and discussion : results showed that poorer performance by older adults could be attributed independently to reduced visual acuity , to less effective use of rehearsal strategies , and to differences in response biases . 0 ###LEFT-WALL### 3 discussion 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 36 . 1 results 2 and 2 and 3 discussion 4 : 5 results 4 : 6 showed 5 results 6 showed 6 showed 7 that 7 that 9 performance 7 that 15 attributed 8 poorer 9 performance 9 performance 10 by 9 performance 13 could 10 by 12 adults 11 older 12 adults 13 could 14 be 14 be 15 attributed 15 attributed 16 independently 15 attributed 30 and 15 attributed 33 in 17 to 20 acuity 17 to 30 and 18 reduced 20 acuity 19 visual 20 acuity 20 acuity 22 to 21 , 22 to 22 to 25 use 22 to 29 , 23 less 25 use 24 effective 25 use 25 use 26 of 26 of 28 strategies 27 rehearsal 28 strategies 29 , 30 and 30 and 31 to 31 to 32 differences 33 in 35 biases 34 response 35 biases objectives : this study investigated predictors of discrepancies in reports of 5 types of support that aging parents and their middle - aged children exchanged with one another . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 investigated 3 this 4 study 4 study 5 investigated 5 investigated 6 predictors 5 investigated 9 in 6 predictors 7 of 7 of 8 discrepancies 9 in 19 and 10 reports 11 of 10 reports 19 and 11 of 13 types 12 5 13 types 13 types 14 of 14 of 18 parents 15 support 18 parents 16 that 17 aging 17 aging 18 parents 19 and 21 middle 19 and 24 children 20 their 21 middle 22 - 24 children 23 aged 24 children 24 children 25 exchanged 24 children 29 . 25 exchanged 26 with 26 with 28 another 27 one 28 another predictors included structural factors , including needs and resources and dyadic characteristics , and psychological factors , including family obligation and investment in the relationship . 0 ###LEFT-WALL### 1 predictors 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 26 . 1 predictors 2 included 2 included 14 and 3 structural 4 factors 4 factors 5 , 5 , 7 needs 5 , 8 and 6 including 7 needs 8 and 9 resources 8 and 10 and 10 and 12 characteristics 10 and 14 and 11 dyadic 12 characteristics 13 , 14 and 14 and 16 factors 14 and 17 , 14 and 18 including 15 psychological 16 factors 18 including 21 and 18 including 23 in 19 family 20 obligation 20 obligation 21 and 21 and 22 investment 23 in 25 relationship 24 the 25 relationship methods : participants included 337 dyads of parents ( aged 59 - 96 years ) and their children ( aged 40 - 60 years ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 3 participants 2 : 4 included 3 participants 4 included 4 included 16 and 5 337 16 and 6 dyads 7 of 6 dyads 16 and 7 of 8 parents 8 parents 14 years 9 ( 14 years 10 aged 14 years 11 59 12 - 12 - 13 96 12 - 14 years 14 years 15 ) 16 and 18 children 16 and 20 aged 16 and 24 years 17 their 18 children 19 ( 20 aged 20 aged 21 40 20 aged 22 - 22 - 24 years 23 60 24 years 24 years 25 ) multilevel models assessed the level of discrepancies between dyadic members and examined predictors accounting for the discrepancies . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 18 . 1 multilevel 2 models 2 models 11 and 3 assessed 5 level 3 assessed 8 between 3 assessed 11 and 4 the 5 level 5 level 6 of 6 of 7 discrepancies 8 between 10 members 9 dyadic 10 members 11 and 12 examined 12 examined 13 predictors 13 predictors 14 accounting 14 accounting 15 for 15 for 17 discrepancies 16 the 17 discrepancies we considered downward ( from parent [to] child ) [and] upward ( from child [to] [parent] ) directions in support exchanges . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 considered 0 ###LEFT-WALL### 22 . 1 we 2 considered 2 considered 3 downward 2 considered 5 from 2 considered 11 upward 2 considered 13 from 2 considered 18 directions 2 considered 19 in 4 ( 5 from 5 from 8 child 5 from 9 ) 6 parent 8 child 12 ( 13 from 13 from 14 child 13 from 17 ) 19 in 21 exchanges 20 support 21 exchanges results : for upward support from adult children to their parents , children reported that they gave more than their aging parents reported receiving . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 1 results 2 : 2 : 3 for 2 : 9 to 3 for 5 support 4 upward 5 support 5 support 6 from 6 from 8 children 7 adult 8 children 9 to 11 parents 10 their 11 parents 11 parents 24 receiving 12 , 23 reported 13 children 14 reported 13 children 15 that 13 children 17 gave 13 children 23 reported 15 that 16 they 15 that 17 gave 16 they 17 gave 17 gave 18 more 17 gave 19 than 19 than 22 parents 20 their 22 parents 21 aging 22 parents 23 reported 24 receiving for [downward] support from parents to children , the results differed depending on the type of support . 0 ###LEFT-WALL### 10 results 0 ###LEFT-WALL### 11 differed 0 ###LEFT-WALL### 18 . 1 for 3 support 1 for 8 , 1 for 10 results 3 support 4 from 4 from 5 parents 5 parents 6 to 6 to 7 children 9 the 10 results 10 results 11 differed 11 differed 12 depending 11 differed 13 on 13 on 17 support 14 the 15 type 15 type 16 of 15 type 17 support 16 of 17 support discrepancies between parents ' and children 's reports were associated with parents ' feelings of obligation toward children and children 's ratings of the importance [of] parent - child relationship . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 28 - 1 discrepancies 2 between 1 discrepancies 5 and 2 between 4 ' 3 parents 4 ' 5 and 8 reports 5 and 9 were 6 children 7 's 7 's 8 reports 9 were 10 associated 10 associated 11 with 10 associated 17 toward 11 with 14 feelings 12 parents 13 ' 13 ' 14 feelings 14 feelings 15 of 15 of 16 obligation 17 toward 19 and 18 children 19 and 19 and 22 ratings 19 and 23 of 20 children 21 's 21 's 22 ratings 23 of 27 parent 24 the 27 parent 25 importance 27 parent 28 - 30 relationship 28 - 31 . 29 child 30 relationship discussion : these results suggest the importance of considering multiple perspectives and the direction of exchanges between generations . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 4 results 2 : 5 suggest 3 these 4 results 4 results 5 suggest 5 suggest 7 importance 5 suggest 17 between 6 the 7 importance 7 importance 8 of 8 of 9 considering 9 considering 12 and 10 multiple 11 perspectives 11 perspectives 12 and 12 and 14 direction 12 and 15 of 13 the 14 direction 15 of 16 exchanges 17 between 18 generations discrepancies in reports of support reflect both self [-] enhancement and family context and may be an important source of misunderstanding and conflict between generations . 0 ###LEFT-WALL### 1 discrepancies 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 26 . 1 discrepancies 2 in 1 discrepancies 4 of 1 discrepancies 14 and 2 in 3 reports 4 of 5 support 6 reflect 11 and 6 reflect 14 and 7 both 11 and 8 self 10 enhancement 10 enhancement 11 and 11 and 13 context 12 family 13 context 14 and 22 and 15 may 16 be 15 may 22 and 16 be 19 source 17 an 18 important 17 an 19 source 18 important 19 source 19 source 20 of 20 of 21 misunderstanding 22 and 23 conflict 23 conflict 24 between 24 between 25 generations background : previous cross - sectional studies demonstrate positive associations of fat - free mass and negative associations [of] centrally distributed fat deposits with respiratory function [in] older adults . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 cross 2 : 5 - 2 : 13 - 3 previous 4 cross 5 - 7 studies 5 - 8 demonstrate 6 sectional 7 studies 7 studies 8 demonstrate 8 demonstrate 10 associations 9 positive 10 associations 10 associations 11 of 11 of 12 fat 13 - 15 mass 13 - 16 and 13 - 30 . 14 free 15 mass 16 and 18 associations 16 and 21 distributed 17 negative 18 associations 18 associations 21 distributed 20 centrally 21 distributed 21 distributed 23 deposits 21 distributed 24 with 22 fat 23 deposits 24 with 29 adults 25 respiratory 26 function 26 function 29 adults 28 older 29 adults few studies have evaluated whether greater losses of muscle and increases in fat are associated with more rapid decline in respiratory function [in] aging . 0 ###LEFT-WALL### 1 few 0 ###LEFT-WALL### 19 decline 0 ###LEFT-WALL### 25 . 1 few 2 studies 1 few 4 evaluated 1 few 19 decline 2 studies 3 have 3 have 4 evaluated 4 evaluated 5 whether 5 whether 7 losses 5 whether 15 associated 6 greater 7 losses 7 losses 8 of 7 losses 14 are 8 of 10 and 9 muscle 10 and 10 and 11 increases 10 and 12 in 12 in 13 fat 14 are 15 associated 15 associated 16 with 15 associated 18 rapid 16 with 17 more 19 decline 20 in 20 in 24 aging 21 respiratory 22 function 22 function 24 aging methods : nine hundred and fifty - seven men and 1,024 women aged , respectively , 73.6 ± 2.8 years and 73.2 ± 2.8 years at baseline were followed for 5 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 1 methods 2 : 2 : 6 fifty 3 nine 4 hundred 4 hundred 5 and 5 and 6 fifty 7 - 10 and 7 - 13 aged 7 - 21 and 7 - 33 . 8 seven 9 men 9 men 10 and 10 and 12 women 10 and 13 aged 11 1,024 12 women 13 aged 15 respectively 13 aged 20 years 14 , 15 respectively 15 respectively 16 , 17 73.6 20 years 18 ± 20 years 19 2.8 20 years 21 and 25 years 21 and 29 followed 22 73.2 23 ± 23 ± 25 years 24 2.8 25 years 25 years 26 at 25 years 28 were 26 at 27 baseline 28 were 29 followed 29 followed 30 for 30 for 32 years 31 5 32 years body weight , waist circumference , bone mineral density , fat - free mass , fat mass and fat mass percentage as measured by dxa , abdominal subcutaneous and visceral adipose tissue , thigh muscle area , thigh intermuscular fat by ct and forced expiratory volume in 1 second ( fev1 ) and forced vital capacity ( fvc ) were evaluated at baseline and after 5 - years follow - up . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 61 evaluated 0 ###LEFT-WALL### 67 - 1 body 2 weight 2 weight 3 , 3 , 5 circumference 3 , 6 , 4 waist 5 circumference 6 , 9 density 6 , 10 , 7 bone 8 mineral 8 mineral 9 density 10 , 14 mass 10 , 15 , 11 fat 12 - 11 fat 14 mass 13 free 14 mass 15 , 17 mass 15 , 18 and 16 fat 17 mass 18 and 21 percentage 18 and 23 measured 18 and 32 tissue 18 and 60 were 19 fat 20 mass 20 mass 21 percentage 22 as 23 measured 23 measured 24 by 24 by 25 dxa 26 , 32 tissue 27 abdominal 32 tissue 28 subcutaneous 29 and 29 and 30 visceral 29 and 32 tissue 31 adipose 32 tissue 32 tissue 43 and 32 tissue 59 ) 33 , 43 and 34 thigh 36 area 35 muscle 36 area 36 area 37 , 37 , 40 fat 37 , 43 and 38 thigh 40 fat 39 intermuscular 40 fat 40 fat 41 by 41 by 42 ct 43 and 46 volume 43 and 47 in 43 and 58 fvc 43 and 59 ) 44 forced 46 volume 45 expiratory 46 volume 47 in 53 and 48 1 49 second 49 second 51 fev1 49 second 53 and 50 ( 51 fev1 51 fev1 52 ) 53 and 56 capacity 54 forced 56 capacity 55 vital 56 capacity 57 ( 58 fvc 58 fvc 59 ) 60 were 61 evaluated 61 evaluated 64 and 62 at 63 baseline 62 at 64 and 64 and 65 after 65 after 66 5 67 - 68 years 67 - 69 follow 67 - 70 - 67 - 72 . 68 years 69 follow 70 - 71 up results : cross - sectional analyses showed that height and thigh muscle area were positively and visceral adipose tissue negatively related to fev1 and fvc . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 results 2 : 2 : 3 cross 4 - 6 analyses 4 - 7 showed 4 - 21 related 5 sectional 6 analyses 6 analyses 7 showed 7 showed 8 that 8 that 16 and 8 that 21 related 9 height 10 and 10 and 11 thigh 10 and 13 area 10 and 14 were 10 and 16 and 12 muscle 13 area 13 area 14 were 14 were 15 positively 16 and 19 tissue 16 and 21 related 17 visceral 18 adipose 18 adipose 19 tissue 20 negatively 21 related 21 related 22 to 22 to 25 fvc 23 fev1 24 and 24 and 25 fvc 25 fvc 26 . increase in fat [mass] over five years was associated with concurrent fev1 and fvc decline . 0 ###LEFT-WALL### 1 increase 0 ###LEFT-WALL### 9 associated 0 ###LEFT-WALL### 16 . 1 increase 2 in 1 increase 8 was 2 in 3 fat 3 fat 5 over 5 over 7 years 6 five 7 years 8 was 9 associated 9 associated 10 with 10 with 13 and 11 concurrent 12 fev1 12 fev1 13 and 13 and 15 decline 14 fvc 15 decline in analyses stratified by weight - change categories , men and women who gained weight ( [vs] stable/lost weight ) had more rapid declines in fev1 and fvc . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 21 had 0 ###LEFT-WALL### 29 . 1 in 2 analyses 1 in 11 and 2 analyses 3 stratified 3 stratified 4 by 4 by 5 weight 5 weight 8 categories 6 - 8 categories 7 change 8 categories 8 categories 9 , 10 men 11 and 11 and 12 women 11 and 13 who 11 and 14 gained 11 and 21 had 13 who 14 gained 14 gained 15 weight 15 weight 19 weight 16 ( 19 weight 18 stable/lost 19 weight 19 weight 20 ) 21 had 24 declines 21 had 25 in 22 more 24 declines 23 rapid 24 declines 25 in 28 fvc 26 fev1 27 and 27 and 28 fvc weight gain and accompanying fat deposition may accelerate age - related declines [in] respiratory function . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 - 1 weight 3 and 2 gain 3 and 3 and 8 accelerate 4 accompanying 6 deposition 4 accompanying 7 may 5 fat 6 deposition 7 may 8 accelerate 8 accelerate 9 age 10 - 15 function 10 - 16 . 11 related 12 declines 12 declines 15 function 14 respiratory 15 function background : self - neglect is the behavior of an elderly person that threatens his or her own health and safety , and it is associated with increased morbidity and mortality . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 background 2 : 2 : 3 self 4 - 5 neglect 4 - 6 is 4 - 23 and 4 - 32 . 5 neglect 6 is 6 is 20 and 7 the 20 and 8 behavior 9 of 8 behavior 16 or 9 of 12 person 10 an 11 elderly 10 an 12 person 11 elderly 12 person 12 person 13 that 12 person 14 threatens 13 that 14 threatens 14 threatens 15 his 16 or 19 health 16 or 20 and 17 her 18 own 17 her 19 health 20 and 21 safety 22 , 23 and 23 and 24 it 23 and 26 associated 24 it 25 is 25 is 26 associated 26 associated 27 with 27 with 30 and 28 increased 29 morbidity 29 morbidity 30 and 30 and 31 mortality although report [of] self [-] neglect is more common among black older adults , the racial/ethnic differences in mortality remain unclear . 0 ###LEFT-WALL### 17 differences 0 ###LEFT-WALL### 20 remain 0 ###LEFT-WALL### 22 . 1 although 6 neglect 1 although 7 is 1 although 14 , 1 although 17 differences 2 report 6 neglect 4 self 6 neglect 6 neglect 7 is 7 is 9 common 8 more 9 common 9 common 10 among 10 among 13 adults 11 black 13 adults 12 older 13 adults 15 the 17 differences 16 racial/ethnic 17 differences 17 differences 18 in 17 differences 20 remain 18 in 19 mortality 20 remain 21 unclear methods : the chicago healthy aging project is a population - based cohort study conducted from 1993 to 2005 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 7 project 2 : 8 is 2 : 11 - 3 the 7 project 4 chicago 5 healthy 5 healthy 6 aging 6 aging 7 project 7 project 8 is 8 is 10 population 9 a 10 population 11 - 14 study 12 based 13 cohort 13 cohort 14 study 14 study 15 conducted 15 conducted 18 to 16 from 18 to 17 1993 18 to 18 to 19 2005 a subset of these participants were suspected to self [-] neglect and were reported to a social services agency . 0 ###LEFT-WALL### 2 subset 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 20 . 1 a 2 subset 2 subset 3 of 2 subset 12 and 3 of 5 participants 4 these 5 participants 6 were 7 suspected 6 were 12 and 7 suspected 8 to 8 to 11 neglect 9 self 11 neglect 12 and 13 were 12 and 15 to 13 were 14 reported 15 to 19 agency 16 a 17 social 16 a 19 agency 17 social 18 services 18 services 19 agency mortality was ascertained during [follow] - up and from the national death index . 0 ###LEFT-WALL### 1 mortality 0 ###LEFT-WALL### 3 ascertained 0 ###LEFT-WALL### 14 . 1 mortality 2 was 2 was 3 ascertained 3 ascertained 8 and 4 during 7 up 4 during 8 and 6 - 7 up 8 and 9 from 9 from 13 index 10 the 13 index 11 national 12 death 12 death 13 index cox proportional hazards models were used to assess the mortality risk . 0 ###LEFT-WALL### 1 cox 0 ###LEFT-WALL### 12 . 1 cox 3 hazards 2 proportional 3 hazards 3 hazards 4 models 3 hazards 8 assess 4 models 5 were 5 were 6 used 6 used 7 to 6 used 8 assess 7 to 8 assess 8 assess 11 risk 9 the 11 risk 10 mortality 11 risk results : in the total cohort , there were 5,963 black and 3,475 white older adults , and of these , 1,479 were reported for self [-] neglect ( 21.7 % in black and 5.3 % in white older adults ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 42 . 1 results 2 : 2 : 3 in 3 in 6 cohort 4 the 6 cohort 5 total 6 cohort 7 , 8 there 7 , 9 were 7 , 18 and 8 there 9 were 9 were 12 and 10 5,963 12 and 11 black 12 and 12 and 16 adults 12 and 17 , 13 3,475 16 adults 14 white 16 adults 15 older 16 adults 18 and 22 1,479 18 and 24 reported 19 of 20 these 19 of 21 , 19 of 22 1,479 22 1,479 23 were 23 were 24 reported 24 reported 25 for 25 for 28 neglect 26 self 28 neglect 28 neglect 34 and 29 ( 34 and 30 21.7 32 in 31 % 32 in 32 in 33 black 33 black 34 and 34 and 40 adults 34 and 41 ) 35 5.3 37 in 36 % 37 in 37 in 40 adults 38 white 40 adults 39 older 40 adults in multivariable analyses with extensive adjustments , the interaction term indicated that impact of self [-] neglect on mortality was significantly stronger in black than in white older adults ( parameter estimate [,] 0.54 , se , 0.14 , p < [.] 001 ) . 0 ###LEFT-WALL### 10 term 0 ###LEFT-WALL### 11 indicated 0 ###LEFT-WALL### 45 . 1 in 3 analyses 1 in 10 term 2 multivariable 3 analyses 4 with 6 adjustments 4 with 7 , 4 with 10 term 5 extensive 6 adjustments 8 the 10 term 9 interaction 10 term 10 term 11 indicated 11 indicated 12 that 12 that 13 impact 12 that 20 was 13 impact 14 of 13 impact 20 was 14 of 17 neglect 15 self 17 neglect 17 neglect 18 on 18 on 19 mortality 20 was 22 stronger 21 significantly 22 stronger 22 stronger 23 in 22 stronger 25 than 22 stronger 41 < 23 in 24 black 25 than 26 in 26 in 29 adults 27 white 29 adults 28 older 29 adults 29 adults 32 estimate 30 ( 32 estimate 31 parameter 32 estimate 32 estimate 34 0.54 32 estimate 36 se 32 estimate 37 , 35 , 36 se 36 se 37 , 38 0.14 41 < 39 , 41 < 40 p 41 < 41 < 43 001 41 < 44 ) this difference persisted over time . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 3 persisted 0 ###LEFT-WALL### 6 . 1 this 2 difference 2 difference 3 persisted 3 persisted 4 over 4 over 5 time in race/ethnicity - stratified analyses , at 6 months after report [of] self - neglect , the hazard ratio for black older adults was 5.00 ( 95 % confidence interval , 4.47 - 5.59 [ )( for white older adults [was] 2.75 ( 95 % confidence interval , 2.19 - 3.44 ) . 0 ###LEFT-WALL### 2 race/ethnicity 0 ###LEFT-WALL### 3 - 1 in 2 race/ethnicity 3 - 5 analyses 3 - 14 - 4 stratified 5 analyses 5 analyses 7 at 6 , 7 at 7 at 9 months 7 at 14 - 8 6 9 months 9 months 10 after 10 after 13 self 11 report 13 self 14 - 15 neglect 14 - 16 , 14 - 24 was 16 , 19 ratio 17 the 19 ratio 18 hazard 19 ratio 19 ratio 20 for 19 ratio 24 was 20 for 23 adults 21 black 23 adults 22 older 23 adults 24 was 25 5.00 25 5.00 30 interval 25 5.00 33 - 26 ( 30 interval 27 95 30 interval 28 % 29 confidence 29 confidence 30 interval 30 interval 31 , 31 , 33 - 32 4.47 33 - 33 - 34 5.59 34 5.59 37 for 37 for 38 white 38 white 49 2.19 39 older 40 adults 40 adults 42 2.75 40 adults 47 interval 43 ( 47 interval 44 95 45 % 45 % 46 confidence 46 confidence 47 interval 47 interval 48 , 48 , 49 2.19 49 2.19 51 3.44 49 2.19 53 . 50 - 51 3.44 51 3.44 52 ) at 3 years [after] report , the hazard ratios were 2.61 ( 95 % confidence interval [,] 2.25 - 3.04 [ )(and 1.47 ( 95 % confidence interval , 1.10 - 1.96 ) [for] black older adults and white older adults , respectively . 0 ###LEFT-WALL### 5 report 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 44 . 1 at 3 years 1 at 5 report 2 3 3 years 6 , 9 ratios 6 , 10 were 7 the 9 ratios 8 hazard 9 ratios 9 ratios 10 were 10 were 11 2.61 10 were 43 respectively 11 2.61 16 interval 12 ( 16 interval 13 95 14 % 14 % 15 confidence 15 confidence 16 interval 16 interval 18 2.25 16 interval 22 )(and 16 interval 42 , 19 - 22 )(and 20 3.04 22 )(and 22 )(and 23 1.47 22 )(and 38 and 22 )(and 42 , 24 ( 38 and 25 95 37 adults 26 % 27 confidence 27 confidence 28 interval 28 interval 37 adults 29 , 31 - 30 1.10 31 - 31 - 32 1.96 31 - 33 ) 31 - 35 black 35 black 37 adults 36 older 37 adults 37 adults 38 and 38 and 41 adults 38 and 42 , 39 white 41 adults 40 older 41 adults conclusions : future studies are needed to qualify the casual mechanisms between self [-] neglect and mortality in black and white older adults in order to devise targeted prevention and intervention strategies . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 1 conclusions 2 : 2 : 3 future 3 future 4 studies 3 future 5 are 3 future 6 needed 3 future 18 in 4 studies 5 are 6 needed 7 to 6 needed 12 between 7 to 8 qualify 8 qualify 11 mechanisms 9 the 11 mechanisms 10 casual 11 mechanisms 12 between 16 and 13 self 15 neglect 15 neglect 16 and 16 and 17 mortality 18 in 23 adults 19 black 20 and 20 and 21 white 20 and 23 adults 22 older 23 adults 23 adults 24 in 24 in 25 order 25 order 26 to 25 order 27 devise 26 to 27 devise 27 devise 30 and 28 targeted 29 prevention 29 prevention 30 and 30 and 32 strategies 31 intervention 32 strategies previous research in the united states suggests that depression related to economic hardship decreases with age . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 7 suggests 0 ###LEFT-WALL### 10 related 1 previous 2 research 2 research 3 in 2 research 7 suggests 3 in 6 states 4 the 6 states 5 united 6 states 7 suggests 8 that 8 that 9 depression 8 that 10 related 9 depression 10 related 10 related 11 to 10 related 15 with 10 related 17 . 11 to 14 decreases 12 economic 13 hardship 13 hardship 14 decreases 15 with 16 age we test whether this pattern can be generalized to other developed nations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 13 . 1 we 2 test 2 test 3 whether 3 whether 5 pattern 3 whether 8 generalized 4 this 5 pattern 5 pattern 6 can 6 can 7 be 7 be 8 generalized 8 generalized 9 to 9 to 12 nations 10 other 12 nations 11 developed 12 nations based on data from 23 countries in the european social survey ( 2006 -- 2007 ) , multilevel analyses show that the moderating role of age depends on the socio - political context . 0 ###LEFT-WALL### 19 analyses 0 ###LEFT-WALL### 20 show 0 ###LEFT-WALL### 34 . 1 based 2 on 1 based 7 in 1 based 17 , 1 based 19 analyses 2 on 3 data 3 data 4 from 4 from 6 countries 5 23 6 countries 7 in 11 survey 8 the 9 european 9 european 11 survey 10 social 11 survey 11 survey 14 -- 12 ( 14 -- 13 2006 14 -- 14 -- 15 2007 14 -- 16 ) 18 multilevel 19 analyses 19 analyses 20 show 20 show 21 that 21 that 24 role 21 that 27 depends 22 the 24 role 23 moderating 24 role 24 role 25 of 24 role 27 depends 25 of 26 age 27 depends 28 on 28 on 33 context 29 the 33 context 30 socio 31 - 30 socio 33 context 32 political 33 context while the hardship -- depression [link] is not significantly different across the life course in nordic and bismarckian regimes , the hardship -- depression link increases with age in southern and eastern european countries and decreases with age in strength in anglo - saxon welfare states . 0 ###LEFT-WALL### 5 depression 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 43 - 1 while 3 hardship 1 while 4 -- 1 while 5 depression 2 the 3 hardship 5 depression 7 is 7 is 8 not 7 is 9 significantly 7 is 10 different 10 different 11 across 10 different 15 in 11 across 14 course 12 the 14 course 13 life 14 course 15 in 17 and 16 nordic 17 and 17 and 19 regimes 17 and 22 hardship 18 bismarckian 19 regimes 20 , 22 hardship 21 the 22 hardship 22 hardship 35 and 22 hardship 43 - 23 -- 35 and 24 depression 26 increases 25 link 26 increases 26 increases 27 with 26 increases 31 and 27 with 28 age 28 age 29 in 29 in 30 southern 31 and 34 countries 31 and 35 and 32 eastern 34 countries 33 european 34 countries 35 and 36 decreases 35 and 43 - 36 decreases 37 with 37 with 38 age 38 age 39 in 38 age 41 in 39 in 40 strength 41 in 42 anglo 43 - 46 states 43 - 47 . 44 saxon 46 states 45 welfare 46 states our findings suggest that welfare state regimes play a significant role in attenuating , boosting , or even reversing the health effects of social experiences such as economic hardship on aging . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 32 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 regimes 4 that 8 play 5 welfare 7 regimes 6 state 7 regimes 8 play 11 role 9 a 11 role 10 significant 11 role 11 role 12 in 12 in 17 or 13 attenuating 14 , 14 , 15 boosting 14 , 17 or 16 , 17 or 17 or 18 even 17 or 19 reversing 17 or 23 of 17 or 30 on 19 reversing 22 effects 20 the 22 effects 21 health 22 effects 23 of 25 experiences 24 social 25 experiences 25 experiences 27 as 26 such 27 as 27 as 29 hardship 28 economic 29 hardship 30 on 31 aging health knowledge gained through research that ignores the socio - political context may be limited in terms of generalization . 0 ###LEFT-WALL### 14 be 0 ###LEFT-WALL### 20 . 1 health 2 knowledge 2 knowledge 3 gained 2 knowledge 6 that 2 knowledge 7 ignores 2 knowledge 13 may 3 gained 4 through 4 through 5 research 6 that 7 ignores 7 ignores 12 context 8 the 12 context 9 socio 10 - 9 socio 12 context 11 political 12 context 13 may 14 be 14 be 15 limited 15 limited 16 in 16 in 17 terms 17 terms 18 of 18 of 19 generalization variation in the apolipoprotein e gene ( apoe ) has been reported to be associated with longevity in humans . 0 ###LEFT-WALL### 1 variation 0 ###LEFT-WALL### 12 reported 0 ###LEFT-WALL### 20 . 1 variation 2 in 1 variation 10 has 2 in 6 gene 3 the 6 gene 4 apolipoprotein 5 e 4 apolipoprotein 6 gene 6 gene 8 apoe 7 ( 8 apoe 8 apoe 9 ) 10 has 11 been 11 been 12 reported 12 reported 13 to 12 reported 15 associated 13 to 14 be 14 be 15 associated 15 associated 16 with 15 associated 18 in 16 with 17 longevity 18 in 19 humans the authors assessed the allelic distribution of apoe isoforms ε2 , ε3 , and ε4 among 10,623 participants from 15 case - control and cohort studies of age - related macular degeneration ( amd ) in populations of european ancestry [(] study dates ranged from 1990 to 2009 ) . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 30 related 0 ###LEFT-WALL### 50 . 1 the 2 authors 2 authors 3 assessed 3 assessed 6 distribution 3 assessed 14 and 3 assessed 16 among 4 the 6 distribution 5 allelic 6 distribution 6 distribution 7 of 7 of 9 isoforms 8 apoe 9 isoforms 10 ε2 11 , 11 , 12 ε3 11 , 14 and 13 , 14 and 14 and 15 ε4 16 among 17 10,623 17 10,623 18 participants 17 10,623 21 case 17 10,623 24 and 18 participants 19 from 18 participants 21 case 19 from 20 15 22 - 24 and 23 control 24 and 24 and 26 studies 24 and 29 - 25 cohort 26 studies 26 studies 27 of 27 of 28 age 29 - 30 related 30 related 32 degeneration 30 related 36 in 30 related 49 ) 31 macular 32 degeneration 32 degeneration 34 amd 33 ( 34 amd 34 amd 35 ) 36 in 37 populations 37 populations 38 of 37 populations 43 dates 37 populations 44 ranged 38 of 42 study 39 european 40 ancestry 40 ancestry 42 study 43 dates 44 ranged 44 ranged 45 from 45 from 47 to 46 1990 47 to 47 to 48 2009 the authors included only the 10,623 control subjects from these studies who were classified as having no evidence of amd , since variation within the apoe gene has previously been associated with amd . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 included 1 the 2 authors 2 authors 3 included 3 included 4 only 3 included 8 subjects 3 included 9 from 5 the 6 10,623 6 10,623 8 subjects 7 control 8 subjects 9 from 11 studies 10 these 11 studies 11 studies 12 who 11 studies 13 were 12 who 13 were 13 were 14 classified 14 classified 15 as 14 classified 22 since 15 as 18 evidence 16 having 18 evidence 17 no 18 evidence 18 evidence 19 of 19 of 20 amd 21 , 22 since 22 since 23 variation 22 since 31 associated 22 since 34 . 23 variation 24 within 23 variation 28 has 24 within 27 gene 25 the 27 gene 26 apoe 27 gene 28 has 30 been 29 previously 30 been 30 been 31 associated 31 associated 32 with 32 with 33 amd the association with age was [strongest] in ε4 homozygotes ; the frequency of ε4 homozygosity decreased from 2.7 % for participants aged 60 years or less to 0.8 % for those over age 85 years , while the proportion of participants with the ε3/ε4 [genotype] decreased from 26.8 % to 17.5 % across the same age range . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 16 decreased 1 the 2 association 2 association 3 with 2 association 5 was 3 with 4 age 5 was 7 in 7 in 9 homozygotes 8 ε4 9 homozygotes 10 ; 12 frequency 11 the 12 frequency 12 frequency 13 of 12 frequency 16 decreased 13 of 15 homozygosity 14 ε4 15 homozygosity 16 decreased 29 % 16 decreased 37 while 17 from 27 to 18 2.7 19 % 18 2.7 27 to 19 % 20 for 19 % 22 aged 20 for 21 participants 22 aged 25 or 23 60 24 years 24 years 25 or 25 or 26 less 27 to 28 0.8 27 to 29 % 29 % 30 for 29 % 32 over 30 for 31 those 32 over 35 years 33 age 35 years 34 85 35 years 36 , 37 while 37 while 39 proportion 37 while 46 decreased 37 while 58 . 38 the 39 proportion 39 proportion 40 of 39 proportion 46 decreased 40 of 41 participants 41 participants 42 with 42 with 44 ε3/ε4 43 the 44 ε3/ε4 46 decreased 47 from 46 decreased 50 to 46 decreased 57 range 47 from 49 % 48 26.8 49 % 50 to 52 % 51 17.5 52 % 52 % 53 across 53 across 56 age 54 the 55 same 54 the 56 age gender had no significant effect on the isoform frequencies . 0 ###LEFT-WALL### 1 gender 0 ###LEFT-WALL### 2 had 0 ###LEFT-WALL### 10 . 1 gender 2 had 2 had 5 effect 2 had 6 on 3 no 5 effect 4 significant 5 effect 6 on 9 frequencies 7 the 9 frequencies 8 isoform 9 frequencies this study provides strong support for an association of the apoe gene with human longevity . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 16 . 1 this 2 study 2 study 3 provides 3 provides 5 support 3 provides 13 with 4 strong 5 support 5 support 6 for 6 for 8 association 7 an 8 association 8 association 9 of 9 of 12 gene 10 the 12 gene 11 apoe 12 gene 13 with 15 longevity 14 human 15 longevity purpose : to evaluate the potential role of the matrix metalloproteinase ( mmp ) [system] of bruch 's membrane in the pathology of age - related macular degeneration . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 18 's 0 ###LEFT-WALL### 26 related 0 ###LEFT-WALL### 29 . 1 purpose 2 : 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 7 role 4 evaluate 18 's 5 the 7 role 6 potential 7 role 7 role 8 of 7 role 16 of 7 role 18 's 8 of 11 metalloproteinase 9 the 11 metalloproteinase 10 matrix 11 metalloproteinase 11 metalloproteinase 13 mmp 12 ( 13 mmp 13 mmp 14 ) 16 of 17 bruch 18 's 19 membrane 18 's 20 in 20 in 22 pathology 21 the 22 pathology 22 pathology 23 of 23 of 24 age 25 - 26 related 26 related 28 degeneration 27 macular 28 degeneration methods : free and bound pools of gelatinase activity in bruch 's membrane - choroid preparations were isolated by phosphate - buffered saline ( pbs ) and sodium dodecyl [sulfate] ( sds ) extraction , respectively . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 1 methods 2 : 2 : 4 and 2 : 36 respectively 3 free 4 and 4 and 34 extraction 4 and 35 , 5 bound 6 pools 6 pools 7 of 6 pools 10 in 6 pools 27 and 7 of 9 activity 8 gelatinase 9 activity 10 in 13 membrane 11 bruch 12 's 12 's 13 membrane 13 membrane 15 choroid 13 membrane 23 saline 14 - 15 choroid 15 choroid 16 preparations 15 choroid 17 were 15 choroid 18 isolated 15 choroid 21 - 16 preparations 17 were 18 isolated 19 by 19 by 20 phosphate 21 - 23 saline 22 buffered 23 saline 23 saline 25 pbs 23 saline 26 ) 24 ( 25 pbs 25 pbs 26 ) 27 and 29 dodecyl 27 and 32 sds 27 and 34 extraction 28 sodium 29 dodecyl 31 ( 32 sds 32 sds 33 ) individual mmp species were separated by gelatin - substrate zymography and the levels were quantified by densitometric techniques . 0 ###LEFT-WALL### 3 species 0 ###LEFT-WALL### 5 separated 0 ###LEFT-WALL### 8 - 1 individual 2 mmp 2 mmp 3 species 3 species 4 were 4 were 5 separated 5 separated 6 by 6 by 7 gelatin 8 - 11 and 8 - 15 quantified 8 - 19 . 9 substrate 10 zymography 10 zymography 11 and 11 and 13 levels 11 and 14 were 12 the 13 levels 14 were 15 quantified 15 quantified 16 by 16 by 18 techniques 17 densitometric 18 techniques altogether , 13 control [(] age range , 71 - 99 years ) and 6 amd ( age range , 71 - 95 years ) donor eyes were used . 0 ###LEFT-WALL### 3 13 0 ###LEFT-WALL### 4 control 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 30 . 1 altogether 2 , 1 altogether 3 13 3 13 4 control 4 control 7 range 6 age 7 range 7 range 10 - 8 , 10 - 9 71 10 - 10 - 12 years 10 - 13 ) 11 99 12 years 14 and 27 eyes 14 and 29 used 15 6 27 eyes 16 amd 19 range 16 amd 22 - 16 amd 27 eyes 17 ( 19 range 18 age 19 range 19 range 20 , 20 , 22 - 21 71 22 - 22 - 24 years 22 - 25 ) 23 95 24 years 26 donor 27 eyes 27 eyes 28 were 28 were 29 used results : all the gelatinase components normally present in control samples were also present in amd tissue without any significant differences in their molecular masses . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 all 2 : 12 were 2 : 26 . 3 all 6 components 3 all 8 present 3 all 12 were 4 the 6 components 5 gelatinase 6 components 6 components 8 present 7 normally 8 present 8 present 9 in 9 in 11 samples 10 control 11 samples 12 were 13 also 12 were 14 present 14 present 15 in 14 present 18 without 14 present 22 in 15 in 17 tissue 16 amd 17 tissue 18 without 21 differences 19 any 21 differences 20 significant 21 differences 22 in 25 masses 23 their 25 masses 24 molecular 25 masses total levels ( bound plus free ) [of] active mmp2 and - 9 [were] significantly reduced in amd donors ( p < 0.05 ) . 0 ###LEFT-WALL### 1 total 0 ###LEFT-WALL### 25 . 1 total 2 levels 1 total 4 bound 3 ( 4 bound 4 bound 5 plus 4 bound 22 < 4 bound 24 ) 5 plus 11 and 6 free 7 ) 6 free 10 mmp2 9 active 10 mmp2 10 mmp2 11 and 11 and 19 donors 12 - 13 9 13 9 17 in 15 significantly 16 reduced 16 reduced 17 in 17 in 19 donors 18 amd 19 donors 20 ( 22 < 21 p 22 < 22 < 23 0.05 the decrease in active mmp2 may be attributable to a similar reduction in the level [of] free pro - mmp2 , the precursor to the active form . 0 ###LEFT-WALL### 2 decrease 0 ###LEFT-WALL### 7 be 1 the 2 decrease 2 decrease 3 in 2 decrease 6 may 3 in 5 mmp2 4 active 5 mmp2 6 may 7 be 7 be 8 attributable 8 attributable 9 to 8 attributable 13 in 9 to 12 reduction 10 a 11 similar 10 a 12 reduction 11 similar 12 reduction 13 in 18 pro 14 the 18 pro 15 level 18 pro 17 free 18 pro 18 pro 20 mmp2 18 pro 23 precursor 19 - 20 mmp2 20 mmp2 21 , 21 , 23 precursor 22 the 23 precursor 23 precursor 24 to 23 precursor 28 . 24 to 27 form 25 the 27 form 26 active 27 form reduction in active mmp9 occurred despite [a] nearly 3.5 - fold increase [in] free pro - mmp9 . 0 ###LEFT-WALL### 1 reduction 0 ###LEFT-WALL### 5 occurred 0 ###LEFT-WALL### 10 - 1 reduction 2 in 1 reduction 5 occurred 2 in 4 mmp9 3 active 4 mmp9 5 occurred 6 despite 6 despite 9 3.5 8 nearly 9 3.5 10 - 15 pro 10 - 16 - 11 fold 15 pro 12 increase 15 pro 14 free 15 pro 16 - 17 mmp9 16 - 18 . the high - molecular - mass gelatinases denoted by hmw1 and - 2 [and] comprising homo - and heteropolymers of pro - mmp2 [and] - 9 [were] also raised in amd ( p < 0.05 ) . 0 ###LEFT-WALL### 2 high 0 ###LEFT-WALL### 3 - 1 the 2 high 3 - 7 gelatinases 3 - 11 and 4 molecular 5 - 4 molecular 7 gelatinases 6 mass 7 gelatinases 7 gelatinases 8 denoted 8 denoted 9 by 9 by 10 hmw1 11 and 12 - 12 - 18 and 13 2 16 homo 15 comprising 16 homo 16 homo 18 and 17 - 18 and 18 and 19 heteropolymers 18 and 20 of 18 and 23 mmp2 18 and 26 9 20 of 21 pro 22 - 23 mmp2 23 mmp2 25 - 25 - 26 9 26 9 29 raised 26 9 34 < 26 9 37 . 28 also 29 raised 29 raised 30 in 30 in 31 amd 32 ( 34 < 33 p 34 < 34 < 35 0.05 34 < 36 ) the sequestration [of] free pro - mmp2 and - 9 by these high - molecular - mass complexes may further contribute to reduced rates of activation of mmps . 0 ###LEFT-WALL### 5 pro 0 ###LEFT-WALL### 6 - 1 the 5 pro 2 sequestration 5 pro 4 free 5 pro 6 - 7 mmp2 6 - 8 and 6 - 29 . 8 and 10 9 8 and 21 contribute 9 - 10 9 10 9 11 by 10 9 19 may 11 by 18 complexes 12 these 18 complexes 13 high 14 - 13 high 17 mass 15 molecular 16 - 15 molecular 17 mass 17 mass 18 complexes 19 may 21 contribute 20 further 21 contribute 21 contribute 22 to 22 to 24 rates 23 reduced 24 rates 24 rates 25 of 25 of 26 activation 26 activation 27 of 27 of 28 mmps conclusions : the reduction in the levels of activated mmp2 and - 9 may be responsible for impaired matrix degradation of bruch 's membrane , leading to the pathology associated with amd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 33 . 1 conclusions 2 : 2 : 4 reduction 3 the 4 reduction 4 reduction 5 in 5 in 7 levels 6 the 7 levels 7 levels 8 of 8 of 10 mmp2 9 activated 10 mmp2 11 and 13 9 11 and 15 be 12 - 13 9 13 9 14 may 14 may 15 be 15 be 16 responsible 16 responsible 17 for 16 responsible 27 to 16 responsible 31 with 17 for 25 , 18 impaired 20 degradation 18 impaired 25 , 19 matrix 20 degradation 20 degradation 21 of 21 of 24 membrane 22 bruch 23 's 23 's 24 membrane 25 , 26 leading 27 to 29 pathology 28 the 29 pathology 29 pathology 30 associated 31 with 32 amd the degradation pathway is therefore a viable therapeutic target for future intervention . 0 ###LEFT-WALL### 3 pathway 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 13 . 1 the 3 pathway 2 degradation 3 pathway 3 pathway 4 is 4 is 5 therefore 4 is 9 target 6 a 7 viable 6 a 9 target 7 viable 9 target 8 therapeutic 9 target 9 target 10 for 10 for 12 intervention 11 future 12 intervention purpose : the purpose of this study was to determine the effects of enriching line drawings with color/texture and environmental context as a facilitator of naming speed and accuracy in older adults . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 enriching 0 ###LEFT-WALL### 33 . 2 : 4 purpose 3 the 4 purpose 4 purpose 5 of 4 purpose 7 study 4 purpose 14 enriching 5 of 6 this 7 study 8 was 8 was 9 to 8 was 10 determine 9 to 10 determine 10 determine 12 effects 11 the 12 effects 12 effects 13 of 13 of 14 enriching 14 enriching 16 drawings 14 enriching 17 with 14 enriching 22 as 15 line 16 drawings 17 with 21 context 18 color/texture 19 and 19 and 20 environmental 19 and 21 context 22 as 28 and 23 a 24 facilitator 24 facilitator 25 of 24 facilitator 28 and 25 of 27 speed 26 naming 27 speed 28 and 29 accuracy 29 accuracy 30 in 30 in 32 adults 31 older 32 adults method : twenty young and 23 older adults named high - frequency picture stimuli from the boston naming test ( kaplan , goodglass , [&] weintraub , 2001 [ )(under three conditions : [(] [a] [ )(black - and - white items , ( [b] [ )(colorized - texturized items , and [(] [c] [ )(scene - primed colored items ( e.g [.] , " hammock " [preceded] 1,000 [ms] by a backyard scene [ )( 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 - 1 method 2 : 2 : 5 and 3 twenty 5 and 4 young 5 and 5 and 10 high 5 and 11 - 6 23 8 adults 7 older 8 adults 8 adults 9 named 9 named 10 high 11 - 14 stimuli 11 - 22 , 12 frequency 13 picture 13 picture 14 stimuli 14 stimuli 15 from 14 stimuli 21 kaplan 15 from 19 test 16 the 19 test 17 boston 18 naming 18 naming 19 test 20 ( 21 kaplan 21 kaplan 22 , 22 , 23 goodglass 22 , 24 , 24 , 26 weintraub 24 , 27 , 27 , 28 2001 27 , 38 - 28 2001 30 )(under 28 2001 33 : 30 )(under 32 conditions 31 three 32 conditions 33 : 37 )(black 38 - 39 and 38 - 43 , 39 and 40 - 40 - 41 white 41 white 42 items 43 , 52 and 44 ( 47 )(colorized 47 )(colorized 48 - 47 )(colorized 52 and 49 texturized 50 items 50 items 52 and 51 , 52 and 52 and 56 )(scene 52 and 57 - 52 and 58 primed 58 primed 60 items 59 colored 60 items 60 items 62 e.g 60 items 66 hammock 61 ( 62 e.g 62 e.g 64 , 64 , 65 " 64 , 66 hammock 66 hammock 67 " 66 hammock 69 1,000 66 hammock 71 by 66 hammock 76 )( 71 by 74 scene 72 a 73 backyard 72 a 74 scene 73 backyard 74 scene results : with respect to speeded naming latencies , mixed - model analyses of variance revealed that young adults did not benefit from colorization [-] texturization but did show scene [-] priming effects . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 did 0 ###LEFT-WALL### 34 . 2 : 8 latencies 2 : 27 but 3 with 4 respect 3 with 8 latencies 4 respect 5 to 5 to 7 naming 6 speeded 7 naming 8 latencies 10 mixed 8 latencies 12 model 9 , 10 mixed 10 mixed 11 - 12 model 13 analyses 12 model 18 young 13 analyses 14 of 14 of 15 variance 15 variance 16 revealed 17 that 18 young 19 adults 20 did 20 did 21 not 20 did 27 but 22 benefit 23 from 22 benefit 27 but 23 from 26 texturization 24 colorization 26 texturization 27 but 28 did 28 did 33 effects 29 show 30 scene 30 scene 32 priming 32 priming 33 effects in contrast , older adults failed to show facilitation effects from either colorized - texturized or scene - primed items . 0 ###LEFT-WALL### 5 adults 0 ###LEFT-WALL### 6 failed 0 ###LEFT-WALL### 21 . 1 in 2 contrast 1 in 3 , 1 in 5 adults 4 older 5 adults 5 adults 6 failed 6 failed 7 to 6 failed 8 show 7 to 8 show 8 show 16 or 8 show 19 primed 9 facilitation 10 effects 10 effects 11 from 10 effects 13 colorized 10 effects 16 or 11 from 12 either 13 colorized 14 - 13 colorized 15 texturized 16 or 17 scene 16 or 18 - 16 or 19 primed 19 primed 20 items moreover , older adults were consistently slower to initiate naming than [were] their younger counterparts across all conditions . 0 ###LEFT-WALL### 4 adults 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 19 . 1 moreover 2 , 1 moreover 4 adults 3 older 4 adults 4 adults 5 were 5 were 6 consistently 5 were 7 slower 7 slower 8 to 8 to 9 initiate 9 initiate 10 naming 9 initiate 11 than 9 initiate 16 across 11 than 15 counterparts 13 their 15 counterparts 14 younger 15 counterparts 16 across 18 conditions 17 all 18 conditions conclusions : perceptual and contextual enrichment of sparse line drawings does not appear to facilitate visual confrontation naming in older adults , whereas younger adults do tend to show benefits of scene priming . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 27 tend 0 ###LEFT-WALL### 34 . 1 conclusions 2 : 2 : 3 perceptual 4 and 6 enrichment 4 and 13 appear 5 contextual 6 enrichment 6 enrichment 7 of 6 enrichment 11 does 7 of 10 drawings 8 sparse 9 line 9 line 10 drawings 11 does 12 not 11 does 13 appear 13 appear 14 to 13 appear 15 facilitate 14 to 15 facilitate 15 facilitate 18 naming 15 facilitate 19 in 15 facilitate 23 whereas 16 visual 17 confrontation 17 confrontation 18 naming 19 in 21 adults 20 older 21 adults 22 , 23 whereas 23 whereas 25 adults 24 younger 25 adults 25 adults 26 do 26 do 27 tend 27 tend 28 to 27 tend 29 show 28 to 29 show 29 show 30 benefits 30 benefits 31 of 31 of 33 priming 32 scene 33 priming we interpret these findings as [generally] [supportive] of a processing speed account of age - related object picture - naming difficulty . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 interpret 0 ###LEFT-WALL### 15 - 1 we 2 interpret 2 interpret 4 findings 2 interpret 5 as 3 these 4 findings 5 as 8 of 8 of 12 account 9 a 12 account 10 processing 12 account 11 speed 12 account 12 account 13 of 13 of 14 age 15 - 18 picture 15 - 19 - 16 related 17 object 17 object 18 picture 19 - 21 difficulty 19 - 22 . 20 naming 21 difficulty background : in adults , dosages of some anaesthetic agents are based on lean body mass [(] lbm ) rather than body weight . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 background 2 : 2 : 3 in 2 : 21 than 3 in 4 adults 4 adults 6 dosages 5 , 6 dosages 6 dosages 7 of 6 dosages 12 based 6 dosages 19 ) 7 of 9 anaesthetic 8 some 9 anaesthetic 9 anaesthetic 10 agents 9 anaesthetic 11 are 10 agents 11 are 12 based 13 on 13 on 18 lbm 14 lean 18 lbm 15 body 16 mass 16 mass 18 lbm 20 rather 21 than 21 than 23 weight 22 body 23 weight our aim was to derive an equation for estimating lbm in children . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 13 . 1 our 2 aim 2 aim 3 was 3 was 4 to 3 was 5 derive 4 to 5 derive 5 derive 7 equation 6 an 7 equation 7 equation 8 for 8 for 9 estimating 9 estimating 10 lbm 9 estimating 11 in 11 in 12 children methods : patients comprised three groups : prospective kidney transplant donors from two separate centres ( centres 1 and 3 ) and children referred to a further centre ( centre 2 ) for the routine clinical measurement of glomerular filtration [rate] ( gfr ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 4 comprised 2 : 7 : 2 : 45 . 3 patients 4 comprised 4 comprised 6 groups 5 three 6 groups 7 : 22 and 8 prospective 9 kidney 9 kidney 11 donors 10 transplant 11 donors 11 donors 12 from 11 donors 22 and 12 from 15 centres 13 two 15 centres 14 separate 15 centres 15 centres 17 centres 16 ( 17 centres 17 centres 19 and 17 centres 21 ) 18 1 19 and 19 and 20 3 22 and 23 children 22 and 33 for 23 children 24 referred 24 referred 25 to 25 to 28 centre 26 a 28 centre 27 further 28 centre 28 centre 30 centre 29 ( 30 centre 30 centre 31 2 30 centre 32 ) 33 for 37 measurement 34 the 37 measurement 35 routine 37 measurement 36 clinical 37 measurement 37 measurement 38 of 37 measurement 43 gfr 38 of 40 filtration 39 glomerular 40 filtration 42 ( 43 gfr 43 gfr 44 ) gfr and extracellular fluid volume ( ecv ) were measured using cr - 51 - edta . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 17 . 1 gfr 2 and 2 and 5 volume 2 and 7 ecv 2 and 9 were 3 extracellular 4 fluid 4 fluid 5 volume 6 ( 7 ecv 7 ecv 8 ) 9 were 10 measured 10 measured 11 using 11 using 12 cr 12 cr 14 51 13 - 14 51 14 51 15 - 15 - 16 edta lbm was directly estimated [(] elbm ) [in] adults using an equation based on height and weight . 0 ###LEFT-WALL### 1 lbm 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 18 . 1 lbm 2 was 2 was 16 and 3 directly 4 estimated 4 estimated 9 adults 4 estimated 16 and 6 elbm 7 ) 6 elbm 9 adults 9 adults 10 using 9 adults 13 based 10 using 12 equation 11 an 12 equation 13 based 14 on 14 on 15 height 16 and 17 weight ecv in children [was] estimated ( eecv ) from another equation based on height and weight , converted to elbm using the relationship between elbm and ecv determined in the adults from centre 1 and then compared with adult data from centre 3 . 0 ###LEFT-WALL### 11 equation 0 ###LEFT-WALL### 35 and 0 ###LEFT-WALL### 44 . 1 ecv 11 equation 2 in 3 children 2 in 11 equation 3 children 5 estimated 3 children 7 eecv 6 ( 7 eecv 7 eecv 8 ) 9 from 10 another 9 from 11 equation 11 equation 35 and 12 based 13 on 12 based 26 and 12 based 35 and 13 on 15 and 14 height 15 and 15 and 16 weight 15 and 17 , 15 and 18 converted 15 and 19 to 15 and 24 between 19 to 20 elbm 20 elbm 21 using 20 elbm 24 between 21 using 23 relationship 22 the 23 relationship 25 elbm 26 and 26 and 27 ecv 26 and 32 from 27 ecv 28 determined 28 determined 29 in 29 in 31 adults 30 the 31 adults 32 from 33 centre 33 centre 34 1 35 and 37 compared 35 and 38 with 35 and 41 from 36 then 37 compared 38 with 40 data 39 adult 40 data 41 from 42 centre 42 centre 43 3 results : in children , the ratio of eecv to ecv was 1.04 ( sd [0.18] ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 18 . 1 results 2 : 2 : 3 in 3 in 4 children 5 , 7 ratio 5 , 12 was 6 the 7 ratio 7 ratio 8 of 7 ratio 12 was 8 of 9 eecv 9 eecv 10 to 10 to 11 ecv 12 was 13 1.04 13 1.04 15 sd 14 ( 15 sd 15 sd 17 ) in centre 1 , elbm [(] [kg] ) was 3.81 ( sd [0.55] ) times greater than ecv ( litres ) in men ( n=50 ) and 3.77 [(] 0.77 [ )(times greater in women ( n=51 ) [.] elbm in children [was] therefore derived by multiplying eecv by 3.8 . 0 ###LEFT-WALL### 3 1 0 ###LEFT-WALL### 9 was 1 in 2 centre 1 in 3 1 3 1 5 elbm 3 1 9 was 4 , 5 elbm 5 elbm 8 ) 9 was 10 3.81 9 was 15 times 10 3.81 12 sd 11 ( 12 sd 12 sd 14 ) 15 times 16 greater 16 greater 17 than 17 than 27 and 18 ecv 20 litres 18 ecv 22 in 18 ecv 27 and 19 ( 20 litres 20 litres 21 ) 22 in 23 men 23 men 25 n=50 24 ( 25 n=50 25 n=50 26 ) 27 and 32 )(times 28 3.77 32 )(times 30 0.77 32 )(times 32 )(times 33 greater 33 greater 34 in 34 in 35 women 35 women 40 elbm 36 ( 40 elbm 37 n=51 38 ) 37 n=51 40 elbm 40 elbm 41 in 40 elbm 45 derived 40 elbm 46 by 40 elbm 51 . 41 in 42 children 44 therefore 45 derived 46 by 48 eecv 47 multiplying 48 eecv 48 eecv 49 by 49 by 50 3.8 in children , elbm showed a close linear correlation with measured ecv ( elbm=3.50ecv+2.0 [;] r ( 2 )=0.857 ) , similar to adults ( elbm=2.82ecv+14.5 [;] r ( 2 )=0.582 ) . 0 ###LEFT-WALL### 4 elbm 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 33 . 1 in 2 children 1 in 3 , 1 in 4 elbm 4 elbm 5 showed 5 showed 9 correlation 6 a 7 close 6 a 9 correlation 7 close 9 correlation 8 linear 9 correlation 9 correlation 10 with 9 correlation 22 similar 10 with 12 ecv 11 measured 12 ecv 12 ecv 14 elbm=3.50ecv+2.0 13 ( 14 elbm=3.50ecv+2.0 14 elbm=3.50ecv+2.0 16 r 14 elbm=3.50ecv+2.0 19 )=0.857 14 elbm=3.50ecv+2.0 21 , 17 ( 19 )=0.857 18 2 19 )=0.857 19 )=0.857 20 ) 21 , 22 similar 22 similar 23 to 22 similar 32 ) 23 to 24 adults 24 adults 26 elbm=2.82ecv+14.5 25 ( 26 elbm=2.82ecv+14.5 26 elbm=2.82ecv+14.5 28 r 26 elbm=2.82ecv+14.5 31 )=0.582 26 elbm=2.82ecv+14.5 32 ) 29 ( 31 )=0.582 30 2 31 )=0.582 31 )=0.582 32 ) in all groups , elbm/weight correlated inversely with weight . 0 ###LEFT-WALL### 5 elbm/weight 0 ###LEFT-WALL### 6 correlated 0 ###LEFT-WALL### 10 . 1 in 3 groups 1 in 4 , 1 in 5 elbm/weight 2 all 3 groups 5 elbm/weight 6 correlated 6 correlated 7 inversely 6 correlated 8 with 8 with 9 weight conclusions : in terms of the relationships between elbm , ecv , and weight , children are similar to adults . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 21 . 1 conclusions 2 : 2 : 3 in 3 in 13 and 4 terms 5 of 4 terms 10 , 5 of 7 relationships 6 the 7 relationships 7 relationships 8 between 8 between 9 elbm 10 , 11 ecv 10 , 13 and 12 , 13 and 13 and 14 weight 15 , 16 children 15 , 17 are 16 children 17 are 17 are 18 similar 18 similar 19 to 19 to 20 adults therefore , drug dosage in children should also be based on elbm rather than weight . 0 ###LEFT-WALL### 4 dosage 0 ###LEFT-WALL### 10 based 0 ###LEFT-WALL### 16 . 1 therefore 2 , 1 therefore 4 dosage 3 drug 4 dosage 4 dosage 5 in 4 dosage 7 should 5 in 6 children 7 should 9 be 8 also 9 be 9 be 10 based 10 based 11 on 10 based 14 than 11 on 12 elbm 13 rather 14 than 14 than 15 weight objective : to examine [whether] the consistency or persistence of knee pain , in addition to its severity , predicts incident total knee replacement ( tkr ) . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 examine 2 : 8 or 2 : 28 . 3 to 4 examine 4 examine 7 consistency 6 the 7 consistency 8 or 9 persistence 8 or 20 predicts 9 persistence 10 of 9 persistence 14 in 9 persistence 20 predicts 10 of 12 pain 11 knee 12 pain 13 , 14 in 14 in 15 addition 14 in 19 , 15 addition 16 to 16 to 18 severity 17 its 18 severity 20 predicts 24 replacement 21 incident 24 replacement 22 total 23 knee 23 knee 24 replacement 24 replacement 26 tkr 25 ( 26 tkr 26 tkr 27 ) methods : the multicenter osteoarthritis study ( most ) is a longitudinal study of persons aged 50 to 79 years with symptomatic knee osteoarthritis or at high risk of disease . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 1 methods 2 : 2 : 20 years 3 the 8 most 4 multicenter 5 osteoarthritis 5 osteoarthritis 6 study 6 study 8 most 7 ( 8 most 8 most 9 ) 8 most 10 is 10 is 13 study 11 a 12 longitudinal 11 a 13 study 12 longitudinal 13 study 13 study 14 of 14 of 15 persons 15 persons 16 aged 16 aged 18 to 17 50 18 to 18 to 19 79 19 79 20 years 20 years 25 or 21 with 24 osteoarthritis 21 with 25 or 22 symptomatic 23 knee 23 knee 24 osteoarthritis 25 or 26 at 26 at 28 risk 27 high 28 risk 28 risk 29 of 29 of 30 disease subjects were queried about the presence of knee pain on most days of the previous 30 days ( i.e [.] , frequent knee pain ; fkp [ )(at 2 timepoints : a telephone screen followed by a clinic visit ( median separation 4 weeks ) . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 3 queried 0 ###LEFT-WALL### 25 ; 1 subjects 2 were 2 were 3 queried 3 queried 4 about 4 about 6 presence 5 the 6 presence 6 presence 7 of 6 presence 10 on 6 presence 13 of 7 of 9 pain 8 knee 9 pain 10 on 12 days 11 most 12 days 13 of 17 days 14 the 15 previous 14 the 16 30 16 30 17 days 17 days 19 i.e 18 ( 19 i.e 19 i.e 24 pain 19 i.e 25 ; 21 , 24 pain 22 frequent 23 knee 23 knee 24 pain 24 pain 25 ; 25 ; 26 fkp 25 ; 30 timepoints 25 ; 31 : 26 fkp 28 )(at 26 fkp 30 timepoints 28 )(at 29 2 31 : 34 screen 31 : 35 followed 31 : 46 . 32 a 34 screen 33 telephone 34 screen 34 screen 35 followed 35 followed 36 by 35 followed 39 visit 37 a 39 visit 38 clinic 39 visit 39 visit 44 weeks 40 ( 44 weeks 41 median 42 separation 42 separation 44 weeks 43 4 44 weeks 44 weeks 45 ) we defined a knee as having " consistent pain " if the subject answered positively to the fkp question at both timepoints , " [inconsistent] pain " if fkp was positive at only one timepoint , [or] as " no fkp " [if] negative at both . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 defined 0 ###LEFT-WALL### 23 , 1 we 2 defined 2 defined 4 knee 2 defined 11 if 2 defined 15 positively 2 defined 16 to 2 defined 20 at 3 a 4 knee 4 knee 5 as 5 as 9 pain 6 having 7 " 6 having 9 pain 8 consistent 9 pain 9 pain 10 " 11 if 13 subject 11 if 14 answered 12 the 13 subject 13 subject 14 answered 16 to 19 question 17 the 19 question 18 fkp 19 question 20 at 22 timepoints 21 both 22 timepoints 23 , 24 " 23 , 26 pain 26 pain 27 " 26 pain 28 if 26 pain 35 timepoint 26 pain 38 as 28 if 29 fkp 28 if 30 was 29 fkp 30 was 30 was 31 positive 31 positive 32 at 32 at 34 one 33 only 34 one 36 , 38 as 38 as 39 " 38 as 44 negative 38 as 47 . 40 no 44 negative 41 fkp 42 " 41 fkp 44 negative 44 negative 45 at 45 at 46 both we examined the association between consistent fkp and risk of tkr using multiple binomial regression with generalized estimating equations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 20 . 1 we 2 examined 2 examined 4 association 2 examined 5 between 2 examined 12 using 3 the 4 association 5 between 8 and 6 consistent 7 fkp 7 fkp 8 and 8 and 9 risk 8 and 10 of 10 of 11 tkr 12 using 15 regression 12 using 16 with 13 multiple 15 regression 14 binomial 15 regression 16 with 19 equations 17 generalized 19 equations 18 estimating 19 equations results : in 3026 persons ( mean age 63 [yrs] , mean body mass index 30.4 ) , 2979 knees ( 50 % ) had no fkp at baseline , 1279 knees ( 21.5 % ) had inconsistent fkp , and 1696 knees ( 28.5 % ) had consistent fkp . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 51 . 1 results 2 : 2 : 3 in 3 in 5 persons 4 3026 5 persons 5 persons 8 age 6 ( 8 age 7 mean 8 age 8 age 9 63 8 age 15 index 8 age 17 ) 11 , 15 index 12 mean 14 mass 13 body 14 mass 14 mass 15 index 15 index 16 30.4 15 index 17 ) 18 , 20 knees 18 , 25 had 18 , 30 , 19 2979 20 knees 20 knees 23 % 20 knees 25 had 21 ( 23 % 22 50 23 % 23 % 24 ) 25 had 27 fkp 25 had 28 at 26 no 27 fkp 28 at 29 baseline 30 , 32 knees 30 , 37 had 30 , 41 and 31 1279 32 knees 32 knees 35 % 32 knees 37 had 33 ( 35 % 34 21.5 35 % 35 % 36 ) 37 had 39 fkp 38 inconsistent 39 fkp 40 , 41 and 41 and 43 knees 41 and 48 had 42 1696 43 knees 43 knees 46 % 43 knees 48 had 44 ( 46 % 45 28.5 46 % 46 % 47 ) 48 had 50 fkp 49 consistent 50 fkp risk of tkr over 30 months was 0.8 % , 2.6 % , [and] 8.8 % for knees with no [,] inconsistent , and consistent fkp , respectively . 0 ###LEFT-WALL### 1 risk 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 29 . 1 risk 2 of 1 risk 7 was 2 of 3 tkr 3 tkr 4 over 4 over 6 months 5 30 6 months 7 was 9 % 7 was 28 respectively 8 0.8 9 % 9 % 12 % 9 % 16 % 10 , 12 % 11 2.6 12 % 12 % 13 , 13 , 16 % 15 8.8 16 % 16 % 17 for 16 % 27 , 17 for 18 knees 18 knees 19 with 19 with 26 fkp 20 no 26 fkp 22 inconsistent 24 and 23 , 24 and 24 and 25 consistent 24 and 26 fkp relative risks [of] tkr over 30 months were 1.2 ( 95 % ci 0.6 - 2.3 ) and 2.3 ( 95 % ci 1.2 - 4.4 ) for knees with inconsistent and consistent fkp , compared with those without fkp . 0 ###LEFT-WALL### 1 relative 0 ###LEFT-WALL### 2 risks 0 ###LEFT-WALL### 41 . 1 relative 2 risks 2 risks 4 tkr 2 risks 28 for 2 risks 30 with 2 risks 39 without 4 tkr 5 over 5 over 18 and 6 30 7 months 6 30 18 and 7 months 8 were 8 were 9 1.2 9 1.2 13 ci 10 ( 13 ci 11 95 13 ci 12 % 13 ci 13 ci 15 - 13 ci 17 ) 14 0.6 15 - 15 - 16 2.3 18 and 19 2.3 18 and 23 ci 20 ( 23 ci 21 95 23 ci 22 % 23 ci 23 ci 25 - 23 ci 27 ) 24 1.2 25 - 25 - 26 4.4 28 for 29 knees 30 with 32 and 30 with 36 compared 31 inconsistent 32 and 32 and 34 fkp 32 and 35 , 33 consistent 34 fkp 36 compared 37 with 37 with 38 those 39 without 40 fkp this association was consistent across each level of pain severity on the western ontario and mcmaster universities osteoarthritis index . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 20 . 1 this 2 association 2 association 3 was 3 was 4 consistent 4 consistent 5 across 4 consistent 11 on 5 across 7 level 6 each 7 level 7 level 8 of 8 of 10 severity 9 pain 10 severity 11 on 15 and 12 the 14 ontario 13 western 14 ontario 14 ontario 15 and 15 and 19 index 16 mcmaster 17 universities 17 universities 18 osteoarthritis 18 osteoarthritis 19 index conclusion : consistency of frequent knee pain is associated with an increased risk of tkr independently of knee pain severity . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 consistency 2 : 9 associated 2 : 21 . 3 consistency 4 of 3 consistency 8 is 4 of 7 pain 5 frequent 6 knee 6 knee 7 pain 8 is 9 associated 9 associated 10 with 9 associated 16 independently 10 with 13 risk 11 an 13 risk 12 increased 13 risk 13 risk 14 of 14 of 15 tkr 16 independently 17 of 17 of 20 severity 18 knee 20 severity 19 pain 20 severity objectives : to test whether different terminal pathologies are associated with different rates of age - related decline [in] fluid and crystallized mental abilities and whether pathology - associated declines are accelerated by age . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 17 related 0 ###LEFT-WALL### 28 - 1 objectives 2 : 2 : 3 to 2 : 4 test 3 to 4 test 4 test 5 whether 4 test 11 with 5 whether 8 pathologies 5 whether 10 associated 6 different 8 pathologies 7 terminal 8 pathologies 8 pathologies 9 are 9 are 10 associated 11 with 13 rates 12 different 13 rates 13 rates 14 of 14 of 15 age 16 - 17 related 17 related 21 and 18 decline 20 fluid 20 fluid 21 and 21 and 27 pathology 22 crystallized 24 abilities 23 mental 24 abilities 24 abilities 25 and 25 and 26 whether 25 and 27 pathology 28 - 30 declines 28 - 32 accelerated 28 - 35 . 29 associated 30 declines 30 declines 31 are 31 are 32 accelerated 32 accelerated 33 by 33 by 34 age methods : during [a] 20 - year longitudinal study , 6203 participants were quadrennially assessed on the heim 's [(] heim , [a] [1970] [ )(the ah4 series of intelligence tests slough , u.k [.] : nep [ )(ah4 [-] 1 and ah4 - 2 tests of fluid intelligence and [on] the raven ['s] ( raven , [j] ..y c ..y [1965] [ )(the mill hill vocabulary scale london : h.k [.] lewis [ )(mill hill a and [b] tests of recognition and production vocabulary . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 6 - 1 methods 2 : 2 : 3 during 3 during 5 20 6 - 9 study 6 - 10 , 7 year 9 study 8 longitudinal 9 study 10 , 12 participants 10 , 22 , 11 6203 12 participants 12 participants 13 were 13 were 14 quadrennially 13 were 15 assessed 15 assessed 16 on 16 on 21 heim 17 the 18 heim 18 heim 19 's 19 's 21 heim 22 , 28 series 22 , 33 , 26 )(the 28 series 27 ah4 28 series 28 series 29 of 28 series 31 tests 29 of 30 intelligence 31 tests 32 slough 33 , 34 u.k 33 , 44 - 34 u.k 36 : 36 : 43 ah4 37 nep 39 )(ah4 39 )(ah4 41 1 39 )(ah4 42 and 42 and 43 ah4 44 - 46 tests 44 - 50 and 45 2 46 tests 46 tests 47 of 47 of 49 intelligence 48 fluid 49 intelligence 50 and 57 , 50 and 59 ..y 50 and 61 ..y 52 the 53 raven 53 raven 56 raven 55 ( 56 raven 56 raven 57 , 59 ..y 60 c 60 c 61 ..y 61 ..y 69 london 64 )(the 69 london 65 mill 66 hill 66 hill 67 vocabulary 67 vocabulary 68 scale 68 scale 69 london 69 london 70 : 70 : 78 and 71 h.k 73 lewis 73 lewis 75 )(mill 75 )(mill 76 hill 76 hill 77 a 76 hill 78 and 78 and 80 tests 78 and 81 of 81 of 83 and 82 recognition 83 and 83 and 85 vocabulary 83 and 86 . 84 production 85 vocabulary dates and proximate causes of death were logged for 2499 participants . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 logged 0 ###LEFT-WALL### 12 . 1 dates 2 and 2 and 4 causes 2 and 5 of 2 and 7 were 3 proximate 4 causes 5 of 6 death 7 were 8 logged 8 logged 9 for 9 for 11 participants 10 2499 11 participants multilevel modelling compared rates of [decline] after effects of sex , demographics , and practice were taken into consideration . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 17 taken 0 ###LEFT-WALL### 20 . 1 multilevel 2 modelling 1 multilevel 11 , 2 modelling 4 rates 3 compared 4 rates 4 rates 5 of 4 rates 9 of 5 of 7 after 7 after 8 effects 9 of 10 sex 11 , 12 demographics 11 , 14 and 13 , 14 and 14 and 15 practice 14 and 16 were 16 were 17 taken 17 taken 18 into 18 into 19 consideration results : rates [of] [cognitive] decline markedly [differed] across pathologies , being most rapid for dementias and infections , slower for malignancies , and most prolonged for cardiovascular conditions . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 decline 2 : 30 . 3 rates 6 decline 6 decline 7 markedly 6 decline 9 across 6 decline 12 being 6 decline 20 slower 6 decline 21 for 9 across 10 pathologies 11 , 12 being 12 being 14 rapid 12 being 19 , 13 most 14 rapid 14 rapid 15 for 15 for 17 and 16 dementias 17 and 17 and 18 infections 21 for 24 and 22 malignancies 24 and 23 , 24 and 24 and 25 most 25 most 26 prolonged 26 prolonged 27 for 27 for 29 conditions 28 cardiovascular 29 conditions pathologies were associated with faster declines in older individuals . 0 ###LEFT-WALL### 1 pathologies 0 ###LEFT-WALL### 3 associated 0 ###LEFT-WALL### 10 . 1 pathologies 2 were 2 were 3 associated 3 associated 4 with 3 associated 7 in 4 with 6 declines 5 faster 6 declines 7 in 9 individuals 8 older 9 individuals discussion : after sex , age , and demographics have also been considered , different terminal pathologies are associated with markedly different rates [of] [decline] . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 17 pathologies 2 : 19 associated 2 : 26 . 3 after 8 and 3 after 13 considered 3 after 14 , 3 after 17 pathologies 4 sex 5 , 5 , 6 age 5 , 8 and 7 , 8 and 8 and 9 demographics 8 and 10 have 10 have 12 been 11 also 12 been 12 been 13 considered 15 different 16 terminal 16 terminal 17 pathologies 17 pathologies 18 are 18 are 19 associated 19 associated 20 with 20 with 23 rates 21 markedly 22 different 22 different 23 rates age accelerates pathology - related decline . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 2 accelerates 0 ###LEFT-WALL### 4 - 1 age 2 accelerates 2 accelerates 3 pathology 4 - 6 decline 4 - 7 . 5 related 6 decline this raises the further question as to whether any , or how much of [,] age [-] related cognitive [decline] is brought about by other causes than an increasing burden of pathologies . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 raises 0 ###LEFT-WALL### 33 . 1 this 2 raises 2 raises 5 question 2 raises 7 to 3 the 5 question 4 further 5 question 6 as 7 to 7 to 8 whether 8 whether 11 or 8 whether 22 brought 9 any 11 or 10 , 11 or 11 or 12 how 11 or 16 age 11 or 21 is 11 or 22 brought 13 much 14 of 13 much 16 age 14 of 16 age 16 age 18 related 16 age 21 is 18 related 19 cognitive 22 brought 23 about 22 brought 24 by 22 brought 27 than 22 brought 30 burden 24 by 26 causes 25 other 26 causes 28 an 30 burden 29 increasing 30 burden 30 burden 31 of 31 of 32 pathologies unlike apoptosis , mechanisms leading to necrosis are less well understood . 0 ###LEFT-WALL### 4 mechanisms 0 ###LEFT-WALL### 11 understood 0 ###LEFT-WALL### 12 . 1 unlike 2 apoptosis 1 unlike 3 , 1 unlike 4 mechanisms 4 mechanisms 5 leading 4 mechanisms 8 are 5 leading 6 to 6 to 7 necrosis 8 are 10 well 8 are 11 understood 9 less 10 well moreover , changes in necrosis as a function of age have not been studied in human lymphocytes . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 14 studied 0 ###LEFT-WALL### 18 . 1 moreover 2 , 1 moreover 3 changes 3 changes 4 in 3 changes 11 have 4 in 5 necrosis 5 necrosis 6 as 6 as 8 function 7 a 8 function 8 function 9 of 9 of 10 age 11 have 12 not 11 have 13 been 13 been 14 studied 14 studied 15 in 15 in 17 lymphocytes 16 human 17 lymphocytes [h] [(] 2 [ ] ( 2 ) - induced death of peripheral lymphocytes ( 56 healthy donors , 24 - 95 years ) [was] evaluated by flow cytometry and propidium iodide staining , caspase activation , dna laddering , and electron microscopy . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 25 [was] 0 ###LEFT-WALL### 43 microscopy 3 2 6 ( 3 2 10 induced 3 2 19 , 3 2 25 [was] 5 ] 6 ( 6 ( 7 2 8 ) 10 induced 9 - 10 induced 10 induced 11 death 10 induced 18 donors 11 death 13 peripheral 12 of 13 peripheral 13 peripheral 17 healthy 14 lymphocytes 17 healthy 15 ( 17 healthy 16 56 17 healthy 17 healthy 18 donors 18 donors 19 , 19 , 22 95 19 , 23 years 20 24 22 95 21 - 22 95 22 95 23 years 25 [was] 26 evaluated 25 [was] 42 electron 26 evaluated 40 , 27 by 28 flow 28 flow 29 cytometry 29 cytometry 31 propidium 29 cytometry 32 iodide 29 cytometry 33 staining 30 and 31 propidium 33 staining 35 caspase 33 staining 36 activation 34 , 35 caspase 36 activation 38 dna 36 activation 40 , 37 , 38 dna 39 laddering 40 , 40 , 41 and [h] [(] 2 [ ] ( 2 [ )(- induced stress [was] associated with high levels of necrosis in young individuals ( ≤30 years ) , whereas progressively enhanced apoptotic death was observed in older donors , without changes in overall lymphocyte survival . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 9 )(- 0 ###LEFT-WALL### 43 survival 3 2 6 ( 3 2 9 )(- 5 ] 6 ( 6 ( 8 [ 9 )(- 10 induced 9 )(- 13 associated 9 )(- 18 necrosis 9 )(- 26 , 9 )(- 37 , 9 )(- 39 changes 10 induced 12 [was] 13 associated 15 high 14 with 15 high 15 high 16 levels 16 levels 17 of 18 necrosis 20 young 19 in 20 young 20 young 23 ≤30 21 individuals 23 ≤30 22 ( 23 ≤30 23 ≤30 24 years 25 ) 26 , 26 , 30 apoptotic 26 , 32 was 26 , 36 donors 27 whereas 28 progressively 28 progressively 30 apoptotic 29 enhanced 30 apoptotic 30 apoptotic 31 death 31 death 32 was 32 was 33 observed 33 observed 35 older 34 in 35 older 37 , 38 without 39 changes 42 lymphocyte 40 in 41 overall 41 overall 42 lymphocyte thus , apoptosis/necrosis ratios were inverted in young [versus] elderly ( ≥65 years ) donors . 0 ###LEFT-WALL### 4 ratios 0 ###LEFT-WALL### 6 inverted 0 ###LEFT-WALL### 16 . 1 thus 2 , 1 thus 4 ratios 3 apoptosis/necrosis 4 ratios 4 ratios 5 were 5 were 6 inverted 6 inverted 7 in 7 in 15 donors 8 young 15 donors 10 elderly 13 years 10 elderly 15 donors 11 ( 13 years 12 ≥65 13 years 13 years 14 ) death was not accompanied by increased caspase activity [and] , accordingly , unaffected by caspase inhibition ; however , it was almost completely prevented by [poly] adp ribose polymerase inhibition . 0 ###LEFT-WALL### 1 death 0 ###LEFT-WALL### 4 accompanied 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 31 . 1 death 2 was 2 was 3 not 2 was 4 accompanied 4 accompanied 5 by 4 accompanied 11 accordingly 4 accompanied 13 unaffected 5 by 8 activity 6 increased 7 caspase 7 caspase 8 activity 10 , 11 accordingly 11 accordingly 12 , 13 unaffected 14 by 14 by 16 inhibition 15 caspase 16 inhibition 17 ; 20 it 17 ; 24 prevented 18 however 19 , 18 however 20 it 20 it 21 was 21 was 24 prevented 22 almost 23 completely 23 completely 24 prevented 24 prevented 25 by 25 by 30 inhibition 27 adp 30 inhibition 28 ribose 30 inhibition 29 polymerase 30 inhibition in summary , aging was associated with changes in the apoptosis/necrosis ratios [,] rather than susceptibility per se to h ( 2 [ ] ( 2 ) - induced death , [which] was caspase independent but [poly] adp ribose [polymerase] dependent . 0 ###LEFT-WALL### 2 summary 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 32 [which] 0 ###LEFT-WALL### 41 dependent 1 in 2 summary 3 , 4 aging 3 , 6 associated 3 , 30 death 4 aging 5 was 5 was 6 associated 6 associated 7 with 6 associated 9 in 6 associated 15 than 6 associated 18 se 6 associated 19 to 6 associated 27 ) 7 with 8 changes 9 in 12 ratios 10 the 12 ratios 11 apoptosis/necrosis 12 ratios 14 rather 15 than 15 than 16 susceptibility 17 per 18 se 19 to 20 h 21 ( 27 ) 22 2 25 ( 22 2 27 ) 24 ] 25 ( 25 ( 26 2 27 ) 29 induced 27 ) 30 death 28 - 29 induced 30 death 32 [which] 32 [which] 33 was 32 [which] 40 [polymerase] 33 was 34 caspase 34 caspase 35 independent 35 independent 38 adp 37 [poly] 38 adp understanding this switch in death modes may aid in understanding age - related disorders . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 8 aid 0 ###LEFT-WALL### 13 related 1 understanding 3 switch 1 understanding 4 in 1 understanding 7 may 2 this 3 switch 4 in 6 modes 5 death 6 modes 7 may 8 aid 8 aid 9 in 8 aid 11 age 9 in 10 understanding 12 - 13 related 13 related 14 disorders 13 related 15 . context : the growth hormone ( gh )/insulin - like growth factor [-] i ( igf - i ) [axis] stimulates collagen synthesis in tendon and skeletal muscle , [but] no studies have investigated the effect of reducing igf - [i] on collagen synthesis in healthy humans . 0 ###LEFT-WALL### 1 context 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 - 1 context 2 : 2 : 5 hormone 3 the 5 hormone 4 growth 5 hormone 5 hormone 8 )/insulin 6 ( 8 )/insulin 7 gh 8 )/insulin 8 )/insulin 9 - 9 - 12 factor 9 - 21 stimulates 10 like 11 growth 10 like 12 factor 12 factor 14 i 12 factor 17 - 12 factor 21 stimulates 15 ( 17 - 16 igf 17 - 17 - 18 i 17 - 19 ) 21 stimulates 23 synthesis 21 stimulates 24 in 22 collagen 23 synthesis 24 in 26 and 25 tendon 26 and 26 and 28 muscle 26 and 29 , 26 and 32 studies 26 and 38 reducing 27 skeletal 28 muscle 31 no 32 studies 32 studies 33 have 33 have 34 investigated 34 investigated 36 effect 35 the 36 effect 36 effect 37 of 37 of 38 reducing 38 reducing 39 igf 39 igf 42 on 40 - 42 on 42 on 44 synthesis 42 on 48 . 43 collagen 44 synthesis 44 synthesis 45 in 45 in 47 humans 46 healthy 47 humans objective : we hypothesised [,] that a gh blockade would decrease igf - i and collagen synthesis in the connective tissue of skeletal muscle and tendon . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 we 2 : 4 hypothesised 2 : 13 - 3 we 4 hypothesised 4 hypothesised 6 that 6 that 9 blockade 6 that 11 decrease 7 a 9 blockade 8 gh 9 blockade 9 blockade 10 would 10 would 11 decrease 11 decrease 12 igf 13 - 15 and 14 i 15 and 15 and 17 synthesis 15 and 18 in 15 and 22 of 16 collagen 17 synthesis 18 in 21 tissue 19 the 21 tissue 20 connective 21 tissue 22 of 25 and 23 skeletal 24 muscle 24 muscle 25 and 25 and 26 tendon design : the study was randomised and [double] blinded . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 was 2 : 10 . 3 the 4 study 4 study 5 was 5 was 7 and 6 randomised 7 and 7 and 9 blinded participants : 20 healthy young males completed the study . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 2 : 6 males 2 : 7 completed 2 : 10 . 3 20 6 males 4 healthy 6 males 5 young 6 males 6 males 7 completed 7 completed 9 study 8 the 9 study intervention : the participants [were] randomised to 2 weeks of gh receptor blocker supplementation ( pegvisomant , 5 mg/day , n=9 ) or placebo ( n=11 ) . 0 ###LEFT-WALL### 1 intervention 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 1 intervention 2 : 2 : 23 or 3 the 4 participants 4 participants 6 randomised 4 participants 10 of 4 participants 23 or 6 randomised 7 to 7 to 9 weeks 8 2 9 weeks 10 of 14 supplementation 11 gh 13 blocker 12 receptor 13 blocker 13 blocker 14 supplementation 14 supplementation 21 n=9 15 ( 21 n=9 16 pegvisomant 19 mg/day 16 pegvisomant 21 n=9 17 , 19 mg/day 18 5 19 mg/day 19 mg/day 20 , 21 n=9 22 ) 23 or 24 placebo 23 or 26 n=11 25 ( 26 n=11 26 n=11 27 ) main outcome measures : serum levels of gh , igf - i and igf - binding protein 3 ( igfbp - 3 ) were measured before and after pegvisomant/placebo supplementation . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 31 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 6 levels 5 serum 6 levels 6 levels 7 of 6 levels 10 igf 6 levels 13 and 7 of 8 gh 9 , 10 igf 10 igf 11 - 11 - 13 and 12 i 13 and 13 and 14 igf 13 and 15 - 15 - 16 binding 15 - 24 were 16 binding 17 protein 16 binding 24 were 18 3 20 igfbp 18 3 24 were 19 ( 20 igfbp 20 igfbp 22 3 20 igfbp 23 ) 21 - 22 3 22 3 23 ) 24 were 25 measured 25 measured 27 and 26 before 27 and 27 and 28 after 28 after 30 supplementation 29 pegvisomant/placebo 30 supplementation results : pegvisomant decreased serum igf [-] i by 20 % ( p<0.01 ) and serum igfbp - 3 by 10 % ( p<0.05 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 1 results 2 : 2 : 15 and 3 pegvisomant 4 decreased 4 decreased 6 igf 5 serum 6 igf 6 igf 8 i 6 igf 9 by 6 igf 15 and 9 by 11 % 10 20 11 % 11 % 13 p<0.01 12 ( 13 p<0.01 13 p<0.01 14 ) 15 and 17 igfbp 15 and 19 3 16 serum 17 igfbp 18 - 19 3 19 3 20 by 19 3 25 ) 20 by 22 % 21 10 22 % 22 % 24 p<0.05 23 ( 24 p<0.05 24 p<0.05 25 ) pegvisomant supplementation had no effect on collagen synthesis in tendon [and] skeletal muscle , nor was muscle myofibrillar protein synthesis affected . 0 ###LEFT-WALL### 2 supplementation 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 22 . 1 pegvisomant 2 supplementation 2 supplementation 3 had 3 had 5 effect 3 had 6 on 3 had 9 in 4 no 5 effect 6 on 8 synthesis 7 collagen 8 synthesis 9 in 13 muscle 10 tendon 13 muscle 12 skeletal 13 muscle 14 , 15 nor 14 , 16 was 15 nor 16 was 16 was 17 muscle 16 was 20 synthesis 18 myofibrillar 19 protein 19 protein 20 synthesis 20 synthesis 21 affected similarly , pegvisomant supplementation had no effect on mrna expression of igf - i and collagen in skeletal muscle . 0 ###LEFT-WALL### 4 supplementation 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 13 - 1 similarly 2 , 1 similarly 4 supplementation 3 pegvisomant 4 supplementation 4 supplementation 5 had 5 had 7 effect 5 had 8 on 6 no 7 effect 8 on 10 expression 9 mrna 10 expression 10 expression 11 of 11 of 12 igf 13 - 15 and 13 - 20 . 14 i 15 and 15 and 16 collagen 15 and 17 in 17 in 19 muscle 18 skeletal 19 muscle conclusion : gh receptor blocker administration in healthy humans resulted in a moderate decrease in serum igf [-] i . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 6 administration 2 : 10 resulted 3 gh 4 receptor 4 receptor 6 administration 5 blocker 6 administration 6 administration 7 in 6 administration 10 resulted 7 in 9 humans 8 healthy 9 humans 10 resulted 11 in 10 resulted 15 in 11 in 14 decrease 12 a 13 moderate 12 a 14 decrease 13 moderate 14 decrease 15 in 17 igf 16 serum 17 igf 17 igf 19 i collagen synthesis [in] tendon and skeletal muscle , as well as skeletal muscle igf - i and collagen mrna expression , was unaffected by gh receptor blocker supplementation . 0 ###LEFT-WALL### 4 tendon 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 29 . 1 collagen 4 tendon 2 synthesis 4 tendon 5 and 7 muscle 5 and 22 was 6 skeletal 7 muscle 7 muscle 11 as 7 muscle 17 and 7 muscle 22 was 8 , 11 as 9 as 10 well 10 well 11 as 11 as 14 igf 11 as 15 - 12 skeletal 14 igf 13 muscle 14 igf 15 - 17 and 16 i 17 and 17 and 20 expression 17 and 21 , 18 collagen 20 expression 19 mrna 20 expression 22 was 23 unaffected 23 unaffected 24 by 24 by 28 supplementation 25 gh 28 supplementation 26 receptor 28 supplementation 27 blocker 28 supplementation background : skin maceration is recognized as a risk factor for the development of certain skin lesions . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 maceration 2 : 6 recognized 2 : 18 . 3 skin 4 maceration 4 maceration 5 is 5 is 6 recognized 6 recognized 7 as 7 as 10 factor 8 a 10 factor 9 risk 10 factor 10 factor 11 for 11 for 13 development 12 the 13 development 13 development 14 of 14 of 17 lesions 15 certain 16 skin 16 skin 17 lesions in health care settings , incontinence - associated skin maceration is highly prevalent in the elderly . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 17 . 1 in 4 settings 1 in 11 is 2 health 4 settings 3 care 4 settings 4 settings 6 incontinence 5 , 6 incontinence 6 incontinence 7 - 8 associated 9 skin 9 skin 10 maceration 10 maceration 11 is 11 is 13 prevalent 12 highly 13 prevalent 13 prevalent 14 in 14 in 16 elderly 15 the 16 elderly however , the effect of senescence on maceration has not been fully elucidated . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 13 elucidated 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 4 effect 3 the 4 effect 4 effect 5 of 4 effect 9 has 5 of 6 senescence 6 senescence 7 on 7 on 8 maceration 9 has 10 not 9 has 11 been 11 been 12 fully 11 been 13 elucidated objective : to reveal the enhancement of the maceration - induced ultrastructural alteration and barrier function of the epidermis by aging . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 reveal 2 : 10 - 3 to 4 reveal 4 reveal 6 enhancement 5 the 6 enhancement 6 enhancement 7 of 7 of 9 maceration 8 the 9 maceration 10 - 14 and 10 - 22 . 11 induced 13 alteration 12 ultrastructural 13 alteration 13 alteration 14 and 14 and 16 function 14 and 17 of 15 barrier 16 function 17 of 19 epidermis 18 the 19 epidermis 19 epidermis 20 by 20 by 21 aging methods : skin maceration was reproduced by exposure to agarose gel in human and rat . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 maceration 2 : 6 reproduced 2 : 16 . 3 skin 4 maceration 4 maceration 5 was 5 was 6 reproduced 6 reproduced 7 by 7 by 8 exposure 8 exposure 9 to 8 exposure 12 in 9 to 11 gel 10 agarose 11 gel 12 in 14 and 13 human 14 and 14 and 15 rat the ultrastructural alterations in human and rat tissue were observed by transmission electron microscopy . 0 ###LEFT-WALL### 3 alterations 0 ###LEFT-WALL### 10 observed 0 ###LEFT-WALL### 15 . 1 the 3 alterations 2 ultrastructural 3 alterations 3 alterations 4 in 3 alterations 9 were 4 in 6 and 5 human 6 and 6 and 8 tissue 7 rat 8 tissue 9 were 10 observed 10 observed 11 by 11 by 14 microscopy 12 transmission 14 microscopy 13 electron 14 microscopy the skin barrier function was evaluated by noninvasive methods in [human] , and by the transdermal penetration of small - and large - fluorescent molecules [in] rat . 0 ###LEFT-WALL### 4 function 0 ###LEFT-WALL### 6 evaluated 0 ###LEFT-WALL### 28 . 1 the 4 function 2 skin 4 function 3 barrier 4 function 4 function 5 was 5 was 6 evaluated 6 evaluated 7 by 6 evaluated 13 and 7 by 9 methods 8 noninvasive 9 methods 10 in 13 and 12 , 13 and 13 and 14 by 13 and 17 penetration 15 the 17 penetration 16 transdermal 17 penetration 17 penetration 18 of 18 of 21 and 19 small 21 and 20 - 21 and 21 and 27 rat 22 large 23 - 22 large 25 molecules 24 fluorescent 25 molecules 25 molecules 27 rat in order to reveal the effect of aging on the skin maceration , we compared these parameters between young and aged rats . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 15 compared 0 ###LEFT-WALL### 23 . 1 in 2 order 1 in 13 , 1 in 14 we 2 order 3 to 2 order 4 reveal 3 to 4 reveal 4 reveal 6 effect 5 the 6 effect 6 effect 7 of 7 of 8 aging 8 aging 9 on 9 on 12 maceration 10 the 12 maceration 11 skin 12 maceration 14 we 15 compared 15 compared 17 parameters 15 compared 18 between 16 these 17 parameters 18 between 22 rats 19 young 20 and 20 and 21 aged 20 and 22 rats results : in macerated skin , we observed expansion of the interstices of the stratum corneum , spinosum , and basale of the epidermis [;] disruption of the intercellular lipid structure in the stratum corneum ; a decreased number of cell processes in the stratum spinosum and basale . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 49 . 1 results 2 : 2 : 3 in 3 in 5 skin 4 macerated 5 skin 6 , 7 we 6 , 8 observed 6 , 36 ; 7 we 8 observed 8 observed 20 and 8 observed 32 in 9 expansion 10 of 9 expansion 20 and 10 of 12 interstices 11 the 12 interstices 12 interstices 13 of 13 of 16 corneum 14 the 16 corneum 15 stratum 16 corneum 16 corneum 18 spinosum 17 , 18 spinosum 18 spinosum 19 , 20 and 21 basale 20 and 27 of 21 basale 22 of 22 of 26 disruption 23 the 26 disruption 24 epidermis 26 disruption 27 of 31 structure 28 the 31 structure 29 intercellular 30 lipid 30 lipid 31 structure 32 in 35 corneum 33 the 35 corneum 34 stratum 35 corneum 36 ; 47 and 37 a 39 number 38 decreased 39 number 39 number 40 of 39 number 47 and 40 of 42 processes 41 cell 42 processes 42 processes 43 in 43 in 46 spinosum 44 the 46 spinosum 45 stratum 46 spinosum 47 and 48 basale the transdermal penetration test in the rat using two types of fluorescein indicated that maceration disrupted skin barrier function . 0 ###LEFT-WALL### 4 test 0 ###LEFT-WALL### 13 indicated 0 ###LEFT-WALL### 20 . 1 the 4 test 2 transdermal 3 penetration 3 penetration 4 test 4 test 5 in 4 test 13 indicated 5 in 7 rat 6 the 7 rat 7 rat 8 using 7 rat 11 of 8 using 10 types 9 two 10 types 11 of 12 fluorescein 13 indicated 19 function 14 that 19 function 15 maceration 16 disrupted 16 disrupted 17 skin 17 skin 19 function 18 barrier 19 function furthermore , senescence [-] enhanced ultrastructural and functional alterations were revealed in the rodent studies . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 11 revealed 0 ###LEFT-WALL### 16 . 1 furthermore 2 , 1 furthermore 7 and 3 senescence 5 enhanced 3 senescence 7 and 5 enhanced 6 ultrastructural 7 and 9 alterations 7 and 10 were 8 functional 9 alterations 10 were 11 revealed 11 revealed 12 in 12 in 15 studies 13 the 15 studies 14 rodent 15 studies conclusion : this study demonstrates that aging enhances skin maceration . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 demonstrates 2 : 11 . 3 this 4 study 4 study 5 demonstrates 5 demonstrates 6 that 6 that 7 aging 6 that 8 enhances 7 aging 8 enhances 8 enhances 10 maceration 9 skin 10 maceration considering that maceration is a risk factor for the skin damage , the development of technology to promote skin barrier recovery after maceration in the elderly is warranted . 0 ###LEFT-WALL### 14 development 0 ###LEFT-WALL### 28 warranted 0 ###LEFT-WALL### 29 . 1 considering 2 that 1 considering 12 , 1 considering 14 development 2 that 3 maceration 2 that 4 is 3 maceration 4 is 4 is 7 factor 5 a 7 factor 6 risk 7 factor 7 factor 8 for 8 for 11 damage 9 the 11 damage 10 skin 11 damage 13 the 14 development 14 development 15 of 14 development 17 to 14 development 18 promote 14 development 27 is 15 of 16 technology 17 to 18 promote 18 promote 21 recovery 18 promote 22 after 18 promote 24 in 19 skin 20 barrier 20 barrier 21 recovery 22 after 23 maceration 24 in 26 elderly 25 the 26 elderly 27 is 28 warranted purpose : the aim of the study was to investigate possible linear [intra] - bone geometry dependencies by determining the relation between the maximum radius length and maximum distal width in two independent populations and test for possible gender or age effects . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 43 . 2 : 4 aim 2 : 8 was 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 the 7 study 8 was 9 to 8 was 31 in 8 was 37 for 9 to 10 investigate 10 investigate 17 dependencies 11 possible 15 bone 12 linear 14 - 12 linear 15 bone 15 bone 16 geometry 16 geometry 17 dependencies 17 dependencies 18 by 17 dependencies 22 between 18 by 19 determining 19 determining 21 relation 20 the 21 relation 22 between 27 and 23 the 26 length 24 maximum 26 length 25 radius 26 length 26 length 27 and 27 and 30 width 28 maximum 30 width 29 distal 30 width 31 in 35 and 32 two 34 populations 33 independent 34 populations 34 populations 35 and 35 and 36 test 37 for 40 or 38 possible 39 gender 39 gender 40 or 40 or 42 effects 41 age 42 effects a strong correlation can help develop more representative fracture models and osteosynthetic devices as well as aid gender and height estimation in anthropologic/forensic cases . 0 ###LEFT-WALL### 3 correlation 0 ###LEFT-WALL### 6 develop 0 ###LEFT-WALL### 25 . 1 a 2 strong 1 a 3 correlation 2 strong 3 correlation 3 correlation 4 can 4 can 5 help 5 help 6 develop 6 develop 11 and 6 develop 15 well 6 develop 16 as 7 more 10 models 8 representative 9 fracture 9 fracture 10 models 10 models 11 and 11 and 13 devices 12 osteosynthetic 13 devices 14 as 15 well 16 as 19 and 17 aid 18 gender 18 gender 19 and 19 and 21 estimation 19 and 22 in 20 height 21 estimation 22 in 24 cases 23 anthropologic/forensic 24 cases methods : first , maximum radius length and distal width of 100 consecutive patients , aged 20 - 70 years , were digitally measured on standard lower arm [radiographs] [by] two independent investigators . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 34 . 1 methods 2 : 2 : 3 first 4 , 8 and 4 , 21 , 5 maximum 6 radius 6 radius 7 length 7 length 8 and 8 and 10 width 8 and 15 , 8 and 21 , 9 distal 10 width 10 width 11 of 11 of 14 patients 12 100 14 patients 13 consecutive 14 patients 16 aged 18 - 16 aged 20 years 16 aged 21 , 17 20 18 - 18 - 19 70 21 , 22 were 22 were 24 measured 23 digitally 24 measured 24 measured 25 on 25 on 33 investigators 26 standard 33 investigators 27 lower 28 arm 28 arm 33 investigators 31 two 32 independent 32 independent 33 investigators second , the same measurements were performed ex vivo on a second cohort , 135 isolated , formalin fixed radii . 0 ###LEFT-WALL### 5 measurements 0 ###LEFT-WALL### 7 performed 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 21 . 1 second 2 , 1 second 5 measurements 3 the 4 same 3 the 5 measurements 5 measurements 6 were 6 were 7 performed 7 performed 9 vivo 7 performed 10 on 8 ex 9 vivo 10 on 13 cohort 11 a 13 cohort 12 second 13 cohort 14 , 20 radii 15 135 20 radii 16 isolated 17 , 16 isolated 18 formalin 18 formalin 19 fixed 19 fixed 20 radii standard descriptive statistics as well as correlations were calculated and possible gender age influences tested for both populations separately . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 13 age 0 ###LEFT-WALL### 20 . 1 standard 3 statistics 2 descriptive 3 statistics 3 statistics 4 as 3 statistics 10 and 4 as 5 well 5 well 9 calculated 6 as 7 correlations 6 as 9 calculated 7 correlations 8 were 8 were 9 calculated 10 and 12 gender 10 and 13 age 11 possible 12 gender 13 age 14 influences 14 influences 15 tested 15 tested 16 for 15 tested 19 separately 16 for 18 populations 17 both 18 populations results : the radiographic dataset resulted in a correlation of radius length and width of r=0.753 ( adj . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 dataset 2 : 6 resulted 3 the 5 dataset 4 radiographic 5 dataset 5 dataset 6 resulted 6 resulted 7 in 7 in 9 correlation 8 a 9 correlation 9 correlation 10 of 10 of 13 and 11 radius 12 length 12 length 13 and 13 and 14 width 13 and 15 of 15 of 16 r=0.753 16 r=0.753 18 adj 17 ( 18 adj 18 adj 19 . [r] [(] 2 )=0.563 , p<0.001 [ )(with sex having a significant ( p=0.005 , adj . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 4 )=0.563 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 6 p<0.001 0 ###LEFT-WALL### 17 . 3 2 4 )=0.563 5 , 6 p<0.001 6 p<0.001 8 )(with 8 )(with 9 sex 9 sex 10 having 10 having 16 adj 11 a 12 significant 11 a 16 adj 12 significant 14 p=0.005 12 significant 15 , 12 significant 16 adj 13 ( 14 p=0.005 14 p=0.005 15 , r ( [2] [ 0 [ )(and side no influence on the correlation . 0 ###LEFT-WALL### 6 [ 0 ###LEFT-WALL### 13 correlation 1 r 6 [ 2 ( 6 [ 6 [ 9 no 6 [ 10 influence 7 )(and 9 no 8 side 9 no 10 influence 12 the 11 on 12 the radius length - width [correlation] for the isolated radii was r=0.621 ( adj . 0 ###LEFT-WALL### 2 length 0 ###LEFT-WALL### 3 - 1 radius 2 length 3 - 4 width 3 - 10 was 4 width 6 for 4 width 10 was 6 for 9 radii 7 the 9 radii 8 isolated 9 radii 10 was 11 r=0.621 11 r=0.621 13 adj 12 ( 13 adj 13 adj 14 . [r] [(] 2 )=0.381 , p<0.001 [ )(with sex significantly influencing this correlation ( p<0.001 , adj . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 4 )=0.381 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 6 p<0.001 0 ###LEFT-WALL### 18 . 3 2 4 )=0.381 5 , 6 p<0.001 6 p<0.001 8 )(with 8 )(with 9 sex 8 )(with 17 adj 9 sex 11 influencing 10 significantly 11 influencing 11 influencing 13 correlation 12 this 13 correlation 13 correlation 15 p<0.001 14 ( 15 p<0.001 15 p<0.001 16 , [r] [(] 2 )=0.598 [ )( 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 4 )=0.598 0 ###LEFT-WALL### 6 )( 3 2 4 )=0.598 conclusion : a relatively strong radius length - distal width [correlation] was found in two different populations , indicating that linear body proportions might not only apply to body height and axial length measurements of long bones but also to proportional dependency of bone shapes in general . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 48 . 1 conclusion 2 : 2 : 7 length 3 a 7 length 4 relatively 5 strong 5 strong 7 length 6 radius 7 length 8 - 10 width 8 - 18 , 9 distal 10 width 10 width 12 was 12 was 18 , 13 found 14 in 13 found 17 populations 13 found 18 , 15 two 17 populations 16 different 17 populations 18 , 27 apply 18 , 38 but 19 indicating 23 proportions 19 indicating 24 might 20 that 21 linear 21 linear 22 body 22 body 23 proportions 24 might 25 not 24 might 27 apply 26 only 27 apply 28 to 31 and 28 to 38 but 29 body 30 height 30 height 31 and 31 and 34 measurements 31 and 35 of 32 axial 33 length 33 length 34 measurements 35 of 37 bones 36 long 37 bones 38 but 39 also 38 but 40 to 40 to 42 dependency 41 proportional 42 dependency 42 dependency 43 of 43 of 45 shapes 44 bone 45 shapes 45 shapes 47 general 46 in 47 general it is unknown whether lifestyle , including mental stimulation , and appropriate training interventions , may directly improve spatial navigation performance and its underlying neural substrates . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 27 . 1 it 2 is 2 is 3 unknown 3 unknown 4 whether 4 whether 5 lifestyle 4 whether 18 improve 5 lifestyle 7 including 5 lifestyle 16 may 6 , 7 including 7 including 11 and 7 including 15 , 8 mental 9 stimulation 9 stimulation 11 and 10 , 11 and 11 and 14 interventions 12 appropriate 13 training 13 training 14 interventions 16 may 18 improve 17 directly 18 improve 18 improve 22 and 19 spatial 20 navigation 20 navigation 21 performance 21 performance 22 and 22 and 26 substrates 23 its 26 substrates 24 underlying 26 substrates 25 neural 26 substrates here we report that healthy younger and older men performing a cognitively demanding spatial navigation task every other day over 4 months display navigation - related gains in performance and stable hippocampal volumes that were maintained 4 months after termination of training . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 36 maintained 0 ###LEFT-WALL### 43 . 1 here 2 we 2 we 3 report 3 report 9 men 4 that 5 healthy 5 healthy 9 men 6 younger 7 and 7 and 8 older 7 and 9 men 9 men 10 performing 10 performing 16 task 11 a 12 cognitively 11 a 16 task 12 cognitively 13 demanding 14 spatial 15 navigation 15 navigation 16 task 17 every 18 other 18 other 19 day 19 day 22 months 19 day 23 display 19 day 36 maintained 20 over 21 4 21 4 22 months 22 months 23 display 23 display 24 navigation 25 - 26 related 26 related 30 and 26 related 36 maintained 27 gains 28 in 27 gains 30 and 28 in 29 performance 30 and 33 volumes 30 and 34 that 30 and 35 were 31 stable 33 volumes 32 hippocampal 33 volumes 34 that 35 were 36 maintained 39 after 37 4 38 months 38 months 39 after 39 after 40 termination 40 termination 41 of 41 of 42 training in contrast , control groups displayed volume [decrements] consistent with longitudinal estimates of age - related decline . 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 6 displayed 0 ###LEFT-WALL### 15 - 1 in 2 contrast 1 in 3 , 1 in 5 groups 4 control 5 groups 5 groups 6 displayed 6 displayed 7 volume 7 volume 9 consistent 9 consistent 10 with 10 with 12 estimates 11 longitudinal 12 estimates 12 estimates 13 of 13 of 14 age 15 - 17 decline 15 - 18 . 16 related 17 decline hippocampal barrier density , as indicated by mean diffusivity estimated from diffusion tensor imaging , showed a quadratic shape of increased density after training followed by a return to baseline in the right hippocampus , but declined in the control groups and in the left hippocampus . 0 ###LEFT-WALL### 3 density 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 47 . 1 hippocampal 2 barrier 2 barrier 3 density 4 , 19 shape 4 , 36 but 5 as 15 , 5 as 19 shape 6 indicated 7 by 6 indicated 14 imaging 6 indicated 15 , 7 by 9 diffusivity 8 mean 9 diffusivity 9 diffusivity 10 estimated 9 diffusivity 11 from 11 from 12 diffusion 13 tensor 14 imaging 15 , 16 showed 17 a 18 quadratic 17 a 19 shape 18 quadratic 19 shape 19 shape 20 of 19 shape 36 but 20 of 22 density 21 increased 22 density 22 density 23 after 23 after 24 training 25 followed 26 by 25 followed 28 return 25 followed 31 in 25 followed 36 but 27 a 28 return 28 return 29 to 29 to 30 baseline 31 in 34 hippocampus 32 the 34 hippocampus 33 right 34 hippocampus 35 , 36 but 36 but 37 declined 37 declined 42 and 38 in 41 groups 38 in 42 and 39 the 41 groups 40 control 41 groups 42 and 43 in 43 in 46 hippocampus 44 the 46 hippocampus 45 left 46 hippocampus we conclude that sustained experiential demands on spatial ability protect hippocampal integrity against age - related decline . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 15 - 1 we 2 conclude 2 conclude 3 that 3 that 6 demands 3 that 10 protect 4 sustained 6 demands 5 experiential 6 demands 6 demands 7 on 6 demands 10 protect 7 on 9 ability 8 spatial 9 ability 10 protect 12 integrity 10 protect 13 against 11 hippocampal 12 integrity 13 against 14 age 15 - 17 decline 15 - 18 . 16 related 17 decline these results provide the first longitudinal evidence indicating that spatial navigation experience modifies hippocampal volumes in humans , and confirm epidemiological results suggesting that mental stimulation may have direct effects on neural integrity . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 34 . 1 these 2 results 2 results 19 and 3 provide 7 evidence 3 provide 16 in 3 provide 19 and 4 the 5 first 4 the 7 evidence 6 longitudinal 7 evidence 7 evidence 8 indicating 7 evidence 12 experience 7 evidence 13 modifies 8 indicating 11 navigation 9 that 11 navigation 10 spatial 11 navigation 12 experience 13 modifies 13 modifies 15 volumes 14 hippocampal 15 volumes 16 in 17 humans 18 , 19 and 19 and 20 confirm 20 confirm 22 results 20 confirm 31 on 21 epidemiological 22 results 22 results 23 suggesting 23 suggesting 24 that 24 that 26 stimulation 24 that 28 have 25 mental 26 stimulation 26 stimulation 27 may 27 may 28 have 28 have 30 effects 29 direct 30 effects 31 on 33 integrity 32 neural 33 integrity the critical commentaries following [our] review of the epigenetics of alzheimer 's disease [(] ad [ )(amplify a number of key points with respect to the role of 1 - carbon metabolism , the phenomenon of allele - specific methylation , the potentially critical explanatory link provided by epigenetic mechanisms for genome - wide association and large - scale gene expression array studies , and new therapeutic approaches afforded by epigenetic manipulation in alzheimer 's disease . 0 ###LEFT-WALL### 6 review 0 ###LEFT-WALL### 12 's 1 the 6 review 2 critical 3 commentaries 3 commentaries 4 following 4 following 6 review 6 review 7 of 6 review 10 of 6 review 12 's 7 of 9 epigenetics 8 the 9 epigenetics 10 of 11 alzheimer 12 's 13 disease 12 's 23 with 13 disease 15 ad 13 disease 17 )(amplify 15 ad 17 )(amplify 17 )(amplify 19 number 18 a 19 number 19 number 20 of 20 of 22 points 21 key 22 points 23 with 24 respect 23 with 35 phenomenon 24 respect 25 to 24 respect 28 of 25 to 27 role 26 the 27 role 28 of 29 1 29 1 32 metabolism 30 - 32 metabolism 31 carbon 32 metabolism 32 metabolism 33 , 34 the 35 phenomenon 35 phenomenon 36 of 35 phenomenon 46 link 35 phenomenon 47 provided 36 of 37 allele 37 allele 40 methylation 38 - 40 methylation 39 specific 40 methylation 40 methylation 41 , 42 the 46 link 43 potentially 44 critical 44 critical 46 link 45 explanatory 46 link 46 link 47 provided 47 provided 48 by 48 by 50 mechanisms 49 epigenetic 50 mechanisms 50 mechanisms 51 for 50 mechanisms 58 - 51 for 52 genome 53 - 58 - 54 wide 55 association 55 association 56 and 56 and 57 large 56 and 58 - 58 - 65 and 59 scale 61 expression 60 gene 61 expression 61 expression 63 studies 62 array 63 studies 63 studies 65 and 64 , 65 and 65 and 68 approaches 65 and 77 . 66 new 68 approaches 67 therapeutic 68 approaches 68 approaches 69 afforded 69 afforded 70 by 70 by 72 manipulation 71 epigenetic 72 manipulation 72 manipulation 73 in 73 in 76 disease 74 alzheimer 75 's 75 's 76 disease epigenetics is the study [of] mitotically heritable , but reversible , changes in gene expression brought about principally through alterations in dna methylation and chromatin structure . 0 ###LEFT-WALL### 1 epigenetics 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 27 . 1 epigenetics 2 is 2 is 4 study 2 is 6 mitotically 2 is 9 but 3 the 4 study 7 heritable 9 but 8 , 9 but 9 but 10 reversible 11 , 12 changes 11 , 16 brought 12 changes 13 in 12 changes 16 brought 13 in 15 expression 14 gene 15 expression 16 brought 17 about 17 about 24 and 18 principally 19 through 19 through 20 alterations 20 alterations 21 in 20 alterations 24 and 21 in 23 methylation 22 dna 23 methylation 24 and 26 structure 25 chromatin 26 structure the comprehensive review [by] mastroeni et al . 0 ###LEFT-WALL### 2 comprehensive 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 8 . 1 the 2 comprehensive 2 comprehensive 3 review 3 review 7 al 5 mastroeni 7 al 6 et 7 al [(] mastroeni , d ..y [,] grover , a ..y [,] delvaux , e ..y [,] whiteside , c ..y [,] coleman , p ..y [,] rogers , j ..y [,] 2010 . 0 ###LEFT-WALL### 2 mastroeni 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 33 . 3 , 4 d 3 , 5 ..y 3 , 8 , 4 d 5 ..y 5 ..y 7 grover 8 , 9 a 8 , 10 ..y 8 , 13 , 9 a 10 ..y 10 ..y 12 delvaux 13 , 14 e 13 , 15 ..y 13 , 18 , 14 e 15 ..y 15 ..y 17 whiteside 18 , 19 c 18 , 20 ..y 18 , 23 , 19 c 20 ..y 20 ..y 22 coleman 23 , 24 p 23 , 25 ..y 23 , 28 , 24 p 25 ..y 25 ..y 27 rogers 28 , 29 j 28 , 30 ..y 29 j 30 ..y 30 ..y 32 2010 epigenetic [mechanisms] in alzheimer 's disease . 0 ###LEFT-WALL### 1 epigenetic 0 ###LEFT-WALL### 5 's 0 ###LEFT-WALL### 7 . 1 epigenetic 3 in 1 epigenetic 5 's 3 in 4 alzheimer 5 's 6 disease neurobiol . 0 ###LEFT-WALL### 1 neurobiol 0 ###LEFT-WALL### 2 . aging , doi:10.1016/j.neurobiolaging.2010.08.017 [ )(in this issue describes mounting evidence for an involvement of epigenetic alterations in the etiology of alzheimer 's disease ( ad ) , highlighting the potential of epigenomic approaches for uncovering novel molecular pathways involved in pathology . 0 ###LEFT-WALL### 3 doi:10.1016/j.neurobiolaging.2010.08.017 0 ###LEFT-WALL### 8 describes 1 aging 2 , 1 aging 3 doi:10.1016/j.neurobiolaging.2010.08.017 3 doi:10.1016/j.neurobiolaging.2010.08.017 5 )(in 3 doi:10.1016/j.neurobiolaging.2010.08.017 8 describes 5 )(in 7 issue 6 this 7 issue 8 describes 10 evidence 9 mounting 10 evidence 10 evidence 11 for 10 evidence 20 of 11 for 13 involvement 12 an 13 involvement 13 involvement 14 of 14 of 16 alterations 15 epigenetic 16 alterations 16 alterations 17 in 17 in 19 etiology 18 the 19 etiology 20 of 23 disease 21 alzheimer 22 's 22 's 23 disease 23 disease 25 ad 23 disease 28 highlighting 24 ( 25 ad 25 ad 26 ) 27 , 28 highlighting 28 highlighting 30 potential 28 highlighting 42 . 29 the 30 potential 30 potential 31 of 30 potential 34 for 30 potential 40 in 31 of 33 approaches 32 epigenomic 33 approaches 34 for 35 uncovering 35 uncovering 38 pathways 36 novel 38 pathways 37 molecular 38 pathways 38 pathways 39 involved 40 in 41 pathology here , we briefly describe some methodological issues related to epigenomic studies using postmortem brain tissue in alzheimer 's disease , and argue for an integrated genetic - epigenetic approach to disease etiology . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 34 . 1 here 2 , 1 here 3 we 3 we 22 and 4 briefly 5 describe 5 describe 8 issues 5 describe 13 using 5 describe 22 and 6 some 8 issues 7 methodological 8 issues 8 issues 9 related 9 related 10 to 10 to 12 studies 11 epigenomic 12 studies 13 using 16 tissue 13 using 17 in 14 postmortem 16 tissue 15 brain 16 tissue 17 in 20 disease 18 alzheimer 19 's 19 's 20 disease 21 , 22 and 22 and 23 argue 22 and 31 to 22 and 33 etiology 23 argue 24 for 24 for 30 approach 25 an 30 approach 26 integrated 30 approach 27 genetic 28 - 27 genetic 30 approach 29 epigenetic 30 approach 31 to 32 disease silent information regulator 2 ( sir2/sirt1 ) , a member of the sirtuin family of class iii histone deacetylases , has been implicated extensively in lifespan extension and is a prominent drug target in antiaging medicine . 0 ###LEFT-WALL### 3 regulator 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 37 . 1 silent 2 information 2 information 3 regulator 3 regulator 4 2 3 regulator 6 sir2/sirt1 3 regulator 10 member 3 regulator 28 and 5 ( 6 sir2/sirt1 6 sir2/sirt1 7 ) 8 , 10 member 9 a 10 member 10 member 11 of 10 member 20 , 11 of 14 family 12 the 14 family 13 sirtuin 14 family 14 family 15 of 15 of 16 class 16 class 17 iii 16 class 18 histone 16 class 19 deacetylases 18 histone 19 deacetylases 21 has 22 been 21 has 28 and 22 been 23 implicated 23 implicated 24 extensively 23 implicated 25 in 25 in 27 extension 26 lifespan 27 extension 28 and 29 is 28 and 34 in 28 and 36 medicine 29 is 33 target 30 a 31 prominent 30 a 33 target 31 prominent 32 drug 32 drug 33 target 34 in 35 antiaging the mammalian sirt1 has multiple targets , which include histones , transcription factors , and other molecules that collectively modulate energy metabolism , stress response , and cell/tissue survival . 0 ###LEFT-WALL### 3 sirt1 0 ###LEFT-WALL### 4 has 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 30 . 1 the 3 sirt1 2 mammalian 3 sirt1 3 sirt1 4 has 4 has 6 targets 5 multiple 6 targets 6 targets 8 which 7 , 8 which 8 which 9 include 8 which 14 , 9 include 10 histones 10 histones 13 factors 11 , 13 factors 12 transcription 13 factors 13 factors 14 , 15 and 17 molecules 15 and 20 modulate 16 other 17 molecules 17 molecules 20 modulate 18 that 19 collectively 19 collectively 20 modulate 20 modulate 27 and 21 energy 22 metabolism 22 metabolism 23 , 23 , 25 response 23 , 27 and 24 stress 25 response 26 , 27 and 27 and 29 survival 28 cell/tissue 29 survival several of sirt1 's substrates regulate key metabolic processes , and sirt1 activation may underlie the lifespan prolonging effect [of] caloric restriction . 0 ###LEFT-WALL### 1 several 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 23 . 1 several 2 of 1 several 11 and 2 of 5 substrates 3 sirt1 4 's 4 's 5 substrates 6 regulate 9 processes 6 regulate 11 and 7 key 9 processes 8 metabolic 9 processes 10 , 11 and 11 and 15 underlie 12 sirt1 13 activation 13 activation 14 may 14 may 15 underlie 15 underlie 22 restriction 16 the 22 restriction 17 lifespan 22 restriction 18 prolonging 22 restriction 19 effect 22 restriction 21 caloric 22 restriction recent studies have also identified multifaceted protective roles for sirt1 against cellular senescence and stress in the neural , cardiovascular , and renal systems . 0 ###LEFT-WALL### 1 recent 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 25 . 1 recent 2 studies 1 recent 3 have 1 recent 5 identified 2 studies 3 have 3 have 4 also 5 identified 8 roles 6 multifaceted 8 roles 7 protective 8 roles 8 roles 9 for 8 roles 16 in 9 for 14 and 10 sirt1 11 against 10 sirt1 14 and 11 against 13 senescence 12 cellular 13 senescence 14 and 15 stress 16 in 24 systems 17 the 24 systems 18 neural 19 , 19 , 20 cardiovascular 19 , 22 and 21 , 22 and 22 and 23 renal 22 and 24 systems sirt1 's activity in multiple tissues may decline with aging , and sustaining or reactivating this activity seems [invariably] beneficial . 0 ###LEFT-WALL### 3 activity 0 ###LEFT-WALL### 8 decline 0 ###LEFT-WALL### 14 or 0 ###LEFT-WALL### 18 seems 0 ###LEFT-WALL### 21 . 1 sirt1 2 's 2 's 3 activity 3 activity 4 in 3 activity 7 may 4 in 6 tissues 5 multiple 6 tissues 7 may 8 decline 8 decline 9 with 9 with 12 and 10 aging 12 and 11 , 12 and 12 and 13 sustaining 14 or 15 reactivating 14 or 18 seems 15 reactivating 17 activity 15 reactivating 18 seems 16 this 17 activity 18 seems 20 beneficial several studies also point towards a general tumor suppressive role for sirt1 , at least in the context of certain human cancers . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 point 1 several 2 studies 2 studies 4 point 3 also 4 point 4 point 5 towards 5 towards 10 role 6 a 7 general 6 a 10 role 7 general 8 tumor 8 tumor 10 role 9 suppressive 10 role 10 role 11 for 11 for 12 sirt1 12 sirt1 16 in 13 , 15 least 13 , 16 in 14 at 15 least 16 in 18 context 16 in 23 . 17 the 18 context 18 context 19 of 19 of 22 cancers 20 certain 22 cancers 21 human 22 cancers development of sirt1 - based therapeutic interventions against systemic aging and aging - associated diseases will benefit from a thorough understanding of underlying pathological mechanisms of diseases as well as metabolic connections between different tissues and organs . 0 ###LEFT-WALL### 15 diseases 0 ###LEFT-WALL### 17 benefit 0 ###LEFT-WALL### 38 . 1 development 2 of 1 development 14 associated 2 of 3 sirt1 3 sirt1 11 and 4 - 11 and 5 based 7 interventions 6 therapeutic 7 interventions 7 interventions 8 against 7 interventions 11 and 8 against 10 aging 9 systemic 10 aging 11 and 12 aging 11 and 13 - 14 associated 15 diseases 15 diseases 16 will 16 will 17 benefit 17 benefit 18 from 17 benefit 28 as 18 from 21 understanding 19 a 20 thorough 19 a 21 understanding 20 thorough 21 understanding 21 understanding 22 of 22 of 23 underlying 23 underlying 25 mechanisms 24 pathological 25 mechanisms 25 mechanisms 26 of 26 of 27 diseases 28 as 32 connections 29 well 31 metabolic 30 as 31 metabolic 31 metabolic 32 connections 32 connections 33 between 33 between 36 and 34 different 35 tissues 35 tissues 36 and 36 and 37 organs none none ample evidence suggests that infection with cytomegalovirus ( cmv ) leads to accelerated aging of the immune system and may contribute to poor responsiveness to influenza vaccination in older persons . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 33 . 1 none 4 evidence 1 none 14 to 1 none 21 and 2 none 3 ample 3 ample 4 evidence 4 evidence 5 suggests 5 suggests 6 that 6 that 7 infection 6 that 13 leads 7 infection 8 with 7 infection 11 cmv 7 infection 13 leads 8 with 9 cytomegalovirus 10 ( 11 cmv 11 cmv 12 ) 13 leads 14 to 15 accelerated 16 aging 15 accelerated 21 and 16 aging 17 of 17 of 20 system 18 the 20 system 19 immune 20 system 21 and 22 may 21 and 27 to 21 and 30 in 22 may 23 contribute 23 contribute 24 to 24 to 26 responsiveness 25 poor 26 responsiveness 27 to 29 vaccination 28 influenza 29 vaccination 30 in 32 persons 31 older 32 persons the objective of this study was to investigate whether cmv [infection] , acquired earlier in life , affects the response to influenza vaccination in a randomized controlled trial among older persons in long - term care facilities . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 38 . 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 investigate 7 to 8 investigate 8 investigate 9 whether 8 investigate 24 in 8 investigate 32 in 9 whether 10 cmv 9 whether 18 affects 10 cmv 13 acquired 10 cmv 18 affects 12 , 13 acquired 13 acquired 14 earlier 13 acquired 15 in 13 acquired 17 , 15 in 16 life 18 affects 20 response 18 affects 21 to 19 the 20 response 21 to 23 vaccination 22 influenza 23 vaccination 24 in 28 trial 25 a 28 trial 26 randomized 28 trial 27 controlled 28 trial 28 trial 29 among 29 among 31 persons 30 older 31 persons 32 in 37 facilities 33 long 34 - 33 long 35 term 35 term 37 facilities 36 care 37 facilities blood samples were collected at day 0 , day 25 , day 84 and day 109 . 0 ###LEFT-WALL### 2 samples 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 17 . 1 blood 2 samples 2 samples 3 were 3 were 4 collected 4 collected 5 at 5 at 14 and 6 day 7 0 6 day 8 , 8 , 9 day 8 , 11 , 9 day 10 25 11 , 12 day 11 , 14 and 12 day 13 84 14 and 15 day 15 day 16 109 seroresponses to influenza vaccination were measured by hemagglutination - inhibition tests to the a/h3n2 strain at all time points . 0 ###LEFT-WALL### 1 seroresponses 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 9 - 1 seroresponses 2 to 1 seroresponses 5 were 2 to 4 vaccination 3 influenza 4 vaccination 5 were 6 measured 6 measured 7 by 7 by 8 hemagglutination 9 - 11 tests 9 - 15 strain 9 - 20 . 10 inhibition 11 tests 11 tests 12 to 11 tests 15 strain 12 to 14 a/h3n2 13 the 14 a/h3n2 15 strain 16 at 16 at 19 points 17 all 19 points 18 time 19 points subsequently , baseline levels of igg anti - [cmv] antibodies were measured using an automated chemiluminescent microparticle [immunoassay] . 0 ###LEFT-WALL### 4 levels 0 ###LEFT-WALL### 17 microparticle 0 ###LEFT-WALL### 19 . 1 subsequently 2 , 1 subsequently 4 levels 3 baseline 4 levels 4 levels 5 of 4 levels 12 measured 4 levels 17 microparticle 5 of 6 igg 6 igg 10 antibodies 6 igg 11 were 7 anti 8 - 7 anti 10 antibodies 10 antibodies 11 were 12 measured 13 using 13 using 16 chemiluminescent 14 an 16 chemiluminescent 15 automated 16 chemiluminescent participants with cmv antibody level≥6 [au/ml] were considered to harbor cmv infection . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 8 considered 0 ###LEFT-WALL### 13 . 1 participants 2 with 1 participants 5 level≥6 1 participants 7 were 1 participants 8 considered 2 with 3 cmv 4 antibody 5 level≥6 5 level≥6 7 were 8 considered 9 to 8 considered 12 infection 9 to 10 harbor 10 harbor 11 cmv at baseline , no differences in pre - vaccination geometric mean antibody titers [(] [gmt] ) were observed between participants with [(] n=571 , 78.1 % ) or without [cmv] infection ( n=160 , 21.9 % ) . 0 ###LEFT-WALL### 5 differences 0 ###LEFT-WALL### 18 observed 0 ###LEFT-WALL### 38 . 1 at 2 baseline 1 at 3 , 1 at 5 differences 4 no 5 differences 5 differences 6 in 5 differences 17 were 6 in 7 pre 7 pre 13 titers 8 - 13 titers 9 vaccination 13 titers 10 geometric 11 mean 11 mean 13 titers 12 antibody 13 titers 13 titers 16 ) 17 were 18 observed 18 observed 19 between 18 observed 28 or 19 between 20 participants 21 with 23 n=571 21 with 28 or 23 n=571 26 % 24 , 26 % 25 78.1 26 % 26 % 27 ) 28 or 29 without 29 without 31 infection 31 infection 33 n=160 32 ( 33 n=160 33 n=160 36 % 33 n=160 37 ) 34 , 36 % 35 21.9 36 % 36 % 37 ) [during] follow - up , participants [with] and without cmv infection had similar responses to influenza vaccination as measured with changes in [gmt] [(] linear mixed model , adjusted for gender , age , pre - vaccination [gmt] and vaccination strategy , p=0.46 ) . 0 ###LEFT-WALL### 2 follow 0 ###LEFT-WALL### 3 - 3 - 4 up 3 - 5 , 5 , 6 participants 5 , 8 and 8 and 11 infection 8 and 12 had 9 without 10 cmv 9 without 11 infection 11 infection 12 had 12 had 14 responses 13 similar 14 responses 14 responses 15 to 14 responses 22 in 15 to 17 vaccination 16 influenza 17 vaccination 17 vaccination 19 measured 18 as 19 measured 19 measured 20 with 20 with 21 changes 22 in 33 age 25 linear 32 , 25 linear 33 age 26 mixed 27 model 27 model 29 adjusted 28 , 29 adjusted 29 adjusted 30 for 29 adjusted 32 , 30 for 31 gender 33 age 35 pre 33 age 39 and 34 , 35 pre 35 pre 36 - 36 - 39 and 37 vaccination 39 and 39 and 41 strategy 39 and 43 p=0.46 39 and 45 . 40 vaccination 41 strategy 42 , 43 p=0.46 43 p=0.46 44 ) analogously , no association was found between cmv infection and [a] more than 4 - [fold] increase in antibody titer ( generalized estimating equations , adjusted or 1.14 [ 95%ci 0.80;1.64 ] ) [or] an antibody titer≥40 ( adjusted or 1.24 [ 95%ci 0.86;1.80 ] ) . 0 ###LEFT-WALL### 4 association 0 ###LEFT-WALL### 6 found 0 ###LEFT-WALL### 13 than 0 ###LEFT-WALL### 47 . 1 analogously 2 , 1 analogously 4 association 3 no 4 association 4 association 5 was 5 was 6 found 6 found 7 between 6 found 10 and 7 between 8 cmv 9 infection 10 and 10 and 12 more 13 than 14 4 13 than 15 - 14 4 15 - 15 - 17 increase 17 increase 18 in 17 increase 37 titer≥40 18 in 20 titer 19 antibody 20 titer 20 titer 24 equations 20 titer 27 or 21 ( 24 equations 22 generalized 24 equations 23 estimating 24 equations 24 equations 25 , 25 , 27 or 26 adjusted 27 or 27 or 28 1.14 27 or 31 0.80;1.64 27 or 33 ) 29 [ 31 0.80;1.64 30 95%ci 31 0.80;1.64 31 0.80;1.64 32 ] 35 an 37 titer≥40 36 antibody 37 titer≥40 37 titer≥40 40 or 38 ( 40 or 39 adjusted 40 or 40 or 41 1.24 40 or 44 0.86;1.80 40 or 46 ) 42 [ 44 0.86;1.80 43 95%ci 44 0.86;1.80 44 0.86;1.80 45 ] in conclusion , cmv [infection] did not explain poor responsiveness to influenza vaccination in residents of long - term care facilities . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 22 . 1 in 2 conclusion 3 , 4 cmv 3 , 8 explain 4 cmv 6 did 6 did 7 not 6 did 8 explain 8 explain 10 responsiveness 8 explain 11 to 8 explain 14 in 9 poor 10 responsiveness 11 to 13 vaccination 12 influenza 13 vaccination 14 in 15 residents 15 residents 16 of 16 of 21 facilities 17 long 18 - 17 long 19 term 19 term 21 facilities 20 care 21 facilities objective : to determine whether a 10 [-] week supervised hip flexor stretching program in frail elderly subjects would increase peak hip extension , stride length , and gait speed and [reduce] anterior pelvic tilt during comfortable and fast - paced walking . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 4 determine 1 objective 2 : 2 : 3 to 2 : 4 determine 3 to 4 determine 4 determine 5 whether 4 determine 43 . 5 whether 14 program 5 whether 20 increase 6 a 14 program 7 10 9 week 9 week 10 supervised 10 supervised 14 program 11 hip 12 flexor 12 flexor 13 stretching 13 stretching 14 program 14 program 15 in 14 program 19 would 15 in 18 subjects 16 frail 18 subjects 17 elderly 18 subjects 19 would 20 increase 20 increase 23 extension 21 peak 23 extension 22 hip 23 extension 23 extension 31 and 24 , 31 and 25 stride 26 length 26 length 28 and 27 , 28 and 28 and 30 speed 28 and 31 and 29 gait 30 speed 31 and 35 tilt 31 and 36 during 31 and 41 paced 31 and 42 walking 31 and 43 . 33 anterior 35 tilt 34 pelvic 35 tilt 36 during 38 and 37 comfortable 38 and 38 and 39 fast 38 and 40 - design : a double - blinded , randomized , controlled trial . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 12 . 1 design 2 : 2 : 4 double 3 a 4 double 4 double 6 blinded 4 double 8 randomized 5 - 6 blinded 6 blinded 7 , 7 , 8 randomized 8 randomized 9 , 9 , 11 trial 10 controlled 11 trial setting : pre - and post - treatment assessments were performed in a gait laboratory and stretching exercises were performed outside of the laboratory , usually in the subjects ' place of residence . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 1 setting 2 : 2 : 5 and 3 pre 5 and 4 - 5 and 5 and 6 post 7 - 9 assessments 7 - 20 performed 8 treatment 9 assessments 9 assessments 16 and 9 assessments 19 were 10 were 11 performed 10 were 16 and 11 performed 12 in 12 in 15 laboratory 13 a 15 laboratory 14 gait 15 laboratory 16 and 17 stretching 16 and 18 exercises 19 were 20 performed 20 performed 22 of 20 performed 27 in 21 outside 22 of 22 of 24 laboratory 23 the 24 laboratory 25 , 26 usually 25 , 27 in 27 in 31 place 27 in 34 . 28 the 29 subjects 29 subjects 30 ' 30 ' 31 place 31 place 32 of 32 of 33 residence participants : seventy - four frail elderly individuals , with 41 subjects in the control group and 33 subjects in the treatment group . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 24 . 1 participants 2 : 2 : 8 individuals 3 seventy 4 - 4 - 5 four 4 - 8 individuals 6 frail 8 individuals 7 elderly 8 individuals 9 , 17 and 9 , 23 group 10 with 12 subjects 10 with 17 and 11 41 12 subjects 13 in 15 control 13 in 17 and 14 the 15 control 16 group 17 and 17 and 19 subjects 17 and 20 in 17 and 23 group 18 33 19 subjects 20 in 22 treatment 21 the 22 treatment intervention : the treatment group completed a 10 [-] week twice [-] daily hip flexor stretching program that was supervised twice weekly by a rehabilitation clinician . 0 ###LEFT-WALL### 1 intervention 0 ###LEFT-WALL### 2 : 2 : 5 group 2 : 6 completed 2 : 27 . 3 the 5 group 4 treatment 5 group 5 group 6 completed 6 completed 17 program 6 completed 23 by 7 a 17 program 8 10 10 week 10 week 17 program 11 twice 14 hip 13 daily 14 hip 14 hip 15 flexor 15 flexor 17 program 16 stretching 17 program 17 program 18 that 17 program 19 was 18 that 19 was 19 was 20 supervised 20 supervised 21 twice 20 supervised 22 weekly 23 by 26 clinician 24 a 25 rehabilitation 24 a 26 clinician 25 rehabilitation 26 clinician the control group completed a 10 [-] week shoulder abductor stretching program . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 completed 0 ###LEFT-WALL### 13 . 1 the 3 group 2 control 3 group 3 group 4 completed 4 completed 12 program 5 a 12 program 6 10 8 week 8 week 11 stretching 9 shoulder 11 stretching 10 abductor 11 stretching 11 stretching 12 program main outcome measurements : dynamic peak hip extension and peak anterior pelvic tilt , stride length , and gait speed while walking at a comfortable pace and a fast pace , as well as passive hip extension range of motion . 0 ###LEFT-WALL### 3 measurements 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 41 . 1 main 2 outcome 2 outcome 3 measurements 3 measurements 4 : 4 : 9 and 5 dynamic 8 extension 6 peak 8 extension 7 hip 8 extension 8 extension 9 and 9 and 13 tilt 10 peak 13 tilt 11 anterior 13 tilt 12 pelvic 13 tilt 14 , 18 and 14 , 20 speed 15 stride 16 length 16 length 18 and 17 , 18 and 18 and 19 gait 18 and 20 speed 20 speed 21 while 20 speed 23 at 20 speed 32 as 21 while 22 walking 23 at 27 and 24 a 26 pace 25 comfortable 26 pace 26 pace 27 and 27 and 30 pace 27 and 31 , 28 a 30 pace 29 fast 30 pace 32 as 38 range 33 well 38 range 34 as 35 passive 35 passive 36 hip 36 hip 37 extension 37 extension 38 range 38 range 39 of 39 of 40 motion results : the treatment group showed significant increases in walking speed and stride length after the intervention but showed no significant changes in peak hip extension or anterior pelvic tilt during comfortable and fast - paced walking . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 5 group 2 : 18 but 3 the 5 group 4 treatment 5 group 5 group 18 but 6 showed 8 increases 6 showed 11 speed 6 showed 12 and 6 showed 15 after 6 showed 18 but 7 significant 8 increases 8 increases 9 in 9 in 10 walking 12 and 14 length 13 stride 14 length 15 after 17 intervention 16 the 17 intervention 18 but 19 showed 19 showed 22 changes 19 showed 23 in 19 showed 31 during 20 no 22 changes 21 significant 22 changes 23 in 27 or 24 peak 25 hip 25 hip 26 extension 26 extension 27 or 27 or 30 tilt 28 anterior 30 tilt 29 pelvic 30 tilt 31 during 33 and 32 comfortable 33 and 33 and 34 fast 33 and 35 - 33 and 36 paced 33 and 37 walking the treatment group also showed significantly increased passive hip extension range of motion . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 14 . 1 the 3 group 2 treatment 3 group 3 group 5 showed 4 also 5 showed 5 showed 10 extension 5 showed 11 range 6 significantly 7 increased 7 increased 10 extension 8 passive 10 extension 9 hip 10 extension 11 range 12 of 12 of 13 motion conclusions : these results indicate that a simple stretching program is effective in improving some measures of age - related decline [in] gait function [in] frail elderly patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 indicate 2 : 20 related 2 : 29 . 3 these 4 results 4 results 5 indicate 5 indicate 6 that 6 that 10 program 6 that 11 is 7 a 8 simple 7 a 10 program 8 simple 10 program 9 stretching 10 program 10 program 11 is 11 is 12 effective 12 effective 13 in 13 in 14 improving 14 improving 16 measures 15 some 16 measures 16 measures 17 of 17 of 18 age 19 - 20 related 20 related 28 patients 21 decline 28 patients 23 gait 24 function 24 function 28 patients 26 frail 28 patients 27 elderly 28 patients the lack of consistent improvements in walking kinematics is attributed to the presence of multiple disabilities and limitations present in the frail subjects . 0 ###LEFT-WALL### 2 lack 0 ###LEFT-WALL### 10 attributed 0 ###LEFT-WALL### 24 . 1 the 2 lack 2 lack 3 of 2 lack 9 is 3 of 5 improvements 4 consistent 5 improvements 5 improvements 6 in 6 in 7 walking 7 walking 8 kinematics 9 is 10 attributed 10 attributed 11 to 10 attributed 19 present 11 to 13 presence 12 the 13 presence 13 presence 14 of 14 of 17 and 15 multiple 16 disabilities 16 disabilities 17 and 17 and 18 limitations 19 present 20 in 20 in 23 subjects 21 the 23 subjects 22 frail 23 subjects objective : to determine whether a 10 [-] week supervised hip flexor stretching program in healthy elderly subjects would increase peak hip extension , stride length and gait speed and [reduce] anterior pelvic tilt [during] walking . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 4 determine 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 37 . 1 objective 2 : 2 : 3 to 2 : 4 determine 3 to 4 determine 4 determine 5 whether 4 determine 24 , 5 whether 14 program 5 whether 20 increase 6 a 14 program 7 10 9 week 9 week 10 supervised 10 supervised 14 program 11 hip 12 flexor 12 flexor 13 stretching 13 stretching 14 program 14 program 15 in 14 program 19 would 15 in 18 subjects 16 healthy 18 subjects 17 elderly 18 subjects 19 would 20 increase 20 increase 23 extension 21 peak 23 extension 22 hip 23 extension 24 , 30 and 25 stride 26 length 26 length 27 and 27 and 29 speed 27 and 30 and 28 gait 29 speed 30 and 34 tilt 30 and 36 walking 32 anterior 34 tilt 33 pelvic 34 tilt design : a double - blinded , randomized , controlled trial . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 12 . 1 design 2 : 2 : 4 double 3 a 4 double 4 double 6 blinded 4 double 8 randomized 5 - 6 blinded 6 blinded 7 , 7 , 8 randomized 8 randomized 9 , 9 , 11 trial 10 controlled 11 trial setting : pre - and posttreatment assessments were performed in a gait laboratory , whereas stretching exercises were performed outside of the laboratory , usually in the subject 's home . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 performed 2 : 5 and 2 : 9 performed 3 pre 5 and 4 - 5 and 5 and 7 assessments 5 and 8 were 6 posttreatment 7 assessments 8 were 9 performed 9 performed 10 in 9 performed 15 whereas 10 in 13 laboratory 11 a 13 laboratory 12 gait 13 laboratory 14 , 15 whereas 15 whereas 17 exercises 16 stretching 17 exercises 17 exercises 18 were 18 were 19 performed 19 performed 21 of 19 performed 26 in 20 outside 21 of 21 of 23 laboratory 22 the 23 laboratory 24 , 25 usually 24 , 26 in 26 in 30 home 26 in 31 . 27 the 28 subject 28 subject 29 's 29 's 30 home participants : eighty - two healthy elderly individuals , with 39 subjects in the control group and 43 subjects in the treatment group . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 24 . 1 participants 2 : 2 : 8 individuals 3 eighty 4 - 4 - 5 two 4 - 8 individuals 6 healthy 8 individuals 7 elderly 8 individuals 9 , 17 and 9 , 23 group 10 with 12 subjects 10 with 17 and 11 39 12 subjects 13 in 15 control 13 in 17 and 14 the 15 control 16 group 17 and 17 and 19 subjects 17 and 20 in 17 and 23 group 18 43 19 subjects 20 in 22 treatment 21 the 22 treatment intervention : the treatment group completed a 10 [-] week , twice - daily hip flexor stretching program , which was supervised twice weekly by a rehabilitation clinician . 0 ###LEFT-WALL### 1 intervention 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 5 group 2 : 6 completed 2 : 13 - 3 the 5 group 4 treatment 5 group 5 group 6 completed 6 completed 10 week 6 completed 12 twice 7 a 10 week 8 10 10 week 11 , 12 twice 12 twice 13 - 13 - 18 program 13 - 19 , 14 daily 18 program 15 hip 18 program 16 flexor 17 stretching 17 stretching 18 program 19 , 20 which 19 , 22 supervised 20 which 21 was 21 was 22 supervised 22 supervised 23 twice 22 supervised 24 weekly 22 supervised 25 by 25 by 28 clinician 26 a 27 rehabilitation 26 a 28 clinician 27 rehabilitation 28 clinician the control group completed a 10 [-] week shoulder abductor stretching program . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 completed 0 ###LEFT-WALL### 13 . 1 the 3 group 2 control 3 group 3 group 4 completed 4 completed 12 program 5 a 12 program 6 10 8 week 8 week 11 stretching 9 shoulder 11 stretching 10 abductor 11 stretching 11 stretching 12 program main outcome measurements : passive hip extension range of motion , dynamic peak hip extension , peak anterior pelvic tilt , stride length , and gait speed [during] walking . 0 ###LEFT-WALL### 3 measurements 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 30 . 1 main 2 outcome 2 outcome 3 measurements 3 measurements 4 : 4 : 8 range 5 passive 6 hip 6 hip 8 range 7 extension 8 range 8 range 9 of 9 of 25 and 10 motion 11 , 11 , 15 extension 11 , 16 , 12 dynamic 15 extension 13 peak 15 extension 14 hip 15 extension 16 , 20 tilt 16 , 21 , 17 peak 20 tilt 18 anterior 20 tilt 19 pelvic 20 tilt 21 , 23 length 21 , 25 and 22 stride 23 length 24 , 25 and 25 and 27 speed 25 and 29 walking 26 gait 27 speed results : the treatment group showed significant improvements in passive hip extension range of motion ( p = [.] 007 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 5 group 2 : 6 showed 3 the 5 group 4 treatment 5 group 5 group 6 showed 6 showed 8 improvements 6 showed 9 in 7 significant 8 improvements 9 in 13 range 10 passive 12 extension 11 hip 12 extension 12 extension 13 range 13 range 14 of 14 of 15 motion 15 motion 18 = 16 ( 18 = 17 p 18 = 18 = 20 007 18 = 21 ) subjects in the treatment group [who] presented with limited preassessment peak hip extension [during] walking had increased stride length ( p = [.] 019 ) and peak hip extension ( p = [.] 012 ) , and decreased anterior pelvic tilt ( p = [.] 006 ) during walking , [whereas] subjects in the control group [showed] only decreased anterior pelvic tilt ( p = [.] 013 [ )( 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 7 presented 1 subjects 2 in 1 subjects 7 presented 2 in 5 group 3 the 5 group 4 treatment 5 group 7 presented 8 with 7 presented 11 peak 8 with 10 preassessment 9 limited 10 preassessment 11 peak 13 extension 11 peak 16 had 12 hip 13 extension 13 extension 15 walking 13 extension 16 had 16 had 26 and 17 increased 19 length 17 increased 26 and 18 stride 19 length 19 length 22 = 20 ( 22 = 21 p 22 = 22 = 24 019 22 = 25 ) 26 and 37 and 27 peak 29 extension 27 peak 32 = 27 peak 37 and 28 hip 29 extension 30 ( 32 = 31 p 32 = 32 = 34 012 32 = 35 ) 36 , 37 and 37 and 38 decreased 38 decreased 41 tilt 38 decreased 48 during 39 anterior 41 tilt 40 pelvic 41 tilt 41 tilt 44 = 42 ( 44 = 43 p 44 = 44 = 46 006 44 = 47 ) 48 during 50 , 49 walking 50 , 50 , 52 subjects 52 subjects 53 in 52 subjects 62 tilt 53 in 55 control 54 the 55 control 56 group 62 tilt 58 only 59 decreased 59 decreased 62 tilt 60 anterior 62 tilt 61 pelvic 62 tilt 62 tilt 65 = 63 ( 65 = 64 p 65 = 65 = 67 013 65 = 69 )( conclusions : the 10 [-] week supervised hip flexor stretching program was effective in increasing stride length and peak hip extension [during] walking in elderly adults who had limited preintervention hip extension during walking . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 11 program 2 : 12 was 2 : 35 . 3 the 11 program 4 10 6 week 6 week 9 flexor 7 supervised 8 hip 8 hip 9 flexor 9 flexor 10 stretching 10 stretching 11 program 11 program 12 was 12 was 13 effective 13 effective 14 in 14 in 18 and 15 increasing 17 length 16 stride 17 length 17 length 18 and 18 and 20 hip 18 and 21 extension 18 and 33 during 18 and 34 walking 19 peak 20 hip 21 extension 23 walking 21 extension 29 limited 23 walking 24 in 23 walking 26 adults 25 elderly 26 adults 26 adults 27 who 26 adults 28 had 27 who 28 had 29 limited 32 extension 29 limited 33 during 30 preintervention 31 hip 31 hip 32 extension these results support the use of a simple stretching program for elderly individuals in counteracting age - related decline [in] gait function . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 17 - 1 these 2 results 2 results 3 support 3 support 5 use 3 support 14 in 4 the 5 use 5 use 6 of 6 of 10 program 7 a 8 simple 7 a 10 program 8 simple 10 program 9 stretching 10 program 10 program 11 for 11 for 13 individuals 12 elderly 13 individuals 14 in 15 counteracting 15 counteracting 16 age 17 - 22 function 17 - 23 . 18 related 19 decline 19 decline 22 function 21 gait 22 function background/purpose : ginsenosides have many biomedical efficacies , such as anti - aging , antioxidation , and anti - inflammatory activities . 0 ###LEFT-WALL### 1 background/purpose 0 ###LEFT-WALL### 2 : 2 : 3 ginsenosides 2 : 4 have 2 : 8 , 2 : 22 . 3 ginsenosides 4 have 4 have 7 efficacies 5 many 7 efficacies 6 biomedical 7 efficacies 8 , 17 and 9 such 13 aging 10 as 11 anti 11 anti 12 - 11 anti 13 aging 13 aging 14 , 14 , 15 antioxidation 14 , 17 and 16 , 17 and 17 and 21 activities 18 anti 19 - 18 anti 21 activities 20 inflammatory 21 activities compound k ( ck ) , one of the major metabolites of ginsenosides , mediates the antimetastatic and anti - allergic activities of the ginsenosides . 0 ###LEFT-WALL### 1 compound 0 ###LEFT-WALL### 15 mediates 0 ###LEFT-WALL### 26 . 1 compound 2 k 1 compound 4 ck 1 compound 7 one 1 compound 15 mediates 3 ( 4 ck 4 ck 5 ) 6 , 7 one 7 one 8 of 7 one 14 , 8 of 11 metabolites 9 the 11 metabolites 10 major 11 metabolites 11 metabolites 12 of 12 of 13 ginsenosides 15 mediates 18 and 16 the 17 antimetastatic 17 antimetastatic 18 and 18 and 22 activities 18 and 23 of 19 anti 20 - 19 anti 22 activities 21 allergic 22 activities 23 of 25 ginsenosides 24 the 25 ginsenosides the purpose of this study was to investigate the effect of ck on level of type i collagen , matrix metalloproteinase ( mmp ) - [1] activity , and protein level in ultraviolet ( uv )a - irradiated fibroblasts . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 31 level 0 ###LEFT-WALL### 40 . 1 the 2 purpose 2 purpose 3 of 2 purpose 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 13 on 7 to 8 investigate 8 investigate 10 effect 9 the 10 effect 10 effect 11 of 11 of 12 ck 13 on 14 level 14 level 15 of 15 of 16 type 16 type 17 i 16 type 29 and 16 type 31 level 18 collagen 21 metalloproteinase 18 collagen 27 activity 19 , 21 metalloproteinase 20 matrix 21 metalloproteinase 21 metalloproteinase 23 mmp 21 metalloproteinase 25 - 22 ( 23 mmp 23 mmp 24 ) 27 activity 29 and 28 , 29 and 29 and 30 protein 29 and 31 level 31 level 32 in 32 in 39 fibroblasts 33 ultraviolet 36 )a 33 ultraviolet 39 fibroblasts 34 ( 36 )a 35 uv 36 )a 36 )a 37 - 38 irradiated 39 fibroblasts methods : fibroblasts were cultured [with] and without ck ( 0.01 μm , 0.1 μm or 1 μm [ )(for 2 hours . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 fibroblasts 2 : 4 were 2 : 7 and 2 : 16 or 3 fibroblasts 4 were 4 were 5 cultured 7 and 14 0.1 7 and 15 μm 8 without 9 ck 8 without 14 0.1 9 ck 12 μm 10 ( 12 μm 11 0.01 12 μm 12 μm 13 , 14 0.1 15 μm 16 or 17 1 16 or 18 μm 17 1 18 μm 18 μm 20 )(for 20 )(for 22 hours 21 2 22 hours cells were sham - irradiated and irradiated with 50 kj/m ( 2 ) , 100 kj/m ( 2 [ )(or 200 kj/m ( 2 ) uva , and incubated in serumfree dulbecco 's modified eagle 's medium , [with] or without ck for 24 hours . 0 ###LEFT-WALL### 1 cells 0 ###LEFT-WALL### 3 sham 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 46 . 1 cells 2 were 2 were 3 sham 4 - 6 and 5 irradiated 6 and 6 and 28 and 7 irradiated 8 with 7 irradiated 10 kj/m 7 irradiated 28 and 8 with 9 50 10 kj/m 12 2 10 kj/m 16 kj/m 11 ( 12 2 12 2 13 ) 14 , 16 kj/m 15 100 16 kj/m 16 kj/m 26 uva 16 kj/m 27 , 17 ( 26 uva 18 2 20 )(or 20 )(or 21 200 20 )(or 26 uva 22 kj/m 24 2 22 kj/m 26 uva 23 ( 24 2 24 2 25 ) 26 uva 27 , 28 and 29 incubated 28 and 40 or 30 in 31 serumfree 30 in 40 or 31 serumfree 32 dulbecco 31 serumfree 34 modified 32 dulbecco 33 's 33 's 34 modified 34 modified 37 medium 35 eagle 36 's 36 's 37 medium 38 , 40 or 40 or 41 without 41 without 42 ck 42 ck 43 for 43 for 45 hours 44 24 45 hours mmp - 1 activity in the supernatants and protein levels in the cells were assessed by zymography and western blotting , respectively . 0 ###LEFT-WALL### 1 mmp 0 ###LEFT-WALL### 2 - 2 - 4 activity 3 1 4 activity 4 activity 5 in 5 in 8 and 6 the 7 supernatants 7 supernatants 8 and 8 and 9 protein 8 and 10 levels 8 and 20 blotting 10 levels 11 in 10 levels 14 were 11 in 13 cells 12 the 13 cells 14 were 15 assessed 15 assessed 16 by 16 by 18 and 17 zymography 18 and 18 and 19 western 18 and 20 blotting 20 blotting 22 respectively 21 , 22 respectively 22 respectively 23 . level of type i collagen was assessed by enzyme - linked immunosorbent assay . 0 ###LEFT-WALL### 5 collagen 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 10 - 1 level 5 collagen 2 of 3 type 2 of 5 collagen 3 type 4 i 5 collagen 6 was 6 was 7 assessed 7 assessed 8 by 8 by 9 enzyme 10 - 13 assay 10 - 14 . 11 linked 13 assay 12 immunosorbent 13 assay results : mmp - 1 activity and protein level were increased by uva , which was downregulated by ck . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 20 . 1 results 2 : 2 : 3 mmp 4 - 7 and 4 - 11 increased 4 - 14 , 5 1 6 activity 6 activity 7 and 7 and 9 level 7 and 10 were 8 protein 9 level 10 were 11 increased 11 increased 12 by 12 by 13 uva 14 , 15 which 14 , 17 downregulated 15 which 16 was 16 was 17 downregulated 17 downregulated 18 by 18 by 19 ck production of type i collagen was inhibited in uva - irradiated fibroblasts , which was upregulated by ck . 0 ###LEFT-WALL### 1 production 0 ###LEFT-WALL### 12 fibroblasts 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 19 . 1 production 2 of 1 production 7 inhibited 1 production 12 fibroblasts 2 of 3 type 3 type 4 i 3 type 5 collagen 3 type 6 was 5 collagen 6 was 7 inhibited 8 in 7 inhibited 10 - 7 inhibited 11 irradiated 8 in 9 uva 13 , 14 which 13 , 16 upregulated 14 which 15 was 15 was 16 upregulated 16 upregulated 17 by 17 by 18 ck conclusion : ck is a potential agent for the prevention and treatment of skin photo - aging . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 ck 2 : 4 is 3 ck 4 is 4 is 7 agent 5 a 6 potential 5 a 7 agent 6 potential 7 agent 7 agent 8 for 7 agent 17 aging 8 for 15 photo 9 the 15 photo 10 prevention 11 and 11 and 12 treatment 11 and 13 of 11 and 15 photo 13 of 14 skin 16 - 17 aging 17 aging 18 . purpose : to evaluate blue - light attenuation in eyes with a tinted intraocular lens ( iol ) or an untinted iol . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 23 . 3 to 4 evaluate 4 evaluate 8 attenuation 4 evaluate 9 in 5 blue 6 - 5 blue 8 attenuation 7 light 8 attenuation 9 in 19 or 10 eyes 11 with 10 eyes 19 or 11 with 15 lens 12 a 15 lens 13 tinted 15 lens 14 intraocular 15 lens 15 lens 17 iol 16 ( 17 iol 17 iol 18 ) 19 or 22 iol 20 an 22 iol 21 untinted 22 iol setting : department of ophthalmology , university hospital of crete , crete , greece . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 15 . 1 setting 2 : 2 : 3 department 3 department 4 of 4 of 5 ophthalmology 5 ophthalmology 8 hospital 5 ophthalmology 12 crete 6 , 8 hospital 7 university 8 hospital 8 hospital 9 of 8 hospital 11 , 9 of 10 crete 11 , 12 crete 12 crete 13 , 13 , 14 greece design : comparative case series . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 . 1 design 2 : 2 : 5 series 3 comparative 4 case 4 case 5 series methods : patients had lens extraction and implantation of an acrysof natural tinted or tecnis za9003 or softec iii untinted acrylic iol . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 20 untinted 2 : 23 . 3 patients 4 had 4 had 7 and 4 had 20 untinted 5 lens 6 extraction 6 extraction 7 and 7 and 8 implantation 7 and 9 of 9 of 17 or 10 an 12 natural 11 acrysof 12 natural 12 natural 13 tinted 12 natural 14 or 14 or 16 za9003 14 or 17 or 15 tecnis 16 za9003 17 or 18 softec 18 softec 19 iii 20 untinted 22 iol 21 acrylic 22 iol the luminance ratio of green ( 530 nm ) and blue ( 465 nm ) light ( green:blue [ratio] ) required for isoluminant perception was determined by heterochromatic flicker photometry . 0 ###LEFT-WALL### 16 light 0 ###LEFT-WALL### 21 required 0 ###LEFT-WALL### 31 . 1 the 3 ratio 2 luminance 3 ratio 3 ratio 4 of 3 ratio 10 and 4 of 5 green 5 green 8 nm 6 ( 8 nm 7 530 8 nm 8 nm 9 ) 10 and 11 blue 10 and 14 nm 10 and 16 light 12 ( 14 nm 13 465 14 nm 14 nm 15 ) 16 light 18 green:blue 16 light 21 required 17 ( 18 green:blue 18 green:blue 20 ) 21 required 22 for 21 required 24 perception 21 required 25 was 22 for 23 isoluminant 24 perception 25 was 25 was 26 determined 26 determined 27 by 27 by 30 photometry 28 heterochromatic 29 flicker 29 flicker 30 photometry patients [were] tested preoperatively and 20 days [postoperatively] . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 . 1 patients 3 tested 1 patients 5 and 3 tested 4 preoperatively 5 and 7 days 6 20 7 days the parafoveal measure of the green:blue ratio , expressed in decibels , is proportional to the blue - light attenuation by the lens . 0 ###LEFT-WALL### 3 measure 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 24 . 1 the 3 measure 2 parafoveal 3 measure 3 measure 4 of 3 measure 13 is 4 of 7 ratio 5 the 7 ratio 6 green:blue 7 ratio 7 ratio 9 expressed 8 , 9 expressed 9 expressed 10 in 9 expressed 12 , 10 in 11 decibels 13 is 14 proportional 14 proportional 15 to 14 proportional 21 by 15 to 20 attenuation 16 the 20 attenuation 17 blue 18 - 17 blue 20 attenuation 19 light 20 attenuation 21 by 23 lens 22 the 23 lens results : twenty - two patients received the tinted iol and 21 [the] untinted iol . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 6 patients 2 : 7 received 2 : 11 and 3 twenty 4 - 4 - 5 two 4 - 6 patients 6 patients 7 received 7 received 10 iol 8 the 10 iol 9 tinted 10 iol 11 and 12 21 11 and 14 untinted 12 21 14 untinted 14 untinted 15 iol preoperatively , age was strongly linearly correlated with the green:blue ratio ( r = 0.59 , p < [.] 001 ) . 0 ###LEFT-WALL### 1 preoperatively 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 22 . 2 , 3 age 2 , 7 correlated 3 age 4 was 4 was 5 strongly 4 was 7 correlated 6 linearly 7 correlated 7 correlated 8 with 8 with 11 ratio 9 the 11 ratio 10 green:blue 11 ratio 11 ratio 14 = 11 ratio 18 < 12 ( 14 = 13 r 14 = 14 = 15 0.59 14 = 16 , 16 , 18 < 17 p 18 < 18 < 20 001 18 < 21 ) the mean postoperative decrease in the green:blue ratio was greater in the untinted iol group ( p = [.] 003 ) . 0 ###LEFT-WALL### 4 decrease 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 22 . 1 the 4 decrease 2 mean 4 decrease 3 postoperative 4 decrease 4 decrease 5 in 4 decrease 9 was 5 in 8 ratio 6 the 8 ratio 7 green:blue 8 ratio 9 was 10 greater 10 greater 11 in 11 in 15 group 12 the 15 group 13 untinted 15 group 14 iol 15 group 15 group 18 = 16 ( 18 = 17 p 18 = 18 = 20 003 18 = 21 ) postoperatively , the tinted iol group had a significantly higher green:blue ratio than the untinted iol group ( p < [.] 001 ) . 0 ###LEFT-WALL### 1 postoperatively 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 24 . 2 , 6 group 2 , 7 had 3 the 6 group 4 tinted 6 group 5 iol 6 group 6 group 7 had 7 had 12 ratio 7 had 13 than 7 had 17 group 8 a 12 ratio 9 significantly 10 higher 10 higher 12 ratio 11 green:blue 12 ratio 13 than 16 iol 14 the 16 iol 15 untinted 16 iol 17 group 20 < 18 ( 20 < 19 p 20 < 20 < 22 001 20 < 23 ) in the tinted iol group , the green:blue ratio was linearly related to iol dioptric power . 0 ###LEFT-WALL### 9 ratio 0 ###LEFT-WALL### 12 related 0 ###LEFT-WALL### 17 . 1 in 5 group 1 in 6 , 1 in 9 ratio 2 the 5 group 3 tinted 5 group 4 iol 5 group 7 the 9 ratio 8 green:blue 9 ratio 9 ratio 10 was 10 was 12 related 11 linearly 12 related 12 related 13 to 13 to 16 power 14 iol 16 power 15 dioptric 16 power conclusion : less blue light reached the retina with tinted iols than with untinted iols . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 light 2 : 6 reached 2 : 16 . 3 less 4 blue 4 blue 5 light 5 light 6 reached 6 reached 8 retina 6 reached 9 with 6 reached 12 than 7 the 8 retina 9 with 11 iols 10 tinted 11 iols 12 than 13 with 13 with 15 iols 14 untinted 15 iols the absorption properties of tinted iols seemed to resemble those of the aging human crystalline lens , while untinted iols resembled the lower levels of blue - light attenuation of younger lenses . 0 ###LEFT-WALL### 3 properties 0 ###LEFT-WALL### 7 seemed 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 33 . 1 the 3 properties 2 absorption 3 properties 3 properties 4 of 3 properties 7 seemed 4 of 6 iols 5 tinted 6 iols 7 seemed 8 to 7 seemed 9 resemble 8 to 9 resemble 9 resemble 10 those 10 those 11 of 11 of 16 lens 12 the 16 lens 13 aging 16 lens 14 human 16 lens 15 crystalline 16 lens 17 , 20 iols 17 , 21 resembled 18 while 19 untinted 18 while 20 iols 20 iols 21 resembled 21 resembled 24 levels 22 the 24 levels 23 lower 24 levels 24 levels 25 of 25 of 29 attenuation 26 blue 27 - 26 blue 29 attenuation 28 light 29 attenuation 29 attenuation 30 of 30 of 32 lenses 31 younger 32 lenses thus , tinted iols may protect against the presumed blue - light hazard . 0 ###LEFT-WALL### 4 iols 0 ###LEFT-WALL### 6 protect 0 ###LEFT-WALL### 14 . 1 thus 2 , 1 thus 4 iols 3 tinted 4 iols 4 iols 5 may 5 may 6 protect 6 protect 7 against 6 protect 13 hazard 7 against 12 light 8 the 12 light 9 presumed 12 light 10 blue 11 - 10 blue 12 light financial disclosure : no author has a financial or proprietary interest in any material or method mentioned . 0 ###LEFT-WALL### 2 disclosure 0 ###LEFT-WALL### 3 : 1 financial 2 disclosure 3 : 5 author 3 : 6 has 3 : 18 . 4 no 5 author 5 author 6 has 6 has 11 interest 6 has 12 in 7 a 11 interest 8 financial 9 or 9 or 10 proprietary 9 or 11 interest 12 in 15 or 13 any 14 material 14 material 15 or 15 or 16 method 15 or 17 mentioned aging is a multifactorial phenomenon , a multiscale process that takes place at the molecular ( proteins , genes ) , cellular and tissue levels and represents a complex set of events . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 33 . 1 aging 2 is 2 is 5 phenomenon 3 a 5 phenomenon 4 multifactorial 5 phenomenon 5 phenomenon 9 process 6 , 9 process 7 a 9 process 8 multiscale 9 process 9 process 10 that 9 process 12 place 9 process 20 ) 10 that 12 place 11 takes 12 place 12 place 13 at 13 at 19 genes 14 the 19 genes 15 molecular 17 proteins 15 molecular 18 , 15 molecular 19 genes 16 ( 17 proteins 17 proteins 18 , 21 , 23 and 21 , 26 and 22 cellular 23 and 23 and 24 tissue 23 and 26 and 25 levels 26 and 26 and 27 represents 27 represents 30 set 28 a 29 complex 28 a 30 set 29 complex 30 set 30 set 31 of 31 of 32 events this review will focus on the databases related to the aging process and on aging - related biological networks recently constructed to decipher the molecular mechanisms of aging , to characterize the effects of environmental factors and calorie restriction on aging and to determine the molecular links between aging and several diseases . 0 ###LEFT-WALL### 50 and 0 ###LEFT-WALL### 53 . 1 this 4 focus 2 review 4 focus 3 will 4 focus 4 focus 5 on 4 focus 8 related 4 focus 50 and 5 on 7 databases 6 the 7 databases 8 related 13 and 9 to 12 process 9 to 13 and 10 the 12 process 11 aging 12 process 13 and 14 on 14 on 15 aging 15 aging 30 to 15 aging 47 links 16 - 17 related 17 related 19 networks 17 related 29 , 17 related 30 to 18 biological 19 networks 19 networks 20 recently 19 networks 21 constructed 19 networks 22 to 19 networks 23 decipher 19 networks 27 of 22 to 23 decipher 23 decipher 26 mechanisms 24 the 26 mechanisms 25 molecular 26 mechanisms 27 of 28 aging 30 to 42 and 31 characterize 37 and 31 characterize 42 and 32 the 37 and 33 effects 34 of 33 effects 37 and 34 of 36 factors 35 environmental 36 factors 37 and 39 restriction 38 calorie 39 restriction 39 restriction 40 on 40 on 41 aging 42 and 43 to 42 and 44 determine 43 to 44 determine 44 determine 46 molecular 45 the 46 molecular 47 links 48 between 48 between 49 aging 50 and 52 diseases 51 several 52 diseases the role played by [chaperones] , that [are] major participants of aging cellular networks [and] connect metabolic stress and dietary restriction , and [by] micrornas as modulators of aging are discussed . 0 ###LEFT-WALL### 2 role 0 ###LEFT-WALL### 3 played 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 32 . 1 the 2 role 2 role 3 played 3 played 4 by 6 , 10 participants 6 , 16 connect 7 that 9 major 9 major 10 participants 10 participants 11 of 10 participants 16 connect 11 of 12 aging 12 aging 14 networks 13 cellular 14 networks 16 connect 23 and 17 metabolic 18 stress 18 stress 19 and 19 and 21 restriction 19 and 22 , 19 and 23 and 20 dietary 21 restriction 23 and 25 micrornas 23 and 31 discussed 26 as 27 modulators 26 as 31 discussed 27 modulators 28 of 27 modulators 30 are 28 of 29 aging 30 are 31 discussed [given] that higher proportions of predicted microrna target sites exist in the transcripts encoding disordered proteins , and that intrinsically disordered proteins are associated with age - related diseases ( cancer , diabetes , cardiovascular and neurodegenerative diseases ) , the study of protein disorder in aging deserves to be investigated . 0 ###LEFT-WALL### 2 that 0 ###LEFT-WALL### 14 encoding 0 ###LEFT-WALL### 28 related 0 ###LEFT-WALL### 40 , 0 ###LEFT-WALL### 52 . 2 that 4 proportions 2 that 14 encoding 3 higher 4 proportions 4 proportions 5 of 4 proportions 10 exist 5 of 9 sites 6 predicted 7 microrna 7 microrna 9 sites 8 target 9 sites 10 exist 11 in 11 in 13 transcripts 12 the 13 transcripts 13 transcripts 14 encoding 14 encoding 18 and 14 encoding 25 with 15 disordered 16 proteins 16 proteins 18 and 17 , 18 and 18 and 19 that 18 and 22 proteins 18 and 23 are 18 and 24 associated 20 intrinsically 21 disordered 21 disordered 22 proteins 22 proteins 23 are 25 with 26 age 27 - 28 related 28 related 29 diseases 28 related 40 , 29 diseases 31 cancer 29 diseases 33 diabetes 30 ( 31 cancer 31 cancer 32 , 32 , 33 diabetes 33 diabetes 36 and 33 diabetes 40 , 34 , 36 and 35 cardiovascular 36 and 36 and 38 diseases 36 and 39 ) 36 and 40 , 37 neurodegenerative 38 diseases 40 , 42 study 40 , 48 deserves 41 the 42 study 42 study 43 of 42 study 48 deserves 43 of 45 disorder 44 protein 45 disorder 45 disorder 46 in 46 in 47 aging 48 deserves 49 to 48 deserves 50 be 49 to 50 be 50 be 51 investigated the klotho gene ( kl ) was identified first as a putative [aging] - suppressor gene that extended life span when overexpressed and accelerated aging - like [phenotypes] when disrupted in mice . 0 ###LEFT-WALL### 3 gene 0 ###LEFT-WALL### 23 and 1 the 3 gene 2 klotho 3 gene 3 gene 5 kl 3 gene 23 and 4 ( 5 kl 5 kl 6 ) 7 was 8 identified 7 was 23 and 8 identified 9 first 8 identified 10 as 8 identified 21 when 10 as 20 span 11 a 12 putative 11 a 20 span 12 putative 14 - 12 putative 20 span 15 suppressor 20 span 16 gene 20 span 17 that 18 extended 18 extended 19 life 19 life 20 span 21 when 22 overexpressed 23 and 24 accelerated 23 and 27 like 24 accelerated 25 aging 26 - 27 like 27 like 29 when 27 like 33 . 29 when 30 disrupted 30 disrupted 31 in 31 in 32 mice it encodes a single - pass transmembrane protein and is expressed [predominantly] [in] [kidney] , where it functions as an [obligate] coreceptor for fibroblast growth factor 23 ( fgf - 23 ) . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 33 . 1 it 9 and 2 encodes 8 protein 2 encodes 9 and 3 a 4 single 3 a 8 protein 4 single 5 - 4 single 8 protein 6 pass 8 protein 7 transmembrane 8 protein 9 and 10 is 9 and 16 where 10 is 11 expressed 15 , 16 where 16 where 17 it 16 where 18 functions 16 where 32 ) 17 it 18 functions 18 functions 19 as 18 functions 23 for 19 as 22 coreceptor 20 an 22 coreceptor 23 for 26 factor 24 fibroblast 26 factor 25 growth 26 factor 26 factor 27 23 26 factor 30 - 28 ( 30 - 29 fgf 30 - 30 - 31 23 30 - 32 ) fgf - [23] is a bone [-] derived hormone that suppresses phosphate reabsorption and 1,25 dihydroxyvitamin d ( 3 ) ( vitamin d ) synthesis in the kidney . 0 ###LEFT-WALL### 1 fgf 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 29 . 1 fgf 2 - 1 fgf 4 is 4 is 9 hormone 4 is 25 synthesis 5 a 9 hormone 6 bone 8 derived 8 derived 9 hormone 9 hormone 10 that 9 hormone 11 suppresses 10 that 11 suppresses 11 suppresses 14 and 12 phosphate 13 reabsorption 13 reabsorption 14 and 14 and 16 dihydroxyvitamin 14 and 19 3 14 and 22 vitamin 15 1,25 16 dihydroxyvitamin 16 dihydroxyvitamin 17 d 18 ( 19 3 19 3 20 ) 21 ( 22 vitamin 22 vitamin 23 d 22 vitamin 24 ) 25 synthesis 26 in 26 in 28 kidney 27 the 28 kidney klotho also is expressed in the parathyroid gland , [where] fgf - 23 decreases parathyroid hormone expression and secretion , further suppressing vitamin d synthesis in [kidney] . 0 ###LEFT-WALL### 1 klotho 0 ###LEFT-WALL### 4 expressed 1 klotho 3 is 2 also 3 is 3 is 4 expressed 4 expressed 5 in 5 in 8 gland 6 the 8 gland 7 parathyroid 8 gland 8 gland 11 fgf 9 , 11 fgf 11 fgf 14 decreases 11 fgf 26 in 11 fgf 28 . 12 - 13 23 13 23 14 decreases 14 decreases 15 parathyroid 15 parathyroid 18 and 15 parathyroid 26 in 16 hormone 17 expression 17 expression 18 and 18 and 19 secretion 18 and 20 , 18 and 22 suppressing 21 further 22 suppressing 22 suppressing 25 synthesis 23 vitamin 24 d 23 vitamin 25 synthesis thus , fgf - 23 functions as a phosphaturic hormone and a counter - regulatory [hormone] for vitamin d , thereby [inducing] negative phosphate balance . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 23 negative 0 ###LEFT-WALL### 26 . 1 thus 2 , 1 thus 11 and 3 fgf 4 - 3 fgf 11 and 5 23 6 functions 6 functions 7 as 6 functions 11 and 7 as 10 hormone 8 a 9 phosphaturic 8 a 10 hormone 9 phosphaturic 10 hormone 11 and 13 counter 11 and 15 regulatory 11 and 23 negative 12 a 13 counter 14 - 15 regulatory 15 regulatory 17 for 15 regulatory 20 , 17 for 18 vitamin 18 vitamin 19 d 21 thereby 23 negative 23 negative 25 balance 24 phosphate 25 balance mice lacking either fgf - [23] or klotho show hyperphosphatemia in addition to developing multiple aging - like phenotypes , [which] can be rescued by resolving phosphate retention . 0 ###LEFT-WALL### 7 or 0 ###LEFT-WALL### 9 show 1 mice 2 lacking 1 mice 7 or 2 lacking 4 fgf 3 either 4 fgf 5 - 7 or 7 or 8 klotho 7 or 9 show 9 show 10 hyperphosphatemia 9 show 16 aging 9 show 18 like 10 hyperphosphatemia 11 in 11 in 12 addition 12 addition 13 to 13 to 14 developing 15 multiple 16 aging 17 - 18 like 18 like 20 , 18 like 29 . 19 phenotypes 20 , 20 , 22 can 22 can 23 be 23 be 24 rescued 24 rescued 25 by 25 by 26 resolving 26 resolving 28 retention 27 phosphate 28 retention these findings have unveiled an unexpected link between aging and phosphate . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 unveiled 0 ###LEFT-WALL### 12 . 1 these 2 findings 2 findings 3 have 3 have 4 unveiled 4 unveiled 10 and 5 an 6 unexpected 5 an 7 link 6 unexpected 7 link 7 link 8 between 7 link 10 and 8 between 9 aging 10 and 11 phosphate in patients with chronic kidney disease ( ckd ) , phosphate retention is seen universally and has been associated with increased mortality risk . 0 ###LEFT-WALL### 12 retention 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 24 . 1 in 2 patients 1 in 10 , 1 in 12 retention 2 patients 3 with 3 with 6 disease 4 chronic 5 kidney 5 kidney 6 disease 6 disease 8 ckd 7 ( 8 ckd 8 ckd 9 ) 11 phosphate 12 retention 12 retention 16 and 13 is 14 seen 13 is 16 and 14 seen 15 universally 16 and 17 has 16 and 23 risk 17 has 18 been 18 been 19 associated 19 associated 20 with 20 with 22 mortality 21 increased 22 mortality patients with ckd have high serum fgf - 23 levels with decreased klotho expression in the kidney and parathyroid , rendering fgf - 23 and klotho as potential biomarkers and therapeutic targets for ckd . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 have 1 patients 2 with 1 patients 4 have 2 with 3 ckd 4 have 7 fgf 4 have 21 rendering 5 high 7 fgf 6 serum 7 fgf 7 fgf 10 levels 8 - 10 levels 9 23 10 levels 10 levels 11 with 10 levels 15 in 10 levels 20 , 11 with 14 expression 12 decreased 14 expression 13 klotho 14 expression 15 in 18 and 16 the 17 kidney 17 kidney 18 and 18 and 19 parathyroid 20 , 21 rendering 21 rendering 22 fgf 21 rendering 35 . 22 fgf 30 and 23 - 30 and 24 23 25 and 25 and 26 klotho 26 klotho 27 as 26 klotho 30 and 27 as 29 biomarkers 28 potential 29 biomarkers 30 and 32 targets 30 and 33 for 30 and 35 . 31 therapeutic 32 targets 33 for 34 ckd the klotho protein not only serves as a coreceptor for fgf - 23 , but also functions as a humoral factor . 0 ###LEFT-WALL### 3 protein 0 ###LEFT-WALL### 16 also 0 ###LEFT-WALL### 22 . 1 the 3 protein 2 klotho 3 protein 3 protein 16 also 4 not 5 only 5 only 16 also 6 serves 7 as 6 serves 16 also 7 as 9 coreceptor 8 a 9 coreceptor 9 coreceptor 10 for 10 for 11 fgf 11 fgf 13 23 12 - 13 23 13 23 14 , 15 but 16 also 16 also 17 functions 16 also 18 as 18 as 21 factor 19 a 20 humoral 19 a 21 factor 20 humoral 21 factor klotho 's extracellular domain is released into blood and urine by ectodomain shedding and exerts various functions independently of fgf - 23 , including regulation of multiple ion channels and transporters . 0 ###LEFT-WALL### 4 domain 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 32 . 1 klotho 2 's 2 's 4 domain 3 extracellular 4 domain 4 domain 14 and 5 is 6 released 5 is 14 and 6 released 7 into 6 released 11 by 7 into 9 and 8 blood 9 and 9 and 10 urine 11 by 13 shedding 12 ectodomain 13 shedding 14 and 15 exerts 14 and 18 independently 15 exerts 17 functions 16 various 17 functions 18 independently 19 of 19 of 30 and 20 fgf 22 23 20 fgf 24 including 20 fgf 30 and 21 - 22 23 22 23 23 , 24 including 25 regulation 25 regulation 26 of 26 of 29 channels 27 multiple 28 ion 28 ion 29 channels 30 and 31 transporters decreased urinary klotho protein level has been identified as one of the earliest biomarkers of ckd progression . 0 ###LEFT-WALL### 5 level 0 ###LEFT-WALL### 8 identified 0 ###LEFT-WALL### 18 . 1 decreased 5 level 2 urinary 5 level 3 klotho 5 level 4 protein 5 level 5 level 6 has 6 has 7 been 7 been 8 identified 8 identified 9 as 9 as 10 one 10 one 11 of 11 of 14 biomarkers 12 the 13 earliest 12 the 14 biomarkers 14 biomarkers 15 of 15 of 17 progression 16 ckd 17 progression this review focuses on the current understanding of klotho protein [function] , with emphasis on its potential involvement in the pathophysiologic process of ckd . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 focuses 1 this 2 review 2 review 3 focuses 3 focuses 4 on 3 focuses 13 with 4 on 7 understanding 5 the 7 understanding 6 current 7 understanding 7 understanding 8 of 8 of 10 protein 9 klotho 10 protein 12 , 13 with 13 with 14 emphasis 13 with 25 . 14 emphasis 15 on 14 emphasis 23 of 15 on 18 involvement 16 its 18 involvement 17 potential 18 involvement 18 involvement 19 in 19 in 22 process 20 the 22 process 21 pathophysiologic 22 process 23 of 24 ckd from the fertilization of an egg until the death of an individual , somatic cells can accumulate genetic changes , such that cells from different tissues or even within the same tissue differ genetically . 0 ###LEFT-WALL### 15 cells 0 ###LEFT-WALL### 17 accumulate 1 from 3 fertilization 1 from 15 cells 2 the 3 fertilization 3 fertilization 4 of 4 of 6 egg 5 an 6 egg 7 until 9 death 7 until 13 , 7 until 15 cells 8 the 9 death 9 death 10 of 10 of 12 individual 11 an 12 individual 14 somatic 15 cells 15 cells 16 can 16 can 17 accumulate 17 accumulate 19 changes 17 accumulate 22 that 18 genetic 19 changes 20 , 22 that 21 such 22 that 22 that 23 cells 22 that 33 differ 22 that 35 . 23 cells 27 or 23 cells 33 differ 24 from 26 tissues 24 from 27 or 25 different 26 tissues 27 or 28 even 27 or 29 within 29 within 32 tissue 30 the 31 same 30 the 32 tissue 33 differ 34 genetically the presence of multiple cell clones [with] distinct [genotypes] in the same individual is referred to as ['] somatic mosaicism ['] . 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 16 to 0 ###LEFT-WALL### 22 . 1 the 2 presence 2 presence 3 of 2 presence 8 distinct 2 presence 14 is 3 of 6 clones 4 multiple 6 clones 5 cell 6 clones 8 distinct 10 in 10 in 13 individual 11 the 12 same 11 the 13 individual 14 is 16 to 15 referred 16 to 16 to 17 as 17 as 20 mosaicism 19 somatic 20 mosaicism many endogenous factors such as mobile elements , dna polymerase slippage , dna double - strand break , inefficient dna repair , unbalanced chromosomal segregation and some exogenous factors such as nicotine and uv exposure can contribute to the generation of somatic mutations , thereby leading to somatic mosaicism . 0 ###LEFT-WALL### 33 and 1 many 3 factors 2 endogenous 3 factors 3 factors 5 as 3 factors 8 , 4 such 5 as 5 as 7 elements 6 mobile 7 elements 8 , 11 slippage 8 , 12 , 9 dna 10 polymerase 10 polymerase 11 slippage 12 , 17 break 12 , 18 , 13 dna 17 break 14 double 15 - 14 double 16 strand 16 strand 17 break 18 , 21 repair 18 , 22 , 19 inefficient 21 repair 20 dna 21 repair 22 , 25 segregation 22 , 26 and 23 unbalanced 25 segregation 24 chromosomal 25 segregation 26 and 29 factors 26 and 31 as 26 and 33 and 27 some 29 factors 28 exogenous 29 factors 30 such 31 as 31 as 32 nicotine 33 and 34 uv 33 and 35 exposure 33 and 37 contribute 35 exposure 36 can 36 can 37 contribute 37 contribute 38 to 37 contribute 46 leading 38 to 40 generation 39 the 40 generation 40 generation 41 of 41 of 43 mutations 42 somatic 43 mutations 44 , 46 leading 45 thereby 46 leading 46 leading 47 to 46 leading 50 . 47 to 49 mosaicism 48 somatic 49 mosaicism such changes can potentially affect the epigenetic patterns and levels of gene expression , and ultimately the [phenotypes] [of] cells . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 5 affect 0 ###LEFT-WALL### 21 . 1 such 2 changes 2 changes 3 can 3 can 5 affect 4 potentially 5 affect 5 affect 15 and 6 the 8 patterns 7 epigenetic 8 patterns 8 patterns 9 and 9 and 10 levels 9 and 11 of 9 and 15 and 11 of 13 expression 12 gene 13 expression 14 , 15 and 15 and 16 ultimately 15 and 20 cells 17 the 20 cells although recent studies suggest that somatic mosaicism is widespread during normal development and aging , its implications for heightened disease risks are incompletely understood . 0 ###LEFT-WALL### 4 suggest 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 25 . 1 although 3 studies 1 although 4 suggest 2 recent 3 studies 4 suggest 5 that 5 that 7 mosaicism 5 that 8 is 6 somatic 7 mosaicism 7 mosaicism 8 is 8 is 9 widespread 9 widespread 10 during 10 during 12 development 11 normal 12 development 13 and 17 implications 13 and 24 understood 14 aging 15 , 14 aging 17 implications 16 its 17 implications 17 implications 18 for 17 implications 22 are 18 for 21 risks 19 heightened 20 disease 20 disease 21 risks 22 are 24 understood 23 incompletely 24 understood here , i discuss the origins , prevalence and implications of somatic mosaicism in healthy human tissues . 0 ###LEFT-WALL### 3 i 0 ###LEFT-WALL### 4 discuss 0 ###LEFT-WALL### 18 . 1 here 2 , 1 here 3 i 3 i 4 discuss 4 discuss 9 and 4 discuss 14 in 5 the 6 origins 6 origins 7 , 7 , 8 prevalence 7 , 9 and 9 and 10 implications 9 and 11 of 11 of 13 mosaicism 12 somatic 13 mosaicism 14 in 17 tissues 15 healthy 17 tissues 16 human 17 tissues at this juncture , clinical management , education for medical providers , and the design and interpretation of clinical trials have been hampered by the absence of a consensus system [for] nomenclature for the description of symptoms as well as classification of causes or potential causes of abnormal uterine bleeding ( aub ) . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 23 hampered 0 ###LEFT-WALL### 54 . 1 at 3 juncture 1 at 16 and 2 this 3 juncture 3 juncture 6 management 4 , 6 management 5 clinical 6 management 6 management 7 , 8 education 9 for 8 education 13 and 9 for 11 providers 10 medical 11 providers 12 , 13 and 13 and 15 design 13 and 16 and 14 the 15 design 16 and 17 interpretation 16 and 18 of 16 and 21 have 18 of 20 trials 19 clinical 20 trials 21 have 22 been 22 been 23 hampered 23 hampered 24 by 24 by 26 absence 25 the 26 absence 26 absence 27 of 26 absence 33 for 26 absence 40 as 27 of 32 nomenclature 28 a 32 nomenclature 29 consensus 32 nomenclature 30 system 32 nomenclature 33 for 35 description 34 the 35 description 35 description 36 of 36 of 37 symptoms 38 as 39 well 39 well 40 as 40 as 41 classification 41 classification 42 of 41 classification 47 of 42 of 44 or 43 causes 44 or 44 or 46 causes 45 potential 46 causes 47 of 50 bleeding 48 abnormal 50 bleeding 49 uterine 50 bleeding 50 bleeding 52 aub 51 ( 52 aub 52 aub 53 ) to address this issue , the fédération internationale de gynécologie [et] d'obstétrique ( figo ) has designed the palm - coein ( polyp , adenomyosis , leiomyoma , malignancy and hyperplasia , coagulopathy , ovulatory disorders , endometrial disorders , iatrogenic causes , and not classified [ )(classification system for causes of aub in the reproductive years . 0 ###LEFT-WALL### 10 gynécologie 0 ###LEFT-WALL### 17 designed 1 to 2 address 1 to 5 , 1 to 10 gynécologie 2 address 4 issue 3 this 4 issue 6 the 10 gynécologie 7 fédération 8 internationale 8 internationale 9 de 9 de 10 gynécologie 10 gynécologie 12 d'obstétrique 10 gynécologie 16 has 10 gynécologie 17 designed 12 d'obstétrique 14 figo 12 d'obstétrique 16 has 13 ( 14 figo 14 figo 15 ) 17 designed 21 coein 18 the 21 coein 19 palm 21 coein 20 - 21 coein 21 coein 30 and 22 ( 30 and 23 polyp 24 , 24 , 25 adenomyosis 24 , 26 , 26 , 27 leiomyoma 26 , 28 , 28 , 29 malignancy 28 , 30 and 30 and 31 hyperplasia 30 and 58 . 31 hyperplasia 44 and 32 , 44 and 33 coagulopathy 34 , 34 , 36 disorders 34 , 37 , 35 ovulatory 36 disorders 37 , 39 disorders 37 , 40 , 38 endometrial 39 disorders 40 , 42 causes 40 , 44 and 41 iatrogenic 42 causes 43 , 44 and 44 and 49 system 44 and 50 for 44 and 52 of 44 and 58 . 45 not 46 classified 46 classified 49 system 48 )(classification 49 system 50 for 51 causes 52 of 53 aub 53 aub 54 in 54 in 57 years 55 the 57 years 56 reproductive 57 years aims : to know the organization of internal medicine departments ( imd ) and the opinion of their heads [of] department . 0 ###LEFT-WALL### 1 aims 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 to 2 : 4 know 3 to 4 know 4 know 21 department 5 the 21 department 6 organization 7 of 6 organization 14 and 7 of 10 departments 8 internal 9 medicine 9 medicine 10 departments 10 departments 12 imd 11 ( 12 imd 12 imd 13 ) 14 and 16 opinion 14 and 17 of 14 and 21 department 15 the 16 opinion 17 of 19 heads 18 their 19 heads methods : in 2008 , a survey was mailed to 410 heads of [department] [of] the imd of 313 spanish public hospitals . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 23 . 1 methods 2 : 2 : 3 in 3 in 4 2008 5 , 7 survey 5 , 9 mailed 6 a 7 survey 7 survey 8 was 8 was 9 mailed 9 mailed 10 to 10 to 12 heads 11 410 12 heads 12 heads 13 of 13 of 17 imd 16 the 17 imd 17 imd 18 of 18 of 22 hospitals 19 313 22 hospitals 20 spanish 21 public 21 public 22 hospitals it included a standardized structured questionnaire on staff , hospitalization , outpatients , consultation , research and teaching . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 19 . 1 it 2 included 2 included 6 questionnaire 2 included 7 on 3 a 6 questionnaire 4 standardized 6 questionnaire 5 structured 6 questionnaire 7 on 17 and 8 staff 9 , 9 , 10 hospitalization 9 , 11 , 11 , 12 outpatients 11 , 13 , 13 , 14 consultation 13 , 15 , 15 , 16 research 15 , 17 and 17 and 18 teaching the heads of departments were also asked for their opinion and suggestions on management , projects and future . 0 ###LEFT-WALL### 2 heads 0 ###LEFT-WALL### 7 asked 0 ###LEFT-WALL### 19 . 1 the 2 heads 2 heads 3 of 2 heads 5 were 3 of 4 departments 5 were 6 also 5 were 7 asked 7 asked 8 for 7 asked 13 on 8 for 11 and 9 their 10 opinion 10 opinion 11 and 11 and 12 suggestions 13 on 17 and 14 management 15 , 15 , 16 projects 15 , 17 and 17 and 18 future results : sixty - eight surveys ( 22 % ) were filled out . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 surveys 2 : 12 filled 2 : 14 . 3 sixty 4 - 4 - 5 eight 4 - 6 surveys 6 surveys 9 % 6 surveys 11 were 7 ( 9 % 8 22 9 % 9 % 10 ) 11 were 12 filled 12 filled 13 out internists are [on] call an average of 3 times a month and perform 200 discharges , 500 outpatient visits and 40 consultations in a year . 0 ###LEFT-WALL### 1 internists 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 26 . 1 internists 2 are 2 are 12 and 4 call 6 average 4 call 11 month 4 call 12 and 5 an 6 average 6 average 7 of 7 of 9 times 8 3 9 times 10 a 11 month 12 and 13 perform 13 perform 20 and 14 200 20 and 15 discharges 16 , 16 , 19 visits 16 , 20 and 17 500 19 visits 18 outpatient 19 visits 20 and 22 consultations 21 40 22 consultations 22 consultations 23 in 23 in 25 year 24 a 25 year the average imd consists of 10 internists with one [-] fifth of the hospital beds . 0 ###LEFT-WALL### 3 imd 0 ###LEFT-WALL### 4 consists 0 ###LEFT-WALL### 16 . 1 the 2 average 2 average 3 imd 3 imd 4 consists 4 consists 5 of 5 of 7 internists 6 10 7 internists 7 internists 8 with 8 with 11 fifth 9 one 11 fifth 11 fifth 12 of 12 of 15 beds 13 the 15 beds 14 hospital 15 beds one third of hospitals have alternatives to inpatient care , the most frequent being palliative care . 0 ###LEFT-WALL### 2 third 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 17 . 1 one 2 third 2 third 3 of 2 third 5 have 3 of 4 hospitals 5 have 6 alternatives 5 have 7 to 7 to 9 care 8 inpatient 9 care 10 , 16 care 11 the 12 most 12 most 16 care 13 frequent 14 being 14 being 16 care 15 palliative 16 care infectious diseases accounts for the most common monographic outpatient visit , one - third of imd lack a structured relationship with primary care and the emergency department is [independent] of imd . 0 ###LEFT-WALL### 3 accounts 0 ###LEFT-WALL### 10 visit 0 ###LEFT-WALL### 11 , 1 infectious 2 diseases 2 diseases 3 accounts 3 accounts 4 for 3 accounts 10 visit 4 for 9 outpatient 5 the 9 outpatient 6 most 7 common 7 common 9 outpatient 8 monographic 9 outpatient 11 , 12 one 11 , 13 - 13 - 20 relationship 13 - 28 is 13 - 32 . 14 third 20 relationship 15 of 17 lack 15 of 20 relationship 16 imd 17 lack 18 a 20 relationship 19 structured 20 relationship 20 relationship 21 with 20 relationship 28 is 21 with 24 and 22 primary 23 care 23 care 24 and 24 and 27 department 25 the 27 department 26 emergency 27 department 28 is 30 of 30 of 31 imd half of the imd have at least one im resident and 6 residents in other specialties ; half are involved in at least two clinical trials and one - third train medical students . 0 ###LEFT-WALL### 1 half 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 34 . 1 half 2 of 1 half 5 have 2 of 4 imd 3 the 4 imd 5 have 11 and 6 at 7 least 7 least 8 one 8 one 10 resident 9 im 10 resident 10 resident 11 and 11 and 13 residents 12 6 13 residents 13 residents 14 in 14 in 16 specialties 15 other 16 specialties 17 ; 18 half 17 ; 20 involved 17 ; 29 - 18 half 19 are 19 are 20 involved 20 involved 21 in 21 in 27 and 22 at 23 least 23 least 24 two 24 two 26 trials 25 clinical 26 trials 26 trials 27 and 27 and 28 one 29 - 33 students 30 third 31 train 31 train 33 students 32 medical 33 students the heads of the imd identify problems in their relationship with hospital managers , other specialties and local population . 0 ###LEFT-WALL### 2 heads 0 ###LEFT-WALL### 6 identify 0 ###LEFT-WALL### 20 . 1 the 2 heads 2 heads 3 of 2 heads 6 identify 3 of 5 imd 4 the 5 imd 6 identify 7 problems 6 identify 11 with 7 problems 8 in 8 in 10 relationship 9 their 10 relationship 11 with 17 and 12 hospital 13 managers 13 managers 14 , 14 , 16 specialties 14 , 17 and 15 other 16 specialties 17 and 19 population 18 local 19 population excessive workload , aging and discouragement of staff and patients ' social problems have negative effects . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 14 have 0 ###LEFT-WALL### 17 . 1 excessive 2 workload 2 workload 3 , 3 , 4 aging 3 , 5 and 5 and 6 discouragement 5 and 7 of 5 and 9 and 7 of 8 staff 9 and 13 problems 9 and 14 have 10 patients 11 ' 11 ' 13 problems 12 social 13 problems 14 have 16 effects 15 negative 16 effects even so , they want to initiate projects , are optimistic about the future and [take] an interest in clinical epidemiology research . 0 ###LEFT-WALL### 4 they 0 ###LEFT-WALL### 5 want 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 23 . 1 even 2 so 1 even 3 , 1 even 4 they 2 so 3 , 4 they 5 want 5 want 6 to 5 want 7 initiate 6 to 7 initiate 7 initiate 8 projects 9 , 10 are 10 are 15 and 10 are 19 in 11 optimistic 12 about 11 optimistic 15 and 12 about 14 future 13 the 14 future 15 and 18 interest 17 an 18 interest 19 in 22 research 20 clinical 21 epidemiology 21 epidemiology 22 research conclusions : although the sample is small and heterogeneous , it permits a valuable panoramic view of the structure and standard operation of a spanish imd as well as their expectations and areas of improvement . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 36 . 1 conclusions 2 : 2 : 3 although 3 although 5 sample 4 the 5 sample 5 sample 6 is 6 is 8 and 7 small 8 and 8 and 9 heterogeneous 10 , 11 it 10 , 12 permits 11 it 12 permits 12 permits 20 and 13 a 16 view 14 valuable 16 view 15 panoramic 16 view 16 view 17 of 16 view 20 and 17 of 19 structure 18 the 19 structure 20 and 22 operation 20 and 23 of 21 standard 22 operation 23 of 26 imd 24 a 25 spanish 24 a 26 imd 25 spanish 26 imd 26 imd 29 as 26 imd 34 of 27 as 28 well 28 well 29 as 29 as 32 and 30 their 31 expectations 31 expectations 32 and 32 and 33 areas 34 of 35 improvement essential [tremor] ( et ) is among the most common neurological disorders . 0 ###LEFT-WALL### 1 essential 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 13 . 1 essential 4 et 1 essential 6 is 3 ( 4 et 4 et 5 ) 6 is 7 among 7 among 12 disorders 8 the 9 most 9 most 12 disorders 10 common 12 disorders 11 neurological 12 disorders this chapter reviews the epidemiology , clinical features , and pathophysiology of et . 0 ###LEFT-WALL### 2 chapter 0 ###LEFT-WALL### 3 reviews 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 14 . 1 this 2 chapter 2 chapter 3 reviews 3 reviews 5 epidemiology 4 the 5 epidemiology 6 , 10 and 7 clinical 8 features 8 features 10 and 9 , 10 and 10 and 11 pathophysiology 10 and 12 of 12 of 13 et the defining feature is a kinetic tremor of the arms . 0 ###LEFT-WALL### 3 feature 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 11 . 1 the 3 feature 2 defining 3 feature 3 feature 4 is 4 is 7 tremor 5 a 6 kinetic 5 a 7 tremor 6 kinetic 7 tremor 7 tremor 8 of 8 of 10 arms 9 the 10 arms patients often have a postural tremor as well . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 9 . 1 patients 3 have 2 often 3 have 3 have 6 tremor 3 have 7 as 4 a 5 postural 4 a 6 tremor 5 postural 6 tremor 7 as 8 well other body regions may also be [involved] [(] especially the head [ )( 0 ###LEFT-WALL### 3 regions 0 ###LEFT-WALL### 6 be 0 ###LEFT-WALL### 13 )( 1 other 3 regions 2 body 3 regions 3 regions 4 may 4 may 6 be 5 also 6 be 6 be 9 especially 6 be 11 head 10 the 11 head the severity [of] tremor may range from mild cases in population settings to more severe cases in treatment settings . 0 ###LEFT-WALL### 4 tremor 0 ###LEFT-WALL### 6 range 0 ###LEFT-WALL### 20 . 1 the 4 tremor 2 severity 4 tremor 4 tremor 5 may 5 may 6 range 6 range 7 from 6 range 10 in 6 range 13 to 6 range 17 in 7 from 9 cases 8 mild 9 cases 10 in 12 settings 11 population 12 settings 13 to 16 cases 14 more 15 severe 15 severe 16 cases 17 in 19 settings 18 treatment 19 settings motor features [aside] [from] [tremor] have been described in et , including tandem gait difficulty . 0 ###LEFT-WALL### 2 features 0 ###LEFT-WALL### 8 described 1 motor 2 features 2 features 6 have 6 have 7 been 7 been 8 described 8 described 9 in 9 in 10 et 10 et 12 including 11 , 12 including 12 including 15 difficulty 12 including 16 . 13 tandem 15 difficulty 14 gait 15 difficulty mild cognitive changes ( especially executive dysfunction ) have been documented in many studies as well . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 11 documented 0 ###LEFT-WALL### 17 . 1 mild 3 changes 2 cognitive 3 changes 3 changes 7 dysfunction 3 changes 9 have 4 ( 7 dysfunction 5 especially 6 executive 6 executive 7 dysfunction 7 dysfunction 8 ) 9 have 10 been 10 been 11 documented 11 documented 12 in 11 documented 15 as 12 in 14 studies 13 many 14 studies 15 as 16 well despite being regarded [as] one of the most common hyperkinetic movement disorders , establishing a precise prevalence has been difficult , yet the prevalence among persons aged 40 and older seems to be 4 % [or] higher . 0 ###LEFT-WALL### 5 one 0 ###LEFT-WALL### 31 seems 0 ###LEFT-WALL### 38 . 1 despite 2 being 1 despite 5 one 2 being 3 regarded 5 one 6 of 5 one 11 movement 5 one 12 disorders 5 one 31 seems 6 of 8 most 7 the 8 most 9 common 11 movement 10 hyperkinetic 11 movement 11 movement 12 disorders 12 disorders 14 establishing 12 disorders 22 yet 12 disorders 29 and 13 , 14 establishing 14 establishing 17 prevalence 14 establishing 19 been 14 establishing 21 , 15 a 17 prevalence 16 precise 17 prevalence 17 prevalence 18 has 18 has 19 been 19 been 20 difficult 23 the 24 prevalence 24 prevalence 25 among 24 prevalence 29 and 25 among 26 persons 26 persons 27 aged 27 aged 28 40 29 and 30 older 31 seems 32 to 31 seems 33 be 32 to 33 be 33 be 35 % 33 be 37 higher 34 4 35 % [there] are numerous examples of families in which the disease appears to be inherited yet genetic studies have not progressed to the point where et genes have been identified . 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 30 . 2 are 4 examples 2 are 23 point 2 are 24 where 3 numerous 4 examples 4 examples 5 of 5 of 6 families 6 families 7 in 6 families 14 inherited 6 families 17 studies 6 families 21 to 7 in 8 which 7 in 10 disease 7 in 11 appears 9 the 10 disease 10 disease 11 appears 11 appears 12 to 11 appears 13 be 12 to 13 be 14 inherited 15 yet 16 genetic 17 studies 17 studies 18 have 18 have 19 not 18 have 20 progressed 20 progressed 21 to 22 the 23 point 24 where 26 genes 24 where 29 identified 25 et 26 genes 26 genes 27 have 27 have 28 been 28 been 29 identified there is also a growing understanding that environmental factors are likely to contribute to the etiology of et . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 19 . 1 there 2 is 2 is 3 also 2 is 6 understanding 4 a 6 understanding 5 growing 6 understanding 6 understanding 7 that 6 understanding 13 contribute 7 that 9 factors 7 that 10 are 8 environmental 9 factors 9 factors 10 are 10 are 11 likely 11 likely 12 to 11 likely 13 contribute 12 to 13 contribute 13 contribute 14 to 14 to 16 etiology 15 the 16 etiology 16 etiology 17 of 17 of 18 et more recent postmortem studies have helped localize the possible source of et to structural alterations in the cerebellum and its connecting pathways . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 helped 0 ###LEFT-WALL### 23 . 1 more 2 recent 2 recent 4 studies 3 postmortem 4 studies 4 studies 5 have 5 have 6 helped 6 helped 7 localize 7 localize 10 source 7 localize 13 to 7 localize 16 in 8 the 10 source 9 possible 10 source 10 source 11 of 11 of 12 et 13 to 15 alterations 14 structural 15 alterations 16 in 19 and 17 the 18 cerebellum 18 cerebellum 19 and 19 and 22 pathways 20 its 22 pathways 21 connecting 22 pathways an expansion of a trinucleotide cag repeat on chromosome 4 causes huntington disease . 0 ###LEFT-WALL### 2 expansion 0 ###LEFT-WALL### 11 causes 0 ###LEFT-WALL### 14 . 1 an 2 expansion 2 expansion 3 of 2 expansion 11 causes 3 of 7 repeat 4 a 7 repeat 5 trinucleotide 7 repeat 6 cag 7 repeat 7 repeat 8 on 8 on 9 chromosome 9 chromosome 10 4 11 causes 13 disease 12 huntington 13 disease the abnormal elongation of the cag increases the polyglutamine stretch of huntingtin , which becomes proportionally toxic . 0 ###LEFT-WALL### 3 elongation 0 ###LEFT-WALL### 7 increases 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 18 . 1 the 3 elongation 2 abnormal 3 elongation 3 elongation 4 of 3 elongation 7 increases 4 of 6 cag 5 the 6 cag 7 increases 10 stretch 8 the 10 stretch 9 polyglutamine 10 stretch 10 stretch 11 of 11 of 12 huntingtin 13 , 14 which 13 , 15 becomes 14 which 15 becomes 15 becomes 16 proportionally 15 becomes 17 toxic the mutated huntingtin is ubiquitous in somatic tissues , yet the pathologic changes are apparently restricted to the brain . 0 ###LEFT-WALL### 3 huntingtin 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 20 . 1 the 3 huntingtin 2 mutated 3 huntingtin 3 huntingtin 4 is 4 is 5 ubiquitous 5 ubiquitous 6 in 6 in 8 tissues 7 somatic 8 tissues 9 , 10 yet 9 , 14 are 10 yet 13 changes 11 the 13 changes 12 pathologic 13 changes 13 changes 14 are 14 are 15 apparently 14 are 17 to 15 apparently 16 restricted 17 to 19 brain 18 the 19 brain the degree of the abnormal expansion of the cag repeats governs the gradually diffuse atrophy of the brain . 0 ###LEFT-WALL### 6 expansion 0 ###LEFT-WALL### 11 governs 0 ###LEFT-WALL### 19 . 1 the 2 degree 2 degree 3 of 2 degree 6 expansion 3 of 6 expansion 4 the 6 expansion 5 abnormal 6 expansion 6 expansion 7 of 6 expansion 11 governs 7 of 10 repeats 8 the 10 repeats 9 cag 10 repeats 11 governs 15 atrophy 12 the 15 atrophy 13 gradually 14 diffuse 14 diffuse 15 atrophy 15 atrophy 16 of 16 of 18 brain 17 the 18 brain however , the brunt of the degenerative process involves the striatum . 0 ###LEFT-WALL### 4 brunt 0 ###LEFT-WALL### 9 involves 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 4 brunt 3 the 4 brunt 4 brunt 5 of 4 brunt 9 involves 5 of 8 process 6 the 8 process 7 degenerative 8 process 9 involves 11 striatum 10 the 11 striatum the onset of symptoms is insidious , but the longer [the] cag expansion , the earlier [their] occurrence . 0 ###LEFT-WALL### 2 onset 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 19 . 1 the 2 onset 2 onset 3 of 2 onset 5 is 3 of 4 symptoms 5 is 6 insidious 6 insidious 8 but 7 , 8 but 8 but 13 expansion 8 but 14 , 9 the 13 expansion 10 longer 13 expansion 12 cag 13 expansion 14 , 18 occurrence 15 the 18 occurrence 16 earlier 18 occurrence they include psychiatric , motor , and cognitive disorders . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 10 . 1 they 2 include 2 include 7 and 3 psychiatric 4 , 4 , 5 motor 4 , 7 and 6 , 7 and 7 and 9 disorders 8 cognitive 9 disorders patients with adult onset [of] symptoms are more prone to exhibit choreic movements whereas those [with] juvenile [onset] tend to develop parkinsonism or rigidity . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 19 tend 0 ###LEFT-WALL### 25 . 1 patients 2 with 1 patients 7 are 2 with 6 symptoms 3 adult 6 symptoms 4 onset 6 symptoms 7 are 9 prone 8 more 9 prone 9 prone 10 to 10 to 11 exhibit 11 exhibit 13 movements 11 exhibit 14 whereas 12 choreic 13 movements 14 whereas 17 juvenile 15 those 17 juvenile 17 juvenile 19 tend 19 tend 20 to 19 tend 21 develop 20 to 21 develop 21 develop 23 or 22 parkinsonism 23 or 23 or 24 rigidity brains from patients [with] [juvenile] [onset] are usually more atrophic than [those] [with] adult onset . 0 ###LEFT-WALL### 1 brains 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 16 . 1 brains 2 from 1 brains 7 are 2 from 3 patients 7 are 8 usually 7 are 10 atrophic 9 more 10 atrophic 10 atrophic 11 than 11 than 15 onset 14 adult 15 onset brains from patients with late onset [of] symptoms might show changes occurring in usual aging in addition to those characteristically observed in huntington disease . 0 ###LEFT-WALL### 21 observed 1 brains 2 from 1 brains 9 might 2 from 3 patients 3 patients 4 with 4 with 8 symptoms 5 late 6 onset 6 onset 8 symptoms 9 might 10 show 10 show 11 changes 10 show 12 occurring 10 show 21 observed 12 occurring 13 in 12 occurring 16 in 12 occurring 18 to 12 occurring 20 characteristically 12 occurring 21 observed 13 in 15 aging 14 usual 15 aging 16 in 17 addition 18 to 19 those 21 observed 22 in 21 observed 25 . 22 in 24 disease 23 huntington 24 disease despite recent important discoveries , the pathogenesis [of] huntington disease is still not elucidated . 0 ###LEFT-WALL### 10 disease 0 ###LEFT-WALL### 14 elucidated 0 ###LEFT-WALL### 15 . 1 despite 4 discoveries 1 despite 5 , 1 despite 10 disease 2 recent 4 discoveries 3 important 4 discoveries 6 the 10 disease 7 pathogenesis 10 disease 9 huntington 10 disease 10 disease 11 is 11 is 13 not 11 is 14 elucidated 12 still 13 not many possible mechanisms underlying the relative selective vulnerability of neurons are being explored . 0 ###LEFT-WALL### 3 mechanisms 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 14 . 1 many 3 mechanisms 2 possible 3 mechanisms 3 mechanisms 4 underlying 3 mechanisms 11 are 4 underlying 8 vulnerability 5 the 8 vulnerability 6 relative 8 vulnerability 7 selective 8 vulnerability 8 vulnerability 9 of 9 of 10 neurons 11 are 12 being 12 being 13 explored in particular , factors promoting apoptosis , and phenomena causing the toxic aggregation of proteins , or the blockage of trophic factors , or mitochondria dysfunction , and excitoxicity have been studied . 0 ###LEFT-WALL### 17 or 0 ###LEFT-WALL### 32 studied 0 ###LEFT-WALL### 33 . 1 in 2 particular 2 particular 3 , 2 particular 17 or 4 factors 5 promoting 4 factors 8 and 5 promoting 6 apoptosis 7 , 8 and 8 and 9 phenomena 8 and 17 or 9 phenomena 10 causing 9 phenomena 14 of 10 causing 13 aggregation 11 the 13 aggregation 12 toxic 13 aggregation 14 of 15 proteins 16 , 17 or 17 or 19 blockage 17 or 20 of 17 or 30 have 18 the 19 blockage 20 of 28 and 21 trophic 22 factors 22 factors 24 or 23 , 24 or 24 or 26 dysfunction 24 or 28 and 25 mitochondria 26 dysfunction 27 , 28 and 28 and 29 excitoxicity 30 have 31 been 31 been 32 studied we investigated the possible differences in lymphocyte subpopulations between healthy young - middle [-] aged and elderly subjects , focusing attention on γδ - tcr - expressing cells . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 29 . 1 we 2 investigated 2 investigated 5 differences 3 the 5 differences 4 possible 5 differences 5 differences 6 in 5 differences 9 between 6 in 8 subpopulations 7 lymphocyte 8 subpopulations 9 between 21 attention 10 healthy 21 attention 11 young 18 subjects 11 young 19 , 11 young 21 attention 12 - 18 subjects 13 middle 18 subjects 15 aged 16 and 16 and 17 elderly 16 and 18 subjects 18 subjects 19 , 20 focusing 21 attention 21 attention 22 on 22 on 28 cells 23 γδ 25 tcr 23 γδ 26 - 23 γδ 28 cells 24 - 25 tcr 25 tcr 26 - 27 expressing 28 cells lymphocyte subpopulations were analyzed in blood samples collected every four hours for 24 hours . 0 ###LEFT-WALL### 2 subpopulations 0 ###LEFT-WALL### 4 analyzed 0 ###LEFT-WALL### 15 . 1 lymphocyte 2 subpopulations 2 subpopulations 3 were 3 were 4 analyzed 4 analyzed 5 in 5 in 7 samples 6 blood 7 samples 7 samples 8 collected 8 collected 9 every 8 collected 12 for 9 every 11 hours 10 four 11 hours 12 for 14 hours 13 24 14 hours the presence of circadian rhythmicity on absolute counts was validated to evaluate the periodicity of variation , and the fractional variation between single time point values was calculated to evaluate the dynamics of variation . 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 12 evaluate 0 ###LEFT-WALL### 35 . 1 the 2 presence 2 presence 3 of 2 presence 9 was 3 of 5 rhythmicity 4 circadian 5 rhythmicity 5 rhythmicity 6 on 6 on 8 counts 7 absolute 8 counts 9 was 10 validated 10 validated 11 to 11 to 12 evaluate 12 evaluate 14 periodicity 12 evaluate 28 calculated 13 the 14 periodicity 14 periodicity 15 of 14 periodicity 27 was 15 of 18 and 16 variation 18 and 17 , 18 and 18 and 21 variation 18 and 22 between 19 the 21 variation 20 fractional 21 variation 22 between 26 values 23 single 26 values 24 time 26 values 25 point 26 values 27 was 28 calculated 28 calculated 29 to 29 to 30 evaluate 30 evaluate 32 dynamics 31 the 32 dynamics 32 dynamics 33 of 33 of 34 variation in the group of young and middle - aged subjects a clear circadian rhythm was validated for the time - qualified changes of all the lymphocyte subpopulations ( cd3 , cd4 , cd4/cd8 ratio , cd20 , cd25 and hla - dr with acrophase at night , cd8 , cd16 and tcr γδ with acrophase at noon ) . 0 ###LEFT-WALL### 14 rhythm 0 ###LEFT-WALL### 16 validated 0 ###LEFT-WALL### 59 . 1 in 3 group 1 in 14 rhythm 2 the 3 group 4 of 10 subjects 4 of 14 rhythm 5 young 6 and 6 and 7 middle 6 and 8 - 6 and 9 aged 6 and 10 subjects 11 a 14 rhythm 12 clear 14 rhythm 13 circadian 14 rhythm 14 rhythm 15 was 15 was 16 validated 16 validated 17 for 17 for 19 time 18 the 19 time 19 time 22 changes 20 - 22 changes 21 qualified 22 changes 22 changes 23 of 22 changes 29 cd3 22 changes 58 ) 23 of 24 all 24 all 26 lymphocyte 24 all 27 subpopulations 25 the 26 lymphocyte 26 lymphocyte 27 subpopulations 28 ( 29 cd3 29 cd3 39 and 29 cd3 42 dr 29 cd3 58 ) 30 , 39 and 31 cd4 32 , 32 , 34 ratio 32 , 35 , 33 cd4/cd8 34 ratio 35 , 36 cd20 35 , 37 , 37 , 38 cd25 37 , 39 and 39 and 40 hla 39 and 41 - 41 - 42 dr 42 dr 43 with 42 dr 51 and 42 dr 53 γδ 42 dr 58 ) 43 with 44 acrophase 44 acrophase 45 at 44 acrophase 48 cd8 45 at 46 night 47 , 48 cd8 48 cd8 49 , 50 cd16 51 and 51 and 52 tcr 51 and 53 γδ 53 γδ 54 with 53 γδ 56 at 54 with 55 acrophase 56 at 57 noon in the group of elderly subjects a clear circadian rhythm was validated for the nyctohemeral changes of cd3 , cd8 , cd4/cd8 ratio , cd16 , cd25 . 0 ###LEFT-WALL### 10 rhythm 0 ###LEFT-WALL### 12 validated 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 28 . 1 in 6 subjects 1 in 10 rhythm 2 the 3 group 3 group 4 of 3 group 6 subjects 4 of 6 subjects 5 elderly 6 subjects 7 a 8 clear 7 a 10 rhythm 8 clear 10 rhythm 9 circadian 10 rhythm 10 rhythm 11 was 11 was 12 validated 12 validated 13 for 13 for 16 changes 14 the 16 changes 15 nyctohemeral 16 changes 16 changes 17 of 17 of 18 cd3 18 cd3 20 cd8 19 , 20 cd8 20 cd8 21 , 21 , 23 ratio 21 , 24 , 22 cd4/cd8 23 ratio 24 , 25 cd16 24 , 26 , 26 , 27 cd25 there was a statistically significant difference for the midline estimating statistic of rhythm ( mesor ) of cd3 ( p=0.001 ) , cd25 ( p=0.003 ) and γδ - tcr - expressing cells ( p=0.004 ) , higher in the elderly , and for the mesor of hla - dr ( p=0.002 ) and cd20 ( p=0.002 ) higher in the young and middle - aged subjects . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 22 , 1 there 2 was 2 was 6 difference 3 a 4 statistically 3 a 6 difference 4 statistically 5 significant 5 significant 6 difference 6 difference 7 for 6 difference 12 of 6 difference 17 of 6 difference 20 p=0.001 7 for 11 statistic 8 the 11 statistic 9 midline 10 estimating 10 estimating 11 statistic 12 of 15 mesor 13 rhythm 15 mesor 14 ( 15 mesor 15 mesor 16 ) 17 of 18 cd3 19 ( 20 p=0.001 20 p=0.001 21 ) 22 , 27 and 22 , 29 - 23 cd25 25 p=0.003 23 cd25 27 and 24 ( 25 p=0.003 25 p=0.003 26 ) 27 and 28 γδ 27 and 29 - 29 - 54 and 29 - 68 . 30 tcr 33 cells 30 tcr 38 higher 30 tcr 54 and 31 - 33 cells 32 expressing 33 cells 33 cells 35 p=0.004 33 cells 37 , 34 ( 35 p=0.004 35 p=0.004 36 ) 38 higher 43 and 39 in 41 elderly 39 in 43 and 40 the 41 elderly 42 , 43 and 43 and 44 for 44 for 46 mesor 45 the 46 mesor 46 mesor 47 of 47 of 48 hla 48 hla 50 dr 49 - 50 dr 50 dr 52 p=0.002 50 dr 53 ) 51 ( 52 p=0.002 52 p=0.002 53 ) 54 and 55 cd20 55 cd20 57 p=0.002 55 cd20 59 higher 56 ( 57 p=0.002 57 p=0.002 58 ) 59 higher 60 in 60 in 67 subjects 61 the 67 subjects 62 young 63 and 63 and 64 middle 63 and 65 - 63 and 67 subjects 66 aged 67 subjects there was a statistically significant difference between the groups in the fractional variation of tcr γδ - expressing cells between 18:00 h and 22:00 h values ( higher [in] elderly subjects , p=0.007 ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 6 difference 2 was 16 γδ 3 a 4 statistically 3 a 6 difference 4 statistically 5 significant 5 significant 6 difference 6 difference 7 between 6 difference 10 in 6 difference 14 of 7 between 9 groups 8 the 9 groups 10 in 13 variation 11 the 13 variation 12 fractional 13 variation 14 of 15 tcr 16 γδ 18 expressing 17 - 18 expressing 18 expressing 19 cells 18 expressing 20 between 18 expressing 35 . 20 between 26 values 21 18:00 22 h 22 h 23 and 23 and 25 h 23 and 26 values 24 22:00 25 h 26 values 31 subjects 27 ( 31 subjects 28 higher 31 subjects 30 elderly 31 subjects 31 subjects 33 p=0.007 31 subjects 35 . 32 , 33 p=0.007 33 p=0.007 34 ) background : cellular senescence plays important roles in the aging process of complex organisms [,] in tumor suppression and in response to stress . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 senescence 2 : 5 plays 2 : 24 . 3 cellular 4 senescence 4 senescence 5 plays 5 plays 7 roles 5 plays 8 in 5 plays 22 to 6 important 7 roles 8 in 11 process 9 the 11 process 10 aging 11 process 11 process 12 of 11 process 19 and 12 of 14 organisms 13 complex 14 organisms 16 in 18 suppression 16 in 19 and 17 tumor 18 suppression 19 and 21 response 20 in 21 response 22 to 23 stress several markers can be used to identify senescent cells , of which the most widely used is the senescence - associated β - galactosidase ( sabg ) activity . 0 ###LEFT-WALL### 2 markers 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 10 , 1 several 2 markers 2 markers 3 can 3 can 4 be 4 be 5 used 5 used 6 to 5 used 7 identify 6 to 7 identify 7 identify 9 cells 8 senescent 9 cells 10 , 14 most 10 , 17 is 10 , 20 - 11 of 12 which 11 of 14 most 13 the 14 most 14 most 16 used 14 most 17 is 15 widely 16 used 17 is 19 senescence 18 the 19 senescence 20 - 28 activity 20 - 29 . 21 associated 28 activity 22 β 24 galactosidase 22 β 28 activity 23 - 24 galactosidase 24 galactosidase 26 sabg 24 galactosidase 27 ) 25 ( 26 sabg 26 sabg 27 ) the main advantage of sabg activity over other markers is the simplicity of the detection assay and the capacity to identify in situ a senescent cell in a heterogeneous cell population . 0 ###LEFT-WALL### 3 advantage 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 32 . 1 the 2 main 1 the 3 advantage 3 advantage 4 of 3 advantage 10 is 4 of 6 activity 5 sabg 6 activity 6 activity 7 over 7 over 9 markers 8 other 9 markers 10 is 12 simplicity 11 the 12 simplicity 12 simplicity 13 of 12 simplicity 20 to 12 simplicity 21 identify 13 of 17 and 14 the 16 assay 15 detection 16 assay 16 assay 17 and 17 and 19 capacity 18 the 19 capacity 20 to 21 identify 21 identify 23 situ 21 identify 26 cell 21 identify 27 in 22 in 23 situ 24 a 25 senescent 24 a 26 cell 25 senescent 26 cell 27 in 31 population 28 a 29 heterogeneous 28 a 31 population 29 heterogeneous 30 cell 30 cell 31 population several approaches have been introduced to render the sabg assay quantitative . 0 ###LEFT-WALL### 2 approaches 0 ###LEFT-WALL### 5 introduced 0 ###LEFT-WALL### 12 . 1 several 2 approaches 2 approaches 3 have 3 have 4 been 4 been 5 introduced 5 introduced 6 to 6 to 7 render 7 render 10 assay 7 render 11 quantitative 8 the 10 assay 9 sabg 10 assay however none of these approaches to date has proven particularly amenable to quantitative analysis of sabg activity in situ . 0 ###LEFT-WALL### 2 none 0 ###LEFT-WALL### 9 proven 0 ###LEFT-WALL### 20 . 1 however 2 none 2 none 3 of 2 none 8 has 3 of 5 approaches 4 these 5 approaches 5 approaches 7 date 6 to 7 date 8 has 9 proven 9 proven 11 amenable 10 particularly 11 amenable 11 amenable 12 to 11 amenable 19 situ 12 to 14 analysis 13 quantitative 14 analysis 14 analysis 15 of 15 of 17 activity 16 sabg 17 activity 18 in 19 situ furthermore the role of cellular senescence ( cs ) in vivo remains unclear mainly due to the ambiguity of current cellular markers in identifying cs of individual cells in tissues . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 12 remains 0 ###LEFT-WALL### 31 . 1 furthermore 3 role 2 the 3 role 3 role 4 of 3 role 12 remains 4 of 6 senescence 5 cellular 6 senescence 6 senescence 8 cs 7 ( 8 cs 8 cs 9 ) 10 in 11 vivo 11 vivo 12 remains 12 remains 13 unclear 13 unclear 14 mainly 13 unclear 23 in 14 mainly 16 to 15 due 16 to 16 to 18 ambiguity 17 the 18 ambiguity 18 ambiguity 19 of 19 of 22 markers 20 current 22 markers 21 cellular 22 markers 23 in 24 identifying 24 identifying 25 cs 24 identifying 29 in 25 cs 26 of 26 of 28 cells 27 individual 28 cells 29 in 30 tissues results : in the current study we applied a digital image analysis technique to the staining generated using the original sabg assay , and demonstrate that this analysis is highly reproducible and sensitive to subtle differences in staining intensities resulting from diverse cellular senescence pathways in culture . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 we 2 : 24 and 2 : 48 . 3 in 6 study 3 in 7 we 4 the 6 study 5 current 6 study 7 we 24 and 8 applied 13 technique 8 applied 14 to 8 applied 18 using 8 applied 24 and 9 a 13 technique 10 digital 11 image 11 image 12 analysis 12 analysis 13 technique 14 to 16 staining 15 the 16 staining 16 staining 17 generated 18 using 22 assay 19 the 22 assay 20 original 22 assay 21 sabg 22 assay 23 , 24 and 24 and 25 demonstrate 25 demonstrate 26 that 26 that 28 analysis 26 that 29 is 27 this 28 analysis 28 analysis 29 is 29 is 30 highly 29 is 32 and 31 reproducible 32 and 32 and 33 sensitive 33 sensitive 34 to 34 to 36 differences 35 subtle 36 differences 36 differences 37 in 37 in 38 staining 38 staining 39 intensities 38 staining 41 from 39 intensities 40 resulting 41 from 45 pathways 42 diverse 44 senescence 43 cellular 44 senescence 44 senescence 45 pathways 45 pathways 46 in 46 in 47 culture we have further validated our method on mouse kidney samples [with] and without diabetes mellitus , and show that a more accurate quantitative sabg activity with a wider range of values can be achieved at a ph lower than that used in the conventional sabg assay . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 47 . 1 we 17 and 2 have 4 validated 2 have 17 and 3 further 4 validated 4 validated 6 method 5 our 6 method 6 method 12 and 7 on 10 samples 7 on 12 and 8 mouse 9 kidney 9 kidney 10 samples 12 and 13 without 13 without 15 mellitus 14 diabetes 15 mellitus 16 , 17 and 17 and 18 show 18 show 19 that 19 that 25 activity 19 that 34 achieved 20 a 25 activity 21 more 22 accurate 22 accurate 25 activity 23 quantitative 25 activity 24 sabg 25 activity 25 activity 26 with 25 activity 30 of 25 activity 32 can 26 with 29 range 27 a 29 range 28 wider 29 range 30 of 31 values 32 can 33 be 33 be 34 achieved 34 achieved 35 at 34 achieved 38 lower 35 at 37 ph 36 a 37 ph 38 lower 39 than 39 than 40 that 39 than 41 used 39 than 42 in 40 that 41 used 42 in 46 assay 43 the 46 assay 44 conventional 46 assay 45 sabg 46 assay conclusions : we conclude that quantitative in [situ] sabg assay , is feasible and reproducible and that [the] ph at which the reaction [is] performed should be tailored [and] chosen , depending on the research question and experimental system of interest . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 conclude 2 : 11 , 2 : 12 is 3 we 4 conclude 4 conclude 5 that 5 that 6 quantitative 6 quantitative 7 in 7 in 10 assay 9 sabg 10 assay 11 , 12 is 12 is 19 ph 13 feasible 14 and 14 and 15 reproducible 14 and 16 and 16 and 17 that 16 and 19 ph 19 ph 20 at 19 ph 28 tailored 19 ph 30 chosen 20 at 21 which 20 at 23 reaction 20 at 27 be 22 the 23 reaction 23 reaction 25 performed 23 reaction 26 should 26 should 27 be 30 chosen 32 depending 30 chosen 33 on 31 , 32 depending 33 on 37 and 34 the 36 question 35 research 36 question 36 question 37 and 37 and 39 system 37 and 42 . 38 experimental 39 system 39 system 40 of 40 of 41 interest introduction : in critically ill patients , it is uncertain whether exposure to older red blood cells ( rbcs ) may contribute to mortality . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 25 . 1 introduction 2 : 2 : 3 in 3 in 6 patients 4 critically 5 ill 5 ill 6 patients 7 , 8 it 7 , 9 is 8 it 9 is 9 is 10 uncertain 10 uncertain 11 whether 11 whether 12 exposure 11 whether 22 contribute 12 exposure 13 to 12 exposure 21 may 13 to 17 cells 14 older 16 blood 15 red 16 blood 16 blood 17 cells 17 cells 19 rbcs 18 ( 19 rbcs 19 rbcs 20 ) 21 may 22 contribute 22 contribute 23 to 23 to 24 mortality we therefore aimed to evaluate the association between the age of rbcs and outcome in a large unselected cohort of critically ill patients in australia and new zealand . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 aimed 0 ###LEFT-WALL### 29 . 1 we 3 aimed 2 therefore 3 aimed 3 aimed 4 to 3 aimed 5 evaluate 4 to 5 evaluate 5 evaluate 7 association 5 evaluate 15 in 5 evaluate 24 in 6 the 7 association 7 association 8 between 8 between 10 age 9 the 10 age 10 age 11 of 11 of 13 and 12 rbcs 13 and 13 and 14 outcome 15 in 19 cohort 16 a 17 large 16 a 19 cohort 17 large 19 cohort 18 unselected 19 cohort 19 cohort 20 of 20 of 23 patients 21 critically 22 ill 22 ill 23 patients 24 in 28 zealand 25 australia 26 and 26 and 27 new 27 new 28 zealand we hypothesized that exposure to [even] a single unit of older rbcs may be associated with an increased risk of death . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 22 . 1 we 2 hypothesized 2 hypothesized 3 that 3 that 4 exposure 3 that 15 associated 4 exposure 5 to 4 exposure 10 of 4 exposure 13 may 5 to 9 unit 7 a 9 unit 8 single 9 unit 10 of 12 rbcs 11 older 12 rbcs 13 may 14 be 14 be 15 associated 15 associated 16 with 16 with 19 risk 17 an 19 risk 18 increased 19 risk 19 risk 20 of 20 of 21 death methods : we conducted a prospective , multicenter observational study in 47 icus during a 5 [-] week period between august 2008 and september 2008 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 conducted 2 : 26 . 3 we 4 conducted 4 conducted 10 study 4 conducted 11 in 5 a 6 prospective 5 a 10 study 6 prospective 7 , 6 prospective 10 study 8 multicenter 10 study 9 observational 10 study 11 in 23 and 12 47 13 icus 13 icus 14 during 13 icus 23 and 14 during 19 period 15 a 19 period 16 5 18 week 18 week 19 period 19 period 20 between 20 between 21 august 21 august 22 2008 23 and 24 september 24 september 25 2008 we included 757 critically ill adult patients receiving at least one unit of rbcs . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 15 . 1 we 2 included 2 included 7 patients 3 757 7 patients 4 critically 5 ill 5 ill 6 adult 6 adult 7 patients 7 patients 8 receiving 8 receiving 12 unit 9 at 10 least 10 least 11 one 11 one 12 unit 12 unit 13 of 13 of 14 rbcs to test our hypothesis we compared hospital mortality according to quartiles of exposure to maximum age of rbcs [without] and with adjustment for possible confounding factors . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 27 . 1 to 2 test 2 test 4 hypothesis 3 our 4 hypothesis 4 hypothesis 5 we 4 hypothesis 9 according 5 we 6 compared 6 compared 8 mortality 7 hospital 8 mortality 8 mortality 9 according 9 according 10 to 10 to 11 quartiles 11 quartiles 12 of 12 of 13 exposure 13 exposure 20 and 14 to 16 age 14 to 20 and 15 maximum 16 age 16 age 17 of 17 of 18 rbcs 20 and 21 with 21 with 22 adjustment 22 adjustment 23 for 23 for 26 factors 24 possible 26 factors 25 confounding 26 factors results : compared with other quartiles [(] mean maximum red cell age 22.7 days [;] [mortality] 121/568 ( 21.3 % ) [ )(, [patients] treated with exposure to the lowest quartile of [oldest] rbcs [(] mean maximum red cell age 7.7 days [;] hospital [mortality] 25/189 ( 13.2 % ) [ )(had an unadjusted absolute risk reduction in hospital mortality of 8.1 % ( 95 % confidence interval = 2.2 to 14.0 % [ )( 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 compared 1 results 2 : 2 : 3 compared 3 compared 4 with 4 with 6 quartiles 4 with 14 days 5 other 6 quartiles 8 mean 9 maximum 9 maximum 14 days 10 red 11 cell 11 cell 14 days 12 age 14 days 13 22.7 14 days 14 days 17 121/568 14 days 20 % 14 days 25 treated 18 ( 20 % 19 21.3 20 % 20 % 21 ) 23 )(, 25 treated 25 treated 26 with 25 treated 28 to 26 with 27 exposure 28 to 31 quartile 29 the 30 lowest 29 the 31 quartile 31 quartile 32 of 32 of 42 days 34 rbcs 37 maximum 36 mean 37 maximum 37 maximum 38 red 38 red 42 days 39 cell 40 age 40 age 42 days 41 7.7 42 days 42 days 44 hospital 42 days 52 )(had 44 hospital 46 25/189 44 hospital 49 % 44 hospital 52 )(had 47 ( 49 % 48 13.2 49 % 49 % 50 ) 52 )(had 57 reduction 52 )(had 58 in 53 an 57 reduction 54 unadjusted 57 reduction 55 absolute 57 reduction 56 risk 57 reduction 58 in 60 mortality 59 hospital 60 mortality 60 mortality 61 of 60 mortality 68 interval 61 of 63 % 62 8.1 63 % 64 ( 68 interval 65 95 68 interval 66 % 67 confidence 67 confidence 68 interval 68 interval 71 to 68 interval 75 )( 69 = 70 2.2 70 2.2 71 to 71 to 72 14.0 72 14.0 73 % after adjustment for acute physiology and chronic health evaluation iii score , other blood component transfusions , number of rbc transfusions , pretransfusion hemoglobin concentration , and cardiac surgery , the odds ratio for hospital mortality for patients exposed to the older three quartiles compared with the lowest quartile was 2.01 ( 95 % confidence interval = 1.07 to 3.77 ) . 0 ###LEFT-WALL### 33 ratio 0 ###LEFT-WALL### 50 was 0 ###LEFT-WALL### 62 . 1 after 2 adjustment 1 after 33 ratio 2 adjustment 3 for 2 adjustment 6 and 2 adjustment 11 score 2 adjustment 16 transfusions 3 for 4 acute 5 physiology 6 and 6 and 9 evaluation 6 and 11 score 7 chronic 8 health 8 health 9 evaluation 9 evaluation 10 iii 12 , 16 transfusions 13 other 16 transfusions 14 blood 15 component 15 component 16 transfusions 16 transfusions 27 and 16 transfusions 30 , 17 , 27 and 18 number 19 of 18 number 22 , 19 of 21 transfusions 20 rbc 21 transfusions 22 , 25 concentration 22 , 27 and 23 pretransfusion 25 concentration 24 hemoglobin 25 concentration 26 , 27 and 27 and 29 surgery 27 and 30 , 28 cardiac 29 surgery 31 the 33 ratio 32 odds 33 ratio 33 ratio 34 for 33 ratio 37 for 33 ratio 40 to 33 ratio 50 was 34 for 36 mortality 35 hospital 36 mortality 37 for 38 patients 38 patients 39 exposed 40 to 44 quartiles 41 the 44 quartiles 42 older 44 quartiles 43 three 44 quartiles 44 quartiles 45 compared 44 quartiles 46 with 46 with 49 quartile 47 the 48 lowest 47 the 49 quartile 50 was 51 2.01 51 2.01 56 interval 52 ( 56 interval 53 95 54 % 54 % 56 interval 55 confidence 56 interval 56 interval 59 to 56 interval 61 ) 57 = 58 1.07 58 1.07 59 to 59 to 60 3.77 conclusions : in critically ill patients , in australia and new zealand , exposure to older rbcs is independently associated with an increased risk of death . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 27 . 1 conclusions 2 : 2 : 3 in 3 in 6 patients 4 critically 5 ill 5 ill 6 patients 6 patients 8 in 7 , 8 in 8 in 10 and 8 in 13 , 9 australia 10 and 10 and 12 zealand 11 new 12 zealand 13 , 14 exposure 13 , 20 associated 14 exposure 15 to 14 exposure 18 is 15 to 17 rbcs 16 older 17 rbcs 18 is 20 associated 19 independently 20 associated 20 associated 21 with 21 with 24 risk 22 an 24 risk 23 increased 24 risk 24 risk 25 of 25 of 26 death aging is characterized by progressive impairment of functional capacities of all system organs , reduction in homeostatic mechanisms , and altered response to receptor stimulation . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 3 characterized 0 ###LEFT-WALL### 26 . 1 aging 2 is 2 is 3 characterized 3 characterized 4 by 3 characterized 23 to 4 by 20 and 5 progressive 6 impairment 6 impairment 7 of 6 impairment 20 and 7 of 9 capacities 8 functional 9 capacities 9 capacities 10 of 10 of 13 organs 11 all 13 organs 12 system 13 organs 13 organs 15 reduction 14 , 15 reduction 15 reduction 16 in 15 reduction 19 , 16 in 18 mechanisms 17 homeostatic 18 mechanisms 19 , 20 and 20 and 22 response 21 altered 22 response 23 to 25 stimulation 24 receptor 25 stimulation these age - related physiologic changes influence both pharmacokinetics and pharmacodynamics of drugs in elderly patients . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 4 related 1 these 2 age 3 - 4 related 4 related 7 influence 4 related 14 in 4 related 17 . 5 physiologic 6 changes 6 changes 7 influence 7 influence 10 and 7 influence 12 of 8 both 9 pharmacokinetics 9 pharmacokinetics 10 and 10 and 11 pharmacodynamics 12 of 13 drugs 14 in 16 patients 15 elderly 16 patients pharmacokinetic and pharmacodynamics changes as well as polypharmacy and comorbidities may alter significantly the effect of pharmacological treatment with advancing age . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 22 . 1 pharmacokinetic 2 and 2 and 3 pharmacodynamics 2 and 9 and 4 changes 7 as 4 changes 9 and 5 as 6 well 6 well 7 as 7 as 8 polypharmacy 9 and 12 alter 10 comorbidities 11 may 11 may 12 alter 12 alter 13 significantly 12 alter 15 effect 12 alter 19 with 14 the 15 effect 15 effect 16 of 16 of 18 treatment 17 pharmacological 18 treatment 19 with 20 advancing 20 advancing 21 age with the same drug concentration at the site of action , significant differences in the response to several drugs have been observed in older patients as compared to younger patients . 0 ###LEFT-WALL### 13 differences 0 ###LEFT-WALL### 27 compared 0 ###LEFT-WALL### 31 . 1 with 5 concentration 1 with 11 , 1 with 13 differences 2 the 3 same 2 the 5 concentration 4 drug 5 concentration 5 concentration 6 at 5 concentration 9 of 6 at 8 site 7 the 8 site 9 of 10 action 12 significant 13 differences 13 differences 14 in 13 differences 20 have 14 in 16 response 15 the 16 response 16 response 17 to 17 to 19 drugs 18 several 19 drugs 20 have 21 been 21 been 22 observed 22 observed 23 in 22 observed 26 as 23 in 25 patients 24 older 25 patients 26 as 27 compared 27 compared 28 to 28 to 30 patients 29 younger 30 patients elderly patients are particularly suceptibles to the effects of frequently prescribed drugs acting on central nervous [system] , such [as] benzodiazepines , antidepressants , antipsychotics and lithium , with high potential for adverse drug reactions . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 24 , 1 elderly 2 patients 2 patients 3 are 3 are 4 particularly 3 are 5 suceptibles 5 suceptibles 6 to 5 suceptibles 9 of 5 suceptibles 13 acting 6 to 8 effects 7 the 8 effects 9 of 12 drugs 10 frequently 11 prescribed 11 prescribed 12 drugs 13 acting 14 on 14 on 23 antidepressants 15 central 23 antidepressants 16 nervous 21 benzodiazepines 16 nervous 22 , 16 nervous 23 antidepressants 18 , 21 benzodiazepines 19 such 21 benzodiazepines 21 benzodiazepines 22 , 24 , 26 and 25 antipsychotics 26 and 26 and 27 lithium 26 and 29 with 28 , 29 with 29 with 31 potential 29 with 36 . 30 high 31 potential 31 potential 32 for 32 for 35 reactions 33 adverse 35 reactions 34 drug 35 reactions moreover , in older patients increased sensitivity to warfarin resulting in increased risk of bleeding has been previously documented . 0 ###LEFT-WALL### 7 sensitivity 0 ###LEFT-WALL### 19 documented 0 ###LEFT-WALL### 20 . 1 moreover 2 , 1 moreover 7 sensitivity 3 in 5 patients 3 in 7 sensitivity 4 older 5 patients 5 patients 6 increased 7 sensitivity 8 to 7 sensitivity 10 resulting 7 sensitivity 16 has 8 to 9 warfarin 10 resulting 11 in 11 in 13 risk 12 increased 13 risk 13 risk 14 of 14 of 15 bleeding 16 has 17 been 17 been 19 documented 18 previously 19 documented on the other hand , reduced effectiveness of conventional doses of cardiovascular drugs , such as diuretics and β - blockers , has been observed . 0 ###LEFT-WALL### 7 effectiveness 0 ###LEFT-WALL### 25 observed 0 ###LEFT-WALL### 26 . 1 on 4 hand 1 on 5 , 1 on 7 effectiveness 2 the 3 other 3 other 4 hand 6 reduced 7 effectiveness 7 effectiveness 8 of 7 effectiveness 11 of 7 effectiveness 23 has 8 of 10 doses 9 conventional 10 doses 11 of 13 drugs 12 cardiovascular 13 drugs 13 drugs 16 as 14 , 16 as 15 such 16 as 16 as 18 and 16 as 22 , 17 diuretics 18 and 18 and 21 blockers 19 β 20 - 19 β 21 blockers 23 has 24 been 24 been 25 observed due to pharmacodynamic changes , therefore , dose adjustment of [the] above mentioned cardiovascular and psychotropic drugs is [recommended] [in] elderly . 0 ###LEFT-WALL### 9 adjustment 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 22 . 1 due 2 to 2 to 4 changes 2 to 5 , 2 to 9 adjustment 3 pharmacodynamic 4 changes 5 , 6 therefore 6 therefore 7 , 6 therefore 9 adjustment 8 dose 9 adjustment 9 adjustment 10 of 9 adjustment 18 is 10 of 12 above 12 above 17 drugs 13 mentioned 17 drugs 14 cardiovascular 15 and 15 and 16 psychotropic 15 and 17 drugs 18 is 21 elderly clinicians should be aware of the age - related physiologic changes affecting several organ systems and their implications on the effect of drugs that are commonly prescribed to elderly patients . 0 ###LEFT-WALL### 1 clinicians 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 9 related 0 ###LEFT-WALL### 31 . 1 clinicians 2 should 2 should 3 be 3 be 4 aware 4 aware 5 of 5 of 7 age 6 the 7 age 8 - 9 related 9 related 16 and 9 related 19 on 9 related 28 to 10 physiologic 11 changes 11 changes 12 affecting 11 changes 16 and 12 affecting 15 systems 13 several 15 systems 14 organ 15 systems 16 and 18 implications 17 their 18 implications 19 on 21 effect 20 the 21 effect 21 effect 22 of 22 of 23 drugs 23 drugs 24 that 23 drugs 25 are 24 that 25 are 25 are 26 commonly 25 are 27 prescribed 28 to 30 patients 29 elderly 30 patients changes in pharmacokinetics and pharmacodynamics , associated with increasing age , are often considered the only culprits of increasing adverse drug reactions ( adr ) rate observed in older adults , but other factors may be responsible for a reduction in drug efficacy and increase the risk of iatrogenic illness in this population . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 14 considered 0 ###LEFT-WALL### 27 observed 0 ###LEFT-WALL### 32 but 0 ###LEFT-WALL### 54 . 1 changes 2 in 1 changes 4 and 2 in 3 pharmacokinetics 4 and 5 pharmacodynamics 4 and 7 associated 4 and 12 are 6 , 7 associated 7 associated 8 with 7 associated 11 , 8 with 9 increasing 9 increasing 10 age 12 are 13 often 12 are 14 considered 15 the 16 only 15 the 17 culprits 17 culprits 18 of 17 culprits 22 reactions 17 culprits 26 rate 17 culprits 27 observed 18 of 19 increasing 19 increasing 21 drug 20 adverse 21 drug 22 reactions 24 adr 22 reactions 26 rate 23 ( 24 adr 24 adr 25 ) 27 observed 28 in 27 observed 31 , 28 in 30 adults 29 older 30 adults 32 but 34 factors 32 but 44 and 33 other 34 factors 34 factors 35 may 35 may 44 and 36 be 37 responsible 36 be 44 and 37 responsible 38 for 38 for 40 reduction 39 a 40 reduction 40 reduction 41 in 41 in 43 efficacy 42 drug 43 efficacy 44 and 45 increase 45 increase 47 risk 46 the 47 risk 47 risk 48 of 47 risk 51 in 48 of 50 illness 49 iatrogenic 50 illness 51 in 53 population 52 this 53 population the aging process is characterized by a high level of complexity , which makes the care of older adults and the use of medications a challenging task . 0 ###LEFT-WALL### 3 process 0 ###LEFT-WALL### 5 characterized 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 28 . 1 the 3 process 2 aging 3 process 3 process 4 is 4 is 5 characterized 5 characterized 6 by 6 by 9 level 7 a 8 high 7 a 9 level 8 high 9 level 9 level 10 of 10 of 11 complexity 12 , 13 which 12 , 14 makes 13 which 14 makes 14 makes 16 care 14 makes 27 task 15 the 16 care 16 care 17 of 17 of 20 and 18 older 19 adults 19 adults 20 and 20 and 22 use 20 and 23 of 21 the 22 use 23 of 24 medications 25 a 27 task 26 challenging 27 task in particular , comorbidity , geriatric syndromes , cognitive and functional deficits , limited life expectancy are typical conditions observed in older adults which may reduce the efficacy of prescribed drugs and increase the risk of iatrogenic illness . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 17 are 0 ###LEFT-WALL### 39 . 1 in 16 expectancy 1 in 17 are 2 particular 10 and 2 particular 16 expectancy 3 , 10 and 4 comorbidity 5 , 5 , 7 syndromes 5 , 8 , 6 geriatric 7 syndromes 8 , 9 cognitive 8 , 10 and 10 and 12 deficits 10 and 13 , 11 functional 12 deficits 14 limited 16 expectancy 15 life 16 expectancy 17 are 19 conditions 18 typical 19 conditions 19 conditions 20 observed 20 observed 21 in 21 in 23 adults 22 older 23 adults 23 adults 24 which 23 adults 32 and 24 which 32 and 25 may 26 reduce 25 may 32 and 26 reduce 28 efficacy 27 the 28 efficacy 28 efficacy 29 of 29 of 31 drugs 30 prescribed 31 drugs 32 and 33 increase 33 increase 35 risk 34 the 35 risk 35 risk 36 of 36 of 38 illness 37 iatrogenic 38 illness as a consequence , a comprehensive assessment and management of the health care problems , with the goal of recognizing and preventing potential drug - related problems and improve quality of prescribing is necessary to reduce the risk of adr . 0 ###LEFT-WALL### 30 quality 0 ###LEFT-WALL### 36 reduce 0 ###LEFT-WALL### 41 . 1 as 8 and 1 as 28 and 1 as 30 quality 2 a 3 consequence 3 consequence 4 , 4 , 7 assessment 4 , 8 and 5 a 6 comprehensive 5 a 7 assessment 6 comprehensive 7 assessment 8 and 9 management 8 and 10 of 8 and 16 with 8 and 28 and 10 of 14 problems 11 the 14 problems 12 health 13 care 13 care 14 problems 15 , 16 with 16 with 18 goal 16 with 25 - 17 the 18 goal 18 goal 19 of 19 of 21 and 20 recognizing 21 and 21 and 24 drug 22 preventing 24 drug 23 potential 24 drug 26 related 27 problems 26 related 28 and 28 and 29 improve 30 quality 31 of 30 quality 33 is 31 of 32 prescribing 33 is 34 necessary 34 necessary 35 to 34 necessary 36 reduce 35 to 36 reduce 36 reduce 38 risk 37 the 38 risk 38 risk 39 of 39 of 40 adr several studies have assessed the effect of a comprehensive geriatric assessment and management on drug prescribing and drug related illness , showing a substantial improvement in quality of prescription and a reduction [in] rate of adr . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 12 and 1 several 2 studies 2 studies 3 have 3 have 4 assessed 4 assessed 6 effect 5 the 6 effect 6 effect 7 of 7 of 11 assessment 8 a 11 assessment 9 comprehensive 11 assessment 10 geriatric 11 assessment 12 and 17 and 12 and 19 related 13 management 14 on 13 management 17 and 14 on 16 prescribing 15 drug 16 prescribing 17 and 18 drug 17 and 19 related 19 related 20 illness 20 illness 22 showing 21 , 22 showing 22 showing 25 improvement 22 showing 30 and 22 showing 37 . 23 a 24 substantial 23 a 25 improvement 24 substantial 25 improvement 25 improvement 26 in 26 in 27 quality 27 quality 28 of 28 of 29 prescription 30 and 34 rate 31 a 32 reduction 31 a 34 rate 32 reduction 34 rate 34 rate 35 of 35 of 36 adr in addition , clinical guidelines providing recommendations regarding the use of drugs in chronic disease rarely assess the level of complexity observed in older adults and therefore they should be applied with caution in this population . 0 ###LEFT-WALL### 5 guidelines 0 ###LEFT-WALL### 17 assess 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 37 . 1 in 2 addition 1 in 3 , 1 in 5 guidelines 4 clinical 5 guidelines 5 guidelines 6 providing 5 guidelines 17 assess 6 providing 7 recommendations 6 providing 13 in 7 recommendations 8 regarding 7 recommendations 11 of 8 regarding 10 use 9 the 10 use 11 of 12 drugs 13 in 15 disease 14 chronic 15 disease 16 rarely 17 assess 17 assess 19 level 17 assess 23 in 18 the 19 level 19 level 20 of 19 level 22 observed 20 of 21 complexity 23 in 25 adults 24 older 25 adults 26 and 27 therefore 26 and 28 they 26 and 31 applied 28 they 29 should 29 should 30 be 30 be 31 applied 31 applied 32 with 31 applied 34 in 32 with 33 caution 34 in 36 population 35 this 36 population ageing is characterized by a progressive decline in the functional reserve of multiple organs and systems , which can influence drug disposition . 0 ###LEFT-WALL### 1 ageing 0 ###LEFT-WALL### 3 characterized 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 23 . 1 ageing 2 is 2 is 3 characterized 3 characterized 4 by 3 characterized 8 in 4 by 7 decline 5 a 6 progressive 5 a 7 decline 6 progressive 7 decline 8 in 15 and 9 the 11 reserve 10 functional 11 reserve 11 reserve 12 of 11 reserve 15 and 12 of 14 organs 13 multiple 14 organs 15 and 16 systems 17 , 18 which 17 , 21 drug 18 which 19 can 18 which 21 drug 19 can 20 influence 19 can 21 drug 21 drug 22 disposition in addition , comorbidity and polypharmacy are highly prevalent in the elderly . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 13 . 1 in 2 addition 1 in 3 , 1 in 5 and 4 comorbidity 5 and 5 and 6 polypharmacy 5 and 7 are 7 are 8 highly 7 are 9 prevalent 9 prevalent 10 in 10 in 12 elderly 11 the 12 elderly as ageing is associated with some reduction in first - pass metabolism , bioavailability of a few drugs can be increased . 0 ###LEFT-WALL### 14 bioavailability 0 ###LEFT-WALL### 21 increased 0 ###LEFT-WALL### 22 . 1 as 2 ageing 1 as 4 associated 1 as 13 , 1 as 14 bioavailability 2 ageing 3 is 3 is 4 associated 4 associated 5 with 5 with 7 reduction 6 some 7 reduction 7 reduction 8 in 7 reduction 12 metabolism 8 in 9 first 10 - 12 metabolism 11 pass 12 metabolism 12 metabolism 13 , 14 bioavailability 15 of 14 bioavailability 19 can 15 of 18 drugs 16 a 17 few 17 few 18 drugs 19 can 20 be 20 be 21 increased with ageing body fat increases and total body water as well as lean body mass decrease . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 water 0 ###LEFT-WALL### 17 . 1 with 2 ageing 1 with 6 and 3 body 5 increases 4 fat 5 increases 5 increases 6 and 6 and 8 body 6 and 9 water 7 total 8 body 9 water 10 as 10 as 16 decrease 11 well 16 decrease 12 as 13 lean 13 lean 14 body 14 body 16 decrease 15 mass 16 decrease consequently , hydrophilic drugs have a smaller apparent volume of distribution ( v ) and lipophilic drugs have an increased v with a prolonged [half] [-] life . 0 ###LEFT-WALL### 4 drugs 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 28 . 1 consequently 2 , 1 consequently 4 drugs 3 hydrophilic 4 drugs 4 drugs 5 have 5 have 9 volume 6 a 9 volume 7 smaller 9 volume 8 apparent 9 volume 9 volume 10 of 10 of 11 distribution 11 distribution 13 v 12 ( 13 v 13 v 14 ) 15 and 17 drugs 15 and 18 have 16 lipophilic 17 drugs 17 drugs 18 have 18 have 21 v 18 have 22 with 19 an 21 v 20 increased 21 v 22 with 27 life 23 a 27 life 24 prolonged 27 life drugs with a high hepatic extraction ratio display some age - related decrease in systemic clearance ( cl ) , but for most drugs with a low hepatic extraction ratio , cl is not reduced with advancing age . 0 ###LEFT-WALL### 1 drugs 0 ###LEFT-WALL### 8 display 0 ###LEFT-WALL### 12 related 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 39 . 1 drugs 2 with 1 drugs 8 display 2 with 7 ratio 3 a 7 ratio 4 high 6 extraction 5 hepatic 6 extraction 6 extraction 7 ratio 8 display 10 age 9 some 10 age 11 - 12 related 12 related 13 decrease 12 related 31 , 13 decrease 14 in 14 in 16 clearance 15 systemic 16 clearance 16 clearance 18 cl 16 clearance 21 but 17 ( 18 cl 18 cl 19 ) 20 , 21 but 21 but 22 for 21 but 31 , 22 for 24 drugs 23 most 24 drugs 24 drugs 25 with 25 with 30 ratio 26 a 30 ratio 27 low 30 ratio 28 hepatic 29 extraction 29 extraction 30 ratio 31 , 32 cl 31 , 35 reduced 32 cl 33 is 33 is 34 not 33 is 35 reduced 35 reduced 36 with 36 with 37 advancing 37 advancing 38 age in general , activities of cytochrome p450 enzymes are preserved in normal ageing and the genetic influence is much more striking than age effects . 0 ###LEFT-WALL### 4 activities 0 ###LEFT-WALL### 10 preserved 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 in 2 general 2 general 3 , 2 general 4 activities 4 activities 5 of 4 activities 9 are 5 of 8 enzymes 6 cytochrome 8 enzymes 7 p450 8 enzymes 9 are 10 preserved 10 preserved 11 in 11 in 13 ageing 12 normal 13 ageing 14 and 17 influence 14 and 18 is 15 the 17 influence 16 genetic 17 influence 17 influence 18 is 18 is 21 striking 19 much 20 more 20 more 21 striking 21 striking 22 than 22 than 24 effects 23 age 24 effects drug transporters play an important role in pharmacokinetic processes , but their function and pharmacology have not yet been fully examined for agerelated effects . 0 ###LEFT-WALL### 2 transporters 0 ###LEFT-WALL### 3 play 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 25 . 1 drug 2 transporters 2 transporters 3 play 3 play 6 role 3 play 7 in 4 an 5 important 4 an 6 role 5 important 6 role 7 in 9 processes 8 pharmacokinetic 9 processes 10 , 11 but 11 but 14 and 11 but 21 examined 12 their 13 function 13 function 14 and 14 and 15 pharmacology 14 and 16 have 16 have 17 not 16 have 19 been 18 yet 19 been 19 been 21 examined 20 fully 21 examined 21 examined 22 for 22 for 24 effects 23 agerelated 24 effects one third of elderly persons show no decrease in renal function [(] gfr > 70 ml/min/1.73 m2 [ )( 0 ###LEFT-WALL### 2 third 0 ###LEFT-WALL### 6 show 0 ###LEFT-WALL### 19 )( 1 one 2 third 2 third 3 of 2 third 6 show 3 of 5 persons 4 elderly 5 persons 6 show 8 decrease 6 show 9 in 6 show 15 70 6 show 16 ml/min/1.73 7 no 8 decrease 9 in 13 gfr 10 renal 11 function 11 function 13 gfr 14 > 15 70 15 70 16 ml/min/1.73 16 ml/min/1.73 17 m2 in about two thirds of elderly subjects , the age - related decline [of] renal function [was] associated with coexisting cardiovascular diseases and other risk factors . 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 25 risk 0 ###LEFT-WALL### 27 . 1 in 2 about 1 in 23 and 2 about 4 thirds 3 two 4 thirds 4 thirds 5 of 4 thirds 12 related 4 thirds 19 with 5 of 7 subjects 6 elderly 7 subjects 7 subjects 10 age 8 , 10 age 9 the 10 age 10 age 11 - 12 related 18 associated 13 decline 18 associated 15 renal 16 function 16 function 18 associated 19 with 20 coexisting 20 coexisting 22 diseases 21 cardiovascular 22 diseases 23 and 24 other 23 and 25 risk 25 risk 26 factors in the elderly a large interindividual variability in drug disposition is particularly prominent . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 14 . 1 in 3 elderly 1 in 11 is 2 the 3 elderly 4 a 5 large 4 a 7 variability 5 large 7 variability 6 interindividual 7 variability 7 variability 8 in 7 variability 11 is 8 in 10 disposition 9 drug 10 disposition 11 is 13 prominent 12 particularly 13 prominent in conclusion , the complexity of interactions between comorbidity , polypharmacy , and age - related changes in pharmacokinetics ( and pharmacodynamics ) justify the old and well - known dosing aphorism " start low , go slow " for aged individuals . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 justify 0 ###LEFT-WALL### 29 - 0 ###LEFT-WALL### 38 slow 0 ###LEFT-WALL### 43 . 1 in 2 conclusion 2 conclusion 3 , 3 , 5 complexity 3 , 13 and 4 the 5 complexity 5 complexity 6 of 6 of 7 interactions 7 interactions 8 between 7 interactions 11 polypharmacy 8 between 9 comorbidity 10 , 11 polypharmacy 11 polypharmacy 12 , 12 , 13 and 13 and 14 age 13 and 24 justify 15 - 16 related 16 related 17 changes 16 related 18 in 16 related 23 ) 16 related 24 justify 18 in 21 and 19 pharmacokinetics 21 and 20 ( 21 and 21 and 22 pharmacodynamics 24 justify 27 and 25 the 26 old 26 old 27 and 27 and 28 well 29 - 35 low 29 - 36 , 30 known 35 low 31 dosing 34 start 32 aphorism 33 " 32 aphorism 34 start 34 start 35 low 36 , 37 go 37 go 38 slow 38 slow 39 " 38 slow 40 for 40 for 42 individuals 41 aged 42 individuals for more than thirty years , the dog has been used as a model for human diseases . 0 ###LEFT-WALL### 8 dog 0 ###LEFT-WALL### 11 used 0 ###LEFT-WALL### 18 . 1 for 5 years 1 for 6 , 1 for 8 dog 2 more 3 than 3 than 4 thirty 4 thirty 5 years 7 the 8 dog 8 dog 9 has 9 has 10 been 10 been 11 used 11 used 12 as 12 as 14 model 13 a 14 model 14 model 15 for 15 for 17 diseases 16 human 17 diseases despite efforts made to develop canine embryonic stem cells , success has been elusive . 0 ###LEFT-WALL### 11 success 0 ###LEFT-WALL### 13 been 0 ###LEFT-WALL### 15 . 1 despite 2 efforts 1 despite 10 , 1 despite 11 success 2 efforts 3 made 2 efforts 4 to 2 efforts 5 develop 4 to 5 develop 5 develop 9 cells 6 canine 8 stem 7 embryonic 8 stem 8 stem 9 cells 11 success 12 has 12 has 13 been 13 been 14 elusive here , we report the generation of canine induced pluripotent stem cells ( cipscs ) from canine adult fibroblasts , which we accomplished by introducing human oct4 , sox2 , c - myc , and klf4 . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 37 . 1 here 2 , 1 here 3 we 3 we 4 report 4 report 35 and 5 the 6 generation 6 generation 7 of 6 generation 16 from 6 generation 35 and 7 of 12 cells 8 canine 10 pluripotent 9 induced 10 pluripotent 10 pluripotent 12 cells 11 stem 12 cells 12 cells 14 cipscs 13 ( 14 cipscs 14 cipscs 15 ) 16 from 19 fibroblasts 17 canine 18 adult 18 adult 19 fibroblasts 19 fibroblasts 21 which 19 fibroblasts 29 sox2 19 fibroblasts 32 - 20 , 21 which 21 which 23 accomplished 21 which 28 , 22 we 23 accomplished 23 accomplished 24 by 24 by 25 introducing 25 introducing 27 oct4 26 human 27 oct4 28 , 29 sox2 29 sox2 30 , 30 , 32 - 31 c 32 - 32 - 33 myc 32 - 34 , 34 , 35 and 35 and 36 klf4 the cipscs expressed critical pluripotency markers and showed evidence of silencing the viral vectors and [normal] karyotypes . 0 ###LEFT-WALL### 2 cipscs 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 18 . 1 the 2 cipscs 2 cipscs 7 and 3 expressed 6 markers 3 expressed 7 and 4 critical 5 pluripotency 5 pluripotency 6 markers 7 and 15 and 8 showed 9 evidence 8 showed 15 and 9 evidence 10 of 10 of 11 silencing 11 silencing 14 vectors 12 the 14 vectors 13 viral 14 vectors 15 and 17 karyotypes microsatellite analysis indicated that the cipscs showed the same profile as the donor fibroblasts but differed from cells taken from other dogs . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 23 . 1 microsatellite 2 analysis 2 analysis 15 but 3 indicated 4 that 3 indicated 15 but 4 that 6 cipscs 4 that 7 showed 5 the 6 cipscs 6 cipscs 7 showed 7 showed 10 profile 7 showed 11 as 8 the 9 same 9 same 10 profile 11 as 14 fibroblasts 12 the 14 fibroblasts 13 donor 14 fibroblasts 15 but 16 differed 16 differed 17 from 16 differed 20 from 17 from 18 cells 18 cells 19 taken 20 from 22 dogs 21 other 22 dogs under culture conditions favoring differentiation , the cipscs could form cell derivatives from the ectoderm , mesoderm , and endoderm . 0 ###LEFT-WALL### 8 cipscs 0 ###LEFT-WALL### 10 form 0 ###LEFT-WALL### 21 . 1 under 3 conditions 1 under 6 , 1 under 8 cipscs 2 culture 3 conditions 3 conditions 4 favoring 4 favoring 5 differentiation 7 the 8 cipscs 8 cipscs 9 could 9 could 10 form 10 form 12 derivatives 10 form 13 from 11 cell 12 derivatives 13 from 19 and 14 the 15 ectoderm 15 ectoderm 16 , 16 , 17 mesoderm 16 , 19 and 18 , 19 and 19 and 20 endoderm further , the cipscs required leukemia inhibitory factor and basic fibroblast growth factor to survive , proliferate , and maintain pluripotency . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 13 factor 0 ###LEFT-WALL### 22 . 1 further 2 , 1 further 9 and 3 the 8 factor 4 cipscs 5 required 5 required 6 leukemia 6 leukemia 8 factor 7 inhibitory 8 factor 8 factor 9 and 9 and 12 growth 9 and 13 factor 10 basic 12 growth 11 fibroblast 12 growth 13 factor 14 to 13 factor 21 pluripotency 14 to 16 , 15 survive 16 , 16 , 19 and 17 proliferate 19 and 18 , 19 and 19 and 20 maintain our results demonstrate an efficient method for deriving canine pluripotent stem cells , providing a powerful platform for the development of new models for regenerative medicine , as well as for the study of the onset , progression , and treatment of human and canine genetic diseases . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 37 , 0 ###LEFT-WALL### 48 . 1 our 2 results 2 results 3 demonstrate 3 demonstrate 6 method 4 an 5 efficient 4 an 6 method 5 efficient 6 method 6 method 7 for 7 for 8 deriving 8 deriving 12 cells 8 deriving 29 well 8 deriving 30 as 9 canine 10 pluripotent 10 pluripotent 12 cells 11 stem 12 cells 12 cells 14 providing 13 , 14 providing 14 providing 17 platform 14 providing 24 for 14 providing 27 , 15 a 16 powerful 15 a 17 platform 16 powerful 17 platform 17 platform 18 for 17 platform 21 of 18 for 20 development 19 the 20 development 21 of 23 models 22 new 23 models 24 for 26 medicine 25 regenerative 26 medicine 28 as 29 well 30 as 31 for 31 for 33 study 32 the 33 study 33 study 34 of 34 of 36 onset 35 the 36 onset 37 , 40 and 38 progression 40 and 39 , 40 and 40 and 41 treatment 41 treatment 42 of 42 of 47 diseases 43 human 44 and 44 and 45 canine 44 and 47 diseases 46 genetic 47 diseases sterol metabolites are critical signaling molecules that regulate metabolism , development , and homeostasis . 0 ###LEFT-WALL### 2 metabolites 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 15 . 1 sterol 2 metabolites 2 metabolites 3 are 3 are 13 and 4 critical 5 signaling 4 critical 10 , 5 signaling 6 molecules 6 molecules 7 that 6 molecules 8 regulate 7 that 8 regulate 8 regulate 9 metabolism 10 , 11 development 10 , 13 and 12 , 13 and 13 and 14 homeostasis oxysterols , bile acids ( bas [ )(, and steroids work primarily through cognate sterol - responsive nuclear hormone receptors to control these processes through feed - forward [and] feedback mechanisms . 0 ###LEFT-WALL### 1 oxysterols 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 32 . 2 , 4 acids 2 , 28 forward 3 bile 4 acids 4 acids 9 and 4 acids 20 receptors 4 acids 28 forward 5 ( 9 and 6 bas 9 and 8 )(, 9 and 9 and 15 sterol 9 and 16 - 10 steroids 15 sterol 11 work 15 sterol 12 primarily 13 through 13 through 14 cognate 14 cognate 15 sterol 16 - 20 receptors 17 responsive 19 hormone 18 nuclear 19 hormone 19 hormone 20 receptors 20 receptors 21 to 20 receptors 22 control 20 receptors 27 - 21 to 22 control 22 control 24 processes 22 control 25 through 23 these 24 processes 25 through 26 feed 28 forward 31 mechanisms 30 feedback 31 mechanisms these signaling pathways are conserved from simple invertebrates to mammals . 0 ###LEFT-WALL### 3 pathways 0 ###LEFT-WALL### 5 conserved 0 ###LEFT-WALL### 11 . 1 these 3 pathways 2 signaling 3 pathways 3 pathways 4 are 4 are 5 conserved 5 conserved 6 from 5 conserved 9 to 6 from 8 invertebrates 7 simple 8 invertebrates 9 to 10 mammals indeed , results from various model organisms have yielded fundamental insights into cholesterol and ba homeostasis , lipid and glucose metabolism , protective mechanisms , tissue differentiation , development , reproduction , and even aging . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 36 . 1 indeed 2 , 1 indeed 3 results 3 results 4 from 3 results 33 and 4 from 7 organisms 5 various 6 model 6 model 7 organisms 8 have 9 yielded 8 have 33 and 9 yielded 11 insights 9 yielded 12 into 10 fundamental 11 insights 12 into 19 and 13 cholesterol 14 and 14 and 16 homeostasis 14 and 17 , 15 ba 16 homeostasis 17 , 18 lipid 17 , 19 and 19 and 21 metabolism 19 and 24 mechanisms 19 and 27 differentiation 19 and 31 reproduction 20 glucose 21 metabolism 22 , 24 mechanisms 23 protective 24 mechanisms 24 mechanisms 25 , 25 , 27 differentiation 26 tissue 27 differentiation 27 differentiation 29 development 27 differentiation 30 , 28 , 29 development 29 development 30 , 30 , 31 reproduction 31 reproduction 32 , 33 and 34 even 34 even 35 aging here , we review [how] sterols act through evolutionarily ancient mechanisms to control these processes . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 16 . 1 here 2 , 1 here 3 we 3 we 4 review 4 review 11 mechanisms 4 review 12 to 6 sterols 11 mechanisms 7 act 11 mechanisms 8 through 11 mechanisms 9 evolutionarily 10 ancient 10 ancient 11 mechanisms 12 to 13 control 13 control 15 processes 14 these 15 processes none none none this paper analyses the literature available on the contribution of grandparents to society and the synergies that develop between grandparents and grandchildren , which are increasingly important to families and the individuals involved . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 37 . 1 none 5 paper 1 none 6 analyses 1 none 36 involved 2 none 3 none 3 none 4 this 4 this 5 paper 5 paper 6 analyses 6 analyses 8 literature 6 analyses 10 on 6 analyses 15 to 7 the 8 literature 8 literature 9 available 10 on 12 contribution 11 the 12 contribution 12 contribution 13 of 13 of 14 grandparents 15 to 17 and 16 society 17 and 17 and 19 synergies 17 and 20 that 17 and 21 develop 18 the 19 synergies 20 that 21 develop 21 develop 22 between 22 between 33 and 23 grandparents 24 and 24 and 25 grandchildren 24 and 26 , 24 and 27 which 24 and 28 are 24 and 33 and 27 which 28 are 28 are 29 increasingly 28 are 30 important 30 important 31 to 31 to 32 families 33 and 35 individuals 34 the 35 individuals the paper interrogates the need for those who are ageing to find goals in life that are life affirming and the way in which grandparenting is contributing to social capital . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 interrogates 1 the 2 paper 2 paper 3 interrogates 3 interrogates 5 need 3 interrogates 6 for 4 the 5 need 6 for 7 those 7 those 8 who 7 those 9 are 8 who 9 are 9 are 20 and 10 ageing 11 to 10 ageing 20 and 11 to 13 goals 12 find 13 goals 13 goals 14 in 13 goals 16 that 13 goals 17 are 14 in 15 life 16 that 17 are 17 are 19 affirming 18 life 19 affirming 20 and 22 way 20 and 31 . 21 the 22 way 22 way 23 in 23 in 24 which 23 in 25 grandparenting 23 in 26 is 25 grandparenting 26 is 26 is 27 contributing 27 contributing 28 to 28 to 30 capital 29 social 30 capital nutritional problems and deficiencies are widespread in geriatric institutions . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 10 . 1 nutritional 2 problems 2 problems 3 and 3 and 4 deficiencies 3 and 5 are 5 are 6 widespread 6 widespread 7 in 7 in 9 institutions 8 geriatric 9 institutions on the other hand , benefits of different interventions to [improve] the nutritional situation of elderly people -- from amelioration of mealtime ambience to the use of artificial nutrition -- have been shown in many studies . 0 ###LEFT-WALL### 6 benefits 0 ###LEFT-WALL### 33 shown 0 ###LEFT-WALL### 37 . 1 on 4 hand 1 on 5 , 1 on 6 benefits 2 the 3 other 3 other 4 hand 6 benefits 7 of 6 benefits 10 to 6 benefits 31 have 7 of 9 interventions 8 different 9 interventions 10 to 14 situation 12 the 14 situation 13 nutritional 14 situation 14 situation 15 of 15 of 17 people 16 elderly 17 people 17 people 19 from 18 -- 19 from 19 from 20 amelioration 19 from 30 -- 20 amelioration 21 of 21 of 23 ambience 22 mealtime 23 ambience 23 ambience 24 to 24 to 26 use 25 the 26 use 26 use 27 of 27 of 29 nutrition 28 artificial 29 nutrition 31 have 32 been 32 been 33 shown 33 shown 34 in 34 in 36 studies 35 many 36 studies in recent years , several guidelines and standards have been developed to facilitate the transfer of this scientific knowledge into practice . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 11 developed 0 ###LEFT-WALL### 22 . 1 in 3 years 1 in 4 , 1 in 7 and 2 recent 3 years 5 several 6 guidelines 6 guidelines 7 and 7 and 8 standards 7 and 9 have 9 have 10 been 10 been 11 developed 11 developed 12 to 12 to 13 facilitate 13 facilitate 15 transfer 13 facilitate 20 into 14 the 15 transfer 15 transfer 16 of 16 of 19 knowledge 17 this 18 scientific 18 scientific 19 knowledge 20 into 21 practice these are in particular [the] medical guidelines for enteral and parenteral nutrition in geriatrics ( dgem/dgg and espen ) , the dnqp expert standard for qualified nurses , the dge quality standards for dietetic personnel , and the interdisciplinary buko - qs standard . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 are 1 these 2 are 2 are 3 in 2 are 13 in 3 in 10 and 4 particular 7 guidelines 6 medical 7 guidelines 7 guidelines 8 for 7 guidelines 10 and 8 for 9 enteral 10 and 12 nutrition 11 parenteral 12 nutrition 13 in 14 geriatrics 14 geriatrics 18 espen 14 geriatrics 24 standard 15 ( 18 espen 16 dgem/dgg 17 and 17 and 18 espen 18 espen 19 ) 20 , 24 standard 21 the 24 standard 22 dnqp 23 expert 23 expert 24 standard 24 standard 25 for 24 standard 44 . 25 for 37 and 26 qualified 27 nurses 27 nurses 28 , 28 , 32 standards 28 , 37 and 29 the 32 standards 30 dge 31 quality 31 quality 32 standards 32 standards 33 for 33 for 35 personnel 34 dietetic 35 personnel 36 , 37 and 37 and 43 standard 38 the 43 standard 39 interdisciplinary 43 standard 40 buko 42 qs 41 - 42 qs 42 qs 43 standard these guidelines and standards provide recommendations for adequate nutritional care and assistance for the institutionalized elderly person based on the scientific state of the art . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 5 provide 0 ###LEFT-WALL### 26 . 1 these 2 guidelines 2 guidelines 3 and 3 and 4 standards 3 and 5 provide 5 provide 6 recommendations 6 recommendations 7 for 6 recommendations 13 for 7 for 11 and 8 adequate 10 care 9 nutritional 10 care 10 care 11 and 11 and 12 assistance 13 for 17 person 14 the 17 person 15 institutionalized 17 person 16 elderly 17 person 17 person 18 based 18 based 19 on 19 on 22 state 20 the 22 state 21 scientific 22 state 22 state 23 of 23 of 25 art 24 the 25 art they should be used as the basis for the development of local instructions for the management of nutritional problems and malnutrition . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 22 . 1 they 2 should 2 should 3 be 3 be 4 used 4 used 5 as 5 as 7 basis 6 the 7 basis 7 basis 8 for 7 basis 11 of 8 for 10 development 9 the 10 development 11 of 13 instructions 12 local 13 instructions 13 instructions 14 for 13 instructions 17 of 14 for 16 management 15 the 16 management 17 of 20 and 18 nutritional 19 problems 19 problems 20 and 20 and 21 malnutrition elderly people will only profit , if these guidelines are used in daily routine . 0 ###LEFT-WALL### 2 people 0 ###LEFT-WALL### 5 profit 1 elderly 2 people 2 people 3 will 3 will 5 profit 4 only 5 profit 5 profit 7 if 6 , 7 if 7 if 9 guidelines 7 if 11 used 7 if 15 . 8 these 9 guidelines 9 guidelines 10 are 10 are 11 used 11 used 12 in 12 in 14 routine 13 daily 14 routine purpose : results from a number of studies have suggested a relationship between cognitive alteration and benzodiazepine use in the elderly . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 results 2 : 10 suggested 3 results 4 from 3 results 9 have 4 from 8 studies 5 a 6 number 6 number 7 of 6 number 8 studies 7 of 8 studies 9 have 10 suggested 10 suggested 12 relationship 10 suggested 13 between 10 suggested 19 in 11 a 12 relationship 13 between 16 and 14 cognitive 15 alteration 15 alteration 16 and 16 and 18 use 17 benzodiazepine 18 use 19 in 21 elderly 20 the 21 elderly the aim of this study was to determine the impact of benzodiazepine use on cognitive functions in a young adult population . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 22 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 determine 7 to 8 determine 8 determine 10 impact 8 determine 14 on 8 determine 17 in 9 the 10 impact 10 impact 11 of 11 of 13 use 12 benzodiazepine 13 use 14 on 16 functions 15 cognitive 16 functions 17 in 21 population 18 a 19 young 18 a 21 population 19 young 20 adult 20 adult 21 population methods : this study included 1,019 french salaried workers from the visat ( aging , health and work ) cohort whose objective was to determine the long - term impact of working conditions on health and aging . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 included 2 : 38 . 3 this 4 study 4 study 5 included 5 included 9 workers 5 included 10 from 6 1,019 9 workers 7 french 9 workers 8 salaried 9 workers 10 from 20 cohort 11 the 20 cohort 12 visat 17 and 12 visat 20 cohort 13 ( 17 and 14 aging 15 , 15 , 16 health 15 , 17 and 17 and 18 work 17 and 19 ) 20 cohort 21 whose 20 cohort 31 of 21 whose 22 objective 22 objective 23 was 23 was 24 to 23 was 25 determine 24 to 25 determine 25 determine 30 impact 26 the 30 impact 27 long 28 - 27 long 30 impact 29 term 30 impact 31 of 32 working 32 working 33 conditions 32 working 34 on 34 on 36 and 35 health 36 and 36 and 37 aging data were collected during interviews by occupational physicians in 1996 , 2001 and 2006 . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 2 were 1 data 2 were 2 were 3 collected 3 collected 4 during 3 collected 6 by 3 collected 9 in 4 during 5 interviews 6 by 8 physicians 7 occupational 8 physicians 9 in 10 1996 10 1996 13 and 11 , 13 and 12 2001 13 and 13 and 14 2006 13 and 15 . cognitive [function] was assessed using five cognitive tests ( immediate free recall [test] , delayed free recall test , recognition test , digit symbol substitution subtest and visual search speed test ) . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 33 . 1 cognitive 3 was 3 was 4 assessed 4 assessed 5 using 5 using 8 tests 6 five 8 tests 7 cognitive 8 tests 8 tests 12 recall 9 ( 12 recall 10 immediate 12 recall 11 free 12 recall 12 recall 14 , 14 , 18 test 14 , 19 , 15 delayed 17 recall 16 free 17 recall 17 recall 18 test 19 , 21 test 19 , 22 , 20 recognition 21 test 22 , 27 and 23 digit 24 symbol 24 symbol 25 substitution 25 substitution 26 subtest 26 subtest 27 and 27 and 31 test 27 and 32 ) 28 visual 29 search 29 search 31 test 30 speed 31 test cognitive scores obtained after a 10 [-] year follow - up were investigated [among] three categories of benzodiazepine users , namely , [non] - users , occasional users and long - term users , using analysis of covariance models adjusted for several potential confounders in men and women [separately] . 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 9 follow 0 ###LEFT-WALL### 10 - 1 cognitive 2 scores 2 scores 3 obtained 2 scores 9 follow 3 obtained 4 after 4 after 8 year 5 a 8 year 6 10 8 year 10 - 11 up 10 - 12 were 10 - 22 , 11 up 12 were 12 were 16 categories 12 were 21 namely 13 investigated 16 categories 15 three 16 categories 16 categories 17 of 17 of 19 users 18 benzodiazepine 19 users 20 , 21 namely 21 namely 22 , 22 , 24 - 22 , 32 term 22 , 34 , 24 - 29 and 25 users 26 , 26 , 28 users 26 , 29 and 27 occasional 28 users 29 and 30 long 29 and 31 - 29 and 32 term 32 term 33 users 34 , 36 analysis 34 , 40 adjusted 35 using 36 analysis 36 analysis 37 of 36 analysis 40 adjusted 37 of 39 models 38 covariance 39 models 40 adjusted 41 for 40 adjusted 45 in 41 for 44 confounders 42 several 43 potential 43 potential 44 confounders 45 in 47 and 46 men 47 and 47 and 48 women 47 and 50 . results : in the course of the 10 year - follow - up , 3.9 % of subjects were defined as occasional users of benzodiazepine [and] 7.5 % as long - term users . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 34 . 1 results 2 : 2 : 3 in 3 in 5 course 4 the 5 course 5 course 6 of 6 of 9 year 7 the 9 year 8 10 9 year 10 - 11 follow 10 - 12 - 12 - 13 up 12 - 14 , 14 , 16 % 14 , 20 defined 15 3.9 16 % 16 % 17 of 16 % 19 were 17 of 18 subjects 19 were 20 defined 20 defined 21 as 21 as 23 users 22 occasional 23 users 23 users 24 of 24 of 33 users 25 benzodiazepine 33 users 27 7.5 28 % 28 % 33 users 29 as 30 long 30 long 31 - 30 long 32 term 32 term 33 users the analysis revealed a significant alteration of long - term memory in women whereas there was no significant association in men . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 22 . 1 the 2 analysis 2 analysis 3 revealed 3 revealed 6 alteration 3 revealed 12 in 3 revealed 14 whereas 3 revealed 20 in 4 a 5 significant 4 a 6 alteration 5 significant 6 alteration 6 alteration 7 of 7 of 11 memory 8 long 9 - 8 long 10 term 10 term 11 memory 12 in 13 women 14 whereas 15 there 14 whereas 16 was 15 there 16 was 16 was 19 association 17 no 19 association 18 significant 19 association 20 in 21 men conclusions : long - term use of benzodiazepine leads to specific impairment in long - term memory only in women . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 conclusions 2 : 2 : 6 use 2 : 10 to 2 : 13 in 2 : 18 only 3 long 4 - 3 long 5 term 5 term 6 use 6 use 7 of 7 of 9 leads 8 benzodiazepine 9 leads 10 to 12 impairment 11 specific 12 impairment 13 in 17 memory 14 long 15 - 14 long 16 term 16 term 17 memory 18 only 19 in 19 in 20 women neuroaxonal degeneration in the central nervous system contributes substantially to the long term disability in multiple sclerosis ( [ms] [ )(patients . 0 ###LEFT-WALL### 2 degeneration 0 ###LEFT-WALL### 8 contributes 1 neuroaxonal 2 degeneration 2 degeneration 3 in 2 degeneration 8 contributes 3 in 7 system 4 the 7 system 5 central 7 system 6 nervous 7 system 8 contributes 9 substantially 8 contributes 10 to 8 contributes 15 in 10 to 14 disability 11 the 14 disability 12 long 13 term 13 term 14 disability 15 in 17 sclerosis 16 multiple 17 sclerosis 17 sclerosis 21 )(patients 18 ( 21 )(patients 21 )(patients 22 . however , in vivo determination and monitoring of neurodegeneration remain difficult . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 remain 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 6 and 3 in 4 vivo 4 vivo 6 and 5 determination 6 and 6 and 7 monitoring 6 and 10 remain 7 monitoring 8 of 8 of 9 neurodegeneration 10 remain 11 difficult as the widely used mri - based approaches , including the brain parenchymal fraction ( bpf ) have some limitations , complementary in vivo measures for neurodegeneration are necessary . 0 ###LEFT-WALL### 8 approaches 0 ###LEFT-WALL### 18 have 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 30 . 1 as 5 mri 1 as 6 - 1 as 8 approaches 2 the 5 mri 3 widely 4 used 4 used 5 mri 7 based 8 approaches 8 approaches 10 including 8 approaches 18 have 9 , 10 including 10 including 14 fraction 10 including 17 ) 11 the 14 fraction 12 brain 14 fraction 13 parenchymal 14 fraction 14 fraction 16 bpf 15 ( 16 bpf 16 bpf 17 ) 18 have 20 limitations 19 some 20 limitations 21 , 22 complementary 21 , 28 are 22 complementary 24 vivo 22 complementary 28 are 23 in 24 vivo 25 measures 26 for 25 measures 28 are 26 for 27 neurodegeneration 28 are 29 necessary optical coherence tomography ( oct ) is a potent tool for the detection [of] [ms] - related retinal neurodegeneration . 0 ###LEFT-WALL### 3 tomography 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 17 related 1 optical 2 coherence 2 coherence 3 tomography 3 tomography 5 oct 3 tomography 7 is 4 ( 5 oct 5 oct 6 ) 7 is 10 tool 8 a 9 potent 8 a 10 tool 9 potent 10 tool 10 tool 11 for 11 for 13 detection 12 the 13 detection 16 - 17 related 17 related 19 neurodegeneration 17 related 20 . 18 retinal 19 neurodegeneration however , crucial aspects including the association between oct - and mri - based atrophy measures or the impact [of] [ms] - related parameters on oct parameters are still unclear . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 28 are 0 ###LEFT-WALL### 31 . 1 however 2 , 1 however 11 and 3 crucial 4 aspects 4 aspects 5 including 4 aspects 11 and 5 including 7 association 5 including 8 between 6 the 7 association 8 between 9 oct 10 - 11 and 11 and 12 mri 11 and 22 - 11 and 28 are 12 mri 17 or 13 - 17 or 14 based 16 measures 15 atrophy 16 measures 16 measures 17 or 17 or 19 impact 17 or 22 - 18 the 19 impact 22 - 23 related 23 related 24 parameters 23 related 25 on 23 related 28 are 25 on 27 parameters 26 oct 27 parameters 28 are 29 still 28 are 30 unclear in this large prospective cross - sectional study on 104 relapsing remitting multiple sclerosis ( rrms ) patients we evaluated the associations of retinal nerve fiber layer thickness ( rnflt ) and total macular volume ( tmv ) with bpf and addressed the impact of disease - determining parameters on rnflt , tmv or bpf . 0 ###LEFT-WALL### 18 patients 0 ###LEFT-WALL### 32 and 1 in 5 cross 1 in 18 patients 2 this 5 cross 3 large 5 cross 4 prospective 5 cross 5 cross 8 study 6 - 8 study 7 sectional 8 study 8 study 9 on 8 study 17 ) 9 on 10 104 10 104 11 relapsing 10 104 12 remitting 12 remitting 14 sclerosis 13 multiple 14 sclerosis 14 sclerosis 16 rrms 15 ( 16 rrms 16 rrms 17 ) 18 patients 19 we 18 patients 20 evaluated 18 patients 32 and 19 we 20 evaluated 20 evaluated 22 associations 21 the 22 associations 22 associations 23 of 23 of 26 fiber 24 retinal 25 nerve 25 nerve 26 fiber 27 layer 28 thickness 27 layer 32 and 28 thickness 30 rnflt 29 ( 30 rnflt 30 rnflt 31 ) 32 and 41 and 32 and 48 determining 33 total 35 volume 33 total 39 with 33 total 41 and 34 macular 35 volume 35 volume 37 tmv 36 ( 37 tmv 37 tmv 38 ) 39 with 40 bpf 41 and 42 addressed 42 addressed 44 impact 43 the 44 impact 44 impact 45 of 45 of 46 disease 47 - 48 determining 48 determining 49 parameters 48 determining 50 on 48 determining 56 . 50 on 54 or 51 rnflt 53 tmv 52 , 53 tmv 53 tmv 54 or 54 or 55 bpf bpf , normalized for subject head size , was estimated with sienax . 0 ###LEFT-WALL### 1 bpf 0 ###LEFT-WALL### 10 estimated 0 ###LEFT-WALL### 13 . 1 bpf 3 normalized 1 bpf 9 was 2 , 3 normalized 3 normalized 4 for 3 normalized 8 , 4 for 7 size 5 subject 6 head 6 head 7 size 9 was 10 estimated 10 estimated 11 with 11 with 12 sienax relations were analyzed primarily by generalized estimating equation ( gee ) models considering within - patient [inter] - eye relations . 0 ###LEFT-WALL### 1 relations 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 15 - 1 relations 2 were 2 were 3 analyzed 3 analyzed 4 primarily 4 primarily 5 by 5 by 7 estimating 6 generalized 7 estimating 7 estimating 10 gee 7 estimating 14 within 8 equation 10 gee 9 ( 10 gee 10 gee 11 ) 10 gee 12 models 12 models 13 considering 12 models 14 within 15 - 20 relations 15 - 21 . 16 patient 18 - 16 patient 19 eye 19 eye 20 relations we found that both rnflt ( p = 0.019 , gee ) and tmv ( p = 0.004 , gee ) associate with bpf . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 25 . 1 we 19 , 2 found 3 that 2 found 5 rnflt 2 found 13 and 2 found 17 = 2 found 19 , 4 both 5 rnflt 5 rnflt 8 = 5 rnflt 11 gee 6 ( 8 = 7 p 8 = 8 = 9 0.019 10 , 11 gee 11 gee 12 ) 13 and 14 tmv 15 ( 17 = 16 p 17 = 17 = 18 0.004 19 , 22 associate 19 , 23 with 20 gee 21 ) 20 gee 22 associate 23 with 24 bpf rnflt was furthermore linked to the disease duration ( p<0.001 , gee ) but neither to disease severity [nor] patients ' age . 0 ###LEFT-WALL### 1 rnflt 0 ###LEFT-WALL### 4 linked 0 ###LEFT-WALL### 23 . 1 rnflt 2 was 2 was 4 linked 3 furthermore 4 linked 4 linked 5 to 4 linked 14 but 4 linked 16 to 5 to 8 duration 6 the 8 duration 7 disease 8 duration 8 duration 10 p<0.001 8 duration 12 gee 9 ( 10 p<0.001 10 p<0.001 11 , 11 , 12 gee 12 gee 13 ) 14 but 15 neither 16 to 22 age 17 disease 20 patients 18 severity 20 patients 20 patients 21 ' 21 ' 22 age contrarily , bpf was [rather] associated with severity ( p<0.001 , gee ) than disease duration and was confounded by age ( p<0.001 , gee ) . 0 ###LEFT-WALL### 3 bpf 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 27 . 1 contrarily 2 , 1 contrarily 3 bpf 3 bpf 4 was 4 was 17 and 6 associated 7 with 6 associated 17 and 7 with 8 severity 7 with 14 than 7 with 16 duration 8 severity 10 p<0.001 9 ( 10 p<0.001 10 p<0.001 12 gee 10 p<0.001 13 ) 11 , 12 gee 12 gee 13 ) 15 disease 16 duration 17 and 18 was 17 and 20 by 18 was 19 confounded 20 by 21 age 21 age 23 p<0.001 21 age 25 gee 22 ( 23 p<0.001 23 p<0.001 24 , 24 , 25 gee 25 gee 26 ) tmv was not associated with any of these parameters . 0 ###LEFT-WALL### 1 tmv 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 10 . 1 tmv 2 was 2 was 3 not 2 was 5 with 3 not 4 associated 5 with 6 any 6 any 7 of 7 of 9 parameters 8 these 9 parameters longitudinal studies are necessary for validation of data [and] to further clarify the relevance of tmv . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 17 . 1 longitudinal 2 studies 2 studies 3 are 3 are 4 necessary 4 necessary 5 for 4 necessary 10 to 5 for 6 validation 6 validation 7 of 7 of 8 data 10 to 12 clarify 11 further 12 clarify 12 clarify 14 relevance 13 the 14 relevance 14 relevance 15 of 15 of 16 tmv background : ozone concentrations in ambient air are related to cardiopulmonary perturbations in the aging population . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 cardiopulmonary 0 ###LEFT-WALL### 17 . 2 : 11 cardiopulmonary 3 ozone 4 concentrations 4 concentrations 5 in 4 concentrations 8 are 5 in 7 air 6 ambient 7 air 8 are 9 related 9 related 10 to 10 to 11 cardiopulmonary 11 cardiopulmonary 12 perturbations 11 cardiopulmonary 13 in 13 in 16 population 14 the 16 population 15 aging 16 population increased central sympathetic nerve activity induced by local airway inflammation may be one possible mechanism . 0 ###LEFT-WALL### 5 activity 0 ###LEFT-WALL### 12 be 0 ###LEFT-WALL### 16 . 1 increased 4 nerve 2 central 4 nerve 3 sympathetic 4 nerve 4 nerve 5 activity 5 activity 6 induced 5 activity 11 may 6 induced 7 by 7 by 10 inflammation 8 local 9 airway 9 airway 10 inflammation 11 may 12 be 12 be 15 mechanism 13 one 15 mechanism 14 possible 15 mechanism methodology/principal findings : to elucidate this issue further , we performed a randomized [,] double - blind , cross - over study , including 14 healthy subjects ( 3 females , age 22 - 47 years ) , who underwent a 3 h exposure with intermittent exercise to either ozone ( 250 ppb [ )(or clean air . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 11 performed 1 methodology/principal 2 findings 3 : 4 to 3 : 5 elucidate 3 : 9 , 4 to 5 elucidate 5 elucidate 7 issue 5 elucidate 8 further 6 this 7 issue 9 , 10 we 10 we 11 performed 11 performed 19 cross 12 a 19 cross 13 randomized 19 cross 15 double 16 - 15 double 19 cross 17 blind 18 , 17 blind 19 cross 19 cross 21 over 19 cross 24 including 20 - 21 over 21 over 22 study 21 over 23 , 23 , 24 including 24 including 27 subjects 25 14 27 subjects 26 healthy 27 subjects 27 subjects 30 females 27 subjects 36 years 27 subjects 39 who 28 ( 30 females 29 3 30 females 30 females 32 age 30 females 34 - 31 , 32 age 32 age 33 22 32 age 34 - 34 - 36 years 35 47 36 years 36 years 37 ) 38 , 39 who 39 who 40 underwent 40 underwent 44 exposure 40 underwent 45 with 41 a 44 exposure 42 3 43 h 43 h 44 exposure 45 with 47 exercise 45 with 50 ozone 46 intermittent 47 exercise 47 exercise 48 to 48 to 49 either 50 ozone 55 )(or 51 ( 55 )(or 52 250 53 ppb 53 ppb 55 )(or 55 )(or 57 air 55 )(or 58 . 56 clean 57 air induced sputum was collected 3 h after exposure . 0 ###LEFT-WALL### 2 sputum 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 9 . 1 induced 2 sputum 2 sputum 3 was 3 was 4 collected 4 collected 7 after 5 3 6 h 6 h 7 after 7 after 8 exposure nineteen to 22 hours after exposure , we recorded ecg , finger blood pressure , brachial blood pressure , respiration , cardiac output , and muscle sympathetic nerve activity ( msna ) at rest , during deep breathing , maximum - inspiratory breath hold , and a valsalva maneuver . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 11 , 1 nineteen 2 to 2 to 3 22 2 to 4 hours 4 hours 5 after 5 after 6 exposure 5 after 7 , 5 after 8 we 8 we 11 , 9 recorded 10 ecg 9 recorded 11 , 11 , 25 and 12 finger 14 pressure 12 finger 25 and 13 blood 14 pressure 14 pressure 18 pressure 15 , 18 pressure 16 brachial 17 blood 17 blood 18 pressure 18 pressure 20 respiration 18 pressure 23 output 18 pressure 24 , 19 , 20 respiration 20 respiration 21 , 21 , 23 output 22 cardiac 23 output 23 output 24 , 24 , 25 and 25 and 26 muscle 26 muscle 29 activity 26 muscle 33 at 26 muscle 36 during 27 sympathetic 28 nerve 28 nerve 29 activity 29 activity 31 msna 30 ( 31 msna 31 msna 32 ) 33 at 34 rest 35 , 36 during 36 during 46 and 36 during 50 . 37 deep 38 breathing 38 breathing 39 , 39 , 44 hold 39 , 46 and 40 maximum 41 - 40 maximum 43 breath 42 inspiratory 43 breath 43 breath 44 hold 45 , 46 and 46 and 49 maneuver 47 a 49 maneuver 48 valsalva 49 maneuver while the ozone exposure induced the expected airway inflammation , as indicated by a significant increase in sputum neutrophils , we did not detect a significant estimated treatment effect adjusted for period on cardiovascular measurements . 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 36 . 1 while 4 exposure 1 while 5 induced 1 while 20 , 2 the 4 exposure 3 ozone 4 exposure 4 exposure 5 induced 5 induced 9 inflammation 5 induced 13 by 5 induced 17 in 6 the 9 inflammation 7 expected 8 airway 8 airway 9 inflammation 9 inflammation 12 indicated 10 , 12 indicated 11 as 12 indicated 13 by 16 increase 14 a 16 increase 15 significant 16 increase 17 in 18 sputum 19 neutrophils 20 , 20 , 24 detect 21 we 22 did 22 did 23 not 22 did 24 detect 24 detect 29 effect 24 detect 33 on 25 a 26 significant 25 a 29 effect 26 significant 28 treatment 27 estimated 28 treatment 28 treatment 29 effect 29 effect 30 adjusted 30 adjusted 31 for 31 for 32 period 33 on 35 measurements 34 cardiovascular 35 measurements no difference of resting msna was observed between ozone and air exposure ( air : 23±2 , ozone : 23±2 [bursts/min] [ )( 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 7 observed 0 ###LEFT-WALL### 15 : 1 no 2 difference 2 difference 3 of 2 difference 6 was 3 of 4 resting 4 resting 5 msna 6 was 7 observed 7 observed 8 between 8 between 10 and 9 ozone 10 and 10 and 12 exposure 10 and 14 air 11 air 12 exposure 13 ( 14 air 14 air 15 : 15 : 18 ozone 15 : 20 23±2 15 : 23 )( 16 23±2 17 , 16 23±2 18 ozone 18 ozone 19 : 19 : 20 23±2 maximum msna obtained at the end of apnea ( air [:] 44±4 , ozone : 48±4 [bursts/min] ) and during the phase ii of the valsalva maneuver ( air [:] 64±5 , ozone : 57±6 [bursts/min] ) was similar . 0 ###LEFT-WALL### 2 msna 0 ###LEFT-WALL### 38 was 0 ###LEFT-WALL### 40 . 1 maximum 2 msna 2 msna 3 obtained 2 msna 38 was 3 obtained 19 and 4 at 6 end 4 at 19 and 5 the 6 end 6 end 7 of 7 of 8 apnea 8 apnea 10 air 9 ( 10 air 10 air 14 ozone 10 air 16 48±4 10 air 18 ) 12 44±4 13 , 12 44±4 14 ozone 14 ozone 15 : 15 : 16 48±4 19 and 20 during 20 during 22 phase 21 the 22 phase 22 phase 23 ii 22 phase 24 of 24 of 27 maneuver 25 the 27 maneuver 26 valsalva 27 maneuver 27 maneuver 29 air 28 ( 29 air 29 air 33 ozone 29 air 35 57±6 29 air 37 ) 31 64±5 32 , 31 64±5 33 ozone 33 ozone 34 : 34 : 35 57±6 38 was 39 similar conclusions/significance : our study suggests that acute ozone - induced airway inflammation does not increase resting sympathetic nerve traffic in healthy subjects , an observation that is relevant for environmental health . 0 ###LEFT-WALL### 1 conclusions/significance 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 suggests 2 : 9 - 3 our 4 study 4 study 5 suggests 5 suggests 8 ozone 6 that 7 acute 7 acute 8 ozone 9 - 12 inflammation 9 - 15 increase 10 induced 11 airway 11 airway 12 inflammation 12 inflammation 13 does 13 does 14 not 13 does 15 increase 15 increase 19 traffic 15 increase 20 in 16 resting 18 nerve 17 sympathetic 18 nerve 18 nerve 19 traffic 20 in 22 subjects 21 healthy 22 subjects 22 subjects 25 observation 23 , 25 observation 24 an 25 observation 25 observation 26 that 25 observation 27 is 25 observation 32 . 26 that 27 is 27 is 28 relevant 28 relevant 29 for 29 for 31 health 30 environmental 31 health however , we can not exclude that chronic airway inflammation may contribute to sympathetic activation . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 6 exclude 0 ###LEFT-WALL### 16 . 1 however 2 , 1 however 3 we 3 we 4 can 4 can 5 not 4 can 6 exclude 6 exclude 9 airway 7 that 9 airway 8 chronic 9 airway 9 airway 10 inflammation 9 airway 12 contribute 10 inflammation 11 may 11 may 12 contribute 12 contribute 13 to 13 to 15 activation 14 sympathetic 15 activation background : in man , [many] different events implying childhood separation from caregivers/unstable parental environment [are] associated [with] heightened risk for panic disorder in adulthood . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 1 background 2 : 2 : 3 in 2 : 9 implying 3 in 8 events 4 man 5 , 4 man 8 events 7 different 8 events 9 implying 11 separation 9 implying 12 from 9 implying 21 for 9 implying 24 in 10 childhood 11 separation 12 from 20 risk 13 caregivers/unstable 15 environment 14 parental 15 environment 15 environment 17 associated 17 associated 20 risk 19 heightened 20 risk 21 for 23 disorder 22 panic 23 disorder 24 in 25 adulthood twin data show that the occurrence of such events in childhood contributes to explaining the covariation between separation anxiety disorder , panic , and the related psychobiological trait of co ( 2 ) hypersensitivity . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 35 . 1 twin 2 data 2 data 3 show 3 show 4 that 3 show 6 occurrence 3 show 12 contributes 5 the 6 occurrence 6 occurrence 7 of 6 occurrence 10 in 6 occurrence 12 contributes 7 of 9 events 8 such 9 events 10 in 11 childhood 12 contributes 13 to 12 contributes 17 between 13 to 14 explaining 14 explaining 16 covariation 15 the 16 covariation 17 between 20 disorder 18 separation 20 disorder 19 anxiety 20 disorder 21 , 34 hypersensitivity 22 panic 24 and 23 , 24 and 24 and 28 trait 24 and 29 of 24 and 34 hypersensitivity 25 the 28 trait 26 related 28 trait 27 psychobiological 28 trait 29 of 30 co 30 co 32 2 31 ( 32 2 32 2 33 ) we hypothesized that early interference with infant [-] mother interaction could moderate the interspecific trait [of] response to co ( 2 ) through genetic control of sensitivity to the environment . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 0 ###LEFT-WALL### 31 . 1 we 2 hypothesized 2 hypothesized 3 that 3 that 5 interference 3 that 12 moderate 4 early 5 interference 5 interference 6 with 5 interference 11 could 6 with 10 interaction 7 infant 9 mother 9 mother 10 interaction 11 could 12 moderate 12 moderate 17 response 12 moderate 18 to 12 moderate 23 through 12 moderate 28 to 13 the 17 response 14 interspecific 15 trait 15 trait 17 response 18 to 19 co 19 co 21 2 20 ( 21 2 21 2 22 ) 23 through 25 control 24 genetic 25 control 25 control 26 of 26 of 27 sensitivity 28 to 30 environment 29 the 30 environment methodology : having spent the first 24 hours after birth with their biological mother , outbred nmri mice were cross - fostered to adoptive mothers for the following 4 post - natal days . 0 ###LEFT-WALL### 1 methodology 0 ###LEFT-WALL### 2 : 1 methodology 2 : 2 : 3 having 3 having 15 , 4 spent 6 first 4 spent 11 with 4 spent 15 , 5 the 6 first 6 first 9 after 7 24 8 hours 8 hours 9 after 9 after 10 birth 11 with 14 mother 12 their 14 mother 13 biological 14 mother 15 , 16 outbred 16 outbred 17 nmri 17 nmri 18 mice 17 nmri 20 cross 18 mice 19 were 19 were 20 cross 20 cross 22 fostered 21 - 22 fostered 22 fostered 23 to 22 fostered 26 for 22 fostered 34 . 23 to 25 mothers 24 adoptive 25 mothers 26 for 30 post 27 the 30 post 28 following 30 post 29 4 30 post 30 post 33 days 31 - 33 days 32 natal 33 days 33 days 34 . they were successively compared to normally [-] reared individuals for : number of ultrasonic vocalizations during isolation , respiratory physiology responses to normal air ( 20%o ( 2 ) ) , co ( 2 ) - enriched air ( 6 % co ( 2 ) ) , hypoxic air ( 10%o ( 2 ) ) , and avoidance of co ( 2 ) - enriched environments . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 65 enriched 0 ###LEFT-WALL### 67 . 1 they 2 were 2 were 3 successively 2 were 4 compared 4 compared 5 to 4 compared 10 for 5 to 9 individuals 6 normally 8 reared 8 reared 9 individuals 10 for 11 : 11 : 57 and 12 number 13 of 12 number 57 and 13 of 15 vocalizations 14 ultrasonic 15 vocalizations 15 vocalizations 16 during 15 vocalizations 21 responses 16 during 17 isolation 18 , 21 responses 19 respiratory 20 physiology 20 physiology 21 responses 21 responses 22 to 21 responses 32 co 21 responses 56 , 22 to 24 air 23 normal 24 air 24 air 26 20%o 25 ( 26 20%o 26 20%o 28 2 26 20%o 30 ) 27 ( 28 2 28 2 29 ) 31 , 32 co 32 co 34 2 32 co 38 air 32 co 55 ) 33 ( 34 2 34 2 35 ) 36 - 38 air 37 enriched 38 air 38 air 42 co 38 air 49 air 38 air 55 ) 39 ( 42 co 40 6 42 co 41 % 42 co 42 co 44 2 42 co 46 ) 43 ( 44 2 44 2 45 ) 47 , 49 air 48 hypoxic 49 air 49 air 51 10%o 49 air 55 ) 50 ( 51 10%o 51 10%o 53 2 51 10%o 54 ) 52 ( 53 2 53 2 54 ) 57 and 58 avoidance 57 and 64 - 57 and 65 enriched 58 avoidance 59 of 59 of 60 co 60 co 62 2 61 ( 62 2 62 2 63 ) 65 enriched 66 environments results : cross - fostered pups showed significantly more ultrasonic vocalizations , more pronounced hyperventilatory responses ( larger tidal volume and minute volume increments ) to co ( 2 ) - enriched air and heightened aversion towards co ( 2 ) - enriched environments , than normally - reared individuals . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 pups 2 : 7 showed 2 : 12 , 3 cross 4 - 3 cross 6 pups 5 fostered 6 pups 6 pups 7 showed 7 showed 9 more 7 showed 11 vocalizations 8 significantly 9 more 10 ultrasonic 11 vocalizations 12 , 13 more 12 , 14 pronounced 12 , 31 - 13 more 14 pronounced 14 pronounced 16 responses 15 hyperventilatory 16 responses 16 responses 21 and 17 ( 21 and 18 larger 20 volume 19 tidal 20 volume 20 volume 21 and 21 and 24 increments 21 and 25 ) 21 and 26 to 21 and 31 - 22 minute 23 volume 23 volume 24 increments 26 to 27 co 27 co 29 2 28 ( 29 2 29 2 30 ) 31 - 34 and 31 - 48 - 32 enriched 33 air 32 enriched 34 and 34 and 35 heightened 35 heightened 36 aversion 35 heightened 37 towards 35 heightened 46 than 35 heightened 47 normally 37 towards 38 co 38 co 40 2 38 co 44 environments 39 ( 40 2 40 2 41 ) 42 - 44 environments 43 enriched 44 environments 44 environments 45 , 48 - 50 individuals 48 - 51 . 49 reared 50 individuals enhanced tidal volume increment response [to] 6%co ( 2 ) was present at 16 - 20 , and 75 - 90 postnatal days , implying the trait 's stability . 0 ###LEFT-WALL### 7 6%co 0 ###LEFT-WALL### 11 was 1 enhanced 3 volume 2 tidal 3 volume 3 volume 4 increment 4 increment 7 6%co 5 response 7 6%co 7 6%co 9 2 7 6%co 11 was 8 ( 9 2 9 2 10 ) 11 was 18 and 12 present 13 at 12 present 18 and 13 at 15 - 14 16 15 - 15 - 16 20 17 , 18 and 18 and 23 days 18 and 25 implying 19 75 20 - 20 - 21 90 20 - 23 days 22 postnatal 23 days 24 , 25 implying 25 implying 29 stability 25 implying 30 . 26 the 27 trait 27 trait 28 's 28 's 29 stability these results support a stress - diathesis model whereby the genetic influences underlying the response to 6%co ( 2 ) increase their contribution in the presence of an environmental adversity . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 6 - 1 these 2 results 2 results 3 support 3 support 5 stress 4 a 5 stress 6 - 7 diathesis 6 - 8 model 6 - 31 . 7 diathesis 8 model 8 model 9 whereby 8 model 23 contribution 8 model 24 in 9 whereby 12 influences 9 whereby 21 increase 10 the 12 influences 11 genetic 12 influences 12 influences 13 underlying 12 influences 21 increase 13 underlying 15 response 13 underlying 16 to 14 the 15 response 16 to 17 6%co 17 6%co 19 2 18 ( 19 2 19 2 20 ) 22 their 23 contribution 24 in 26 presence 25 the 26 presence 26 presence 27 of 27 of 30 adversity 28 an 29 environmental 28 an 30 adversity 29 environmental 30 adversity maternal grooming/licking behaviour , and corticosterone basal levels were similar among cross - fostered [and] normally - reared individuals . 0 ###LEFT-WALL### 2 grooming/licking 0 ###LEFT-WALL### 18 reared 0 ###LEFT-WALL### 20 . 1 maternal 2 grooming/licking 2 grooming/licking 5 and 2 grooming/licking 12 cross 2 grooming/licking 14 fostered 2 grooming/licking 18 reared 3 behaviour 5 and 4 , 5 and 5 and 6 corticosterone 5 and 8 levels 5 and 11 among 5 and 12 cross 7 basal 8 levels 8 levels 9 were 9 were 10 similar 10 similar 11 among 13 - 14 fostered 14 fostered 16 normally 14 fostered 17 - 18 reared 19 individuals conclusions : a mechanism [of] gene - [by] - environment interplay connects this form of early perturbation [of] infant [-] mother interaction , heightened co ( 2 ) sensitivity and anxiety . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 32 . 1 conclusions 2 : 2 : 6 gene 3 a 6 gene 4 mechanism 6 gene 7 - 9 - 7 - 23 , 9 - 11 interplay 10 environment 11 interplay 11 interplay 23 , 12 connects 14 form 12 connects 23 , 13 this 14 form 14 form 15 of 15 of 22 interaction 16 early 17 perturbation 17 perturbation 19 infant 19 infant 21 mother 21 mother 22 interaction 23 , 24 heightened 24 heightened 30 and 25 co 27 2 25 co 29 sensitivity 26 ( 27 2 27 2 28 ) 29 sensitivity 30 and 30 and 31 anxiety some [non] - inferential physiological measurements can enhance animal models of human neurodevelopmental anxiety disorders . 0 ###LEFT-WALL### 1 some 0 ###LEFT-WALL### 3 - 3 - 6 measurements 3 - 8 enhance 3 - 16 . 4 inferential 6 measurements 5 physiological 6 measurements 6 measurements 7 can 7 can 8 enhance 8 enhance 10 models 9 animal 10 models 10 models 11 of 11 of 15 disorders 12 human 14 anxiety 13 neurodevelopmental 14 anxiety 14 anxiety 15 disorders acquisition of a final shape and size during organ development requires a regulated program of growth and patterning controlled by a complex genetic network of signalling molecules that must be coordinated to provide positional information to each cell within the corresponding organ or tissue . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 45 . 1 acquisition 2 of 1 acquisition 6 and 2 of 5 shape 3 a 5 shape 4 final 5 shape 6 and 7 size 7 size 8 during 8 during 9 organ 9 organ 10 development 9 organ 19 controlled 10 development 11 requires 11 requires 17 and 11 requires 19 controlled 12 a 14 program 13 regulated 14 program 14 program 15 of 14 program 17 and 15 of 16 growth 17 and 18 patterning 17 and 19 controlled 19 controlled 20 by 19 controlled 36 to 19 controlled 39 within 20 by 24 network 21 a 22 complex 21 a 24 network 22 complex 24 network 23 genetic 24 network 24 network 25 of 25 of 26 signalling 26 signalling 27 molecules 26 signalling 32 to 27 molecules 28 that 27 molecules 29 must 28 that 29 must 29 must 30 be 30 be 31 coordinated 32 to 33 provide 33 provide 35 information 34 positional 35 information 36 to 38 cell 37 each 38 cell 39 within 43 or 40 the 42 organ 41 corresponding 42 organ 42 organ 43 or 43 or 44 tissue the mechanism by which all these signals are coordinated to yield a final response is not well understood . 0 ###LEFT-WALL### 2 mechanism 0 ###LEFT-WALL### 15 is 0 ###LEFT-WALL### 19 . 1 the 2 mechanism 2 mechanism 3 by 2 mechanism 15 is 3 by 4 which 3 by 5 all 3 by 9 coordinated 5 all 6 these 5 all 7 signals 5 all 8 are 6 these 7 signals 8 are 9 coordinated 9 coordinated 10 to 10 to 11 yield 11 yield 14 response 12 a 14 response 13 final 14 response 15 is 16 not 15 is 17 well 17 well 18 understood here , i have characterized the drosophila ortholog of the human tgf - β inducible early gene [1] ( dtieg ) . 0 ###LEFT-WALL### 3 i 0 ###LEFT-WALL### 5 characterized 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 14 β 0 ###LEFT-WALL### 22 . 1 here 2 , 1 here 3 i 3 i 4 have 4 have 5 characterized 5 characterized 8 ortholog 6 the 8 ortholog 7 drosophila 8 ortholog 8 ortholog 9 of 9 of 12 tgf 10 the 11 human 11 human 12 tgf 13 - 14 β 14 β 17 gene 15 inducible 16 early 16 early 17 gene 17 gene 20 dtieg 19 ( 20 dtieg 20 dtieg 21 ) tieg are zinc [-] finger proteins that belong to the krüppel - like factor [(] klf ) family and were initially identified in human osteoblasts and pancreatic tumor cells for the ability to enhance tgf - β response . 0 ###LEFT-WALL### 1 tieg 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 36 - 0 ###LEFT-WALL### 39 . 1 tieg 2 are 2 are 6 proteins 2 are 29 cells 3 zinc 5 finger 5 finger 6 proteins 6 proteins 7 that 6 proteins 19 and 7 that 19 and 8 belong 9 to 8 belong 19 and 9 to 18 family 10 the 18 family 11 krüppel 13 like 11 krüppel 18 family 12 - 13 like 13 like 16 klf 13 like 17 ) 14 factor 16 klf 19 and 20 were 20 were 22 identified 21 initially 22 identified 22 identified 23 in 23 in 26 and 24 human 25 osteoblasts 25 osteoblasts 26 and 26 and 28 tumor 27 pancreatic 28 tumor 29 cells 30 for 30 for 32 ability 31 the 32 ability 32 ability 33 to 32 ability 34 enhance 33 to 34 enhance 34 enhance 35 tgf 36 - 38 response 37 β 38 response using the developing wing of drosophila as " in vivo " [model] , the dtieg function has been studied in the control of cell proliferation [and] patterning . 0 ###LEFT-WALL### 16 function 0 ###LEFT-WALL### 19 studied 0 ###LEFT-WALL### 28 . 1 using 4 wing 1 using 10 vivo 1 using 13 , 1 using 16 function 2 the 4 wing 3 developing 4 wing 4 wing 5 of 5 of 6 drosophila 7 as 8 " 7 as 10 vivo 9 in 10 vivo 10 vivo 11 " 14 the 16 function 15 dtieg 16 function 16 function 17 has 17 has 18 been 18 been 19 studied 19 studied 20 in 20 in 22 control 21 the 22 control 22 control 23 of 23 of 27 patterning 24 cell 27 patterning 25 proliferation 27 patterning these results show that dtieg can modulate dpp signalling . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 10 . 1 these 2 results 2 results 3 show 3 show 4 that 4 that 5 dtieg 4 that 7 modulate 5 dtieg 6 can 6 can 7 modulate 7 modulate 8 dpp 8 dpp 9 signalling furthermore , dtieg also regulates the activity of jak/stat [pathway] suggesting a conserved role of tieg proteins as positive regulators of tgf - β signalling [and] as mediators of the crosstalk between signalling pathways acting in a [same] cellular context . 0 ###LEFT-WALL### 3 dtieg 0 ###LEFT-WALL### 5 regulates 1 furthermore 2 , 1 furthermore 3 dtieg 3 dtieg 5 regulates 4 also 5 regulates 5 regulates 7 activity 6 the 7 activity 7 activity 8 of 7 activity 15 of 8 of 9 jak/stat 9 jak/stat 11 suggesting 11 suggesting 14 role 12 a 14 role 13 conserved 14 role 15 of 17 proteins 16 tieg 17 proteins 17 proteins 18 as 17 proteins 24 β 18 as 20 regulators 19 positive 20 regulators 20 regulators 21 of 21 of 22 tgf 23 - 24 β 24 β 25 signalling 24 β 27 as 24 β 41 . 27 as 28 mediators 28 mediators 29 of 28 mediators 35 acting 29 of 31 crosstalk 30 the 31 crosstalk 31 crosstalk 32 between 32 between 33 signalling 33 signalling 34 pathways 35 acting 36 in 36 in 40 context 37 a 40 context 39 cellular 40 context several studies have shown that obesity is associated with changes in human brain function and structure . 0 ###LEFT-WALL### 1 several 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 17 . 1 several 2 studies 1 several 4 shown 1 several 15 and 2 studies 3 have 3 have 4 shown 4 shown 5 that 5 that 6 obesity 5 that 8 associated 6 obesity 7 is 7 is 8 associated 8 associated 9 with 8 associated 11 in 9 with 10 changes 11 in 13 brain 12 human 13 brain 14 function 15 and 15 and 16 structure since women are more susceptible to obesity than men , it seems plausible that [neural] [correlates] may also be different . 0 ###LEFT-WALL### 11 it 0 ###LEFT-WALL### 12 seems 0 ###LEFT-WALL### 21 . 1 since 2 women 1 since 3 are 1 since 10 , 1 since 11 it 2 women 3 are 3 are 4 more 3 are 5 susceptible 5 susceptible 6 to 5 susceptible 8 than 6 to 7 obesity 8 than 9 men 11 it 12 seems 12 seems 13 plausible 13 plausible 14 that 13 plausible 19 be 14 that 17 may 17 may 19 be 18 also 19 be 19 be 20 different however , this has not been demonstrated so far . 0 ###LEFT-WALL### 3 this 0 ###LEFT-WALL### 7 demonstrated 0 ###LEFT-WALL### 10 . 1 however 2 , 1 however 3 this 3 this 4 has 4 has 5 not 4 has 6 been 6 been 7 demonstrated 7 demonstrated 9 far 8 so 9 far there was no significant age ( p>0.2 [ )(or bmi ( p>0.7 ) difference between female and male participants . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 5 age 3 no 5 age 4 significant 5 age 5 age 9 )(or 6 ( 9 )(or 7 p>0.2 9 )(or 9 )(or 14 difference 9 )(or 15 between 9 )(or 20 . 10 bmi 12 p>0.7 10 bmi 14 difference 11 ( 12 p>0.7 12 p>0.7 13 ) 15 between 19 participants 16 female 17 and 17 and 18 male 17 and 19 participants in female and male subjects , the putative axon marker λ ( ∥ ) was consistently reduced throughout the corpus callosum , particularly in the splenium ( r = - 0.62 , p<0.005 ) . 0 ###LEFT-WALL### 11 λ 0 ###LEFT-WALL### 17 reduced 0 ###LEFT-WALL### 35 . 1 in 3 and 1 in 6 , 1 in 11 λ 2 female 3 and 3 and 5 subjects 4 male 5 subjects 7 the 11 λ 8 putative 11 λ 9 axon 11 λ 10 marker 11 λ 11 λ 13 ∥ 11 λ 15 was 12 ( 13 ∥ 13 ∥ 14 ) 15 was 17 reduced 16 consistently 17 reduced 17 reduced 18 throughout 17 reduced 24 in 18 throughout 21 callosum 19 the 21 callosum 20 corpus 21 callosum 22 , 23 particularly 22 , 24 in 24 in 33 p<0.005 24 in 34 ) 25 the 33 p<0.005 26 splenium 33 p<0.005 27 ( 30 - 28 r 29 = 29 = 30 - 30 - 31 0.62 30 - 32 , 30 - 33 p<0.005 this suggests that obesity may be associated with axonal degeneration . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 suggests 0 ###LEFT-WALL### 11 . 1 this 2 suggests 2 suggests 3 that 3 that 4 obesity 3 that 7 associated 4 obesity 5 may 5 may 6 be 6 be 7 associated 7 associated 8 with 8 with 10 degeneration 9 axonal 10 degeneration [only] in women , the putative myelin marker λ ( ⊥ ) significantly increased with increasing bmi ( r = 0.57 , p<0.005 ) and serum leptin levels ( r = 0.62 , p<0.005 ) [predominantly] in the genu of the corpus callosum , suggesting additional myelin degeneration . 0 ###LEFT-WALL### 9 λ 0 ###LEFT-WALL### 14 increased 0 ###LEFT-WALL### 25 and 2 in 3 women 2 in 4 , 2 in 9 λ 5 the 9 λ 6 putative 7 myelin 7 myelin 8 marker 8 marker 9 λ 9 λ 11 ⊥ 9 λ 14 increased 10 ( 11 ⊥ 11 ⊥ 12 ) 13 significantly 14 increased 14 increased 15 with 15 with 16 increasing 16 increasing 17 bmi 16 increasing 20 = 18 ( 20 = 19 r 20 = 20 = 21 0.57 21 0.57 23 p<0.005 22 , 23 p<0.005 23 p<0.005 24 ) 25 and 27 leptin 25 and 28 levels 26 serum 27 leptin 27 leptin 28 levels 28 levels 31 = 28 levels 37 in 29 ( 31 = 30 r 31 = 31 = 32 0.62 32 0.62 34 p<0.005 33 , 34 p<0.005 34 p<0.005 35 ) 37 in 39 genu 38 the 39 genu 39 genu 40 of 39 genu 45 suggesting 40 of 43 callosum 41 the 43 callosum 42 corpus 43 callosum 44 , 45 suggesting 45 suggesting 48 degeneration 45 suggesting 49 . 46 additional 47 myelin 47 myelin 48 degeneration comparable structural changes were reported for the aging brain , which may point to accelerated aging of wm structure in obese subjects . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 5 reported 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 23 . 1 comparable 3 changes 2 structural 3 changes 3 changes 4 were 4 were 5 reported 5 reported 6 for 6 for 9 brain 7 the 9 brain 8 aging 9 brain 10 , 11 which 10 , 13 point 11 which 12 may 12 may 13 point 13 point 14 to 14 to 16 aging 15 accelerated 16 aging 16 aging 17 of 16 aging 20 in 17 of 19 structure 18 wm 19 structure 20 in 22 subjects 21 obese 22 subjects in conclusion , we demonstrate structural wm changes related to an elevated body weight , but with differences between men and women . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 23 . 1 in 2 conclusion 3 , 4 we 3 , 5 demonstrate 4 we 5 demonstrate 5 demonstrate 8 changes 5 demonstrate 9 related 6 structural 8 changes 7 wm 8 changes 8 changes 9 related 9 related 16 but 9 related 19 between 10 to 14 weight 10 to 16 but 11 an 14 weight 12 elevated 13 body 13 body 14 weight 15 , 16 but 16 but 17 with 17 with 18 differences 19 between 21 and 20 men 21 and 21 and 22 women future studies on obesity - related functional and structural brain changes should therefore account for sex - related differences . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 14 account 0 ###LEFT-WALL### 18 related 1 future 2 studies 2 studies 3 on 2 studies 12 should 3 on 4 obesity 5 - 6 related 6 related 11 changes 6 related 12 should 7 functional 8 and 8 and 9 structural 8 and 10 brain 10 brain 11 changes 12 should 14 account 13 therefore 14 account 14 account 15 for 15 for 16 sex 17 - 18 related 18 related 19 differences 18 related 20 . none objective : to identify exposures possibly contributing to anemia cases among hexavalent chromium medical surveillance program enrollees . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 10 anemia 0 ###LEFT-WALL### 19 . 1 none 2 objective 1 none 9 to 1 none 10 anemia 2 objective 3 : 3 : 4 to 3 : 5 identify 4 to 5 identify 5 identify 6 exposures 6 exposures 8 contributing 7 possibly 8 contributing 8 contributing 9 to 10 anemia 11 cases 10 anemia 12 among 12 among 18 enrollees 13 hexavalent 14 chromium 14 chromium 18 enrollees 15 medical 16 surveillance 16 surveillance 18 enrollees 17 program 18 enrollees methods : an investigation encompassed metals surveillance programs , extensive workplace sampling and remediation , consultation , evaluation of laboratory accuracy , and [follow] [-] up of anemic individuals . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 1 methods 2 : 2 : 18 evaluation 3 an 18 evaluation 4 investigation 8 programs 5 encompassed 6 metals 6 metals 8 programs 7 surveillance 8 programs 8 programs 9 , 9 , 12 sampling 9 , 13 and 10 extensive 11 workplace 11 workplace 12 sampling 13 and 14 remediation 13 and 16 consultation 13 and 18 evaluation 15 , 16 consultation 16 consultation 17 , 18 evaluation 19 of 19 of 23 and 20 laboratory 21 accuracy 21 accuracy 23 and 22 , 23 and 23 and 26 up 23 and 27 of 27 of 29 individuals 28 anemic 29 individuals results : workers had underlying medical conditions that affected surveillance results . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 workers 2 : 4 had 2 : 12 . 3 workers 4 had 4 had 7 conditions 5 underlying 7 conditions 6 medical 7 conditions 7 conditions 8 that 7 conditions 9 affected 8 that 9 affected 9 affected 11 results 10 surveillance 11 results there was a systemic error in classification based on hematocrit value . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 12 . 1 there 2 was 2 was 5 error 3 a 4 systemic 3 a 5 error 4 systemic 5 error 5 error 6 in 6 in 7 classification 7 classification 8 based 8 based 9 on 9 on 11 value 10 hematocrit 11 value the prevalence of anemia in a workforce averaging 52 years old was 16 % . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 15 . 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 12 was 3 of 4 anemia 4 anemia 5 in 5 in 7 workforce 6 a 7 workforce 7 workforce 8 averaging 7 workforce 11 old 9 52 10 years 10 years 11 old 12 was 14 % 13 16 14 % conclusions : anemia may be more prevalent in middle [-] aged workers than expected . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 anemia 2 : 5 be 2 : 15 . 3 anemia 4 may 4 may 5 be 5 be 7 prevalent 6 more 7 prevalent 7 prevalent 8 in 7 prevalent 14 expected 8 in 12 workers 9 middle 11 aged 11 aged 12 workers 13 than 14 expected modern laboratories generally report a calculated hematocrit value , and using hemoglobin for most classification purposes is preferred . 0 ###LEFT-WALL### 2 laboratories 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 . 1 modern 2 laboratories 2 laboratories 4 report 3 generally 4 report 4 report 8 value 5 a 8 value 6 calculated 8 value 7 hematocrit 8 value 9 , 10 and 10 and 11 using 10 and 18 preferred 11 using 12 hemoglobin 11 using 13 for 11 using 17 is 13 for 16 purposes 14 most 16 purposes 15 classification 16 purposes 17 is 18 preferred characteristics of a specific workforce , including age , health , hobbies , and diet , should be taken into account when interpreting medical surveillance program findings . 0 ###LEFT-WALL### 1 characteristics 0 ###LEFT-WALL### 19 taken 0 ###LEFT-WALL### 28 . 1 characteristics 2 of 1 characteristics 17 should 2 of 5 workforce 3 a 4 specific 3 a 5 workforce 4 specific 5 workforce 5 workforce 7 including 5 workforce 14 and 6 , 7 including 7 including 8 age 7 including 9 , 9 , 14 and 10 health 11 , 11 , 12 hobbies 11 , 14 and 13 , 14 and 14 and 15 diet 14 and 16 , 17 should 18 be 18 be 19 taken 19 taken 21 account 19 taken 22 when 20 into 21 account 22 when 23 interpreting 23 interpreting 27 findings 24 medical 25 surveillance 25 surveillance 27 findings 26 program 27 findings the value of a team approach in addressing occupational health problems was demonstrated . 0 ###LEFT-WALL### 2 value 0 ###LEFT-WALL### 13 demonstrated 0 ###LEFT-WALL### 14 . 1 the 2 value 2 value 3 of 2 value 12 was 3 of 6 approach 4 a 6 approach 5 team 6 approach 6 approach 7 in 7 in 8 addressing 8 addressing 11 problems 9 occupational 10 health 10 health 11 problems 12 was 13 demonstrated background and objectives : ankle - brachial index [(] abi ) is currently recommended for the screening of peripheral arterial disease . 0 ###LEFT-WALL### 3 objectives 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 objectives 4 : 5 ankle 4 : 14 recommended 4 : 22 . 5 ankle 10 abi 5 ankle 12 is 6 - 10 abi 7 brachial 8 index 8 index 10 abi 10 abi 11 ) 12 is 14 recommended 13 currently 14 recommended 14 recommended 15 for 15 for 17 screening 16 the 17 screening 17 screening 18 of 18 of 21 disease 19 peripheral 21 disease 20 arterial 21 disease however , this method becomes less reliable in the presence [of] calcified , incompressible arteries , as they result in an erroneously elevated abi , and an additional measure termed the toe - brachial index [(] tbi ) is recommended . 0 ###LEFT-WALL### 4 method 0 ###LEFT-WALL### 5 becomes 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 41 . 1 however 2 , 1 however 4 method 3 this 4 method 4 method 5 becomes 5 becomes 7 reliable 6 less 7 reliable 7 reliable 8 in 8 in 10 presence 9 the 10 presence 10 presence 12 calcified 10 presence 15 arteries 13 , 15 arteries 14 incompressible 15 arteries 15 arteries 16 , 16 , 32 toe 16 , 39 is 17 as 18 they 17 as 19 result 17 as 32 toe 18 they 19 result 19 result 20 in 20 in 26 and 21 an 24 abi 22 erroneously 23 elevated 23 elevated 24 abi 24 abi 26 and 25 , 26 and 26 and 29 measure 26 and 30 termed 27 an 28 additional 27 an 29 measure 28 additional 29 measure 31 the 32 toe 32 toe 37 tbi 32 toe 39 is 33 - 37 tbi 34 brachial 37 tbi 35 index 37 tbi 37 tbi 38 ) 39 is 40 recommended the evaluation of abi , [and] in particular tbi , typically requires significant technical skill and often involves referral to a vascular laboratory . 0 ###LEFT-WALL### 2 evaluation 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 24 . 1 the 2 evaluation 2 evaluation 3 of 2 evaluation 16 and 3 of 4 abi 4 abi 7 in 5 , 7 in 7 in 9 tbi 7 in 10 , 8 particular 9 tbi 11 typically 12 requires 12 requires 15 skill 12 requires 16 and 13 significant 15 skill 14 technical 15 skill 16 and 18 involves 17 often 18 involves 18 involves 19 referral 18 involves 20 to 20 to 23 laboratory 21 a 22 vascular 21 a 23 laboratory 22 vascular 23 laboratory this present situation reveals the need for a valid and reliable , automatic , noninvasive device that will provide both abi and tbi at the level of the primary care physician . 0 ###LEFT-WALL### 3 situation 0 ###LEFT-WALL### 4 reveals 0 ###LEFT-WALL### 32 . 1 this 3 situation 2 present 3 situation 3 situation 4 reveals 4 reveals 6 need 4 reveals 24 at 5 the 6 need 6 need 7 for 7 for 22 and 8 a 21 abi 9 valid 10 and 10 and 16 device 10 and 17 that 10 and 18 will 10 and 21 abi 11 reliable 12 , 11 reliable 16 device 13 automatic 14 , 13 automatic 16 device 15 noninvasive 16 device 17 that 18 will 18 will 19 provide 19 provide 20 both 21 abi 22 and 22 and 23 tbi 24 at 26 level 25 the 26 level 26 level 27 of 27 of 31 physician 28 the 31 physician 29 primary 30 care 30 care 31 physician the aim of this study was to evaluate the accuracy and reliability of such a device , the vasera vs - 1500at , in the assessment [of] toe , ankle , and brachial systolic blood pressures . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 37 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 evaluate 7 to 8 evaluate 8 evaluate 11 and 8 evaluate 21 - 8 evaluate 24 in 9 the 11 and 10 accuracy 11 and 11 and 12 reliability 12 reliability 13 of 13 of 16 device 14 such 15 a 15 a 16 device 17 , 21 - 18 the 20 vs 19 vasera 20 vs 20 vs 21 - 21 - 22 1500at 21 - 23 , 24 in 32 and 25 the 28 toe 26 assessment 28 toe 28 toe 29 , 29 , 30 ankle 29 , 32 and 31 , 32 and 32 and 36 pressures 33 brachial 35 blood 34 systolic 35 blood 35 blood 36 pressures materials and methods : this study involved the assessment of 80 limbs from 40 normotensive and hypertensive individuals ( 17 men and 23 women ) with a mean age of 45 ± 18 years . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 materials 2 and 2 and 3 methods 4 : 6 study 4 : 7 involved 4 : 35 . 5 this 6 study 6 study 7 involved 7 involved 9 assessment 7 involved 13 from 7 involved 26 with 8 the 9 assessment 9 assessment 10 of 10 of 12 limbs 11 80 12 limbs 13 from 18 individuals 14 40 18 individuals 15 normotensive 16 and 16 and 17 hypertensive 16 and 18 individuals 18 individuals 22 and 19 ( 22 and 20 17 21 men 21 men 22 and 22 and 24 women 22 and 25 ) 23 23 24 women 26 with 29 age 27 a 29 age 28 mean 29 age 29 age 30 of 30 of 34 years 31 45 34 years 32 ± 34 years 33 18 34 years results : there was a statistically significant correlation ( r=0.92 ) between toe systolic blood pressures obtained manually with photoplethysmography compared with those obtained through the automated device . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 was 2 : 29 . 3 there 4 was 4 was 8 correlation 4 was 12 between 4 was 25 through 5 a 6 statistically 5 a 8 correlation 6 statistically 7 significant 7 significant 8 correlation 8 correlation 10 r=0.92 9 ( 10 r=0.92 10 r=0.92 11 ) 12 between 16 pressures 13 toe 16 pressures 14 systolic 15 blood 15 blood 16 pressures 16 pressures 17 obtained 16 pressures 19 with 16 pressures 21 compared 17 obtained 18 manually 19 with 20 photoplethysmography 21 compared 22 with 22 with 23 those 23 those 24 obtained 25 through 28 device 26 the 28 device 27 automated 28 device the same significant correlation was also seen between the two with ankle [(] r=0.87 [ )(and brachial ( r=0.88 ) systolic blood pressures . 0 ###LEFT-WALL### 4 correlation 0 ###LEFT-WALL### 7 seen 0 ###LEFT-WALL### 24 . 1 the 2 same 2 same 4 correlation 3 significant 4 correlation 4 correlation 5 was 5 was 6 also 5 was 7 seen 7 seen 8 between 7 seen 11 with 8 between 10 two 9 the 10 two 11 with 16 )(and 12 ankle 14 r=0.87 14 r=0.87 16 )(and 16 )(and 23 pressures 17 brachial 19 r=0.88 17 brachial 22 blood 18 ( 19 r=0.88 19 r=0.88 20 ) 21 systolic 22 blood 22 blood 23 pressures conclusion : these strong correlations demonstrate that further investigation of this device is [warranted] regarding its use as a screening tool for the assessment of peripheral arterial disease . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 5 correlations 2 : 6 demonstrate 3 these 5 correlations 4 strong 5 correlations 5 correlations 6 demonstrate 6 demonstrate 7 that 7 that 9 investigation 7 that 13 is 8 further 9 investigation 9 investigation 10 of 9 investigation 13 is 10 of 12 device 11 this 12 device 13 is 15 regarding 15 regarding 17 use 15 regarding 18 as 16 its 17 use 18 as 21 tool 19 a 21 tool 20 screening 21 tool 21 tool 22 for 22 for 24 assessment 23 the 24 assessment 24 assessment 25 of 25 of 28 disease 26 peripheral 28 disease 27 arterial 28 disease the automation provided by this device could potentially eliminate variability in these measurements thereby allowing for screening and diagnosis to be done without referral to a vascular laboratory . 0 ###LEFT-WALL### 2 automation 0 ###LEFT-WALL### 9 eliminate 0 ###LEFT-WALL### 29 . 1 the 2 automation 2 automation 3 provided 2 automation 7 could 3 provided 4 by 4 by 6 device 5 this 6 device 7 could 9 eliminate 8 potentially 9 eliminate 9 eliminate 10 variability 9 eliminate 25 to 10 variability 11 in 10 variability 20 to 10 variability 21 be 11 in 18 and 12 these 13 measurements 13 measurements 16 for 13 measurements 18 and 14 thereby 16 for 15 allowing 16 for 16 for 17 screening 18 and 19 diagnosis 20 to 21 be 21 be 22 done 22 done 23 without 23 without 24 referral 25 to 28 laboratory 26 a 28 laboratory 27 vascular 28 laboratory aims : given that high cholesterol levels at midlife are a risk factor [for] future cognitive decline , the goal of the current study was to determine if cholesterol - related alterations in the cerebrovascular response to cognition could be detected at midlife . 0 ###LEFT-WALL### 1 aims 0 ###LEFT-WALL### 2 : 2 : 7 levels 2 : 10 are 2 : 27 determine 2 : 44 . 3 given 6 cholesterol 4 that 5 high 5 high 6 cholesterol 6 cholesterol 7 levels 7 levels 8 at 7 levels 10 are 8 at 9 midlife 10 are 17 decline 11 a 17 decline 12 risk 15 future 13 factor 15 future 15 future 17 decline 16 cognitive 17 decline 18 , 27 determine 19 the 20 goal 20 goal 21 of 20 goal 25 was 21 of 24 study 22 the 24 study 23 current 24 study 25 was 26 to 25 was 27 determine 26 to 27 determine 27 determine 28 if 27 determine 42 at 28 if 29 cholesterol 28 if 41 detected 29 cholesterol 39 could 30 - 31 related 31 related 32 alterations 31 related 37 to 31 related 39 could 32 alterations 33 in 33 in 36 response 34 the 36 response 35 cerebrovascular 36 response 37 to 38 cognition 39 could 40 be 40 be 41 detected 42 at 43 midlife methods : forty adults , aged 40 - 60 years , performed a 2 [-] back working memory task during fmri . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 adults 2 : 12 performed 2 : 22 . 3 forty 4 adults 4 adults 6 aged 4 adults 10 years 4 adults 12 performed 5 , 6 aged 6 aged 7 40 6 aged 8 - 8 - 10 years 9 60 10 years 10 years 11 , 12 performed 19 task 12 performed 20 during 13 a 19 task 14 2 16 back 16 back 17 working 17 working 18 memory 18 memory 19 task 20 during 21 fmri the associations between serum total cholesterol , hdl - cholesterol , and total cholesterol/hdl - cholesterol concentrations to task - related activation intensity were modeled using multivariate multiple regression ( two - tailed p < 0.02 ) . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 5 total 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 38 . 1 the 2 associations 2 associations 3 between 2 associations 5 total 3 between 4 serum 5 total 6 cholesterol 7 , 12 and 7 , 25 modeled 8 hdl 9 - 8 hdl 12 and 10 cholesterol 12 and 11 , 12 and 12 and 23 intensity 12 and 24 were 13 total 23 intensity 14 cholesterol/hdl 17 concentrations 14 cholesterol/hdl 20 - 14 cholesterol/hdl 22 activation 15 - 17 concentrations 16 cholesterol 17 concentrations 17 concentrations 18 to 17 concentrations 19 task 17 concentrations 20 - 18 to 19 task 21 related 22 activation 22 activation 23 intensity 24 were 25 modeled 25 modeled 26 using 25 modeled 33 tailed 26 using 29 regression 27 multivariate 29 regression 28 multiple 29 regression 29 regression 31 two 30 ( 31 two 31 two 32 - 32 - 33 tailed 33 tailed 35 < 33 tailed 37 ) 34 p 35 < 35 < 36 0.02 35 < 37 ) results : higher levels of total cholesterol/hdl - cholesterol related to reduced working memory - related activation [intensity] in the left inferior parietal lobe , right superior frontal gyrus , and right middle frontal gyrus . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 levels 2 : 10 related 2 : 15 - 3 higher 4 levels 4 levels 5 of 4 levels 10 related 5 of 9 cholesterol 6 total 9 cholesterol 7 cholesterol/hdl 8 - 7 cholesterol/hdl 9 cholesterol 10 related 11 to 11 to 14 memory 12 reduced 14 memory 13 working 14 memory 15 - 31 and 15 - 33 middle 15 - 36 . 16 related 17 activation 17 activation 19 in 17 activation 25 , 19 in 24 lobe 20 the 24 lobe 21 left 24 lobe 22 inferior 24 lobe 23 parietal 24 lobe 25 , 29 gyrus 25 , 31 and 26 right 29 gyrus 27 superior 29 gyrus 28 frontal 29 gyrus 30 , 31 and 31 and 32 right 31 and 33 middle 33 middle 35 gyrus 34 frontal 35 gyrus conclusion : these data provide preliminary support for a deleterious effect [of] elevated total cholesterol/hdl - cholesterol ratio on cerebrovascular support for cognition in midlife . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 data 2 : 5 provide 3 these 4 data 4 data 5 provide 5 provide 7 support 5 provide 8 for 5 provide 24 in 6 preliminary 7 support 8 for 18 ratio 9 a 10 deleterious 9 a 18 ratio 10 deleterious 17 cholesterol 11 effect 13 elevated 13 elevated 17 cholesterol 14 total 17 cholesterol 15 cholesterol/hdl 16 - 15 cholesterol/hdl 17 cholesterol 17 cholesterol 18 ratio 18 ratio 19 on 18 ratio 22 for 19 on 21 support 20 cerebrovascular 21 support 22 for 23 cognition 24 in 25 midlife background : mutations in the cardiac na ( [+] [ )(channel gene [(] scn5a ) can adversely affect [electric] function in the heart , but effects can be age [dependent] . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 3 mutations 2 : 25 but 3 mutations 4 in 3 mutations 7 na 3 mutations 18 affect 3 mutations 25 but 4 in 6 cardiac 5 the 6 cardiac 7 na 14 scn5a 7 na 16 can 8 ( 14 scn5a 11 )(channel 12 gene 12 gene 14 scn5a 14 scn5a 15 ) 16 can 18 affect 17 adversely 18 affect 20 function 21 in 20 function 25 but 21 in 23 heart 22 the 23 heart 24 , 25 but 25 but 29 age 26 effects 27 can 27 can 28 be 28 be 29 age we explored the interacting effects of scn5a disruption and aging on the pathogenesis of sinus node dysfunction in a heterozygous [scn5a] [knockout] ( scn5a ( +/ - ) ) mouse model . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 explored 0 ###LEFT-WALL### 32 . 1 we 2 explored 2 explored 5 effects 2 explored 11 on 2 explored 18 in 3 the 5 effects 4 interacting 5 effects 5 effects 6 of 6 of 9 and 7 scn5a 8 disruption 8 disruption 9 and 9 and 10 aging 11 on 13 pathogenesis 12 the 13 pathogenesis 13 pathogenesis 14 of 14 of 17 dysfunction 15 sinus 16 node 16 node 17 dysfunction 18 in 31 model 19 a 20 heterozygous 19 a 31 model 20 heterozygous 24 scn5a 20 heterozygous 29 ) 20 heterozygous 30 mouse 23 ( 24 scn5a 24 scn5a 26 +/ 24 scn5a 28 ) 25 ( 26 +/ 26 +/ 27 - 30 mouse 31 model both scn5a disruption and aging were associated with decreased heart rate variability , reduced sinoatrial node automaticity , and slowed sinoatrial conduction . 0 ###LEFT-WALL### 3 disruption 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 23 . 1 both 3 disruption 2 scn5a 3 disruption 4 and 5 aging 4 and 19 and 5 aging 19 and 6 were 7 associated 6 were 19 and 7 associated 8 with 8 with 13 , 9 decreased 12 variability 9 decreased 13 , 10 heart 12 variability 11 rate 12 variability 13 , 14 reduced 14 reduced 17 automaticity 15 sinoatrial 16 node 16 node 17 automaticity 18 , 19 and 19 and 20 slowed 20 slowed 22 conduction 21 sinoatrial 22 conduction they also led to increased collagen and fibroblast levels and upregulated transforming growth factor - β ( 1 ) ( tgf - β ( 1 ) ) and vimentin transcripts , providing measures of fibrosis [and] reduced nav1.5 expression . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 led 0 ###LEFT-WALL### 40 . 1 they 3 led 2 also 3 led 3 led 4 to 4 to 7 and 5 increased 6 collagen 6 collagen 7 and 7 and 33 measures 8 fibroblast 9 levels 9 levels 10 and 10 and 14 factor 10 and 15 - 10 and 16 β 10 and 28 and 11 upregulated 14 factor 12 transforming 13 growth 13 growth 14 factor 15 - 16 β 16 β 18 1 16 β 21 tgf 16 β 27 ) 17 ( 18 1 18 1 19 ) 20 ( 21 tgf 21 tgf 23 β 21 tgf 26 ) 22 - 23 β 23 β 25 1 23 β 26 ) 24 ( 25 1 25 1 26 ) 28 and 30 transcripts 28 and 31 , 28 and 32 providing 28 and 33 measures 29 vimentin 30 transcripts 33 measures 34 of 34 of 39 expression 35 fibrosis 37 reduced 37 reduced 39 expression 38 nav1.5 39 expression all these effects were most noticeable in old [scn5a] ( +/ - ) mice . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 15 . 1 all 2 these 1 all 3 effects 1 all 4 were 2 these 3 effects 4 were 6 noticeable 5 most 6 noticeable 6 noticeable 7 in 7 in 14 mice 8 old 11 +/ 8 old 13 ) 8 old 14 mice 10 ( 11 +/ 11 +/ 12 - na [(] [+] ) channel inhibition by nav1.5 - e3 antibody directly increased tgf - β ( 1 ) production in both cultured human cardiac myocytes and fibroblasts . 0 ###LEFT-WALL### 5 channel 0 ###LEFT-WALL### 15 - 1 na 4 ) 1 na 5 channel 5 channel 6 inhibition 5 channel 7 by 7 by 8 nav1.5 8 nav1.5 14 tgf 9 - 14 tgf 10 e3 14 tgf 11 antibody 14 tgf 12 directly 13 increased 13 increased 14 tgf 14 tgf 15 - 15 - 27 and 15 - 29 . 16 β 18 1 16 β 19 ) 16 β 20 production 17 ( 18 1 18 1 19 ) 20 production 21 in 20 production 27 and 21 in 26 myocytes 22 both 26 myocytes 23 cultured 26 myocytes 24 human 26 myocytes 25 cardiac 26 myocytes 27 and 28 fibroblasts finally , aging was associated with downregulation of a wide range [of] ion channel and related transcripts [and] , again , was [greatest] in old [scn5a] ( +/ - ) mice . 0 ###LEFT-WALL### 3 aging 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 32 . 1 finally 2 , 1 finally 3 aging 3 aging 21 , 4 was 5 associated 4 was 21 , 5 associated 6 with 5 associated 20 again 6 with 7 downregulation 7 downregulation 8 of 8 of 15 and 9 a 10 wide 9 a 14 channel 10 wide 11 range 11 range 14 channel 13 ion 14 channel 14 channel 15 and 15 and 17 transcripts 15 and 19 , 16 related 17 transcripts 21 , 22 was 22 was 24 in 24 in 31 mice 25 old 28 +/ 25 old 30 ) 25 old 31 mice 27 ( 28 +/ 28 +/ 29 - the quantitative results from these studies permitted computer simulations that successfully replicated the observed sinoatrial node phenotypes shown by the different experimental groups . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 7 permitted 0 ###LEFT-WALL### 24 . 1 the 3 results 2 quantitative 3 results 3 results 4 from 3 results 7 permitted 4 from 6 studies 5 these 6 studies 7 permitted 9 simulations 8 computer 9 simulations 9 simulations 12 replicated 9 simulations 16 node 9 simulations 17 phenotypes 9 simulations 18 shown 10 that 11 successfully 11 successfully 12 replicated 13 the 16 node 14 observed 16 node 15 sinoatrial 16 node 16 node 17 phenotypes 18 shown 19 by 19 by 23 groups 20 the 23 groups 21 different 23 groups 22 experimental 23 groups conclusions : these results implicate a tissue degeneration triggered by nav1.5 deficiency manifesting as a tgf - β ( 1 ) - mediated fibrosis accompanied by electric remodeling in the sinus node dysfunction associated with scn5a disruption or aging . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 4 results 2 : 5 implicate 3 these 4 results 4 results 5 implicate 5 implicate 7 tissue 6 a 7 tissue 7 tissue 8 degeneration 7 tissue 13 manifesting 8 degeneration 9 triggered 9 triggered 10 by 9 triggered 12 deficiency 10 by 11 nav1.5 12 deficiency 13 manifesting 13 manifesting 14 as 13 manifesting 35 with 14 as 24 fibrosis 15 a 24 fibrosis 16 tgf 18 β 16 tgf 23 mediated 17 - 18 β 18 β 20 1 18 β 22 - 19 ( 20 1 20 1 21 ) 23 mediated 24 fibrosis 24 fibrosis 25 accompanied 25 accompanied 26 by 25 accompanied 34 associated 26 by 28 remodeling 27 electric 28 remodeling 28 remodeling 29 in 29 in 33 dysfunction 30 the 33 dysfunction 31 sinus 32 node 32 node 33 dysfunction 35 with 36 scn5a 35 with 38 or 37 disruption 38 or 38 or 39 aging the latter effects interact to produce the most severe phenotype in old [scn5a] ( +/ - ) mice . 0 ###LEFT-WALL### 2 latter 0 ###LEFT-WALL### 6 produce 0 ###LEFT-WALL### 19 . 1 the 2 latter 2 latter 3 effects 2 latter 5 to 2 latter 6 produce 3 effects 4 interact 4 interact 5 to 6 produce 10 phenotype 6 produce 11 in 7 the 10 phenotype 8 most 9 severe 9 severe 10 phenotype 11 in 18 mice 12 old 15 +/ 12 old 17 ) 12 old 18 mice 14 ( 15 +/ 15 +/ 16 - in demonstrating this , our findings suggest a novel regulatory role for nav1.5 in cellular biological processes in addition to its electrophysiologic function . 0 ###LEFT-WALL### 6 findings 0 ###LEFT-WALL### 7 suggest 0 ###LEFT-WALL### 24 . 1 in 2 demonstrating 1 in 4 , 1 in 6 findings 2 demonstrating 3 this 5 our 6 findings 6 findings 7 suggest 7 suggest 11 role 7 suggest 14 in 7 suggest 18 in 7 suggest 20 to 8 a 9 novel 8 a 11 role 9 novel 11 role 10 regulatory 11 role 11 role 12 for 12 for 13 nav1.5 14 in 17 processes 15 cellular 17 processes 16 biological 17 processes 18 in 19 addition 20 to 23 function 21 its 23 function 22 electrophysiologic 23 function none the population aged 65 years and older is increasing at a faster rate than the total population , with predictions that by 2030 , 20 % of the population will be 65 years or older . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 9 is 1 none 3 population 1 none 4 aged 1 none 9 is 2 the 3 population 3 population 4 aged 4 aged 7 and 5 65 6 years 6 years 7 and 7 and 8 older 9 is 10 increasing 10 increasing 11 at 10 increasing 15 than 10 increasing 20 with 11 at 14 rate 12 a 14 rate 13 faster 14 rate 15 than 18 population 16 the 18 population 17 total 18 population 19 , 20 with 20 with 21 predictions 20 with 37 . 21 predictions 22 that 21 predictions 32 be 22 that 27 % 22 that 32 be 23 by 24 2030 23 by 25 , 23 by 27 % 26 20 27 % 27 % 28 of 27 % 32 be 28 of 31 will 29 the 31 will 30 population 31 will 32 be 35 or 33 65 34 years 34 years 35 or 35 or 36 older in 2006 , between 35 [%] and 50 % of those aged 65 years or older reportedly had presbycusis , [a] sensory impairment that contributes to social isolation and loss of autonomy and is associated with anxiety , depression , and cognitive decline . 0 ###LEFT-WALL### 9 % 0 ###LEFT-WALL### 18 had 1 in 2 2006 1 in 3 , 1 in 9 % 4 between 7 and 5 35 7 and 7 and 8 50 7 and 9 % 9 % 10 of 9 % 12 aged 9 % 18 had 10 of 11 those 12 aged 15 or 13 65 14 years 14 years 15 or 15 or 16 older 17 reportedly 18 had 18 had 19 presbycusis 19 presbycusis 23 impairment 20 , 23 impairment 22 sensory 23 impairment 23 impairment 24 that 23 impairment 33 and 23 impairment 44 . 24 that 33 and 25 contributes 26 to 25 contributes 33 and 26 to 29 and 27 social 28 isolation 28 isolation 29 and 29 and 30 loss 29 and 31 of 31 of 32 autonomy 33 and 34 is 34 is 35 associated 35 associated 36 with 36 with 41 and 37 anxiety 38 , 38 , 39 depression 38 , 41 and 40 , 41 and 41 and 43 decline 42 cognitive 43 decline to address these concerns , [the] geriatric committee of the american academy of otolaryngology , in conjunction with the hearing committee , focused on 3 challenges and opportunities in the management of presbycusis [:] ( 1 ) the financial burden of caring for patients with presbycusis in the face of increasing costs and declining reimbursements [;] ( 2 ) future treatment options arising from improved understanding of the molecular mechanisms underlying presbycusis , and [(] 3 [ )(recognition of central presbycusis as a condition commonly superimposed on peripheral age - related hearing loss whose diagnosis and management can improve outcomes . 1 to 2 address 1 to 5 , 1 to 12 academy 2 address 4 concerns 3 these 4 concerns 5 , 7 geriatric 7 geriatric 12 academy 8 committee 12 academy 9 of 11 american 9 of 12 academy 10 the 11 american 12 academy 13 of 12 academy 16 in 12 academy 23 focused 13 of 14 otolaryngology 15 , 16 in 16 in 17 conjunction 16 in 22 , 17 conjunction 18 with 18 with 21 committee 19 the 21 committee 20 hearing 21 committee 23 focused 24 on 23 focused 27 and 23 focused 29 in 24 on 25 3 26 challenges 27 and 27 and 28 opportunities 29 in 31 management 30 the 31 management 31 management 32 of 31 management 39 financial 31 management 40 burden 31 management 41 of 32 of 33 presbycusis 33 presbycusis 36 1 35 ( 36 1 36 1 37 ) 38 the 39 financial 39 financial 40 burden 41 of 42 caring 42 caring 43 for 42 caring 47 in 42 caring 50 of 43 for 44 patients 44 patients 45 with 45 with 46 presbycusis 47 in 49 face 48 the 49 face 50 of 62 options 51 increasing 62 options 52 costs 53 and 53 and 55 reimbursements 53 and 58 2 53 and 62 options 54 declining 55 reimbursements 57 ( 58 2 58 2 59 ) 60 future 62 options 61 treatment 62 options 62 options 63 arising 62 options 67 of 62 options 71 underlying 63 arising 64 from 64 from 66 understanding 65 improved 66 understanding 67 of 70 mechanisms 68 the 70 mechanisms 69 molecular 70 mechanisms 71 underlying 74 and 71 underlying 82 as 72 presbycusis 74 and 73 , 74 and 74 and 78 )(recognition 74 and 79 of 76 3 78 )(recognition 79 of 81 presbycusis 80 central 81 presbycusis 82 as 84 condition 83 a 84 condition 84 condition 86 superimposed 84 condition 93 loss 85 commonly 86 superimposed 86 superimposed 87 on 87 on 89 age 88 peripheral 89 age 90 - 93 loss 91 related 93 loss 92 hearing 93 loss 93 loss 94 whose 93 loss 101 . 94 whose 95 diagnosis 95 diagnosis 96 and 96 and 97 management 96 and 98 can 98 can 99 improve 99 improve 100 outcomes tauopathies are characterized by hyperphosphorylation of the microtubule - associated protein tau and its accumulation into fibrillar aggregates . 0 ###LEFT-WALL### 1 tauopathies 0 ###LEFT-WALL### 3 characterized 0 ###LEFT-WALL### 19 . 1 tauopathies 2 are 2 are 3 characterized 3 characterized 4 by 3 characterized 16 into 4 by 5 hyperphosphorylation 5 hyperphosphorylation 6 of 6 of 13 and 7 the 12 tau 8 microtubule 9 - 8 microtubule 11 protein 10 associated 11 protein 11 protein 12 tau 12 tau 13 and 13 and 15 accumulation 14 its 15 accumulation 16 into 18 aggregates 17 fibrillar 18 aggregates toxic effects of aggregated tau [and/or] dysfunction of soluble tau could both contribute to neural defects in these neurodegenerative diseases . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 13 contribute 0 ###LEFT-WALL### 21 . 1 toxic 2 effects 2 effects 3 of 2 effects 11 could 3 of 7 dysfunction 4 aggregated 5 tau 5 tau 7 dysfunction 7 dysfunction 8 of 8 of 10 tau 9 soluble 10 tau 11 could 13 contribute 12 both 13 contribute 13 contribute 14 to 13 contribute 17 in 14 to 16 defects 15 neural 16 defects 17 in 20 diseases 18 these 20 diseases 19 neurodegenerative 20 diseases we have generated a novel knockin mouse model of an inherited tauopathy , frontotemporal dementia with parkinsonism linked to tau mutations on chromosome 17 ( ftdp - 17 t ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 generated 0 ###LEFT-WALL### 31 . 1 we 2 have 2 have 3 generated 3 generated 8 model 4 a 8 model 5 novel 8 model 6 knockin 8 model 7 mouse 8 model 8 model 9 of 8 model 15 dementia 9 of 12 tauopathy 10 an 12 tauopathy 11 inherited 12 tauopathy 13 , 15 dementia 14 frontotemporal 15 dementia 15 dementia 16 with 15 dementia 18 linked 15 dementia 22 on 15 dementia 29 t 15 dementia 30 ) 16 with 17 parkinsonism 18 linked 19 to 19 to 21 mutations 20 tau 21 mutations 22 on 23 chromosome 23 chromosome 24 17 23 chromosome 26 ftdp 25 ( 26 ftdp 26 ftdp 27 - 27 - 29 t 28 17 29 t 29 t 30 ) we incorporated a single mutation , homologous to the common ftdp - 17 t p301l mutation , directly into the endogenous mouse gene , mimicking the human disease situation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 incorporated 1 we 2 incorporated 2 incorporated 5 mutation 2 incorporated 18 directly 2 incorporated 19 into 3 a 4 single 3 a 5 mutation 4 single 5 mutation 5 mutation 7 homologous 6 , 7 homologous 7 homologous 8 to 7 homologous 17 , 8 to 16 mutation 9 the 16 mutation 10 common 16 mutation 11 ftdp 16 mutation 12 - 13 17 13 17 14 t 14 t 16 mutation 15 p301l 16 mutation 19 into 23 gene 20 the 23 gene 21 endogenous 22 mouse 22 mouse 23 gene 23 gene 25 mimicking 24 , 25 mimicking 25 mimicking 29 situation 25 mimicking 30 . 26 the 29 situation 27 human 28 disease 28 disease 29 situation these mice express p301l - equivalent mutant tau at normal physiological levels from the knockin allele . 0 ###LEFT-WALL### 2 mice 0 ###LEFT-WALL### 3 express 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 17 . 1 these 2 mice 2 mice 3 express 3 express 4 p301l 5 - 8 tau 6 equivalent 8 tau 7 mutant 8 tau 8 tau 9 at 9 at 12 levels 10 normal 12 levels 11 physiological 12 levels 12 levels 13 from 13 from 16 allele 14 the 16 allele 15 knockin 16 allele importantly , in contrast to existing transgenic mouse models that overexpress human p301l mutant tau , no overt tau pathology developed during the normal lifespan of the knockin mice . 0 ###LEFT-WALL### 20 pathology 0 ###LEFT-WALL### 21 developed 0 ###LEFT-WALL### 30 . 1 importantly 2 , 1 importantly 20 pathology 3 in 4 contrast 3 in 16 , 3 in 20 pathology 4 contrast 5 to 5 to 9 models 6 existing 8 mouse 7 transgenic 8 mouse 8 mouse 9 models 9 models 10 that 9 models 11 overexpress 10 that 11 overexpress 11 overexpress 15 tau 12 human 14 mutant 13 p301l 14 mutant 14 mutant 15 tau 17 no 20 pathology 18 overt 19 tau 19 tau 20 pathology 20 pathology 21 developed 21 developed 22 during 22 during 25 lifespan 23 the 25 lifespan 24 normal 25 lifespan 25 lifespan 26 of 26 of 29 mice 27 the 29 mice 28 knockin 29 mice in fact , overall phosphorylation of tau was reduced , perhaps due to reduced microtubule binding . 0 ###LEFT-WALL### 5 phosphorylation 0 ###LEFT-WALL### 9 reduced 1 in 2 fact 2 fact 3 , 2 fact 5 phosphorylation 4 overall 5 phosphorylation 5 phosphorylation 6 of 5 phosphorylation 8 was 6 of 7 tau 8 was 9 reduced 9 reduced 13 to 10 , 11 perhaps 10 , 13 to 12 due 13 to 13 to 15 microtubule 13 to 17 . 14 reduced 15 microtubule 15 microtubule 16 binding however , homozygous knockin mice did display intriguing age - dependent changes in axonal transport of mitochondria , and increased spontaneous locomotor activity in old age . 0 ###LEFT-WALL### 5 mice 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 27 . 1 however 2 , 1 however 5 mice 3 homozygous 4 knockin 4 knockin 5 mice 5 mice 19 and 6 did 7 display 6 did 19 and 7 display 9 age 8 intriguing 9 age 9 age 12 changes 10 - 12 changes 11 dependent 12 changes 12 changes 13 in 12 changes 18 , 13 in 15 transport 14 axonal 15 transport 15 transport 16 of 16 of 17 mitochondria 19 and 20 increased 19 and 24 in 20 increased 23 activity 21 spontaneous 22 locomotor 22 locomotor 23 activity 24 in 26 age 25 old 26 age these could represent early consequences of the tau dysfunction that eventually precipitates pathogenesis in humans . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 3 represent 0 ###LEFT-WALL### 16 . 1 these 2 could 2 could 3 represent 3 represent 5 consequences 4 early 5 consequences 5 consequences 6 of 6 of 9 dysfunction 7 the 9 dysfunction 8 tau 9 dysfunction 9 dysfunction 10 that 9 dysfunction 12 precipitates 10 that 12 precipitates 11 eventually 12 precipitates 12 precipitates 13 pathogenesis 12 precipitates 14 in 14 in 15 humans purpose : to measure choroidal thickness and to determine parameters associated with it . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 7 and 2 : 14 . 3 to 7 and 4 measure 6 thickness 4 measure 7 and 5 choroidal 6 thickness 7 and 8 to 7 and 9 determine 8 to 9 determine 9 determine 10 parameters 10 parameters 11 associated 11 associated 12 with 12 with 13 it design : cross - sectional study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 7 . 1 design 2 : 2 : 3 cross 4 - 6 study 5 sectional 6 study participants : seventy - four glaucoma patients and glaucoma suspects . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 2 : 8 and 2 : 11 . 3 seventy 4 - 4 - 5 four 4 - 7 patients 6 glaucoma 7 patients 7 patients 8 and 8 and 10 suspects 9 glaucoma 10 suspects methods : spectral domain optical coherence tomography ( sd - oct ) scans were obtained to estimate average choroidal thickness in a group of glaucoma suspects and glaucoma patients . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 1 methods 2 : 2 : 3 spectral 3 spectral 6 coherence 3 spectral 17 estimate 4 domain 6 coherence 5 optical 6 coherence 6 coherence 7 tomography 6 coherence 13 scans 6 coherence 14 were 7 tomography 11 oct 7 tomography 13 scans 8 ( 11 oct 9 sd 11 oct 10 - 11 oct 11 oct 12 ) 14 were 15 obtained 15 obtained 16 to 16 to 17 estimate 17 estimate 20 thickness 17 estimate 21 in 18 average 20 thickness 19 choroidal 20 thickness 21 in 27 and 22 a 23 group 23 group 24 of 23 group 27 and 24 of 26 suspects 25 glaucoma 26 suspects 27 and 29 patients 28 glaucoma 29 patients the average thickness was calculated from enhanced depth sd - oct images and manually analyzed with image j software . 0 ###LEFT-WALL### 3 thickness 0 ###LEFT-WALL### 5 calculated 0 ###LEFT-WALL### 20 . 1 the 3 thickness 2 average 3 thickness 3 thickness 4 was 4 was 5 calculated 5 calculated 6 from 6 from 13 and 7 enhanced 12 images 7 enhanced 13 and 8 depth 12 images 9 sd 11 oct 10 - 11 oct 11 oct 12 images 13 and 15 analyzed 13 and 16 with 14 manually 15 analyzed 16 with 19 software 17 image 18 j 17 image 19 software open - angle glaucoma , open - angle glaucoma suspect , primary angle - closure glaucoma , primary angle closure , and primary angle - closure [suspect] were defined by published criteria . 0 ###LEFT-WALL### 1 open 0 ###LEFT-WALL### 2 - 2 - 4 glaucoma 2 - 5 , 2 - 24 angle 2 - 25 - 3 angle 4 glaucoma 5 , 10 suspect 5 , 11 , 6 open 7 - 6 open 8 angle 8 angle 9 glaucoma 9 glaucoma 10 suspect 11 , 13 angle 11 , 14 - 12 primary 13 angle 14 - 15 closure 15 closure 22 and 15 closure 24 angle 16 glaucoma 17 , 17 , 20 closure 17 , 22 and 18 primary 20 closure 19 angle 20 closure 21 , 22 and 22 and 23 primary 22 and 24 angle 25 - 26 closure 25 - 29 defined 25 - 33 . 26 closure 28 were 28 were 29 defined 29 defined 30 by 30 by 32 criteria 31 published 32 criteria glaucoma suspects had normal visual fields bilaterally . 0 ###LEFT-WALL### 2 suspects 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 8 . 1 glaucoma 2 suspects 2 suspects 3 had 3 had 6 fields 3 had 7 bilaterally 4 normal 6 fields 5 visual 6 fields glaucoma was defined by specific criteria for optic disc damage and visual field loss in ≥1 [eye] . 0 ###LEFT-WALL### 1 glaucoma 0 ###LEFT-WALL### 3 defined 0 ###LEFT-WALL### 18 . 1 glaucoma 2 was 2 was 3 defined 3 defined 4 by 3 defined 7 for 3 defined 15 in 4 by 6 criteria 5 specific 6 criteria 7 for 11 and 8 optic 9 disc 9 disc 10 damage 10 damage 11 and 11 and 14 loss 12 visual 13 field 13 field 14 loss 15 in 16 ≥1 the most affected eye was analyzed for comparisons across individuals , and right/left and upper half/lower half comparisons were made to compare thickness against degree of visual field damage . 0 ###LEFT-WALL### 4 eye 0 ###LEFT-WALL### 6 analyzed 0 ###LEFT-WALL### 30 . 1 the 4 eye 2 most 3 affected 3 affected 4 eye 4 eye 5 was 5 was 6 analyzed 6 analyzed 7 for 6 analyzed 9 across 7 for 8 comparisons 9 across 12 and 10 individuals 12 and 11 , 12 and 12 and 25 degree 12 and 26 of 13 right/left 14 and 14 and 16 half/lower 14 and 17 half 14 and 24 against 14 and 25 degree 15 upper 16 half/lower 17 half 18 comparisons 17 half 21 to 17 half 22 compare 18 comparisons 19 were 19 were 20 made 20 made 21 to 22 compare 23 thickness 22 compare 24 against 26 of 29 damage 27 visual 28 field 28 field 29 damage main outcome measures : average macular and peripapillary choroidal thickness measured using sd - oct . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 5 average 0 ###LEFT-WALL### 16 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 5 average 5 average 10 thickness 6 macular 7 and 7 and 8 peripapillary 7 and 10 thickness 9 choroidal 10 thickness 10 thickness 11 measured 11 measured 12 using 12 using 15 oct 13 sd 15 oct 14 - 15 oct results : the choroidal - scleral interface was visualized in 86 % and 96 % of the macular and peripapillary scans , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 interface 2 : 9 visualized 2 : 13 and 3 the 7 interface 4 choroidal 5 - 4 choroidal 7 interface 6 scleral 7 interface 7 interface 8 was 8 was 9 visualized 9 visualized 10 in 10 in 12 % 11 86 12 % 13 and 15 % 13 and 21 scans 14 96 15 % 15 % 16 of 15 % 21 scans 16 of 19 and 17 the 18 macular 18 macular 19 and 19 and 20 peripapillary 21 scans 23 respectively 22 , 23 respectively 23 respectively 24 . the choroid was not significantly thinner in glaucoma patients than in suspects ( 14 μm [[] 95 % ci , - 54 , 26 ] [;] p = 0.5 ) . 0 ###LEFT-WALL### 2 choroid 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 31 . 1 the 2 choroid 2 choroid 3 was 3 was 4 not 3 was 5 significantly 3 was 6 thinner 6 thinner 7 in 6 thinner 10 than 7 in 9 patients 8 glaucoma 9 patients 10 than 11 in 11 in 12 suspects 12 suspects 19 ci 12 suspects 22 54 13 ( 19 ci 14 14 15 μm 15 μm 19 ci 17 95 19 ci 18 % 19 ci 19 ci 20 , 20 , 22 54 21 - 22 54 22 54 24 26 22 54 28 = 22 54 30 ) 23 , 24 26 24 26 25 ] 27 p 28 = 28 = 29 0.5 28 = 30 ) peripapillary choroidal thickness was not significantly different between glaucoma and suspect patients . 0 ###LEFT-WALL### 3 thickness 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 13 . 1 peripapillary 3 thickness 2 choroidal 3 thickness 3 thickness 4 was 4 was 5 not 4 was 7 different 5 not 6 significantly 6 significantly 7 different 7 different 8 between 8 between 10 and 9 glaucoma 10 and 10 and 12 patients 11 suspect 12 patients thickness was not associated with damage severity as estimated by visual field mean deviation or nerve fiber layer thickness , including comparisons of right with left [eye] or upper with lower values . 0 ###LEFT-WALL### 1 thickness 0 ###LEFT-WALL### 2 was 1 thickness 2 was 2 was 3 not 2 was 5 with 2 was 10 by 3 not 4 associated 5 with 7 severity 6 damage 7 severity 7 severity 9 estimated 8 as 9 estimated 10 by 15 or 11 visual 12 field 12 field 14 deviation 13 mean 14 deviation 14 deviation 15 or 15 or 19 thickness 15 or 21 including 16 nerve 17 fiber 17 fiber 19 thickness 18 layer 19 thickness 20 , 21 including 21 including 22 comparisons 21 including 33 . 22 comparisons 23 of 22 comparisons 25 with 23 of 24 right 25 with 28 or 26 left 28 or 28 or 29 upper 28 or 30 with 30 with 32 values 31 lower 32 values conclusions : age , axial length , cct , and diastolic ocular perfusion pressure are significantly associated with choroidal thickness in glaucoma suspects and glaucoma patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 27 . 1 conclusions 2 : 2 : 3 age 4 , 10 and 4 , 17 associated 5 axial 6 length 6 length 7 , 7 , 8 cct 7 , 10 and 9 , 10 and 10 and 14 pressure 10 and 15 are 11 diastolic 13 perfusion 12 ocular 13 perfusion 13 perfusion 14 pressure 15 are 16 significantly 15 are 17 associated 17 associated 18 with 17 associated 21 in 18 with 20 thickness 19 choroidal 20 thickness 21 in 24 and 22 glaucoma 23 suspects 23 suspects 24 and 24 and 26 patients 25 glaucoma 26 patients degree of glaucoma damage was not consistently associated with choroidal thickness . 0 ###LEFT-WALL### 1 degree 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 12 . 1 degree 2 of 1 degree 5 was 2 of 4 damage 3 glaucoma 4 damage 5 was 6 not 5 was 8 associated 7 consistently 8 associated 8 associated 9 with 9 with 11 thickness 10 choroidal 11 thickness financial disclosure ( s ) : proprietary or commercial disclosure may be found after the references . 0 ###LEFT-WALL### 2 disclosure 0 ###LEFT-WALL### 6 : 0 ###LEFT-WALL### 8 or 0 ###LEFT-WALL### 17 . 1 financial 2 disclosure 2 disclosure 4 s 2 disclosure 6 : 3 ( 4 s 4 s 5 ) 6 : 7 proprietary 8 or 10 disclosure 8 or 13 found 9 commercial 10 disclosure 10 disclosure 11 may 11 may 12 be 12 be 13 found 13 found 14 after 14 after 16 references 15 the 16 references background : as the scope of neurosurgical spinal operations has broadened widely , spinal neurosurgery is certainly the one of the fields of neurosurgery where the most changes are observed . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 15 neurosurgery 2 : 16 is 2 : 31 . 3 as 5 scope 3 as 11 broadened 3 as 13 , 3 as 15 neurosurgery 4 the 5 scope 5 scope 6 of 5 scope 10 has 6 of 9 operations 7 neurosurgical 9 operations 8 spinal 9 operations 10 has 11 broadened 11 broadened 12 widely 14 spinal 15 neurosurgery 15 neurosurgery 16 is 16 is 17 certainly 16 is 19 one 18 the 19 one 19 one 20 of 20 of 22 fields 21 the 22 fields 22 fields 23 of 22 fields 25 where 23 of 24 neurosurgery 25 where 28 changes 25 where 30 observed 26 the 27 most 27 most 28 changes 28 changes 29 are 29 are 30 observed increasing health costs and an aging population will make this issue even more crucial in the future . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 9 make 0 ###LEFT-WALL### 18 . 1 increasing 2 health 2 health 3 costs 3 costs 4 and 4 and 7 population 4 and 8 will 5 an 7 population 6 aging 7 population 8 will 9 make 9 make 11 issue 10 this 11 issue 11 issue 14 crucial 12 even 13 more 13 more 14 crucial 14 crucial 15 in 15 in 17 future 16 the 17 future methods : we reviewed the number of spinal procedures performed by neurosurgeons in belgium between 2000 and 2005 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 reviewed 2 : 19 . 3 we 4 reviewed 4 reviewed 9 procedures 5 the 6 number 6 number 7 of 6 number 9 procedures 7 of 9 procedures 8 spinal 9 procedures 9 procedures 10 performed 10 performed 11 by 10 performed 13 in 11 by 12 neurosurgeons 13 in 14 belgium 14 belgium 17 and 15 between 17 and 16 2000 17 and 17 and 18 2005 during this period , the number of lumbar spinal operations for degenerative spinal diseases has increased by 20 % , reaching more than 23,000 operations per year , among which 77 % were decompressive surgeries , 43 % posterior fusions , and 50 % anterior fusions , all done by neurosurgeons . 0 ###LEFT-WALL### 6 number 0 ###LEFT-WALL### 16 increased 0 ###LEFT-WALL### 36 , 0 ###LEFT-WALL### 52 . 1 during 3 period 1 during 4 , 1 during 6 number 2 this 3 period 5 the 6 number 6 number 7 of 6 number 15 has 7 of 10 operations 8 lumbar 10 operations 9 spinal 10 operations 10 operations 11 for 11 for 14 diseases 12 degenerative 14 diseases 13 spinal 14 diseases 15 has 16 increased 16 increased 17 by 17 by 19 % 18 20 19 % 19 % 21 reaching 20 , 21 reaching 21 reaching 25 operations 21 reaching 36 , 22 more 23 than 23 than 24 23,000 24 23,000 25 operations 25 operations 26 per 25 operations 29 among 26 per 27 year 28 , 29 among 29 among 30 which 29 among 32 % 29 among 33 were 29 among 36 , 31 77 32 % 32 % 33 were 33 were 35 surgeries 34 decompressive 35 surgeries 36 , 42 and 37 43 40 fusions 38 % 40 fusions 39 posterior 40 fusions 40 fusions 42 and 41 , 42 and 42 and 46 fusions 42 and 47 , 42 and 49 done 42 and 50 by 43 50 46 fusions 44 % 46 fusions 45 anterior 46 fusions 48 all 49 done 50 by 51 neurosurgeons the neurosurgical prevalence is even more striking in cervical or intradural procedures . 0 ###LEFT-WALL### 3 prevalence 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 13 . 1 the 3 prevalence 2 neurosurgical 3 prevalence 3 prevalence 4 is 4 is 5 even 4 is 7 striking 6 more 7 striking 7 striking 8 in 8 in 12 procedures 9 cervical 10 or 10 or 11 intradural 10 or 12 procedures conclusion : as a result we created a neurosurgical spine society to represent neurosurgeons who were otherwise almost absent from the political decision - making processes . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 represent 2 : 6 we 2 : 7 created 3 as 5 result 3 as 6 we 4 a 5 result 6 we 7 created 7 created 11 society 7 created 12 to 8 a 9 neurosurgical 8 a 11 society 9 neurosurgical 11 society 10 spine 11 society 12 to 13 represent 13 represent 14 neurosurgeons 14 neurosurgeons 15 who 14 neurosurgeons 16 were 15 who 16 were 16 were 17 otherwise 16 were 19 absent 18 almost 19 absent 19 absent 20 from 19 absent 25 making 20 from 23 decision 21 the 23 decision 22 political 23 decision 24 - 25 making 25 making 26 processes 25 making 27 . these observations , not unique to belgium , should encourage colleagues to play a pivotal role in all spine [-] related discussions with healthcare providers , state or private , to get involved in teaching spinal surgery , [and] to participate in clinical and laboratory research leading to the publications that are essential to put forward the contribution of neurosurgeons in spinal surgery [.] 0 ###LEFT-WALL### 2 observations 0 ###LEFT-WALL### 10 encourage 1 these 2 observations 2 observations 5 unique 2 observations 9 should 3 , 4 not 3 , 5 unique 5 unique 6 to 5 unique 8 , 6 to 7 belgium 9 should 10 encourage 10 encourage 11 colleagues 10 encourage 12 to 12 to 13 play 13 play 16 role 13 play 23 with 14 a 16 role 15 pivotal 16 role 16 role 17 in 17 in 22 discussions 18 all 22 discussions 19 spine 22 discussions 21 related 22 discussions 23 with 28 or 24 healthcare 25 providers 25 providers 26 , 26 , 27 state 26 , 28 or 28 or 29 private 28 or 30 , 28 or 31 to 28 or 32 get 28 or 40 to 31 to 32 get 32 get 33 involved 33 involved 34 in 34 in 35 teaching 35 teaching 37 surgery 36 spinal 37 surgery 38 , 40 to 40 to 41 participate 41 participate 42 in 41 participate 48 to 42 in 44 and 43 clinical 44 and 44 and 46 research 44 and 47 leading 45 laboratory 46 research 48 to 50 publications 49 the 50 publications 50 publications 51 that 50 publications 52 are 51 that 52 are 52 are 53 essential 53 essential 54 to 54 to 55 put 55 put 56 forward 55 put 58 contribution 57 the 58 contribution 58 contribution 59 of 59 of 60 neurosurgeons 60 neurosurgeons 61 in 61 in 63 surgery 62 spinal 63 surgery anxiety is a major cause for distress among older people with dementia , and it impedes care . 0 ###LEFT-WALL### 1 anxiety 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 18 . 1 anxiety 2 is 2 is 5 cause 3 a 4 major 3 a 5 cause 4 major 5 cause 5 cause 6 for 6 for 7 distress 7 distress 8 among 8 among 10 people 9 older 10 people 10 people 11 with 11 with 12 dementia 13 , 14 and 14 and 15 it 14 and 16 impedes 15 it 16 impedes 16 impedes 17 care in order to develop interventions to treat anxiety and [identify] who might be most likely to benefit , mental health nurses need to understand what clinical and demographic factors are associated with anxiety in dementia . 0 ###LEFT-WALL### 5 interventions 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 36 . 1 in 2 order 1 in 5 interventions 2 order 3 to 2 order 4 develop 3 to 4 develop 5 interventions 6 to 5 interventions 12 might 6 to 9 and 7 treat 8 anxiety 8 anxiety 9 and 9 and 11 who 12 might 18 , 13 be 14 most 13 be 15 likely 13 be 18 , 15 likely 16 to 15 likely 17 benefit 16 to 17 benefit 18 , 24 understand 18 , 32 with 18 , 34 in 19 mental 20 health 20 health 21 nurses 21 nurses 22 need 22 need 23 to 23 to 24 understand 24 understand 25 what 24 understand 31 associated 25 what 27 and 25 what 30 are 25 what 31 associated 26 clinical 27 and 27 and 29 factors 27 and 30 are 28 demographic 29 factors 32 with 33 anxiety 34 in 35 dementia this cross [-] sectional study is a detailed assessment of anxiety in people living in assisted - living facilities using the rating anxiety in dementia ( raid ) scale and the clinical anxiety scale ( cas ) . 0 ###LEFT-WALL### 2 cross 0 ###LEFT-WALL### 16 assisted 0 ###LEFT-WALL### 38 . 1 this 2 cross 2 cross 4 sectional 2 cross 5 study 2 cross 15 in 2 cross 16 assisted 5 study 6 is 6 is 9 assessment 7 a 9 assessment 8 detailed 9 assessment 9 assessment 10 of 10 of 11 anxiety 11 anxiety 12 in 11 anxiety 14 living 12 in 13 people 14 living 15 in 16 assisted 18 living 17 - 18 living 18 living 19 facilities 18 living 20 using 18 living 37 ) 20 using 30 and 21 the 29 scale 22 rating 23 anxiety 23 anxiety 24 in 23 anxiety 27 raid 24 in 25 dementia 26 ( 27 raid 27 raid 28 ) 27 raid 29 scale 29 scale 30 and 30 and 36 cas 31 the 36 cas 32 clinical 33 anxiety 33 anxiety 34 scale 34 scale 36 cas 35 ( 36 cas one hundred and forty - eight people , with a mean age of 86.2 years , were recruited from 19 assisted - living facilities in the usa . 0 ###LEFT-WALL### 4 forty 0 ###LEFT-WALL### 18 recruited 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 28 . 1 one 2 hundred 2 hundred 3 and 3 and 4 forty 4 forty 7 people 4 forty 17 were 5 - 7 people 6 eight 7 people 7 people 9 with 7 people 16 , 8 , 9 with 9 with 12 age 9 with 16 , 10 a 12 age 11 mean 12 age 12 age 13 of 13 of 15 years 14 86.2 15 years 17 were 18 recruited 18 recruited 19 from 18 recruited 21 assisted 19 from 20 19 22 - 24 facilities 23 living 24 facilities 24 facilities 25 in 25 in 27 usa 26 the 27 usa prevalence rates for anxiety were 11 [%] and 18 % , as measured on the raid and cas , respectively . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 21 . 1 prevalence 2 rates 2 rates 3 for 2 rates 5 were 3 for 4 anxiety 5 were 10 % 5 were 20 respectively 6 11 8 and 8 and 9 18 8 and 10 % 10 % 13 measured 11 , 13 measured 12 as 13 measured 13 measured 14 on 13 measured 19 , 14 on 18 cas 15 the 18 cas 16 raid 17 and 17 and 18 cas one or more symptoms of anxiety [were] exhibited for 49 % ( raid ) and 48 [%] ( cas ) of participants . 0 ###LEFT-WALL### 2 or 0 ###LEFT-WALL### 23 . 1 one 2 or 2 or 4 symptoms 2 or 5 of 3 more 4 symptoms 5 of 15 and 6 anxiety 8 exhibited 6 anxiety 15 and 8 exhibited 9 for 9 for 11 % 10 49 11 % 11 % 13 raid 12 ( 13 raid 13 raid 14 ) 15 and 19 cas 15 and 21 of 16 48 19 cas 18 ( 19 cas 19 cas 20 ) 21 of 22 participants behavioural symptoms and the presence of depression strongly predicted anxiety , as did staff 's reaction to behavioural symptoms and their sense of competence to care . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 9 predicted 1 behavioural 2 symptoms 2 symptoms 3 and 3 and 5 presence 3 and 6 of 3 and 9 predicted 4 the 5 presence 6 of 7 depression 8 strongly 9 predicted 9 predicted 10 anxiety 9 predicted 12 as 11 , 12 as 12 as 13 did 12 as 27 . 13 did 16 reaction 14 staff 15 's 15 's 16 reaction 16 reaction 17 to 16 reaction 23 of 17 to 20 and 18 behavioural 19 symptoms 19 symptoms 20 and 20 and 22 sense 21 their 22 sense 23 of 24 competence 24 competence 25 to 24 competence 26 care 25 to 26 care these findings demonstrate that anxiety is prominent enough to warrant further investigation and treatment , and that anxiety in older people with dementia is closely associated with staff skill . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 30 . 1 these 2 findings 2 findings 3 demonstrate 3 demonstrate 4 that 4 that 5 anxiety 4 that 6 is 5 anxiety 6 is 6 is 7 prominent 7 prominent 8 enough 7 prominent 9 to 7 prominent 10 warrant 9 to 10 warrant 10 warrant 12 investigation 11 further 12 investigation 13 and 16 and 13 and 28 staff 14 treatment 16 and 15 , 16 and 16 and 17 that 16 and 18 anxiety 16 and 27 with 16 and 28 staff 18 anxiety 19 in 18 anxiety 22 with 18 anxiety 24 is 19 in 21 people 20 older 21 people 22 with 23 dementia 24 is 25 closely 24 is 26 associated 26 associated 27 with 28 staff 29 skill this study has also identified areas for mental health nurses to target interventions . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 14 . 1 this 2 study 2 study 3 has 3 has 5 identified 4 also 5 identified 5 identified 6 areas 5 identified 11 to 6 areas 7 for 7 for 10 nurses 8 mental 9 health 9 health 10 nurses 11 to 12 target 12 target 13 interventions background/purpose : near - infrared ( nir ) spectroscopy and skin impedance ( imp ) measurements are useful techniques for objective diagnostics of various skin diseases . 0 ###LEFT-WALL### 1 background/purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 16 measurements 2 : 17 are 3 near 10 and 3 near 16 measurements 4 - 10 and 5 infrared 7 nir 5 infrared 8 ) 5 infrared 9 spectroscopy 6 ( 7 nir 7 nir 8 ) 9 spectroscopy 10 and 10 and 12 impedance 10 and 14 imp 10 and 15 ) 11 skin 12 impedance 13 ( 14 imp 14 imp 15 ) 16 measurements 17 are 17 are 19 techniques 17 are 20 for 18 useful 19 techniques 20 for 22 diagnostics 21 objective 22 diagnostics 22 diagnostics 23 of 23 of 26 diseases 24 various 26 diseases 25 skin 26 diseases here , we present a combined probe head for simultaneous , time - saving nir spectroscopy and skin impedance measurements . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 1 here 2 , 1 here 3 we 3 we 4 present 4 present 8 head 5 a 8 head 6 combined 7 probe 7 probe 8 head 8 head 9 for 8 head 14 saving 9 for 12 time 10 simultaneous 11 , 10 simultaneous 12 time 13 - 14 saving 14 saving 17 and 14 saving 21 . 15 nir 16 spectroscopy 16 spectroscopy 17 and 17 and 20 measurements 18 skin 20 measurements 19 impedance 20 measurements the probe also ensures that both measurements are performed under equal conditions and at the same skin location . 0 ###LEFT-WALL### 2 probe 0 ###LEFT-WALL### 4 ensures 0 ###LEFT-WALL### 19 . 1 the 2 probe 2 probe 4 ensures 3 also 4 ensures 4 ensures 5 that 5 that 7 measurements 5 that 9 performed 6 both 7 measurements 7 measurements 8 are 8 are 9 performed 9 performed 13 and 10 under 12 conditions 10 under 13 and 11 equal 12 conditions 13 and 14 at 14 at 18 location 15 the 16 same 16 same 18 location 17 skin 18 location methods : finite element method simulations were performed for [evaluation] of the impedance . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 . 2 : 3 finite 3 finite 6 simulations 3 finite 9 for 3 finite 11 of 4 element 6 simulations 5 method 6 simulations 6 simulations 7 were 7 were 8 performed 8 performed 9 for 11 of 13 impedance 12 the 13 impedance in vivo skin measurements were performed and combined nir and impedance spectra were analysed by means of multivariate methods with respect to body location [,] age and gender . 0 ###LEFT-WALL### 4 measurements 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 29 . 1 in 2 vivo 2 vivo 4 measurements 3 skin 4 measurements 4 measurements 5 were 5 were 6 performed 7 and 10 and 7 and 14 analysed 8 combined 9 nir 9 nir 10 and 10 and 12 spectra 10 and 13 were 11 impedance 12 spectra 13 were 14 analysed 14 analysed 15 by 14 analysed 20 with 14 analysed 22 to 15 by 16 means 16 means 17 of 17 of 19 methods 18 multivariate 19 methods 20 with 21 respect 22 to 27 and 23 body 26 age 24 location 26 age 26 age 27 and 27 and 28 gender the classification rate was determined by a planar discriminant analysis . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 11 . 1 the 3 rate 2 classification 3 rate 3 rate 4 was 4 was 5 determined 5 determined 6 by 6 by 10 analysis 7 a 8 planar 7 a 10 analysis 8 planar 10 analysis 9 discriminant 10 analysis reproducibility was investigated by calculation of scatter values and statistical significance between overlapping groups was assessed by the calculation of [intra] - model distances , [q] . 0 ###LEFT-WALL### 1 reproducibility 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 27 . 1 reproducibility 2 was 2 was 3 investigated 3 investigated 4 by 4 by 5 calculation 5 calculation 6 of 6 of 9 and 7 scatter 8 values 8 values 9 and 9 and 10 statistical 9 and 11 significance 9 and 20 of 9 and 24 distances 11 significance 12 between 11 significance 15 was 12 between 13 overlapping 13 overlapping 14 groups 15 was 16 assessed 16 assessed 17 by 17 by 19 calculation 18 the 19 calculation 19 calculation 20 of 22 - 24 distances 23 model 24 distances 24 distances 25 , results : the novel probe yielded rapid reproducible results and was easy to manage . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 probe 2 : 10 and 2 : 15 . 3 the 5 probe 4 novel 5 probe 5 probe 10 and 6 yielded 9 results 6 yielded 10 and 7 rapid 9 results 8 reproducible 9 results 10 and 11 was 11 was 12 easy 12 easy 13 to 12 easy 14 manage 13 to 14 manage significant differences between skin locations and to a lesser extent age groups and gender were demonstrated . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 16 demonstrated 0 ###LEFT-WALL### 17 . 1 significant 2 differences 2 differences 6 and 2 differences 16 demonstrated 3 between 5 locations 3 between 6 and 4 skin 5 locations 6 and 7 to 7 to 11 age 8 a 9 lesser 8 a 11 age 9 lesser 10 extent 10 extent 11 age 11 age 13 and 11 age 15 were 12 groups 13 and 13 and 14 gender 13 and 15 were conclusion : with the novel probe , statistically significant differences between overlapping classes in score plots can be confirmed by calculating [intra] - model distances . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 10 differences 2 : 19 confirmed 2 : 26 . 3 with 6 probe 3 with 7 , 3 with 10 differences 4 the 6 probe 5 novel 6 probe 8 statistically 10 differences 9 significant 10 differences 10 differences 11 between 10 differences 17 can 11 between 12 overlapping 12 overlapping 13 classes 13 classes 14 in 14 in 16 plots 15 score 16 plots 17 can 18 be 18 be 19 confirmed 19 confirmed 20 by 20 by 25 distances 21 calculating 23 - 21 calculating 24 model 24 model 25 distances the influence of molecular differences in the skin at different body locations is larger than the influence of gender or age and therefore relevant reference measurements are discussed . 0 ###LEFT-WALL### 2 influence 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 29 . 1 the 2 influence 2 influence 3 of 2 influence 13 is 3 of 5 differences 4 molecular 5 differences 5 differences 6 in 6 in 8 skin 7 the 8 skin 8 skin 9 at 9 at 12 locations 10 different 11 body 11 body 12 locations 13 is 14 larger 14 larger 15 than 15 than 17 influence 15 than 18 of 16 the 17 influence 18 of 20 or 19 gender 20 or 20 or 21 age 22 and 23 therefore 22 and 26 measurements 22 and 28 discussed 24 relevant 25 reference 25 reference 26 measurements 26 measurements 27 are 27 are 28 discussed none the relation between actn3 r577x [polymorphism] and muscle mass in women has been reported , but its relation to age remains unclear . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 15 reported 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 24 . 2 the 3 relation 2 the 14 been 2 the 15 reported 3 relation 4 between 3 relation 11 in 3 relation 13 has 4 between 8 and 5 actn3 6 r577x 6 r577x 8 and 8 and 10 mass 9 muscle 10 mass 11 in 12 women 13 has 14 been 15 reported 16 , 16 , 17 but 17 but 19 relation 17 but 22 remains 18 its 19 relation 19 relation 20 to 19 relation 22 remains 20 to 21 age 22 remains 23 unclear we investigated the relationship between actn3 r577x [polymorphism] and muscle mass in both middle - aged and elderly women . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 15 - 1 we 2 investigated 2 investigated 4 relationship 2 investigated 5 between 3 the 4 relationship 5 between 6 actn3 6 actn3 9 and 6 actn3 14 middle 7 r577x 9 and 9 and 11 mass 9 and 12 in 9 and 14 middle 10 muscle 11 mass 12 in 13 both 15 - 19 women 15 - 20 . 16 aged 17 and 17 and 18 elderly 17 and 19 women two age groups [(] middle - aged [and] [older] ) were formed among 162 healthy , nontraining japanese women ( mean ± se , 58.6 ± [0.8] year ) . 0 ###LEFT-WALL### 1 two 0 ###LEFT-WALL### 12 formed 0 ###LEFT-WALL### 30 . 1 two 3 groups 1 two 5 middle 1 two 11 were 2 age 3 groups 3 groups 5 middle 5 middle 7 aged 6 - 7 aged 7 aged 10 ) 11 were 12 formed 12 formed 13 among 12 formed 15 healthy 13 among 14 162 15 healthy 17 nontraining 16 , 17 nontraining 17 nontraining 19 women 17 nontraining 29 ) 18 japanese 19 women 19 women 23 se 19 women 28 year 20 ( 23 se 21 mean 23 se 22 ± 23 se 23 se 24 , 24 , 28 year 25 58.6 28 year 26 ± 28 year 28 year 29 ) their midthigh - muscle cross - sectional area ( csa ) was assessed using magnetic resonance imaging , revealing no difference in thigh - muscle csa among actn3 r577x genotypes in the middle [-] aged group ( xx , 87.3 ± [2.5] [cm] ( 2 ) [;] rr&rx , 86.1 ± 1.7 [cm] ( 2 ) , p=0.7 ) . 0 ###LEFT-WALL### 5 cross 0 ###LEFT-WALL### 6 - 1 their 5 cross 2 midthigh 3 - 2 midthigh 5 cross 4 muscle 5 cross 6 - 7 sectional 6 - 18 , 7 sectional 12 was 7 sectional 14 using 8 area 10 csa 8 area 12 was 9 ( 10 csa 10 csa 11 ) 12 was 13 assessed 14 using 17 imaging 15 magnetic 16 resonance 16 resonance 17 imaging 18 , 25 muscle 19 revealing 21 difference 19 revealing 24 - 19 revealing 25 muscle 20 no 21 difference 21 difference 22 in 22 in 23 thigh 25 muscle 26 csa 26 csa 27 among 26 csa 31 in 27 among 28 actn3 28 actn3 29 r577x 28 actn3 30 genotypes 29 r577x 30 genotypes 31 in 36 group 32 the 36 group 33 middle 35 aged 35 aged 36 group 36 group 38 xx 36 group 48 rr&rx 37 ( 38 xx 38 xx 39 , 39 , 48 rr&rx 40 87.3 48 rr&rx 41 ± 45 2 41 ± 46 ) 41 ± 48 rr&rx 44 ( 45 2 45 2 46 ) 48 rr&rx 51 ± 48 rr&rx 60 . 49 , 51 ± 50 86.1 51 ± 51 ± 52 1.7 51 ± 55 2 51 ± 58 p=0.7 51 ± 60 . 54 ( 55 2 55 2 56 ) 57 , 58 p=0.7 58 p=0.7 59 ) in contrast , [the] [xx] genotype in the older group [had] a smaller thigh - muscle csa adjusted to body weight than the rr&rx genotypes ( xx , 67.8 ± 2.0 [cm] ( 2 ) ; rr&rx , 72.5 ± 1.2 [cm] ( 2 ) , p<0.05 ) . 0 ###LEFT-WALL### 6 genotype 0 ###LEFT-WALL### 36 ; 0 ###LEFT-WALL### 49 . 1 in 2 contrast 1 in 3 , 1 in 6 genotype 6 genotype 7 in 6 genotype 14 thigh 7 in 10 group 8 the 10 group 9 older 10 group 12 a 14 thigh 13 smaller 14 thigh 14 thigh 16 muscle 15 - 16 muscle 16 muscle 17 csa 16 muscle 18 adjusted 16 muscle 27 xx 16 muscle 36 ; 17 csa 18 adjusted 18 adjusted 19 to 18 adjusted 22 than 19 to 21 weight 20 body 21 weight 22 than 24 rr&rx 22 than 25 genotypes 23 the 24 rr&rx 24 rr&rx 25 genotypes 26 ( 27 xx 27 xx 30 ± 27 xx 36 ; 28 , 30 ± 29 67.8 30 ± 30 ± 31 2.0 30 ± 34 2 30 ± 36 ; 33 ( 34 2 34 2 35 ) 36 ; 39 72.5 36 ; 40 ± 37 rr&rx 38 , 37 rr&rx 39 72.5 39 72.5 40 ± 40 ± 41 1.2 41 1.2 44 2 41 1.2 47 p<0.05 43 ( 44 2 44 2 45 ) 46 , 47 p<0.05 47 p<0.05 48 ) the present study showed an association between actn3 r577x [polymorphism] and smaller thigh - muscle csa in a group of elderly women but not in a group of middle [-] aged women . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 33 . 1 the 3 study 2 present 3 study 3 study 4 showed 4 showed 6 association 4 showed 11 and 4 showed 15 muscle 5 an 6 association 6 association 7 between 7 between 8 actn3 9 r577x 11 and 11 and 13 thigh 11 and 14 - 11 and 15 muscle 12 smaller 13 thigh 15 muscle 16 csa 15 muscle 23 but 17 in 22 women 17 in 23 but 18 a 19 group 19 group 20 of 19 group 22 women 20 of 22 women 21 elderly 22 women 23 but 24 not 23 but 25 in 25 in 32 women 26 a 27 group 27 group 28 of 27 group 32 women 28 of 32 women 29 middle 31 aged 31 aged 32 women ischemic [stroke] causes the largest loss of qaly . 0 ###LEFT-WALL### 1 ischemic 0 ###LEFT-WALL### 3 causes 0 ###LEFT-WALL### 9 . 1 ischemic 3 causes 3 causes 6 loss 4 the 5 largest 4 the 6 loss 6 loss 7 of 7 of 8 qaly aging is the most important risk factor . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 8 . 1 aging 2 is 2 is 7 factor 3 the 7 factor 4 most 5 important 5 important 7 factor 6 risk 7 factor the majority of ischemic strokes can be prevented by managing the key risk factors : hypertension , smoking , abdominal obesity , diabetes , dyslipidemia and atrial fibrillation . 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 15 : 1 the 2 majority 2 majority 3 of 2 majority 5 strokes 3 of 5 strokes 4 ischemic 5 strokes 5 strokes 6 can 6 can 7 be 7 be 8 prevented 8 prevented 9 by 9 by 10 managing 10 managing 14 factors 11 the 14 factors 12 key 14 factors 13 risk 14 factors 15 : 16 hypertension 15 : 17 , 15 : 29 . 17 , 26 and 18 smoking 19 , 19 , 21 obesity 19 , 22 , 20 abdominal 21 obesity 22 , 23 diabetes 22 , 24 , 24 , 25 dyslipidemia 24 , 26 and 26 and 28 fibrillation 27 atrial 28 fibrillation effective treatment can significantly reduce disability . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 5 reduce 0 ###LEFT-WALL### 7 . 1 effective 2 treatment 2 treatment 3 can 3 can 5 reduce 4 significantly 5 reduce 5 reduce 6 disability health system and hospital reforms have led to important [and] [on] - going legislative , structural and organizational changes . 0 ###LEFT-WALL### 2 system 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 20 . 1 health 2 system 3 and 5 reforms 3 and 7 led 4 hospital 5 reforms 5 reforms 6 have 6 have 7 led 7 led 8 to 8 to 19 changes 9 important 12 - 9 important 19 changes 13 going 19 changes 14 legislative 15 , 15 , 16 structural 15 , 17 and 17 and 18 organizational 17 and 19 changes [is] there any logic at work within the health system and hospitals that could call into question the principle of solidarity , the secular values of ethics that govern the texts of law and ethics ? 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 17 question 2 there 11 and 3 any 4 logic 4 logic 5 at 4 logic 11 and 5 at 6 work 6 work 7 within 7 within 10 system 8 the 10 system 9 health 10 system 11 and 12 hospitals 11 and 13 that 11 and 16 into 11 and 17 question 13 that 14 could 14 could 15 call 15 call 16 into 17 question 19 principle 18 the 19 principle 19 principle 20 of 20 of 21 solidarity 21 solidarity 34 and 22 , 34 and 23 the 25 values 24 secular 25 values 25 values 26 of 25 values 32 of 25 values 34 and 26 of 27 ethics 27 ethics 28 that 27 ethics 29 govern 28 that 29 govern 29 govern 31 texts 30 the 31 texts 32 of 33 law 34 and 35 ethics 34 and 36 ? in order to respond , we compared our experiences to a review of the professional and scientific literature from 1992 to 2010 . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 23 . 1 in 2 order 1 in 5 , 1 in 6 we 2 order 3 to 2 order 4 respond 3 to 4 respond 6 we 7 compared 7 compared 9 experiences 7 compared 10 to 8 our 9 experiences 10 to 12 review 11 a 12 review 12 review 13 of 13 of 16 and 14 the 15 professional 15 professional 16 and 16 and 18 literature 17 scientific 18 literature 18 literature 21 to 19 from 21 to 20 1992 21 to 21 to 22 2010 over the course of the past eighteen years , health system organization was subjected to variations and significant tensions . 0 ###LEFT-WALL### 12 organization 0 ###LEFT-WALL### 14 subjected 0 ###LEFT-WALL### 20 . 1 over 3 course 1 over 9 , 1 over 12 organization 2 the 3 course 3 course 4 of 4 of 8 years 5 the 6 past 5 the 7 eighteen 7 eighteen 8 years 10 health 12 organization 11 system 12 organization 12 organization 13 was 13 was 14 subjected 14 subjected 15 to 15 to 17 and 16 variations 17 and 17 and 19 tensions 18 significant 19 tensions these variations are witnesses to a paradigm shift : although a step towards the regionalization of the health system integrating the choice of public health priorities , consultation and participatory democracy has been implemented , nevertheless the system was then [re] - oriented towards the trend of returning to centralization on the basis of uniting economics , technical modernization and contracting . 0 ###LEFT-WALL### 2 variations 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 9 : 0 ###LEFT-WALL### 62 . 1 these 2 variations 2 variations 3 are 3 are 4 witnesses 4 witnesses 5 to 5 to 8 shift 6 a 8 shift 7 paradigm 8 shift 9 : 22 choice 9 : 34 implemented 9 : 35 , 9 : 57 , 10 although 12 step 10 although 22 choice 11 a 12 step 12 step 13 towards 12 step 16 of 13 towards 15 regionalization 14 the 15 regionalization 16 of 20 integrating 17 the 20 integrating 18 health 19 system 19 system 20 integrating 21 the 22 choice 22 choice 23 of 22 choice 32 has 23 of 29 and 24 public 25 health 25 health 26 priorities 26 priorities 27 , 27 , 28 consultation 27 , 29 and 29 and 31 democracy 30 participatory 31 democracy 32 has 33 been 33 been 34 implemented 35 , 38 system 35 , 39 was 36 nevertheless 38 system 37 the 38 system 38 system 39 was 39 was 40 then 39 was 43 oriented 42 - 43 oriented 43 oriented 44 towards 43 oriented 51 on 43 oriented 57 , 44 towards 46 trend 45 the 46 trend 46 trend 47 of 46 trend 49 to 47 of 48 returning 49 to 50 centralization 51 on 53 basis 52 the 53 basis 53 basis 54 of 54 of 55 uniting 55 uniting 56 economics 57 , 60 and 58 technical 59 modernization 59 modernization 60 and 60 and 61 contracting this change of doctrine may undermine the social mission of hospitals and the principle of solidarity . 0 ###LEFT-WALL### 2 change 0 ###LEFT-WALL### 6 undermine 0 ###LEFT-WALL### 17 . 1 this 2 change 2 change 3 of 2 change 5 may 3 of 4 doctrine 5 may 6 undermine 6 undermine 9 mission 7 the 9 mission 8 social 9 mission 9 mission 10 of 10 of 12 and 11 hospitals 12 and 12 and 14 principle 12 and 15 of 13 the 14 principle 15 of 16 solidarity progress , the aging population and financial constraints would force policy [-] makers to steer the health system towards more centralized control . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 force 0 ###LEFT-WALL### 23 . 1 progress 2 , 2 , 5 population 2 , 6 and 3 the 5 population 4 aging 5 population 6 and 8 constraints 6 and 9 would 7 financial 8 constraints 9 would 10 force 10 force 13 makers 10 force 14 to 10 force 15 steer 10 force 19 towards 11 policy 13 makers 14 to 15 steer 15 steer 18 system 16 the 18 system 17 health 18 system 19 towards 22 control 20 more 22 control 21 centralized 22 control hospitals , health professionals and users may feel torn within a system that tends to simplify and minimize what is [becoming] increasingly complex and global . 0 ###LEFT-WALL### 1 hospitals 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 26 . 2 , 4 professionals 2 , 5 and 3 health 4 professionals 5 and 6 users 5 and 17 and 6 users 7 may 7 may 17 and 8 feel 9 torn 8 feel 17 and 9 torn 10 within 10 within 12 system 11 a 12 system 12 system 13 that 12 system 16 simplify 13 that 14 tends 14 tends 15 to 14 tends 16 simplify 15 to 16 simplify 17 and 18 minimize 18 minimize 19 what 19 what 20 is 20 is 22 increasingly 20 is 24 and 23 complex 24 and 24 and 25 global benchmarks on values , ethics and law for the hospitals , healthcare professionals and users are questioned . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 17 questioned 0 ###LEFT-WALL### 18 . 1 benchmarks 2 on 1 benchmarks 4 , 2 on 3 values 4 , 5 ethics 4 , 6 and 6 and 7 law 6 and 8 for 6 and 16 are 8 for 14 and 9 the 10 hospitals 10 hospitals 11 , 11 , 13 professionals 11 , 14 and 12 healthcare 13 professionals 14 and 15 users 16 are 17 questioned these are important elements to consider when the law on the reform of hospitals , patients , health care and territories and regional health agencies is implemented . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 28 . 1 these 2 are 2 are 4 elements 3 important 4 elements 4 elements 5 to 4 elements 6 consider 5 to 6 consider 6 consider 7 when 7 when 9 law 7 when 27 implemented 8 the 9 law 9 law 10 on 9 law 13 of 9 law 26 is 10 on 12 reform 11 the 12 reform 13 of 22 and 14 hospitals 15 , 15 , 16 patients 15 , 17 , 17 , 19 care 17 , 20 and 18 health 19 care 20 and 21 territories 20 and 22 and 22 and 25 agencies 23 regional 24 health 24 health 25 agencies 26 is 27 implemented secondary spontaneous pneumothorax ( ssp [ )(such as lymphangioleiomyomatosis ( lam ) , bronchiolitis obliterans ( bo ) is intractable or repeated the recurrence of pneumothorax . 0 ###LEFT-WALL### 3 pneumothorax 0 ###LEFT-WALL### 21 or 0 ###LEFT-WALL### 27 . 1 secondary 3 pneumothorax 2 spontaneous 3 pneumothorax 3 pneumothorax 5 ssp 3 pneumothorax 15 obliterans 3 pneumothorax 21 or 4 ( 5 ssp 5 ssp 8 as 5 ssp 13 , 7 )(such 8 as 8 as 9 lymphangioleiomyomatosis 9 lymphangioleiomyomatosis 11 lam 10 ( 11 lam 11 lam 12 ) 13 , 15 obliterans 14 bronchiolitis 15 obliterans 15 obliterans 17 bo 15 obliterans 18 ) 16 ( 17 bo 17 bo 18 ) 19 is 20 intractable 19 is 21 or 21 or 22 repeated 21 or 24 recurrence 23 the 24 recurrence 24 recurrence 25 of 25 of 26 pneumothorax the most effective chemical [pleurodesis] for intractable pneumothorax is talc poudrage and so on that is associated with a reduction in the rate of pneumothorax recurrence . 0 ###LEFT-WALL### 4 chemical 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 27 . 1 the 4 chemical 2 most 3 effective 3 effective 4 chemical 4 chemical 6 for 4 chemical 9 is 6 for 8 pneumothorax 7 intractable 8 pneumothorax 9 is 11 poudrage 10 talc 11 poudrage 12 and 14 on 12 and 17 associated 13 so 14 on 14 on 17 associated 15 that 16 is 16 is 17 associated 17 associated 18 with 18 with 20 reduction 18 with 21 in 19 a 20 reduction 21 in 23 rate 22 the 23 rate 23 rate 24 of 24 of 26 recurrence 25 pneumothorax 26 recurrence however , severe and broad pleural adhesion due to the pleural interventional procedures sometimes cause serious bleeding when the patients undergo lung transplantation . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 15 cause 0 ###LEFT-WALL### 24 . 1 however 2 , 1 however 4 and 3 severe 4 and 4 and 7 adhesion 4 and 9 to 4 and 15 cause 5 broad 7 adhesion 6 pleural 7 adhesion 8 due 9 to 9 to 13 procedures 10 the 13 procedures 11 pleural 13 procedures 12 interventional 13 procedures 14 sometimes 15 cause 15 cause 17 bleeding 16 serious 17 bleeding 17 bleeding 18 when 18 when 20 patients 18 when 21 undergo 19 the 20 patients 20 patients 21 undergo 21 undergo 23 transplantation 22 lung 23 transplantation we must be considered for new approaches to these intractable secondary pneumothoraces which replaced traditional conservative and surgical approaches . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 considered 0 ###LEFT-WALL### 20 . 1 we 2 must 2 must 3 be 3 be 4 considered 4 considered 5 for 4 considered 8 to 5 for 7 approaches 6 new 7 approaches 8 to 12 pneumothoraces 9 these 12 pneumothoraces 10 intractable 12 pneumothoraces 11 secondary 12 pneumothoraces 12 pneumothoraces 13 which 12 pneumothoraces 14 replaced 13 which 14 replaced 14 replaced 19 approaches 15 traditional 19 approaches 16 conservative 17 and 17 and 18 surgical 17 and 19 approaches we had proposed new 2 approaches of total pleural covering ( tpc ) and awake surgical intervention ( asi ) for intractable pneumothorax . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 24 . 1 we 14 and 2 had 3 proposed 2 had 14 and 3 proposed 6 approaches 4 new 6 approaches 5 2 6 approaches 6 approaches 7 of 7 of 10 covering 8 total 10 covering 9 pleural 10 covering 10 covering 12 tpc 11 ( 12 tpc 12 tpc 13 ) 14 and 15 awake 15 awake 17 intervention 15 awake 21 for 16 surgical 17 intervention 17 intervention 19 asi 18 ( 19 asi 19 asi 20 ) 21 for 23 pneumothorax 22 intractable 23 pneumothorax we applied the tpc modified with coverage of air leak points with polyglycolic acid ( pga ) sheet to 5 patients with intractable bilateral pneumothorax to reduce the risk of excessive bleeding by chemical pleurodesis in lung transplantation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 27 reduce 0 ###LEFT-WALL### 39 . 1 we 2 applied 2 applied 4 tpc 2 applied 6 with 2 applied 12 with 2 applied 26 to 3 the 4 tpc 4 tpc 5 modified 6 with 7 coverage 7 coverage 8 of 8 of 11 points 9 air 10 leak 10 leak 11 points 12 with 18 sheet 12 with 19 to 13 polyglycolic 18 sheet 14 acid 16 pga 14 acid 17 ) 14 acid 18 sheet 15 ( 16 pga 16 pga 17 ) 19 to 21 patients 20 5 21 patients 21 patients 22 with 22 with 25 pneumothorax 23 intractable 25 pneumothorax 24 bilateral 25 pneumothorax 26 to 27 reduce 27 reduce 29 risk 28 the 29 risk 29 risk 30 of 30 of 32 bleeding 31 excessive 32 bleeding 32 bleeding 33 by 32 bleeding 36 in 33 by 35 pleurodesis 34 chemical 35 pleurodesis 36 in 38 transplantation 37 lung 38 transplantation the bilateral pneumothorax was well controlled , and no recurrence has been observed . 0 ###LEFT-WALL### 3 pneumothorax 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 14 . 1 the 3 pneumothorax 2 bilateral 3 pneumothorax 3 pneumothorax 4 was 4 was 5 well 5 well 6 controlled 7 , 8 and 8 and 10 recurrence 8 and 13 observed 9 no 10 recurrence 10 recurrence 11 has 11 has 12 been 12 been 13 observed tpc is reliable procedure for management intractable bilateral ssp . 0 ###LEFT-WALL### 1 tpc 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 tpc 2 is 2 is 4 procedure 3 reliable 4 procedure 4 procedure 5 for 5 for 9 ssp 6 management 9 ssp 7 intractable 9 ssp 8 bilateral 9 ssp for 12 high - risk patients with other underling pulmonary diseases on general poor conditions , a surgical intervention was performed in [awake] condition . 0 ###LEFT-WALL### 19 intervention 0 ###LEFT-WALL### 21 performed 0 ###LEFT-WALL### 25 . 1 for 6 patients 1 for 16 , 1 for 19 intervention 2 12 6 patients 3 high 4 - 3 high 6 patients 5 risk 6 patients 6 patients 7 with 7 with 11 diseases 8 other 11 diseases 9 underling 11 diseases 10 pulmonary 11 diseases 11 diseases 12 on 12 on 15 conditions 13 general 15 conditions 14 poor 15 conditions 17 a 18 surgical 17 a 19 intervention 18 surgical 19 intervention 19 intervention 20 was 20 was 21 performed 21 performed 22 in 22 in 24 condition the air leaks were stopped in 11 cases except for 1 case . 0 ###LEFT-WALL### 3 leaks 0 ###LEFT-WALL### 5 stopped 0 ###LEFT-WALL### 13 . 1 the 3 leaks 2 air 3 leaks 3 leaks 4 were 4 were 5 stopped 5 stopped 6 in 5 stopped 9 except 6 in 8 cases 7 11 8 cases 9 except 10 for 10 for 12 case 11 1 12 case the recurrence of pneumothorax after surgery was 2 cases . 0 ###LEFT-WALL### 2 recurrence 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 10 . 1 the 2 recurrence 2 recurrence 3 of 2 recurrence 7 was 3 of 4 pneumothorax 4 pneumothorax 5 after 5 after 6 surgery 7 was 9 cases 8 2 9 cases asi for intractable secondary pneumothorax can be applicable to selected patients with [deteriorated] general condition . 0 ###LEFT-WALL### 1 asi 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 16 . 1 asi 2 for 1 asi 6 can 2 for 5 pneumothorax 3 intractable 5 pneumothorax 4 secondary 5 pneumothorax 6 can 7 be 7 be 8 applicable 8 applicable 9 to 8 applicable 12 with 9 to 11 patients 10 selected 11 patients 12 with 15 condition 14 general 15 condition objective : to identify neuropsychological predictors of transition from healthy cognitive aging to mild cognitive impairment ( mci ) or any mild cognitive disorder ( any - mcd ) in a community - based longitudinal study of aging . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 3 to 2 : 4 identify 2 : 33 - 3 to 4 identify 4 identify 20 or 4 identify 30 in 5 neuropsychological 6 predictors 6 predictors 7 of 6 predictors 20 or 7 of 8 transition 8 transition 9 from 9 from 12 aging 10 healthy 12 aging 11 cognitive 12 aging 12 aging 13 to 13 to 16 impairment 14 mild 16 impairment 15 cognitive 16 impairment 16 impairment 18 mci 17 ( 18 mci 18 mci 19 ) 20 or 24 disorder 20 or 26 any 21 any 24 disorder 22 mild 24 disorder 23 cognitive 24 disorder 25 ( 26 any 26 any 28 mcd 26 any 29 ) 27 - 28 mcd 28 mcd 29 ) 30 in 32 community 31 a 32 community 33 - 36 study 34 based 36 study 35 longitudinal 36 study 36 study 37 of 37 of 38 aging design : longitudinal participants : two thousand eighty - two individuals , aged 60 – 64 years and participating in a prospective epidemiologic study of mental health , and aging were assessed at two time points 4 years apart for mci using the international consensus criteria , the clinical dementia rating scale ( cdr , 0.5 ) , or any of a suite of criteria sets for mcds ( any - mcd ) . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 74 . 1 design 2 : 2 : 4 participants 3 longitudinal 4 participants 5 : 8 eighty 5 : 13 aged 5 : 15 – 5 : 36 points 5 : 59 or 6 two 7 thousand 7 thousand 8 eighty 8 eighty 11 individuals 8 eighty 13 aged 9 - 11 individuals 10 two 11 individuals 11 individuals 12 , 13 aged 14 60 15 – 18 and 15 – 29 and 16 64 17 years 17 years 18 and 18 and 19 participating 18 and 20 in 18 and 25 of 20 in 24 study 21 a 24 study 22 prospective 24 study 23 epidemiologic 24 study 25 of 27 health 26 mental 27 health 28 , 29 and 29 and 30 aging 29 and 32 assessed 30 aging 31 were 31 were 32 assessed 32 assessed 33 at 33 at 34 two 34 two 35 time 34 two 36 points 35 time 36 points 36 points 39 apart 36 points 40 for 36 points 42 using 37 4 38 years 38 years 39 apart 40 for 41 mci 42 using 46 criteria 43 the 46 criteria 44 international 45 consensus 45 consensus 46 criteria 46 criteria 52 scale 47 , 52 scale 48 the 52 scale 49 clinical 50 dementia 50 dementia 52 scale 51 rating 52 scale 52 scale 54 cdr 52 scale 58 , 53 ( 54 cdr 54 cdr 56 0.5 54 cdr 58 , 55 , 56 0.5 56 0.5 57 ) 59 or 60 any 59 or 66 sets 60 any 61 of 60 any 64 of 60 any 66 sets 61 of 63 suite 62 a 63 suite 64 of 65 criteria 66 sets 67 for 66 sets 71 - 67 for 68 mcds 69 ( 71 - 70 any 71 - 71 - 72 mcd 71 - 73 ) measurements : logistic regression was used to assess the neuropsychological predictors of conversion to diagnosis including the mini - mental state examination , immediate and delayed recall ( ir and dr ) , digit backward , spot - the [-] word ( stw ) , symbol digits modalities test ( sdmt ) , simple and choice reaction time , and reaction time variability . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 64 . 2 : 4 regression 2 : 8 assess 2 : 19 - 3 logistic 4 regression 4 regression 5 was 5 was 6 used 6 used 7 to 7 to 8 assess 8 assess 11 predictors 9 the 11 predictors 10 neuropsychological 11 predictors 11 predictors 12 of 11 predictors 14 to 12 of 13 conversion 14 to 15 diagnosis 15 diagnosis 16 including 16 including 18 mini 17 the 18 mini 19 - 22 examination 19 - 23 , 20 mental 21 state 21 state 22 examination 23 , 60 and 23 , 62 time 24 immediate 25 and 25 and 27 recall 25 and 31 dr 25 and 33 , 26 delayed 27 recall 28 ( 31 dr 29 ir 30 and 30 and 31 dr 31 dr 32 ) 33 , 35 backward 33 , 36 , 34 digit 35 backward 36 , 37 spot 36 , 53 , 37 spot 41 word 38 - 41 word 39 the 41 word 41 word 43 stw 41 word 51 sdmt 41 word 52 ) 42 ( 43 stw 43 stw 44 ) 45 , 51 sdmt 46 symbol 47 digits 47 digits 48 modalities 48 modalities 49 test 49 test 51 sdmt 50 ( 51 sdmt 51 sdmt 52 ) 53 , 54 simple 53 , 55 and 55 and 58 time 55 and 60 and 56 choice 58 time 57 reaction 58 time 59 , 60 and 60 and 61 reaction 60 and 62 time 62 time 63 variability results : of the 2,082 participants with no cognitive impairment in the first wave of data [collection] , 18 participants were diagnosed with mci , 32 with cdr 0.5 , and 64 participants presented with any - mcd 4 years later . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 42 . 1 results 2 : 2 : 3 of 3 of 6 participants 4 the 5 2,082 5 2,082 6 participants 6 participants 7 with 6 participants 15 of 7 with 10 impairment 8 no 10 impairment 9 cognitive 10 impairment 10 impairment 11 in 11 in 14 wave 12 the 13 first 12 the 14 wave 15 of 16 data 18 , 20 participants 18 , 22 diagnosed 19 18 20 participants 20 participants 21 were 21 were 22 diagnosed 22 diagnosed 23 with 22 diagnosed 41 later 23 with 24 mci 23 with 38 mcd 24 mci 26 32 25 , 26 32 26 32 27 with 26 32 34 presented 26 32 35 with 26 32 37 - 27 with 31 and 28 cdr 29 0.5 28 cdr 31 and 30 , 31 and 31 and 33 participants 32 64 33 participants 35 with 36 any 39 4 40 years 40 years 41 later the main neuropsychological predictors of conversion identified in multivariate analyses were measures of ir/dr , stw , symbol digit modalities task , and reaction time variability . 0 ###LEFT-WALL### 4 predictors 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 27 . 1 the 2 main 1 the 4 predictors 3 neuropsychological 4 predictors 4 predictors 5 of 4 predictors 11 were 5 of 6 conversion 6 conversion 7 identified 7 identified 8 in 8 in 10 analyses 9 multivariate 10 analyses 11 were 12 measures 12 measures 13 of 13 of 14 ir/dr 14 ir/dr 16 stw 15 , 16 stw 16 stw 17 , 17 , 23 and 17 , 25 time 18 symbol 19 digit 19 digit 20 modalities 20 modalities 21 task 21 task 23 and 22 , 23 and 23 and 24 reaction 23 and 25 time 25 time 26 variability conclusions : although most measures were significant predictors of conversion to mci or any - mcd [when] assessed independently , four tests ( ir/dr , stw , sdmt , and simple reaction time variability ) accounted for the explained variance in diagnosis when all tests were assessed together . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 49 . 1 conclusions 2 : 2 : 3 although 3 although 5 measures 4 most 5 measures 5 measures 6 were 6 were 13 or 7 significant 8 predictors 8 predictors 9 of 8 predictors 13 or 9 of 10 conversion 10 conversion 11 to 11 to 12 mci 13 or 14 any 13 or 15 - 15 - 16 mcd 15 - 18 assessed 15 - 37 for 16 mcd 18 assessed 18 assessed 22 tests 18 assessed 37 for 19 independently 20 , 19 independently 22 tests 21 four 22 tests 22 tests 24 ir/dr 22 tests 26 stw 22 tests 37 for 23 ( 24 ir/dr 24 ir/dr 25 , 25 , 26 stw 26 stw 30 and 26 stw 35 ) 27 , 30 and 28 sdmt 30 and 29 , 30 and 30 and 34 variability 30 and 35 ) 31 simple 34 variability 32 reaction 34 variability 33 time 34 variability 36 accounted 37 for 37 for 40 variance 38 the 40 variance 39 explained 40 variance 40 variance 41 in 40 variance 43 when 40 variance 47 assessed 41 in 42 diagnosis 43 when 45 tests 43 when 46 were 44 all 45 tests 45 tests 46 were 47 assessed 48 together when predictive value , stability across clinical categories , and psychometric characteristics were considered together , the reaction time variability measure was the best predictor of future cognitive disorder . 0 ###LEFT-WALL### 21 measure 0 ###LEFT-WALL### 22 was 0 ###LEFT-WALL### 30 . 1 when 10 and 1 when 14 considered 1 when 21 measure 2 predictive 3 value 3 value 4 , 4 , 5 stability 4 , 10 and 5 stability 6 across 6 across 8 categories 7 clinical 8 categories 9 , 10 and 10 and 12 characteristics 10 and 13 were 11 psychometric 12 characteristics 13 were 14 considered 15 together 16 , 15 together 21 measure 17 the 21 measure 18 reaction 21 measure 19 time 21 measure 20 variability 21 measure 21 measure 22 was 22 was 25 predictor 23 the 24 best 23 the 25 predictor 25 predictor 26 of 26 of 29 disorder 27 future 29 disorder 28 cognitive 29 disorder the authors analyze the effect of participation in short - term training measures on older german recipients of means - tested unemployment benefits . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 analyze 0 ###LEFT-WALL### 24 . 1 the 2 authors 2 authors 3 analyze 3 analyze 5 effect 3 analyze 8 in 4 the 5 effect 5 effect 6 of 6 of 7 participation 8 in 23 benefits 9 short 13 measures 9 short 22 unemployment 10 - 13 measures 11 term 13 measures 12 training 13 measures 13 measures 14 on 13 measures 20 - 14 on 17 recipients 15 older 16 german 16 german 17 recipients 17 recipients 18 of 18 of 19 means 21 tested 22 unemployment 22 unemployment 23 benefits their analysis uses administrative data of the german federal employment agency , and they estimate the effects of participating in two types of short - term training -- classroom and in [-] firm training -- on different outcomes of the participants . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 uses 0 ###LEFT-WALL### 13 and 1 their 2 analysis 2 analysis 3 uses 3 uses 5 data 4 administrative 5 data 5 data 6 of 6 of 11 agency 7 the 11 agency 8 german 9 federal 9 federal 10 employment 10 employment 11 agency 12 , 13 and 13 and 14 they 13 and 15 estimate 14 they 15 estimate 15 estimate 17 effects 16 the 17 effects 17 effects 18 of 17 effects 30 and 18 of 19 participating 20 in 23 of 20 in 30 and 21 two 23 of 22 types 23 of 23 of 29 classroom 24 short 27 training 24 short 29 classroom 25 - 27 training 26 term 27 training 27 training 28 -- 30 and 31 in 31 in 34 training 33 firm 34 training 34 training 36 on 35 -- 36 on 36 on 38 outcomes 36 on 42 . 37 different 38 outcomes 38 outcomes 39 of 39 of 41 participants 40 the 41 participants results show that classroom training is not effective [in] making participants independent [of] benefit receipt . 0 ###LEFT-WALL### 15 receipt 0 ###LEFT-WALL### 16 . 1 results 2 show 2 show 3 that 3 that 5 training 3 that 6 is 4 classroom 5 training 5 training 6 is 6 is 7 not 7 not 8 effective 8 effective 15 receipt 10 making 15 receipt 11 participants 15 receipt 12 independent 14 benefit 14 benefit 15 receipt it has a moderately positive effect on employment outcomes , which are [highest] for west german men . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 18 . 1 it 2 has 2 has 6 effect 2 has 7 on 3 a 4 moderately 3 a 6 effect 4 moderately 5 positive 5 positive 6 effect 7 on 9 outcomes 8 employment 9 outcomes 10 , 11 which 10 , 12 are 11 which 12 are 12 are 14 for 14 for 17 men 15 west 16 german 16 german 17 men in contrast , [in] - firm training significantly raises the participants ' likelihood of finding regular jobs and [of] being independent of unemployment benefit receipt . 0 ###LEFT-WALL### 2 contrast 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 26 . 1 in 2 contrast 3 , 5 - 3 , 9 raises 5 - 7 training 6 firm 7 training 7 training 9 raises 8 significantly 9 raises 9 raises 25 receipt 10 the 11 participants 11 participants 12 ' 12 ' 25 receipt 13 likelihood 14 of 13 likelihood 18 and 14 of 15 finding 15 finding 17 jobs 16 regular 17 jobs 18 and 21 independent 18 and 22 of 18 and 24 benefit 20 being 21 independent 22 of 23 unemployment 24 benefit 25 receipt title v of the older americans act , the senior community service employment program ( scsep ) , is a 40+ - year - old federal program providing subsidized community service and employment training to low - income , unemployed individuals aged 55 and older . 0 ###LEFT-WALL### 1 title 0 ###LEFT-WALL### 19 is 0 ###LEFT-WALL### 46 . 1 title 2 v 1 title 3 of 1 title 19 is 3 of 7 act 4 the 6 americans 5 older 6 americans 6 americans 7 act 7 act 16 scsep 8 , 16 scsep 9 the 16 scsep 10 senior 11 community 11 community 12 service 12 service 13 employment 13 employment 14 program 14 program 16 scsep 15 ( 16 scsep 16 scsep 17 ) 16 scsep 18 , 19 is 23 year 19 is 44 and 20 a 23 year 21 40+ 22 - 21 40+ 23 year 23 year 34 training 24 - 34 training 25 old 30 community 26 federal 30 community 27 program 29 subsidized 28 providing 29 subsidized 29 subsidized 30 community 30 community 34 training 31 service 32 and 32 and 33 employment 32 and 34 training 34 training 35 to 34 training 36 low 34 training 38 income 34 training 39 , 35 to 36 low 37 - 38 income 38 income 39 , 40 unemployed 41 individuals 41 individuals 42 aged 41 individuals 44 and 42 aged 43 55 44 and 45 older it is the only nationally mandated workforce training program for seniors . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 12 . 1 it 2 is 2 is 9 program 3 the 4 only 3 the 9 program 5 nationally 6 mandated 6 mandated 7 workforce 7 workforce 9 program 8 training 9 program 9 program 10 for 10 for 11 seniors because of scsep 's dual mission , participants added 48 million hours of community service ( valued at almost $ 1 billion ) to the u.s [.] economy in 2008 . 0 ###LEFT-WALL### 8 participants 0 ###LEFT-WALL### 9 added 0 ###LEFT-WALL### 31 . 1 because 2 of 1 because 7 , 1 because 8 participants 2 of 6 mission 3 scsep 4 's 4 's 6 mission 5 dual 6 mission 8 participants 9 added 9 added 12 hours 9 added 24 to 9 added 29 in 10 48 11 million 11 million 12 hours 12 hours 13 of 13 of 15 service 14 community 15 service 15 service 17 valued 16 ( 17 valued 17 valued 18 at 17 valued 23 ) 18 at 20 $ 19 almost 20 $ 20 $ 22 billion 21 1 22 billion 24 to 28 economy 25 the 28 economy 26 u.s 28 economy 29 in 30 2008 almost [half] [(] 48.9 % [ )(of the participants are racial or ethnic minorities , which makes it crucial to understand the program experience of these individuals . 0 ###LEFT-WALL### 5 % 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 28 . 1 almost 4 48.9 4 48.9 5 % 5 % 7 )(of 5 % 10 are 7 )(of 9 participants 8 the 9 participants 10 are 14 minorities 11 racial 12 or 12 or 13 ethnic 12 or 14 minorities 15 , 16 which 15 , 21 understand 16 which 17 makes 17 makes 18 it 17 makes 19 crucial 19 crucial 20 to 19 crucial 21 understand 20 to 21 understand 21 understand 24 experience 22 the 24 experience 23 program 24 experience 24 experience 25 of 25 of 27 individuals 26 these 27 individuals participation , program duration , and employment placement of minorities are examined . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 12 examined 0 ###LEFT-WALL### 13 . 1 participation 2 , 2 , 4 duration 2 , 6 and 3 program 4 duration 5 , 6 and 6 and 8 placement 6 and 9 of 6 and 11 are 7 employment 8 placement 9 of 10 minorities 11 are 12 examined findings show successful enrollment rates , an interactive effect of age and education on program duration , and no indication of a minority disadvantage in employment placement . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 28 . 1 findings 2 show 2 show 5 rates 3 successful 4 enrollment 4 enrollment 5 rates 6 , 12 and 7 an 8 interactive 7 an 9 effect 8 interactive 9 effect 9 effect 10 of 9 effect 12 and 10 of 11 age 12 and 13 education 12 and 14 on 12 and 21 of 14 on 18 and 15 program 16 duration 16 duration 18 and 17 , 18 and 18 and 20 indication 19 no 20 indication 21 of 24 disadvantage 22 a 24 disadvantage 23 minority 24 disadvantage 24 disadvantage 25 in 25 in 27 placement 26 employment 27 placement recommendations include funding for innovative grants , leveraging of federal partnerships , and targeted technical assistance . 0 ###LEFT-WALL### 1 recommendations 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 17 . 1 recommendations 2 include 2 include 3 funding 3 funding 4 for 4 for 13 and 5 innovative 6 grants 6 grants 7 , 7 , 8 leveraging 7 , 13 and 8 leveraging 9 of 9 of 11 partnerships 10 federal 11 partnerships 12 , 13 and 13 and 16 assistance 14 targeted 16 assistance 15 technical 16 assistance the study examined employers ' knowledge of [and] attitudes toward working carers who care for aging family members . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 19 . 1 the 2 study 2 study 3 examined 3 examined 6 knowledge 3 examined 10 toward 4 employers 5 ' 5 ' 6 knowledge 6 knowledge 7 of 7 of 9 attitudes 10 toward 11 working 11 working 12 carers 11 working 15 for 12 carers 13 who 12 carers 14 care 13 who 14 care 15 for 16 aging 16 aging 18 members 17 family 18 members the study was based on the ecological model . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 based 0 ###LEFT-WALL### 9 . 1 the 2 study 2 study 3 was 3 was 4 based 4 based 5 on 5 on 8 model 6 the 8 model 7 ecological 8 model one hundred employers were interviewed using structured questionnaires and 13 employers by additional [in] - depth interviews . 0 ###LEFT-WALL### 3 employers 0 ###LEFT-WALL### 5 interviewed 0 ###LEFT-WALL### 18 . 1 one 2 hundred 2 hundred 3 employers 3 employers 4 were 4 were 5 interviewed 5 interviewed 6 using 6 using 9 and 6 using 12 by 7 structured 8 questionnaires 8 questionnaires 9 and 9 and 11 employers 10 13 11 employers 12 by 17 interviews 13 additional 15 - 13 additional 16 depth 16 depth 17 interviews both research instruments included areas of disruption to the organization , existing policies , and feasibility as to developing appropriate policies to support working carers . 0 ###LEFT-WALL### 3 instruments 0 ###LEFT-WALL### 4 included 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 26 . 1 both 3 instruments 2 research 3 instruments 3 instruments 4 included 4 included 5 areas 5 areas 6 of 6 of 7 disruption 7 disruption 8 to 8 to 10 organization 9 the 10 organization 11 , 15 and 11 , 20 appropriate 12 existing 13 policies 13 policies 15 and 14 , 15 and 15 and 16 feasibility 15 and 17 as 15 and 20 appropriate 17 as 18 to 18 to 19 developing 20 appropriate 21 policies 20 appropriate 22 to 22 to 25 carers 23 support 24 working 24 working 25 carers results show that caregiving caused a disruption in workers ' functioning mainly by being absent , leaving work early , and coming to work late . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 26 . 1 results 2 show 2 show 4 caregiving 2 show 21 and 3 that 4 caregiving 4 caregiving 21 and 5 caused 7 disruption 5 caused 21 and 6 a 7 disruption 7 disruption 8 in 7 disruption 11 functioning 8 in 10 ' 9 workers 10 ' 11 functioning 12 mainly 11 functioning 17 leaving 12 mainly 13 by 13 by 14 being 14 being 15 absent 16 , 17 leaving 17 leaving 18 work 17 leaving 19 early 17 leaving 20 , 21 and 22 coming 21 and 23 to 21 and 25 late 23 to 24 work usually , there was " no policy , " and half of the employers did [not] support introducing such a policy . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 22 . 1 usually 2 , 1 usually 3 there 3 there 4 was 4 was 5 " 4 was 7 policy 6 no 7 policy 8 , 9 " 8 , 10 and 10 and 11 half 10 and 15 did 11 half 12 of 11 half 15 did 12 of 14 employers 13 the 14 employers 15 did 17 support 17 support 18 introducing 18 introducing 21 policy 19 such 20 a 20 a 21 policy women managers in public organizations , who had less seniority and less previous experience with working - carers , tended to be more positive about supportive policies . 0 ###LEFT-WALL### 2 managers 0 ###LEFT-WALL### 20 tended 0 ###LEFT-WALL### 28 . 1 women 2 managers 2 managers 3 in 2 managers 20 tended 3 in 5 organizations 4 public 5 organizations 5 organizations 7 who 5 organizations 18 carers 6 , 7 who 7 who 8 had 7 who 17 - 8 had 11 and 8 had 15 with 9 less 11 and 10 seniority 11 and 11 and 14 experience 12 less 14 experience 13 previous 14 experience 15 with 16 working 17 - 18 carers 18 carers 19 , 20 tended 21 to 20 tended 22 be 21 to 22 be 22 be 23 more 22 be 24 positive 24 positive 25 about 25 about 27 policies 26 supportive 27 policies recommendations are included . 0 ###LEFT-WALL### 1 recommendations 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 4 . 1 recommendations 2 are 2 are 3 included this article addresses possible changes in dutch employers ' behavior regarding the recruitment and retention of older workers during the last decade . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 addresses 0 ###LEFT-WALL### 23 . 1 this 2 article 2 article 3 addresses 3 addresses 5 changes 3 addresses 6 in 3 addresses 19 during 4 possible 5 changes 6 in 14 and 7 dutch 8 employers 8 employers 9 ' 9 ' 10 behavior 10 behavior 11 regarding 10 behavior 14 and 11 regarding 13 recruitment 12 the 13 recruitment 14 and 15 retention 14 and 16 of 16 of 18 workers 17 older 18 workers 19 during 22 decade 20 the 21 last 20 the 22 decade the authors analyze surveys administered to dutch employers in 2000 , 2002 , 2005 , 2008 , [and] 2009 . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 analyze 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 20 . 1 the 2 authors 2 authors 3 analyze 3 analyze 4 surveys 4 surveys 5 administered 5 administered 6 to 5 administered 9 in 6 to 8 employers 7 dutch 8 employers 9 in 10 2000 11 , 12 2002 11 , 13 , 13 , 14 2005 13 , 15 , 15 , 16 2008 15 , 17 , 17 , 19 2009 the results show that efforts to recruit older workers are changing , congruous with the economic climate , while retention behavior shows a clear and rather gradual time effect . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 30 . 1 the 2 results 2 results 3 show 3 show 4 that 4 that 5 efforts 4 that 11 changing 5 efforts 6 to 5 efforts 7 recruit 5 efforts 10 are 6 to 7 recruit 7 recruit 9 workers 8 older 9 workers 10 are 11 changing 11 changing 12 , 12 , 21 behavior 12 , 22 shows 13 congruous 14 with 13 congruous 18 , 13 congruous 21 behavior 14 with 17 climate 15 the 17 climate 16 economic 17 climate 19 while 20 retention 19 while 21 behavior 21 behavior 22 shows 22 shows 28 time 22 shows 29 effect 23 a 28 time 24 clear 25 and 25 and 27 gradual 25 and 28 time 26 rather 27 gradual the authors conclude that the position of older workers has improved between 2000 and 2008 and has done so in comparison with other underrepresented groups in the labor market . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 conclude 0 ###LEFT-WALL### 30 . 1 the 2 authors 2 authors 3 conclude 3 conclude 4 that 4 that 6 position 4 that 16 and 5 the 6 position 6 position 7 of 6 position 16 and 7 of 9 workers 8 older 9 workers 10 has 11 improved 10 has 16 and 11 improved 12 between 12 between 14 and 13 2000 14 and 14 and 15 2008 16 and 17 has 16 and 26 in 17 has 18 done 18 done 19 so 18 done 20 in 18 done 22 with 20 in 21 comparison 22 with 25 groups 23 other 25 groups 24 underrepresented 25 groups 26 in 29 market 27 the 29 market 28 labor 29 market during the recession [,] recruitment of older workers declined substantially , while efforts to retain older workers are in both absolute and relative terms higher than in 2000 . 0 ###LEFT-WALL### 17 workers 0 ###LEFT-WALL### 18 are 0 ###LEFT-WALL### 29 . 1 during 5 recruitment 1 during 11 , 1 during 17 workers 2 the 5 recruitment 3 recession 5 recruitment 5 recruitment 6 of 6 of 8 workers 7 older 8 workers 8 workers 9 declined 9 declined 10 substantially 12 while 13 efforts 12 while 17 workers 13 efforts 14 to 13 efforts 15 retain 14 to 15 retain 16 older 17 workers 17 workers 18 are 18 are 19 in 19 in 24 terms 20 both 24 terms 21 absolute 22 and 22 and 23 relative 22 and 24 terms 24 terms 25 higher 24 terms 27 in 25 higher 26 than 27 in 28 2000 with respect to organizational policies , the authors conclude that throughout the period under observation these policies are dominated by measures that " spare " older workers . 0 ###LEFT-WALL### 8 authors 0 ###LEFT-WALL### 9 conclude 0 ###LEFT-WALL### 28 . 1 with 2 respect 1 with 6 , 1 with 8 authors 2 respect 3 to 3 to 5 policies 4 organizational 5 policies 7 the 8 authors 8 authors 9 conclude 9 conclude 10 that 10 that 17 policies 10 that 19 dominated 11 throughout 13 period 11 throughout 17 policies 12 the 13 period 13 period 14 under 14 under 15 observation 16 these 17 policies 17 policies 18 are 18 are 19 dominated 19 dominated 20 by 20 by 21 measures 21 measures 22 that 21 measures 24 spare 22 that 23 " 22 that 24 spare 24 spare 25 " 24 spare 27 workers 26 older 27 workers even in the midst of massive layoffs that come with an economic downturn , employers must remain aware of the pending impact of their aging workforce . 0 ###LEFT-WALL### 15 employers 0 ###LEFT-WALL### 17 remain 0 ###LEFT-WALL### 27 . 1 even 2 in 1 even 14 , 1 even 15 employers 2 in 4 midst 3 the 4 midst 4 midst 5 of 5 of 7 layoffs 6 massive 7 layoffs 7 layoffs 8 that 7 layoffs 9 come 8 that 9 come 9 come 10 with 10 with 13 downturn 11 an 12 economic 11 an 13 downturn 12 economic 13 downturn 15 employers 16 must 16 must 17 remain 17 remain 18 aware 18 aware 19 of 19 of 22 impact 20 the 22 impact 21 pending 22 impact 22 impact 23 of 23 of 26 workforce 24 their 26 workforce 25 aging 26 workforce losing older employees to retirement drains knowledge and expertise . 0 ###LEFT-WALL### 1 losing 0 ###LEFT-WALL### 6 drains 0 ###LEFT-WALL### 10 . 1 losing 3 employees 1 losing 4 to 1 losing 6 drains 2 older 3 employees 4 to 5 retirement 6 drains 8 and 7 knowledge 8 and 8 and 9 expertise in response , employers are looking at new ways to retain older workers at the same time that older workers are reevaluating the traditional approach to retirement . 0 ###LEFT-WALL### 4 employers 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 28 . 1 in 2 response 2 response 3 , 2 response 4 employers 4 employers 5 are 5 are 6 looking 6 looking 7 at 6 looking 14 at 7 at 9 ways 8 new 9 ways 9 ways 10 to 9 ways 11 retain 10 to 11 retain 11 retain 13 workers 12 older 13 workers 14 at 17 time 15 the 16 same 15 the 17 time 17 time 18 that 18 that 20 workers 18 that 21 are 19 older 20 workers 20 workers 21 are 21 are 22 reevaluating 22 reevaluating 25 approach 22 reevaluating 26 to 23 the 25 approach 24 traditional 25 approach 26 to 27 retirement this article presents findings from case study research consisting of interviews with key employees at 18 companies in 13 states . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 presents 0 ###LEFT-WALL### 21 . 1 this 2 article 2 article 3 presents 3 presents 4 findings 3 presents 5 from 3 presents 12 with 3 presents 15 at 3 presents 18 in 5 from 8 research 6 case 7 study 7 study 8 research 8 research 9 consisting 9 consisting 10 of 10 of 11 interviews 12 with 14 employees 13 key 14 employees 15 at 17 companies 16 18 17 companies 18 in 20 states 19 13 20 states five of those companies subsequently participated in in [-] person site visits . 0 ###LEFT-WALL### 1 five 0 ###LEFT-WALL### 11 site 0 ###LEFT-WALL### 13 . 1 five 2 of 1 five 11 site 2 of 3 those 3 those 4 companies 3 those 7 in 4 companies 6 participated 5 subsequently 6 participated 6 participated 7 in 8 in 10 person 10 person 11 site 11 site 12 visits interviews were held with a wide range of informants , including company leadership , supervisors , and older workers . 0 ###LEFT-WALL### 1 interviews 0 ###LEFT-WALL### 3 held 0 ###LEFT-WALL### 20 . 1 interviews 2 were 2 were 3 held 3 held 4 with 4 with 17 and 5 a 6 wide 5 a 7 range 6 wide 7 range 7 range 8 of 7 range 17 and 8 of 9 informants 9 informants 11 including 9 informants 15 supervisors 10 , 11 including 11 including 13 leadership 11 including 14 , 12 company 13 leadership 14 , 15 supervisors 15 supervisors 16 , 16 , 17 and 17 and 19 workers 18 older 19 workers findings include a description of the cultural context within which the development of formal and informal older worker retention strategies occurred [,] as well as the retention strategies themselves . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 30 . 1 findings 2 include 2 include 4 description 3 a 4 description 4 description 5 of 5 of 8 context 6 the 8 context 7 cultural 8 context 8 context 9 within 9 within 10 which 9 within 12 development 9 within 21 occurred 11 the 12 development 12 development 13 of 12 development 21 occurred 13 of 20 strategies 14 formal 15 and 15 and 16 informal 15 and 20 strategies 17 older 20 strategies 18 worker 20 strategies 19 retention 20 strategies 21 occurred 25 as 21 occurred 29 themselves 23 as 24 well 24 well 25 as 25 as 28 strategies 26 the 28 strategies 27 retention 28 strategies the discussion section explores the universal nature of these retention initiatives and how consideration of universality benefits not only older workers but a range of diverse groups as well . 0 ###LEFT-WALL### 3 section 0 ###LEFT-WALL### 4 explores 0 ###LEFT-WALL### 30 . 1 the 3 section 2 discussion 3 section 3 section 4 explores 4 explores 27 groups 4 explores 28 as 5 the 7 nature 6 universal 7 nature 7 nature 8 of 7 nature 12 and 8 of 11 initiatives 9 these 11 initiatives 10 retention 11 initiatives 12 and 13 how 12 and 14 consideration 12 and 25 of 12 and 27 groups 14 consideration 15 of 14 consideration 17 benefits 15 of 16 universality 17 benefits 22 but 18 not 19 only 19 only 22 but 20 older 21 workers 21 workers 22 but 22 but 24 range 23 a 24 range 24 range 25 of 26 diverse 27 groups 28 as 29 well workers ' ability to delay retirement depends partly on the demands of their jobs . 0 ###LEFT-WALL### 3 ability 0 ###LEFT-WALL### 7 depends 0 ###LEFT-WALL### 15 . 1 workers 2 ' 2 ' 3 ability 3 ability 4 to 3 ability 5 delay 3 ability 7 depends 4 to 5 delay 5 delay 6 retirement 7 depends 8 partly 8 partly 9 on 9 on 11 demands 10 the 11 demands 11 demands 12 of 12 of 14 jobs 13 their 14 jobs matching occupational characteristics from the occupational information network to current population survey respondents , this study finds that 7 % of american workers held highly physically demanding jobs in 2006 and 35 % held highly cognitively demanding jobs . 0 ###LEFT-WALL### 16 study 0 ###LEFT-WALL### 17 finds 0 ###LEFT-WALL### 39 . 1 matching 3 characteristics 1 matching 14 , 1 matching 16 study 2 occupational 3 characteristics 3 characteristics 4 from 3 characteristics 9 to 4 from 8 network 5 the 8 network 6 occupational 7 information 7 information 8 network 9 to 13 respondents 10 current 11 population 11 population 12 survey 12 survey 13 respondents 15 this 16 study 16 study 17 finds 17 finds 18 that 17 finds 20 % 17 finds 31 and 19 7 20 % 20 % 21 of 20 % 24 held 20 % 27 demanding 21 of 23 workers 22 american 23 workers 25 highly 26 physically 26 physically 27 demanding 27 demanding 28 jobs 27 demanding 29 in 29 in 30 2006 31 and 33 % 32 35 33 % 33 % 34 held 33 % 37 demanding 34 held 35 highly 36 cognitively 37 demanding 37 demanding 38 jobs the share of the workforce in physically demanding jobs fell by about one - [sixth] between 1971 and 2006 , while the share in cognitively demanding jobs increased by more than one - third . 0 ###LEFT-WALL### 2 share 0 ###LEFT-WALL### 10 fell 0 ###LEFT-WALL### 35 . 1 the 2 share 2 share 3 of 2 share 10 fell 3 of 5 workforce 4 the 5 workforce 5 workforce 6 in 6 in 8 demanding 7 physically 8 demanding 8 demanding 9 jobs 10 fell 11 by 10 fell 21 while 10 fell 34 third 11 by 13 one 12 about 13 one 13 one 16 between 14 - 16 between 16 between 18 and 16 between 20 , 17 1971 18 and 18 and 19 2006 20 , 21 while 21 while 23 share 21 while 28 increased 21 while 33 - 22 the 23 share 23 share 24 in 23 share 28 increased 24 in 26 demanding 25 cognitively 26 demanding 26 demanding 27 jobs 28 increased 29 by 28 increased 31 than 29 by 30 more 31 than 32 one the decline in physically demanding occupations will likely improve employment prospects for older adults , but the growth in cognitive demands may limit options for some older workers . 0 ###LEFT-WALL### 2 decline 0 ###LEFT-WALL### 9 improve 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 29 . 1 the 2 decline 2 decline 3 in 2 decline 7 will 3 in 5 demanding 4 physically 5 demanding 5 demanding 6 occupations 7 will 9 improve 8 likely 9 improve 9 improve 11 prospects 10 employment 11 prospects 11 prospects 12 for 12 for 14 adults 13 older 14 adults 15 , 16 but 16 but 18 growth 16 but 23 limit 17 the 18 growth 18 growth 19 in 18 growth 22 may 19 in 21 demands 20 cognitive 21 demands 22 may 23 limit 23 limit 24 options 24 options 25 for 25 for 28 workers 26 some 28 workers 27 older 28 workers the aging of the baby boom cohorts poses challenges for societies , employers , and the baby boomers themselves : will societies be able to sustain an exponentially increasing number of retirees and older workers ? 0 ###LEFT-WALL### 2 aging 0 ###LEFT-WALL### 8 poses 0 ###LEFT-WALL### 20 : 0 ###LEFT-WALL### 23 be 0 ###LEFT-WALL### 36 ? 1 the 2 aging 2 aging 3 of 2 aging 8 poses 3 of 7 cohorts 4 the 7 cohorts 5 baby 7 cohorts 6 boom 7 cohorts 8 poses 9 challenges 8 poses 19 themselves 9 challenges 10 for 10 for 15 and 11 societies 12 , 12 , 13 employers 12 , 15 and 14 , 15 and 15 and 18 boomers 16 the 18 boomers 17 baby 18 boomers 20 : 21 will 21 will 22 societies 21 will 23 be 23 be 35 workers 24 able 25 to 24 able 33 and 25 to 26 sustain 26 sustain 32 retirees 27 an 30 number 28 exponentially 29 increasing 29 increasing 30 number 30 number 31 of 30 number 32 retirees 31 of 32 retirees 33 and 34 older 33 and 35 workers will employers be prepared to accommodate an aging workforce , especially in times of economic recession ? 0 ###LEFT-WALL### 1 will 1 will 2 employers 1 will 3 be 3 be 4 prepared 4 prepared 5 to 4 prepared 6 accommodate 5 to 6 accommodate 6 accommodate 9 workforce 7 an 9 workforce 8 aging 9 workforce 9 workforce 12 in 10 , 11 especially 10 , 12 in 12 in 13 times 12 in 17 ? 13 times 14 of 14 of 16 recession 15 economic 16 recession will aging baby boomers [desire] and be able to postpone retirement and remain in their career jobs or seek bridge employment or be forced to do so out of financial necessity ? 0 ###LEFT-WALL### 1 will 0 ###LEFT-WALL### 32 ? 1 will 2 aging 1 will 6 and 3 baby 4 boomers 3 baby 6 and 6 and 12 and 7 be 8 able 7 be 12 and 8 able 9 to 8 able 10 postpone 9 to 10 postpone 10 postpone 11 retirement 12 and 18 or 13 remain 14 in 13 remain 18 or 14 in 17 jobs 15 their 17 jobs 16 career 17 jobs 18 or 22 or 19 seek 21 employment 19 seek 22 or 20 bridge 21 employment 22 or 23 be 23 be 24 forced 24 forced 25 to 24 forced 26 do 25 to 26 do 26 do 27 so 26 do 29 of 28 out 29 of 29 of 31 necessity 30 financial 31 necessity objectives : this study aimed at testing the proposition of socioemotional selectivity theory whether older people would use more antecedent [-] focused emotion regulatory strategies like cognitive [reappraisal] but fewer response [-] focused strategies like suppression . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 4 study 3 this 4 study 4 study 5 aimed 5 aimed 6 at 5 aimed 14 whether 5 aimed 26 like 5 aimed 35 like 6 at 7 testing 7 testing 9 proposition 8 the 9 proposition 9 proposition 10 of 10 of 13 theory 11 socioemotional 12 selectivity 12 selectivity 13 theory 14 whether 16 people 14 whether 18 use 15 older 16 people 16 people 17 would 17 would 18 use 18 use 25 strategies 19 more 25 strategies 20 antecedent 22 focused 22 focused 23 emotion 23 emotion 25 strategies 24 regulatory 25 strategies 26 like 34 strategies 27 cognitive 29 but 29 but 30 fewer 29 but 34 strategies 31 response 33 focused 33 focused 34 strategies 35 like 36 suppression it also aimed at investigating the mediating role of emotion regulation on the relationship between age and emotions . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 aimed 0 ###LEFT-WALL### 19 . 1 it 3 aimed 2 also 3 aimed 3 aimed 4 at 4 at 5 investigating 5 investigating 8 role 5 investigating 12 on 5 investigating 15 between 6 the 8 role 7 mediating 8 role 8 role 9 of 9 of 11 regulation 10 emotion 11 regulation 12 on 14 relationship 13 the 14 relationship 15 between 17 and 16 age 17 and 17 and 18 emotions method : the sample consisted of 654 younger and older adults aged between 18 and 64 . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 4 sample 2 : 5 consisted 3 the 4 sample 4 sample 5 consisted 5 consisted 6 of 6 of 7 654 7 654 11 adults 7 654 12 aged 8 younger 9 and 9 and 10 older 9 and 11 adults 11 adults 12 aged 12 aged 13 between 13 between 15 and 14 18 15 and 15 and 16 64 results and conclusion : results showed that age was significantly associated with positive emotions and cognitive reappraisal . 0 ###LEFT-WALL### 3 conclusion 0 ###LEFT-WALL### 4 : 1 results 2 and 2 and 3 conclusion 4 : 5 results 4 : 6 showed 4 : 18 . 5 results 6 showed 6 showed 7 that 7 that 8 age 7 that 11 associated 8 age 9 was 9 was 10 significantly 9 was 11 associated 11 associated 12 with 12 with 15 and 13 positive 14 emotions 14 emotions 15 and 15 and 17 reappraisal 16 cognitive 17 reappraisal no difference was found in negative emotions and suppression between younger and older adults . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 15 . 1 no 2 difference 2 difference 3 was 3 was 4 found 4 found 5 in 4 found 10 between 5 in 8 and 6 negative 7 emotions 7 emotions 8 and 8 and 9 suppression 10 between 14 adults 11 younger 12 and 12 and 13 older 12 and 14 adults cognitive [reappraisal] partially mediated the effect of age on positive emotions . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 4 mediated 0 ###LEFT-WALL### 12 . 1 cognitive 4 mediated 3 partially 4 mediated 4 mediated 6 effect 4 mediated 9 on 5 the 6 effect 6 effect 7 of 7 of 8 age 9 on 11 emotions 10 positive 11 emotions findings of this study contribute to our understanding of the underlying mechanism of age variations in emotional experiences . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 5 contribute 0 ###LEFT-WALL### 19 . 1 findings 2 of 1 findings 5 contribute 2 of 4 study 3 this 4 study 5 contribute 6 to 5 contribute 16 in 6 to 8 understanding 7 our 8 understanding 8 understanding 9 of 9 of 12 mechanism 10 the 12 mechanism 11 underlying 12 mechanism 12 mechanism 13 of 13 of 15 variations 14 age 15 variations 16 in 18 experiences 17 emotional 18 experiences objectives : dementia increasingly diminishes the ability to communicate . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 dementia 2 : 5 diminishes 2 : 10 . 3 dementia 5 diminishes 4 increasingly 5 diminishes 5 diminishes 7 ability 6 the 7 ability 7 ability 8 to 7 ability 9 communicate 8 to 9 communicate we aimed to develop and evaluate a psychosocial intervention program that focuses on communication in dementia care . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 18 . 1 we 2 aimed 2 aimed 3 to 2 aimed 5 and 3 to 5 and 4 develop 5 and 5 and 6 evaluate 5 and 15 in 5 and 17 care 6 evaluate 10 program 7 a 10 program 8 psychosocial 9 intervention 9 intervention 10 program 10 program 11 that 10 program 12 focuses 11 that 12 focuses 12 focuses 13 on 13 on 14 communication 15 in 16 dementia this was intended to enhance the quality of life ( qol ) of people with dementia and to reduce the burden on their informal caregivers . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 intended 0 ###LEFT-WALL### 26 . 1 this 2 was 2 was 3 intended 3 intended 4 to 3 intended 17 and 4 to 17 and 5 enhance 7 quality 5 enhance 15 with 5 enhance 17 and 6 the 7 quality 7 quality 8 of 7 quality 13 of 8 of 9 life 9 life 11 qol 10 ( 11 qol 11 qol 12 ) 13 of 14 people 15 with 16 dementia 17 and 18 to 17 and 19 reduce 18 to 19 reduce 19 reduce 21 burden 19 reduce 22 on 20 the 21 burden 22 on 25 caregivers 23 their 25 caregivers 24 informal 25 caregivers method : a training program for informal caregivers of people with dementia was developed . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 5 program 2 : 14 developed 2 : 15 . 3 a 4 training 3 a 5 program 4 training 5 program 5 program 6 for 5 program 13 was 6 for 8 caregivers 7 informal 8 caregivers 8 caregivers 9 of 9 of 10 people 10 people 11 with 11 with 12 dementia 13 was 14 developed the training combines the expertise of geriatric psychiatry , geriatric care , and educational psychology . 0 ###LEFT-WALL### 2 training 0 ###LEFT-WALL### 3 combines 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 16 . 1 the 2 training 2 training 3 combines 3 combines 5 expertise 4 the 5 expertise 5 expertise 6 of 6 of 8 psychiatry 7 geriatric 8 psychiatry 9 , 13 and 10 geriatric 11 care 11 care 13 and 12 , 13 and 13 and 15 psychology 14 educational 15 psychology caregivers [acquire] and [deepen] competencies required to improve communication in dementia care . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 13 . 1 caregivers 3 and 3 and 5 competencies 3 and 6 required 6 required 7 to 6 required 8 improve 7 to 8 improve 8 improve 9 communication 8 improve 10 in 10 in 12 care 11 dementia 12 care the training was evaluated with a pre - post - control group design and time - series analyses . 0 ###LEFT-WALL### 2 training 0 ###LEFT-WALL### 4 evaluated 1 the 2 training 2 training 3 was 3 was 4 evaluated 4 evaluated 5 with 5 with 9 post 6 a 7 pre 6 a 9 post 7 pre 8 - 7 pre 9 post 9 post 14 and 10 - 14 and 11 control 13 design 12 group 13 design 13 design 14 and 14 and 15 time 14 and 18 analyses 14 and 19 . 16 - 18 analyses 17 series 18 analyses 18 analyses 19 . twenty - four informal caregivers participated in the study . 0 ###LEFT-WALL### 5 caregivers 0 ###LEFT-WALL### 6 participated 0 ###LEFT-WALL### 10 . 1 twenty 2 - 2 - 3 four 2 - 5 caregivers 4 informal 5 caregivers 5 caregivers 6 participated 6 participated 7 in 7 in 9 study 8 the 9 study results : the results of the study provide evidence that tandem training increases caregivers ' use of strategies that are relevant for communication in dementia care and the care receivers ' qol . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 4 results 2 : 8 provide 3 the 4 results 4 results 5 of 4 results 8 provide 5 of 7 study 6 the 7 study 8 provide 9 evidence 9 evidence 10 that 10 that 12 training 10 that 13 increases 11 tandem 12 training 12 training 13 increases 13 increases 27 and 14 caregivers 15 ' 15 ' 16 use 16 use 17 of 16 use 27 and 17 of 18 strategies 18 strategies 19 that 18 strategies 20 are 19 that 20 are 20 are 21 relevant 21 relevant 22 for 22 for 23 communication 23 communication 24 in 24 in 26 care 25 dementia 26 care 27 and 32 qol 28 the 30 receivers 29 care 30 receivers 30 receivers 31 ' 31 ' 32 qol conclusion : the results of research in this program show the relevance of including caregivers in interventions and the importance of communication for the qol of people with dementia . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 10 show 2 : 30 . 3 the 4 results 4 results 5 of 4 results 7 in 4 results 10 show 5 of 6 research 7 in 9 program 8 this 9 program 10 show 12 relevance 10 show 18 and 10 show 28 with 11 the 12 relevance 12 relevance 13 of 13 of 14 including 14 including 15 caregivers 14 including 16 in 16 in 17 interventions 18 and 20 importance 19 the 20 importance 20 importance 21 of 20 importance 26 of 21 of 22 communication 22 communication 23 for 23 for 25 qol 24 the 25 qol 26 of 27 people 28 with 29 dementia objective : to explore the help - seeking strategies and the acceptance of services among a national sample of italian , greek and chinese compared to third generation australians . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 to 2 : 4 explore 2 : 21 , 3 to 4 explore 4 explore 6 help 4 explore 8 seeking 5 the 6 help 7 - 8 seeking 8 seeking 10 and 8 seeking 15 among 8 seeking 21 , 9 strategies 10 and 10 and 12 acceptance 10 and 13 of 11 the 12 acceptance 13 of 14 services 15 among 18 sample 16 a 18 sample 17 national 18 sample 18 sample 19 of 19 of 20 italian 21 , 23 and 21 , 25 compared 22 greek 23 and 23 and 24 chinese 23 and 25 compared 25 compared 26 to 26 to 29 australians 27 third 28 generation 28 generation 29 australians methods : a cross - sectional telephone survey [of] 350 italian , 414 greek , 437 chinese and 500 third generation australians whose households were randomly selected from the national telephone directory was carried out . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 36 . 1 methods 2 : 2 : 4 cross 3 a 4 cross 4 cross 11 italian 5 - 11 italian 6 sectional 7 telephone 7 telephone 11 italian 8 survey 11 italian 10 350 11 italian 11 italian 12 , 12 , 13 414 12 , 34 carried 13 414 18 and 13 414 27 selected 13 414 33 was 14 greek 15 , 15 , 17 chinese 15 , 18 and 16 437 17 chinese 18 and 22 australians 18 and 23 whose 18 and 27 selected 19 500 22 australians 20 third 21 generation 21 generation 22 australians 23 whose 24 households 24 households 25 were 26 randomly 27 selected 27 selected 28 from 28 from 32 directory 29 the 32 directory 30 national 32 directory 31 telephone 32 directory 33 was 34 carried 34 carried 35 out participants were asked how they would seek help for a character in a vignette with dementia and what aged care services they would use . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 asked 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 25 . 1 participants 2 were 2 were 3 asked 3 asked 4 how 4 how 5 they 4 how 7 seek 5 they 6 would 6 would 7 seek 7 seek 8 help 7 seek 12 in 7 seek 15 with 8 help 9 for 9 for 11 character 10 a 11 character 12 in 14 vignette 13 a 14 vignette 15 with 16 dementia 17 and 18 what 17 and 19 aged 18 what 19 aged 19 aged 21 services 20 care 21 services 21 services 22 they 21 services 24 use 22 they 23 would 23 would 24 use results : the most frequently reported sources of help for all participants [were] general practitioners ( 55 % ) , community organisations ( 27 % ) and family ( 26 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 27 and 2 : 33 . 3 the 4 most 4 most 5 frequently 5 frequently 6 reported 6 reported 7 sources 7 sources 8 of 7 sources 27 and 8 of 9 help 9 help 10 for 10 for 15 practitioners 11 all 15 practitioners 12 participants 15 practitioners 14 general 15 practitioners 15 practitioners 18 % 15 practitioners 22 organisations 16 ( 18 % 17 55 18 % 18 % 19 ) 20 , 22 organisations 21 community 22 organisations 22 organisations 25 % 22 organisations 26 ) 23 ( 25 % 24 27 25 % 25 % 26 ) 27 and 28 family 27 and 31 % 29 ( 31 % 30 26 31 % 31 % 32 ) significantly more racial minority participants reported that they would seek help from their families ( 32 % ) than did third generation australians ( 13 % ) . 0 ###LEFT-WALL### 5 participants 0 ###LEFT-WALL### 11 help 0 ###LEFT-WALL### 28 . 1 significantly 5 participants 2 more 3 racial 3 racial 4 minority 4 minority 5 participants 5 participants 6 reported 5 participants 7 that 5 participants 10 seek 5 participants 11 help 7 that 8 they 7 that 10 seek 8 they 9 would 9 would 10 seek 11 help 12 from 11 help 19 than 12 from 14 families 13 their 14 families 14 families 17 % 15 ( 17 % 16 32 17 % 17 % 18 ) 19 than 20 did 20 did 23 australians 21 third 22 generation 22 generation 23 australians 23 australians 26 % 24 ( 26 % 25 13 26 % 26 % 27 ) racial minorities were equally or more likely to say that they would use some community - based services than third generation australians and less likely to use residential respite . 0 ###LEFT-WALL### 2 minorities 0 ###LEFT-WALL### 5 or 0 ###LEFT-WALL### 30 . 1 racial 2 minorities 2 minorities 5 or 3 were 4 equally 3 were 5 or 5 or 8 to 5 or 23 and 6 more 7 likely 7 likely 8 to 8 to 9 say 9 say 10 that 10 that 11 they 10 that 13 use 11 they 12 would 12 would 13 use 13 use 15 community 14 some 15 community 16 - 23 and 17 based 18 services 17 based 19 than 17 based 23 and 19 than 22 australians 20 third 21 generation 21 generation 22 australians 23 and 26 to 23 and 27 use 24 less 25 likely 25 likely 26 to 26 to 27 use 27 use 29 respite 28 residential 29 respite italians were less likely to use permanent residential care . 0 ###LEFT-WALL### 1 italians 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 10 . 1 italians 2 were 2 were 4 likely 3 less 4 likely 4 likely 5 to 4 likely 6 use 5 to 6 use 6 use 9 care 7 permanent 9 care 8 residential 9 care acculturation parameters were inconsistently associated with help - seeking and service acceptability . 0 ###LEFT-WALL### 2 parameters 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 8 - 1 acculturation 2 parameters 2 parameters 3 were 3 were 5 associated 4 inconsistently 5 associated 5 associated 6 with 6 with 7 help 8 - 10 and 8 - 13 . 9 seeking 10 and 10 and 12 acceptability 11 service 12 acceptability conclusions : racial minority groups have a greater preference for community services than third generation australians . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 5 groups 2 : 6 have 3 racial 4 minority 4 minority 5 groups 5 groups 6 have 6 have 9 preference 6 have 13 than 7 a 9 preference 8 greater 9 preference 9 preference 10 for 10 for 12 services 11 community 12 services 13 than 16 australians 14 third 15 generation 15 generation 16 australians there are differences between racial minority groups on help - seeking and acceptability of services . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 - 1 there 2 are 2 are 3 differences 3 differences 4 between 4 between 7 groups 5 racial 6 minority 6 minority 7 groups 7 groups 8 on 8 on 9 help 10 - 12 and 10 - 16 . 11 seeking 12 and 12 and 13 acceptability 12 and 14 of 14 of 15 services education and outreach to these groups needs to be tailored . 0 ###LEFT-WALL### 1 education 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 11 . 2 and 3 outreach 2 and 7 needs 3 outreach 4 to 3 outreach 7 needs 4 to 6 groups 5 these 6 groups 7 needs 8 to 7 needs 10 tailored 8 to 9 be 9 be 10 tailored objectives : [affect] and loneliness are important indicators of mental health and well - being in older adulthood [and] [are] linked to significant outcomes including physical health and mortality . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 21 linked 0 ###LEFT-WALL### 30 . 1 objectives 2 : 4 and 5 loneliness 4 and 6 are 5 loneliness 6 are 6 are 12 and 7 important 8 indicators 8 indicators 9 of 8 indicators 12 and 9 of 11 health 10 mental 11 health 12 and 13 well 12 and 14 - 12 and 15 being 12 and 18 adulthood 12 and 21 linked 15 being 16 in 17 older 18 adulthood 18 adulthood 21 linked 21 linked 22 to 22 to 28 and 23 significant 24 outcomes 24 outcomes 25 including 24 outcomes 28 and 25 including 27 health 26 physical 27 health 28 and 29 mortality given a large focus on young - old adults within gerontological research , the primary aim of this study was to examine the ability of individual and social resources in predicting affect and loneliness within a sample [of] [oldest] - old individuals including centenarians , an understudied population . 0 ###LEFT-WALL### 16 aim 0 ###LEFT-WALL### 45 , 0 ###LEFT-WALL### 49 . 1 given 4 focus 1 given 10 within 1 given 13 , 1 given 16 aim 2 a 4 focus 3 large 4 focus 4 focus 5 on 5 on 9 adults 6 young 7 - 6 young 8 old 8 old 9 adults 10 within 12 research 11 gerontological 12 research 14 the 16 aim 15 primary 16 aim 16 aim 17 of 16 aim 20 was 17 of 19 study 18 this 19 study 20 was 21 to 20 was 22 examine 21 to 22 examine 22 examine 24 ability 22 examine 35 within 23 the 24 ability 24 ability 25 of 25 of 33 and 26 individual 27 and 27 and 28 social 27 and 29 resources 27 and 32 affect 27 and 33 and 29 resources 30 in 29 resources 32 affect 30 in 31 predicting 33 and 34 loneliness 35 within 37 sample 36 a 37 sample 37 sample 42 individuals 40 - 42 individuals 41 old 42 individuals 42 individuals 43 including 42 individuals 45 , 43 including 44 centenarians 45 , 48 population 46 an 48 population 47 understudied 48 population methods : participants were assessed during the most recent cross - sectional data [collection] of the georgia centenarian study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 5 assessed 2 : 11 - 2 : 20 . 3 participants 4 were 4 were 5 assessed 5 assessed 6 during 6 during 10 cross 7 the 10 cross 8 most 9 recent 9 recent 10 cross 11 - 13 data 12 sectional 13 data 13 data 15 of 15 of 19 study 16 the 19 study 17 georgia 18 centenarian 18 centenarian 19 study the eligible sample included 55 octogenarians ( m = 83.70 years , sd = 2.68 ; range = 81 - 90 [ )(and 77 centenarians ( m = 99.78 years , sd = 1.64 ; range = 98 - 109 ) . 0 ###LEFT-WALL### 3 sample 0 ###LEFT-WALL### 4 included 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 42 . 1 the 3 sample 2 eligible 3 sample 3 sample 4 included 4 included 6 octogenarians 4 included 9 = 5 55 6 octogenarians 7 ( 9 = 8 m 9 = 9 = 11 years 10 83.70 11 years 12 , 13 sd 12 , 14 = 12 , 16 ; 13 sd 14 = 14 = 15 2.68 16 ; 23 )(and 16 ; 31 , 17 range 20 - 17 range 23 )(and 18 = 19 81 19 81 20 - 20 - 21 90 23 )(and 25 centenarians 23 )(and 28 = 24 77 25 centenarians 26 ( 28 = 27 m 28 = 28 = 30 years 29 99.78 30 years 31 , 32 sd 31 , 33 = 31 , 35 ; 32 sd 33 = 33 = 34 1.64 35 ; 36 range 35 ; 37 = 36 range 37 = 37 = 38 98 38 98 40 109 39 - 40 109 40 109 41 ) subjects scored 17 [or] greater on the mini - mental status exam and completed mental health assessments . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 2 scored 0 ###LEFT-WALL### 9 - 1 subjects 2 scored 2 scored 3 17 3 17 5 greater 5 greater 6 on 6 on 8 mini 7 the 8 mini 9 - 13 and 9 - 18 . 10 mental 11 status 11 status 12 exam 12 exam 13 and 13 and 17 assessments 14 completed 16 health 15 mental 16 health 16 health 17 assessments results : hierarchical regression analyses were conducted to examine the relation [of] [affect] and loneliness with demographic characteristics , physical and social functioning , cognition , and personality . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 5 analyses 2 : 9 examine 3 hierarchical 4 regression 4 regression 5 analyses 5 analyses 6 were 6 were 7 conducted 7 conducted 8 to 8 to 9 examine 9 examine 14 and 9 examine 16 with 10 the 14 and 11 relation 14 and 14 and 15 loneliness 16 with 27 and 17 demographic 18 characteristics 18 characteristics 19 , 19 , 20 physical 19 , 21 and 21 and 22 social 21 and 23 functioning 21 and 25 cognition 21 and 27 and 24 , 25 cognition 25 cognition 26 , 26 , 27 and 27 and 28 personality [within] this sample of cognitively intact [oldest] old , measures of executive control and cognitive functioning demonstrated limited association with mental health . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 23 . 2 this 3 sample 3 sample 4 of 3 sample 14 and 4 of 10 measures 5 cognitively 6 intact 6 intact 10 measures 8 old 9 , 8 old 10 measures 10 measures 11 of 11 of 13 control 12 executive 13 control 14 and 19 association 14 and 20 with 15 cognitive 19 association 16 functioning 19 association 17 demonstrated 19 association 18 limited 19 association 20 with 22 health 21 mental 22 health personality , specifically neuroticism , was strongly related to mental health indicators for both age groups and social relations were particularly important associates of centenarians ' mental health . 0 ###LEFT-WALL### 1 personality 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 29 . 1 personality 4 neuroticism 1 personality 6 was 2 , 4 neuroticism 3 specifically 4 neuroticism 4 neuroticism 5 , 6 was 7 strongly 6 was 8 related 8 related 9 to 9 to 12 indicators 10 mental 11 health 11 health 12 indicators 12 indicators 13 for 13 for 16 groups 14 both 16 groups 15 age 16 groups 17 and 19 relations 17 and 20 were 18 social 19 relations 19 relations 20 were 20 were 21 particularly 20 were 23 associates 22 important 23 associates 23 associates 24 of 24 of 28 health 25 centenarians 26 ' 26 ' 28 health 27 mental 28 health discussion : findings indicate the distinctiveness of mental health indicators and the need to distinguish differential roles of individual and social resources in determining these outcomes among octogenarians and centenarians . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 3 findings 2 : 4 indicate 2 : 31 . 3 findings 4 indicate 4 indicate 6 distinctiveness 4 indicate 27 among 5 the 6 distinctiveness 6 distinctiveness 7 of 7 of 11 and 8 mental 9 health 9 health 10 indicators 10 indicators 11 and 11 and 13 need 11 and 14 to 11 and 24 determining 12 the 13 need 14 to 15 distinguish 15 distinguish 17 roles 16 differential 17 roles 17 roles 18 of 18 of 22 resources 19 individual 20 and 20 and 21 social 20 and 22 resources 22 resources 23 in 23 in 24 determining 24 determining 26 outcomes 25 these 26 outcomes 27 among 29 and 28 octogenarians 29 and 29 and 30 centenarians objectives : this pilot study evaluates satisfaction with foreign home care arrangement from the perspectives of older adults , their family members , and their foreign home care workers . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 5 study 2 : 6 evaluates 2 : 30 . 3 this 5 study 4 pilot 5 study 5 study 6 evaluates 6 evaluates 7 satisfaction 6 evaluates 8 with 8 with 12 arrangement 8 with 13 from 9 foreign 12 arrangement 10 home 12 arrangement 11 care 12 arrangement 13 from 24 and 14 the 15 perspectives 15 perspectives 16 of 15 perspectives 24 and 16 of 18 adults 17 older 18 adults 18 adults 22 members 19 , 22 members 20 their 22 members 21 family 22 members 22 members 23 , 24 and 29 workers 25 their 29 workers 26 foreign 27 home 27 home 29 workers 28 care 29 workers methods : a matched cross [-] sectional sample of 148 family members and foreign home care workers and 90 older care recipients completed a satisfaction survey in the years 2007 - 2008 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 18 and 2 : 23 completed 3 a 8 sample 4 matched 5 cross 5 cross 8 sample 7 sectional 8 sample 8 sample 9 of 8 sample 13 and 9 of 12 members 10 148 11 family 11 family 12 members 13 and 17 workers 13 and 18 and 14 foreign 15 home 15 home 16 care 16 care 17 workers 18 and 22 recipients 18 and 23 completed 19 90 22 recipients 20 older 22 recipients 21 care 22 recipients 23 completed 26 survey 24 a 25 satisfaction 24 a 26 survey 25 satisfaction 26 survey 26 survey 27 in 27 in 29 years 28 the 29 years 29 years 31 - 30 2007 31 - 31 - 32 2008 results : foreign home care workers ' satisfaction was directly associated with family members ['] and care recipients ' satisfaction . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 satisfaction 2 : 11 associated 2 : 21 . 3 foreign 6 workers 4 home 5 care 5 care 6 workers 6 workers 7 ' 7 ' 8 satisfaction 8 satisfaction 9 was 9 was 11 associated 10 directly 11 associated 11 associated 12 with 12 with 16 and 13 family 14 members 14 members 16 and 16 and 20 satisfaction 17 care 18 recipients 18 recipients 19 ' 19 ' 20 satisfaction in addition , the well - being of older care recipients and foreign home care workers was directly associated with their satisfaction with this arrangement . 0 ###LEFT-WALL### 7 being 0 ###LEFT-WALL### 19 associated 0 ###LEFT-WALL### 26 . 1 in 2 addition 1 in 7 being 2 addition 5 well 3 , 5 well 4 the 5 well 5 well 6 - 7 being 8 of 7 being 17 was 8 of 12 and 9 older 10 care 10 care 11 recipients 11 recipients 12 and 12 and 16 workers 13 foreign 14 home 14 home 15 care 15 care 16 workers 17 was 19 associated 18 directly 19 associated 19 associated 20 with 20 with 22 satisfaction 21 their 22 satisfaction 22 satisfaction 23 with 23 with 25 arrangement 24 this 25 arrangement finally , there was an inverse association between care recipients ' cognitive functioning and family members ' satisfaction . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 19 . 1 finally 2 , 1 finally 3 there 3 there 4 was 4 was 7 association 5 an 6 inverse 5 an 7 association 6 inverse 7 association 7 association 8 between 8 between 14 and 9 care 10 recipients 10 recipients 11 ' 11 ' 13 functioning 12 cognitive 13 functioning 13 functioning 14 and 14 and 18 satisfaction 15 family 16 members 16 members 17 ' 17 ' 18 satisfaction conclusions : this study demonstrates the complex associations between the various stakeholders involved in this caregiving arrangement . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 demonstrates 2 : 18 . 3 this 4 study 4 study 5 demonstrates 5 demonstrates 8 associations 5 demonstrates 9 between 6 the 8 associations 7 complex 8 associations 9 between 12 stakeholders 10 the 12 stakeholders 11 various 12 stakeholders 12 stakeholders 13 involved 13 involved 14 in 14 in 17 arrangement 15 this 17 arrangement 16 caregiving 17 arrangement it is possible that better working conditions would result in improved satisfaction with services of all parties involved . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 19 . 1 it 2 is 2 is 3 possible 3 possible 4 that 4 that 6 working 4 that 18 involved 5 better 6 working 6 working 7 conditions 6 working 8 would 8 would 9 result 9 result 10 in 9 result 13 with 10 in 12 satisfaction 11 improved 12 satisfaction 13 with 14 services 13 with 18 involved 14 services 15 of 15 of 17 parties 16 all 17 parties the provision of informal care to infirm family members is of central importance to social gerontology ; concomitantly , caregiver burden is a topic of considerable research interest . 0 ###LEFT-WALL### 2 provision 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 29 . 1 the 2 provision 2 provision 3 of 2 provision 10 is 3 of 5 care 4 informal 5 care 5 care 6 to 6 to 9 members 7 infirm 8 family 8 family 9 members 10 is 11 of 10 is 14 to 11 of 13 importance 12 central 13 importance 14 to 16 gerontology 15 social 16 gerontology 17 ; 21 burden 17 ; 22 is 18 concomitantly 19 , 18 concomitantly 21 burden 20 caregiver 21 burden 21 burden 22 is 22 is 24 topic 23 a 24 topic 24 topic 25 of 25 of 28 interest 26 considerable 27 research 27 research 28 interest to this end , psychometrically sound instruments are required to advance cross - national research . 0 ###LEFT-WALL### 12 cross 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 16 . 1 to 3 end 1 to 4 , 1 to 12 cross 2 this 3 end 4 , 11 advance 5 psychometrically 6 sound 6 sound 7 instruments 7 instruments 8 are 8 are 9 required 9 required 10 to 9 required 11 advance 10 to 11 advance 11 advance 12 cross 13 - 15 research 14 national 15 research the current study builds upon previous research examining the reliability and validity of responses to a brief hebrew language version of the zarit burden interview . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 builds 0 ###LEFT-WALL### 26 . 1 the 3 study 2 current 3 study 3 study 4 builds 4 builds 5 upon 4 builds 15 to 5 upon 7 research 6 previous 7 research 7 research 8 examining 7 research 13 of 8 examining 11 and 9 the 11 and 10 reliability 11 and 11 and 12 validity 13 of 14 responses 15 to 20 version 16 a 17 brief 16 a 20 version 17 brief 18 hebrew 18 hebrew 19 language 19 language 20 version 20 version 21 of 21 of 25 interview 22 the 25 interview 23 zarit 24 burden 24 burden 25 interview for this study , factorial validity of responses to this instrument is [examined] relative to a representative english canadian sample of caregivers . 0 ###LEFT-WALL### 6 validity 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 23 . 1 for 3 study 1 for 4 , 1 for 6 validity 2 this 3 study 5 factorial 6 validity 6 validity 7 of 6 validity 12 is 7 of 8 responses 8 responses 9 to 9 to 11 instrument 10 this 11 instrument 12 is 14 relative 14 relative 15 to 15 to 20 sample 16 a 17 representative 16 a 20 sample 17 representative 19 canadian 18 english 19 canadian 19 canadian 20 sample 20 sample 21 of 21 of 22 caregivers invariance analyses comparing english and hebrew responses support a 2 [-] factor model of burden ( role strain , personal strain ) ; furthermore , invariance analyses comparing responses indicate that caregivers interpret and respond to the majority of items in a consistent manner . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 8 support 0 ###LEFT-WALL### 23 ; 0 ###LEFT-WALL### 45 . 1 invariance 2 analyses 2 analyses 3 comparing 2 analyses 5 and 3 comparing 4 english 5 and 7 responses 5 and 8 support 6 hebrew 7 responses 8 support 13 model 9 a 13 model 10 2 12 factor 12 factor 13 model 13 model 14 of 13 model 18 strain 14 of 15 burden 16 ( 18 strain 17 role 18 strain 18 strain 21 strain 18 strain 23 ; 19 , 21 strain 20 personal 21 strain 21 strain 22 ) 23 ; 27 analyses 23 ; 34 and 24 furthermore 25 , 24 furthermore 27 analyses 26 invariance 27 analyses 27 analyses 28 comparing 27 analyses 34 and 28 comparing 29 responses 30 indicate 31 that 30 indicate 34 and 31 that 32 caregivers 31 that 33 interpret 32 caregivers 33 interpret 34 and 35 respond 34 and 36 to 36 to 40 items 37 the 38 majority 38 majority 39 of 38 majority 40 items 39 of 40 items 40 items 41 in 41 in 44 manner 42 a 44 manner 43 consistent 44 manner this finding suggests reliable translation of items from english to hebrew . 0 ###LEFT-WALL### 2 finding 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 12 . 1 this 2 finding 2 finding 3 suggests 3 suggests 5 translation 3 suggests 10 to 4 reliable 5 translation 5 translation 6 of 6 of 7 items 7 items 8 from 8 from 9 english 10 to 11 hebrew caregiver burden is discussed in the context of changing demographics and the growing prevalence of disorders affecting older adults . 0 ###LEFT-WALL### 2 burden 0 ###LEFT-WALL### 4 discussed 0 ###LEFT-WALL### 20 . 1 caregiver 2 burden 2 burden 3 is 3 is 4 discussed 4 discussed 5 in 5 in 11 and 6 the 7 context 7 context 8 of 7 context 11 and 8 of 9 changing 9 changing 10 demographics 11 and 14 prevalence 11 and 15 of 12 the 14 prevalence 13 growing 14 prevalence 15 of 16 disorders 16 disorders 17 affecting 17 affecting 19 adults 18 older 19 adults subjective memory [complaint] ( smc ) is common among elderly people , and is thought to be part of mild cognitive impairment ( mci ) . 0 ###LEFT-WALL### 2 memory 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 26 . 1 subjective 2 memory 2 memory 5 smc 2 memory 13 and 4 ( 5 smc 5 smc 6 ) 7 is 8 common 7 is 13 and 8 common 9 among 9 among 11 people 10 elderly 11 people 12 , 13 and 13 and 14 is 13 and 16 to 13 and 22 impairment 14 is 15 thought 16 to 17 be 18 part 19 of 18 part 22 impairment 19 of 22 impairment 20 mild 22 impairment 21 cognitive 22 impairment 22 impairment 24 mci 23 ( 24 mci 24 mci 25 ) we evaluated whether impaired digit span [(] ids [ )(in older people with smc can predict wider impairment in future neuropsychological tests that correspond to mci . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 evaluated 0 ###LEFT-WALL### 27 . 1 we 2 evaluated 2 evaluated 3 whether 3 whether 8 ids 3 whether 16 predict 4 impaired 5 digit 5 digit 8 ids 6 span 8 ids 8 ids 10 )(in 8 ids 13 with 8 ids 15 can 10 )(in 12 people 11 older 12 people 13 with 14 smc 15 can 16 predict 16 predict 18 impairment 16 predict 19 in 17 wider 18 impairment 19 in 22 tests 20 future 22 tests 21 neuropsychological 22 tests 22 tests 23 that 22 tests 24 correspond 23 that 24 correspond 24 correspond 25 to 25 to 26 mci after a mean of 6.6 years from the initial assessment , we reevaluated 16 subjects with smc and normal digit span ( nds ) scores ( mean age 57.6 ± 8.1 years ) and 28 subjects with smc and ids scores ( mean age 59.7 ± 9.9 years ) . 0 ###LEFT-WALL### 12 we 0 ###LEFT-WALL### 13 reevaluated 0 ###LEFT-WALL### 50 . 1 after 3 mean 1 after 11 , 1 after 12 we 2 a 3 mean 3 mean 4 of 4 of 7 from 5 6.6 6 years 6 years 7 from 7 from 10 assessment 8 the 10 assessment 9 initial 10 assessment 12 we 13 reevaluated 13 reevaluated 34 and 13 reevaluated 37 with 14 16 15 subjects 15 subjects 16 with 15 subjects 34 and 16 with 25 scores 17 smc 18 and 18 and 21 span 18 and 23 nds 18 and 25 scores 19 normal 21 span 20 digit 21 span 22 ( 23 nds 23 nds 24 ) 25 scores 32 years 26 ( 32 years 27 mean 28 age 28 age 32 years 29 57.6 30 ± 30 ± 32 years 31 8.1 32 years 32 years 33 ) 34 and 36 subjects 35 28 36 subjects 37 with 39 and 38 smc 39 and 39 and 41 scores 39 and 48 years 40 ids 41 scores 42 ( 48 years 43 mean 48 years 44 age 48 years 45 59.7 48 years 46 ± 48 years 47 9.9 48 years 48 years 49 ) the ids group showed wider cognitive decline [in] tests of short - term verbal memory and category verbal fluency compared to the nds group . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 25 . 1 the 3 group 2 ids 3 group 3 group 4 showed 4 showed 9 tests 4 showed 19 fluency 5 wider 7 decline 6 cognitive 7 decline 7 decline 9 tests 9 tests 10 of 10 of 16 and 11 short 12 - 11 short 13 term 13 term 15 memory 14 verbal 15 memory 15 memory 16 and 16 and 17 category 18 verbal 19 fluency 19 fluency 20 compared 20 compared 21 to 21 to 24 group 22 the 24 group 23 nds 24 group ids scores indicate an earlier step for conversion of smc to mci . 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 13 . 1 ids 2 scores 2 scores 3 indicate 3 indicate 6 step 3 indicate 11 to 4 an 6 step 5 earlier 6 step 6 step 7 for 7 for 8 conversion 8 conversion 9 of 9 of 10 smc 11 to 12 mci method : analyses are based on the changing lives of older couples ( cloc ) study , a prospective study of a two [-] stage area probability sample of 1532 married men and women aged 65 or older . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 3 analyses 2 : 5 based 3 analyses 4 are 4 are 5 based 5 based 6 on 5 based 37 or 6 on 9 lives 7 the 9 lives 8 changing 9 lives 9 lives 10 of 10 of 11 older 12 couples 14 cloc 13 ( 14 cloc 14 cloc 15 ) 14 cloc 16 study 16 study 17 , 17 , 20 study 17 , 33 and 18 a 19 prospective 18 a 20 study 19 prospective 20 study 20 study 21 of 21 of 28 sample 22 a 28 sample 23 two 25 stage 25 stage 28 sample 26 area 28 sample 27 probability 28 sample 28 sample 29 of 29 of 32 men 30 1532 32 men 31 married 32 men 33 and 34 women 33 and 35 aged 33 and 37 or 35 aged 36 65 37 or 38 older depressive and grief symptoms , six months after spousal loss , were regressed on social contact , support , and congruence [between] preferred and actual social contact . 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 28 . 1 depressive 2 and 2 and 3 grief 2 and 4 symptoms 2 and 18 support 2 and 20 and 4 symptoms 8 after 4 symptoms 12 were 5 , 8 after 6 six 7 months 7 months 8 after 8 after 10 loss 8 after 11 , 9 spousal 10 loss 12 were 17 , 13 regressed 14 on 13 regressed 17 , 14 on 16 contact 15 social 16 contact 17 , 18 support 19 , 20 and 20 and 21 congruence 20 and 23 preferred 20 and 24 and 24 and 27 contact 25 actual 26 social 26 social 27 contact results : frequency of contact did not have a significant influence on psychological distress when contextual factors are controlled . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 frequency 2 : 8 have 2 : 20 . 3 frequency 4 of 3 frequency 6 did 4 of 5 contact 6 did 7 not 6 did 8 have 8 have 11 influence 8 have 12 on 9 a 10 significant 9 a 11 influence 10 significant 11 influence 12 on 14 distress 13 psychological 14 distress 14 distress 15 when 15 when 17 factors 15 when 19 controlled 16 contextual 17 factors 17 factors 18 are 18 are 19 controlled social support and the incongruence between preferred [and] actual social contact were significantly associated with decreased psychological distress for several outcomes . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 22 . 1 social 2 support 2 support 3 and 3 and 5 incongruence 3 and 6 between 3 and 12 were 4 the 5 incongruence 6 between 11 contact 7 preferred 10 social 9 actual 10 social 10 social 11 contact 12 were 13 significantly 12 were 14 associated 14 associated 15 with 15 with 18 distress 16 decreased 18 distress 17 psychological 18 distress 18 distress 19 for 19 for 21 outcomes 20 several 21 outcomes as for the moderating effects of social support and incongruence on the link between social contact and distress , those who had high social contact and high social support experienced less anger and fewer intrusive thoughts than their counterparts ; and those who had low social contact but preferred high social contact experienced greater anger . 0 ###LEFT-WALL### 20 those 0 ###LEFT-WALL### 29 support 0 ###LEFT-WALL### 40 ; 0 ###LEFT-WALL### 56 . 1 as 2 for 1 as 19 , 1 as 20 those 2 for 17 and 3 the 5 effects 4 moderating 5 effects 5 effects 6 of 5 effects 17 and 6 of 9 and 7 social 8 support 8 support 9 and 9 and 10 incongruence 9 and 11 on 11 on 13 link 12 the 13 link 13 link 14 between 14 between 16 contact 15 social 16 contact 17 and 18 distress 20 those 21 who 20 those 22 had 20 those 29 support 21 who 22 had 22 had 26 and 23 high 24 social 24 social 25 contact 25 contact 26 and 26 and 28 social 27 high 28 social 29 support 36 thoughts 29 support 37 than 30 experienced 36 thoughts 31 less 32 anger 32 anger 33 and 33 and 34 fewer 33 and 36 thoughts 35 intrusive 36 thoughts 37 than 39 counterparts 38 their 39 counterparts 40 ; 41 and 40 ; 48 but 41 and 42 those 41 and 45 low 42 those 43 who 42 those 44 had 42 those 45 low 43 who 44 had 45 low 47 contact 46 social 47 contact 48 but 52 contact 48 but 53 experienced 49 preferred 52 contact 50 high 52 contact 51 social 52 contact 52 contact 53 experienced 53 experienced 55 anger 54 greater 55 anger conclusion : the findings highlight the importance of understanding the quality of widowed persons ' relationships as well as the congruence between their preferred [and] actual social contact . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 4 findings 2 : 5 highlight 3 the 4 findings 4 findings 5 highlight 5 highlight 7 importance 5 highlight 19 as 5 highlight 22 between 6 the 7 importance 7 importance 8 of 7 importance 12 of 8 of 9 understanding 9 understanding 11 quality 10 the 11 quality 12 of 16 relationships 13 widowed 14 persons 14 persons 15 ' 15 ' 16 relationships 17 as 18 well 18 well 19 as 19 as 21 congruence 20 the 21 congruence 22 between 28 contact 23 their 28 contact 24 preferred 28 contact 26 actual 28 contact 27 social 28 contact in this study of 125 older couples married for an average of 34 years , multilevel models were computed to simultaneously examine [intra] - couple personality trait averages [and] between [-] spouse trait similarity as predictors of marital satisfaction . 0 ###LEFT-WALL### 7 couples 0 ###LEFT-WALL### 25 couple 0 ###LEFT-WALL### 40 . 1 in 3 study 1 in 7 couples 2 this 3 study 4 of 5 125 4 of 7 couples 6 older 7 couples 7 couples 8 married 7 couples 9 for 7 couples 25 couple 9 for 11 average 10 an 11 average 11 average 12 of 12 of 14 years 13 34 14 years 14 years 16 multilevel 15 , 16 multilevel 16 multilevel 17 models 16 multilevel 22 examine 16 multilevel 24 - 17 models 18 were 18 were 19 computed 19 computed 20 to 20 to 22 examine 21 simultaneously 22 examine 25 couple 28 averages 25 couple 30 between 25 couple 35 as 26 personality 28 averages 27 trait 28 averages 30 between 34 similarity 32 spouse 34 similarity 33 trait 34 similarity 35 as 36 predictors 36 predictors 37 of 37 of 39 satisfaction 38 marital 39 satisfaction our findings suggest that higher [intra] - couple levels of extraversion predict marital satisfaction , both husbands and wives . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 20 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 9 levels 4 that 12 predict 5 higher 7 - 5 higher 8 couple 8 couple 9 levels 9 levels 10 of 10 of 11 extraversion 12 predict 18 and 13 marital 14 satisfaction 14 satisfaction 15 , 15 , 17 husbands 15 , 18 and 16 both 17 husbands 18 and 19 wives in addition , [between] - spouse similarity in openness to experience appears associated with higher levels of marital satisfaction as reported by husbands ; concomitantly [,] [between] - spouse similarity in agreeableness predicts wives ' marital satisfaction . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 38 . 1 in 2 addition 3 , 5 - 3 , 21 reported 3 , 24 ; 5 - 7 similarity 6 spouse 7 similarity 7 similarity 8 in 7 similarity 10 to 7 similarity 12 appears 8 in 9 openness 10 to 11 experience 12 appears 13 associated 13 associated 14 with 13 associated 20 as 14 with 16 levels 15 higher 16 levels 16 levels 17 of 17 of 19 satisfaction 18 marital 19 satisfaction 20 as 21 reported 21 reported 22 by 22 by 23 husbands 24 ; 30 similarity 24 ; 33 predicts 25 concomitantly 28 - 25 concomitantly 30 similarity 29 spouse 30 similarity 30 similarity 31 in 30 similarity 33 predicts 31 in 32 agreeableness 33 predicts 37 satisfaction 34 wives 35 ' 35 ' 37 satisfaction 36 marital 37 satisfaction with respect to openness ( husbands ) and agreeableness ( wives ) , it did not matter which spouse within couples reported higher or lower trait levels . 0 ###LEFT-WALL### 14 it 0 ###LEFT-WALL### 17 matter 0 ###LEFT-WALL### 28 . 1 with 8 and 1 with 13 , 1 with 14 it 2 respect 3 to 2 respect 8 and 3 to 4 openness 4 openness 6 husbands 5 ( 6 husbands 6 husbands 7 ) 8 and 9 agreeableness 8 and 11 wives 10 ( 11 wives 11 wives 12 ) 14 it 15 did 15 did 16 not 15 did 17 matter 17 matter 18 which 18 which 19 spouse 19 spouse 20 within 19 spouse 24 or 20 within 21 couples 21 couples 22 reported 22 reported 23 higher 24 or 26 trait 24 or 27 levels 25 lower 26 trait the most notable finding to emerge from this study [is] that neuroticism is not associated with marital satisfaction , neither husbands nor wives . 0 ###LEFT-WALL### 22 nor 0 ###LEFT-WALL### 24 . 1 the 3 notable 2 most 3 notable 3 notable 4 finding 3 notable 22 nor 4 finding 5 to 4 finding 11 that 5 to 6 emerge 6 emerge 7 from 7 from 9 study 8 this 9 study 11 that 12 neuroticism 11 that 19 , 12 neuroticism 13 is 13 is 14 not 13 is 19 , 15 associated 16 with 15 associated 19 , 16 with 18 satisfaction 17 marital 18 satisfaction 19 , 21 husbands 20 neither 21 husbands 22 nor 23 wives this result stands in contrast to previously reported findings -- the vast majority of prior research conducted with dating and newlywed couples . 0 ###LEFT-WALL### 2 result 0 ###LEFT-WALL### 3 stands 1 this 2 result 2 result 3 stands 3 stands 4 in 3 stands 6 to 4 in 5 contrast 6 to 9 findings 7 previously 8 reported 8 reported 9 findings 9 findings 20 and 10 -- 20 and 11 the 13 majority 12 vast 13 majority 13 majority 14 of 13 majority 20 and 14 of 16 research 15 prior 16 research 16 research 17 conducted 17 conducted 18 with 18 with 19 dating 20 and 22 couples 20 and 23 . 21 newlywed 22 couples conflicting results may reflect the degree to which neuroticism determines divorce within the first years of married life , adaptation to the foibles of one 's spouse over time , overreliance on younger samples in marriage and family research , or some combination of these alternate explanations . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 reflect 0 ###LEFT-WALL### 48 . 1 conflicting 2 results 2 results 3 may 3 may 4 reflect 4 reflect 41 or 5 the 6 degree 6 degree 7 to 6 degree 19 , 7 to 8 which 7 to 9 neuroticism 7 to 10 determines 9 neuroticism 10 determines 10 determines 11 divorce 11 divorce 12 within 11 divorce 16 of 12 within 15 years 13 the 15 years 14 first 15 years 16 of 18 life 17 married 18 life 19 , 20 adaptation 19 , 30 , 20 adaptation 21 to 21 to 23 foibles 22 the 23 foibles 23 foibles 24 of 24 of 27 spouse 25 one 26 's 26 's 27 spouse 27 spouse 28 over 28 over 29 time 30 , 31 overreliance 30 , 37 and 31 overreliance 32 on 32 on 34 samples 33 younger 34 samples 34 samples 35 in 35 in 36 marriage 37 and 39 research 37 and 40 , 37 and 41 or 38 family 39 research 40 , 41 or 41 or 43 combination 41 or 44 of 42 some 43 combination 44 of 47 explanations 45 these 47 explanations 46 alternate 47 explanations objectives : to examine patient preferences for incorporating religion [and/or] spirituality into therapy for anxiety or depression and examine the relations between patient preferences and religious and spiritual coping styles , beliefs and behaviors . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 3 to 2 : 18 and 2 : 31 , 3 to 18 and 4 examine 6 preferences 4 examine 7 for 4 examine 18 and 5 patient 6 preferences 7 for 8 incorporating 8 incorporating 11 spirituality 8 incorporating 12 into 9 religion 11 spirituality 12 into 13 therapy 13 therapy 14 for 14 for 16 or 15 anxiety 16 or 16 or 17 depression 18 and 19 examine 19 examine 25 and 20 the 21 relations 21 relations 22 between 21 relations 25 and 22 between 24 preferences 23 patient 24 preferences 25 and 30 styles 26 religious 27 and 27 and 28 spiritual 27 and 30 styles 29 coping 30 styles 31 , 33 and 32 beliefs 33 and 33 and 34 behaviors spearman 's rank - order correlations and ordinal logistic regression examined religious/spiritual variables as predictors of preferences for inclusion of religion or spirituality into counseling . 0 ###LEFT-WALL### 3 rank 0 ###LEFT-WALL### 5 order 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 26 . 1 spearman 2 's 2 's 3 rank 4 - 5 order 5 order 6 correlations 7 and 10 regression 7 and 11 examined 8 ordinal 10 regression 9 logistic 10 regression 10 regression 11 examined 11 examined 13 variables 11 examined 14 as 11 examined 18 for 11 examined 24 into 12 religious/spiritual 13 variables 14 as 15 predictors 15 predictors 16 of 16 of 17 preferences 18 for 22 or 19 inclusion 20 of 19 inclusion 22 or 20 of 21 religion 22 or 23 spirituality 24 into 25 counseling results : most participants ( 77 - 83 % ) preferred including religion [and/or] spirituality in therapy for anxiety and depression . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 participants 2 : 11 preferred 3 most 4 participants 4 participants 9 % 4 participants 11 preferred 5 ( 9 % 6 77 7 - 7 - 8 83 7 - 9 % 9 % 10 ) 11 preferred 15 spirituality 11 preferred 16 in 11 preferred 18 for 12 including 15 spirituality 13 religion 15 spirituality 16 in 17 therapy 18 for 20 and 19 anxiety 20 and 20 and 21 depression participants who thought it was important to include religion or spirituality in therapy reported more positive religious - based coping , greater strength of religious faith , and greater collaborative and less self - directed problem - solving styles than participants who did not think it was important . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 8 include 1 participants 2 who 1 participants 3 thought 1 participants 5 was 2 who 3 thought 3 thought 4 it 5 was 6 important 6 important 7 to 6 important 8 include 7 to 8 include 8 include 10 or 8 include 38 solving 9 religion 10 or 10 or 36 problem 11 spirituality 12 in 11 spirituality 28 and 12 in 20 coping 13 therapy 14 reported 14 reported 20 coping 15 more 16 positive 16 positive 20 coping 17 religious 18 - 17 religious 20 coping 19 based 20 coping 20 coping 23 strength 21 , 23 strength 22 greater 23 strength 23 strength 24 of 23 strength 27 , 24 of 26 faith 25 religious 26 faith 28 and 33 self 28 and 34 - 28 and 36 problem 29 greater 33 self 30 collaborative 31 and 31 and 32 less 31 and 33 self 35 directed 36 problem 37 - 38 solving 38 solving 39 styles 38 solving 40 than 38 solving 49 . 40 than 41 participants 41 participants 42 who 41 participants 43 did 42 who 43 did 43 did 44 not 43 did 45 think 45 think 46 it 45 think 47 was 46 it 47 was 47 was 48 important conclusion : for individuals like most participants in this study ( christians ) , incorporating spirituality/religion into counseling for anxiety and depression was desirable . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 25 . 1 conclusion 2 : 2 : 3 for 2 : 5 like 2 : 8 in 3 for 4 individuals 5 like 7 participants 6 most 7 participants 8 in 10 study 9 this 10 study 10 study 12 christians 11 ( 12 christians 12 christians 13 ) 14 , 15 incorporating 14 , 23 was 15 incorporating 16 spirituality/religion 15 incorporating 19 for 15 incorporating 23 was 16 spirituality/religion 17 into 17 into 18 counseling 19 for 21 and 20 anxiety 21 and 21 and 22 depression 23 was 24 desirable objectives : an exploratory investigation is reported into the role of spirituality and religious practice in protecting against depression among older people living in rural villages in bulgaria and romania , two neighbouring countries with similar cultural , political and religious histories , but with differing levels of current religiosity . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 5 investigation 2 : 7 reported 3 an 4 exploratory 3 an 5 investigation 4 exploratory 5 investigation 5 investigation 6 is 6 is 7 reported 7 reported 8 into 7 reported 16 in 7 reported 20 among 8 into 10 role 9 the 10 role 10 role 11 of 11 of 13 and 12 spirituality 13 and 13 and 15 practice 14 religious 15 practice 16 in 17 protecting 17 protecting 18 against 18 against 19 depression 20 among 29 and 21 older 22 people 22 people 23 living 22 people 24 in 22 people 29 and 24 in 26 villages 25 rural 26 villages 26 villages 27 in 27 in 28 bulgaria 29 and 30 romania 30 romania 32 two 31 , 32 two 32 two 33 neighbouring 32 two 44 but 32 two 51 . 33 neighbouring 34 countries 35 with 42 histories 35 with 44 but 36 similar 42 histories 37 cultural 38 , 38 , 39 political 38 , 40 and 40 and 41 religious 40 and 42 histories 43 , 44 but 44 but 45 with 45 with 46 differing 46 differing 47 levels 47 levels 48 of 48 of 50 religiosity 49 current 50 religiosity methods : in both countries , interviews were conducted with samples of 160 persons of 60 years and over in villages of similar socio - economic status . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 28 . 1 methods 2 : 2 : 3 in 3 in 5 countries 4 both 5 countries 6 , 7 interviews 6 , 9 conducted 7 interviews 8 were 8 were 9 conducted 9 conducted 18 and 10 with 11 samples 10 with 18 and 11 samples 12 of 12 of 14 persons 13 160 14 persons 14 persons 15 of 15 of 17 years 16 60 17 years 18 and 19 over 19 over 20 in 20 in 21 villages 21 villages 22 of 22 of 27 status 23 similar 27 status 24 socio 25 - 24 socio 27 status 26 economic 27 status the hospital anxiety and depression [-] d scale and the royal free interview for religious and spiritual beliefs were used to assess depression and spiritual belief and practice respectively . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 20 used 0 ###LEFT-WALL### 30 . 1 the 3 anxiety 2 hospital 3 anxiety 3 anxiety 4 and 4 and 8 scale 4 and 9 and 5 depression 7 d 5 depression 8 scale 9 and 13 interview 9 and 14 for 9 and 16 and 10 the 13 interview 11 royal 12 free 12 free 13 interview 14 for 15 religious 16 and 18 beliefs 16 and 19 were 17 spiritual 18 beliefs 19 were 20 used 20 used 21 to 20 used 22 assess 21 to 22 assess 22 assess 27 and 22 assess 29 respectively 23 depression 24 and 24 and 26 belief 24 and 27 and 25 spiritual 26 belief 27 and 28 practice in addition social support , physical functioning and the presence of chronic diseases were assessed . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 15 assessed 0 ###LEFT-WALL### 16 . 1 in 4 support 1 in 5 , 1 in 8 and 2 addition 4 support 3 social 4 support 6 physical 7 functioning 6 physical 8 and 8 and 10 presence 8 and 11 of 8 and 14 were 9 the 10 presence 11 of 13 diseases 12 chronic 13 diseases 14 were 15 assessed one year later , follow - up interviews were conducted with 58 of the original sample in bulgaria , in which additional measures of depression [and] of spiritual belief and practice were also included . 0 ###LEFT-WALL### 5 follow 0 ###LEFT-WALL### 6 - 1 one 2 year 2 year 3 later 3 later 4 , 3 later 5 follow 6 - 8 interviews 6 - 10 conducted 7 up 8 interviews 8 interviews 9 were 9 were 10 conducted 10 conducted 11 with 10 conducted 17 in 11 with 12 58 12 58 13 of 13 of 16 sample 14 the 16 sample 15 original 16 sample 17 in 18 bulgaria 18 bulgaria 20 in 19 , 20 in 20 in 21 which 20 in 23 measures 20 in 34 included 20 in 35 . 22 additional 23 measures 23 measures 24 of 23 measures 27 of 23 measures 32 were 24 of 25 depression 27 of 30 and 28 spiritual 29 belief 29 belief 30 and 30 and 31 practice 32 were 33 also 32 were 34 included 34 included 35 . however , analyses from both [the] cross - sectional study and the one [-] year follow - up of the bulgarian sample do suggest that spiritual belief and [practice] may both influence [and] [reflect] physical and mental illness . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 7 cross 0 ###LEFT-WALL### 8 - 1 however 2 , 1 however 3 analyses 3 analyses 4 from 3 analyses 7 cross 4 from 5 both 8 - 11 and 8 - 16 follow 8 - 17 - 9 sectional 10 study 10 study 11 and 11 and 15 year 11 and 16 follow 12 the 13 one 13 one 15 year 17 - 22 sample 17 - 28 and 18 up 22 sample 19 of 21 bulgarian 19 of 22 sample 20 the 21 bulgarian 22 sample 28 and 23 do 24 suggest 23 do 28 and 24 suggest 27 belief 25 that 27 belief 26 spiritual 27 belief 28 and 30 may 30 may 32 influence 31 both 32 influence 32 influence 36 and 35 physical 36 and 36 and 38 illness 36 and 39 . 37 mental 38 illness conclusions : much of eastern europe displays high rates of depression among its older population and provides opportunities for investigation of the role of religious belief and practice in preventing and coping with depression . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 3 much 2 : 16 and 3 much 4 of 3 much 16 and 4 of 6 europe 5 eastern 6 europe 7 displays 9 rates 7 displays 12 among 7 displays 16 and 8 high 9 rates 9 rates 10 of 10 of 11 depression 12 among 15 population 13 its 15 population 14 older 15 population 16 and 17 provides 16 and 19 for 16 and 29 in 16 and 33 with 17 provides 18 opportunities 19 for 20 investigation 20 investigation 21 of 20 investigation 24 of 21 of 23 role 22 the 23 role 24 of 27 and 25 religious 26 belief 26 belief 27 and 27 and 28 practice 29 in 31 and 30 preventing 31 and 31 and 32 coping 33 with 34 depression further research is encouraged in populations of diverse religiosity . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 encouraged 0 ###LEFT-WALL### 10 . 1 further 2 research 2 research 3 is 3 is 4 encouraged 4 encouraged 5 in 5 in 6 populations 6 populations 7 of 7 of 9 religiosity 8 diverse 9 religiosity objectives : peaceful mind , a [cognitive] - behavioral therapy for treating anxiety in persons with dementia , is a promising new treatment currently under investigation . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 27 . 1 objectives 2 : 2 : 4 mind 3 peaceful 4 mind 4 mind 8 - 5 , 8 - 6 a 8 - 8 - 10 therapy 8 - 18 , 9 behavioral 10 therapy 10 therapy 11 for 11 for 12 treating 12 treating 13 anxiety 12 treating 14 in 12 treating 16 with 14 in 15 persons 16 with 17 dementia 18 , 19 is 19 is 23 treatment 19 is 24 currently 19 is 25 under 20 a 23 treatment 21 promising 23 treatment 22 new 23 treatment 25 under 26 investigation this article reports results of our examination of a modification of the treatment protocol in two cases that included multiple caregivers in treating two persons with dementia . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 reports 0 ###LEFT-WALL### 28 . 1 this 2 article 2 article 3 reports 3 reports 4 results 3 reports 15 in 3 reports 22 in 3 reports 26 with 4 results 5 of 4 results 8 of 5 of 7 examination 6 our 7 examination 8 of 10 modification 9 a 10 modification 10 modification 11 of 11 of 14 protocol 12 the 14 protocol 13 treatment 14 protocol 15 in 17 cases 16 two 17 cases 17 cases 18 that 17 cases 19 included 18 that 19 included 19 included 21 caregivers 20 multiple 21 caregivers 22 in 23 treating 23 treating 25 persons 24 two 25 persons 26 with 27 dementia method : two case presentations of the benefits and challenges of including multiple caregivers in treatment are discussed . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 19 . 1 method 2 : 2 : 5 presentations 3 two 5 presentations 4 case 5 presentations 5 presentations 6 of 6 of 8 benefits 7 the 8 benefits 9 and 10 challenges 9 and 18 discussed 10 challenges 11 of 10 challenges 17 are 11 of 12 including 12 including 14 caregivers 12 including 15 in 13 multiple 14 caregivers 15 in 16 treatment 17 are 18 discussed treatment outcome data for these cases were collected as part of a larger investigation of peaceful mind . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 18 . 1 treatment 3 data 2 outcome 3 data 3 data 4 for 3 data 7 were 4 for 6 cases 5 these 6 cases 7 were 8 collected 8 collected 9 as 9 as 10 part 10 part 11 of 11 of 14 investigation 12 a 14 investigation 13 larger 14 investigation 14 investigation 15 of 15 of 17 mind 16 peaceful 17 mind results : the involvement of multiple collaterals resulted in several benefits , including increased family communication , as well as increased opportunities for the practice of new skills . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 increased 0 ###LEFT-WALL### 29 . 2 : 4 involvement 2 : 8 resulted 3 the 4 involvement 4 involvement 5 of 4 involvement 8 resulted 5 of 7 collaterals 6 multiple 7 collaterals 8 resulted 9 in 8 resulted 13 including 8 resulted 19 well 8 resulted 20 as 9 in 11 benefits 10 several 11 benefits 12 , 13 including 13 including 16 communication 13 including 17 , 14 increased 15 family 15 family 16 communication 18 as 19 well 20 as 21 increased 21 increased 22 opportunities 22 opportunities 23 for 22 opportunities 26 of 23 for 25 practice 24 the 25 practice 26 of 28 skills 27 new 28 skills these cases have also presented unique challenges requiring alterations in therapy structure and attention to issues of family conflict . 0 ###LEFT-WALL### 2 cases 0 ###LEFT-WALL### 5 presented 0 ###LEFT-WALL### 20 . 1 these 2 cases 2 cases 3 have 3 have 5 presented 4 also 5 presented 5 presented 7 challenges 5 presented 10 in 5 presented 15 to 6 unique 7 challenges 7 challenges 8 requiring 8 requiring 9 alterations 10 in 13 and 11 therapy 12 structure 12 structure 13 and 13 and 14 attention 15 to 16 issues 16 issues 17 of 17 of 19 conflict 18 family 19 conflict conclusions : including multiple collaterals in cognitive - behavioral therapy for treating anxiety in persons with dementia is feasible and may be beneficial in maximizing treatment gains and increasing the family 's investment in therapy . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 3 including 2 : 20 and 2 : 28 and 2 : 32 's 3 including 5 collaterals 3 including 14 in 3 including 20 and 4 multiple 5 collaterals 5 collaterals 6 in 6 in 10 therapy 7 cognitive 8 - 7 cognitive 10 therapy 9 behavioral 10 therapy 10 therapy 11 for 11 for 13 anxiety 12 treating 13 anxiety 14 in 15 persons 15 persons 16 with 16 with 17 dementia 18 is 19 feasible 18 is 20 and 20 and 21 may 20 and 27 gains 21 may 22 be 22 be 23 beneficial 23 beneficial 24 in 24 in 25 maximizing 25 maximizing 26 treatment 28 and 29 increasing 28 and 32 's 29 increasing 31 family 29 increasing 32 's 30 the 31 family 32 's 33 investment 33 investment 34 in 34 in 35 therapy none the potential for development of biomedical technologies capable of extending the human lifespan raises at least two kinds of question that it is important both to distinguish and to connect with one another : scientific , factual questions regarding the feasibility of life extension interventions [;] and questions concerning the ethical issues related to the extension of life - and healthspans . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 54 related 2 the 3 potential 2 the 6 of 2 the 9 capable 2 the 48 and 3 potential 4 for 4 for 5 development 6 of 8 technologies 7 biomedical 8 technologies 9 capable 10 of 10 of 11 extending 11 extending 14 lifespan 12 the 14 lifespan 13 human 14 lifespan 15 raises 20 of 15 raises 48 and 16 at 17 least 17 least 18 two 18 two 20 of 19 kinds 20 of 20 of 21 question 20 of 22 that 20 of 31 connect 22 that 23 it 22 that 29 and 23 it 24 is 24 is 25 important 25 important 27 to 26 both 27 to 27 to 29 and 28 distinguish 29 and 29 and 30 to 29 and 31 connect 30 to 31 connect 31 connect 32 with 32 with 33 one 32 with 39 questions 33 one 34 another 33 one 35 : 34 another 35 : 36 scientific 37 , 36 scientific 39 questions 38 factual 39 questions 39 questions 40 regarding 40 regarding 42 feasibility 41 the 42 feasibility 42 feasibility 43 of 43 of 46 interventions 44 life 46 interventions 45 extension 46 interventions 48 and 49 questions 49 questions 50 concerning 49 questions 54 related 50 concerning 53 issues 50 concerning 54 related 51 the 53 issues 52 ethical 53 issues 54 related 55 to 54 related 63 . 55 to 57 extension 56 the 57 extension 57 extension 58 of 58 of 61 and 59 life 61 and 60 - 61 and 61 and 62 healthspans this paper provides an account of some life extension interventions considered to be amongst the most promising , and presents the ethical questions raised by the prospect of their pursuit . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 31 . 1 this 2 paper 2 paper 19 and 3 provides 5 account 3 provides 19 and 4 an 5 account 5 account 6 of 5 account 11 considered 6 of 10 interventions 7 some 10 interventions 8 life 9 extension 9 extension 10 interventions 11 considered 12 to 11 considered 13 be 12 to 13 be 13 be 14 amongst 13 be 17 promising 14 amongst 16 most 15 the 16 most 18 , 19 and 19 and 20 presents 20 presents 23 questions 21 the 23 questions 22 ethical 23 questions 23 questions 24 raised 23 questions 28 of 24 raised 25 by 25 by 27 prospect 26 the 27 prospect 28 of 30 pursuit 29 their 30 pursuit it is suggested that problems concerning the effects of these technologies on health care resources and on intergenerational relationships will be the most difficult to tackle . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 suggested 0 ###LEFT-WALL### 27 . 1 it 2 is 2 is 3 suggested 3 suggested 4 that 4 that 5 problems 4 that 21 be 5 problems 6 concerning 5 problems 9 of 5 problems 20 will 6 concerning 8 effects 7 the 8 effects 9 of 11 technologies 10 these 11 technologies 11 technologies 16 and 12 on 15 resources 12 on 16 and 13 health 14 care 14 care 15 resources 16 and 17 on 17 on 19 relationships 18 intergenerational 19 relationships 20 will 21 be 21 be 23 most 21 be 24 difficult 22 the 23 most 24 difficult 25 to 24 difficult 26 tackle 25 to 26 tackle none the purpose of this work was to evaluate the potential of grewia gum ( gg ) as a suspending agent [in] pharmaceutical oral formulation using ibuprofen [as] model drug . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 13 grewia 0 ###LEFT-WALL### 31 . 1 none 3 purpose 1 none 12 of 1 none 13 grewia 2 the 3 purpose 3 purpose 4 of 3 purpose 7 was 4 of 6 work 5 this 6 work 7 was 8 to 7 was 9 evaluate 8 to 9 evaluate 9 evaluate 11 potential 10 the 11 potential 11 potential 12 of 13 grewia 14 gum 13 grewia 18 as 14 gum 16 gg 15 ( 16 gg 16 gg 17 ) 18 as 30 drug 19 a 30 drug 20 suspending 21 agent 21 agent 25 formulation 23 pharmaceutical 24 oral 24 oral 25 formulation 25 formulation 27 ibuprofen 26 using 27 ibuprofen 27 ibuprofen 30 drug 29 model 30 drug ibuprofen pediatric suspension ( 25 mg/5 [ml] ) was formulated with grewia gum ( 0.5 % [w/v] ) as the suspending agent . 0 ###LEFT-WALL### 3 suspension 0 ###LEFT-WALL### 10 formulated 0 ###LEFT-WALL### 23 . 1 ibuprofen 3 suspension 2 pediatric 3 suspension 3 suspension 6 mg/5 3 suspension 9 was 4 ( 6 mg/5 5 25 6 mg/5 6 mg/5 8 ) 9 was 10 formulated 10 formulated 11 with 10 formulated 19 as 11 with 13 gum 12 grewia 13 gum 13 gum 16 % 14 ( 16 % 15 0.5 16 % 16 % 18 ) 19 as 22 agent 20 the 22 agent 21 suspending 22 agent similar suspensions of ibuprofen containing either sodium carboxymethylcellulose ( na - cmc ) or hydroxymethylpropylcellulose ( hpmc ) were also produced . 0 ###LEFT-WALL### 2 suspensions 0 ###LEFT-WALL### 21 produced 0 ###LEFT-WALL### 22 . 1 similar 2 suspensions 2 suspensions 3 of 2 suspensions 5 containing 2 suspensions 19 were 3 of 4 ibuprofen 5 containing 8 carboxymethylcellulose 6 either 8 carboxymethylcellulose 7 sodium 8 carboxymethylcellulose 8 carboxymethylcellulose 14 or 9 ( 14 or 10 na 12 cmc 11 - 12 cmc 12 cmc 13 ) 12 cmc 14 or 14 or 15 hydroxymethylpropylcellulose 14 or 17 hpmc 14 or 18 ) 16 ( 17 hpmc 17 hpmc 18 ) 19 were 20 also 19 were 21 produced the suspensions were evaluated for ease of redispersion , sedimentation , rheological properties , and the effect of aging on the rheological properties at 25 °c . the particle size and particle size distributions of the dispersed solute were determined . 0 ###LEFT-WALL### 2 suspensions 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 27 . 0 ###LEFT-WALL### 41 . 1 the 2 suspensions 2 suspensions 3 were 3 were 4 evaluated 4 evaluated 5 for 4 evaluated 20 on 4 evaluated 24 at 5 for 15 and 6 ease 7 of 6 ease 15 and 7 of 8 redispersion 8 redispersion 10 sedimentation 8 redispersion 13 properties 9 , 10 sedimentation 10 sedimentation 11 , 11 , 13 properties 12 rheological 13 properties 13 properties 14 , 14 , 15 and 15 and 17 effect 15 and 18 of 16 the 17 effect 18 of 19 aging 20 on 23 properties 21 the 23 properties 22 rheological 23 properties 24 at 26 °c 25 25 26 °c 27 . 30 size 27 . 31 and 28 the 30 size 29 particle 30 size 31 and 34 distributions 31 and 40 determined 32 particle 33 size 33 size 34 distributions 34 distributions 35 of 34 distributions 39 were 35 of 38 solute 36 the 38 solute 37 dispersed 38 solute 39 were 40 determined the redispersion time was 19 , 11 , [and] 0.5 min , respectively , for formulation containing na - cmc , hpmc , and gg . the sedimentation volumes were 0.05 , 0.05 [,] and 0.125 ml , respectively , for na - cmc , hpmc , and gg . 0 ###LEFT-WALL### 3 time 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 26 . 0 ###LEFT-WALL### 50 . 1 the 3 time 2 redispersion 3 time 3 time 4 was 4 was 5 19 4 was 13 respectively 4 was 15 for 5 19 7 11 6 , 7 11 7 11 11 min 7 11 12 , 8 , 11 min 10 0.5 11 min 11 min 12 , 12 , 13 respectively 13 respectively 14 , 15 for 24 and 16 formulation 17 containing 16 formulation 24 and 17 containing 22 hpmc 18 na 20 cmc 19 - 20 cmc 20 cmc 21 , 20 cmc 22 hpmc 21 , 22 hpmc 22 hpmc 23 , 23 , 24 and 24 and 25 gg 26 . 29 volumes 26 . 30 were 27 the 29 volumes 28 sedimentation 29 volumes 29 volumes 30 were 30 were 31 0.05 30 were 39 respectively 30 were 41 for 31 0.05 37 ml 32 , 37 ml 33 0.05 35 and 35 and 36 0.125 35 and 37 ml 37 ml 38 , 38 , 39 respectively 39 respectively 40 , 41 for 49 gg 42 na 44 cmc 43 - 44 cmc 44 cmc 46 hpmc 45 , 46 hpmc 46 hpmc 47 , 46 hpmc 48 and 48 and 49 gg the particles size was 72.72 , 73.82 , 81.93 [,] and 83.41 μm , respectively , for suspensions containing na - cmc , ibuprofen alone , hpmc , and gg . 0 ###LEFT-WALL### 3 size 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 31 . 1 the 3 size 2 particles 3 size 3 size 4 was 4 was 5 72.72 4 was 15 respectively 4 was 17 for 5 72.72 7 73.82 6 , 7 73.82 7 73.82 13 μm 7 73.82 14 , 8 , 13 μm 9 81.93 11 and 11 and 12 83.41 11 and 13 μm 13 μm 14 , 14 , 15 respectively 15 respectively 16 , 17 for 29 and 18 suspensions 19 containing 18 suspensions 29 and 19 containing 20 na 20 na 22 cmc 21 - 22 cmc 22 cmc 24 ibuprofen 22 cmc 27 hpmc 22 cmc 28 , 23 , 24 ibuprofen 24 ibuprofen 25 alone 24 ibuprofen 26 , 26 , 27 hpmc 27 hpmc 28 , 29 and 30 gg [greatest] hysteresis [was] observed in formulation containing hpmc . 0 ###LEFT-WALL### 4 observed 2 hysteresis 4 observed 4 observed 5 in 4 observed 9 . 5 in 6 formulation 6 formulation 7 containing 7 containing 8 hpmc all the formulations were stable . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 6 . 1 all 2 the 1 all 3 formulations 1 all 4 were 2 the 3 formulations 4 were 5 stable it was our conclusion that the difference in the physicochemical properties of ibuprofen pediatric formulations was influenced more by the suspending agent used in the formulations than the drug . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 30 . 1 it 2 was 2 was 4 conclusion 3 our 4 conclusion 4 conclusion 5 that 5 that 7 difference 5 that 17 influenced 6 the 7 difference 7 difference 8 in 7 difference 16 was 8 in 11 properties 9 the 11 properties 10 physicochemical 11 properties 11 properties 12 of 12 of 15 formulations 13 ibuprofen 15 formulations 14 pediatric 15 formulations 16 was 17 influenced 17 influenced 18 more 17 influenced 19 by 17 influenced 27 than 19 by 22 agent 20 the 22 agent 21 suspending 22 agent 22 agent 23 used 23 used 24 in 24 in 26 formulations 25 the 26 formulations 27 than 29 drug 28 the 29 drug gg combined better redispersion with minimal changes in viscosity on storage compared to na - cmc and hpmc as suspending agent . 0 ###LEFT-WALL### 1 gg 0 ###LEFT-WALL### 2 combined 0 ###LEFT-WALL### 22 . 1 gg 2 combined 2 combined 4 redispersion 2 combined 13 to 3 better 4 redispersion 4 redispersion 5 with 4 redispersion 8 in 4 redispersion 12 compared 5 with 7 changes 6 minimal 7 changes 8 in 9 viscosity 9 viscosity 10 on 10 on 11 storage 13 to 17 and 14 na 16 cmc 15 - 16 cmc 16 cmc 17 and 17 and 18 hpmc 17 and 19 as 19 as 21 agent 20 suspending 21 agent thus gg may serve as a good suspending agent requiring no further aid in suspension redispersibility . 0 ###LEFT-WALL### 2 gg 0 ###LEFT-WALL### 4 serve 0 ###LEFT-WALL### 17 . 1 thus 2 gg 2 gg 3 may 3 may 4 serve 4 serve 5 as 5 as 9 agent 6 a 7 good 6 a 9 agent 7 good 9 agent 8 suspending 9 agent 9 agent 10 requiring 10 requiring 13 aid 10 requiring 14 in 11 no 13 aid 12 further 13 aid 14 in 16 redispersibility 15 suspension 16 redispersibility atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient 's quality of life . 0 ###LEFT-WALL### 4 scarring 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 23 . 1 atrophic 3 acne 2 facial 3 acne 3 acne 4 scarring 4 scarring 5 is 5 is 9 condition 6 a 9 condition 7 widely 8 prevalent 8 prevalent 9 condition 9 condition 10 that 9 condition 11 can 10 that 11 can 11 can 12 have 12 have 15 impact 13 a 15 impact 14 negative 15 impact 15 impact 16 on 16 on 20 quality 17 a 18 patient 18 patient 19 's 19 's 20 quality 20 quality 21 of 21 of 22 life the appearance of these scars is often worsened by the normal effects of aging . 0 ###LEFT-WALL### 2 appearance 0 ###LEFT-WALL### 8 worsened 0 ###LEFT-WALL### 15 . 1 the 2 appearance 2 appearance 3 of 2 appearance 6 is 3 of 5 scars 4 these 5 scars 6 is 7 often 6 is 8 worsened 8 worsened 9 by 9 by 12 effects 10 the 12 effects 11 normal 12 effects 12 effects 13 of 13 of 14 aging a number of options are available for the treatment of acne scarring , including chemical peeling , dermabrasion , ablative or nonablative laser resurfacing , dermal fillers , and surgical techniques such as subcision or punch excision . 0 ###LEFT-WALL### 4 options 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 38 . 1 a 2 number 2 number 3 of 2 number 4 options 3 of 4 options 4 options 5 are 5 are 6 available 6 available 7 for 7 for 9 treatment 8 the 9 treatment 9 treatment 10 of 10 of 11 acne 11 acne 12 scarring 12 scarring 14 including 12 scarring 18 dermabrasion 13 , 14 including 14 including 16 peeling 14 including 17 , 15 chemical 16 peeling 19 , 29 and 20 ablative 21 or 21 or 23 laser 21 or 24 resurfacing 21 or 27 fillers 21 or 29 and 22 nonablative 23 laser 25 , 27 fillers 26 dermal 27 fillers 27 fillers 28 , 28 , 29 and 29 and 31 techniques 29 and 33 as 30 surgical 31 techniques 32 such 33 as 33 as 37 excision 34 subcision 35 or 35 or 36 punch 35 or 37 excision depending on the type and extent of scarring , a multimodal approach is generally necessary to provide satisfactory results . 0 ###LEFT-WALL### 12 approach 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 20 . 1 depending 2 on 1 depending 9 , 1 depending 12 approach 2 on 5 and 3 the 4 type 4 type 5 and 5 and 6 extent 5 and 7 of 7 of 8 scarring 10 a 11 multimodal 10 a 12 approach 11 multimodal 12 approach 12 approach 13 is 13 is 14 generally 13 is 15 necessary 15 necessary 16 to 15 necessary 17 provide 16 to 17 provide 17 provide 19 results 18 satisfactory 19 results resurfacing techniques correct surface irregularities , long - lasting dermal fillers address the volume loss resulting from acne , and sub - superficial musculoaponeurotic [system] ( smas ) face - lift procedures counter the soft tissue laxity and ptosis associated with aging . 0 ###LEFT-WALL### 5 irregularities 0 ###LEFT-WALL### 6 , 1 resurfacing 5 irregularities 2 techniques 5 irregularities 3 correct 4 surface 4 surface 5 irregularities 6 , 11 fillers 6 , 12 address 6 , 22 - 7 long 8 - 7 long 11 fillers 9 lasting 11 fillers 10 dermal 11 fillers 11 fillers 12 address 12 address 20 and 13 the 20 and 14 volume 15 loss 15 loss 16 resulting 15 loss 20 and 16 resulting 17 from 17 from 18 acne 19 , 20 and 20 and 21 sub 22 - 29 face 22 - 30 - 22 - 43 . 23 superficial 29 face 24 musculoaponeurotic 27 smas 24 musculoaponeurotic 29 face 26 ( 27 smas 27 smas 28 ) 30 - 32 procedures 30 - 33 counter 30 - 38 and 31 lift 32 procedures 32 procedures 33 counter 33 counter 37 laxity 34 the 37 laxity 35 soft 37 laxity 36 tissue 37 laxity 38 and 39 ptosis 38 and 40 associated 39 ptosis 40 associated 40 associated 41 with 41 with 42 aging this article briefly reviews the evolution of individual approaches to treating atrophic acne scarring , followed by case examples illustrating results that can be achieved using a multimodal approach . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 30 . 1 this 2 article 2 article 15 , 3 briefly 4 reviews 4 reviews 6 evolution 4 reviews 10 to 4 reviews 15 , 5 the 6 evolution 6 evolution 7 of 7 of 9 approaches 8 individual 9 approaches 10 to 11 treating 11 treating 14 scarring 12 atrophic 13 acne 13 acne 14 scarring 15 , 16 followed 15 , 17 by 15 , 26 using 17 by 19 examples 18 case 19 examples 19 examples 20 illustrating 19 examples 22 that 19 examples 23 can 20 illustrating 21 results 22 that 23 can 23 can 24 be 24 be 25 achieved 26 using 29 approach 27 a 28 multimodal 27 a 29 approach 28 multimodal 29 approach representative cases [from] patients in [their] 30 s , 40 s , and 50 s are presented . 0 ###LEFT-WALL### 1 representative 0 ###LEFT-WALL### 2 cases 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 18 . 1 representative 2 cases 2 cases 4 patients 4 patients 5 in 4 patients 11 s 5 in 8 s 7 30 8 s 9 , 11 s 10 40 11 s 11 s 12 , 12 , 13 and 13 and 15 s 13 and 17 presented 14 50 15 s 15 s 16 are 16 are 17 presented in the author 's clinical practice , multimodal approaches incorporating fractionated laser , injectable poly - l : - lactic acid , and sub - smas face - lift procedures have achieved optimal aesthetic outcomes , high patient satisfaction , and durability of aesthetic effect over time . 0 ###LEFT-WALL### 6 practice 0 ###LEFT-WALL### 7 , 1 in 5 clinical 1 in 6 practice 2 the 3 author 3 author 4 's 4 's 5 clinical 7 , 12 laser 7 , 13 , 8 multimodal 9 approaches 9 approaches 11 fractionated 10 incorporating 11 fractionated 11 fractionated 12 laser 13 , 17 l 13 , 18 : 13 , 19 - 14 injectable 15 poly 14 injectable 16 - 14 injectable 17 l 17 l 18 : 19 - 23 and 19 - 25 - 20 lactic 21 acid 21 acid 23 and 22 , 23 and 23 and 24 sub 25 - 27 face 25 - 28 - 25 - 48 . 26 smas 27 face 28 - 30 procedures 28 - 32 achieved 29 lift 30 procedures 30 procedures 31 have 31 have 32 achieved 32 achieved 41 and 33 optimal 35 outcomes 34 aesthetic 35 outcomes 35 outcomes 36 , 36 , 39 satisfaction 36 , 41 and 37 high 39 satisfaction 38 patient 39 satisfaction 40 , 41 and 41 and 42 durability 41 and 43 of 43 of 45 effect 44 aesthetic 45 effect 45 effect 46 over 46 over 47 time in addition to excessive proliferation [,] reduced apoptosis of vascular smooth muscle cells ( vsmcs ) plays a key role in aging - exaggerated neointima formation after vascular injury . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 17 plays 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 30 . 1 in 2 addition 2 addition 3 to 2 addition 17 plays 3 to 8 apoptosis 4 excessive 8 apoptosis 5 proliferation 7 reduced 7 reduced 8 apoptosis 8 apoptosis 9 of 9 of 13 cells 10 vascular 12 muscle 11 smooth 12 muscle 12 muscle 13 cells 13 cells 15 vsmcs 14 ( 15 vsmcs 15 vsmcs 16 ) 17 plays 20 role 17 plays 21 in 18 a 20 role 19 key 20 role 21 in 22 aging 23 - 26 formation 24 exaggerated 26 formation 25 neointima 26 formation 26 formation 27 after 27 after 29 injury 28 vascular 29 injury our previous studies have shown that impaired expression of jagged1 in the endothelium may be a key event that leads to enhanced vsmc [proliferation] in the elderly . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 28 . 1 our 3 studies 2 previous 3 studies 3 studies 4 have 4 have 5 shown 5 shown 8 expression 5 shown 15 be 6 that 7 impaired 7 impaired 8 expression 8 expression 9 of 8 expression 11 in 8 expression 14 may 9 of 10 jagged1 11 in 13 endothelium 12 the 13 endothelium 14 may 15 be 15 be 18 event 16 a 18 event 17 key 18 event 18 event 19 that 18 event 20 leads 19 that 20 leads 20 leads 21 to 20 leads 25 in 21 to 23 vsmc 22 enhanced 23 vsmc 25 in 27 elderly 26 the 27 elderly here , we are the first to investigate whether the expression of jagged1 in endothelial cells ( ecs ) may regulate apoptosis of vsmcs . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 25 . 1 here 2 , 1 here 3 we 3 we 4 are 4 are 6 first 5 the 6 first 6 first 7 to 6 first 8 investigate 7 to 8 investigate 8 investigate 9 whether 9 whether 11 expression 9 whether 21 regulate 10 the 11 expression 11 expression 12 of 11 expression 20 may 12 of 13 jagged1 13 jagged1 14 in 14 in 16 cells 15 endothelial 16 cells 16 cells 18 ecs 17 ( 18 ecs 18 ecs 19 ) 20 may 21 regulate 21 regulate 22 apoptosis 22 apoptosis 23 of 23 of 24 vsmcs we discovered that vsmcs co - cultured with senescent ecs exhibited decreased susceptibility to h₂o₂ - induced apoptosis compared with those co - cultured with young ecs . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 discovered 0 ###LEFT-WALL### 28 . 1 we 2 discovered 2 discovered 3 that 3 that 5 co 3 that 17 induced 4 vsmcs 5 co 5 co 7 cultured 5 co 17 induced 6 - 7 cultured 7 cultured 8 with 7 cultured 16 - 8 with 9 senescent 9 senescent 12 decreased 10 ecs 11 exhibited 10 ecs 12 decreased 12 decreased 13 susceptibility 12 decreased 16 - 13 susceptibility 14 to 13 susceptibility 15 h₂o₂ 14 to 15 h₂o₂ 17 induced 18 apoptosis 17 induced 25 with 18 apoptosis 19 compared 19 compared 20 with 19 compared 23 - 19 compared 24 cultured 20 with 22 co 21 those 22 co 25 with 27 ecs 26 young 27 ecs senescent ecs also displayed lower jagged1 expression compared to young ecs , which was more evident after h₂o₂ stimulation . 0 ###LEFT-WALL### 2 ecs 0 ###LEFT-WALL### 5 lower 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 20 . 1 senescent 2 ecs 2 ecs 4 displayed 2 ecs 5 lower 3 also 4 displayed 5 lower 7 expression 6 jagged1 7 expression 7 expression 8 compared 8 compared 9 to 9 to 11 ecs 10 young 11 ecs 12 , 13 which 12 , 14 was 13 which 14 was 14 was 16 evident 15 more 16 evident 16 evident 17 after 17 after 19 stimulation 18 h₂o₂ 19 stimulation overexpression of jagged1 in senescent ecs significantly promoted h₂o₂ - induced apoptosis in the co - cultured vsmcs , whereas silencing jagged1 expression in young ecs reduced h2o2 - induced apoptosis in the co - cultured vsmcs . 0 ###LEFT-WALL### 1 overexpression 0 ###LEFT-WALL### 17 cultured 0 ###LEFT-WALL### 35 - 1 overexpression 2 of 1 overexpression 6 ecs 1 overexpression 9 h₂o₂ 1 overexpression 12 apoptosis 1 overexpression 17 cultured 2 of 3 jagged1 3 jagged1 4 in 4 in 5 senescent 6 ecs 8 promoted 6 ecs 9 h₂o₂ 7 significantly 8 promoted 10 - 12 apoptosis 11 induced 12 apoptosis 12 apoptosis 13 in 12 apoptosis 16 - 13 in 15 co 14 the 15 co 17 cultured 18 vsmcs 17 cultured 20 whereas 19 , 20 whereas 20 whereas 21 silencing 20 whereas 27 reduced 20 whereas 35 - 21 silencing 23 expression 21 silencing 27 reduced 22 jagged1 23 expression 23 expression 24 in 24 in 26 ecs 25 young 26 ecs 27 reduced 28 h2o2 28 h2o2 31 apoptosis 29 - 31 apoptosis 30 induced 31 apoptosis 31 apoptosis 32 in 31 apoptosis 35 - 32 in 34 co 33 the 34 co 35 - 37 vsmcs 35 - 38 . 36 cultured 37 vsmcs our studies also revealed that jagged1 expressed in ecs exerted its pro - apoptotic activity by lowering expression of the anti - apoptotic protein bcl - 2 . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 revealed 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 28 . 1 our 2 studies 2 studies 4 revealed 3 also 4 revealed 4 revealed 5 that 5 that 6 jagged1 5 that 10 exerted 6 jagged1 7 expressed 6 jagged1 10 exerted 7 expressed 8 in 8 in 9 ecs 10 exerted 12 pro 11 its 12 pro 13 - 15 activity 14 apoptotic 15 activity 15 activity 16 by 16 by 17 lowering 17 lowering 18 expression 17 lowering 27 2 18 expression 19 of 19 of 25 bcl 20 the 24 protein 21 anti 22 - 21 anti 24 protein 23 apoptotic 24 protein 24 protein 25 bcl 26 - 27 2 these results demonstrate that aging reduces the susceptibility of co - cultured vsmcs to h₂o₂ - induced apoptosis through impaired jagged1 expression in ecs . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 25 . 1 these 2 results 2 results 3 demonstrate 3 demonstrate 4 that 3 demonstrate 6 reduces 4 that 5 aging 4 that 6 reduces 6 reduces 8 susceptibility 6 reduces 19 through 7 the 8 susceptibility 8 susceptibility 9 of 9 of 13 vsmcs 10 co 11 - 10 co 13 vsmcs 12 cultured 13 vsmcs 13 vsmcs 14 to 14 to 18 apoptosis 15 h₂o₂ 16 - 15 h₂o₂ 18 apoptosis 17 induced 18 apoptosis 19 through 22 expression 20 impaired 22 expression 21 jagged1 22 expression 22 expression 23 in 23 in 24 ecs purpose : few studies have focused on the aging changes in the upper eyelid . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 studies 2 : 6 focused 2 : 15 . 3 few 4 studies 4 studies 5 have 5 have 6 focused 6 focused 7 on 6 focused 11 in 7 on 10 changes 8 the 10 changes 9 aging 10 changes 11 in 14 eyelid 12 the 14 eyelid 13 upper 14 eyelid this study evaluated the differential changes in the nasal and central fat pads of the upper eyelid associated with aging . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 21 . 1 this 2 study 2 study 3 evaluated 3 evaluated 6 changes 3 evaluated 7 in 3 evaluated 19 with 4 the 6 changes 5 differential 6 changes 7 in 13 pads 8 the 13 pads 9 nasal 10 and 10 and 11 central 10 and 13 pads 12 fat 13 pads 13 pads 14 of 14 of 17 eyelid 15 the 17 eyelid 16 upper 17 eyelid 17 eyelid 18 associated 19 with 20 aging methods : in this retrospective , consecutive series , the medical records and photographs of 77 patients were reviewed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 20 . 1 methods 2 : 2 : 3 in 3 in 8 series 4 this 5 retrospective 5 retrospective 6 , 5 retrospective 8 series 7 consecutive 8 series 9 , 13 and 9 , 19 reviewed 10 the 12 records 11 medical 12 records 12 records 13 and 13 and 14 photographs 13 and 18 were 14 photographs 15 of 15 of 17 patients 16 77 17 patients 18 were 19 reviewed the patients were grouped in 7 categories according to decade [of] life . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 4 grouped 0 ###LEFT-WALL### 13 . 1 the 2 patients 2 patients 3 were 3 were 4 grouped 4 grouped 5 in 4 grouped 9 to 5 in 7 categories 6 7 7 categories 8 according 9 to 9 to 12 life 10 decade 12 life using a standardized scale , the volume grade of the nasal and central fat pads was graded from 0 to 3 . 0 ###LEFT-WALL### 8 grade 0 ###LEFT-WALL### 17 graded 0 ###LEFT-WALL### 22 . 1 using 4 scale 1 using 5 , 1 using 8 grade 2 a 4 scale 3 standardized 4 scale 6 the 8 grade 7 volume 8 grade 8 grade 9 of 8 grade 16 was 9 of 15 pads 10 the 15 pads 11 nasal 12 and 12 and 13 central 12 and 15 pads 14 fat 15 pads 16 was 17 graded 17 graded 20 to 18 from 20 to 19 0 20 to 20 to 21 3 statistical evaluation correlating age with central and nasal fat pad change was performed . 0 ###LEFT-WALL### 4 age 0 ###LEFT-WALL### 13 performed 0 ###LEFT-WALL### 14 . 1 statistical 4 age 2 evaluation 3 correlating 3 correlating 4 age 4 age 5 with 4 age 12 was 5 with 11 change 6 central 7 and 7 and 8 nasal 7 and 10 pad 9 fat 10 pad 10 pad 11 change 12 was 13 performed results : with aging , the central fat pad volume appeared to diminish , with relative sparing of the nasal fat pad . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 1 results 2 : 2 : 3 with 3 with 4 aging 5 , 10 volume 5 , 11 appeared 6 the 10 volume 7 central 8 fat 8 fat 10 volume 9 pad 10 volume 10 volume 11 appeared 11 appeared 12 to 11 appeared 13 diminish 12 to 13 diminish 13 diminish 15 with 14 , 15 with 15 with 17 sparing 15 with 23 . 16 relative 17 sparing 17 sparing 18 of 18 of 22 pad 19 the 22 pad 20 nasal 22 pad 21 fat 22 pad there was a positive correlation of the volume grade of the nasal fat pad with age and a negative correlation of the central fat pad with age . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 28 . 1 there 2 was 2 was 5 correlation 3 a 5 correlation 4 positive 5 correlation 5 correlation 6 of 5 correlation 15 with 6 of 9 grade 7 the 9 grade 8 volume 9 grade 9 grade 10 of 10 of 14 pad 11 the 14 pad 12 nasal 13 fat 13 fat 14 pad 15 with 17 and 16 age 17 and 17 and 20 correlation 17 and 21 of 17 and 26 with 18 a 20 correlation 19 negative 20 correlation 21 of 25 pad 22 the 25 pad 23 central 25 pad 24 fat 25 pad 26 with 27 age in addition , there was a statistically significant difference between the volume grades of the nasal and central fat pads in the groups 70 years and older . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 28 . 1 in 2 addition 1 in 3 , 1 in 4 there 4 there 5 was 5 was 9 difference 6 a 9 difference 7 statistically 8 significant 8 significant 9 difference 9 difference 10 between 9 difference 14 of 10 between 13 grades 11 the 13 grades 12 volume 13 grades 14 of 16 nasal 15 the 16 nasal 17 and 19 fat 17 and 20 pads 18 central 19 fat 19 fat 20 pads 20 pads 21 in 20 pads 24 70 20 pads 26 and 21 in 23 groups 22 the 23 groups 25 years 26 and 26 and 27 older conclusions : with aging , there appears to be a pattern of differential fat pad alteration . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 there 2 : 7 appears 2 : 17 . 3 with 4 aging 3 with 5 , 3 with 6 there 6 there 7 appears 7 appears 8 to 7 appears 9 be 8 to 9 be 9 be 11 pattern 10 a 11 pattern 11 pattern 12 of 12 of 16 alteration 13 differential 14 fat 14 fat 16 alteration 15 pad 16 alteration this study shows that in the upper eyelids of patients >70 years of age , the medial fat pad becomes prominent whereas the central fat pad atrophies . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 shows 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 28 . 1 this 2 study 2 study 3 shows 3 shows 4 that 4 that 8 eyelids 4 that 11 >70 5 in 7 upper 5 in 8 eyelids 6 the 7 upper 8 eyelids 9 of 8 eyelids 11 >70 9 of 10 patients 11 >70 12 years 12 years 13 of 13 of 14 age 15 , 19 pad 15 , 20 becomes 16 the 19 pad 17 medial 19 pad 18 fat 19 pad 19 pad 20 becomes 20 becomes 21 prominent 21 prominent 22 whereas 22 whereas 26 pad 22 whereas 27 atrophies 23 the 26 pad 24 central 26 pad 25 fat 26 pad 26 pad 27 atrophies teleologically , the relative preservation of nasal fat may be due to its higher abundance of neural - crest progenitor cells . 0 ###LEFT-WALL### 1 teleologically 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 22 . 2 , 5 preservation 2 , 10 be 3 the 5 preservation 4 relative 5 preservation 5 preservation 6 of 5 preservation 9 may 6 of 8 fat 7 nasal 8 fat 9 may 10 be 10 be 12 to 11 due 12 to 12 to 15 abundance 13 its 15 abundance 14 higher 15 abundance 15 abundance 16 of 16 of 21 cells 17 neural 18 - 17 neural 19 crest 19 crest 21 cells 20 progenitor 21 cells clinically , this finding has implications in esthetic and functional upper eyelid blepharoplasty . 0 ###LEFT-WALL### 4 finding 0 ###LEFT-WALL### 5 has 0 ###LEFT-WALL### 14 . 1 clinically 2 , 1 clinically 4 finding 3 this 4 finding 4 finding 5 has 5 has 6 implications 5 has 7 in 7 in 13 blepharoplasty 8 esthetic 9 and 9 and 10 functional 9 and 11 upper 11 upper 13 blepharoplasty 12 eyelid 13 blepharoplasty background : resections for elderly colorectal cancer ( crc ) are forecasted to grow , particularly in those beyond the age limit of screening ( >80 years ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 resections 2 : 12 forecasted 2 : 29 . 3 resections 4 for 3 resections 11 are 4 for 7 cancer 5 elderly 7 cancer 6 colorectal 7 cancer 7 cancer 9 crc 8 ( 9 crc 9 crc 10 ) 11 are 12 forecasted 12 forecasted 13 to 12 forecasted 17 in 13 to 14 grow 15 , 16 particularly 15 , 17 in 17 in 18 those 17 in 28 ) 18 those 19 beyond 19 beyond 22 limit 20 the 22 limit 21 age 22 limit 22 limit 23 of 23 of 24 screening 24 screening 27 years 25 ( 27 years 26 >80 27 years 27 years 28 ) however , literature on operative outcomes after crc procedures in the oldest old is focused primarily on operative mortality . 0 ###LEFT-WALL### 3 literature 0 ###LEFT-WALL### 15 focused 0 ###LEFT-WALL### 20 . 1 however 2 , 1 however 3 literature 3 literature 4 on 3 literature 14 is 4 on 6 outcomes 5 operative 6 outcomes 6 outcomes 7 after 7 after 9 procedures 8 crc 9 procedures 9 procedures 10 in 10 in 13 old 11 the 12 oldest 11 the 13 old 14 is 15 focused 15 focused 16 primarily 16 primarily 17 on 17 on 19 mortality 18 operative 19 mortality we hypothesize that older age will additionally impact operative morbidity after crc resections in a multihospital , risk - adjusted database . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesize 0 ###LEFT-WALL### 22 . 1 we 2 hypothesize 2 hypothesize 3 that 3 that 5 age 3 that 8 impact 4 older 5 age 5 age 6 will 6 will 8 impact 7 additionally 8 impact 8 impact 10 morbidity 8 impact 11 after 9 operative 10 morbidity 11 after 12 crc 11 after 13 resections 12 crc 13 resections 13 resections 14 in 14 in 21 database 15 a 21 database 16 multihospital 18 risk 16 multihospital 21 database 17 , 18 risk 18 risk 19 - 20 adjusted 21 database study design : we identified 19,375 patients >40 years who underwent crc procedures in the 2005 to 2008 american college of surgeons national surgical quality improvement program ( acs nsqip ) database . 0 ###LEFT-WALL### 2 design 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 33 . 1 study 2 design 3 : 4 we 3 : 5 identified 4 we 5 identified 5 identified 9 years 6 19,375 9 years 7 patients 9 years 8 >40 9 years 9 years 10 who 9 years 11 underwent 10 who 11 underwent 11 underwent 13 procedures 11 underwent 14 in 11 underwent 17 to 12 crc 13 procedures 14 in 16 2005 15 the 16 2005 17 to 20 college 18 2008 20 college 19 american 20 college 20 college 21 of 21 of 32 database 22 surgeons 23 national 23 national 24 surgical 24 surgical 25 quality 25 quality 26 improvement 26 improvement 27 program 27 program 30 nsqip 27 program 32 database 28 ( 30 nsqip 29 acs 30 nsqip 30 nsqip 31 ) [pre] - [,] [intra] - , and postoperative factors were compared by age groups . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 15 . 2 - 5 - 5 - 7 and 6 , 7 and 7 and 9 factors 7 and 11 compared 8 postoperative 9 factors 9 factors 10 were 10 were 11 compared 11 compared 12 by 12 by 14 groups 13 age 14 groups multivariable techniques were used to assess the effects of older age on operative outcome measures , adjusting for covariates . 0 ###LEFT-WALL### 2 techniques 0 ###LEFT-WALL### 4 used 1 multivariable 2 techniques 2 techniques 3 were 3 were 4 used 4 used 5 to 4 used 6 assess 5 to 6 assess 6 assess 8 effects 6 assess 12 on 7 the 8 effects 8 effects 9 of 9 of 11 age 10 older 11 age 12 on 15 measures 13 operative 15 measures 14 outcome 15 measures 15 measures 17 adjusting 16 , 17 adjusting 17 adjusting 18 for 17 adjusting 20 . 18 for 19 covariates results : over 20 % of our cohort was older than 80 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 % 2 : 9 was 2 : 14 . 3 over 4 20 4 20 5 % 5 % 6 of 5 % 9 was 6 of 8 cohort 7 our 8 cohort 9 was 10 older 10 older 11 than 11 than 13 years 12 80 13 years of those , 17 % developed major complications and 29 % experienced prolonged length [of] stay ( los ) . 0 ###LEFT-WALL### 5 % 0 ###LEFT-WALL### 6 developed 0 ###LEFT-WALL### 20 . 1 of 2 those 1 of 3 , 1 of 5 % 4 17 5 % 5 % 6 developed 6 developed 9 and 7 major 8 complications 8 complications 9 and 9 and 16 stay 9 and 18 los 10 29 11 % 11 % 12 experienced 12 experienced 14 length 13 prolonged 14 length 14 length 16 stay 17 ( 18 los 18 los 19 ) these unadjusted comparisons persisted in multivariable analyses demonstrating that older age independently predicted worse operative outcomes after crc procedures . 0 ###LEFT-WALL### 3 comparisons 0 ###LEFT-WALL### 4 persisted 0 ###LEFT-WALL### 20 . 1 these 3 comparisons 2 unadjusted 3 comparisons 3 comparisons 4 persisted 4 persisted 5 in 5 in 7 analyses 6 multivariable 7 analyses 7 analyses 8 demonstrating 7 analyses 9 that 7 analyses 13 predicted 9 that 11 age 9 that 13 predicted 10 older 11 age 11 age 13 predicted 12 independently 13 predicted 13 predicted 16 outcomes 13 predicted 17 after 14 worse 16 outcomes 15 operative 16 outcomes 17 after 19 procedures 18 crc 19 procedures conclusions : the effects of older age extend to other important outcome measures after crc procedures beyond operative mortality . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 effects 2 : 8 extend 2 : 20 . 3 the 4 effects 4 effects 5 of 4 effects 8 extend 5 of 7 age 6 older 7 age 8 extend 9 to 8 extend 14 after 8 extend 17 beyond 9 to 13 measures 10 other 13 measures 11 important 12 outcome 12 outcome 13 measures 14 after 16 procedures 15 crc 16 procedures 17 beyond 19 mortality 18 operative 19 mortality as one of the largest multihospital studies , our study identified increased morbidity in the oldest old , a growing population . 0 ###LEFT-WALL### 10 study 0 ###LEFT-WALL### 12 increased 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 22 . 1 as 2 one 1 as 8 , 1 as 10 study 2 one 3 of 3 of 7 studies 4 the 5 largest 4 the 7 studies 6 multihospital 7 studies 9 our 10 study 10 study 11 identified 10 study 12 increased 12 increased 13 morbidity 12 increased 14 in 14 in 17 old 15 the 16 oldest 15 the 17 old 18 , 21 population 19 a 21 population 20 growing 21 population our results should stimulate review of current policy and resource allocation . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 stimulate 0 ###LEFT-WALL### 12 . 1 our 2 results 2 results 3 should 3 should 4 stimulate 4 stimulate 5 review 5 review 6 of 6 of 9 and 7 current 8 policy 8 policy 9 and 9 and 11 allocation 10 resource 11 allocation the aim of this study is to develop strategies to screen diabetic subjects with isolated postload hyperglycemia ( iph ) in chinese population . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 11 screen 0 ###LEFT-WALL### 24 . 1 the 2 aim 2 aim 3 of 2 aim 6 is 3 of 5 study 4 this 5 study 6 is 7 to 6 is 8 develop 7 to 8 develop 8 develop 9 strategies 8 develop 10 to 10 to 11 screen 11 screen 13 subjects 11 screen 14 with 12 diabetic 13 subjects 14 with 17 hyperglycemia 14 with 21 in 15 isolated 17 hyperglycemia 16 postload 17 hyperglycemia 17 hyperglycemia 19 iph 18 ( 19 iph 19 iph 20 ) 21 in 23 population 22 chinese 23 population we included 1175 adult subjects who did not report diabetes were included . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 13 . 1 we 2 included 2 included 5 subjects 3 1175 5 subjects 4 adult 5 subjects 5 subjects 6 who 5 subjects 7 did 6 who 7 did 7 did 8 not 7 did 9 report 9 report 10 diabetes 9 report 12 included 10 diabetes 11 were 11 were 12 included diabetes was diagnosed by oral glucose tolerance tests . 0 ###LEFT-WALL### 1 diabetes 0 ###LEFT-WALL### 3 diagnosed 0 ###LEFT-WALL### 9 . 1 diabetes 2 was 2 was 3 diagnosed 3 diagnosed 4 by 4 by 8 tests 5 oral 6 glucose 6 glucose 8 tests 7 tolerance 8 tests iph was defined as fasting plasma glucose ( fpg )<7 [mmol/l] and 2 [-] hour post - load plasma glucose ( 2hpg ) greater than 11.1 mmol/l . 0 ###LEFT-WALL### 1 iph 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 28 . 1 iph 2 was 2 was 7 glucose 2 was 27 mmol/l 3 defined 6 plasma 4 as 5 fasting 5 fasting 6 plasma 6 plasma 7 glucose 7 glucose 12 and 7 glucose 20 glucose 8 ( 12 and 9 fpg 10 )<7 10 )<7 12 and 12 and 16 post 12 and 17 - 13 2 15 hour 15 hour 16 post 17 - 20 glucose 18 load 20 glucose 19 plasma 20 glucose 20 glucose 22 2hpg 20 glucose 23 ) 21 ( 22 2hpg 22 2hpg 23 ) 24 greater 25 than 25 than 26 11.1 26 11.1 27 mmol/l using fpg criteria , only 59.8 % of diabetic subjects were not identified , showing a poor agreement between fpg and 2hpg criteria ( kappa 0.294 ) . 0 ###LEFT-WALL### 7 % 0 ###LEFT-WALL### 13 identified 0 ###LEFT-WALL### 28 . 1 using 3 criteria 1 using 4 , 1 using 7 % 2 fpg 3 criteria 5 only 6 59.8 6 59.8 7 % 7 % 8 of 7 % 11 were 8 of 10 subjects 9 diabetic 10 subjects 11 were 12 not 11 were 13 identified 13 identified 15 showing 14 , 15 showing 15 showing 18 agreement 15 showing 27 ) 16 a 17 poor 16 a 18 agreement 17 poor 18 agreement 18 agreement 19 between 18 agreement 25 kappa 19 between 21 and 20 fpg 21 and 21 and 23 criteria 22 2hpg 23 criteria 24 ( 25 kappa 25 kappa 26 0.294 25 kappa 27 ) age , fpg , total cholesterol , triglycerides , blood pressure , body mass index , hba1c and medication for hypertension [were] associated factors for iph . 0 ###LEFT-WALL### 3 fpg 0 ###LEFT-WALL### 8 triglycerides 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 27 . 1 age 3 fpg 2 , 3 fpg 3 fpg 6 cholesterol 3 fpg 8 triglycerides 4 , 6 cholesterol 5 total 6 cholesterol 6 cholesterol 7 , 9 , 18 and 10 blood 11 pressure 11 pressure 12 , 12 , 15 index 12 , 16 , 13 body 15 index 14 mass 15 index 16 , 17 hba1c 16 , 18 and 18 and 19 medication 18 and 20 for 18 and 25 for 20 for 24 factors 21 hypertension 23 associated 23 associated 24 factors 25 for 26 iph four scores were constructed using all these factors , age and blood test results , age and hba1c , and data [from] [non] - invasive examinations , respectively . 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 4 constructed 0 ###LEFT-WALL### 29 . 1 four 2 scores 2 scores 3 were 3 were 4 constructed 4 constructed 5 using 5 using 6 all 5 using 24 - 5 using 28 respectively 6 all 7 these 6 all 8 factors 7 these 8 factors 9 , 24 - 10 age 11 and 11 and 12 blood 11 and 13 test 13 test 20 and 13 test 24 - 14 results 15 , 15 , 16 age 15 , 17 and 17 and 18 hba1c 17 and 20 and 19 , 20 and 20 and 21 data 20 and 24 - 24 - 26 examinations 24 - 27 , 25 invasive 26 examinations the area under the roc curve were 0.9296 ( 95%ci 0.8948 - 0.9643 ) , 0.9111 ( 95%ci 0.8713 - 0.9508 ) , 0.8902 ( 95%ci 0.8341 - 0.9646 ) , 0.8924 ( 95%ci 0.7835 - 0.8753 ) , [and] 0.8654 ( 95%ci 0.7963 - 0.9345 ) for score 1 , 2 , 3 , 4 [,] and hba1c , respectively . 0 ###LEFT-WALL### 2 area 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 62 . 1 the 2 area 2 area 3 under 2 area 7 were 3 under 6 curve 4 the 6 curve 5 roc 6 curve 7 were 8 0.9296 7 were 48 for 7 were 61 respectively 8 0.9296 10 95%ci 8 0.9296 16 0.9111 9 ( 10 95%ci 10 95%ci 12 - 10 95%ci 14 ) 11 0.8948 12 - 12 - 13 0.9643 15 , 16 0.9111 16 0.9111 18 95%ci 16 0.9111 24 0.8902 16 0.9111 47 ) 17 ( 18 95%ci 18 95%ci 20 - 18 95%ci 22 ) 19 0.8713 20 - 20 - 21 0.9508 23 , 24 0.8902 24 0.8902 26 95%ci 24 0.8902 47 ) 25 ( 26 95%ci 26 95%ci 27 0.8341 26 95%ci 29 0.9646 26 95%ci 32 0.8924 26 95%ci 41 0.8654 26 95%ci 47 ) 28 - 29 0.9646 29 0.9646 30 ) 31 , 32 0.8924 32 0.8924 34 95%ci 32 0.8924 38 ) 33 ( 34 95%ci 34 95%ci 36 - 34 95%ci 38 ) 35 0.7835 36 - 36 - 37 0.8753 39 , 41 0.8654 41 0.8654 43 95%ci 41 0.8654 47 ) 42 ( 43 95%ci 43 95%ci 45 - 43 95%ci 47 ) 44 0.7963 45 - 45 - 46 0.9345 48 for 49 score 49 score 50 1 49 score 52 2 49 score 59 hba1c 51 , 52 2 52 2 54 3 52 2 55 , 53 , 54 3 54 3 55 , 55 , 59 hba1c 56 4 58 and 58 and 59 hba1c 59 hba1c 60 , the sensitivity of all four risk scores to detect iph was better than that of impaired fasting glucose ( ifg ) . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 22 . 1 the 2 sensitivity 2 sensitivity 3 of 2 sensitivity 8 to 2 sensitivity 9 detect 2 sensitivity 11 was 3 of 4 all 4 all 6 risk 4 all 7 scores 5 four 6 risk 6 risk 7 scores 8 to 9 detect 9 detect 10 iph 11 was 12 better 12 better 13 than 13 than 14 that 13 than 15 of 15 of 18 glucose 16 impaired 18 glucose 17 fasting 18 glucose 18 glucose 20 ifg 19 ( 20 ifg 20 ifg 21 ) the sensitivity and specificity of hba1c at cutoff 6.2 % for detecting iph was also better than that of ifg . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 21 . 1 the 2 sensitivity 2 sensitivity 3 and 3 and 4 specificity 3 and 10 % 3 and 14 was 4 specificity 5 of 5 of 6 hba1c 6 hba1c 7 at 7 at 8 cutoff 9 6.2 10 % 10 % 11 for 10 % 14 was 11 for 12 detecting 12 detecting 13 iph 14 was 15 also 14 was 16 better 14 was 17 than 17 than 18 that 17 than 19 of 19 of 20 ifg in conclusion , the risk scores and hba1c are useful to identify subjects with undiagnosed iph , with better performance than ifg . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 9 are 1 in 2 conclusion 2 conclusion 3 , 3 , 6 scores 3 , 7 and 4 the 6 scores 5 risk 6 scores 7 and 8 hba1c 7 and 9 are 9 are 10 useful 10 useful 11 to 10 useful 12 identify 11 to 12 identify 12 identify 13 subjects 12 identify 14 with 14 with 16 iph 15 undiagnosed 16 iph 16 iph 18 with 17 , 18 with 18 with 20 performance 18 with 21 than 18 with 22 ifg 18 with 23 . 19 better 20 performance older adults [(] o [ )(may have a longer phase i pulmonary [o] ( 2 ) uptake kinetics ( vo ( 2 ) [(] [p] ) [ )(than young adults ( y ) ; this may affect parameter estimates of phase ii [vo] ( 2 ) [(] [p] [ )( 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 7 have 0 ###LEFT-WALL### 34 ; 0 ###LEFT-WALL### 50 )( 1 older 2 adults 2 adults 4 o 2 adults 6 )(may 6 )(may 7 have 7 have 10 phase 7 have 28 )(than 8 a 10 phase 9 longer 10 phase 10 phase 11 i 10 phase 17 uptake 10 phase 18 kinetics 10 phase 20 vo 12 pulmonary 15 2 12 pulmonary 17 uptake 14 ( 15 2 15 2 16 ) 17 uptake 18 kinetics 19 ( 20 vo 20 vo 22 2 20 vo 26 ) 21 ( 22 2 22 2 23 ) 28 )(than 30 adults 29 young 30 adults 30 adults 32 y 31 ( 32 y 32 y 33 ) 34 ; 35 this 34 ; 37 affect 35 this 36 may 36 may 37 affect 37 affect 39 estimates 38 parameter 39 estimates 39 estimates 40 of 40 of 41 phase 41 phase 42 ii 41 phase 45 2 44 ( 45 2 45 2 46 ) vo ( 2 [ )( [p] ) was measured breath - by [-] breath in [19] o ( 68 ± 6 yr [;] mean ± sd ) and 19 y [(] 24 ± 5 yr [ )(using a volume turbine and mass spectrometer . 0 ###LEFT-WALL### 1 vo 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 43 spectrometer 0 ###LEFT-WALL### 44 . 1 vo 3 2 1 vo 8 was 2 ( 3 2 3 2 7 ) 8 was 10 breath 9 measured 10 breath 10 breath 12 by 11 - 12 by 12 by 14 breath 12 by 27 ) 14 breath 15 in 14 breath 26 sd 15 in 17 o 18 ( 26 sd 19 68 20 ± 20 ± 25 ± 21 6 22 yr 22 yr 24 mean 24 mean 25 ± 25 ± 26 sd 26 sd 27 ) 28 and 29 19 28 and 33 ± 29 19 30 y 32 24 33 ± 33 ± 37 )(using 34 5 35 yr 35 yr 37 )(using 37 )(using 41 and 37 )(using 43 spectrometer 38 a 39 volume 38 a 40 turbine 39 volume 40 turbine 40 turbine 41 and 41 and 42 mass 41 and 43 spectrometer phase i vo ( 2 [ )( [p] [ )( longer in o ( 31 ± [4] s ) than [y] [(] 20 ± 7 s [ )(( p < 0.05 ) . 0 ###LEFT-WALL### 1 phase 0 ###LEFT-WALL### 20 than 0 ###LEFT-WALL### 33 . 1 phase 2 i 1 phase 3 vo 3 vo 5 2 4 ( 5 2 5 2 11 longer 5 2 18 s 5 2 19 ) 11 longer 12 in 12 in 13 o 14 ( 18 s 15 31 18 s 16 ± 18 s 18 s 19 ) 20 than 23 20 20 than 24 ± 23 20 24 ± 24 ± 30 < 25 7 26 s 26 s 30 < 28 )(( 30 < 29 p 30 < 30 < 31 0.05 30 < 32 ) in o , phase ii [τvo] ( 2 [ )( [p] ) was larger ( p < 0.05 ) when fitting started at 15 s ( 49 ± [12] s ) compared with fits starting at the individual ee phase i [(] 43 ± 12 [s] [ )(, 25 s [(] 42 ± 10 [s] [ )(, 35 [s] ( 42 ± 12 [s] ) [,] [and] [45] [s] [(] [45] [±] [15] [s] [ )( 1 in 2 o 1 in 3 , 1 in 4 phase 4 phase 5 ii 4 phase 8 2 4 phase 13 was 7 ( 8 2 8 2 12 ) 13 was 14 larger 14 larger 17 < 14 larger 20 when 15 ( 17 < 16 p 17 < 17 < 18 0.05 17 < 19 ) 20 when 21 fitting 20 when 32 compared 21 fitting 22 started 21 fitting 30 s 21 fitting 32 compared 22 started 23 at 23 at 25 s 24 15 25 s 26 ( 30 s 27 49 30 s 28 ± 30 s 30 s 31 ) 32 compared 33 with 33 with 34 fits 34 fits 35 starting 35 starting 36 at 35 starting 45 12 36 at 44 ± 37 the 44 ± 38 individual 40 phase 39 ee 40 phase 40 phase 41 i 40 phase 44 ± 43 43 44 ± 45 12 53 ± 48 )(, 53 ± 49 25 50 s 50 s 53 ± 52 42 53 ± 53 ± 54 10 53 ± 58 35 53 ± 65 ) 57 )(, 58 35 58 35 62 ± 58 35 65 ) 60 ( 62 ± 61 42 62 ± 62 ± 63 12 62 ± 65 ) in y , τvo ( 2 [ )( [p] ) was not affected by the time at which phase ii vo ( 2 ) ( [p] [ )(fitting started [(] τvo ( 2 ) ( p [ )(= 31 ± 7 s [,] 29 ± 9 s [,] 30 ± 10 s [,] [32] ± 11 s [,] and 30 ± [8] [s] for fittings starting at 15 s , 25 s , 35 s , 45 [s] [,] [and] ee phase [i] , respectively ) . 0 ###LEFT-WALL### 4 τvo 0 ###LEFT-WALL### 11 was 1 in 2 y 1 in 3 , 1 in 4 τvo 4 τvo 6 2 4 τvo 11 was 5 ( 6 2 6 2 10 ) 11 was 12 not 11 was 14 by 12 not 13 affected 14 by 16 time 15 the 16 time 16 time 17 at 17 at 18 which 17 at 19 phase 17 at 21 vo 17 at 29 started 18 which 19 phase 19 phase 20 ii 21 vo 23 2 21 vo 28 )(fitting 21 vo 29 started 22 ( 23 2 23 2 24 ) 25 ( 28 )(fitting 29 started 31 τvo 29 started 38 )(= 31 τvo 33 2 32 ( 33 2 33 2 34 ) 35 ( 38 )(= 36 p 38 )(= 38 )(= 50 ± 39 31 45 ± 40 ± 45 ± 41 7 42 s 42 s 45 ± 44 29 45 ± 45 ± 50 ± 46 9 47 s 47 s 50 ± 49 30 50 ± 50 ± 59 and 50 ± 61 ± 51 10 52 s 51 10 59 and 52 s 55 ± 55 ± 57 s 56 11 57 s 59 and 60 30 61 ± 64 for 64 for 66 starting 65 fittings 66 starting 66 starting 67 at 66 starting 72 s 66 starting 75 s 66 starting 77 45 67 at 69 s 68 15 69 s 70 , 72 s 71 25 72 s 72 s 73 , 73 , 75 s 74 35 75 s 75 s 76 , 76 , 77 45 77 45 81 ee 77 45 82 phase 77 45 87 . 81 ee 82 phase 82 phase 85 respectively 84 , 85 respectively 85 respectively 86 ) fitting from ee phase i , 25 s , or 35 s resulted in the smallest ci τvo ( 2 [ )( [p] ) in both [o] and y [.] [thus] , fitting [phase] [ii] vo ( 2 [ )( [p] ) [from] ( but not constrained [to] ) 25 s or 35 s [provides] consistent estimates of vo ( 2 [ )( [p] ) kinetics parameters in y and [o] [,] [despite] the longer phase [i] vo [(] 2 [ )( [p] [ )(in [o] [.] the gender paradox in mortality [--] where men die earlier than women despite having more socioeconomic resources -- [may] [be] partly explained by men 's lower levels of preventive health care . 0 ###LEFT-WALL### 10 or 1 fitting 2 from 2 from 4 phase 3 ee 4 phase 4 phase 5 i 4 phase 8 s 6 , 8 s 7 25 8 s 8 s 9 , 9 , 10 or 10 or 12 s 10 or 13 resulted 11 35 12 s 12 s 13 resulted 13 resulted 14 in 13 resulted 25 in 14 in 18 τvo 15 the 16 smallest 15 the 18 τvo 17 ci 18 τvo 18 τvo 20 2 19 ( 20 2 20 2 24 ) 25 in 28 and 26 both 28 and 28 and 29 y 28 and 32 , 28 and 33 fitting 32 , 33 fitting 33 fitting 45 but 36 vo 38 2 36 vo 45 but 37 ( 38 2 38 2 42 ) 44 ( 45 but 45 but 46 not 45 but 57 estimates 46 not 47 constrained 47 constrained 49 ) 50 25 51 s 51 s 52 or 52 or 54 s 52 or 57 estimates 53 35 54 s 56 consistent 57 estimates 57 estimates 58 of 58 of 70 and 59 vo 61 2 59 vo 67 parameters 60 ( 61 2 61 2 65 ) 66 kinetics 67 parameters 67 parameters 68 in 67 parameters 70 and 68 in 69 y 70 and 78 vo 74 the 76 phase 75 longer 76 phase 76 phase 78 vo 78 vo 80 2 78 vo 85 )(in 85 )(in 90 paradox 88 the 90 paradox 89 gender 90 paradox 90 paradox 91 in 90 paradox 94 where 91 in 92 mortality 94 where 95 men 94 where 101 having 95 men 96 die 96 die 97 earlier 96 die 98 than 96 die 100 despite 98 than 99 women 100 despite 101 having 101 having 104 resources 102 more 104 resources 103 socioeconomic 104 resources 104 resources 109 explained 105 -- 109 explained 108 partly 109 explained 109 explained 110 by 109 explained 119 . 110 by 114 levels 111 men 112 's 112 's 114 levels 113 lower 114 levels 114 levels 115 of 115 of 118 care 116 preventive 118 care 117 health 118 care stereotypical notions of masculinity reduce preventive health care ; however , the relationship between masculinity , socioeconomic status ( ses ) , and preventive health care is unknown . 0 ###LEFT-WALL### 2 notions 0 ###LEFT-WALL### 5 reduce 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 29 . 1 stereotypical 2 notions 2 notions 3 of 2 notions 5 reduce 3 of 4 masculinity 5 reduce 8 care 6 preventive 7 health 7 health 8 care 9 ; 26 care 9 ; 27 is 10 however 11 , 10 however 26 care 12 the 13 relationship 13 relationship 14 between 13 relationship 23 and 14 between 15 masculinity 15 masculinity 18 status 16 , 18 status 17 socioeconomic 18 status 18 status 20 ses 18 status 22 , 19 ( 20 ses 20 ses 21 ) 22 , 23 and 23 and 25 health 23 and 26 care 24 preventive 25 health 26 care 27 is 27 is 28 unknown using the wisconsin longitudinal study , the authors conduct a population - based assessment of masculinity beliefs and preventive health care , [including] whether these relationships vary by ses . 0 ###LEFT-WALL### 8 authors 0 ###LEFT-WALL### 9 conduct 0 ###LEFT-WALL### 30 . 1 using 5 study 1 using 6 , 1 using 8 authors 2 the 5 study 3 wisconsin 4 longitudinal 4 longitudinal 5 study 7 the 8 authors 8 authors 9 conduct 9 conduct 11 population 9 conduct 24 whether 9 conduct 28 by 10 a 11 population 11 population 14 assessment 12 - 14 assessment 13 based 14 assessment 14 assessment 15 of 14 assessment 22 , 15 of 18 and 16 masculinity 17 beliefs 17 beliefs 18 and 18 and 21 care 19 preventive 20 health 20 health 21 care 24 whether 26 relationships 24 whether 27 vary 25 these 26 relationships 26 relationships 27 vary 28 by 29 ses the results show that men with strong masculinity beliefs are [half] as likely as men with more moderate masculinity beliefs to receive preventive care . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 25 . 1 the 2 results 2 results 3 show 3 show 4 that 3 show 5 men 5 men 6 with 5 men 9 beliefs 5 men 10 are 5 men 13 likely 6 with 8 masculinity 7 strong 8 masculinity 9 beliefs 10 are 12 as 13 likely 13 likely 14 as 13 likely 16 with 14 as 15 men 16 with 20 beliefs 16 with 24 care 17 more 18 moderate 18 moderate 20 beliefs 19 masculinity 20 beliefs 20 beliefs 21 to 20 beliefs 22 receive 21 to 22 receive 23 preventive 24 care furthermore , in contrast to the well - established ses [gradient] in health , men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive health care decreases as their occupational status , wealth , and/or income increases . 0 ###LEFT-WALL### 15 men 0 ###LEFT-WALL### 22 benefit 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 44 increases 0 ###LEFT-WALL### 45 . 1 furthermore 2 , 1 furthermore 15 men 2 , 3 in 3 in 4 contrast 3 in 14 , 3 in 15 men 4 contrast 5 to 5 to 7 well 6 the 7 well 7 well 10 ses 8 - 10 ses 9 established 10 ses 10 ses 12 in 10 ses 14 , 12 in 13 health 15 men 16 with 15 men 20 do 16 with 19 beliefs 17 strong 18 masculinity 18 masculinity 19 beliefs 20 do 21 not 20 do 22 benefit 22 benefit 23 from 23 from 25 education 24 higher 25 education 26 and 28 probability 26 and 34 decreases 27 their 28 probability 28 probability 29 of 28 probability 34 decreases 29 of 30 obtaining 30 obtaining 33 care 31 preventive 32 health 32 health 33 care 34 decreases 35 as 34 decreases 42 and/or 35 as 38 status 36 their 38 status 37 occupational 38 status 38 status 40 wealth 39 , 40 wealth 40 wealth 41 , 42 and/or 43 income 43 income 44 increases masculinity may be a partial explanation for the paradox of men 's lower life expectancy [,] despite their higher ses . β - adrenergic receptors ( βars ) are crucial for maintaining the rate and force of cardiac muscle contraction in vertebrates . 0 ###LEFT-WALL### 1 masculinity 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 21 . 0 ###LEFT-WALL### 43 . 1 masculinity 2 may 2 may 3 be 3 be 6 explanation 3 be 17 despite 4 a 5 partial 4 a 6 explanation 5 partial 6 explanation 6 explanation 7 for 7 for 9 paradox 8 the 9 paradox 9 paradox 10 of 10 of 15 expectancy 11 men 12 's 12 's 15 expectancy 13 lower 15 expectancy 14 life 15 expectancy 17 despite 20 ses 18 their 20 ses 19 higher 20 ses 21 . 25 receptors 21 . 29 are 22 β 23 - 22 β 25 receptors 24 adrenergic 25 receptors 25 receptors 27 βars 25 receptors 29 are 26 ( 27 βars 27 βars 28 ) 29 are 30 crucial 30 crucial 31 for 30 crucial 41 in 31 for 32 maintaining 32 maintaining 35 and 33 the 34 rate 34 rate 35 and 35 and 36 force 36 force 37 of 37 of 40 contraction 38 cardiac 39 muscle 39 muscle 40 contraction 41 in 42 vertebrates zebrafish ( danio rerio ) [have] [one] β1ar gene and two β2ar genes ( β2aar and β2bar ) . 0 ###LEFT-WALL### 9 gene 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 . 1 zebrafish 4 rerio 1 zebrafish 9 gene 2 ( 4 rerio 3 danio 4 rerio 4 rerio 5 ) 8 β1ar 9 gene 10 and 11 two 10 and 12 β2ar 11 two 12 β2ar 12 β2ar 13 genes 13 genes 16 and 14 ( 16 and 15 β2aar 16 and 16 and 17 β2bar 16 and 18 ) we examined the roles of these receptors in larval zebrafish in vivo by assessing the impact [of] translational gene knockdown [on] cardiac function . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 24 . 1 we 2 examined 2 examined 4 roles 2 examined 8 in 2 examined 12 vivo 2 examined 13 by 3 the 4 roles 4 roles 5 of 5 of 7 receptors 6 these 7 receptors 8 in 10 zebrafish 9 larval 10 zebrafish 11 in 12 vivo 13 by 14 assessing 14 assessing 23 function 15 the 23 function 16 impact 23 function 18 translational 19 gene 19 gene 23 function 20 knockdown 23 function 22 cardiac 23 function zebrafish larvae lacking β1ar expression by morpholino knockdown displayed lower heart rates than control fish , whereas larvae deficient in both β2aar and β2bar expression exhibited significantly higher heart rates than controls . 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 33 . 1 zebrafish 2 larvae 2 larvae 3 lacking 2 larvae 6 by 2 larvae 23 and 3 lacking 5 expression 4 β1ar 5 expression 6 by 7 morpholino 7 morpholino 12 rates 7 morpholino 22 β2aar 8 knockdown 12 rates 9 displayed 11 heart 10 lower 11 heart 11 heart 12 rates 12 rates 14 control 13 than 14 control 14 control 15 fish 14 control 17 whereas 16 , 17 whereas 17 whereas 18 larvae 18 larvae 19 deficient 18 larvae 22 β2aar 19 deficient 20 in 20 in 21 both 23 and 25 expression 23 and 29 heart 23 and 30 rates 24 β2bar 25 expression 26 exhibited 29 heart 27 significantly 28 higher 28 higher 29 heart 29 heart 30 rates 30 rates 31 than 31 than 32 controls these results suggested a potential inhibitory role for one or both β2ar genes . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggested 0 ###LEFT-WALL### 14 . 1 these 2 results 2 results 3 suggested 3 suggested 10 or 3 suggested 12 β2ar 4 a 5 potential 4 a 7 role 5 potential 7 role 6 inhibitory 7 role 7 role 8 for 7 role 10 or 8 for 9 one 10 or 11 both 10 or 12 β2ar 12 β2ar 13 genes by using cultured hek293 cells transfected with zebrafish βars , we demonstrated that stimulation with adrenaline or procaterol ( a β2ar agonist ) resulted in an increase in intracellular camp levels in cells expressing any of the three zebrafish βars . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 12 demonstrated 0 ###LEFT-WALL### 41 . 1 by 2 using 1 by 10 , 1 by 11 we 2 using 5 cells 3 cultured 5 cells 4 hek293 5 cells 5 cells 6 transfected 6 transfected 7 with 7 with 8 zebrafish 7 with 9 βars 11 we 12 demonstrated 12 demonstrated 13 that 13 that 17 or 13 that 24 resulted 14 stimulation 15 with 14 stimulation 17 or 15 with 16 adrenaline 17 or 18 procaterol 17 or 22 agonist 17 or 24 resulted 19 ( 22 agonist 20 a 22 agonist 21 β2ar 22 agonist 22 agonist 23 ) 24 resulted 25 in 24 resulted 28 in 25 in 27 increase 26 an 27 increase 28 in 31 levels 29 intracellular 31 levels 30 camp 31 levels 31 levels 32 in 31 levels 36 of 32 in 33 cells 33 cells 34 expressing 34 expressing 35 any 36 of 40 βars 37 the 38 three 38 three 40 βars 39 zebrafish 40 βars in comparison with its human βar counterpart , zebrafish β2aar expressed in hek293 cells appeared to exhibit a unique binding affinity profile for adrenergic ligands . 0 ###LEFT-WALL### 10 β2aar 0 ###LEFT-WALL### 25 ligands 0 ###LEFT-WALL### 26 . 1 in 2 comparison 1 in 10 β2aar 3 with 7 counterpart 3 with 8 , 3 with 10 β2aar 4 its 7 counterpart 5 human 6 βar 6 βar 7 counterpart 9 zebrafish 10 β2aar 10 β2aar 11 expressed 10 β2aar 25 ligands 11 expressed 12 in 11 expressed 24 adrenergic 12 in 13 hek293 13 hek293 14 cells 13 hek293 23 for 14 cells 15 appeared 15 appeared 16 to 15 appeared 17 exhibit 16 to 17 exhibit 17 exhibit 22 profile 17 exhibit 23 for 18 a 22 profile 19 unique 21 affinity 20 binding 21 affinity 21 affinity 22 profile specifically , zebrafish β2aar had a high binding affinity for phenylephrine , a classical α - adrenergic receptor agonist . 0 ###LEFT-WALL### 4 β2aar 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 20 . 1 specifically 2 , 1 specifically 4 β2aar 3 zebrafish 4 β2aar 4 β2aar 5 had 5 had 7 high 5 had 10 for 6 a 7 high 7 high 8 binding 8 binding 9 affinity 10 for 11 phenylephrine 12 , 19 agonist 13 a 19 agonist 14 classical 18 receptor 15 α 16 - 15 α 18 receptor 17 adrenergic 18 receptor 18 receptor 19 agonist the zebrafish receptors also had distinct [ligand] binding affinities for adrenergic agonists when compared with human βars in culture , with zebrafish β2aar being distinct from human β2ar and zebrafish β2bar . 0 ###LEFT-WALL### 3 receptors 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 1 the 3 receptors 2 zebrafish 3 receptors 3 receptors 5 had 4 also 5 had 5 had 9 affinities 5 had 13 when 5 had 18 in 6 distinct 9 affinities 8 binding 9 affinities 9 affinities 10 for 10 for 12 agonists 11 adrenergic 12 agonists 13 when 14 compared 14 compared 15 with 15 with 17 βars 16 human 17 βars 18 in 19 culture 20 , 29 and 20 , 31 β2bar 21 with 22 zebrafish 21 with 29 and 23 β2aar 24 being 23 β2aar 29 and 24 being 25 distinct 25 distinct 26 from 26 from 28 β2ar 27 human 28 β2ar 29 and 30 zebrafish 29 and 31 β2bar overall , this study provides insight into the function and evolution of both fish and mammalian β - adrenergic receptors . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 provides 0 ###LEFT-WALL### 21 . 1 overall 2 , 1 overall 4 study 3 this 4 study 4 study 5 provides 5 provides 6 insight 5 provides 7 into 7 into 10 and 8 the 9 function 9 function 10 and 10 and 11 evolution 10 and 12 of 12 of 15 and 13 both 15 and 14 fish 15 and 15 and 20 receptors 16 mammalian 20 receptors 17 β 18 - 17 β 20 receptors 19 adrenergic 20 receptors inflammation is a double - edged sword that can promote [or] suppress cancer progression . 0 ###LEFT-WALL### 1 inflammation 0 ###LEFT-WALL### 12 suppress 0 ###LEFT-WALL### 15 . 1 inflammation 2 is 2 is 7 sword 2 is 12 suppress 3 a 4 double 3 a 7 sword 4 double 5 - 4 double 7 sword 6 edged 7 sword 7 sword 8 that 7 sword 10 promote 8 that 9 can 9 can 10 promote 12 suppress 14 progression 13 cancer 14 progression in this study , we report that thymic stromal lymphopoietin ( tslp ) , an il - 7 - like [type] 1 inflammatory cytokine that is often associated with the induction of th2 - type allergic responses in the lungs , is also expressed in human and murine cancers . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 report 0 ###LEFT-WALL### 50 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 report 6 report 7 that 7 that 10 lymphopoietin 7 that 44 expressed 8 thymic 10 lymphopoietin 9 stromal 10 lymphopoietin 10 lymphopoietin 12 tslp 10 lymphopoietin 16 il 10 lymphopoietin 42 is 11 ( 12 tslp 12 tslp 13 ) 14 , 16 il 15 an 16 il 16 il 18 7 16 il 41 , 17 - 18 7 18 7 20 like 18 7 41 , 19 - 20 like 20 like 24 cytokine 20 like 41 , 22 1 24 cytokine 23 inflammatory 24 cytokine 24 cytokine 28 associated 25 that 26 is 26 is 28 associated 27 often 28 associated 28 associated 29 with 29 with 31 induction 30 the 31 induction 31 induction 32 of 32 of 33 th2 33 th2 37 responses 34 - 37 responses 35 type 37 responses 36 allergic 37 responses 37 responses 38 in 37 responses 41 , 38 in 40 lungs 39 the 40 lungs 42 is 44 expressed 43 also 44 expressed 44 expressed 45 in 45 in 47 and 46 human 47 and 47 and 49 cancers 48 murine 49 cancers our studies with murine cancer cells indicate that tslp plays an essential role in cancer escape , as its inactivation in cancer cells alone was sufficient to almost completely abrogate cancer progression and lung metastasis . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 36 . 1 our 2 studies 2 studies 3 with 2 studies 17 , 3 with 6 cells 4 murine 5 cancer 5 cancer 6 cells 7 indicate 8 that 7 indicate 17 , 8 that 9 tslp 8 that 10 plays 9 tslp 10 plays 10 plays 13 role 10 plays 14 in 11 an 13 role 12 essential 13 role 14 in 16 escape 15 cancer 16 escape 17 , 30 abrogate 18 as 20 inactivation 18 as 25 was 19 its 20 inactivation 20 inactivation 21 in 20 inactivation 25 was 21 in 23 cells 22 cancer 23 cells 24 alone 25 was 25 was 26 sufficient 26 sufficient 27 to 27 to 30 abrogate 28 almost 29 completely 29 completely 30 abrogate 30 abrogate 35 metastasis 31 cancer 32 progression 32 progression 33 and 33 and 34 lung 33 and 35 metastasis the cancer - promoting activity of tslp primarily required signaling through the tslp receptor on cd4 [(] [+] [ )(t cells , promoting th2 - skewed immune responses and production of immunosuppressive factors such as il - 10 and il - 13 . 0 ###LEFT-WALL### 2 cancer 0 ###LEFT-WALL### 9 required 1 the 2 cancer 2 cancer 4 promoting 2 cancer 9 required 3 - 4 promoting 4 promoting 5 activity 5 activity 6 of 6 of 7 tslp 8 primarily 9 required 9 required 10 signaling 9 required 15 on 10 signaling 11 through 11 through 14 receptor 12 the 14 receptor 13 tslp 14 receptor 15 on 21 cells 16 cd4 20 )(t 16 cd4 21 cells 21 cells 25 - 22 , 25 - 23 promoting 24 th2 23 promoting 25 - 25 - 29 and 26 skewed 28 responses 27 immune 28 responses 28 responses 29 and 29 and 30 production 29 and 31 of 29 and 35 as 31 of 33 factors 32 immunosuppressive 33 factors 34 such 35 as 35 as 36 il 36 il 41 - 37 - 41 - 38 10 39 and 39 and 40 il 40 il 41 - 41 - 42 13 41 - 43 . expression of tslp therefore may be a useful prognostic marker , and its targeting could have therapeutic potential . 0 ###LEFT-WALL### 1 expression 0 ###LEFT-WALL### 6 be 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 19 . 1 expression 2 of 1 expression 5 may 2 of 3 tslp 4 therefore 5 may 5 may 6 be 6 be 10 marker 7 a 10 marker 8 useful 10 marker 9 prognostic 10 marker 11 , 12 and 12 and 14 targeting 12 and 16 have 13 its 14 targeting 14 targeting 15 could 15 could 16 have 16 have 18 potential 17 therapeutic 18 potential background : fast - [tracking] and early endotracheal extubation have been described in patients undergoing surgery for congenital heart disease ( chd ) ; however , criteria for patient selection have not been validated in a prospective manner . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 6 and 2 : 12 described 2 : 24 ; 3 fast 6 and 4 - 6 and 6 and 9 extubation 6 and 10 have 7 early 9 extubation 8 endotracheal 9 extubation 10 have 11 been 11 been 12 described 12 described 13 in 12 described 17 for 13 in 14 patients 14 patients 15 undergoing 15 undergoing 16 surgery 17 for 20 disease 18 congenital 19 heart 19 heart 20 disease 20 disease 22 chd 21 ( 22 chd 22 chd 23 ) 24 ; 27 criteria 24 ; 34 validated 25 however 26 , 25 however 27 criteria 27 criteria 28 for 27 criteria 31 have 28 for 30 selection 29 patient 30 selection 31 have 32 not 31 have 33 been 33 been 34 validated 34 validated 35 in 35 in 38 manner 36 a 37 prospective 36 a 38 manner 37 prospective 38 manner our goal in this study was to prospectively identify factors associated with the decision to defer endotracheal extubation in the operating room ( or ) . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 26 . 1 our 2 goal 2 goal 3 in 2 goal 6 was 3 in 5 study 4 this 5 study 6 was 7 to 6 was 11 associated 7 to 9 identify 8 prospectively 9 identify 9 identify 10 factors 11 associated 12 with 11 associated 15 to 12 with 14 decision 13 the 14 decision 15 to 16 defer 16 defer 18 extubation 16 defer 19 in 17 endotracheal 18 extubation 19 in 22 room 20 the 22 room 21 operating 22 room 22 room 24 or 23 ( 24 or 24 or 25 ) methods : we performed a prospective observational study of 275 patients ( median age 18 months ) at the mount sinai medical center ( msmc ) , new york , new york , and 49 patients ( median age 25 months ) at the university of tokyo hospital ( uth ) , tokyo , japan , undergoing surgery for chd requiring cardiopulmonary [bypass] . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 performed 3 we 4 performed 4 performed 8 study 4 performed 18 at 4 performed 43 at 4 performed 57 undergoing 5 a 6 prospective 5 a 8 study 6 prospective 8 study 7 observational 8 study 8 study 9 of 8 study 16 months 9 of 11 patients 10 275 11 patients 12 ( 16 months 13 median 14 age 14 age 16 months 15 18 16 months 16 months 17 ) 18 at 34 and 19 the 25 msmc 20 mount 21 sinai 21 sinai 22 medical 22 medical 23 center 23 center 25 msmc 24 ( 25 msmc 25 msmc 26 ) 25 msmc 27 , 27 , 29 york 27 , 30 , 28 new 29 york 30 , 32 york 30 , 34 and 31 new 32 york 33 , 34 and 34 and 36 patients 34 and 41 months 35 49 36 patients 37 ( 41 months 38 median 39 age 39 age 41 months 40 25 41 months 41 months 42 ) 43 at 45 university 44 the 45 university 45 university 46 of 46 of 50 uth 47 tokyo 48 hospital 48 hospital 50 uth 49 ( 50 uth 50 uth 51 ) 50 uth 53 tokyo 50 uth 55 japan 52 , 53 tokyo 53 tokyo 54 , 54 , 55 japan 55 japan 56 , 56 , 57 undergoing 57 undergoing 58 surgery 57 undergoing 59 for 57 undergoing 64 . 59 for 60 chd 60 chd 61 requiring 61 requiring 62 cardiopulmonary these patients were all eligible for fast - tracking , including extubation in the or immediately after surgery , according to the respective inclusion/exclusion criteria applied at the 2 sites . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 31 . 1 these 2 patients 2 patients 3 were 3 were 4 all 3 were 21 to 3 were 27 at 4 all 5 eligible 5 eligible 6 for 6 for 9 tracking 7 fast 8 - 7 fast 9 tracking 9 tracking 11 including 10 , 11 including 11 including 12 extubation 11 including 13 in 11 including 17 after 11 including 19 , 13 in 15 or 14 the 15 or 16 immediately 17 after 17 after 18 surgery 20 according 21 to 21 to 25 criteria 22 the 25 criteria 23 respective 24 inclusion/exclusion 24 inclusion/exclusion 25 criteria 25 criteria 26 applied 27 at 30 sites 28 the 29 2 29 2 30 sites results : eighty - nine percent of patients at the msmc , and 65 % of patients at the uth were extubated in the or . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 26 . 1 results 2 : 2 : 3 eighty 3 eighty 6 percent 4 - 6 percent 5 nine 6 percent 6 percent 7 of 6 percent 12 , 7 of 8 patients 8 patients 9 at 9 at 11 msmc 10 the 11 msmc 13 and 15 % 13 and 22 extubated 14 65 15 % 15 % 16 of 15 % 21 were 16 of 17 patients 17 patients 18 at 18 at 20 uth 19 the 20 uth 21 were 22 extubated 22 extubated 23 in 23 in 25 or 24 the 25 or at the msmc , all patients [without] [aortic] cross - clamp , and patients with simple procedures ( risk adjustment for congenital heart surgery [ rachs ] score 1 ) were extubated in the or . 0 ###LEFT-WALL### 6 patients 0 ###LEFT-WALL### 9 cross 0 ###LEFT-WALL### 10 - 1 at 3 msmc 1 at 4 , 1 at 6 patients 2 the 3 msmc 5 all 6 patients 6 patients 9 cross 10 - 11 clamp 10 - 13 and 10 - 36 . 12 , 13 and 13 and 14 patients 13 and 32 extubated 14 patients 15 with 14 patients 31 were 15 with 17 procedures 16 simple 17 procedures 17 procedures 20 adjustment 18 ( 20 adjustment 19 risk 20 adjustment 20 adjustment 21 for 20 adjustment 30 ) 21 for 28 score 22 congenital 23 heart 23 heart 24 surgery 24 surgery 26 rachs 25 [ 26 rachs 26 rachs 27 ] 26 rachs 28 score 28 score 29 1 31 were 32 extubated 32 extubated 33 in 33 in 35 or 34 the 35 or among the remaining msmc patients , regression analysis showed that procedure complexity was still an independent predictor for not proceeding with planned extubation in the or . 0 ###LEFT-WALL### 8 analysis 0 ###LEFT-WALL### 9 showed 0 ###LEFT-WALL### 27 . 1 among 5 patients 1 among 6 , 1 among 8 analysis 2 the 3 remaining 2 the 5 patients 4 msmc 5 patients 7 regression 8 analysis 8 analysis 9 showed 9 showed 10 that 9 showed 12 complexity 9 showed 13 was 11 procedure 12 complexity 12 complexity 13 was 13 was 14 still 13 was 17 predictor 15 an 17 predictor 16 independent 17 predictor 17 predictor 18 for 18 for 19 not 19 not 20 proceeding 20 proceeding 21 with 20 proceeding 24 in 21 with 23 extubation 22 planned 23 extubation 24 in 26 or 25 the 26 or extubation was more likely to be deferred in the rachs score 3 surgical risk patients compared with the rachs score 2 group ( p = 0.005 , odds ratio 3.8 [ ci [:] 1.5 , 9.7 ] ) . 0 ###LEFT-WALL### 1 extubation 0 ###LEFT-WALL### 16 compared 0 ###LEFT-WALL### 39 . 1 extubation 2 was 2 was 3 more 2 was 4 likely 4 likely 5 to 4 likely 7 deferred 5 to 6 be 6 be 7 deferred 7 deferred 8 in 8 in 11 score 9 the 11 score 10 rachs 11 score 11 score 15 patients 11 score 16 compared 12 3 15 patients 13 surgical 15 patients 14 risk 15 patients 15 patients 16 compared 16 compared 17 with 16 compared 25 = 17 with 22 group 18 the 22 group 19 rachs 20 score 20 score 22 group 21 2 22 group 23 ( 25 = 24 p 25 = 25 = 26 0.005 26 0.005 29 ratio 27 , 29 ratio 28 odds 29 ratio 29 ratio 30 3.8 29 ratio 32 ci 29 ratio 36 9.7 29 ratio 38 ) 31 [ 32 ci 32 ci 34 1.5 32 ci 35 , 35 , 36 9.7 36 9.7 37 ] additionally [,] trisomy 21 ( p = 0.0003 , odds ratio 9.9 [ ci [:] 2.9 , 34.5 ] ) and age ( p = 0.0015 ) were significant independent predictors for deferring or extubation . 0 ###LEFT-WALL### 3 trisomy 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 36 . 1 additionally 3 trisomy 3 trisomy 4 21 4 21 7 = 4 21 11 ratio 5 ( 7 = 6 p 7 = 7 = 8 0.0003 7 = 9 , 9 , 11 ratio 10 odds 11 ratio 11 ratio 12 9.9 11 ratio 14 ci 11 ratio 20 ) 13 [ 14 ci 14 ci 16 2.9 14 ci 18 34.5 14 ci 20 ) 17 , 18 34.5 18 34.5 19 ] 21 and 22 age 21 and 28 were 22 age 25 = 22 age 28 were 23 ( 25 = 24 p 25 = 25 = 26 0.0015 25 = 27 ) 28 were 31 predictors 29 significant 31 predictors 30 independent 31 predictors 31 predictors 32 for 32 for 33 deferring 33 deferring 35 extubation 34 or 35 extubation we tested our findings on the patients from the uth by developing risk categories from the msmc data that ranked eligible patients according to the chance of or extubation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 tested 0 ###LEFT-WALL### 30 . 1 we 2 tested 2 tested 4 findings 2 tested 13 risk 3 our 4 findings 4 findings 5 on 4 findings 11 by 4 findings 13 risk 5 on 7 patients 6 the 7 patients 7 patients 8 from 8 from 10 uth 9 the 10 uth 11 by 12 developing 13 risk 14 categories 14 categories 15 from 14 categories 19 that 14 categories 20 ranked 15 from 18 data 16 the 18 data 17 msmc 18 data 19 that 20 ranked 20 ranked 22 patients 20 ranked 24 to 21 eligible 22 patients 23 according 24 to 24 to 26 chance 25 the 26 chance 26 chance 27 of 27 of 29 extubation 28 or 29 extubation the risk categories proved to predict endotracheal extubation in the 49 patients who had undergone surgery at the uth relative to their overall extubation rate , despite differences in anesthetic [regimen] and inclusion/exclusion criteria . 0 ###LEFT-WALL### 3 categories 0 ###LEFT-WALL### 4 proved 1 the 3 categories 2 risk 3 categories 3 categories 4 proved 4 proved 5 to 4 proved 12 patients 4 proved 25 rate 5 to 6 predict 6 predict 8 extubation 7 endotracheal 8 extubation 9 in 11 49 9 in 12 patients 10 the 11 49 12 patients 13 who 12 patients 14 had 12 patients 25 rate 13 who 14 had 14 had 15 undergone 15 undergone 16 surgery 16 surgery 17 at 16 surgery 20 relative 17 at 19 uth 18 the 19 uth 20 relative 21 to 21 to 24 extubation 22 their 24 extubation 23 overall 24 extubation 25 rate 27 despite 26 , 27 despite 27 despite 28 differences 27 despite 35 . 28 differences 29 in 29 in 32 and 30 anesthetic 32 and 32 and 34 criteria 33 inclusion/exclusion 34 criteria conclusions : preoperatively known factors alone can predict the relative chances of deferring extubation after surgery for chd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 1 conclusions 2 : 2 : 3 preoperatively 3 preoperatively 4 known 3 preoperatively 5 factors 3 preoperatively 13 deferring 5 factors 7 can 6 alone 7 can 7 can 8 predict 8 predict 11 chances 9 the 11 chances 10 relative 11 chances 11 chances 12 of 12 of 13 deferring 13 deferring 14 extubation 14 extubation 15 after 14 extubation 17 for 15 after 16 surgery 17 for 18 chd the early extubation strategies applied in the 2 centers were successful in the majority of cases . 0 ###LEFT-WALL### 4 strategies 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 17 . 1 the 4 strategies 2 early 3 extubation 3 extubation 4 strategies 4 strategies 5 applied 4 strategies 10 were 5 applied 6 in 6 in 9 centers 7 the 8 2 8 2 9 centers 10 were 11 successful 11 successful 12 in 12 in 16 cases 13 the 14 majority 14 majority 15 of 14 majority 16 cases 15 of 16 cases in the normal brain , tau protein is phosphorylated at a number of proline - and [non] [-] proline directed sites , which reduce tau microtubule binding and thus regulate microtubule dynamics . 0 ###LEFT-WALL### 7 protein 0 ###LEFT-WALL### 9 phosphorylated 1 in 4 brain 1 in 5 , 1 in 7 protein 2 the 4 brain 3 normal 4 brain 6 tau 7 protein 7 protein 8 is 8 is 9 phosphorylated 9 phosphorylated 10 at 10 at 21 sites 11 a 12 number 12 number 13 of 12 number 21 sites 13 of 21 sites 14 proline 16 and 15 - 16 and 16 and 19 proline 16 and 21 sites 20 directed 21 sites 21 sites 23 which 22 , 23 which 23 which 28 and 23 which 33 . 24 reduce 26 microtubule 24 reduce 28 and 25 tau 26 microtubule 26 microtubule 27 binding 28 and 30 regulate 29 thus 30 regulate 30 regulate 32 dynamics 31 microtubule 32 dynamics in alzheimer disease ( ad ) , tau is abnormally hyperphosphorylated , leading to neurofibrillary tangle formation and microtubule disruption , suggesting a loss of regulatory mechanisms controlling tau phosphorylation . 0 ###LEFT-WALL### 8 tau 0 ###LEFT-WALL### 11 hyperphosphorylated 1 in 3 disease 1 in 7 , 1 in 8 tau 2 alzheimer 3 disease 3 disease 5 ad 4 ( 5 ad 5 ad 6 ) 8 tau 9 is 9 is 10 abnormally 9 is 11 hyperphosphorylated 11 hyperphosphorylated 13 leading 12 , 13 leading 13 leading 14 to 13 leading 22 suggesting 13 leading 31 . 14 to 18 and 15 neurofibrillary 16 tangle 16 tangle 17 formation 17 formation 18 and 18 and 20 disruption 19 microtubule 20 disruption 21 , 22 suggesting 22 suggesting 24 loss 22 suggesting 31 . 23 a 24 loss 24 loss 25 of 25 of 27 mechanisms 26 regulatory 27 mechanisms 27 mechanisms 28 controlling 28 controlling 30 phosphorylation 29 tau 30 phosphorylation early growth response 1 ( egr - 1 ) is a transcription factor that is significantly up - regulated in ad brain . 0 ###LEFT-WALL### 3 response 0 ###LEFT-WALL### 10 is 1 early 3 response 2 growth 3 response 3 response 4 1 3 response 6 egr 3 response 8 1 3 response 10 is 5 ( 6 egr 6 egr 7 - 7 - 8 1 8 1 9 ) 10 is 13 factor 11 a 12 transcription 11 a 13 factor 12 transcription 13 factor 13 factor 14 that 13 factor 15 is 14 that 15 is 15 is 16 significantly 15 is 17 up 17 up 19 regulated 18 - 19 regulated 19 regulated 20 in 19 regulated 23 . 20 in 22 brain 21 ad 22 brain the pathological significance of this up - regulation is not known . 0 ###LEFT-WALL### 3 significance 0 ###LEFT-WALL### 11 known 0 ###LEFT-WALL### 12 . 1 the 3 significance 2 pathological 3 significance 3 significance 4 of 3 significance 9 is 4 of 8 regulation 5 this 6 up 6 up 7 - 6 up 8 regulation 9 is 10 not 9 is 11 known in this study , we found that lentivirus - mediated overexpression of egr - 1 in rat brain hippocampus and primary neurons in culture activates proline - directed kinase cdk5 , inactivates pp1 , promotes tau phosphorylation at both proline - directed ser ( 396/404 ) and [non] [-] proline - directed ser ( 262 ) sites , and [destabilizes] microtubules . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 , 1 in 2 this 1 in 3 study 4 , 5 we 4 , 6 found 4 , 14 - 5 we 6 found 6 found 8 lentivirus 7 that 8 lentivirus 8 lentivirus 11 overexpression 9 - 11 overexpression 10 mediated 11 overexpression 11 overexpression 12 of 11 overexpression 14 - 12 of 13 egr 14 - 19 hippocampus 14 - 20 and 15 1 16 in 16 in 19 hippocampus 17 rat 19 hippocampus 18 brain 19 hippocampus 20 and 22 neurons 21 primary 22 neurons 22 neurons 23 in 22 neurons 31 , 23 in 24 culture 25 activates 30 cdk5 25 activates 31 , 26 proline 27 - 26 proline 29 kinase 28 directed 29 kinase 29 kinase 30 cdk5 31 , 34 , 32 inactivates 33 pp1 32 inactivates 34 , 34 , 35 promotes 35 promotes 47 and 36 tau 37 phosphorylation 37 phosphorylation 38 at 37 phosphorylation 47 and 38 at 43 ser 39 both 43 ser 40 proline 41 - 40 proline 43 ser 42 directed 43 ser 43 ser 45 396/404 44 ( 45 396/404 45 396/404 46 ) 47 and 50 proline 47 and 59 and 51 - 59 and 52 directed 57 sites 53 ser 55 262 53 ser 57 sites 54 ( 55 262 55 262 56 ) 57 sites 59 and 58 , 59 and 59 and 61 microtubules 59 and 62 . furthermore , in egr - 1 [(] - [/] - [ )(mouse brain , cdk5 activity was decreased , pp1 activity [was] increased , and tau phosphorylation was reduced at both proline - directed [and] [non] - proline - directed sites . 0 ###LEFT-WALL### 16 activity 0 ###LEFT-WALL### 19 , 1 furthermore 2 , 1 furthermore 16 activity 3 in 4 egr 3 in 16 activity 4 egr 6 1 4 egr 13 brain 5 - 6 1 6 1 8 - 10 - 13 brain 12 )(mouse 13 brain 13 brain 14 , 15 cdk5 16 activity 16 activity 17 was 17 was 18 decreased 19 , 25 and 19 , 37 - 20 pp1 21 activity 21 activity 23 increased 21 activity 25 and 24 , 25 and 25 and 26 tau 25 and 27 phosphorylation 25 and 28 was 25 and 29 reduced 25 and 34 directed 27 phosphorylation 28 was 29 reduced 30 at 29 reduced 32 proline 30 at 31 both 33 - 34 directed 34 directed 37 - 37 - 41 sites 37 - 42 . 38 proline 39 - 38 proline 41 sites 40 directed 41 sites by using nerve growth [factor] - exposed pc12 cells , we determined that egr - 1 activates cdk5 to promote phosphorylation of tau and inactivates pp1 via phosphorylation . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 12 determined 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 29 . 1 by 2 using 1 by 10 , 1 by 11 we 2 using 4 growth 3 nerve 4 growth 4 growth 9 cells 6 - 9 cells 7 exposed 9 cells 8 pc12 9 cells 9 cells 10 , 11 we 12 determined 12 determined 14 egr 13 that 14 egr 15 - 16 1 16 1 24 and 17 activates 18 cdk5 17 activates 19 to 17 activates 24 and 19 to 20 promote 20 promote 21 phosphorylation 21 phosphorylation 22 of 22 of 23 tau 24 and 25 inactivates 24 and 26 pp1 24 and 27 via 27 via 28 phosphorylation when cdk5 was inhibited , tau phosphorylation at both proline - and [non] [-] proline directed sites and pp1 phosphorylation were blocked , indicating that egr - 1 acts through cdk5 . 0 ###LEFT-WALL### 7 phosphorylation 0 ###LEFT-WALL### 22 blocked 1 when 2 cdk5 1 when 3 was 1 when 5 , 1 when 7 phosphorylation 2 cdk5 3 was 3 was 4 inhibited 6 tau 7 phosphorylation 7 phosphorylation 8 at 7 phosphorylation 21 were 8 at 18 and 9 both 18 and 10 proline 12 and 11 - 12 and 12 and 17 sites 12 and 18 and 15 proline 17 sites 16 directed 17 sites 18 and 20 phosphorylation 19 pp1 20 phosphorylation 21 were 22 blocked 22 blocked 24 indicating 23 , 24 indicating 24 indicating 26 egr 24 indicating 32 . 25 that 26 egr 26 egr 29 acts 27 - 29 acts 28 1 29 acts 29 acts 30 through 29 acts 32 . 30 through 31 cdk5 by using an in [vitro] kinase assay [and] hek - 293 cells transfected with tau , pp1 , and cdk5 , we found that cdk5 phosphorylates ser ( 396/404 ) directly . 0 ###LEFT-WALL### 12 cells 0 ###LEFT-WALL### 13 transfected 0 ###LEFT-WALL### 32 . 1 by 2 using 1 by 12 cells 2 using 9 hek 3 an 4 in 4 in 7 assay 6 kinase 7 assay 7 assay 9 hek 10 - 11 293 11 293 12 cells 12 cells 13 transfected 13 transfected 14 with 13 transfected 27 ser 13 transfected 31 directly 14 with 19 and 15 tau 16 , 16 , 17 pp1 16 , 19 and 18 , 19 and 19 and 20 cdk5 19 and 21 , 19 and 22 we 19 and 26 phosphorylates 22 we 23 found 23 found 24 that 24 that 25 cdk5 24 that 26 phosphorylates 25 cdk5 26 phosphorylates 27 ser 29 396/404 28 ( 29 396/404 29 396/404 30 ) in addition , by phosphorylating and inactivating pp1 , cdk5 promotes tau phosphorylation at ser ( 262 ) indirectly . 0 ###LEFT-WALL### 10 cdk5 0 ###LEFT-WALL### 11 promotes 0 ###LEFT-WALL### 20 . 1 in 2 addition 1 in 9 , 1 in 10 cdk5 2 addition 4 by 3 , 4 by 4 by 8 pp1 4 by 9 , 5 phosphorylating 6 and 6 and 7 inactivating 6 and 8 pp1 10 cdk5 11 promotes 11 promotes 13 phosphorylation 11 promotes 14 at 11 promotes 19 indirectly 12 tau 13 phosphorylation 14 at 15 ser 15 ser 17 262 16 ( 17 262 17 262 18 ) our results indicate that egr - 1 is an in [vivo] regulator of tau phosphorylation and [suggest] that in ad brain increased levels of egr - 1 aberrantly activate an egr - 1/cdk5/pp1 pathway , leading to accumulation of hyperphosphorylated tau , thus destabilizing the microtubule cytoskeleton . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 6 - 1 our 2 results 2 results 3 indicate 3 indicate 5 egr 4 that 5 egr 6 - 7 1 6 - 8 is 7 1 8 is 8 is 12 regulator 8 is 19 in 9 an 10 in 10 in 12 regulator 12 regulator 13 of 13 of 16 and 14 tau 15 phosphorylation 15 phosphorylation 16 and 16 and 18 that 19 in 23 levels 20 ad 21 brain 21 brain 23 levels 22 increased 23 levels 23 levels 24 of 24 of 25 egr 25 egr 27 1 25 egr 29 activate 25 egr 36 leading 26 - 27 1 27 1 29 activate 28 aberrantly 29 activate 29 activate 31 egr 30 an 31 egr 31 egr 34 pathway 32 - 34 pathway 33 1/cdk5/pp1 34 pathway 34 pathway 35 , 35 , 36 leading 36 leading 37 to 36 leading 44 destabilizing 37 to 38 accumulation 38 accumulation 39 of 39 of 41 tau 40 hyperphosphorylated 41 tau 42 , 44 destabilizing 43 thus 44 destabilizing 44 destabilizing 47 cytoskeleton 44 destabilizing 48 . 45 the 47 cytoskeleton 46 microtubule 47 cytoskeleton th17 cells produce il - 17 that plays an important role in host defense . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 3 produce 0 ###LEFT-WALL### 5 - 1 th17 2 cells 2 cells 3 produce 3 produce 4 il 5 - 6 17 5 - 13 host 5 - 15 . 6 17 7 that 6 17 12 in 6 17 13 host 7 that 8 plays 8 plays 11 role 8 plays 12 in 9 an 10 important 9 an 11 role 10 important 11 role 13 host 14 defense however , little is known about whether aging affects human th17 cells . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 13 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 5 known 5 known 6 about 6 about 7 whether 7 whether 8 aging 7 whether 9 affects 8 aging 9 affects 9 affects 12 cells 10 human 12 cells 11 th17 12 cells here we demonstrated that healthy elderly people ( age ≥ 65 ) had a decreased frequency of il - 17 - producing cells in memory cd4 [(] [+] [ )(t cells compared to healthy young people ( age ≤ 40 ) while both groups had similar frequencies of ifn [-] [γ] - producing cells in the same memory cell subset as measured by flow cytometry . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 demonstrated 1 here 2 we 2 we 3 demonstrated 3 demonstrated 7 people 3 demonstrated 13 had 4 that 7 people 5 healthy 7 people 6 elderly 7 people 7 people 10 ≥ 7 people 13 had 8 ( 10 ≥ 9 age 10 ≥ 10 ≥ 11 65 10 ≥ 12 ) 13 had 16 frequency 14 a 16 frequency 15 decreased 16 frequency 16 frequency 17 of 16 frequency 22 producing 17 of 18 il 18 il 20 17 19 - 20 17 20 17 21 - 21 - 22 producing 22 producing 23 cells 23 cells 24 in 23 cells 32 compared 24 in 31 cells 25 memory 31 cells 26 cd4 30 )(t 26 cd4 31 cells 32 compared 33 to 32 compared 42 while 33 to 36 people 34 healthy 36 people 35 young 36 people 36 people 39 ≤ 37 ( 39 ≤ 38 age 39 ≤ 39 ≤ 40 40 39 ≤ 41 ) 42 while 44 groups 42 while 45 had 43 both 44 groups 44 groups 45 had 45 had 47 frequencies 46 similar 47 frequencies 47 frequencies 48 of 47 frequencies 54 cells 48 of 49 ifn 52 - 54 cells 53 producing 54 cells 54 cells 55 in 54 cells 62 measured 54 cells 66 . 55 in 60 subset 56 the 57 same 56 the 60 subset 58 memory 60 subset 59 cell 60 subset 61 as 62 measured 62 measured 63 by 63 by 65 cytometry 64 flow 65 cytometry in contrast , the healthy elderly [had] increased differentiation of il - 17 - producing effector cells but not ifn - [γ] - producing cells from naive cd4 [(] [+] ) t [cells] compared to the healthy young . 0 ###LEFT-WALL### 32 t 0 ###LEFT-WALL### 34 compared 0 ###LEFT-WALL### 39 . 1 in 2 contrast 1 in 31 ) 1 in 32 t 2 contrast 9 differentiation 3 , 9 differentiation 4 the 9 differentiation 5 healthy 9 differentiation 6 elderly 9 differentiation 8 increased 9 differentiation 9 differentiation 10 of 9 differentiation 31 ) 10 of 11 il 11 il 13 17 11 il 15 producing 11 il 24 producing 12 - 13 17 13 17 14 - 14 - 15 producing 15 producing 18 but 15 producing 21 - 16 effector 17 cells 17 cells 18 but 18 but 19 not 18 but 20 ifn 23 - 24 producing 24 producing 25 cells 24 producing 31 ) 25 cells 26 from 26 from 28 cd4 27 naive 28 cd4 32 t 34 compared 34 compared 35 to 34 compared 38 young 35 to 37 healthy 36 the 37 healthy the results of elisa also showed similar findings with increased il - 17 production from naive cd4 [(] [+] [ )(t cells and decreased il - 17 production from memory cd4 [(] + [ )( cells in the elderly compared to the young . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 12 - 1 the 2 results 2 results 3 of 2 results 6 showed 3 of 4 elisa 5 also 6 showed 6 showed 8 findings 7 similar 8 findings 8 findings 9 with 9 with 11 il 10 increased 11 il 12 - 23 and 13 17 14 production 14 production 15 from 14 production 23 and 15 from 22 cells 16 naive 22 cells 17 cd4 21 )(t 17 cd4 22 cells 23 and 25 il 23 and 33 + 24 decreased 25 il 26 - 33 + 27 17 28 production 28 production 29 from 28 production 33 + 29 from 31 cd4 30 memory 31 cd4 33 + 36 cells 33 + 44 . 36 cells 37 in 36 cells 40 compared 37 in 39 elderly 38 the 39 elderly 40 compared 41 to 41 to 43 young 42 the 43 young these findings indicate that aging differentially affects naive and memory th17 cell responses in humans . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 16 . 1 these 2 findings 2 findings 3 indicate 3 indicate 4 that 4 that 5 aging 4 that 7 affects 5 aging 6 differentially 5 aging 7 affects 7 affects 9 and 7 affects 14 in 8 naive 9 and 9 and 13 responses 10 memory 13 responses 11 th17 13 responses 12 cell 13 responses 14 in 15 humans hippocampal atrophy as [assessed] by magnetic resonance imaging ( mri ) and abnormal cerebrospinal fluid ( csf ) biomarkers are supportive features for the diagnosis of alzheimer 's disease ( ad ) [and] are assumed to be indirect pathological markers of the disease . 0 ###LEFT-WALL### 22 features 0 ###LEFT-WALL### 44 . 1 hippocampal 22 features 2 atrophy 3 as 2 atrophy 12 and 3 as 5 by 5 by 8 imaging 6 magnetic 8 imaging 7 resonance 8 imaging 8 imaging 10 mri 9 ( 10 mri 10 mri 11 ) 12 and 13 abnormal 12 and 19 biomarkers 12 and 20 are 12 and 21 supportive 12 and 22 features 14 cerebrospinal 19 biomarkers 15 fluid 17 csf 15 fluid 19 biomarkers 16 ( 17 csf 17 csf 18 ) 19 biomarkers 20 are 22 features 23 for 22 features 26 of 22 features 34 are 23 for 25 diagnosis 24 the 25 diagnosis 26 of 29 disease 27 alzheimer 28 's 28 's 29 disease 29 disease 31 ad 30 ( 31 ad 31 ad 32 ) 34 are 35 assumed 35 assumed 36 to 36 to 37 be 37 be 40 markers 38 indirect 40 markers 39 pathological 40 markers 40 markers 41 of 41 of 43 disease 42 the 43 disease in ad patients , antemortem mri hippocampal volumes ( hvs ) correlate with the density of neurofibrillary tangles ( but not with senile plaques ) at autopsy suggesting that hvs may better correlate with csf tau and hyperphosphorylated tau ( p - tau ) levels than csf amyloid beta protein ( aβ ) ( 42 ) level . 0 ###LEFT-WALL### 30 hvs 0 ###LEFT-WALL### 33 correlate 0 ###LEFT-WALL### 58 . 1 in 3 patients 1 in 30 hvs 2 ad 3 patients 3 patients 6 mri 4 , 6 mri 5 antemortem 6 mri 6 mri 8 volumes 6 mri 12 correlate 6 mri 25 ) 7 hippocampal 8 volumes 8 volumes 10 hvs 8 volumes 12 correlate 9 ( 10 hvs 10 hvs 11 ) 12 correlate 20 but 13 with 15 density 13 with 20 but 14 the 15 density 15 density 16 of 16 of 18 tangles 17 neurofibrillary 18 tangles 19 ( 20 but 20 but 21 not 20 but 22 with 22 with 24 plaques 23 senile 24 plaques 26 at 28 suggesting 26 at 30 hvs 27 autopsy 28 suggesting 29 that 30 hvs 30 hvs 31 may 31 may 33 correlate 32 better 33 correlate 33 correlate 34 with 33 correlate 57 level 34 with 45 levels 34 with 46 than 34 with 50 protein 35 csf 36 tau 36 tau 37 and 37 and 39 tau 37 and 42 - 37 and 45 levels 38 hyperphosphorylated 39 tau 40 ( 42 - 41 p 42 - 42 - 43 tau 42 - 44 ) 47 csf 49 beta 48 amyloid 49 beta 49 beta 50 protein 50 protein 52 aβ 50 protein 55 42 51 ( 52 aβ 52 aβ 53 ) 54 ( 55 42 55 42 56 ) here , we tested this hypothesis in a well - defined ad group . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 tested 0 ###LEFT-WALL### 10 - 1 here 2 , 1 here 3 we 3 we 4 tested 4 tested 6 hypothesis 4 tested 7 in 5 this 6 hypothesis 7 in 9 well 8 a 9 well 10 - 12 ad 10 - 13 group 10 - 14 . 11 defined 12 ad 12 ad 13 group patients were selected according to the new research criteria for ad , including specific episodic memory deficit and csf ad profile [(] defined as abnormal ratio of aβ ( 42 ):tau ) . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 3 selected 0 ###LEFT-WALL### 33 . 1 patients 2 were 2 were 3 selected 3 selected 5 to 3 selected 10 for 4 according 5 to 5 to 9 criteria 6 the 9 criteria 7 new 8 research 8 research 9 criteria 10 for 18 and 11 ad 12 , 12 , 17 deficit 12 , 18 and 13 including 16 memory 14 specific 16 memory 15 episodic 16 memory 16 memory 17 deficit 18 and 26 ratio 18 and 27 of 19 csf 20 ad 20 ad 23 defined 21 profile 23 defined 23 defined 26 ratio 24 as 25 abnormal 25 abnormal 26 ratio 27 of 28 aβ 28 aβ 31 ):tau 29 ( 31 ):tau 30 42 31 ):tau 31 ):tau 32 ) mri was performed within 6 months [of] lumbar [puncture] . 0 ###LEFT-WALL### 1 mri 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 10 . 1 mri 2 was 2 was 3 performed 3 performed 4 within 3 performed 8 lumbar 4 within 6 months 5 6 6 months hvs were obtained using automated segmentation software . 0 ###LEFT-WALL### 1 hvs 0 ###LEFT-WALL### 3 obtained 0 ###LEFT-WALL### 8 . 1 hvs 2 were 2 were 3 obtained 3 obtained 4 using 4 using 7 software 5 automated 6 segmentation 6 segmentation 7 software thirty - six patients were included . 0 ###LEFT-WALL### 4 patients 0 ###LEFT-WALL### 6 included 0 ###LEFT-WALL### 7 . 1 thirty 2 - 2 - 3 six 2 - 4 patients 4 patients 5 were 5 were 6 included left hv correlated with csf tau ( r = - 0.53 ) and p - tau ( r = - 0.56 ) levels . 0 ###LEFT-WALL### 2 hv 0 ###LEFT-WALL### 3 correlated 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 levels 0 ###LEFT-WALL### 24 . 1 left 2 hv 2 hv 3 correlated 3 correlated 4 with 3 correlated 10 - 4 with 6 tau 5 csf 6 tau 7 ( 10 - 8 r 9 = 9 = 10 - 10 - 11 0.53 10 - 12 ) 13 and 14 p 13 and 15 - 14 p 15 - 15 - 16 tau 16 tau 20 - 16 tau 23 levels 17 ( 20 - 18 r 19 = 19 = 20 - 20 - 21 0.56 20 - 22 ) mean hvs correlated with the csf p - tau level ( r = - 0.52 ) . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 17 . 1 mean 2 hvs 1 mean 3 correlated 2 hvs 3 correlated 3 correlated 4 with 4 with 6 csf 5 the 6 csf 6 csf 7 p 6 csf 10 level 8 - 10 level 9 tau 10 level 10 level 14 - 10 level 16 ) 11 ( 14 - 12 r 13 = 13 = 14 - 14 - 15 0.52 14 - 16 ) no correlation was found between any brain measurement and csf aβ ( 42 ) level . 0 ###LEFT-WALL### 2 correlation 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 . 1 no 2 correlation 2 correlation 3 was 3 was 4 found 4 found 5 between 5 between 7 brain 6 any 7 brain 7 brain 9 and 7 brain 15 level 8 measurement 9 and 9 and 11 aβ 9 and 13 42 9 and 15 level 10 csf 11 aβ 12 ( 13 42 13 42 14 ) the csf tau and p - tau levels , but not the csf aβ ( 42 ) level , correlated with hv , suggesting that csf tau markers reflect the neuronal loss associated with the physiopathological process of ad . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 18 level 1 the 3 tau 2 csf 3 tau 3 tau 4 and 4 and 5 p 4 and 8 levels 4 and 18 level 6 - 8 levels 7 tau 8 levels 8 levels 10 but 8 levels 17 ) 9 , 10 but 10 but 11 not 10 but 14 aβ 10 but 17 ) 12 the 14 aβ 13 csf 14 aβ 14 aβ 16 42 15 ( 16 42 16 42 17 ) 18 level 20 correlated 19 , 20 correlated 20 correlated 21 with 20 correlated 40 . 21 with 22 hv 22 hv 24 suggesting 23 , 24 suggesting 24 suggesting 25 that 24 suggesting 40 . 25 that 28 markers 25 that 29 reflect 26 csf 28 markers 27 tau 28 markers 29 reflect 32 loss 30 the 32 loss 31 neuronal 32 loss 32 loss 33 associated 32 loss 34 with 32 loss 38 of 34 with 37 process 35 the 37 process 36 physiopathological 37 process 38 of 39 ad background : posttraumatic stress disorder ( ptsd ) is associated with increased risk for age - related diseases and early mortality . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 stress 2 : 12 increased 2 : 17 related 3 posttraumatic 4 stress 4 stress 5 disorder 4 stress 11 with 4 stress 12 increased 5 disorder 7 ptsd 5 disorder 9 is 6 ( 7 ptsd 7 ptsd 8 ) 9 is 10 associated 10 associated 11 with 12 increased 13 risk 13 risk 14 for 14 for 15 age 16 - 17 related 17 related 19 and 18 diseases 19 and 19 and 21 mortality 20 early 21 mortality an accelerated rate of biological aging could contribute to this increased risk . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 8 contribute 0 ###LEFT-WALL### 13 . 1 an 3 rate 2 accelerated 3 rate 3 rate 4 of 3 rate 7 could 4 of 6 aging 5 biological 6 aging 7 could 8 contribute 8 contribute 9 to 9 to 12 risk 10 this 11 increased 11 increased 12 risk to investigate , we assessed leukocyte telomere length ( ltl ) , an emerging marker of biological age , in men and women [with] and without ptsd . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 investigate 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 28 . 1 to 2 investigate 3 , 4 we 3 , 5 assessed 4 we 5 assessed 5 assessed 8 length 5 assessed 25 and 6 leukocyte 8 length 7 telomere 8 length 8 length 10 ltl 8 length 15 marker 9 ( 10 ltl 10 ltl 11 ) 12 , 15 marker 13 an 15 marker 14 emerging 15 marker 15 marker 16 of 15 marker 19 , 16 of 18 age 17 biological 18 age 20 in 22 and 20 in 25 and 21 men 22 and 22 and 23 women 25 and 26 without 26 without 27 ptsd we also examined childhood trauma , a risk factor for both ptsd and short ltl , as a potential contributor to short ltl in ptsd . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 26 . 1 we 3 examined 2 also 3 examined 3 examined 5 trauma 3 examined 17 as 4 childhood 5 trauma 5 trauma 13 and 6 , 13 and 7 a 9 factor 8 risk 9 factor 9 factor 10 for 9 factor 13 and 10 for 12 ptsd 11 both 12 ptsd 13 and 15 ltl 13 and 16 , 14 short 15 ltl 17 as 20 contributor 18 a 20 contributor 19 potential 20 contributor 20 contributor 21 to 20 contributor 24 in 21 to 23 ltl 22 short 23 ltl 24 in 25 ptsd exclusion criteria included physical illness , medication use , obesity , alcohol or substance abuse , and pregnancy . 0 ###LEFT-WALL### 2 criteria 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 19 . 1 exclusion 2 criteria 2 criteria 3 included 3 included 17 and 4 physical 5 illness 5 illness 6 , 6 , 8 use 6 , 9 , 7 medication 8 use 9 , 10 obesity 9 , 11 , 11 , 12 alcohol 11 , 13 or 13 or 15 abuse 13 or 17 and 14 substance 15 abuse 16 , 17 and 17 and 18 pregnancy structured clinical interviews were conducted to assess ptsd and other psychiatric disorders and childhood trauma exposure . 0 ###LEFT-WALL### 3 interviews 0 ###LEFT-WALL### 5 conducted 0 ###LEFT-WALL### 17 . 1 structured 3 interviews 2 clinical 3 interviews 3 interviews 4 were 4 were 5 conducted 5 conducted 6 to 6 to 7 assess 7 assess 13 and 8 ptsd 9 and 9 and 12 disorders 9 and 13 and 10 other 12 disorders 11 psychiatric 12 disorders 13 and 16 exposure 14 childhood 16 exposure 15 trauma 16 exposure ltl was measured with a quantitative polymerase chain reaction method . 0 ###LEFT-WALL### 1 ltl 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 11 . 1 ltl 2 was 2 was 3 measured 3 measured 4 with 4 with 10 method 5 a 6 quantitative 5 a 10 method 6 quantitative 7 polymerase 7 polymerase 9 reaction 8 chain 9 reaction 9 reaction 10 method results : as predicted , participants with ptsd had shorter age - adjusted ltl than control subjects . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 participants 2 : 9 had 2 : 12 - 3 as 4 predicted 3 as 5 , 3 as 6 participants 4 predicted 5 , 6 participants 7 with 6 participants 9 had 7 with 8 ptsd 9 had 11 age 10 shorter 11 age 12 - 14 ltl 12 - 16 control 12 - 18 . 13 adjusted 14 ltl 14 ltl 16 control 15 than 16 control 16 control 17 subjects exposure to childhood trauma was also associated with short ltl . 0 ###LEFT-WALL### 1 exposure 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 11 . 1 exposure 2 to 1 exposure 5 was 2 to 4 trauma 3 childhood 4 trauma 5 was 6 also 5 was 7 associated 7 associated 8 with 8 with 10 ltl 9 short 10 ltl in fact , childhood trauma seemed to account for the ptsd group difference in ltl ; only participants with ptsd and exposure to multiple categories of childhood trauma had significantly shorter ltl than control subjects . 0 ###LEFT-WALL### 5 trauma 0 ###LEFT-WALL### 6 seemed 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 36 . 1 in 2 fact 2 fact 3 , 2 fact 5 trauma 4 childhood 5 trauma 5 trauma 6 seemed 6 seemed 7 to 6 seemed 8 account 7 to 8 account 8 account 9 for 9 for 13 difference 10 the 13 difference 11 ptsd 12 group 12 group 13 difference 13 difference 14 in 14 in 15 ltl 16 ; 17 only 16 ; 29 had 17 only 21 and 18 participants 19 with 18 participants 21 and 19 with 20 ptsd 21 and 22 exposure 21 and 29 had 22 exposure 23 to 23 to 25 categories 24 multiple 25 categories 25 categories 26 of 26 of 28 trauma 27 childhood 28 trauma 29 had 32 ltl 29 had 33 than 30 significantly 31 shorter 31 shorter 32 ltl 33 than 35 subjects 34 control 35 subjects conclusions : childhood trauma is associated with short ltl in individuals with ptsd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 trauma 2 : 6 associated 2 : 14 . 3 childhood 4 trauma 4 trauma 5 is 5 is 6 associated 6 associated 7 with 6 associated 10 in 7 with 9 ltl 8 short 9 ltl 10 in 11 individuals 11 individuals 12 with 12 with 13 ptsd chronic exposure to the psychobiological sequelae of childhood trauma could increase risk for ptsd and short ltl . 0 ###LEFT-WALL### 2 exposure 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 18 . 1 chronic 2 exposure 2 exposure 3 to 2 exposure 7 of 2 exposure 10 could 3 to 6 sequelae 4 the 6 sequelae 5 psychobiological 6 sequelae 7 of 9 trauma 8 childhood 9 trauma 10 could 15 and 11 increase 12 risk 11 increase 15 and 12 risk 13 for 13 for 14 ptsd 15 and 16 short 16 short 17 ltl thus , the lasting psychological impact of exposure to trauma in childhood might be accompanied by equally enduring changes at the molecular level . 0 ###LEFT-WALL### 6 impact 0 ###LEFT-WALL### 15 accompanied 0 ###LEFT-WALL### 24 . 1 thus 2 , 1 thus 6 impact 3 the 6 impact 4 lasting 6 impact 5 psychological 6 impact 6 impact 7 of 6 impact 13 might 7 of 8 exposure 8 exposure 9 to 9 to 10 trauma 10 trauma 11 in 11 in 12 childhood 13 might 14 be 14 be 15 accompanied 15 accompanied 16 by 16 by 18 enduring 17 equally 18 enduring 18 enduring 19 changes 18 enduring 20 at 20 at 23 level 21 the 23 level 22 molecular 23 level after birth , there is striking biological and functional development of the brain 's fiber tracts as well as remodeling of cortical and subcortical structures . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 26 . 1 after 2 birth 1 after 3 , 1 after 4 there 4 there 5 is 5 is 10 development 6 striking 10 development 7 biological 8 and 8 and 9 functional 8 and 10 development 10 development 11 of 10 development 19 as 11 of 16 tracts 12 the 13 brain 13 brain 14 's 14 's 16 tracts 15 fiber 16 tracts 17 as 18 well 18 well 19 as 19 as 20 remodeling 20 remodeling 21 of 21 of 23 and 22 cortical 23 and 23 and 25 structures 24 subcortical 25 structures behavioral development in children involves a complex and dynamic set of genetically guided processes by which neural structures interact constantly with the environment . 0 ###LEFT-WALL### 2 development 0 ###LEFT-WALL### 5 involves 0 ###LEFT-WALL### 24 . 1 behavioral 2 development 2 development 3 in 2 development 5 involves 3 in 4 children 5 involves 10 set 6 a 10 set 7 complex 8 and 8 and 9 dynamic 8 and 10 set 10 set 11 of 11 of 14 processes 12 genetically 13 guided 13 guided 14 processes 14 processes 15 by 15 by 16 which 15 by 18 structures 15 by 19 interact 17 neural 18 structures 18 structures 19 interact 19 interact 20 constantly 19 interact 21 with 21 with 23 environment 22 the 23 environment this is a protracted process , beginning in the third week of gestation and continuing into early adulthood . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 1 this 2 is 2 is 5 process 3 a 5 process 4 protracted 5 process 5 process 7 beginning 6 , 7 beginning 7 beginning 8 in 7 beginning 16 into 7 beginning 19 . 8 in 11 week 9 the 10 third 9 the 11 week 11 week 12 of 12 of 14 and 13 gestation 14 and 14 and 15 continuing 16 into 18 adulthood 17 early 18 adulthood reviewed here are studies using structural imaging techniques , with a special focus on diffusion weighted imaging , describing age - related brain maturational changes in children and adolescents , as well as studies that link these changes to behavioral differences . 0 ###LEFT-WALL### 1 reviewed 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 22 related 1 reviewed 2 here 1 reviewed 3 are 3 are 4 studies 4 studies 5 using 4 studies 19 describing 5 using 8 techniques 5 using 10 with 6 structural 8 techniques 7 imaging 8 techniques 9 , 10 with 10 with 13 focus 10 with 14 on 10 with 18 , 11 a 13 focus 12 special 13 focus 14 on 17 imaging 15 diffusion 16 weighted 16 weighted 17 imaging 18 , 19 describing 19 describing 20 age 19 describing 21 - 21 - 22 related 22 related 25 changes 22 related 26 in 22 related 33 as 23 brain 25 changes 24 maturational 25 changes 26 in 28 and 27 children 28 and 28 and 29 adolescents 30 , 33 as 31 as 32 well 32 well 33 as 33 as 34 studies 33 as 42 . 34 studies 35 that 34 studies 36 link 35 that 36 link 36 link 38 changes 36 link 39 to 37 these 38 changes 39 to 41 differences 40 behavioral 41 differences finally , we discuss evidence for effects on the brain of several factors that may play a role in mediating these brain - behavior associations in children , including genetic variation , behavioral interventions , and hormonal variation associated with puberty . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 discuss 0 ###LEFT-WALL### 36 and 0 ###LEFT-WALL### 42 . 1 finally 2 , 1 finally 3 we 3 we 4 discuss 4 discuss 5 evidence 4 discuss 6 for 4 discuss 8 on 4 discuss 29 including 6 for 7 effects 8 on 10 brain 9 the 10 brain 10 brain 11 of 10 brain 25 associations 11 of 12 several 12 several 13 factors 12 several 22 brain 13 factors 14 that 13 factors 15 may 13 factors 22 brain 14 that 15 may 15 may 16 play 16 play 18 role 16 play 19 in 17 a 18 role 19 in 20 mediating 20 mediating 21 these 23 - 25 associations 24 behavior 25 associations 25 associations 26 in 25 associations 28 , 26 in 27 children 28 , 29 including 29 including 31 variation 29 including 35 , 30 genetic 31 variation 31 variation 34 interventions 32 , 34 interventions 33 behavioral 34 interventions 34 interventions 35 , 36 and 38 variation 36 and 39 associated 37 hormonal 38 variation 38 variation 39 associated 39 associated 40 with 40 with 41 puberty at present longitudinal studies are few , and we do not yet know [how] variability in individual trajectories of biological development in specific neural systems [map] onto similar variability in behavioral trajectories . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 33 . 1 at 2 present 2 present 4 studies 3 longitudinal 4 studies 4 studies 5 are 5 are 6 few 7 , 8 and 8 and 9 we 8 and 13 know 9 we 10 do 10 do 11 not 10 do 13 know 12 yet 13 know 13 know 15 variability 13 know 16 in 13 know 22 in 13 know 27 onto 13 know 30 in 16 in 18 trajectories 17 individual 18 trajectories 18 trajectories 19 of 19 of 21 development 20 biological 21 development 22 in 25 systems 23 specific 25 systems 24 neural 25 systems 27 onto 29 variability 28 similar 29 variability 30 in 32 trajectories 31 behavioral 32 trajectories background : the aging population in prison is growing rapidly in the united kingdom . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 population 2 : 8 is 2 : 15 . 3 the 5 population 4 aging 5 population 5 population 6 in 5 population 8 is 6 in 7 prison 8 is 9 growing 9 growing 10 rapidly 9 growing 11 in 11 in 14 kingdom 12 the 14 kingdom 13 united 14 kingdom this trend is also found in other countries worldwide . 0 ###LEFT-WALL### 2 trend 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 10 . 1 this 2 trend 2 trend 3 is 3 is 4 also 3 is 5 found 5 found 6 in 5 found 9 worldwide 6 in 8 countries 7 other 8 countries as this population increases prison authorities will need to adjust the custody process to accommodate increasing mental and physical frailty . 0 ###LEFT-WALL### 6 authorities 0 ###LEFT-WALL### 8 need 0 ###LEFT-WALL### 21 . 1 as 3 population 1 as 4 increases 1 as 6 authorities 2 this 3 population 3 population 4 increases 5 prison 6 authorities 6 authorities 7 will 7 will 8 need 8 need 9 to 8 need 14 to 8 need 15 accommodate 9 to 10 adjust 10 adjust 13 process 11 the 13 process 12 custody 13 process 14 to 15 accommodate 15 accommodate 20 frailty 16 increasing 20 frailty 17 mental 18 and 18 and 19 physical 18 and 20 frailty methods : this study examined the prevalence of psychiatric disorders and physical disorders , including dementia , in prisoners aged 50 years and over from four prisons in and around staffordshire to see whether detection and treatment rates have improved over the past decade during which there has been a dramatic increase in the number of older prisoners . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 59 . 1 methods 2 : 2 : 4 study 2 : 23 and 3 this 4 study 4 study 5 examined 4 study 7 prevalence 4 study 13 disorders 6 the 7 prevalence 7 prevalence 8 of 7 prevalence 13 disorders 8 of 11 and 9 psychiatric 10 disorders 10 disorders 11 and 11 and 12 physical 13 disorders 15 including 14 , 15 including 15 including 16 dementia 15 including 17 , 18 in 22 years 18 in 23 and 19 prisoners 20 aged 20 aged 22 years 21 50 22 years 23 and 24 over 24 over 25 from 25 from 27 prisons 26 four 27 prisons 27 prisons 29 and 27 prisons 32 to 27 prisons 33 see 28 in 29 and 29 and 30 around 29 and 31 staffordshire 32 to 33 see 33 see 34 whether 33 see 41 over 34 whether 38 rates 34 whether 40 improved 35 detection 36 and 36 and 37 treatment 36 and 38 rates 38 rates 39 have 39 have 40 improved 41 over 44 decade 42 the 44 decade 43 past 44 decade 44 decade 45 during 44 decade 56 of 45 during 46 which 45 during 47 there 45 during 49 been 47 there 48 has 48 has 49 been 49 been 52 increase 49 been 53 in 50 a 51 dramatic 50 a 52 increase 51 dramatic 52 increase 53 in 55 number 54 the 55 number 56 of 58 prisoners 57 older 58 prisoners subjects were assessed using the geriatric mental state examination , the mini - mental state examination and short form 12 and their prison records . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 25 . 1 subjects 2 were 2 were 3 assessed 3 assessed 4 using 4 using 9 examination 5 the 9 examination 6 geriatric 7 mental 7 mental 8 state 8 state 9 examination 9 examination 12 mini 10 , 12 mini 11 the 12 mini 12 mini 13 - 13 - 21 and 14 mental 15 state 15 state 16 examination 16 examination 17 and 17 and 19 form 17 and 21 and 18 short 19 form 19 form 20 12 21 and 24 records 22 their 24 records 23 prison 24 records results : sixty prisoners ( 50 % ) had a diagnosable mental disorder , with depression being most common , [and] 15 ( 12 % ) prisoners had signs of cognitive impairment . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 prisoners 2 : 9 had 2 : 14 , 2 : 33 . 3 sixty 4 prisoners 4 prisoners 7 % 4 prisoners 9 had 5 ( 7 % 6 50 7 % 7 % 8 ) 9 had 13 disorder 10 a 11 diagnosable 10 a 13 disorder 11 diagnosable 13 disorder 12 mental 13 disorder 14 , 17 being 14 , 28 had 15 with 16 depression 15 with 17 being 17 being 27 prisoners 17 being 28 had 18 most 27 prisoners 19 common 22 15 19 common 27 prisoners 20 , 22 15 22 15 25 % 22 15 26 ) 23 ( 25 % 24 12 25 % 25 % 26 ) 28 had 29 signs 29 signs 30 of 30 of 32 impairment 31 cognitive 32 impairment only 18 % of those with a psychiatric diagnosis were prescribed medication from the appropriate class . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 17 . 1 only 2 18 2 18 3 % 3 % 4 of 3 % 10 were 4 of 5 those 5 those 6 with 6 with 9 diagnosis 7 a 8 psychiatric 7 a 9 diagnosis 8 psychiatric 9 diagnosis 10 were 12 medication 11 prescribed 12 medication 12 medication 13 from 13 from 16 class 14 the 16 class 15 appropriate 16 class physical problems were also common in this population with an average [self] - report of 2.26 problems per prisoner . 0 ###LEFT-WALL### 2 problems 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 20 . 1 physical 2 problems 2 problems 3 were 3 were 4 also 3 were 5 common 5 common 6 in 5 common 9 with 6 in 8 population 7 this 8 population 9 with 14 report 10 an 14 report 11 average 13 - 11 average 14 report 14 report 15 of 15 of 17 problems 16 2.26 17 problems 17 problems 18 per 18 per 19 prisoner conclusions : mental disorders in older prisoners are common , but despite recent training initiatives they often go undetected and untreated . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 disorders 2 : 8 are 2 : 11 but 3 mental 4 disorders 4 disorders 5 in 4 disorders 8 are 5 in 7 prisoners 6 older 7 prisoners 8 are 9 common 10 , 11 but 11 but 16 they 11 but 18 go 12 despite 15 initiatives 12 despite 16 they 13 recent 14 training 14 training 15 initiatives 16 they 18 go 17 often 18 go 18 go 20 and 19 undetected 20 and 20 and 21 untreated prisoners themselves accurately [self] [-] report mental disorder , but the best way of detecting dementia in the prison population remains unclear . 0 ###LEFT-WALL### 1 prisoners 0 ###LEFT-WALL### 6 report 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 23 . 1 prisoners 6 report 2 themselves 6 report 3 accurately 6 report 6 report 8 disorder 7 mental 8 disorder 9 , 10 but 10 but 13 way 10 but 21 remains 11 the 12 best 11 the 13 way 13 way 14 of 13 way 21 remains 14 of 15 detecting 15 detecting 16 dementia 15 detecting 17 in 17 in 20 population 18 the 20 population 19 prison 20 population 21 remains 22 unclear the psychological and physical health of this prison population was poorer than that of their community - based peers . 0 ###LEFT-WALL### 5 health 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 17 - 1 the 5 health 2 psychological 3 and 3 and 4 physical 3 and 5 health 5 health 6 of 5 health 10 was 6 of 9 population 7 this 9 population 8 prison 9 population 10 was 11 poorer 11 poorer 12 than 12 than 13 that 12 than 14 of 14 of 16 community 15 their 16 community 17 - 19 peers 17 - 20 . 18 based 19 peers purpose : to provide a review of the literature regarding programs for mentoring new nurse practitioners ( nps ) to accelerate their development as primary care providers . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 to 2 : 4 provide 3 to 4 provide 4 provide 6 review 4 provide 24 as 5 a 6 review 6 review 7 of 6 review 10 regarding 7 of 9 literature 8 the 9 literature 10 regarding 11 programs 11 programs 12 for 12 for 13 mentoring 13 mentoring 16 practitioners 13 mentoring 20 to 14 new 15 nurse 15 nurse 16 practitioners 16 practitioners 18 nps 17 ( 18 nps 18 nps 19 ) 20 to 21 accelerate 21 accelerate 23 development 22 their 23 development 24 as 27 providers 25 primary 26 care 26 care 27 providers data sources : a search was conducted in pubmed , ovid , cinahl , and cochrane database of systematic reviews . 0 ###LEFT-WALL### 2 sources 0 ###LEFT-WALL### 3 : 1 data 2 sources 3 : 5 search 3 : 7 conducted 3 : 21 . 4 a 5 search 5 search 6 was 6 was 7 conducted 7 conducted 8 in 8 in 15 and 9 pubmed 10 , 10 , 11 ovid 10 , 12 , 12 , 13 cinahl 12 , 15 and 14 , 15 and 15 and 20 reviews 16 cochrane 17 database 17 database 18 of 17 database 20 reviews 18 of 19 systematic conclusions : there is currently a critical shortage of primary care providers and an aging population requiring management of chronic medical conditions . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 there 2 : 4 is 3 there 4 is 4 is 5 currently 4 is 8 shortage 6 a 7 critical 6 a 8 shortage 7 critical 8 shortage 8 shortage 9 of 8 shortage 17 requiring 9 of 13 and 10 primary 11 care 11 care 12 providers 12 providers 13 and 13 and 16 population 14 an 16 population 15 aging 16 population 17 requiring 18 management 18 management 19 of 19 of 22 conditions 20 chronic 22 conditions 21 medical 22 conditions although nps are trained in health [promotion] , disease prevention , and medical management [and] are well equipped to treat patients in primary care , the work can be overwhelming to the novice np . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 18 equipped 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 29 be 0 ###LEFT-WALL### 35 . 1 although 2 nps 1 although 4 trained 1 although 8 , 1 although 12 and 2 nps 3 are 3 are 4 trained 4 trained 5 in 5 in 6 health 9 disease 10 prevention 10 prevention 12 and 11 , 12 and 12 and 14 management 12 and 16 are 13 medical 14 management 16 are 17 well 16 are 18 equipped 18 equipped 19 to 18 equipped 22 in 19 to 21 patients 20 treat 21 patients 22 in 24 care 23 primary 24 care 25 , 29 be 26 the 27 work 27 work 28 can 28 can 29 be 29 be 30 overwhelming 30 overwhelming 31 to 30 overwhelming 34 np 31 to 33 novice 32 the 33 novice a mentoring program could help the new np further develop competencies and capabilities as a provider . 0 ###LEFT-WALL### 3 program 0 ###LEFT-WALL### 5 help 0 ###LEFT-WALL### 17 . 1 a 3 program 2 mentoring 3 program 3 program 4 could 4 could 5 help 5 help 8 np 5 help 10 develop 6 the 8 np 7 new 8 np 9 further 10 develop 10 develop 12 and 10 develop 14 as 11 competencies 12 and 12 and 13 capabilities 14 as 16 provider 15 a 16 provider however , there is a gap in the literature concerning any mentoring programs for novice nps . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 3 there 3 there 4 is 4 is 6 gap 5 a 6 gap 6 gap 7 in 6 gap 12 mentoring 7 in 9 literature 8 the 9 literature 9 literature 10 concerning 10 concerning 11 any 12 mentoring 13 programs 13 programs 14 for 14 for 16 nps 15 novice 16 nps nonetheless , the literature review has provided a mentoring definition , program models , desired characteristics of nurse mentors , and barriers to mentoring programs . 0 ###LEFT-WALL### 4 literature 0 ###LEFT-WALL### 15 desired 0 ###LEFT-WALL### 26 . 1 nonetheless 2 , 1 nonetheless 4 literature 3 the 4 literature 4 literature 5 review 4 literature 7 provided 4 literature 15 desired 5 review 6 has 6 has 7 provided 7 provided 10 definition 8 a 10 definition 9 mentoring 10 definition 10 definition 13 models 11 , 13 models 12 program 13 models 13 models 14 , 15 desired 16 characteristics 15 desired 23 to 16 characteristics 17 of 17 of 21 and 18 nurse 19 mentors 19 mentors 21 and 20 , 21 and 21 and 22 barriers 23 to 24 mentoring 24 mentoring 25 programs it has also described the benefits , goals and outcomes of a mentoring relationship . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 described 0 ###LEFT-WALL### 15 . 1 it 2 has 2 has 4 described 3 also 4 described 4 described 9 and 5 the 6 benefits 6 benefits 7 , 7 , 8 goals 7 , 9 and 9 and 10 outcomes 9 and 11 of 11 of 14 relationship 12 a 14 relationship 13 mentoring 14 relationship these insights from the literature provide a foundation for future mentoring program development . 0 ###LEFT-WALL### 2 insights 0 ###LEFT-WALL### 6 provide 0 ###LEFT-WALL### 14 . 1 these 2 insights 2 insights 3 from 2 insights 6 provide 3 from 5 literature 4 the 5 literature 6 provide 8 foundation 7 a 8 foundation 8 foundation 9 for 9 for 13 development 10 future 13 development 11 mentoring 13 development 12 program 13 development implications for practice : a mentoring program for new nps working in primary care could accelerate productivity , increase job satisfaction , and provide longevity in the primary care setting . 0 ###LEFT-WALL### 3 practice 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 31 . 1 implications 2 for 2 for 3 practice 4 : 7 program 4 : 23 and 5 a 7 program 6 mentoring 7 program 7 program 8 for 7 program 15 could 8 for 10 nps 9 new 10 nps 10 nps 11 working 11 working 12 in 11 working 14 care 13 primary 14 care 15 could 23 and 16 accelerate 17 productivity 16 accelerate 23 and 17 productivity 21 satisfaction 18 , 21 satisfaction 19 increase 20 job 20 job 21 satisfaction 21 satisfaction 22 , 22 , 23 and 23 and 24 provide 23 and 29 care 24 provide 25 longevity 24 provide 26 in 26 in 28 primary 27 the 28 primary 29 care 30 setting alterations in connective tissue collagen are prominent features of both chronologically aged and photoaged ( [ageing] because of sun exposure ) human skin . 0 ###LEFT-WALL### 1 alterations 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 . 1 alterations 2 in 1 alterations 13 and 2 in 4 tissue 3 connective 4 tissue 4 tissue 5 collagen 4 tissue 9 of 5 collagen 6 are 6 are 8 features 7 prominent 8 features 8 features 9 of 10 both 12 aged 11 chronologically 12 aged 12 aged 13 and 13 and 14 photoaged 13 and 18 of 13 and 23 skin 15 ( 18 of 17 because 18 of 18 of 20 exposure 18 of 21 ) 19 sun 20 exposure 22 human 23 skin these age - related abnormalities are mediated in part by cysteine - rich protein 61 ( ccn1 ) . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 3 - 1 these 2 age 3 - 5 abnormalities 3 - 7 mediated 3 - 19 . 4 related 5 abnormalities 5 abnormalities 6 are 6 are 7 mediated 7 mediated 9 part 8 in 9 part 9 part 10 by 10 by 11 cysteine 11 cysteine 14 protein 12 - 14 protein 13 rich 14 protein 14 protein 15 61 14 protein 17 ccn1 14 protein 18 ) 16 ( 17 ccn1 17 ccn1 18 ) ccn1 is elevated in the dermis of both chronologically aged and photoaged human skin in vivo and promotes aberrant collagen homeostasis by down - regulating type i collagen , the major structural protein in skin , and promoting collagen degradation . 0 ###LEFT-WALL### 1 ccn1 0 ###LEFT-WALL### 28 collagen 0 ###LEFT-WALL### 29 , 0 ###LEFT-WALL### 41 . 1 ccn1 2 is 2 is 3 elevated 3 elevated 4 in 4 in 6 dermis 5 the 6 dermis 6 dermis 7 of 7 of 11 and 8 both 10 aged 9 chronologically 10 aged 10 aged 11 and 11 and 17 and 12 photoaged 14 skin 12 photoaged 16 vivo 12 photoaged 17 and 13 human 14 skin 15 in 16 vivo 17 and 18 promotes 18 promotes 20 collagen 19 aberrant 20 collagen 20 collagen 21 homeostasis 20 collagen 28 collagen 21 homeostasis 22 by 21 homeostasis 28 collagen 22 by 26 type 23 down 24 - 23 down 26 type 25 regulating 26 type 26 type 27 i 29 , 37 and 29 , 39 collagen 30 the 33 protein 31 major 33 protein 32 structural 33 protein 33 protein 34 in 33 protein 37 and 34 in 35 skin 36 , 37 and 37 and 38 promoting 37 and 39 collagen 39 collagen 40 degradation vitamin a and its metabolites have been shown to improve chronologically aged and photoaged skin by promoting deposition of new collagen and preventing its degradation . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 shown 0 ###LEFT-WALL### 26 . 1 vitamin 2 a 1 vitamin 3 and 3 and 5 metabolites 3 and 6 have 4 its 5 metabolites 6 have 7 been 7 been 8 shown 8 shown 9 to 8 shown 25 degradation 9 to 10 improve 10 improve 11 chronologically 10 improve 13 and 10 improve 16 by 12 aged 13 and 13 and 15 skin 14 photoaged 15 skin 16 by 17 promoting 17 promoting 18 deposition 18 deposition 19 of 19 of 22 and 20 new 21 collagen 21 collagen 22 and 22 and 23 preventing 24 its 25 degradation here , we investigated regulation of ccn1 expression by retinoids in skin equivalent cultures and chronologically aged and photoaged human skin in vivo . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 24 . 1 here 2 , 1 here 3 we 3 we 4 investigated 4 investigated 5 regulation 4 investigated 9 by 5 regulation 6 of 6 of 8 expression 7 ccn1 8 expression 9 by 15 and 10 retinoids 11 in 10 retinoids 15 and 11 in 14 cultures 12 skin 14 cultures 13 equivalent 14 cultures 15 and 18 and 15 and 23 vivo 16 chronologically 17 aged 17 aged 18 and 18 and 19 photoaged 18 and 21 skin 20 human 21 skin 22 in 23 vivo addition of recombinant human ccn1 to skin equivalent cultures significantly reduced type i procollagen and increased mmp - 1 . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 20 . 1 addition 2 of 1 addition 15 and 2 of 5 ccn1 3 recombinant 5 ccn1 4 human 5 ccn1 5 ccn1 6 to 5 ccn1 13 i 5 ccn1 14 procollagen 6 to 7 skin 7 skin 9 cultures 7 skin 12 type 8 equivalent 9 cultures 9 cultures 11 reduced 9 cultures 12 type 10 significantly 11 reduced 13 i 14 procollagen 15 and 17 mmp 16 increased 17 mmp 18 - 19 1 importantly [,] [ra] significantly reduced ccn1 expression [in] skin equivalent cultures . 0 ###LEFT-WALL### 11 cultures 0 ###LEFT-WALL### 12 . 1 importantly 5 reduced 4 significantly 5 reduced 5 reduced 11 cultures 6 ccn1 11 cultures 7 expression 11 cultures 9 skin 11 cultures 10 equivalent 11 cultures topical treatment with retinol ( vitamin a , 0.4 % ) for 7 days significantly reduced ccn1 mrna and protein expression in both chronologically aged ( 80+years ) and photoaged human skin in vivo , compared to vehicle [-] treated skin . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 35 , 0 ###LEFT-WALL### 42 . 1 topical 2 treatment 2 treatment 3 with 2 treatment 12 for 2 treatment 35 , 3 with 4 retinol 4 retinol 6 vitamin 5 ( 6 vitamin 6 vitamin 7 a 6 vitamin 10 % 6 vitamin 11 ) 8 , 10 % 9 0.4 10 % 10 % 11 ) 12 for 14 days 13 7 14 days 15 significantly 16 reduced 16 reduced 17 ccn1 16 reduced 35 , 17 ccn1 29 and 17 ccn1 32 skin 18 mrna 19 and 19 and 21 expression 19 and 22 in 19 and 25 aged 19 and 27 80+years 19 and 29 and 20 protein 21 expression 22 in 23 both 24 chronologically 25 aged 26 ( 27 80+years 27 80+years 28 ) 29 and 31 human 29 and 32 skin 30 photoaged 31 human 32 skin 34 vivo 33 in 34 vivo 35 , 36 compared 36 compared 37 to 37 to 41 skin 38 vehicle 40 treated 40 treated 41 skin these data indicate that the mechanism by which retinoids improve aged skin , through increased collagen production , involves down - regulation of ccn1 . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 25 . 1 these 2 data 2 data 3 indicate 3 indicate 4 that 4 that 6 mechanism 4 that 19 involves 5 the 6 mechanism 6 mechanism 7 by 6 mechanism 19 involves 7 by 8 which 7 by 9 retinoids 7 by 10 improve 9 retinoids 10 improve 10 improve 12 skin 11 aged 12 skin 12 skin 17 production 13 , 17 production 14 through 17 production 15 increased 17 production 16 collagen 17 production 17 production 18 , 19 involves 22 regulation 20 down 21 - 20 down 22 regulation 22 regulation 23 of 23 of 24 ccn1 cataracts are crystalline lens opacities leading to a loss of visual acuity . 0 ###LEFT-WALL### 1 cataracts 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 13 . 1 cataracts 2 are 2 are 5 opacities 3 crystalline 4 lens 4 lens 5 opacities 5 opacities 6 leading 6 leading 7 to 7 to 9 loss 8 a 9 loss 9 loss 10 of 10 of 12 acuity 11 visual 12 acuity cataracts mainly affect the elderly , and [are] more or less incapacitating depending on their intensity and location . 0 ###LEFT-WALL### 1 cataracts 0 ###LEFT-WALL### 3 affect 0 ###LEFT-WALL### 19 . 1 cataracts 3 affect 2 mainly 3 affect 3 affect 13 depending 3 affect 14 on 4 the 13 depending 5 elderly 7 and 6 , 7 and 7 and 12 incapacitating 7 and 13 depending 9 more 10 or 10 or 11 less 10 or 12 incapacitating 14 on 17 and 15 their 16 intensity 16 intensity 17 and 17 and 18 location cataracts are irreversible . 0 ###LEFT-WALL### 1 cataracts 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 4 . 1 cataracts 2 are 2 are 3 irreversible they are rarely [drug] - related but can be caused by a wide variety of medications . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 5 - 1 they 2 are 2 are 3 rarely 5 - 7 but 5 - 17 . 6 related 7 but 7 but 8 can 8 can 9 be 9 be 10 caused 10 caused 11 by 11 by 14 variety 12 a 13 wide 12 a 14 variety 13 wide 14 variety 14 variety 15 of 15 of 16 medications the most frequently implicated drugs are corticosteroids , even after local or inhaled treatment . 0 ###LEFT-WALL### 5 drugs 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 15 . 1 the 2 most 2 most 3 frequently 3 frequently 4 implicated 4 implicated 5 drugs 5 drugs 6 are 6 are 8 , 7 corticosteroids 8 , 8 , 9 even 9 even 10 after 10 after 12 or 11 local 12 or 12 or 14 treatment 13 inhaled 14 treatment bed bug infestations have resurged globally , nationally , and [locally] , yet the public health community in the u.s [.] has yet to mount a coordinated response to the escalating bed bug problem . 0 ###LEFT-WALL### 3 infestations 0 ###LEFT-WALL### 5 resurged 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 25 mount 0 ###LEFT-WALL### 35 . 1 bed 3 infestations 2 bug 3 infestations 3 infestations 4 have 4 have 5 resurged 5 resurged 6 globally 5 resurged 8 nationally 7 , 8 nationally 8 nationally 9 , 9 , 10 and 10 and 12 , 10 and 13 yet 10 and 17 community 10 and 22 has 14 the 17 community 15 public 16 health 16 health 17 community 17 community 18 in 17 community 22 has 18 in 20 u.s 19 the 20 u.s 22 has 23 yet 22 has 24 to 24 to 25 mount 25 mount 28 response 26 a 28 response 27 coordinated 28 response 28 response 29 to 29 to 34 problem 30 the 34 problem 31 escalating 32 bed 32 bed 34 problem 33 bug 34 problem surveys of attendees at the 2009 national environmental health association annual educational conference & exhibition , 2009 ohio association of health commissioners fall conference , 2009 central ohio bed bug summit , and 2010 hamilton county council on aging annual conference were conducted to gauge opinions about bed bugs . 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 43 conducted 0 ###LEFT-WALL### 50 . 1 surveys 2 of 1 surveys 33 and 2 of 3 attendees 3 attendees 4 at 3 attendees 19 association 4 at 15 exhibition 5 the 6 2009 6 2009 15 exhibition 7 national 8 environmental 8 environmental 9 health 9 health 10 association 10 association 11 annual 11 annual 12 educational 12 educational 13 conference 13 conference 14 & 14 & 15 exhibition 16 , 19 association 17 2009 19 association 18 ohio 19 association 19 association 20 of 19 association 32 , 20 of 24 conference 21 health 22 commissioners 22 commissioners 23 fall 23 fall 24 conference 24 conference 31 summit 25 , 31 summit 26 2009 28 ohio 27 central 28 ohio 28 ohio 29 bed 29 bed 30 bug 30 bug 31 summit 31 summit 32 , 33 and 37 council 33 and 38 on 33 and 42 were 34 2010 37 council 35 hamilton 36 county 36 county 37 council 38 on 41 conference 39 aging 40 annual 40 annual 41 conference 42 were 43 conducted 43 conducted 44 to 44 to 45 gauge 45 gauge 46 opinions 45 gauge 47 about 47 about 49 bugs 48 bed 49 bugs survey results revealed that 90 % of all respondents considered bed bugs to be a public health concern , and 73 % indicated that bed bugs pose an environmental justice concern . 0 ###LEFT-WALL### 1 survey 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 32 . 1 survey 2 results 1 survey 13 to 2 results 3 revealed 2 results 4 that 2 results 10 considered 4 that 6 % 4 that 10 considered 5 90 6 % 6 % 7 of 6 % 10 considered 7 of 9 respondents 8 all 9 respondents 10 considered 12 bugs 11 bed 12 bugs 13 to 14 be 14 be 18 concern 15 a 18 concern 16 public 17 health 17 health 18 concern 19 , 20 and 20 and 22 % 20 and 23 indicated 21 73 22 % 22 % 23 indicated 23 indicated 24 that 24 that 26 bugs 24 that 27 pose 25 bed 26 bugs 26 bugs 27 pose 27 pose 31 concern 28 an 29 environmental 28 an 31 concern 29 environmental 30 justice 30 justice 31 concern these findings , which indicate that bed bugs are an inescapable public health mandate with environmental justice undertones , should rally public health agencies at federal , state , and local levels to respond with authority of [agency] to the escalating bed bug problem . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 21 rally 0 ###LEFT-WALL### 45 . 1 these 2 findings 2 findings 4 which 2 findings 20 should 3 , 4 which 4 which 5 indicate 4 which 19 , 5 indicate 6 that 6 that 8 bugs 6 that 9 are 7 bed 8 bugs 8 bugs 9 are 9 are 14 mandate 10 an 11 inescapable 10 an 14 mandate 11 inescapable 13 health 12 public 13 health 13 health 14 mandate 14 mandate 15 with 15 with 18 undertones 16 environmental 17 justice 17 justice 18 undertones 20 should 21 rally 21 rally 24 agencies 21 rally 25 at 21 rally 33 to 22 public 23 health 23 health 24 agencies 25 at 30 and 26 federal 27 , 27 , 28 state 27 , 30 and 29 , 30 and 30 and 32 levels 31 local 32 levels 33 to 34 respond 34 respond 35 with 35 with 36 authority 36 authority 37 of 37 of 39 to 39 to 44 problem 40 the 44 problem 41 escalating 42 bed 42 bed 44 problem 43 bug 44 problem human cytomegalovirus ( hcmv ) is [a] ubiquitous beta human herpesvirus type 5 . 0 ###LEFT-WALL### 2 cytomegalovirus 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 14 . 1 human 2 cytomegalovirus 2 cytomegalovirus 4 hcmv 2 cytomegalovirus 6 is 3 ( 4 hcmv 4 hcmv 5 ) 6 is 12 type 8 ubiquitous 9 beta 9 beta 12 type 10 human 11 herpesvirus 11 herpesvirus 12 type 12 type 13 5 compared to other human herpesviruses , hcmv is the largest , with a genome of approximately 235 kb containing approximately 250 orfs with the potential to encode proteins . 0 ###LEFT-WALL### 7 hcmv 0 ###LEFT-WALL### 8 is 1 compared 2 to 1 compared 6 , 1 compared 7 hcmv 2 to 5 herpesviruses 3 other 5 herpesviruses 4 human 5 herpesviruses 7 hcmv 8 is 8 is 10 largest 9 the 10 largest 10 largest 12 with 11 , 12 with 12 with 14 genome 12 with 29 . 13 a 14 genome 14 genome 15 of 14 genome 19 containing 15 of 18 kb 16 approximately 17 235 17 235 18 kb 19 containing 22 orfs 19 containing 23 with 19 containing 26 to 20 approximately 21 250 21 250 22 orfs 23 with 25 potential 24 the 25 potential 26 to 27 encode 27 encode 28 proteins usually , hcmv asymptomatically infects the host during childhood , and establishes life - long latency . 0 ###LEFT-WALL### 3 hcmv 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 17 . 1 usually 2 , 1 usually 3 hcmv 3 hcmv 11 and 4 asymptomatically 5 infects 5 infects 7 host 5 infects 8 during 5 infects 11 and 6 the 7 host 8 during 9 childhood 10 , 11 and 11 and 12 establishes 12 establishes 13 life 14 - 16 latency 15 long 16 latency the infection is life - threatening for infants and immunocompromised individuals , because of direct cytopathicity by viral replication [,] causing systemic organ injuries . 0 ###LEFT-WALL### 2 infection 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 25 . 1 the 2 infection 2 infection 3 is 3 is 4 life 3 is 14 of 3 is 17 by 4 life 9 and 5 - 9 and 6 threatening 7 for 6 threatening 9 and 7 for 8 infants 9 and 11 individuals 9 and 12 , 10 immunocompromised 11 individuals 13 because 14 of 14 of 16 cytopathicity 15 direct 16 cytopathicity 17 by 24 injuries 18 viral 19 replication 19 replication 24 injuries 21 causing 24 injuries 22 systemic 23 organ 23 organ 24 injuries intrauterine infection occasionally causes microcephaly [,] sensorineural hearing loss and mental retardation . 0 ###LEFT-WALL### 2 infection 0 ###LEFT-WALL### 4 causes 0 ###LEFT-WALL### 13 . 1 intrauterine 2 infection 2 infection 4 causes 3 occasionally 4 causes 4 causes 5 microcephaly 4 causes 10 and 7 sensorineural 8 hearing 8 hearing 9 loss 9 loss 10 and 10 and 12 retardation 11 mental 12 retardation hcmv [genome] contains a number of accessory genes . 0 ###LEFT-WALL### 1 hcmv 0 ###LEFT-WALL### 3 contains 0 ###LEFT-WALL### 9 . 1 hcmv 3 contains 3 contains 8 genes 4 a 5 number 5 number 6 of 5 number 8 genes 6 of 8 genes 7 accessory 8 genes most of them are engaged in immune evasion or inhibition of cell death , possibly , resulting in [a] symbiosis between virus and host . 0 ###LEFT-WALL### 3 them 0 ###LEFT-WALL### 5 engaged 0 ###LEFT-WALL### 25 . 1 most 2 of 1 most 3 them 2 of 3 them 3 them 4 are 4 are 5 engaged 5 engaged 6 in 5 engaged 18 in 6 in 9 or 7 immune 8 evasion 8 evasion 9 or 9 or 10 inhibition 9 or 11 of 11 of 13 death 12 cell 13 death 13 death 17 resulting 14 , 15 possibly 15 possibly 16 , 15 possibly 17 resulting 18 in 23 and 20 symbiosis 21 between 20 symbiosis 23 and 21 between 22 virus 23 and 24 host cd34 - positive myeloid progenitor cells are considered as a site of latency . 0 ###LEFT-WALL### 6 cells 0 ###LEFT-WALL### 8 considered 0 ###LEFT-WALL### 14 . 1 cd34 2 - 1 cd34 6 cells 3 positive 5 progenitor 4 myeloid 5 progenitor 5 progenitor 6 cells 6 cells 7 are 7 are 8 considered 8 considered 9 as 9 as 11 site 10 a 11 site 11 site 12 of 12 of 13 latency however , the molecular mechanisms by which hcmv establishes and maintains latency and reactivates remain poorly understood . 0 ###LEFT-WALL### 5 mechanisms 0 ###LEFT-WALL### 17 understood 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 5 mechanisms 3 the 5 mechanisms 4 molecular 5 mechanisms 5 mechanisms 6 by 5 mechanisms 17 understood 6 by 7 which 6 by 8 hcmv 6 by 15 remain 8 hcmv 10 and 8 hcmv 15 remain 9 establishes 10 and 10 and 13 and 11 maintains 12 latency 11 maintains 13 and 13 and 14 reactivates 16 poorly 17 understood recently in japan , the decline of maternal hcmv seropositivity may increase the risk of intrauterine infection . 0 ###LEFT-WALL### 6 decline 0 ###LEFT-WALL### 12 increase 0 ###LEFT-WALL### 18 . 1 recently 6 decline 2 in 3 japan 2 in 4 , 2 in 6 decline 5 the 6 decline 6 decline 7 of 6 decline 11 may 7 of 10 seropositivity 8 maternal 10 seropositivity 9 hcmv 10 seropositivity 11 may 12 increase 12 increase 14 risk 13 the 14 risk 14 risk 15 of 15 of 17 infection 16 intrauterine 17 infection it needs to immediately establish the protection against transplacental hcmv infection , such as a new type of neutralizing antibody or vaccine , which effectively interferes viral entry specific to endothelial and epithelial cells . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 needs 1 it 2 needs 2 needs 3 to 2 needs 5 establish 3 to 5 establish 4 immediately 5 establish 5 establish 7 protection 5 establish 8 against 6 the 7 protection 8 against 11 infection 9 transplacental 11 infection 10 hcmv 11 infection 11 infection 14 as 12 , 14 as 13 such 14 as 14 as 28 entry 14 as 35 . 15 a 18 of 16 new 18 of 17 type 18 of 18 of 20 antibody 18 of 21 or 19 neutralizing 20 antibody 21 or 22 vaccine 21 or 23 , 21 or 24 which 21 or 26 interferes 21 or 27 viral 24 which 26 interferes 25 effectively 26 interferes 27 viral 28 entry 28 entry 29 specific 29 specific 30 to 30 to 34 cells 31 endothelial 32 and 32 and 33 epithelial 32 and 34 cells furthermore , hcmv infection might be considered as the most important factor for driving immune senescence in the elderly . 0 ###LEFT-WALL### 4 infection 0 ###LEFT-WALL### 7 considered 0 ###LEFT-WALL### 20 . 1 furthermore 2 , 1 furthermore 4 infection 3 hcmv 4 infection 4 infection 5 might 5 might 6 be 6 be 7 considered 7 considered 8 as 8 as 12 factor 9 the 12 factor 10 most 11 important 11 important 12 factor 12 factor 13 for 13 for 14 driving 14 driving 16 senescence 14 driving 17 in 15 immune 16 senescence 17 in 19 elderly 18 the 19 elderly introduction : loss of lumbar extensor muscle strength and fatigue resistance may contribute to functional disability . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 introduction 2 : 2 : 3 loss 3 loss 4 of 3 loss 11 resistance 3 loss 13 contribute 4 of 9 and 5 lumbar 6 extensor 6 extensor 8 strength 7 muscle 8 strength 8 strength 9 and 9 and 10 fatigue 11 resistance 12 may 12 may 13 contribute 13 contribute 14 to 14 to 16 disability 15 functional 16 disability methods : two groups of subjects were recruited : young ( n = 26 , 20 - 35 years of age ) and old ( n = 26 , ≥65 years of age ) adults . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 groups 2 : 8 recruited 2 : 9 : 3 two 4 groups 4 groups 5 of 4 groups 7 were 5 of 6 subjects 7 were 8 recruited 9 : 35 adults 9 : 36 . 10 young 13 = 10 young 17 - 10 young 23 and 11 ( 13 = 12 n 13 = 13 = 14 26 13 = 15 , 15 , 17 - 16 20 17 - 17 - 19 years 17 - 22 ) 18 35 19 years 19 years 20 of 20 of 21 age 23 and 24 old 23 and 35 adults 24 old 27 = 25 ( 27 = 26 n 27 = 27 = 28 26 28 26 31 years 29 , 31 years 30 ≥65 31 years 31 years 32 of 31 years 34 ) 32 of 33 age lumbar extensor muscle strength was measured with a load cell , and electromyographic activities were recorded to study muscle fatigue at 60 % of maximum voluntary contraction . 0 ###LEFT-WALL### 4 strength 0 ###LEFT-WALL### 6 measured 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 18 study 0 ###LEFT-WALL### 28 . 1 lumbar 2 extensor 2 extensor 3 muscle 3 muscle 4 strength 4 strength 5 was 5 was 6 measured 6 measured 7 with 7 with 10 cell 8 a 10 cell 9 load 10 cell 11 , 12 and 12 and 14 activities 12 and 16 recorded 13 electromyographic 14 activities 14 activities 15 were 15 were 16 recorded 16 recorded 17 to 17 to 18 study 18 study 20 fatigue 19 muscle 20 fatigue 20 fatigue 21 at 21 at 23 % 22 60 23 % 23 % 24 of 24 of 27 contraction 25 maximum 27 contraction 26 voluntary 27 contraction results : we found that the muscle moments generated by the extensor muscles decreased with age ( p < 0.05 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 found 2 : 22 . 3 we 4 found 4 found 5 that 5 that 8 moments 5 that 9 generated 6 the 8 moments 7 muscle 8 moments 8 moments 9 generated 9 generated 10 by 9 generated 13 muscles 10 by 12 extensor 11 the 12 extensor 13 muscles 14 decreased 13 muscles 19 < 14 decreased 15 with 15 with 16 age 17 ( 19 < 18 p 19 < 19 < 20 0.05 19 < 21 ) aging was associated with a significant increase in the power of the lower frequency band ( 101 - 200 hz ) of the electromyographic signals ( p < 0.05 ) , but the spectral characteristics did not appear to change with sustained contraction ( p > 0.05 ) . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 3 associated 0 ###LEFT-WALL### 32 but 0 ###LEFT-WALL### 49 . 1 aging 2 was 2 was 3 associated 3 associated 4 with 3 associated 8 in 4 with 7 increase 5 a 6 significant 5 a 7 increase 6 significant 7 increase 8 in 10 power 9 the 10 power 10 power 11 of 10 power 18 - 10 power 22 of 11 of 15 band 12 the 15 band 13 lower 15 band 14 frequency 15 band 16 ( 18 - 17 101 18 - 18 - 20 hz 18 - 21 ) 19 200 20 hz 22 of 25 signals 23 the 25 signals 24 electromyographic 25 signals 25 signals 28 < 26 ( 28 < 27 p 28 < 28 < 29 0.05 28 < 30 ) 31 , 32 but 32 but 35 characteristics 32 but 38 appear 33 the 35 characteristics 34 spectral 35 characteristics 35 characteristics 36 did 36 did 37 not 36 did 38 appear 38 appear 39 to 38 appear 40 change 39 to 40 change 40 change 41 with 40 change 46 > 41 with 43 contraction 42 sustained 43 contraction 44 ( 46 > 45 p 46 > 46 > 47 0.05 46 > 48 ) conclusions : the changes in strength and spectral properties of the electromyographic signals of lumbar extensor muscles may be related to age - related alterations in muscle fiber composition and recruitment . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 19 be 2 : 24 related 3 the 4 changes 4 changes 5 in 4 changes 7 and 5 in 6 strength 7 and 9 properties 7 and 18 may 8 spectral 9 properties 9 properties 10 of 10 of 13 signals 11 the 13 signals 12 electromyographic 13 signals 13 signals 14 of 14 of 17 muscles 15 lumbar 17 muscles 16 extensor 17 muscles 18 may 19 be 19 be 20 related 20 related 21 to 21 to 22 age 23 - 24 related 24 related 25 alterations 24 related 26 in 26 in 30 and 27 muscle 29 composition 28 fiber 29 composition 29 composition 30 and 30 and 31 recruitment these changes should be considered [in] clinical [functional] [task] [evaluation] . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 5 considered 0 ###LEFT-WALL### 11 . 1 these 2 changes 2 changes 3 should 3 should 4 be 4 be 5 considered 5 considered 7 clinical none the [objective] of this study was to investigate the relationship between cutaneous vasodilatory function [and] nonlinear complexity of blood flow oscillations ( bfo ) in older people . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 15 function 0 ###LEFT-WALL### 29 . 1 none 2 the 1 none 7 was 1 none 15 function 2 the 4 of 2 the 7 was 4 of 6 study 5 this 6 study 7 was 8 to 8 to 9 investigate 9 investigate 11 relationship 9 investigate 12 between 10 the 11 relationship 12 between 14 vasodilatory 13 cutaneous 14 vasodilatory 15 function 18 complexity 15 function 26 in 17 nonlinear 18 complexity 18 complexity 19 of 18 complexity 24 bfo 19 of 22 oscillations 20 blood 21 flow 21 flow 22 oscillations 23 ( 24 bfo 24 bfo 25 ) 26 in 28 people 27 older 28 people a [non] - painful fast local heating protocol was applied to the sacral skin in 20 older subjects with various vasodilatory functions . 0 ###LEFT-WALL### 1 a 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 23 . 1 a 3 - 3 - 8 protocol 4 painful 5 fast 5 fast 8 protocol 6 local 7 heating 7 heating 8 protocol 8 protocol 9 was 9 was 10 applied 10 applied 11 to 10 applied 15 in 10 applied 19 with 11 to 14 skin 12 the 14 skin 13 sacral 14 skin 15 in 18 subjects 16 20 18 subjects 17 older 18 subjects 19 with 22 functions 20 various 21 vasodilatory 21 vasodilatory 22 functions laser doppler flowmetry was used to measure skin blood oscillations . 0 ###LEFT-WALL### 1 laser 0 ###LEFT-WALL### 11 . 1 laser 2 doppler 2 doppler 3 flowmetry 2 doppler 7 measure 3 flowmetry 4 was 4 was 5 used 5 used 6 to 5 used 7 measure 6 to 7 measure 7 measure 10 oscillations 8 skin 10 oscillations 9 blood 10 oscillations compared with the 65 - 75 years group , the complexity of metabolic bfo in the 75 - 85 years group was significantly lower at the baseline ( p < 0.05 ) and the second peak ( p < 0.001 ) . 0 ###LEFT-WALL### 11 complexity 0 ###LEFT-WALL### 22 was 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 42 . 1 compared 2 with 1 compared 9 , 1 compared 11 complexity 2 with 8 group 3 the 8 group 4 65 5 - 5 - 6 75 5 - 7 years 7 years 8 group 10 the 11 complexity 11 complexity 12 of 11 complexity 15 in 11 complexity 22 was 12 of 14 bfo 13 metabolic 14 bfo 15 in 17 75 16 the 17 75 17 75 20 years 17 75 21 group 18 - 19 85 19 85 20 years 20 years 21 group 22 was 23 significantly 22 was 24 lower 24 lower 25 at 24 lower 30 < 25 at 27 baseline 26 the 27 baseline 28 ( 30 < 29 p 30 < 30 < 31 0.05 30 < 32 ) 33 and 35 second 33 and 36 peak 34 the 35 second 35 second 36 peak 36 peak 39 < 37 ( 39 < 38 p 39 < 39 < 40 0.001 39 < 41 ) compared with baseline bfo , subjects in the 65 - 75 years group had a significant increase in the complexity of metabolic bfo ( p < 0.01 ) in response to local heating ; while subjects in the 75 - 85 years group did not . 0 ###LEFT-WALL### 6 subjects 0 ###LEFT-WALL### 14 had 0 ###LEFT-WALL### 34 ; 0 ###LEFT-WALL### 46 . 1 compared 2 with 1 compared 5 , 1 compared 6 subjects 2 with 3 baseline 2 with 4 bfo 6 subjects 7 in 6 subjects 14 had 7 in 9 65 8 the 9 65 9 65 12 years 9 65 13 group 10 - 11 75 11 75 12 years 12 years 13 group 14 had 17 increase 14 had 30 response 14 had 31 to 15 a 17 increase 16 significant 17 increase 17 increase 18 in 17 increase 26 < 18 in 20 complexity 19 the 20 complexity 20 complexity 21 of 21 of 23 bfo 22 metabolic 23 bfo 24 ( 26 < 25 p 26 < 26 < 27 0.01 26 < 28 ) 29 in 30 response 31 to 33 heating 32 local 33 heating 34 ; 41 85 35 while 36 subjects 35 while 41 85 37 in 39 75 37 in 41 85 38 the 39 75 40 - 41 85 41 85 42 years 41 85 43 group 41 85 44 did 42 years 43 group 44 did 45 not our findings support the use of multifractal analysis to assess aging - related microvascular dysfunction . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 13 related 1 our 2 findings 2 findings 3 support 3 support 5 use 4 the 5 use 5 use 6 of 5 use 11 aging 6 of 8 analysis 7 multifractal 8 analysis 8 analysis 9 to 8 analysis 10 assess 9 to 10 assess 12 - 13 related 13 related 15 dysfunction 13 related 16 . 14 microvascular 15 dysfunction aims/hypothesis : previous danish twin studies have found a highly increased risk of precursors of type 2 diabetes as well as a higher prevalence of type 2 diabetes among twins compared with singletons . 0 ###LEFT-WALL### 1 aims/hypothesis 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 6 studies 2 : 8 found 3 previous 4 danish 4 danish 6 studies 5 twin 6 studies 6 studies 7 have 7 have 8 found 8 found 12 risk 8 found 28 diabetes 9 a 10 highly 9 a 12 risk 10 highly 11 increased 12 risk 13 of 13 of 14 precursors 14 precursors 15 of 14 precursors 21 as 14 precursors 25 of 15 of 18 diabetes 16 type 18 diabetes 17 2 18 diabetes 19 as 20 well 20 well 21 as 21 as 24 prevalence 22 a 24 prevalence 23 higher 24 prevalence 25 of 26 type 26 type 27 2 28 diabetes 29 among 28 diabetes 31 compared 29 among 30 twins 31 compared 32 with 32 with 33 singletons likewise , small - scale studies of danish twins have shown that monozygotic twins have a higher risk of developing precursors of type 2 diabetes compared with dizygotic twins . 0 ###LEFT-WALL### 6 studies 0 ###LEFT-WALL### 11 shown 0 ###LEFT-WALL### 30 . 1 likewise 2 , 1 likewise 6 studies 3 small 4 - 3 small 5 scale 5 scale 6 studies 6 studies 7 of 6 studies 10 have 7 of 9 twins 8 danish 9 twins 10 have 11 shown 11 shown 14 twins 11 shown 15 have 12 that 13 monozygotic 13 monozygotic 14 twins 14 twins 15 have 15 have 18 risk 15 have 27 with 16 a 18 risk 17 higher 18 risk 18 risk 19 of 18 risk 22 of 18 risk 25 diabetes 18 risk 26 compared 19 of 20 developing 20 developing 21 precursors 22 of 23 type 23 type 24 2 25 diabetes 26 compared 27 with 29 twins 28 dizygotic 29 twins in the present register - based study , the 10 year period diabetes prevalence in danish twins is compared with that in a random sample of danish citizens . 0 ###LEFT-WALL### 14 prevalence 0 ###LEFT-WALL### 19 compared 0 ###LEFT-WALL### 29 . 1 in 4 register 1 in 8 , 1 in 14 prevalence 2 the 4 register 3 present 4 register 4 register 7 study 5 - 7 study 6 based 7 study 7 study 8 , 9 the 14 prevalence 10 10 11 year 11 year 14 prevalence 12 period 14 prevalence 13 diabetes 14 prevalence 14 prevalence 15 in 14 prevalence 18 is 15 in 17 twins 16 danish 17 twins 18 is 19 compared 19 compared 20 with 19 compared 22 in 20 with 21 that 22 in 25 sample 23 a 25 sample 24 random 25 sample 25 sample 26 of 26 of 28 citizens 27 danish 28 citizens furthermore , the 10 year period prevalence of diabetes in monozygotic twins is compared with that in dizygotic twins . 0 ###LEFT-WALL### 7 prevalence 0 ###LEFT-WALL### 14 compared 0 ###LEFT-WALL### 20 . 1 furthermore 2 , 1 furthermore 7 prevalence 3 the 7 prevalence 4 10 5 year 5 year 7 prevalence 6 period 7 prevalence 7 prevalence 8 of 7 prevalence 13 is 8 of 9 diabetes 9 diabetes 10 in 10 in 12 twins 11 monozygotic 12 twins 13 is 14 compared 14 compared 15 with 14 compared 17 in 15 with 16 that 17 in 19 twins 18 dizygotic 19 twins methods : the study population [consisted] of twins ( n = 77,885 ) identified in the danish twin registry , and a 5 % random sample ( n = 215,264 ) from the birth cohorts 1910 - 1989 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 5 population 3 the 5 population 4 study 5 population 5 population 7 of 5 population 14 identified 7 of 8 twins 8 twins 11 = 9 ( 11 = 10 n 11 = 11 = 12 77,885 11 = 13 ) 14 identified 15 in 14 identified 29 = 14 identified 32 from 14 identified 37 - 15 in 21 and 16 the 17 danish 17 danish 19 registry 18 twin 19 registry 19 registry 21 and 20 , 21 and 21 and 26 sample 22 a 26 sample 23 5 24 % 24 % 26 sample 25 random 26 sample 27 ( 29 = 28 n 29 = 29 = 30 215,264 29 = 31 ) 32 from 35 cohorts 33 the 35 cohorts 34 birth 35 cohorts 36 1910 37 - 37 - 38 1989 we identified diabetes patients by means of three nationwide danish health registers . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 identified 0 ###LEFT-WALL### 13 . 1 we 2 identified 2 identified 4 patients 2 identified 5 by 3 diabetes 4 patients 5 by 6 means 6 means 7 of 7 of 12 registers 8 three 12 registers 9 nationwide 11 health 10 danish 11 health 11 health 12 registers results : the number of identified diabetes cases among males was 6,677 ( 6.24 % ) for singletons vs 2,271 ( 5.68 % ) for twins ( [difference] = 0.56 % [ 0.29 - 0.83 % ] ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 4 number 2 : 11 was 3 the 4 number 4 number 5 of 4 number 11 was 5 of 8 cases 6 identified 7 diabetes 7 diabetes 8 cases 8 cases 9 among 9 among 10 males 11 was 12 6,677 11 was 17 for 12 6,677 15 % 13 ( 15 % 14 6.24 15 % 15 % 16 ) 17 for 18 singletons 18 singletons 19 vs 18 singletons 25 for 19 vs 20 2,271 20 2,271 23 % 21 ( 23 % 22 5.68 23 % 23 % 24 ) 25 for 26 twins 26 twins 31 % 27 ( 31 % 29 = 30 0.56 30 0.56 31 % 31 % 36 % 31 % 38 ) 32 [ 36 % 33 0.29 34 - 34 - 35 0.83 34 - 36 % 36 % 37 ] the number among females was 6,143 ( 5.67 % ) for singletons [and] 1,722 ( 4.54 % ) for twins ( [difference] = 1.13 % [ 0.88 - 0.38 % ] ) . 0 ###LEFT-WALL### 2 number 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 33 . 1 the 2 number 2 number 3 among 2 number 5 was 3 among 4 females 5 was 6 6,143 5 was 11 for 5 was 19 for 6 6,143 9 % 7 ( 9 % 8 5.67 9 % 9 % 10 ) 11 for 12 singletons 12 singletons 14 1,722 12 singletons 17 % 15 ( 17 % 16 4.54 17 % 17 % 18 ) 19 for 20 twins 20 twins 25 % 21 ( 25 % 23 = 24 1.13 24 1.13 25 % 25 % 30 % 25 % 32 ) 26 [ 30 % 27 0.88 28 - 28 - 29 0.38 28 - 30 % 30 % 31 ] restriction to various birth cohorts , known zygosity and known type 2 diabetes did not alter the overall conclusions . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 16 alter 0 ###LEFT-WALL### 20 . 1 restriction 2 to 1 restriction 6 , 2 to 5 cohorts 3 various 4 birth 4 birth 5 cohorts 6 , 8 zygosity 6 , 9 and 7 known 8 zygosity 9 and 13 diabetes 9 and 14 did 10 known 11 type 11 type 13 diabetes 12 2 13 diabetes 14 did 15 not 14 did 16 alter 16 alter 19 conclusions 17 the 19 conclusions 18 overall 19 conclusions the difference between monozygotic twins ( males , 5.29 % [;] females , 4.40 % ) and dizygotic twins ( males , 5.77 % ; females , 4.63 % [ )(was [non] [-] significant . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 25 ; 0 ###LEFT-WALL### 35 . 1 the 2 difference 2 difference 3 between 2 difference 17 and 3 between 5 twins 4 monozygotic 5 twins 5 twins 7 males 5 twins 12 females 5 twins 15 % 6 ( 7 males 7 males 8 , 8 , 12 females 9 5.29 12 females 10 % 12 females 12 females 13 , 13 , 15 % 14 4.40 15 % 15 % 16 ) 17 and 19 twins 17 and 21 males 17 and 24 % 18 dizygotic 19 twins 20 ( 21 males 21 males 22 , 22 , 24 % 23 5.77 24 % 24 % 25 ; 25 ; 26 females 25 ; 27 , 27 , 29 % 27 , 31 )(was 28 4.63 29 % 29 % 31 )(was 31 )(was 34 significant conclusions/interpretation : danish twins do not have an increased risk of developing diabetes compared with singletons , and the risk of diabetes among monozygotic twins does not differ from that of dizygotic twins . 0 ###LEFT-WALL### 1 conclusions/interpretation 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 4 twins 2 : 7 have 2 : 18 and 3 danish 4 twins 4 twins 5 do 5 do 6 not 5 do 7 have 7 have 10 risk 8 an 10 risk 9 increased 10 risk 10 risk 11 of 10 risk 14 compared 11 of 12 developing 12 developing 13 diabetes 14 compared 15 with 15 with 16 singletons 17 , 18 and 18 and 20 risk 18 and 28 differ 19 the 20 risk 20 risk 21 of 20 risk 26 does 21 of 22 diabetes 22 diabetes 23 among 23 among 25 twins 24 monozygotic 25 twins 26 does 27 not 26 does 28 differ 28 differ 29 from 29 from 30 that 30 that 31 of 31 of 33 twins 32 dizygotic 33 twins shorter survival in the elderly has been associated with deterioration of the immune system and also with functional disability . 0 ###LEFT-WALL### 2 survival 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 20 . 1 shorter 2 survival 2 survival 3 in 2 survival 6 has 3 in 5 elderly 4 the 5 elderly 6 has 7 been 7 been 8 associated 8 associated 15 and 9 with 10 deterioration 9 with 15 and 10 deterioration 11 of 11 of 14 system 12 the 14 system 13 immune 14 system 15 and 16 also 15 and 17 with 17 with 19 disability 18 functional 19 disability to analyze the relationship between functional and immune impairment in older individuals , we studied 100 [elderly] who lived in a nursing home , were age matched , and grouped according to their functional status . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 15 studied 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 36 . 1 to 2 analyze 1 to 13 , 1 to 14 we 2 analyze 4 relationship 3 the 4 relationship 4 relationship 5 between 5 between 7 and 6 functional 7 and 7 and 9 impairment 7 and 13 , 8 immune 9 impairment 9 impairment 10 in 10 in 12 individuals 11 older 12 individuals 14 we 15 studied 15 studied 16 100 16 100 18 who 16 100 19 lived 18 who 19 lived 19 lived 20 in 20 in 23 home 21 a 23 home 22 nursing 23 home 24 , 25 were 25 were 29 and 25 were 32 to 26 age 27 matched 26 age 29 and 28 , 29 and 29 and 31 according 30 grouped 31 according 32 to 35 status 33 their 35 status 34 functional 35 status we characterized cell subpopulations by flow cytometry , quantified trec by rt - pcr , and measured [the] [t] - cell proliferation and activation response ( ifn - [γ] by elispot , cd69 ) against anti - cd3 [and] cmv . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 41 . 1 we 8 , 2 characterized 4 subpopulations 2 characterized 8 , 3 cell 4 subpopulations 4 subpopulations 5 by 5 by 7 cytometry 6 flow 7 cytometry 8 , 9 quantified 9 quantified 10 trec 9 quantified 11 by 9 quantified 35 against 11 by 23 and 12 rt 14 pcr 13 - 14 pcr 14 pcr 16 and 15 , 16 and 16 and 22 proliferation 16 and 23 and 17 measured 20 - 17 measured 21 cell 21 cell 22 proliferation 23 and 25 response 23 and 27 ifn 24 activation 25 response 26 ( 27 ifn 27 ifn 30 by 27 ifn 33 cd69 27 ifn 34 ) 28 - 30 by 30 by 31 elispot 30 by 32 , 32 , 33 cd69 33 cd69 34 ) 35 against 38 cd3 36 anti 37 - 36 anti 38 cd3 38 cd3 40 cmv specific antibody titers against influenza virus [and] cmv were determined by elisa . 0 ###LEFT-WALL### 3 titers 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 13 . 1 specific 2 antibody 2 antibody 3 titers 3 titers 4 against 3 titers 9 were 4 against 6 virus 5 influenza 6 virus 6 virus 8 cmv 9 were 10 determined 10 determined 11 by 11 by 12 elisa individuals with worse functional status had significantly higher levels of nk cells and fewer [b] cells . 0 ###LEFT-WALL### 1 individuals 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 17 . 1 individuals 2 with 1 individuals 6 had 2 with 5 status 3 worse 5 status 4 functional 5 status 6 had 9 levels 7 significantly 8 higher 8 higher 9 levels 9 levels 10 of 10 of 13 and 11 nk 12 cells 12 cells 13 and 13 and 16 cells 14 fewer 16 cells these poorly functioning elders also had a significantly lower proportion of cd4+ [t] cells , increased cd8+ [t] cells , and a decreased cd4/cd8 ratio . 0 ###LEFT-WALL### 4 elders 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 26 . 1 these 4 elders 2 poorly 3 functioning 3 functioning 4 elders 4 elders 6 had 5 also 6 had 6 had 10 proportion 7 a 10 proportion 8 significantly 9 lower 9 lower 10 proportion 10 proportion 11 of 11 of 14 cells 12 cd4+ 14 cells 15 , 21 and 16 increased 19 cells 17 cd8+ 19 cells 19 cells 21 and 20 , 21 and 21 and 25 ratio 22 a 25 ratio 23 decreased 25 ratio 24 cd4/cd8 25 ratio trec levels in cd4+ t cells were significantly lower in individuals with a high disability . 0 ###LEFT-WALL### 1 trec 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 16 . 1 trec 2 levels 2 levels 3 in 2 levels 4 cd4+ 2 levels 12 with 4 cd4+ 5 t 4 cd4+ 6 cells 4 cd4+ 9 lower 6 cells 7 were 7 were 9 lower 8 significantly 9 lower 9 lower 10 in 10 in 11 individuals 12 with 15 disability 13 a 14 high 13 a 15 disability 14 high 15 disability lower trec levels correlated with a lower frequency of naïve [t] - cell subpopulations ( cd45ra+ccr7+ ) and higher percentages of effector cells ( cd45ra - ccr7 - ) . 0 ###LEFT-WALL### 1 lower 0 ###LEFT-WALL### 30 . 1 lower 3 levels 2 trec 3 levels 3 levels 4 correlated 4 correlated 5 with 5 with 20 percentages 6 a 8 frequency 7 lower 8 frequency 8 frequency 9 of 8 frequency 18 and 9 of 14 subpopulations 10 naïve 12 - 10 naïve 13 cell 13 cell 14 subpopulations 14 subpopulations 16 cd45ra+ccr7+ 15 ( 16 cd45ra+ccr7+ 16 cd45ra+ccr7+ 17 ) 18 and 19 higher 18 and 20 percentages 20 percentages 21 of 21 of 23 cells 22 effector 23 cells 23 cells 25 cd45ra 24 ( 25 cd45ra 25 cd45ra 27 ccr7 25 cd45ra 29 ) 26 - 27 ccr7 27 ccr7 28 - the functionally impaired group had lower anti - cd3 responses , but gradually increased responses against cmv . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 18 . 1 the 4 group 2 functionally 3 impaired 3 impaired 4 group 4 group 5 had 5 had 12 but 5 had 16 against 6 lower 10 responses 7 anti 8 - 7 anti 10 responses 9 cd3 10 responses 10 responses 12 but 11 , 12 but 12 but 13 gradually 12 but 15 responses 14 increased 15 responses 16 against 17 cmv similarly , the higher [cmv] titers were found [in] elderly with worse functional status . 0 ###LEFT-WALL### 6 titers 0 ###LEFT-WALL### 8 found 0 ###LEFT-WALL### 15 . 1 similarly 2 , 1 similarly 6 titers 3 the 6 titers 4 higher 6 titers 6 titers 7 were 7 were 8 found 8 found 10 elderly 10 elderly 11 with 11 with 14 status 12 worse 14 status 13 functional 14 status on the contrary , [the] functional response in vivo , [and] the titer of antibodies generated after vaccination against influenza virus , was higher in individuals with better performance status . 0 ###LEFT-WALL### 13 titer 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 31 . 1 on 7 response 1 on 13 titer 2 the 7 response 3 contrary 4 , 3 contrary 7 response 6 functional 7 response 8 in 9 vivo 9 vivo 10 , 9 vivo 13 titer 12 the 13 titer 13 titer 14 of 13 titer 22 , 14 of 15 antibodies 16 generated 17 after 16 generated 19 against 16 generated 21 virus 16 generated 22 , 17 after 18 vaccination 19 against 20 influenza 22 , 23 was 23 was 24 higher 24 higher 25 in 24 higher 27 with 25 in 26 individuals 27 with 30 status 28 better 29 performance 29 performance 30 status in summary , we concluded that the functional decline of elderly individuals was clearly associated with the aging of their immune system , and the intensity of the response to cmv . 0 ###LEFT-WALL### 2 summary 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 32 . 1 in 2 summary 3 , 4 we 3 , 5 concluded 4 we 5 concluded 5 concluded 6 that 6 that 9 decline 6 that 15 associated 7 the 9 decline 8 functional 9 decline 9 decline 10 of 9 decline 13 was 10 of 12 individuals 11 elderly 12 individuals 13 was 15 associated 14 clearly 15 associated 15 associated 16 with 15 associated 30 to 16 with 18 aging 17 the 18 aging 18 aging 19 of 19 of 24 and 20 their 22 system 21 immune 22 system 22 system 24 and 23 , 24 and 24 and 26 intensity 24 and 27 of 25 the 26 intensity 27 of 29 response 28 the 29 response 30 to 31 cmv inappropriate interleukin - 6 production is thought to play a role in the development of several age - related conditions including atherosclerosis . 0 ###LEFT-WALL### 2 interleukin 0 ###LEFT-WALL### 19 related 0 ###LEFT-WALL### 23 . 1 inappropriate 2 interleukin 2 interleukin 19 related 3 - 7 thought 4 6 5 production 4 6 6 is 4 6 7 thought 5 production 6 is 7 thought 8 to 7 thought 12 in 7 thought 18 - 7 thought 19 related 8 to 9 play 9 play 11 role 10 a 11 role 12 in 14 development 13 the 14 development 14 development 15 of 15 of 17 age 16 several 17 age 19 related 20 conditions 20 conditions 21 including 21 including 22 atherosclerosis this study aimed to determine whether aging affects circulating interleukin - 6 ( il - 6 ) levels . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 aimed 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 19 . 1 this 2 study 2 study 3 aimed 3 aimed 4 to 4 to 5 determine 5 determine 6 whether 6 whether 7 aging 6 whether 8 affects 7 aging 8 affects 8 affects 10 interleukin 9 circulating 10 interleukin 11 - 14 il 11 - 18 levels 12 6 14 il 13 ( 14 il 14 il 15 - 14 il 16 6 14 il 18 levels 15 - 16 6 16 6 17 ) cytokine levels in serum and those produced from peripheral blood mononuclear [cell] ( pbmc ) were measured . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 16 were 0 ###LEFT-WALL### 18 . 1 cytokine 2 levels 2 levels 3 in 2 levels 7 produced 2 levels 14 pbmc 2 levels 16 were 3 in 5 and 4 serum 5 and 5 and 6 those 7 produced 8 from 7 produced 11 mononuclear 8 from 10 blood 9 peripheral 10 blood 13 ( 14 pbmc 14 pbmc 15 ) 16 were 17 measured the oldest group had the highest circulating levels of il - 6 [and] oxidized low - density lipoprotein ( ox - ldl ) and higher pbmc production of il - 6 , tumor necrosis factor - α ( tnf - α ) , and interleukin - 1 alpha ( il - 1β ) . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 11 - 1 the 2 oldest 1 the 3 group 3 group 4 had 4 had 8 levels 5 the 6 highest 5 the 8 levels 7 circulating 8 levels 8 levels 9 of 9 of 10 il 11 - 12 6 11 - 16 - 12 6 14 oxidized 14 oxidized 15 low 16 - 18 lipoprotein 16 - 24 and 17 density 18 lipoprotein 18 lipoprotein 20 ox 18 lipoprotein 22 ldl 19 ( 20 ox 20 ox 21 - 21 - 22 ldl 22 ldl 23 ) 24 and 32 , 24 and 34 necrosis 25 higher 27 production 26 pbmc 27 production 27 production 28 of 27 production 31 6 28 of 29 il 30 - 31 6 31 6 32 , 33 tumor 34 necrosis 34 necrosis 35 factor 35 factor 36 - 35 factor 37 α 35 factor 46 - 38 ( 46 - 39 tnf 41 α 39 tnf 44 and 40 - 41 α 41 α 42 ) 43 , 44 and 44 and 45 interleukin 44 and 46 - 46 - 48 alpha 46 - 54 . 47 1 48 alpha 48 alpha 50 il 49 ( 50 il 50 il 52 1β 50 il 53 ) 51 - 52 1β 52 1β 53 ) additionally , significant interactions between age and menopause were found for serum il - 6 ( p = 0.024 ) , and tnf - α ( p = 0.011 ) and il - 1β ( p < 0.001 ) produced from pbmcs . 0 ###LEFT-WALL### 4 interactions 0 ###LEFT-WALL### 10 found 0 ###LEFT-WALL### 43 . 1 additionally 2 , 1 additionally 4 interactions 3 significant 4 interactions 4 interactions 5 between 4 interactions 9 were 5 between 7 and 6 age 7 and 7 and 8 menopause 9 were 10 found 10 found 11 for 10 found 31 and 10 found 41 from 11 for 12 serum 13 il 15 6 13 il 22 and 14 - 15 6 15 6 18 = 15 6 21 , 16 ( 18 = 17 p 18 = 18 = 19 0.024 18 = 20 ) 22 and 23 tnf 22 and 25 α 22 and 31 and 24 - 25 α 25 α 28 = 25 α 30 ) 26 ( 28 = 27 p 28 = 28 = 29 0.011 31 and 32 il 31 and 40 produced 32 il 34 1β 33 - 34 1β 34 1β 37 < 34 1β 39 ) 35 ( 37 < 36 p 37 < 37 < 38 0.001 41 from 42 pbmcs sub - analysis was performed according to menopausal status . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 5 performed 0 ###LEFT-WALL### 10 . 1 sub 2 - 1 sub 3 analysis 3 analysis 4 was 4 was 5 performed 5 performed 7 to 6 according 7 to 7 to 9 status 8 menopausal 9 status serum il - 6 levels were positively associated with levels of il - 6 , tnf - α , and il - 1β in pbmc supernatants [(] unstimulated ) from postmenopausal women , whereas these were negatively associated in premenopausal women . 0 ###LEFT-WALL### 2 il 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 42 . 1 serum 2 il 3 - 5 levels 3 - 8 associated 4 6 5 levels 5 levels 6 were 6 were 7 positively 6 were 8 associated 8 associated 9 with 8 associated 34 whereas 9 with 10 levels 10 levels 11 of 10 levels 20 and 11 of 12 il 12 il 14 6 13 - 14 6 14 6 15 , 15 , 20 and 16 tnf 18 α 16 tnf 20 and 17 - 18 α 18 α 19 , 19 , 20 and 20 and 21 il 20 and 30 from 20 and 33 , 21 il 23 1β 22 - 23 1β 23 1β 24 in 23 1β 26 supernatants 23 1β 28 unstimulated 23 1β 29 ) 24 in 25 pbmc 26 supernatants 28 unstimulated 30 from 32 women 31 postmenopausal 32 women 34 whereas 35 these 34 whereas 38 associated 35 these 36 were 36 were 37 negatively 36 were 38 associated 38 associated 39 in 39 in 41 women 40 premenopausal 41 women in conclusion , circulating il - 6 levels may be interactively influenced by age and menopause . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 17 . 1 in 2 conclusion 3 , 8 levels 3 , 12 influenced 4 circulating 5 il 4 circulating 6 - 4 circulating 8 levels 7 6 8 levels 8 levels 9 may 9 may 10 be 10 be 11 interactively 10 be 12 influenced 12 influenced 13 by 13 by 15 and 14 age 15 and 15 and 16 menopause additionally , estrogen deprivation [after] [menopause] may enhance pbmc cytokine production in postmenopausal women , resulting in increased il - 6 levels which are closely related to oxidative stress . 0 ###LEFT-WALL### 4 deprivation 0 ###LEFT-WALL### 8 enhance 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 30 . 1 additionally 2 , 1 additionally 4 deprivation 3 estrogen 4 deprivation 4 deprivation 7 may 7 may 8 enhance 8 enhance 11 production 9 pbmc 11 production 10 cytokine 11 production 11 production 12 in 12 in 14 women 13 postmenopausal 14 women 14 women 16 resulting 15 , 16 resulting 16 resulting 17 in 16 resulting 20 - 17 in 19 il 18 increased 19 il 20 - 22 levels 21 6 22 levels 22 levels 23 which 22 levels 24 are 23 which 24 are 24 are 26 related 25 closely 26 related 26 related 27 to 27 to 29 stress 28 oxidative 29 stress the plasma membrane redox system ( pmrs [ )(of nicotinamide adenine dinucleotide ( nadh ) - related enzymes plays a key role in the maintenance of cellular energetics . 0 ###LEFT-WALL### 5 system 0 ###LEFT-WALL### 19 plays 0 ###LEFT-WALL### 29 . 1 the 5 system 2 plasma 5 system 3 membrane 5 system 4 redox 5 system 5 system 7 pmrs 5 system 19 plays 6 ( 7 pmrs 7 pmrs 9 )(of 7 pmrs 16 - 9 )(of 12 dinucleotide 10 nicotinamide 12 dinucleotide 11 adenine 12 dinucleotide 12 dinucleotide 14 nadh 13 ( 14 nadh 14 nadh 15 ) 16 - 17 related 17 related 18 enzymes 17 related 19 plays 19 plays 22 role 19 plays 23 in 20 a 22 role 21 key 22 role 23 in 25 maintenance 24 the 25 maintenance 25 maintenance 26 of 26 of 28 energetics 27 cellular 28 energetics during the aging process , neural cells are particularly sensitive to impaired energy metabolism and oxidative damage , but the involvement of the pmrs in these processes is unknown . 0 ###LEFT-WALL### 7 cells 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 30 . 1 during 4 process 1 during 5 , 1 during 7 cells 2 the 4 process 3 aging 4 process 6 neural 7 cells 7 cells 8 are 8 are 9 particularly 8 are 10 sensitive 10 sensitive 11 to 11 to 15 and 12 impaired 13 energy 13 energy 14 metabolism 14 metabolism 15 and 15 and 17 damage 16 oxidative 17 damage 18 , 19 but 19 but 21 involvement 19 but 28 is 20 the 21 involvement 21 involvement 22 of 21 involvement 28 is 22 of 24 pmrs 23 the 24 pmrs 24 pmrs 25 in 25 in 27 processes 26 these 27 processes 28 is 29 unknown here , we used human neuroblastoma cells with either elevated or reduced levels of the pmrs enzyme nadh - quinone oxidoreductase 1 ( nqo1 ) to investigate [how] the pmrs [regulates] neuronal stress responses . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 35 . 1 here 2 , 1 here 3 we 3 we 4 used 4 used 7 cells 5 human 6 neuroblastoma 6 neuroblastoma 7 cells 7 cells 8 with 8 with 11 or 9 either 10 elevated 10 elevated 11 or 11 or 12 reduced 12 reduced 13 levels 12 reduced 26 to 13 levels 14 of 14 of 18 nadh 15 the 18 nadh 16 pmrs 17 enzyme 17 enzyme 18 nadh 18 nadh 21 oxidoreductase 19 - 21 oxidoreductase 20 quinone 21 oxidoreductase 21 oxidoreductase 22 1 21 oxidoreductase 24 nqo1 21 oxidoreductase 25 ) 23 ( 24 nqo1 24 nqo1 25 ) 26 to 27 investigate 27 investigate 34 responses 29 the 34 responses 30 pmrs 33 stress 32 neuronal 33 stress 33 stress 34 responses cells with elevated nqo1 levels were more resistant to death induced by 2 - deoxyglucose , potassium cyanide ( energetic stress ) , and lactacystin ( proteotoxic stress ) , [but] were not protected from being killed by h ( 2 [ ] ( 2 ) [and] serum withdrawal . 0 ###LEFT-WALL### 1 cells 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 49 withdrawal 1 cells 2 with 1 cells 30 , 2 with 5 levels 3 elevated 5 levels 4 nqo1 5 levels 6 were 8 resistant 6 were 30 , 7 more 8 resistant 8 resistant 9 to 9 to 24 and 10 death 11 induced 10 death 24 and 11 induced 12 by 12 by 13 2 13 2 15 deoxyglucose 14 - 15 deoxyglucose 15 deoxyglucose 18 cyanide 15 deoxyglucose 22 ) 16 , 18 cyanide 17 potassium 18 cyanide 18 cyanide 21 stress 18 cyanide 22 ) 19 ( 21 stress 20 energetic 21 stress 21 stress 22 ) 23 , 24 and 24 and 25 lactacystin 24 and 28 stress 26 ( 28 stress 27 proteotoxic 28 stress 28 stress 29 ) 30 , 32 were 30 , 35 from 30 , 48 serum 32 were 33 not 32 were 34 protected 33 not 34 protected 35 from 36 being 36 being 37 killed 36 being 41 2 37 killed 38 by 38 by 39 h 40 ( 41 2 41 2 44 ( 41 2 45 2 43 ] 44 ( 44 ( 45 2 47 [and] 48 serum the nad ( [+] [ )( an oxidized form of nadh )/nadh [ratio] was maintained at a significantly higher level in cells overexpressing nqo1 , consistent with enhanced levels of nqo1 activity . 0 ###LEFT-WALL### 2 nad 0 ###LEFT-WALL### 15 maintained 1 the 2 nad 3 ( 15 maintained 7 an 9 form 8 oxidized 9 form 9 form 10 of 9 form 12 )/nadh 9 form 14 was 9 form 15 maintained 10 of 11 nadh 12 )/nadh 14 was 15 maintained 16 at 15 maintained 21 in 15 maintained 33 . 16 at 20 level 17 a 20 level 18 significantly 19 higher 19 higher 20 level 21 in 22 cells 22 cells 23 overexpressing 23 overexpressing 24 nqo1 24 nqo1 26 consistent 25 , 26 consistent 26 consistent 27 with 26 consistent 33 . 27 with 29 levels 28 enhanced 29 levels 29 levels 30 of 30 of 32 activity 31 nqo1 32 activity cells in which nqo1 levels were decreased by rna interference exhibited increased vulnerability to death induced by 2 - deoxyglucose and lactacystin . 0 ###LEFT-WALL### 1 cells 0 ###LEFT-WALL### 7 decreased 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 23 . 1 cells 2 in 1 cells 6 were 2 in 3 which 2 in 4 nqo1 2 in 5 levels 4 nqo1 5 levels 6 were 7 decreased 7 decreased 8 by 7 decreased 14 to 8 by 13 vulnerability 9 rna 11 exhibited 10 interference 11 exhibited 11 exhibited 13 vulnerability 12 increased 13 vulnerability 14 to 15 death 15 death 16 induced 16 induced 17 by 17 by 18 2 19 - 21 and 20 deoxyglucose 21 and 21 and 22 lactacystin thus , a higher nad [(] [+] )/nadh ratio and activation of adaptive stress response pathways are enhanced by the pmrs in neuroblastoma cells , enabling them to maintain redox homeostasis under conditions of energetic and proteotoxic stress . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 18 enhanced 1 thus 2 , 1 thus 10 and 3 a 9 ratio 4 higher 8 )/nadh 5 nad 8 )/nadh 8 )/nadh 9 ratio 9 ratio 10 and 10 and 11 activation 10 and 12 of 10 and 17 are 12 of 16 pathways 13 adaptive 14 stress 14 stress 15 response 15 response 16 pathways 17 are 18 enhanced 18 enhanced 19 by 19 by 21 pmrs 20 the 21 pmrs 21 pmrs 22 in 22 in 24 cells 23 neuroblastoma 24 cells 24 cells 26 enabling 25 , 26 enabling 26 enabling 27 them 26 enabling 28 to 26 enabling 39 . 28 to 29 maintain 29 maintain 31 homeostasis 29 maintain 32 under 30 redox 31 homeostasis 32 under 33 conditions 33 conditions 34 of 34 of 38 stress 35 energetic 36 and 36 and 37 proteotoxic 36 and 38 stress these findings have implications for the development of therapeutic interventions for neural tumors and neurodegenerative conditions . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 17 . 1 these 2 findings 2 findings 3 have 3 have 4 implications 4 implications 5 for 5 for 7 development 6 the 7 development 7 development 8 of 8 of 10 interventions 9 therapeutic 10 interventions 10 interventions 11 for 11 for 14 and 12 neural 13 tumors 13 tumors 14 and 14 and 16 conditions 15 neurodegenerative 16 conditions the development of palliative care in china is vital to the care of its aging population and associated increase in cancer incidence . 0 ###LEFT-WALL### 2 development 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 23 . 1 the 2 development 2 development 3 of 2 development 8 is 3 of 5 care 4 palliative 5 care 5 care 6 in 6 in 7 china 8 is 9 vital 9 vital 10 to 10 to 12 care 11 the 12 care 12 care 13 of 13 of 22 incidence 14 its 22 incidence 15 aging 16 population 16 population 17 and 17 and 19 increase 17 and 20 in 17 and 22 incidence 18 associated 19 increase 20 in 21 cancer there are physician - related [and] population - related barriers which impede palliative care development . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 16 . 1 there 2 are 2 are 10 barriers 3 physician 10 barriers 4 - 5 related 5 related 7 population 5 related 8 - 5 related 9 related 9 related 10 barriers 10 barriers 11 which 10 barriers 12 impede 11 which 12 impede 12 impede 15 development 13 palliative 15 development 14 care 15 development the first institute for hospice care was established in tianjin . 0 ###LEFT-WALL### 3 institute 0 ###LEFT-WALL### 8 established 0 ###LEFT-WALL### 11 . 1 the 3 institute 2 first 3 institute 3 institute 4 for 3 institute 7 was 4 for 6 care 5 hospice 6 care 7 was 8 established 8 established 9 in 9 in 10 tianjin community hospices ( ning yang [yuan] ) have been established by the li ka shing foundation . 0 ###LEFT-WALL### 2 hospices 0 ###LEFT-WALL### 10 established 0 ###LEFT-WALL### 17 . 1 community 2 hospices 2 hospices 5 yang 2 hospices 8 have 3 ( 5 yang 4 ning 5 yang 5 yang 7 ) 8 have 9 been 9 been 10 established 10 established 11 by 11 by 16 foundation 12 the 16 foundation 13 li 14 ka 14 ka 15 shing 15 shing 16 foundation academic centers such as the one in chengdu associated with [sichuan] university have partnered with the world health organization to establish centers of excellence to both develop and teach palliative care to physicians in training and practice . 0 ###LEFT-WALL### 2 centers 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 38 . 1 academic 2 centers 2 centers 4 as 2 centers 13 have 3 such 4 as 4 as 6 one 5 the 6 one 6 one 7 in 6 one 9 associated 7 in 8 chengdu 9 associated 10 with 10 with 12 university 13 have 14 partnered 14 partnered 15 with 14 partnered 19 organization 14 partnered 20 to 15 with 17 world 16 the 17 world 18 health 19 organization 20 to 21 establish 21 establish 22 centers 21 establish 25 to 22 centers 23 of 23 of 24 excellence 25 to 28 and 26 both 27 develop 27 develop 28 and 28 and 29 teach 28 and 32 to 29 teach 31 care 30 palliative 31 care 32 to 33 physicians 33 physicians 34 in 34 in 36 and 35 training 36 and 36 and 37 practice the national hospice service program has developed five principles to the practice of palliative care in china . 0 ###LEFT-WALL### 5 program 0 ###LEFT-WALL### 7 developed 0 ###LEFT-WALL### 18 . 1 the 5 program 2 national 3 hospice 3 hospice 4 service 4 service 5 program 5 program 6 has 6 has 7 developed 7 developed 9 principles 7 developed 10 to 7 developed 16 in 8 five 9 principles 10 to 12 practice 11 the 12 practice 12 practice 13 of 13 of 15 care 14 palliative 15 care 16 in 17 china objectives : the purposes of this study were 1 [ )(to determine compliance with a pedometer and mobile phone - based physical activity diary , [and] 2 ) to assess concordance between self - reported daily steps recorded and transmitted by a mobile phone and pedometer - measured daily steps in sedentary women . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 were 2 : 4 purposes 3 the 4 purposes 4 purposes 5 of 4 purposes 8 were 5 of 7 study 6 this 7 study 8 were 9 1 8 were 11 )(to 11 )(to 12 determine 12 determine 17 and 12 determine 21 based 13 compliance 14 with 13 compliance 17 and 14 with 16 pedometer 15 a 16 pedometer 17 and 19 phone 17 and 20 - 17 and 21 based 18 mobile 19 phone 21 based 24 diary 21 based 29 to 22 physical 24 diary 23 activity 24 diary 24 diary 27 2 25 , 27 2 27 2 28 ) 29 to 30 assess 30 assess 31 concordance 30 assess 32 between 30 assess 41 by 32 between 33 self 33 self 39 and 34 - 35 reported 35 reported 37 steps 35 reported 38 recorded 36 daily 37 steps 38 recorded 39 and 39 and 40 transmitted 41 by 45 and 42 a 44 phone 43 mobile 44 phone 44 phone 45 and 45 and 46 pedometer 45 and 47 - 45 and 50 steps 47 - 50 steps 48 measured 49 daily 49 daily 50 steps 50 steps 51 in 50 steps 54 . 51 in 53 women 52 sedentary 53 women methods : in this 3 [-] week pilot clinical study , 41 sedentary women who met all inclusion criteria were recruited from local communities . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 14 women 2 : 21 recruited 2 : 25 . 3 in 10 study 3 in 11 , 3 in 14 women 4 this 10 study 5 3 7 week 7 week 10 study 8 pilot 10 study 9 clinical 10 study 12 41 14 women 13 sedentary 14 women 14 women 15 who 14 women 16 met 14 women 20 were 15 who 16 met 16 met 19 criteria 17 all 19 criteria 18 inclusion 19 criteria 20 were 21 recruited 21 recruited 22 from 22 from 24 communities 23 local 24 communities we asked the participants to wear a pedometer every day and to report their daily steps using a mobile phone diary each night before retiring . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 26 . 1 we 11 and 2 asked 4 participants 2 asked 5 to 2 asked 6 wear 2 asked 11 and 3 the 4 participants 5 to 6 wear 6 wear 8 pedometer 6 wear 10 day 7 a 8 pedometer 9 every 10 day 11 and 12 to 11 and 13 report 11 and 24 before 12 to 13 report 13 report 16 steps 13 report 17 using 14 their 16 steps 15 daily 16 steps 17 using 21 diary 18 a 19 mobile 18 a 21 diary 19 mobile 21 diary 20 phone 21 diary 21 diary 23 night 22 each 23 night 24 before 25 retiring in the first week , women were asked to monitor their daily steps ( baseline steps ) . 0 ###LEFT-WALL### 6 women 0 ###LEFT-WALL### 8 asked 0 ###LEFT-WALL### 18 . 1 in 4 week 1 in 5 , 1 in 6 women 2 the 3 first 2 the 4 week 6 women 7 were 7 were 8 asked 8 asked 9 to 8 asked 10 monitor 9 to 10 monitor 10 monitor 13 steps 11 their 13 steps 12 daily 13 steps 13 steps 16 steps 14 ( 16 steps 15 baseline 16 steps 16 steps 17 ) in the second and third weeks , they were asked to increase their steps by 20 % from the previous week . 0 ###LEFT-WALL### 8 they 0 ###LEFT-WALL### 10 asked 0 ###LEFT-WALL### 22 . 1 in 4 and 1 in 7 , 1 in 8 they 2 the 3 second 3 second 4 and 4 and 6 weeks 5 third 6 weeks 8 they 9 were 9 were 10 asked 10 asked 11 to 10 asked 12 increase 11 to 12 increase 12 increase 14 steps 13 their 14 steps 14 steps 15 by 15 by 17 % 16 20 17 % 17 % 18 from 18 from 21 week 19 the 21 week 20 previous 21 week although the pedometer can automatically store the most recent 41 days ' performance , the participants were not informed of this function of the pedometer . 0 ###LEFT-WALL### 16 participants 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 26 . 1 although 3 pedometer 1 although 6 store 1 although 14 , 1 although 16 participants 2 the 3 pedometer 3 pedometer 4 can 4 can 6 store 5 automatically 6 store 6 store 13 performance 7 the 8 most 8 most 11 days 9 recent 11 days 10 41 11 days 11 days 12 ' 12 ' 13 performance 15 the 16 participants 16 participants 17 were 17 were 18 not 17 were 20 of 18 not 19 informed 20 of 22 function 21 this 22 function 22 function 23 of 23 of 25 pedometer 24 the 25 pedometer results : overall compliance was 93.8 % with pedometer use and 88.3 % with the mobile phone physical activity [diary] . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 compliance 2 : 5 was 2 : 11 and 2 : 21 . 3 overall 4 compliance 4 compliance 5 was 5 was 7 % 6 93.8 7 % 7 % 8 with 8 with 10 use 9 pedometer 10 use 11 and 13 % 11 and 17 phone 12 88.3 13 % 13 % 14 with 13 % 17 phone 14 with 16 mobile 15 the 16 mobile 17 phone 19 activity 18 physical 19 activity bland altman plots showed that the agreement between self - reported daily steps by mobile [phone] [diary] and pedometer - recorded daily steps from [week] 1 to [week] 3 was high . 0 ###LEFT-WALL### 3 plots 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 32 . 1 bland 2 altman 2 altman 3 plots 3 plots 4 showed 4 showed 5 that 5 that 7 agreement 5 that 30 was 6 the 7 agreement 7 agreement 8 between 7 agreement 30 was 8 between 23 steps 9 self 23 steps 10 - 11 reported 11 reported 13 steps 11 reported 14 by 11 reported 20 - 11 reported 21 recorded 12 daily 13 steps 14 by 18 and 15 mobile 18 and 18 and 19 pedometer 21 recorded 23 steps 22 daily 23 steps 23 steps 27 to 24 from 27 to 26 1 27 to 27 to 29 3 30 was 31 high conclusion : the combination of a pedometer and a mobile phone diary may enhance the quality [of] self - reported data in clinical studies . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 8 and 2 : 14 enhance 2 : 20 reported 2 : 25 . 3 the 4 combination 4 combination 5 of 4 combination 8 and 5 of 7 pedometer 6 a 7 pedometer 8 and 12 diary 8 and 13 may 9 a 10 mobile 9 a 12 diary 10 mobile 11 phone 11 phone 12 diary 13 may 14 enhance 14 enhance 18 self 15 the 18 self 16 quality 18 self 19 - 20 reported 20 reported 21 data 20 reported 22 in 22 in 24 studies 23 clinical 24 studies late - onset male hypogonadism ( loh ) is a clinical and biochemical syndrome associated with advancing age and characterised by low serum testosterone concentrations . 0 ###LEFT-WALL### 1 late 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 26 . 1 late 5 hypogonadism 1 late 19 and 2 - 5 hypogonadism 3 onset 4 male 4 male 5 hypogonadism 5 hypogonadism 7 loh 5 hypogonadism 8 ) 6 ( 7 loh 7 loh 8 ) 9 is 14 syndrome 9 is 19 and 10 a 14 syndrome 11 clinical 12 and 12 and 13 biochemical 12 and 14 syndrome 14 syndrome 15 associated 14 syndrome 16 with 16 with 18 age 17 advancing 18 age 19 and 20 characterised 19 and 21 by 19 and 25 concentrations 21 by 23 serum 22 low 23 serum 24 testosterone 25 concentrations an understanding of the physiology of androgens in the ageing man is essential for the appropriate diagnosis of loh . 0 ###LEFT-WALL### 2 understanding 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 20 . 1 an 2 understanding 2 understanding 3 of 2 understanding 12 is 3 of 5 physiology 4 the 5 physiology 5 physiology 6 of 5 physiology 8 in 6 of 7 androgens 8 in 11 man 9 the 11 man 10 ageing 11 man 12 is 13 essential 13 essential 14 for 14 for 17 diagnosis 15 the 17 diagnosis 16 appropriate 17 diagnosis 17 diagnosis 18 of 18 of 19 loh clinical assessment of androgen status relevant to clinical biochemists and chemical pathologists is outlined in this review . 0 ###LEFT-WALL### 2 assessment 0 ###LEFT-WALL### 14 outlined 0 ###LEFT-WALL### 18 . 1 clinical 2 assessment 2 assessment 3 of 2 assessment 13 is 3 of 5 status 4 androgen 5 status 5 status 6 relevant 6 relevant 7 to 7 to 10 and 8 clinical 9 biochemists 9 biochemists 10 and 10 and 12 pathologists 11 chemical 12 pathologists 13 is 14 outlined 14 outlined 15 in 15 in 17 review 16 this 17 review laboratory investigations of androgen status in men are not without pitfalls and the authors highlight problems associated with measuring and calculating serum testosterone and its fractions , the interpretation of which can be problematic . 0 ###LEFT-WALL### 2 investigations 0 ###LEFT-WALL### 17 associated 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 35 . 1 laboratory 2 investigations 2 investigations 3 of 2 investigations 6 in 2 investigations 8 are 3 of 5 status 4 androgen 5 status 6 in 7 men 8 are 9 not 8 are 10 without 8 are 17 associated 10 without 12 and 11 pitfalls 12 and 12 and 16 problems 13 the 16 problems 14 authors 16 problems 15 highlight 16 problems 17 associated 18 with 18 with 24 and 19 measuring 20 and 20 and 21 calculating 20 and 23 testosterone 22 serum 23 testosterone 23 testosterone 24 and 24 and 26 fractions 25 its 26 fractions 27 , 29 interpretation 27 , 33 be 28 the 29 interpretation 29 interpretation 30 of 29 interpretation 32 can 30 of 31 which 32 can 33 be 33 be 34 problematic current clinical guidelines and recommendations regarding the diagnosis and monitoring of loh are also summarised . 0 ###LEFT-WALL### 3 guidelines 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 16 . 1 current 3 guidelines 2 clinical 3 guidelines 4 and 9 and 4 and 15 summarised 5 recommendations 6 regarding 5 recommendations 9 and 6 regarding 8 diagnosis 7 the 8 diagnosis 9 and 10 monitoring 9 and 13 are 10 monitoring 11 of 11 of 12 loh 13 are 15 summarised 14 also 15 summarised none hypoglossal motoneurons ( hms ) innervate tongue muscles [and] are critical in maintaining patency of the upper airway during respiration . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 22 . 1 none 3 motoneurons 1 none 7 innervate 1 none 11 are 2 hypoglossal 3 motoneurons 3 motoneurons 5 hms 3 motoneurons 7 innervate 4 ( 5 hms 5 hms 6 ) 7 innervate 9 muscles 8 tongue 9 muscles 11 are 12 critical 12 critical 13 in 13 in 14 maintaining 14 maintaining 15 patency 14 maintaining 20 during 15 patency 16 of 16 of 19 airway 17 the 19 airway 18 upper 19 airway 20 during 21 respiration abnormalities in hms have been implicated in sudden infant death syndrome [(] sids [ )(and obstructive sleep apnoea . 0 ###LEFT-WALL### 1 abnormalities 0 ###LEFT-WALL### 6 implicated 0 ###LEFT-WALL### 19 . 1 abnormalities 2 in 1 abnormalities 4 have 2 in 3 hms 4 have 5 been 5 been 6 implicated 6 implicated 7 in 6 implicated 18 apnoea 7 in 15 )(and 8 sudden 13 sids 9 infant 13 sids 10 death 13 sids 11 syndrome 13 sids 13 sids 15 )(and 15 )(and 17 sleep 16 obstructive 17 sleep previously , we found a critical period in respiratory network development in rats around postnatal day ( p ) 12 - 13 , when abrupt neurochemical , metabolic and physiological changes occurred . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 1 previously 2 , 1 previously 3 we 3 we 4 found 4 found 7 period 4 found 12 in 4 found 14 around 4 found 21 - 4 found 24 when 5 a 7 period 6 critical 7 period 7 period 8 in 8 in 11 development 9 respiratory 10 network 10 network 11 development 12 in 13 rats 14 around 16 day 15 postnatal 16 day 16 day 18 p 17 ( 18 p 18 p 19 ) 20 12 21 - 21 - 22 13 23 , 24 when 24 when 31 changes 24 when 32 occurred 24 when 33 . 25 abrupt 31 changes 26 neurochemical 27 , 26 neurochemical 31 changes 28 metabolic 29 and 29 and 30 physiological 29 and 31 changes 31 changes 32 occurred to test our hypothesis that an imbalance between inhibitory and excitatory synaptic transmission exists during the critical period , whole - cell patch - clamp recordings of hms were done in brainstem slices of rats daily from p0 to p16 . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 19 , 1 to 2 test 2 test 4 hypothesis 2 test 15 during 3 our 4 hypothesis 4 hypothesis 5 that 5 that 7 imbalance 5 that 14 exists 6 an 7 imbalance 7 imbalance 8 between 7 imbalance 14 exists 8 between 13 transmission 9 inhibitory 10 and 10 and 11 excitatory 10 and 13 transmission 12 synaptic 13 transmission 15 during 18 period 16 the 18 period 17 critical 18 period 19 , 23 patch 19 , 24 - 20 whole 21 - 20 whole 23 patch 22 cell 23 patch 24 - 26 recordings 24 - 29 were 24 - 41 . 25 clamp 26 recordings 26 recordings 27 of 26 recordings 29 were 27 of 28 hms 29 were 30 done 30 done 31 in 30 done 36 daily 30 done 37 from 31 in 33 slices 32 brainstem 33 slices 33 slices 34 of 34 of 35 rats 37 from 38 p0 38 p0 39 to 39 to 40 p16 the results indicated that : [(] 1 [ )(the amplitude and charge transfer of miniature excitatory postsynaptic currents ( mepscs ) were significantly reduced at p12 - 13 [;] ( [2] [ )(the amplitude , mean frequency and charge transfer of miniature inhibitory postsynaptic currents ( mipscs ) were significantly increased at p12 - 13 [;] ( 3 ) the kinetics [(] rise time and decay time ) of both mepscs and mipscs accelerated with age [;] ( 4 ) the amplitude and frequency of spontaneous epscs [were] significantly reduced at p12 - 13 , whereas those of spontaneous ipscs were significantly increased at p12 - 13 [;] [and] ( 5 ) [both] glycine and gaba contributed to mipscs . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicated 1 the 2 results 2 results 3 indicated 3 indicated 4 that 3 indicated 5 : 4 that 5 : 5 : 11 and 7 1 11 and 9 )(the 10 amplitude 10 amplitude 11 and 11 and 13 transfer 12 charge 13 transfer 13 transfer 14 of 14 of 15 miniature 15 miniature 18 currents 15 miniature 22 were 15 miniature 24 reduced 16 excitatory 18 currents 17 postsynaptic 18 currents 18 currents 20 mepscs 18 currents 22 were 19 ( 20 mepscs 20 mepscs 21 ) 22 were 23 significantly 24 reduced 25 at 25 at 26 p12 26 p12 28 13 26 p12 38 and 27 - 28 13 28 13 34 amplitude 28 13 38 and 30 ( 34 amplitude 33 )(the 34 amplitude 34 amplitude 35 , 36 mean 37 frequency 36 mean 38 and 38 and 39 charge 39 charge 40 transfer 39 charge 51 increased 40 transfer 41 of 40 transfer 51 increased 41 of 42 miniature 42 miniature 45 currents 42 miniature 49 were 43 inhibitory 45 currents 44 postsynaptic 45 currents 45 currents 47 mipscs 45 currents 49 were 46 ( 47 mipscs 47 mipscs 48 ) 50 significantly 51 increased 51 increased 52 at 51 increased 63 rise 52 at 53 p12 53 p12 55 13 54 - 55 13 55 13 58 3 55 13 59 ) 57 ( 58 3 58 3 59 ) 60 the 63 rise 61 kinetics 63 rise 63 rise 65 and 63 rise 74 accelerated 64 time 65 and 65 and 67 time 65 and 68 ) 65 and 69 of 65 and 74 accelerated 66 decay 67 time 69 of 72 and 70 both 71 mepscs 71 mepscs 72 and 72 and 73 mipscs 74 accelerated 75 with 75 with 76 age 75 with 83 and 76 age 79 4 78 ( 79 4 79 4 80 ) 81 the 82 amplitude 82 amplitude 83 and 83 and 84 frequency 83 and 85 of 83 and 90 reduced 85 of 87 epscs 86 spontaneous 87 epscs 89 significantly 90 reduced 90 reduced 91 at 90 reduced 96 whereas 91 at 92 p12 92 p12 94 13 93 - 94 13 94 13 95 , 96 whereas 97 those 96 whereas 103 increased 97 those 98 of 97 those 101 were 98 of 100 ipscs 99 spontaneous 100 ipscs 101 were 103 increased 102 significantly 103 increased 103 increased 104 at 104 at 115 and 105 p12 107 13 105 p12 114 glycine 106 - 107 13 107 13 111 5 107 13 112 ) 110 ( 111 5 111 5 112 ) 114 glycine 115 and 115 and 116 gaba 115 and 120 . 116 gaba 117 contributed 117 contributed 118 to 118 to 119 mipscs however , gabaergic currents fluctuated within a narrow range during the first three postnatal weeks , whereas glycinergic ones exhibited age - dependent changes comparable to those of total mipscs , indicating a reversal in dominance from gaba to glycine with development . 0 ###LEFT-WALL### 4 currents 0 ###LEFT-WALL### 5 fluctuated 1 however 2 , 1 however 4 currents 3 gabaergic 4 currents 4 currents 5 fluctuated 5 fluctuated 6 within 5 fluctuated 17 whereas 6 within 9 range 7 a 8 narrow 7 a 9 range 8 narrow 9 range 9 range 10 during 10 during 15 weeks 11 the 12 first 11 the 13 three 13 three 15 weeks 14 postnatal 15 weeks 16 , 17 whereas 17 whereas 19 ones 17 whereas 20 exhibited 17 whereas 43 . 18 glycinergic 19 ones 19 ones 20 exhibited 20 exhibited 21 age 20 exhibited 32 indicating 21 age 24 changes 22 - 24 changes 23 dependent 24 changes 24 changes 25 comparable 24 changes 31 , 25 comparable 26 to 26 to 27 those 27 those 28 of 28 of 30 mipscs 29 total 30 mipscs 31 , 32 indicating 32 indicating 34 reversal 32 indicating 35 in 32 indicating 43 . 33 a 34 reversal 35 in 36 dominance 36 dominance 37 from 37 from 38 gaba 38 gaba 39 to 38 gaba 41 with 39 to 40 glycine 41 with 42 development thus , our results provide strong electrophysiological evidence for an excitatory - inhibitory imbalance in hms during the critical period of postnatal development in rats that may have significant implications for sids . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 provide 0 ###LEFT-WALL### 33 . 1 thus 2 , 1 thus 4 results 3 our 4 results 4 results 5 provide 5 provide 8 evidence 5 provide 17 during 5 provide 24 in 6 strong 8 evidence 7 electrophysiological 8 evidence 8 evidence 9 for 8 evidence 15 in 9 for 14 imbalance 10 an 14 imbalance 11 excitatory 12 - 11 excitatory 14 imbalance 13 inhibitory 14 imbalance 15 in 16 hms 17 during 20 period 18 the 20 period 19 critical 20 period 20 period 21 of 21 of 23 development 22 postnatal 23 development 24 in 25 rats 25 rats 26 that 25 rats 27 may 26 that 27 may 27 may 28 have 28 have 30 implications 29 significant 30 implications 30 implications 31 for 31 for 32 sids the ability to modulate sympathetic α - adrenergic vasoconstriction in contracting muscle is impaired with age . 0 ###LEFT-WALL### 2 ability 0 ###LEFT-WALL### 14 impaired 0 ###LEFT-WALL### 17 . 1 the 2 ability 2 ability 3 to 2 ability 4 modulate 2 ability 13 is 3 to 4 modulate 4 modulate 9 vasoconstriction 4 modulate 10 in 5 sympathetic 9 vasoconstriction 6 α 7 - 6 α 9 vasoconstriction 8 adrenergic 9 vasoconstriction 10 in 11 contracting 11 contracting 12 muscle 13 is 14 impaired 14 impaired 15 with 15 with 16 age in young adults , adenosine triphosphate ( atp ) has been shown to blunt sympathetic vasoconstrictor responsiveness similar to exercise . 0 ###LEFT-WALL### 6 triphosphate 0 ###LEFT-WALL### 14 blunt 0 ###LEFT-WALL### 21 . 1 in 3 adults 1 in 4 , 1 in 6 triphosphate 2 young 3 adults 5 adenosine 6 triphosphate 6 triphosphate 8 atp 6 triphosphate 10 has 7 ( 8 atp 8 atp 9 ) 10 has 11 been 11 been 12 shown 12 shown 13 to 13 to 14 blunt 14 blunt 17 responsiveness 15 sympathetic 17 responsiveness 16 vasoconstrictor 17 responsiveness 17 responsiveness 18 similar 18 similar 19 to 18 similar 20 exercise 19 to 20 exercise forearm hyperaemia was matched across all vasodilatating conditions . 0 ###LEFT-WALL### 2 hyperaemia 0 ###LEFT-WALL### 4 matched 0 ###LEFT-WALL### 9 . 1 forearm 2 hyperaemia 2 hyperaemia 3 was 3 was 4 matched 4 matched 5 across 5 across 8 conditions 6 all 8 conditions 7 vasodilatating 8 conditions during adenosine , forearm vasoconstrictor responses to direct α₁ - stimulation were lower in older compared [with] young adults ( δfvc= - 25 ± 3 % [vs] . - 41 ± 5 % [;] p < 0.05 ) , whereas the responses to α₂ - stimulation were not different [(] - 35±6 % [vs] [.] - 44 ± 8 % ; ns [ )( 0 ###LEFT-WALL### 6 responses 0 ###LEFT-WALL### 9 α₁ 0 ###LEFT-WALL### 10 - 1 during 2 adenosine 1 during 3 , 1 during 6 responses 4 forearm 6 responses 5 vasoconstrictor 6 responses 6 responses 7 to 6 responses 8 direct 6 responses 9 α₁ 7 to 8 direct 10 - 11 stimulation 10 - 12 were 10 - 22 - 11 stimulation 12 were 12 were 13 lower 13 lower 14 in 14 in 19 adults 15 older 19 adults 16 compared 19 adults 18 young 19 adults 19 adults 21 δfvc= 20 ( 21 δfvc= 21 δfvc= 22 - 22 - 23 25 22 - 24 ± 22 - 28 . 23 25 24 ± 24 ± 26 % 25 3 26 % 28 . 30 41 28 . 39 , 29 - 30 41 30 41 31 ± 31 ± 33 % 32 5 33 % 33 % 36 < 35 p 36 < 36 < 37 0.05 36 < 38 ) 39 , 46 stimulation 39 , 47 were 39 , 51 - 40 whereas 42 responses 40 whereas 45 - 40 whereas 46 stimulation 41 the 42 responses 42 responses 43 to 42 responses 44 α₂ 43 to 44 α₂ 46 stimulation 47 were 47 were 48 not 47 were 49 different 48 not 49 different 51 - 53 % 51 - 56 - 52 35±6 53 % 56 - 57 44 56 - 58 ± 56 - 61 ; 56 - 64 )( 57 44 58 ± 58 ± 60 % 59 8 60 % 61 ; 62 ns during exercise , α₁ [-] mediated vasoconstriction was significantly blunted compared with adenosine in both young [(] - 9 ± 2 % vs [.] - 41 ± 5 % [ )( older adults [(] - [15] [±] 2 % vs [.] - 25 ± 3 % [ )( however [,] the magnitude of sympatholysis was reduced in older adults ( 32 ± 13 [vs] [.] 74 ± 8 [%] [;] p < 0.05 ) . 0 ###LEFT-WALL### 4 α₁ 0 ###LEFT-WALL### 11 compared 1 during 2 exercise 1 during 3 , 1 during 4 α₁ 4 α₁ 6 mediated 4 α₁ 7 vasoconstriction 4 α₁ 8 was 4 α₁ 10 blunted 4 α₁ 11 compared 7 vasoconstriction 8 was 9 significantly 10 blunted 11 compared 12 with 12 with 13 adenosine 13 adenosine 14 in 14 in 20 ± 15 both 16 young 16 young 18 - 16 young 20 ± 19 9 20 ± 20 ± 22 % 20 ± 27 ± 21 2 22 % 22 % 23 vs 22 % 27 ± 23 vs 26 41 25 - 26 41 27 ± 35 - 28 5 29 % 28 5 35 - 29 % 33 adults 32 older 33 adults 35 - 38 2 38 2 39 % 39 % 40 vs 39 % 44 ± 40 vs 43 25 42 - 43 25 44 ± 46 % 44 ± 49 however 45 3 46 % 49 however 52 magnitude 49 however 56 reduced 51 the 52 magnitude 52 magnitude 53 of 52 magnitude 55 was 53 of 54 sympatholysis 55 was 56 reduced 56 reduced 57 in 57 in 59 adults 58 older 59 adults 59 adults 67 ± 60 ( 67 ± 61 32 62 ± 62 ± 67 ± 63 13 67 ± 66 74 67 ± 67 ± 68 8 67 ± 72 < 67 ± 75 . 71 p 72 < 72 < 73 0.05 72 < 74 ) similarly [,] α₂ - mediated vasoconstriction during exercise was significantly blunted in both young [(] - 15 ± 4 % [vs] . - 44 ± 8 [%] [ )(and older adults [(] - 26 ± 3 % [vs] . - 35 ± 6 % [ )(, however the magnitude of sympatholysis was reduced in older adults ( 19 ± 8 % [vs] [.] 60 ± 10 [%] [;] p < 0.05 ) . 0 ###LEFT-WALL### 3 α₂ 0 ###LEFT-WALL### 4 - 1 similarly 3 α₂ 4 - 6 vasoconstriction 4 - 16 - 5 mediated 6 vasoconstriction 6 vasoconstriction 7 during 6 vasoconstriction 9 was 7 during 8 exercise 9 was 10 significantly 9 was 11 blunted 11 blunted 12 in 11 blunted 14 young 12 in 13 both 16 - 17 15 16 - 22 . 17 15 18 ± 18 ± 20 % 19 4 20 % 22 . 31 adults 22 . 33 - 23 - 24 44 24 44 31 adults 25 ± 26 8 25 ± 29 )(and 29 )(and 30 older 29 )(and 31 adults 33 - 34 26 33 - 35 ± 33 - 39 . 34 26 35 ± 35 ± 37 % 36 3 37 % 39 . 40 - 39 . 42 ± 39 . 46 )(, 40 - 41 35 41 35 42 ± 42 ± 44 % 43 6 44 % 46 )(, 49 magnitude 47 however 49 magnitude 48 the 49 magnitude 49 magnitude 50 of 49 magnitude 52 was 50 of 51 sympatholysis 52 was 53 reduced 53 reduced 54 in 54 in 56 adults 55 older 56 adults 56 adults 65 ± 57 ( 65 ± 58 19 59 ± 59 ± 65 ± 60 8 61 % 61 % 65 ± 64 60 65 ± 65 ± 66 10 65 ± 70 < 65 ± 73 . 69 p 70 < 70 < 71 0.05 70 < 72 ) during atp , both α₁ - and α₂ - mediated vasoconstriction was nearly abolished in young and older adults ( δfvc ∼ - 5 % ) , and the magnitude of sympatholysis was similar in both age groups ( ∼85 - 90 % ) . 0 ###LEFT-WALL### 11 vasoconstriction 0 ###LEFT-WALL### 14 abolished 0 ###LEFT-WALL### 28 and 1 during 2 atp 1 during 9 - 1 during 11 vasoconstriction 2 atp 7 and 3 , 7 and 4 both 7 and 5 α₁ 7 and 6 - 7 and 7 and 8 α₂ 7 and 9 - 10 mediated 11 vasoconstriction 11 vasoconstriction 12 was 12 was 14 abolished 13 nearly 14 abolished 14 abolished 15 in 15 in 19 adults 16 young 17 and 17 and 18 older 17 and 19 adults 19 adults 22 ∼ 20 ( 22 ∼ 21 δfvc 22 ∼ 22 ∼ 25 % 22 ∼ 27 , 23 - 25 % 24 5 25 % 25 % 26 ) 28 and 30 magnitude 28 and 33 was 29 the 30 magnitude 30 magnitude 31 of 30 magnitude 33 was 31 of 32 sympatholysis 33 was 34 similar 34 similar 35 in 35 in 38 groups 36 both 38 groups 37 age 38 groups 38 groups 40 ∼85 39 ( 40 ∼85 40 ∼85 43 % 40 ∼85 45 . 41 - 43 % 42 90 43 % 43 % 44 ) our findings indicate that the ability to modulate postjunctional α - adrenergic vasoconstriction during exercise is impaired with age , whereas the sympatholytic effect of exogenous atp is preserved . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 30 . 1 our 2 findings 2 findings 3 indicate 3 indicate 4 that 4 that 6 ability 4 that 29 preserved 5 the 6 ability 6 ability 7 to 6 ability 8 modulate 6 ability 16 is 7 to 8 modulate 8 modulate 13 vasoconstriction 8 modulate 14 during 9 postjunctional 13 vasoconstriction 10 α 11 - 10 α 13 vasoconstriction 12 adrenergic 13 vasoconstriction 14 during 15 exercise 16 is 17 impaired 17 impaired 18 with 17 impaired 21 whereas 18 with 19 age 20 , 21 whereas 21 whereas 24 effect 22 the 24 effect 23 sympatholytic 24 effect 24 effect 25 of 24 effect 28 is 25 of 27 atp 26 exogenous 27 atp 28 is 29 preserved thus , if impairments in vascular control during exercise in older adults involve vasoactive atp , we speculate that circulating atp is reduced with advancing age . 0 ###LEFT-WALL### 17 we 0 ###LEFT-WALL### 18 speculate 0 ###LEFT-WALL### 27 . 1 thus 2 , 1 thus 17 we 3 if 4 impairments 3 if 13 involve 3 if 16 , 3 if 17 we 4 impairments 5 in 4 impairments 13 involve 5 in 7 control 6 vascular 7 control 7 control 8 during 7 control 10 in 8 during 9 exercise 10 in 12 adults 11 older 12 adults 13 involve 15 atp 14 vasoactive 15 atp 17 we 18 speculate 18 speculate 19 that 19 that 20 circulating 19 that 23 reduced 20 circulating 21 atp 20 circulating 22 is 22 is 23 reduced 23 reduced 24 with 24 with 25 advancing 25 advancing 26 age spinal motoneurons are highly vulnerable in amyotrophic lateral sclerosis ( als ).previous research using a standard animal model , the mutant superoxide dismutase - 1 ( sod1 )mouse , has revealed deficits in many cellular properties throughout its lifespan . 0 ###LEFT-WALL### 1 spinal 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 40 . 1 spinal 3 are 2 motoneurons 3 are 3 are 5 vulnerable 4 highly 5 vulnerable 5 vulnerable 6 in 6 in 9 sclerosis 7 amyotrophic 9 sclerosis 8 lateral 9 sclerosis 9 sclerosis 13 research 10 ( 13 research 11 als 13 research 12 ).previous 13 research 13 research 14 using 13 research 19 , 14 using 18 model 15 a 16 standard 15 a 18 model 16 standard 17 animal 17 animal 18 model 19 , 23 dismutase 19 , 31 revealed 20 the 23 dismutase 21 mutant 22 superoxide 22 superoxide 23 dismutase 23 dismutase 25 1 23 dismutase 30 has 24 - 25 1 25 1 28 )mouse 25 1 29 , 26 ( 28 )mouse 27 sod1 28 )mouse 28 )mouse 29 , 30 has 31 revealed 31 revealed 32 deficits 31 revealed 33 in 31 revealed 37 throughout 33 in 36 properties 34 many 36 properties 35 cellular 36 properties 37 throughout 39 lifespan 38 its 39 lifespan the electrical properties underlying motoneuron excitability are some of the earliest to change ; starting at 1 week postnatal , persistent [inward] currents ( pics ) mediated by na+ [are] upregulated and electrical conductance , a measure of cell size , increases . 0 ###LEFT-WALL### 3 properties 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 27 mediated 1 the 3 properties 2 electrical 3 properties 3 properties 4 underlying 3 properties 7 are 4 underlying 6 excitability 5 motoneuron 6 excitability 7 are 8 some 8 some 9 of 9 of 11 earliest 10 the 11 earliest 11 earliest 12 to 12 to 13 change 14 ; 15 starting 15 starting 16 at 15 starting 23 currents 15 starting 27 mediated 16 at 18 week 17 1 18 week 19 postnatal 20 , 19 postnatal 23 currents 21 persistent 23 currents 23 currents 25 pics 24 ( 25 pics 25 pics 26 ) 27 mediated 28 by 28 by 32 and 29 na+ 31 upregulated 29 na+ 32 and 32 and 34 conductance 32 and 40 size 33 electrical 34 conductance 35 , 40 size 36 a 37 measure 37 measure 38 of 37 measure 40 size 38 of 40 size 39 cell 40 size 40 size 42 increases 40 size 43 . 41 , 42 increases 42 increases 43 . we found that the na+ pic and the conductance increased during development . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 13 . 1 we 2 found 2 found 3 that 3 that 7 and 3 that 10 increased 4 the 6 pic 5 na+ 6 pic 6 pic 7 and 7 and 9 conductance 7 and 10 increased 8 the 9 conductance 10 increased 11 during 11 during 12 development however , mutant sod1 motoneurons showed much greater increases than normal motoneurons ; the mean na+pic in sod1 motoneurons was double that of wild - type motoneurons . 0 ###LEFT-WALL### 5 motoneurons 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 5 motoneurons 3 mutant 5 motoneurons 4 sod1 5 motoneurons 5 motoneurons 6 showed 6 showed 9 increases 6 showed 10 than 7 much 8 greater 8 greater 9 increases 10 than 12 motoneurons 11 normal 12 motoneurons 13 ; 15 mean 13 ; 21 double 14 the 15 mean 15 mean 16 na+pic 15 mean 19 motoneurons 15 mean 20 was 16 na+pic 17 in 16 na+pic 19 motoneurons 17 in 18 sod1 20 was 21 double 21 double 22 that 22 that 23 of 23 of 27 motoneurons 24 wild 25 - 24 wild 26 type 26 type 27 motoneurons additionally , in mutant sod1 motoneurons the pic mediated by ca2+ increased , spike width decreased and the time course of the [after] [-] spike after [-] hyperpolarization shortened . 0 ###LEFT-WALL### 8 pic 0 ###LEFT-WALL### 9 mediated 0 ###LEFT-WALL### 30 . 1 additionally 2 , 1 additionally 8 pic 3 in 6 motoneurons 3 in 8 pic 4 mutant 6 motoneurons 5 sod1 6 motoneurons 7 the 8 pic 8 pic 9 mediated 9 mediated 10 by 9 mediated 26 after 10 by 17 and 11 ca2+ 12 increased 11 ca2+ 17 and 12 increased 13 , 12 increased 16 decreased 14 spike 16 decreased 15 width 16 decreased 17 and 20 course 17 and 21 of 18 the 20 course 19 time 20 course 21 of 25 spike 22 the 25 spike 26 after 28 hyperpolarization 28 hyperpolarization 29 shortened these changes were advances of the normal effects of maturation . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 11 . 1 these 2 changes 2 changes 3 were 3 were 4 advances 4 advances 5 of 5 of 8 effects 6 the 8 effects 7 normal 8 effects 8 effects 9 of 9 of 10 maturation thus , our results show that the development of normal and mutant sod1 motoneurons follows generally similar patterns , but that the rate of development is accelerated in the mutant sod1 motoneurons . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 33 . 1 thus 2 , 1 thus 4 results 3 our 4 results 4 results 5 show 5 show 6 that 6 that 8 development 6 that 15 follows 7 the 8 development 8 development 9 of 8 development 15 follows 9 of 14 motoneurons 10 normal 11 and 11 and 12 mutant 11 and 14 motoneurons 13 sod1 14 motoneurons 15 follows 18 patterns 16 generally 17 similar 17 similar 18 patterns 19 , 23 rate 19 , 27 accelerated 20 but 21 that 20 but 23 rate 22 the 23 rate 23 rate 24 of 23 rate 26 is 24 of 25 development 26 is 27 accelerated 27 accelerated 28 in 28 in 32 motoneurons 29 the 32 motoneurons 30 mutant 32 motoneurons 31 sod1 32 motoneurons statistical analysis of all measured properties indicates that approximately 55 % of changes attributed to the g93a sod1 mutation can be attributed to an increased rate of maturation . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 7 indicates 0 ###LEFT-WALL### 29 . 1 statistical 2 analysis 2 analysis 3 of 2 analysis 7 indicates 3 of 6 properties 4 all 6 properties 5 measured 6 properties 7 indicates 9 approximately 7 indicates 11 % 7 indicates 22 attributed 8 that 9 approximately 10 55 11 % 11 % 12 of 11 % 20 can 12 of 13 changes 13 changes 14 attributed 14 attributed 15 to 15 to 19 mutation 16 the 19 mutation 17 g93a 18 sod1 18 sod1 19 mutation 20 can 21 be 21 be 22 attributed 22 attributed 23 to 23 to 26 rate 24 an 26 rate 25 increased 26 rate 26 rate 27 of 27 of 28 maturation unlabelled : aims of investigation : the chronological age of the caucasian population and their anthropometrical data have significantly changed within the last five decades . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 : 1 unlabelled 2 : 2 : 5 investigation 3 aims 4 of 4 of 5 investigation 6 : 14 and 6 : 20 changed 6 : 26 . 7 the 9 age 8 chronological 9 age 9 age 10 of 9 age 14 and 10 of 13 population 11 the 13 population 12 caucasian 13 population 14 and 17 data 14 and 18 have 15 their 17 data 16 anthropometrical 17 data 18 have 20 changed 19 significantly 20 changed 20 changed 21 within 21 within 25 decades 22 the 25 decades 23 last 25 decades 24 five 25 decades therefore the question arises whether or not the commonly used reference values of the european community ( eccs ) [for] lung function may still be accepted today . 0 ###LEFT-WALL### 3 question 0 ###LEFT-WALL### 4 arises 0 ###LEFT-WALL### 28 . 1 therefore 3 question 2 the 3 question 3 question 4 arises 4 arises 7 not 5 whether 6 or 6 or 7 not 7 not 12 values 7 not 26 accepted 8 the 12 values 9 commonly 10 used 10 used 11 reference 11 reference 12 values 12 values 13 of 12 values 23 may 13 of 22 function 14 the 22 function 15 european 22 function 16 community 18 eccs 17 ( 18 eccs 18 eccs 19 ) 18 eccs 22 function 21 lung 22 function 23 may 25 be 24 still 25 be 25 be 26 accepted 26 accepted 27 today since these values were obtained in the 1960s from subjects in a limited age range . 0 ###LEFT-WALL### 15 range 0 ###LEFT-WALL### 16 . 1 since 3 values 1 since 5 obtained 1 since 15 range 2 these 3 values 3 values 4 were 4 were 5 obtained 5 obtained 6 in 5 obtained 9 from 5 obtained 11 in 6 in 8 1960s 7 the 8 1960s 9 from 10 subjects 11 in 14 age 12 a 13 limited 12 a 14 age 13 limited 14 age for the elderly , the measured values are deduced by extrapolation beyond the range of reference equations which had been obtained in a different population . 0 ###LEFT-WALL### 7 values 0 ###LEFT-WALL### 9 deduced 0 ###LEFT-WALL### 26 . 1 for 3 elderly 1 for 4 , 1 for 7 values 2 the 3 elderly 5 the 7 values 6 measured 7 values 7 values 8 are 8 are 9 deduced 9 deduced 10 by 9 deduced 12 beyond 10 by 11 extrapolation 12 beyond 14 range 13 the 14 range 14 range 15 of 15 of 17 equations 16 reference 17 equations 17 equations 18 which 17 equations 19 had 18 which 19 had 19 had 20 been 20 been 21 obtained 21 obtained 22 in 22 in 25 population 23 a 25 population 24 different 25 population therefore decisions concerning elderly and smaller subjects concerning remuneration due to impaired lung function [after] industrial exposure on the basis of egks values are questionable . 0 ###LEFT-WALL### 2 decisions 0 ###LEFT-WALL### 24 are 0 ###LEFT-WALL### 26 . 1 therefore 2 decisions 2 decisions 3 concerning 2 decisions 11 to 2 decisions 24 are 3 concerning 7 subjects 4 elderly 5 and 5 and 6 smaller 5 and 7 subjects 7 subjects 8 concerning 8 concerning 9 remuneration 10 due 11 to 11 to 17 exposure 12 impaired 13 lung 13 lung 14 function 14 function 17 exposure 16 industrial 17 exposure 17 exposure 18 on 18 on 20 basis 19 the 20 basis 20 basis 21 of 21 of 23 values 22 egks 23 values 24 are 25 questionable methods : lung function tests were performed by pneumotachography , recording static lung volumes and flow - volume - curves in 262 asymptomatic [non] smoking males , aged 20 to 90 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 33 . 1 methods 2 : 2 : 32 years 3 lung 5 tests 4 function 5 tests 5 tests 27 , 6 were 7 performed 6 were 27 , 7 performed 8 by 7 performed 21 in 8 by 20 curves 9 pneumotachography 15 and 9 pneumotachography 19 - 9 pneumotachography 20 curves 10 , 15 and 11 recording 14 volumes 12 static 13 lung 13 lung 14 volumes 14 volumes 15 and 15 and 16 flow 15 and 17 - 15 and 18 volume 15 and 19 - 17 - 18 volume 18 volume 19 - 21 in 26 males 22 262 26 males 23 asymptomatic 25 smoking 25 smoking 26 males 27 , 28 aged 27 , 30 to 29 20 30 to 30 to 31 90 31 90 32 years measurements were performed with the masterlab , or pneumoscreen systems ( carefusion , höchberg ) . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 16 . 1 measurements 2 were 2 were 3 performed 3 performed 4 with 4 with 8 or 5 the 6 masterlab 6 masterlab 8 or 7 , 8 or 8 or 10 systems 8 or 12 carefusion 8 or 14 höchberg 9 pneumoscreen 10 systems 11 ( 12 carefusion 12 carefusion 13 , 13 , 14 höchberg 14 höchberg 15 ) results were compared to the reference values of eccs , sapaldia and luftibus . - results : for simplicity analysis of age and height dependence of investigated respiratory parameters ( vc , fvc , fev⊂1 , fev⊂1%fvc , pef , mef⊂75,50,25 ) can be described by linear functions ( y = [a] * [height] [?] b [*] age + c ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 compared 0 ###LEFT-WALL### 14 . 0 ###LEFT-WALL### 62 . 1 results 2 were 2 were 3 compared 3 compared 4 to 4 to 7 values 5 the 7 values 6 reference 7 values 7 values 8 of 8 of 13 luftibus 9 eccs 11 sapaldia 10 , 11 sapaldia 11 sapaldia 12 and 12 and 13 luftibus 14 . 15 - 14 . 17 : 14 . 23 and 15 - 16 results 16 results 17 : 17 : 18 for 18 for 20 analysis 19 simplicity 20 analysis 20 analysis 21 of 21 of 22 age 23 and 25 dependence 23 and 45 described 24 height 25 dependence 25 dependence 26 of 25 dependence 31 vc 25 dependence 33 fvc 25 dependence 43 can 26 of 29 parameters 27 investigated 29 parameters 28 respiratory 29 parameters 30 ( 31 vc 31 vc 32 , 32 , 33 fvc 33 fvc 35 fev⊂1 33 fvc 42 ) 34 , 35 fev⊂1 35 fev⊂1 37 fev⊂1%fvc 35 fev⊂1 42 ) 36 , 37 fev⊂1%fvc 37 fev⊂1%fvc 39 pef 37 fev⊂1%fvc 42 ) 38 , 39 pef 39 pef 41 mef⊂75,50,25 39 pef 42 ) 40 , 41 mef⊂75,50,25 41 mef⊂75,50,25 42 ) 43 can 44 be 44 be 45 described 45 described 46 by 45 described 59 + 46 by 48 functions 47 linear 48 functions 49 ( 59 + 50 y 51 = 51 = 53 * 53 * 56 b 53 * 58 age 58 age 59 + 59 + 60 c 59 + 61 ) the forced expiratory vital capacity , fvc , was calculated by fvc [=] 0.0615*h - 0.0308*a - 4.673 [;] r = 0.78 . 0 ###LEFT-WALL### 5 capacity 0 ###LEFT-WALL### 10 calculated 0 ###LEFT-WALL### 23 . 1 the 5 capacity 2 forced 5 capacity 3 expiratory 5 capacity 4 vital 5 capacity 5 capacity 7 fvc 5 capacity 9 was 6 , 7 fvc 7 fvc 8 , 9 was 10 calculated 10 calculated 11 by 11 by 14 0.0615*h 12 fvc 14 0.0615*h 14 0.0615*h 16 0.0308*a 14 0.0615*h 21 = 15 - 16 0.0308*a 16 0.0308*a 17 - 18 4.673 21 = 20 r 21 = 21 = 22 0.78 mean fvc for younger subjects was found to be 104.7 ± 10.7 % of the eccs reference values and 96.5 ± 11.8 % in older subjects . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 27 . 1 mean 2 fvc 1 mean 9 be 2 fvc 3 for 2 fvc 6 was 3 for 5 subjects 4 younger 5 subjects 6 was 7 found 7 found 8 to 8 to 9 be 9 be 11 ± 10 104.7 11 ± 11 ± 13 % 11 ± 18 values 12 10.7 13 % 13 % 14 of 13 % 18 values 14 of 17 reference 15 the 17 reference 16 eccs 17 reference 19 and 20 96.5 19 and 21 ± 20 96.5 21 ± 21 ± 23 % 21 ± 24 in 22 11.8 23 % 24 in 26 subjects 25 older 26 subjects for most parameters investigated linear regressions on age were steeper than described by the eccs reference values . 0 ###LEFT-WALL### 1 for 0 ###LEFT-WALL### 16 reference 0 ###LEFT-WALL### 18 . 1 for 3 parameters 2 most 3 parameters 3 parameters 4 investigated 3 parameters 6 regressions 3 parameters 9 were 3 parameters 10 steeper 3 parameters 12 described 3 parameters 16 reference 5 linear 6 regressions 6 regressions 7 on 6 regressions 9 were 7 on 8 age 10 steeper 11 than 12 described 13 by 13 by 15 eccs 14 the 15 eccs 16 reference 17 values the regression of lung function [to] height largely follows the eccs prescriptions . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 9 follows 0 ###LEFT-WALL### 13 . 1 the 2 regression 2 regression 3 of 2 regression 9 follows 3 of 7 height 4 lung 7 height 5 function 7 height 8 largely 9 follows 9 follows 12 prescriptions 10 the 12 prescriptions 11 eccs 12 prescriptions summary : bochum lung function values of younger healthy subjects were higher compared to the reference values of the eccs and showed a steeper age descent . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 bochum 2 : 21 and 3 bochum 6 values 3 bochum 11 were 3 bochum 21 and 4 lung 6 values 5 function 6 values 6 values 7 of 6 values 11 were 7 of 10 subjects 8 younger 10 subjects 9 healthy 10 subjects 11 were 12 higher 13 compared 14 to 13 compared 21 and 14 to 17 values 15 the 17 values 16 reference 17 values 17 values 18 of 18 of 20 eccs 19 the 20 eccs 21 and 22 showed 22 showed 25 age 22 showed 26 descent 23 a 25 age 24 steeper 25 age the alternatively discussed reference values of the sapaldia - [,] or luftibus - study are higher , [but] do [not] cover all necessary parameters [and/or] the age range . 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 13 - 1 the 5 values 2 alternatively 3 discussed 3 discussed 4 reference 4 reference 5 values 5 values 6 of 5 values 11 or 6 of 8 sapaldia 7 the 8 sapaldia 9 - 11 or 11 or 12 luftibus 13 - 14 study 13 - 15 are 13 - 29 . 14 study 15 are 15 are 24 parameters 15 are 28 range 16 higher 17 , 16 higher 19 do 19 do 21 cover 21 cover 24 parameters 22 all 23 necessary 23 necessary 24 parameters 26 the 28 range 27 age 28 range a multi centre study for contemporary reference values is recommended . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 10 recommended 0 ###LEFT-WALL### 11 . 1 a 2 multi 1 a 4 study 2 multi 3 centre 3 centre 4 study 4 study 5 for 4 study 9 is 5 for 8 values 6 contemporary 7 reference 7 reference 8 values 9 is 10 recommended purpose : many women identify their intimate partner as important source of support during cancer diagnosis and recovery , but little is known about how women deal with breast cancer while in a relationship self - described as difficult . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 but 1 purpose 2 : 2 : 3 many 2 : 14 during 3 many 4 women 3 many 5 identify 4 women 5 identify 5 identify 11 source 6 their 11 source 7 intimate 8 partner 8 partner 11 source 9 as 10 important 10 important 11 source 11 source 12 of 12 of 13 support 14 during 17 and 15 cancer 16 diagnosis 16 diagnosis 17 and 17 and 18 recovery 19 , 20 but 20 but 21 little 20 but 23 known 21 little 22 is 22 is 23 known 23 known 24 about 24 about 25 how 25 how 26 women 25 how 27 deal 26 women 27 deal 27 deal 28 with 27 deal 31 while 28 with 30 cancer 29 breast 30 cancer 31 while 32 in 32 in 35 self 33 a 35 self 34 relationship 35 self 35 self 37 described 36 - 37 described 37 described 38 as 37 described 40 . 38 as 39 difficult the purpose of this article is to describe the aging - related experiences of older women who were diagnosed with breast cancer while in a [non] [-] supportive , difficult intimate relationship . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 12 related 1 the 2 purpose 2 purpose 3 of 2 purpose 6 is 3 of 5 article 4 this 5 article 6 is 7 to 6 is 8 describe 7 to 8 describe 8 describe 10 aging 9 the 10 aging 11 - 12 related 12 related 13 experiences 12 related 33 . 13 experiences 14 of 13 experiences 17 who 13 experiences 18 were 14 of 16 women 15 older 16 women 17 who 18 were 18 were 19 diagnosed 19 diagnosed 20 with 19 diagnosed 23 while 20 with 22 cancer 21 breast 22 cancer 23 while 24 in 24 in 32 relationship 25 a 32 relationship 28 supportive 29 , 28 supportive 32 relationship 30 difficult 32 relationship 31 intimate 32 relationship method : semi - structured qualitative interviews were conducted with a convenience sample of 16 women aged 55 - 84 years ( mean 68.1 years ) in community settings in the mid - atlantic united states . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 7 interviews 2 : 9 conducted 3 semi 4 - 3 semi 7 interviews 5 structured 7 interviews 6 qualitative 7 interviews 7 interviews 8 were 8 were 9 conducted 9 conducted 10 with 9 conducted 27 in 10 with 13 sample 10 with 21 years 11 a 13 sample 12 convenience 13 sample 13 sample 14 of 14 of 16 women 15 16 16 women 16 women 17 aged 17 aged 19 - 18 55 19 - 19 - 20 84 21 years 25 years 22 ( 25 years 23 mean 25 years 24 68.1 25 years 25 years 26 ) 27 in 29 settings 28 community 29 settings 29 settings 30 in 30 in 36 states 31 the 36 states 32 mid 33 - 32 mid 36 states 34 atlantic 35 united 35 united 36 states data were analyzed using hermeneutic phenomenological analysis . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 8 . 1 data 2 were 2 were 3 analyzed 3 analyzed 4 using 4 using 7 analysis 5 hermeneutic 7 analysis 6 phenomenological 7 analysis results : participants [self] - identified as being in a difficult intimate relationship ( relationship length range : 1 year - 60 years , mean 35.6 years ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 : 0 ###LEFT-WALL### 29 . 1 results 2 : 2 : 3 participants 3 participants 6 identified 5 - 6 identified 6 identified 7 as 6 identified 18 : 7 as 8 being 8 being 9 in 8 being 17 range 9 in 13 relationship 10 a 13 relationship 11 difficult 13 relationship 12 intimate 13 relationship 14 ( 17 range 15 relationship 16 length 16 length 17 range 17 range 18 : 18 : 23 years 19 1 20 year 20 year 21 - 21 - 22 60 21 - 23 years 23 years 27 years 24 , 27 years 25 mean 27 years 26 35.6 27 years 27 years 28 ) reasons for relationship difficulty ranged from intimate partner abuse to terminal illness . 0 ###LEFT-WALL### 1 reasons 0 ###LEFT-WALL### 5 ranged 0 ###LEFT-WALL### 13 . 1 reasons 2 for 1 reasons 5 ranged 2 for 4 difficulty 3 relationship 4 difficulty 5 ranged 6 from 5 ranged 10 to 6 from 9 abuse 7 intimate 8 partner 8 partner 9 abuse 10 to 12 illness 11 terminal 12 illness the findings included the themes : " [at] my age " : participants reflect on aging and breast cancer ; breast cancer , sexuality , and aging [;] and silence . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 6 : 0 ###LEFT-WALL### 31 . 1 the 2 findings 2 findings 3 included 3 included 5 themes 4 the 5 themes 6 : 7 " 6 : 9 my 6 : 12 : 9 my 10 age 10 age 11 " 12 : 13 participants 12 : 17 and 12 : 20 ; 13 participants 17 and 14 reflect 15 on 14 reflect 17 and 15 on 16 aging 17 and 18 breast 17 and 19 cancer 20 ; 29 and 21 breast 22 cancer 22 cancer 23 , 23 , 24 sexuality 23 , 26 and 25 , 26 and 26 and 27 aging 26 and 29 and 29 and 30 silence conclusions : issues related to aging such as changes in sexual relationships , comorbidities , and partner illness complicated the women 's breast cancer experience . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 issues 2 : 4 related 2 : 16 and 2 : 26 . 3 issues 4 related 4 related 5 to 5 to 6 aging 6 aging 8 as 6 aging 10 in 7 such 8 as 8 as 9 changes 10 in 12 relationships 11 sexual 12 relationships 12 relationships 14 comorbidities 13 , 14 comorbidities 14 comorbidities 15 , 16 and 18 illness 16 and 19 complicated 17 partner 18 illness 18 illness 19 complicated 19 complicated 25 experience 20 the 21 women 21 women 22 's 22 's 25 experience 23 breast 25 experience 24 cancer 25 experience despite relationship difficulties , these women coped effectively with breast cancer in various ways . 0 ###LEFT-WALL### 6 women 0 ###LEFT-WALL### 7 coped 0 ###LEFT-WALL### 15 . 1 despite 3 difficulties 1 despite 4 , 1 despite 6 women 2 relationship 3 difficulties 5 these 6 women 6 women 7 coped 7 coped 8 effectively 7 coped 9 with 7 coped 12 in 9 with 11 cancer 10 breast 11 cancer 12 in 14 ways 13 various 14 ways study findings will increase awareness about the unique , complex needs of older women facing breast cancer with [non] - supportive intimate partners . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 increase 0 ###LEFT-WALL### 20 - 1 study 2 findings 2 findings 3 will 3 will 4 increase 4 increase 5 awareness 4 increase 6 about 6 about 10 complex 7 the 10 complex 8 unique 9 , 8 unique 10 complex 10 complex 11 needs 10 complex 18 with 11 needs 12 of 11 needs 16 breast 12 of 14 women 13 older 14 women 14 women 15 facing 16 breast 17 cancer 16 breast 18 with 20 - 23 partners 20 - 24 . 21 supportive 23 partners 22 intimate 23 partners nurses should assess older breast cancer patients keeping in mind physical functioning , comorbidities , social support network , and quality of intimate partner support . 0 ###LEFT-WALL### 1 nurses 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 26 . 1 nurses 2 should 2 should 3 assess 3 assess 7 patients 4 older 7 patients 5 breast 6 cancer 6 cancer 7 patients 7 patients 8 keeping 7 patients 12 functioning 8 keeping 10 mind 8 keeping 11 physical 9 in 10 mind 13 , 20 and 14 comorbidities 15 , 15 , 18 network 15 , 20 and 16 social 18 network 17 support 18 network 19 , 20 and 20 and 21 quality 20 and 22 of 22 of 25 support 23 intimate 25 support 24 partner 25 support obesity can adversely affect human health , including fertility . 0 ###LEFT-WALL### 1 obesity 0 ###LEFT-WALL### 4 affect 1 obesity 2 can 2 can 4 affect 3 adversely 4 affect 4 affect 6 health 5 human 6 health 6 health 8 including 7 , 8 including 8 including 9 fertility 8 including 10 . while obesity can disturb the hormonal profile of the female organism and is associated with fertility loss , little is known about what effect male obesity has on fertility . 0 ###LEFT-WALL### 19 little 0 ###LEFT-WALL### 21 known 0 ###LEFT-WALL### 30 . 1 while 2 obesity 1 while 12 and 1 while 18 , 1 while 19 little 2 obesity 12 and 3 can 4 disturb 3 can 12 and 4 disturb 7 profile 5 the 7 profile 6 hormonal 7 profile 7 profile 8 of 8 of 11 organism 9 the 11 organism 10 female 11 organism 12 and 13 is 12 and 15 with 12 and 17 loss 13 is 14 associated 15 with 16 fertility 19 little 20 is 20 is 21 known 21 known 22 about 21 known 28 on 22 about 23 what 23 what 24 effect 24 effect 27 has 25 male 26 obesity 26 obesity 27 has 28 on 29 fertility the present study analysed sperm samples of 153 donors . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 analysed 0 ###LEFT-WALL### 10 . 1 the 3 study 2 present 3 study 3 study 4 analysed 4 analysed 6 samples 5 sperm 6 samples 6 samples 7 of 7 of 9 donors 8 153 9 donors the men were selected from couples attending an infertility clinic , who had tried for 12 months or more to achieve pregnancy without success . 0 ###LEFT-WALL### 2 men 0 ###LEFT-WALL### 4 selected 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 25 . 1 the 2 men 2 men 3 were 3 were 4 selected 4 selected 5 from 5 from 6 couples 6 couples 7 attending 7 attending 10 clinic 8 an 10 clinic 9 infertility 10 clinic 11 , 12 who 11 , 21 achieve 12 who 13 had 12 who 21 achieve 13 had 14 tried 14 tried 15 for 14 tried 18 or 15 for 16 12 17 months 18 or 18 or 19 more 20 to 21 achieve 21 achieve 22 pregnancy 21 achieve 23 without 23 without 24 success the age of the men under investigation was recorded , and their body mass index ( bmi ) was calculated . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 9 recorded 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 21 . 1 the 2 age 2 age 3 of 2 age 8 was 3 of 5 men 4 the 5 men 5 men 6 under 6 under 7 investigation 8 was 9 recorded 10 , 11 and 11 and 15 index 11 and 20 calculated 12 their 15 index 13 body 15 index 14 mass 15 index 15 index 17 bmi 15 index 19 was 16 ( 17 bmi 17 bmi 18 ) 19 was 20 calculated all semen samples were assessed for volume , concentration , motility and morphology . 0 ###LEFT-WALL### 3 samples 0 ###LEFT-WALL### 5 assessed 0 ###LEFT-WALL### 14 . 1 all 3 samples 2 semen 3 samples 3 samples 4 were 4 were 5 assessed 5 assessed 6 for 6 for 12 and 7 volume 8 , 8 , 9 concentration 8 , 10 , 10 , 11 motility 10 , 12 and 12 and 13 morphology sperm chromatin integrity was measured by sperm chromatin structure [assay] . 0 ###LEFT-WALL### 3 integrity 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 11 . 1 sperm 3 integrity 2 chromatin 3 integrity 3 integrity 4 was 4 was 5 measured 5 measured 6 by 6 by 9 structure 7 sperm 9 structure 8 chromatin 9 structure quality of sperm chromatin condensation was assessed by toluidine blue , aniline blue and chromomycin a3 staining . 0 ###LEFT-WALL### 1 quality 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 18 . 1 quality 2 of 1 quality 6 was 2 of 5 condensation 3 sperm 5 condensation 4 chromatin 5 condensation 6 was 7 assessed 7 assessed 8 by 7 assessed 14 and 8 by 9 toluidine 10 blue 11 , 11 , 13 blue 11 , 14 and 12 aniline 13 blue 14 and 17 staining 15 chromomycin 17 staining 16 a3 17 staining we can conclude that the impact of elevated bmi on the parameters investigated ( basic semen parameters , chromatin integrity and chromatin condensation ) was not proven in this study . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 conclude 0 ###LEFT-WALL### 31 . 1 we 2 can 2 can 3 conclude 3 conclude 4 that 4 that 6 impact 4 that 25 was 5 the 6 impact 6 impact 7 of 6 impact 25 was 7 of 9 bmi 8 elevated 9 bmi 9 bmi 10 on 10 on 12 parameters 11 the 12 parameters 12 parameters 13 investigated 12 parameters 21 and 14 ( 21 and 15 basic 16 semen 16 semen 17 parameters 17 parameters 18 , 18 , 20 integrity 18 , 21 and 19 chromatin 20 integrity 21 and 23 condensation 21 and 24 ) 22 chromatin 23 condensation 25 was 26 not 25 was 28 in 26 not 27 proven 28 in 30 study 29 this 30 study on the other hand , [ejaculate] quality appeared to be affected by ageing . 0 ###LEFT-WALL### 7 quality 0 ###LEFT-WALL### 8 appeared 0 ###LEFT-WALL### 14 . 1 on 4 hand 1 on 5 , 1 on 7 quality 2 the 3 other 3 other 4 hand 7 quality 8 appeared 8 appeared 9 to 8 appeared 11 affected 9 to 10 be 10 be 11 affected 11 affected 12 by 12 by 13 ageing the impact was reflected by chromatin integrity , which is a factor that can substantially affect fertility in men , rather than by basic sperm parameters . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 4 reflected 0 ###LEFT-WALL### 27 . 1 the 2 impact 2 impact 3 was 3 was 4 reflected 4 reflected 5 by 4 reflected 22 than 5 by 7 integrity 6 chromatin 7 integrity 7 integrity 9 which 8 , 9 which 9 which 10 is 9 which 20 , 10 is 12 factor 11 a 12 factor 12 factor 13 that 12 factor 14 can 13 that 14 can 14 can 16 affect 15 substantially 16 affect 16 affect 17 fertility 17 fertility 18 in 18 in 19 men 21 rather 22 than 22 than 23 by 23 by 26 parameters 24 basic 25 sperm 25 sperm 26 parameters introduction : little is known about risperidone metabolism in a clinical sample , where polypharmacy is common . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 3 little 2 : 5 known 3 little 4 is 4 is 5 known 5 known 6 about 5 known 9 in 6 about 8 metabolism 7 risperidone 8 metabolism 9 in 12 sample 10 a 11 clinical 10 a 12 sample 11 clinical 12 sample 12 sample 14 where 13 , 14 where 14 where 15 polypharmacy 14 where 16 is 14 where 18 . 15 polypharmacy 16 is 16 is 17 common such knowledge is important since several of its side effects are [dose] dependent . 0 ###LEFT-WALL### 2 knowledge 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 14 . 1 such 2 knowledge 2 knowledge 3 is 3 is 4 important 4 important 5 since 5 since 6 several 5 since 11 are 6 several 7 of 6 several 11 are 7 of 10 effects 8 its 10 effects 9 side 10 effects 11 are 13 dependent methods : medically healthy patients aged 7 to 17 years old treated with risperidone for at least 6 months were enrolled . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 healthy 2 : 20 were 3 medically 4 healthy 4 healthy 20 were 5 patients 6 aged 5 patients 11 old 5 patients 12 treated 5 patients 20 were 6 aged 8 to 7 7 8 to 8 to 9 17 9 17 10 years 10 years 11 old 12 treated 13 with 12 treated 15 for 13 with 14 risperidone 15 for 19 months 16 at 17 least 17 least 18 6 18 6 19 months 20 were 21 enrolled trough serum risperidone and 9 [-] hydroxyrisperidone concentrations were measured . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 11 . 1 trough 3 risperidone 2 serum 3 risperidone 3 risperidone 4 and 4 and 8 concentrations 4 and 9 were 5 9 8 concentrations 7 hydroxyrisperidone 8 concentrations 9 were 10 measured results : one hundred seven participants ( 92 % males ) were recruited , representing a heterogenous clinical group with attention - deficit/hyperactivity disorder , disruptive behavior disorders , pervasive developmental disorders , anxiety disorders , mood disorders , tic disorders , or psychotic disorders . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 46 . 2 : 6 participants 2 : 13 recruited 2 : 22 - 3 one 4 hundred 4 hundred 5 seven 5 seven 6 participants 6 participants 10 males 6 participants 12 were 7 ( 10 males 8 92 10 males 9 % 10 males 10 males 11 ) 12 were 13 recruited 13 recruited 15 representing 14 , 15 representing 15 representing 19 group 15 representing 22 - 16 a 17 heterogenous 16 a 19 group 17 heterogenous 19 group 18 clinical 19 group 19 group 20 with 20 with 21 attention 22 - 43 or 23 deficit/hyperactivity 24 disorder 24 disorder 25 , 25 , 28 disorders 25 , 29 , 26 disruptive 27 behavior 27 behavior 28 disorders 29 , 32 disorders 29 , 33 , 30 pervasive 32 disorders 31 developmental 32 disorders 33 , 35 disorders 33 , 36 , 34 anxiety 35 disorders 36 , 38 disorders 36 , 39 , 37 mood 38 disorders 39 , 41 disorders 39 , 43 or 40 tic 41 disorders 42 , 43 or 43 or 45 disorders 44 psychotic 45 disorders risperidone had been used at a mean dose of 0.03 mg/kg , for a mean 2.5 years , [predominantly] to treat irritability and aggression . 0 ###LEFT-WALL### 1 risperidone 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 25 . 1 risperidone 2 had 2 had 3 been 3 been 4 used 4 used 5 at 4 used 20 to 5 at 8 dose 6 a 7 mean 6 a 8 dose 7 mean 8 dose 8 dose 9 of 8 dose 13 for 9 of 11 mg/kg 10 0.03 11 mg/kg 12 , 13 for 13 for 17 years 13 for 18 , 14 a 15 mean 14 a 17 years 15 mean 17 years 16 2.5 17 years 20 to 23 and 21 treat 22 irritability 22 irritability 23 and 23 and 24 aggression cytochrome cyp2d6 inhibitors were divided into prominent ( fluoxetine , bupropion , and lamotrigine ) , intermediate ( sertraline ) , [and] weak inhibition groups ( citalopram or escitalopram ) . 0 ###LEFT-WALL### 3 inhibitors 0 ###LEFT-WALL### 5 divided 0 ###LEFT-WALL### 31 . 1 cytochrome 2 cyp2d6 2 cyp2d6 3 inhibitors 3 inhibitors 4 were 4 were 5 divided 5 divided 6 into 6 into 13 and 7 prominent 9 fluoxetine 7 prominent 10 , 7 prominent 11 bupropion 8 ( 9 fluoxetine 9 fluoxetine 10 , 11 bupropion 13 and 12 , 13 and 13 and 14 lamotrigine 13 and 15 ) 13 and 25 groups 16 , 25 groups 17 intermediate 19 sertraline 17 intermediate 21 , 17 intermediate 24 inhibition 18 ( 19 sertraline 19 sertraline 20 ) 23 weak 24 inhibition 24 inhibition 25 groups 25 groups 28 or 25 groups 30 ) 26 ( 28 or 27 citalopram 28 or 28 or 29 escitalopram 28 or 30 ) the concentrations of risperidone and its metabolite were strongly associated with the dose of risperidone and time since the last dose [and] , to a lesser extent , with male sex . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 32 . 1 the 2 concentrations 2 concentrations 3 of 2 concentrations 5 and 3 of 4 risperidone 5 and 7 metabolite 5 and 8 were 6 its 7 metabolite 8 were 9 strongly 8 were 10 associated 10 associated 11 with 10 associated 18 since 10 associated 29 with 11 with 16 and 12 the 13 dose 13 dose 14 of 13 dose 16 and 14 of 15 risperidone 16 and 17 time 18 since 21 dose 19 the 20 last 19 the 21 dose 21 dose 24 to 23 , 24 to 24 to 27 extent 24 to 28 , 25 a 26 lesser 25 a 27 extent 26 lesser 27 extent 29 with 31 sex 30 male 31 sex in addition , risperidone concentration increased [with] pubertal [stage] ( p < 0.05 ) , [while] body mass index [z] - score ( p = 0.001 ) [predicted] a higher [9] - hydroxyrisperidone concentration . 0 ###LEFT-WALL### 5 concentration 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 15 , 1 in 2 addition 1 in 3 , 1 in 5 concentration 4 risperidone 5 concentration 5 concentration 6 increased 6 increased 8 pubertal 8 pubertal 12 < 10 ( 12 < 11 p 12 < 12 < 13 0.05 12 < 14 ) 15 , 19 index 15 , 21 - 17 body 19 index 18 mass 19 index 21 - 22 score 21 - 35 . 22 score 25 = 22 score 34 concentration 23 ( 25 = 24 p 25 = 25 = 26 0.001 25 = 27 ) 29 a 34 concentration 30 higher 32 - 30 higher 33 hydroxyrisperidone 33 hydroxyrisperidone 34 concentration the use of cyp2d6 inhibitors was much more strongly associated with risperidone concentration ( p < 0.0001 ) than with its metabolite's ( p = 0.06 ) . 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 28 . 1 the 2 use 2 use 3 of 2 use 6 was 3 of 5 inhibitors 4 cyp2d6 5 inhibitors 6 was 9 strongly 6 was 10 associated 7 much 8 more 8 more 9 strongly 10 associated 11 with 10 associated 19 than 11 with 13 concentration 12 risperidone 13 concentration 13 concentration 16 < 14 ( 16 < 15 p 16 < 16 < 17 0.0001 16 < 18 ) 19 than 20 with 20 with 22 metabolite's 21 its 22 metabolite's 22 metabolite's 25 = 23 ( 25 = 24 p 25 = 25 = 26 0.06 25 = 27 ) conclusions : in chronically treated youths , the metabolism of risperidone depends on the stage of sexual development , whereas that of 9 - hydroxyrisperidone varies with body fat . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 30 . 1 conclusions 2 : 2 : 3 in 3 in 6 youths 4 chronically 5 treated 5 treated 6 youths 7 , 9 metabolism 7 , 12 depends 7 , 19 , 8 the 9 metabolism 9 metabolism 10 of 9 metabolism 12 depends 10 of 11 risperidone 12 depends 13 on 13 on 15 stage 14 the 15 stage 15 stage 16 of 16 of 18 development 17 sexual 18 development 19 , 25 hydroxyrisperidone 19 , 26 varies 20 whereas 21 that 20 whereas 25 hydroxyrisperidone 22 of 23 9 22 of 24 - 22 of 25 hydroxyrisperidone 25 hydroxyrisperidone 26 varies 26 varies 27 with 27 with 29 fat 28 body 29 fat moreover , cyp2d6 inhibitors more strongly affect risperidone metabolism than that of its metabolite . 0 ###LEFT-WALL### 4 inhibitors 0 ###LEFT-WALL### 7 affect 0 ###LEFT-WALL### 15 . 1 moreover 2 , 1 moreover 4 inhibitors 3 cyp2d6 4 inhibitors 4 inhibitors 7 affect 5 more 6 strongly 6 strongly 7 affect 7 affect 9 metabolism 7 affect 10 than 8 risperidone 9 metabolism 10 than 11 that 10 than 12 of 12 of 14 metabolite 13 its 14 metabolite the clinical implications of these findings , in relation to efficacy and tolerability , deserve further investigation . 0 ###LEFT-WALL### 3 implications 0 ###LEFT-WALL### 15 deserve 0 ###LEFT-WALL### 18 . 1 the 3 implications 2 clinical 3 implications 3 implications 4 of 3 implications 15 deserve 4 of 6 findings 5 these 6 findings 6 findings 10 to 7 , 10 to 8 in 9 relation 9 relation 10 to 10 to 12 and 10 to 14 , 11 efficacy 12 and 12 and 13 tolerability 15 deserve 17 investigation 16 further 17 investigation none the idealized image [of] successful aging as living independently and autonomously does not convey reality for many adults in the united states and [globally] who are living with a disability . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 27 are 0 ###LEFT-WALL### 32 . 1 none 2 the 1 none 15 convey 1 none 27 are 2 the 11 and 3 idealized 7 aging 3 idealized 10 independently 3 idealized 11 and 4 image 7 aging 6 successful 7 aging 7 aging 9 living 8 as 9 living 11 and 13 does 12 autonomously 13 does 13 does 14 not 13 does 15 convey 15 convey 16 reality 15 convey 20 in 16 reality 17 for 17 for 19 adults 18 many 19 adults 20 in 24 and 21 the 23 states 22 united 23 states 23 states 24 and 24 and 26 who 27 are 28 living 28 living 29 with 29 with 31 disability 30 a 31 disability there have been inconsistencies throughout the literature in defining disability and aging . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 3 been 0 ###LEFT-WALL### 13 . 1 there 2 have 2 have 3 been 3 been 4 inconsistencies 3 been 5 throughout 5 throughout 11 and 6 the 7 literature 7 literature 8 in 7 literature 11 and 8 in 9 defining 9 defining 10 disability 11 and 12 aging a concept analysis using rodgers ' method was undertaken to define the concept of disability and aging , understand its antecedents and consequences , and determine the implications for nursing practice and research . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 9 undertaken 0 ###LEFT-WALL### 34 . 1 a 3 analysis 2 concept 3 analysis 3 analysis 4 using 3 analysis 8 was 4 using 7 method 5 rodgers 6 ' 6 ' 7 method 8 was 9 undertaken 9 undertaken 10 to 9 undertaken 29 for 10 to 18 , 11 define 13 concept 11 define 18 , 12 the 13 concept 13 concept 14 of 14 of 16 and 15 disability 16 and 16 and 17 aging 18 , 25 and 19 understand 22 and 19 understand 25 and 20 its 22 and 21 antecedents 22 and 22 and 23 consequences 24 , 25 and 25 and 26 determine 26 determine 28 implications 27 the 28 implications 29 for 30 nursing 30 nursing 32 and 31 practice 32 and 32 and 33 research four attributes were defined : limitation in physical , sensory , [and/or] mental function [;] universal human experience ; difficulties in activities of daily living [(] adls )/instrumental adls ; [and] social construction . 0 ###LEFT-WALL### 2 attributes 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 34 . 1 four 2 attributes 2 attributes 3 were 3 were 4 defined 5 : 6 limitation 5 : 19 ; 6 limitation 7 in 7 in 18 experience 8 physical 9 , 8 physical 18 experience 10 sensory 11 , 10 sensory 14 function 13 mental 14 function 14 function 18 experience 16 universal 17 human 17 human 18 experience 19 ; 20 difficulties 19 ; 28 )/instrumental 19 ; 30 ; 20 difficulties 21 in 20 difficulties 23 of 20 difficulties 28 )/instrumental 21 in 22 activities 23 of 25 living 24 daily 25 living 25 living 27 adls 28 )/instrumental 29 adls 30 ; 33 construction 32 social 33 construction exemplars were identified to provide a representation of the attributes in context , and a model of disability and aging was created . 0 ###LEFT-WALL### 1 exemplars 0 ###LEFT-WALL### 3 identified 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 23 . 1 exemplars 2 were 2 were 3 identified 3 identified 4 to 4 to 5 provide 5 provide 7 representation 5 provide 11 in 6 a 7 representation 7 representation 8 of 8 of 10 attributes 9 the 10 attributes 11 in 14 and 12 context 14 and 13 , 14 and 14 and 16 model 14 and 17 of 15 a 16 model 17 of 18 disability 19 and 20 aging 19 and 22 created 20 aging 21 was 21 was 22 created this concept analysis provides a better understanding of disability and aging , which can enable nurses to provide education and advocacy to older adults and their families . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 4 provides 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 28 . 1 this 3 analysis 2 concept 3 analysis 3 analysis 4 provides 4 provides 7 understanding 5 a 7 understanding 6 better 7 understanding 7 understanding 8 of 8 of 10 and 9 disability 10 and 10 and 11 aging 12 , 13 which 12 , 15 enable 13 which 14 can 14 can 15 enable 15 enable 16 nurses 15 enable 17 to 15 enable 18 provide 17 to 18 provide 18 provide 20 and 18 provide 22 to 19 education 20 and 20 and 21 advocacy 22 to 25 and 23 older 24 adults 24 adults 25 and 25 and 27 families 26 their 27 families as more individuals live past age 100 , it is important for health professionals to better understand characteristics important to the mental health of the oldest - old in our society . 0 ###LEFT-WALL### 9 it 0 ###LEFT-WALL### 17 understand 0 ###LEFT-WALL### 32 . 1 as 3 individuals 1 as 4 live 1 as 8 , 1 as 9 it 2 more 3 individuals 3 individuals 4 live 4 live 5 past 5 past 6 age 6 age 7 100 9 it 10 is 10 is 11 important 11 important 12 for 11 important 15 to 12 for 14 professionals 13 health 14 professionals 15 to 17 understand 16 better 17 understand 17 understand 18 characteristics 18 characteristics 19 important 18 characteristics 24 of 18 characteristics 29 in 19 important 20 to 20 to 23 health 21 the 23 health 22 mental 23 health 24 of 28 old 25 the 26 oldest 25 the 28 old 26 oldest 27 - 29 in 31 society 30 our 31 society few studies have been conducted on mental health in this group , but current literature suggests these individuals are very resilient with respect to mental health and life satisfaction , despite their health disadvantages . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 5 conducted 0 ###LEFT-WALL### 13 but 0 ###LEFT-WALL### 35 . 1 few 2 studies 2 studies 3 have 3 have 4 been 4 been 5 conducted 5 conducted 6 on 5 conducted 9 in 6 on 8 health 7 mental 8 health 9 in 11 group 10 this 11 group 12 , 13 but 13 but 15 literature 13 but 16 suggests 14 current 15 literature 15 literature 16 suggests 16 suggests 18 individuals 16 suggests 19 are 17 these 18 individuals 18 individuals 19 are 19 are 21 resilient 20 very 21 resilient 21 resilient 22 with 21 resilient 24 to 21 resilient 31 despite 22 with 23 respect 24 to 27 and 25 mental 26 health 26 health 27 and 27 and 29 satisfaction 27 and 30 , 28 life 29 satisfaction 31 despite 34 disadvantages 32 their 34 disadvantages 33 health 34 disadvantages in interviews in a variety of studies , participants talked of the importance of both inner and outer resources for empowerment . 0 ###LEFT-WALL### 9 participants 0 ###LEFT-WALL### 10 talked 0 ###LEFT-WALL### 22 . 1 in 2 interviews 1 in 8 , 1 in 9 participants 2 interviews 3 in 2 interviews 6 of 3 in 5 variety 4 a 5 variety 6 of 7 studies 9 participants 10 talked 10 talked 11 of 10 talked 19 resources 11 of 13 importance 12 the 13 importance 13 importance 14 of 14 of 15 both 16 inner 17 and 17 and 18 outer 17 and 19 resources 19 resources 20 for 20 for 21 empowerment greater understanding of mental health in aging can inform policy makers as they draft new legislation and programs to enhance quality of life for the oldest - old [.] 0 ###LEFT-WALL### 2 understanding 0 ###LEFT-WALL### 9 inform 1 greater 2 understanding 2 understanding 3 of 2 understanding 6 in 2 understanding 8 can 3 of 5 health 4 mental 5 health 6 in 7 aging 8 can 9 inform 9 inform 11 makers 9 inform 12 as 9 inform 19 to 9 inform 22 of 10 policy 11 makers 12 as 13 they 12 as 18 programs 13 they 17 and 14 draft 16 legislation 14 draft 17 and 15 new 16 legislation 17 and 18 programs 19 to 20 enhance 20 enhance 21 quality 22 of 23 life 23 life 24 for 24 for 28 old 25 the 26 oldest 25 the 28 old 26 oldest 27 - major depressive disorder ( mdd ) is associated with a high rate of developing serious medical comorbidities such as cardiovascular disease , stroke , dementia , osteoporosis , diabetes , and the metabolic syndrome . 0 ###LEFT-WALL### 3 disorder 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 35 . 1 major 3 disorder 2 depressive 3 disorder 3 disorder 5 mdd 3 disorder 7 is 4 ( 5 mdd 5 mdd 6 ) 7 is 8 associated 8 associated 9 with 9 with 12 rate 10 a 12 rate 11 high 12 rate 12 rate 13 of 13 of 14 developing 14 developing 17 comorbidities 14 developing 19 as 15 serious 17 comorbidities 16 medical 17 comorbidities 18 such 19 as 19 as 31 and 20 cardiovascular 21 disease 21 disease 22 , 22 , 23 stroke 22 , 24 , 24 , 25 dementia 24 , 26 , 26 , 27 osteoporosis 26 , 28 , 28 , 29 diabetes 28 , 31 and 30 , 31 and 31 and 34 syndrome 32 the 34 syndrome 33 metabolic 34 syndrome these are conditions that typically occur late in life , and it has been suggested that mdd may be associated with " accelerated aging . " 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 25 . 1 these 2 are 2 are 3 conditions 2 are 8 in 3 conditions 4 that 3 conditions 6 occur 4 that 6 occur 5 typically 6 occur 6 occur 7 late 8 in 9 life 10 , 11 and 11 and 12 it 11 and 15 suggested 12 it 13 has 13 has 14 been 14 been 15 suggested 15 suggested 16 that 16 that 17 mdd 16 that 20 associated 17 mdd 18 may 18 may 19 be 19 be 20 associated 20 associated 21 with 21 with 22 " 21 with 24 aging 23 accelerated 24 aging 25 . 26 " we review several moderators and mediators that may accompany mdd and that may give rise to these comorbid medical conditions . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 21 . 1 we 2 review 2 review 4 moderators 3 several 4 moderators 5 and 6 mediators 5 and 15 rise 6 mediators 7 that 6 mediators 11 and 6 mediators 15 rise 7 that 11 and 8 may 9 accompany 8 may 11 and 9 accompany 10 mdd 11 and 14 give 12 that 13 may 13 may 14 give 15 rise 16 to 16 to 20 conditions 17 these 20 conditions 18 comorbid 20 conditions 19 medical 20 conditions we first review the moderating effects of psychological styles of coping , genetic predisposition , and epigenetic modifications ( eg , secondary to childhood adversity ) . 0 ###LEFT-WALL### 2 first 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 27 . 1 we 2 first 2 first 3 review 3 review 6 effects 4 the 6 effects 5 moderating 6 effects 6 effects 7 of 7 of 16 and 8 psychological 9 styles 9 styles 10 of 9 styles 12 , 10 of 11 coping 12 , 14 predisposition 12 , 16 and 13 genetic 14 predisposition 15 , 16 and 16 and 18 modifications 16 and 20 eg 16 and 22 secondary 17 epigenetic 18 modifications 19 ( 20 eg 20 eg 21 , 21 , 22 secondary 22 secondary 23 to 22 secondary 26 ) 23 to 25 adversity 24 childhood 25 adversity in this model , mdd is characterized by a surfeit of potentially destructive mediators and an insufficiency of protective or restorative ones . 0 ###LEFT-WALL### 5 mdd 0 ###LEFT-WALL### 7 characterized 0 ###LEFT-WALL### 23 . 1 in 3 model 1 in 4 , 1 in 5 mdd 2 this 3 model 5 mdd 6 is 6 is 7 characterized 7 characterized 8 by 8 by 10 surfeit 9 a 10 surfeit 10 surfeit 11 of 11 of 15 and 12 potentially 13 destructive 13 destructive 14 mediators 14 mediators 15 and 15 and 17 insufficiency 15 and 18 of 16 an 17 insufficiency 18 of 22 ones 19 protective 20 or 20 or 21 restorative 20 or 22 ones these factors interact in increasing the likelihood of physical disease and [of] accelerated aging at the cellular level . 0 ###LEFT-WALL### 2 factors 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 19 . 1 these 2 factors 2 factors 11 and 3 interact 4 in 3 interact 11 and 4 in 5 increasing 5 increasing 7 likelihood 6 the 7 likelihood 7 likelihood 8 of 8 of 10 disease 9 physical 10 disease 11 and 13 accelerated 11 and 15 at 13 accelerated 14 aging 15 at 18 level 16 the 18 level 17 cellular 18 level we conclude with suggestions for novel [mechanism] - based therapeutics based on these mediators . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 15 . 1 we 2 conclude 2 conclude 3 with 2 conclude 5 for 2 conclude 12 on 2 conclude 14 mediators 3 with 4 suggestions 5 for 10 therapeutics 6 novel 8 - 6 novel 10 therapeutics 9 based 10 therapeutics 10 therapeutics 11 based 12 on 13 these first time p53 was found in the complex with viral large [t] - antigene in the cells transformed by small dna virus sv40 . 0 ###LEFT-WALL### 2 time 0 ###LEFT-WALL### 18 transformed 0 ###LEFT-WALL### 24 . 1 first 2 time 2 time 3 p53 2 time 5 found 2 time 18 transformed 3 p53 4 was 4 was 5 found 5 found 6 in 5 found 9 with 6 in 8 complex 7 the 8 complex 9 with 14 antigene 10 viral 14 antigene 11 large 13 - 11 large 14 antigene 14 antigene 15 in 15 in 17 cells 16 the 17 cells 18 transformed 19 by 18 transformed 23 sv40 19 by 22 virus 20 small 22 virus 21 dna 22 virus the cloning of p53 cdna was done in the beginning [of] [eighties] and soon after that the whole p53 gene was cloned . 0 ###LEFT-WALL### 2 cloning 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 . 1 the 2 cloning 2 cloning 3 of 2 cloning 6 was 3 of 5 cdna 4 p53 5 cdna 6 was 7 done 7 done 8 in 8 in 10 beginning 9 the 10 beginning 13 and 14 soon 13 and 20 gene 13 and 22 cloned 15 after 16 that 15 after 20 gene 17 the 20 gene 18 whole 20 gene 19 p53 20 gene 20 gene 21 was 21 was 22 cloned the p53 family is comprised of three genes : tp53,tp63 and tp73 , each of which is expressed as a set [of] structurally and functionally different isoforms . 0 ###LEFT-WALL### 3 family 0 ###LEFT-WALL### 5 comprised 0 ###LEFT-WALL### 9 : 0 ###LEFT-WALL### 28 . 1 the 3 family 2 p53 3 family 3 family 4 is 4 is 5 comprised 5 comprised 6 of 6 of 8 genes 7 three 8 genes 9 : 24 and 10 tp53,tp63 11 and 11 and 12 tp73 12 tp73 13 , 13 , 14 each 13 , 24 and 14 each 15 of 15 of 16 which 16 which 17 is 17 is 18 expressed 18 expressed 19 as 18 expressed 23 structurally 19 as 21 set 20 a 21 set 24 and 27 isoforms 25 functionally 26 different 26 different 27 isoforms all of them intensively interact with each other forming a united functional network of proteins . 0 ###LEFT-WALL### 3 them 0 ###LEFT-WALL### 5 interact 0 ###LEFT-WALL### 16 . 1 all 2 of 1 all 3 them 2 of 3 them 3 them 5 interact 4 intensively 5 interact 5 interact 6 with 6 with 8 other 6 with 9 forming 7 each 8 other 9 forming 13 network 10 a 13 network 11 united 13 network 12 functional 13 network 13 network 14 of 14 of 15 proteins in this review we discuss evolution of the p53 family and significance of all its members in embryonic development , reproduction , regeneration , regulation of aging and life span , as well as in the body 's defense against cancer . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 discuss 0 ###LEFT-WALL### 42 . 1 in 3 review 1 in 4 we 2 this 3 review 4 we 5 discuss 5 discuss 11 and 5 discuss 33 well 5 discuss 34 as 6 evolution 7 of 6 evolution 11 and 7 of 10 family 8 the 10 family 9 p53 10 family 11 and 12 significance 11 and 21 reproduction 11 and 23 regeneration 12 significance 13 of 13 of 14 all 14 all 15 its 14 all 16 members 15 its 16 members 16 members 17 in 17 in 19 development 18 embryonic 19 development 20 , 21 reproduction 21 reproduction 22 , 22 , 23 regeneration 23 regeneration 28 and 23 regeneration 31 , 24 , 28 and 25 regulation 26 of 25 regulation 28 and 26 of 27 aging 28 and 30 span 28 and 31 , 29 life 30 span 32 as 33 well 34 as 35 in 35 in 39 defense 36 the 37 body 37 body 38 's 38 's 39 defense 39 defense 40 against 40 against 41 cancer with special attention we review the role of less studied members of the p53 family : p63 and p73 , in oncogenesis and tumor progression and show that different isoforms of these proteins might exert a contrary effect on these processes . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 42 . 1 with 3 attention 1 with 4 we 2 special 3 attention 4 we 26 and 5 review 23 and 5 review 26 and 6 the 7 role 7 role 8 of 7 role 12 of 7 role 18 and 8 of 11 members 9 less 10 studied 10 studied 11 members 12 of 14 p53 13 the 14 p53 14 p53 15 family 14 p53 17 p63 15 family 16 : 16 : 17 p63 18 and 19 p73 18 and 20 , 18 and 21 in 18 and 23 and 21 in 22 oncogenesis 23 and 25 progression 24 tumor 25 progression 26 and 27 show 27 show 28 that 28 that 30 isoforms 28 that 35 exert 29 different 30 isoforms 30 isoforms 31 of 30 isoforms 34 might 31 of 33 proteins 32 these 33 proteins 34 might 35 exert 35 exert 38 effect 35 exert 39 on 36 a 38 effect 37 contrary 38 effect 39 on 41 processes 40 these 41 processes male reproductive success is dependent on insemination success and reproductive output . 0 ###LEFT-WALL### 3 success 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 12 . 1 male 3 success 2 reproductive 3 success 3 success 4 is 4 is 5 dependent 5 dependent 6 on 6 on 9 and 7 insemination 8 success 8 success 9 and 9 and 11 output 10 reproductive 11 output during mating [,] male mosquitoes transfer not just sperm , but also seminal fluid proteins that may have profound effects on mated female biology and behavior . 0 ###LEFT-WALL### 15 proteins 0 ###LEFT-WALL### 18 have 0 ###LEFT-WALL### 27 . 1 during 6 transfer 1 during 15 proteins 2 mating 6 transfer 4 male 6 transfer 5 mosquitoes 6 transfer 7 not 11 but 7 not 15 proteins 8 just 9 sperm 9 sperm 11 but 10 , 11 but 11 but 12 also 11 but 14 fluid 13 seminal 14 fluid 15 proteins 16 that 15 proteins 17 may 15 proteins 18 have 16 that 17 may 18 have 20 effects 18 have 21 on 19 profound 20 effects 21 on 25 and 22 mated 24 biology 23 female 24 biology 24 biology 25 and 25 and 26 behavior in this study , we investigated the role of male body size and mating history on semen depletion , female longevity , and reproductive success in aedes aegypti l ..y small and large males were mated in rapid succession with up to five females . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 30 ..y 0 ###LEFT-WALL### 45 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 investigated 6 investigated 13 and 6 investigated 26 in 7 the 8 role 8 role 9 of 8 role 13 and 9 of 12 size 10 male 11 body 11 body 12 size 13 and 15 history 13 and 16 on 14 mating 15 history 16 on 23 and 17 semen 18 depletion 18 depletion 19 , 19 , 21 longevity 19 , 23 and 20 female 21 longevity 22 , 23 and 23 and 25 success 24 reproductive 25 success 26 in 28 aegypti 27 aedes 28 aegypti 28 aegypti 29 l 29 l 30 ..y 30 ..y 32 and 31 small 32 and 32 and 34 males 32 and 35 were 33 large 34 males 35 were 36 mated 36 mated 37 in 36 mated 40 with 37 in 39 succession 38 rapid 39 succession 40 with 44 females 41 up 42 to 42 to 43 five 43 five 44 females our results indicate that large males had greater mating capacity than small males . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 14 . 1 our 2 results 2 results 3 indicate 3 indicate 4 that 4 that 6 males 4 that 7 had 5 large 6 males 6 males 7 had 7 had 10 capacity 7 had 11 than 8 greater 10 capacity 9 mating 10 capacity 11 than 13 males 12 small 13 males a reduction in fecundity by >50 % was observed in females that were fourth to mate with small males in comparison with females that mated earlier in sequence . 0 ###LEFT-WALL### 2 reduction 0 ###LEFT-WALL### 9 observed 0 ###LEFT-WALL### 29 . 1 a 2 reduction 2 reduction 3 in 2 reduction 5 by 2 reduction 8 was 3 in 4 fecundity 5 by 7 % 6 >50 7 % 8 was 9 observed 9 observed 10 in 9 observed 15 to 9 observed 17 with 9 observed 20 in 10 in 11 females 11 females 12 that 11 females 13 were 12 that 13 were 13 were 14 fourth 15 to 16 mate 17 with 19 males 18 small 19 males 20 in 21 comparison 21 comparison 22 with 21 comparison 24 that 21 comparison 25 mated 22 with 23 females 24 that 25 mated 25 mated 26 earlier 25 mated 27 in 27 in 28 sequence for females mated to large males , this reduction became evident for females that mated fifth in sequence . 0 ###LEFT-WALL### 9 reduction 0 ###LEFT-WALL### 10 became 0 ###LEFT-WALL### 19 . 1 for 2 females 1 for 7 , 1 for 9 reduction 2 females 3 mated 3 mated 4 to 4 to 6 males 5 large 6 males 8 this 9 reduction 9 reduction 10 became 10 became 11 evident 11 evident 12 for 12 for 13 females 13 females 14 that 13 females 15 mated 14 that 15 mated 15 mated 16 fifth 15 mated 17 in 17 in 18 sequence no loss of fertility ( measured [as] [hatch] [rate] ) was observed in females that were third - fifth in mating sequence compared with females mated to virgin males . 0 ###LEFT-WALL### 2 loss 0 ###LEFT-WALL### 12 observed 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 30 . 1 no 2 loss 2 loss 3 of 2 loss 11 was 3 of 4 fertility 4 fertility 6 measured 5 ( 6 measured 6 measured 10 ) 11 was 12 observed 12 observed 13 in 13 in 14 females 14 females 15 that 14 females 16 were 15 that 16 were 16 were 17 third 18 - 22 sequence 18 - 26 mated 19 fifth 22 sequence 20 in 21 mating 20 in 22 sequence 22 sequence 23 compared 22 sequence 24 with 22 sequence 26 mated 24 with 25 females 26 mated 27 to 27 to 29 males 28 virgin 29 males when females were maintained on a low - quality ( 5 % sucrose ) diet , those mated to virgin males had a greater longevity compared with females mated third in sequence . 0 ###LEFT-WALL### 17 those 0 ###LEFT-WALL### 22 had 0 ###LEFT-WALL### 33 . 1 when 2 females 1 when 4 maintained 1 when 16 , 1 when 17 those 2 females 3 were 3 were 4 maintained 4 maintained 5 on 5 on 15 diet 6 a 15 diet 7 low 9 quality 7 low 14 ) 7 low 15 diet 8 - 9 quality 9 quality 13 sucrose 9 quality 14 ) 10 ( 13 sucrose 11 5 12 % 12 % 13 sucrose 13 sucrose 14 ) 17 those 18 mated 17 those 22 had 18 mated 19 to 19 to 21 males 20 virgin 21 males 22 had 25 longevity 22 had 31 in 23 a 25 longevity 24 greater 25 longevity 25 longevity 26 compared 25 longevity 27 with 25 longevity 29 mated 27 with 28 females 29 mated 30 third 31 in 32 sequence we conclude that small males experience more rapid seminal depletion than large males , and discuss the role of semen depletion in the mated female . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 26 . 1 we 2 conclude 2 conclude 3 that 3 that 5 males 3 that 15 and 4 small 5 males 5 males 15 and 6 experience 10 depletion 6 experience 11 than 6 experience 15 and 7 more 8 rapid 8 rapid 10 depletion 9 seminal 10 depletion 11 than 13 males 12 large 13 males 14 , 15 and 15 and 16 discuss 16 discuss 18 role 16 discuss 22 in 17 the 18 role 18 role 19 of 19 of 21 depletion 20 semen 21 depletion 22 in 25 female 23 the 25 female 24 mated 25 female our results contribute toward a better understanding of the complexity of ae . aegypti mating biology [and] provide refined estimates of mating capacity for genetic control efforts . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 contribute 0 ###LEFT-WALL### 13 . 1 our 2 results 2 results 3 contribute 3 contribute 4 toward 4 toward 7 understanding 5 a 7 understanding 6 better 7 understanding 7 understanding 8 of 8 of 10 complexity 9 the 10 complexity 10 complexity 11 of 11 of 12 ae 13 . 14 aegypti 13 . 18 provide 13 . 28 . 14 aegypti 15 mating 14 aegypti 18 provide 15 mating 16 biology 18 provide 20 estimates 19 refined 20 estimates 20 estimates 21 of 21 of 22 mating 22 mating 23 capacity 23 capacity 24 for 24 for 27 efforts 25 genetic 26 control 26 control 27 efforts a 65 [-] year [-] old man presented with complaints of general [malaise] and severe disturbance of consciousness since 2 months prior to admission . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 a 7 man 2 65 4 year 4 year 7 man 6 old 7 man 7 man 8 presented 7 man 11 of 7 man 14 and 8 presented 9 with 9 with 10 complaints 11 of 12 general 14 and 16 disturbance 14 and 22 prior 15 severe 16 disturbance 16 disturbance 17 of 17 of 18 consciousness 18 consciousness 19 since 19 since 21 months 20 2 21 months 22 prior 23 to 23 to 24 admission mri of the head showed high intensity area in flair [image] in the left base [l] ganglia , the medial side of the left temporal lobe and both sides of the frontal lobe and brainstem . 0 ###LEFT-WALL### 1 mri 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 36 . 1 mri 2 of 1 mri 5 showed 2 of 4 head 3 the 4 head 5 showed 8 area 6 high 8 area 7 intensity 8 area 8 area 9 in 8 area 12 in 9 in 10 flair 12 in 17 ganglia 13 the 17 ganglia 14 left 17 ganglia 15 base 17 ganglia 18 , 34 and 19 the 21 side 20 medial 21 side 21 side 22 of 21 side 27 and 22 of 26 lobe 23 the 26 lobe 24 left 26 lobe 25 temporal 26 lobe 27 and 29 sides 27 and 30 of 27 and 34 and 28 both 29 sides 30 of 33 lobe 31 the 33 lobe 32 frontal 33 lobe 34 and 35 brainstem the contrasting effect was insignificant . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 6 . 1 the 3 effect 2 contrasting 3 effect 3 effect 4 was 4 was 5 insignificant laboratory investigations showed positive results of ebv antibody titer and elevated ebv - dna in the spinal fluid . 0 ###LEFT-WALL### 2 investigations 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 . 1 laboratory 2 investigations 2 investigations 10 and 3 showed 5 results 3 showed 9 titer 3 showed 10 and 4 positive 5 results 5 results 6 of 6 of 7 ebv 8 antibody 9 titer 10 and 11 elevated 11 elevated 14 dna 11 elevated 15 in 12 ebv 14 dna 13 - 14 dna 15 in 18 fluid 16 the 18 fluid 17 spinal 18 fluid we suspected encephalitis due to epstein - barr virus and the patient was treated with acyclovir and high dosage of steroids . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 suspected 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 22 . 1 we 2 suspected 2 suspected 3 encephalitis 2 suspected 5 to 4 due 5 to 5 to 6 epstein 7 - 9 virus 7 - 10 and 8 barr 9 virus 10 and 12 patient 10 and 14 treated 11 the 12 patient 12 patient 13 was 13 was 14 treated 14 treated 15 with 15 with 17 and 16 acyclovir 17 and 17 and 19 dosage 17 and 20 of 18 high 19 dosage 20 of 21 steroids however , the patient 's consciousness gradually deteriorated and he died on day 146 of admission . 0 ###LEFT-WALL### 6 consciousness 0 ###LEFT-WALL### 8 deteriorated 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 6 consciousness 3 the 4 patient 4 patient 5 's 5 's 6 consciousness 6 consciousness 8 deteriorated 7 gradually 8 deteriorated 9 and 10 he 9 and 11 died 10 he 11 died 11 died 12 on 12 on 13 day 13 day 14 146 13 day 15 of 15 of 16 admission autopsy revealed proliferation [of] large atypical cells with clear and irregular nuclei in the brain tissue . 0 ###LEFT-WALL### 1 autopsy 0 ###LEFT-WALL### 2 revealed 0 ###LEFT-WALL### 17 . 1 autopsy 2 revealed 2 revealed 7 cells 2 revealed 8 with 2 revealed 13 in 3 proliferation 7 cells 5 large 7 cells 6 atypical 7 cells 8 with 12 nuclei 9 clear 10 and 10 and 11 irregular 10 and 12 nuclei 13 in 16 tissue 14 the 16 tissue 15 brain 16 tissue immunohistochemistry expressed positive eber - ish . 0 ###LEFT-WALL### 1 immunohistochemistry 0 ###LEFT-WALL### 2 expressed 0 ###LEFT-WALL### 7 . 1 immunohistochemistry 2 expressed 2 expressed 6 ish 3 positive 6 ish 4 eber 6 ish 5 - 6 ish this case was finally diagnosed as the central nervous system involvement by age - related epstein - barr virus - associated [b] - cell lymphoproliferative disorder . 0 ###LEFT-WALL### 2 case 0 ###LEFT-WALL### 5 diagnosed 0 ###LEFT-WALL### 15 related 1 this 2 case 2 case 3 was 3 was 5 diagnosed 4 finally 5 diagnosed 5 diagnosed 6 as 5 diagnosed 12 by 6 as 11 involvement 7 the 11 involvement 8 central 10 system 9 nervous 10 system 10 system 11 involvement 12 by 13 age 14 - 15 related 15 related 16 epstein 16 epstein 19 virus 17 - 19 virus 18 barr 19 virus 19 virus 21 associated 19 virus 26 disorder 19 virus 27 . 20 - 21 associated 21 associated 23 - 23 - 26 disorder 24 cell 26 disorder 25 lymphoproliferative 26 disorder 26 disorder 27 . background : increased production of reactive oxygen species ( ros ) in mitochondria has been proposed as the pathogenic mechanism for chronic complications of diabetes . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 production 2 : 16 proposed 2 : 26 . 3 increased 4 production 4 production 5 of 4 production 12 in 4 production 14 has 5 of 8 species 6 reactive 7 oxygen 7 oxygen 8 species 8 species 10 ros 9 ( 10 ros 10 ros 11 ) 12 in 13 mitochondria 14 has 15 been 15 been 16 proposed 16 proposed 17 as 17 as 20 mechanism 18 the 20 mechanism 19 pathogenic 20 mechanism 20 mechanism 21 for 21 for 23 complications 22 chronic 23 complications 23 complications 24 of 24 of 25 diabetes mitochondrial dna ( mtdna ) is more vulnerable to reactive oxygen species . 0 ###LEFT-WALL### 2 dna 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 13 . 1 mitochondrial 2 dna 2 dna 4 mtdna 2 dna 6 is 3 ( 4 mtdna 4 mtdna 5 ) 6 is 8 vulnerable 7 more 8 vulnerable 8 vulnerable 9 to 9 to 12 species 10 reactive 11 oxygen 11 oxygen 12 species however , there are few data on the mitochondrial dna damage in diabetes and these are available only from patients with different duration of the disease and tissues not relevant to the chronic complications of diabetes . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 37 . 1 however 2 , 1 however 3 there 3 there 4 are 4 are 6 data 5 few 6 data 6 data 7 on 6 data 17 available 7 on 10 dna 8 the 10 dna 9 mitochondrial 10 dna 10 dna 14 and 10 dna 16 are 11 damage 12 in 11 damage 14 and 12 in 13 diabetes 14 and 15 these 14 and 16 are 17 available 18 only 17 available 19 from 17 available 21 with 19 from 20 patients 21 with 27 and 21 with 29 not 21 with 30 relevant 22 different 23 duration 23 duration 24 of 23 duration 27 and 24 of 26 disease 25 the 26 disease 27 and 28 tissues 29 not 30 relevant 30 relevant 31 to 31 to 34 complications 32 the 34 complications 33 chronic 34 complications 34 complications 35 of 35 of 36 diabetes we therefore proposed to study the stability of mitochondrial dna under controlled experimental conditions , to understand its contribution to chronic complications of diabetes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 proposed 0 ###LEFT-WALL### 25 . 1 we 3 proposed 2 therefore 3 proposed 3 proposed 4 to 3 proposed 15 , 4 to 15 , 5 study 7 stability 5 study 11 under 5 study 15 , 6 the 7 stability 7 stability 8 of 8 of 10 dna 9 mitochondrial 10 dna 11 under 14 conditions 12 controlled 14 conditions 13 experimental 14 conditions 15 , 16 to 15 , 17 understand 15 , 20 to 16 to 17 understand 17 understand 19 contribution 18 its 19 contribution 20 to 22 complications 21 chronic 22 complications 22 complications 23 of 23 of 24 diabetes methods : the mitochondrial dna damage was evaluated by long - fragment polymerase chain reaction in human dermal fibroblasts exposed to high glucose level and hypoxia ( an additional source of reactive oxygen species ) or in organs from diabetic animals ( db/db mice ) at different ages . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 49 . 2 : 6 damage 2 : 8 evaluated 3 the 6 damage 4 mitochondrial 6 damage 5 dna 6 damage 6 damage 7 was 7 was 8 evaluated 8 evaluated 9 by 8 evaluated 16 in 8 evaluated 36 or 8 evaluated 46 at 9 by 15 reaction 10 long 11 - 10 long 12 fragment 12 fragment 15 reaction 13 polymerase 15 reaction 14 chain 15 reaction 16 in 19 fibroblasts 17 human 19 fibroblasts 18 dermal 19 fibroblasts 19 fibroblasts 20 exposed 21 to 25 and 21 to 36 or 22 high 23 glucose 23 glucose 24 level 24 level 25 and 25 and 26 hypoxia 25 and 30 source 27 ( 30 source 28 an 29 additional 28 an 30 source 29 additional 30 source 30 source 31 of 30 source 35 ) 31 of 34 species 32 reactive 33 oxygen 33 oxygen 34 species 36 or 37 in 37 in 38 organs 38 organs 39 from 38 organs 44 mice 39 from 41 animals 40 diabetic 41 animals 42 ( 44 mice 43 db/db 44 mice 44 mice 45 ) 46 at 48 ages 47 different 48 ages reactive oxygen species production was assessed in vitro by fluorescence [and] in vivo by nitrosylation of the proteins . 0 ###LEFT-WALL### 4 production 0 ###LEFT-WALL### 6 assessed 0 ###LEFT-WALL### 19 . 1 reactive 4 production 2 oxygen 4 production 3 species 4 production 4 production 5 was 5 was 6 assessed 6 assessed 8 vitro 6 assessed 9 by 6 assessed 13 vivo 6 assessed 14 by 7 in 8 vitro 9 by 10 fluorescence 12 in 13 vivo 14 by 15 nitrosylation 15 nitrosylation 16 of 16 of 18 proteins 17 the 18 proteins the antioxidant enzymes were assessed by enzyme activity and by quantitative real - time polymerase chain reaction while the mitochondrial repair activity ( base excision repair ) was determined by using abasic site [-] containing oligonucleotides as substrates . 0 ###LEFT-WALL### 3 enzymes 0 ###LEFT-WALL### 5 assessed 0 ###LEFT-WALL### 39 . 1 the 3 enzymes 2 antioxidant 3 enzymes 3 enzymes 4 were 4 were 5 assessed 5 assessed 9 and 5 assessed 18 while 5 assessed 30 by 6 by 8 activity 6 by 9 and 7 enzyme 8 activity 9 and 10 by 10 by 17 reaction 11 quantitative 17 reaction 12 real 13 - 12 real 15 polymerase 14 time 15 polymerase 15 polymerase 17 reaction 16 chain 17 reaction 18 while 22 activity 18 while 29 determined 19 the 22 activity 20 mitochondrial 21 repair 21 repair 22 activity 22 activity 26 repair 22 activity 28 was 23 ( 26 repair 24 base 26 repair 25 excision 26 repair 26 repair 27 ) 28 was 29 determined 30 by 31 using 31 using 36 oligonucleotides 31 using 37 as 32 abasic 33 site 33 site 36 oligonucleotides 35 containing 36 oligonucleotides 37 as 38 substrates results : hyperglycaemia , when combined with hypoxia , is able to induce mitochondrial dna damage in human dermal fibroblasts . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 hyperglycaemia 2 : 10 is 2 : 21 . 3 hyperglycaemia 10 is 4 , 5 when 5 when 6 combined 5 when 9 , 5 when 10 is 6 combined 7 with 7 with 8 hypoxia 10 is 11 able 11 able 12 to 11 able 13 induce 12 to 13 induce 13 induce 16 damage 13 induce 17 in 14 mitochondrial 16 damage 15 dna 16 damage 17 in 20 fibroblasts 18 human 20 fibroblasts 19 dermal 20 fibroblasts the deleterious effect is mediated by mitochondrial reactive oxygen species , being abolished when the mitochondria electron transport is blocked . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 5 mediated 1 the 3 effect 2 deleterious 3 effect 3 effect 4 is 4 is 5 mediated 5 mediated 6 by 6 by 10 species 7 mitochondrial 9 oxygen 8 reactive 9 oxygen 9 oxygen 10 species 10 species 12 being 11 , 12 being 12 being 13 abolished 12 being 21 . 13 abolished 14 when 14 when 18 transport 14 when 20 blocked 15 the 18 transport 16 mitochondria 18 transport 17 electron 18 transport 18 transport 19 is 19 is 20 blocked the accumulation of mitochondrial dna damage in vivo is , however , decreased in ['] old ['] diabetic animals ( db/db ) despite higher reactive oxygen species levels . 0 ###LEFT-WALL### 2 accumulation 0 ###LEFT-WALL### 13 decreased 0 ###LEFT-WALL### 29 . 1 the 2 accumulation 2 accumulation 3 of 2 accumulation 9 is 3 of 6 damage 4 mitochondrial 6 damage 5 dna 6 damage 7 in 8 vivo 8 vivo 9 is 9 is 13 decreased 10 , 11 however 11 however 12 , 11 however 13 decreased 13 decreased 14 in 13 decreased 23 despite 14 in 19 animals 16 old 19 animals 18 diabetic 19 animals 19 animals 21 db/db 20 ( 21 db/db 21 db/db 22 ) 23 despite 28 levels 24 higher 28 levels 25 reactive 26 oxygen 26 oxygen 28 levels 27 species 28 levels this mitochondrial dna protection might be conferred by an increased base excision repair activity . 0 ###LEFT-WALL### 4 protection 0 ###LEFT-WALL### 7 conferred 0 ###LEFT-WALL### 15 . 1 this 4 protection 2 mitochondrial 4 protection 3 dna 4 protection 4 protection 5 might 5 might 6 be 6 be 7 conferred 7 conferred 8 by 8 by 14 activity 9 an 14 activity 10 increased 11 base 11 base 12 excision 12 excision 14 activity 13 repair 14 activity conclusion : increased base excision repair activity in tissues affected by the chronic complications of diabetes is a potential mechanism that can overcome mitochondrial dna damage induced by hyperglycaemia - related reactive oxygen species overproduction . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 excision 2 : 17 is 2 : 31 related 3 increased 5 excision 4 base 5 excision 5 excision 7 activity 5 excision 10 affected 5 excision 17 is 6 repair 7 activity 7 activity 8 in 7 activity 10 affected 8 in 9 tissues 10 affected 11 by 11 by 14 complications 12 the 14 complications 13 chronic 14 complications 14 complications 15 of 15 of 16 diabetes 17 is 20 mechanism 18 a 20 mechanism 19 potential 20 mechanism 20 mechanism 21 that 20 mechanism 27 induced 21 that 26 damage 21 that 27 induced 22 can 23 overcome 23 overcome 26 damage 24 mitochondrial 26 damage 25 dna 26 damage 26 damage 27 induced 27 induced 28 by 28 by 29 hyperglycaemia 30 - 31 related 31 related 35 overproduction 31 related 36 . 32 reactive 33 oxygen 33 oxygen 34 species 34 species 35 overproduction context : the mountain ok ( mt ok [ )(people of telefomin , who live at the interior of papua new guinea ( png ) , were documented over 25 years ago to be one of the shortest populations on record , with average adult height below the fifth percentile ( us ) . 0 ###LEFT-WALL### 1 context 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 54 . 1 context 2 : 2 : 5 ok 3 the 5 ok 4 mountain 5 ok 5 ok 10 )(people 6 ( 10 )(people 7 mt 8 ok 8 ok 10 )(people 10 )(people 11 of 10 )(people 13 , 11 of 12 telefomin 13 , 14 who 13 , 28 documented 14 who 26 , 15 live 16 at 15 live 26 , 16 at 18 interior 17 the 18 interior 18 interior 19 of 18 interior 24 png 19 of 22 guinea 20 papua 21 new 21 new 22 guinea 23 ( 24 png 24 png 25 ) 26 , 27 were 27 were 28 documented 28 documented 29 over 28 documented 32 ago 28 documented 33 to 28 documented 43 with 29 over 30 25 31 years 32 ago 33 to 34 be 34 be 35 one 35 one 36 of 36 of 39 populations 37 the 38 shortest 37 the 39 populations 39 populations 40 on 40 on 41 record 42 , 43 with 43 with 46 height 43 with 47 below 43 with 53 ) 44 average 46 height 45 adult 46 height 47 below 50 percentile 48 the 49 fifth 48 the 50 percentile 50 percentile 52 us 51 ( 52 us 52 us 53 ) serum growth hormone was detectable , insulin - like growth factor - 1 and serum indicators of protein nutritional status fell within the normal range , suggesting that these were not primary factors for their relative short stature . 0 ###LEFT-WALL### 3 hormone 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 12 - 1 serum 2 growth 2 growth 3 hormone 3 hormone 4 was 4 was 7 insulin 5 detectable 6 , 5 detectable 7 insulin 7 insulin 9 like 8 - 9 like 9 like 11 factor 9 like 12 - 10 growth 11 factor 12 - 13 1 12 - 14 and 14 and 16 indicators 14 and 21 fell 15 serum 16 indicators 16 indicators 17 of 16 indicators 21 fell 17 of 20 status 18 protein 20 status 19 nutritional 20 status 21 fell 22 within 21 fell 27 suggesting 22 within 25 range 23 the 25 range 24 normal 25 range 26 , 27 suggesting 27 suggesting 28 that 27 suggesting 39 . 28 that 29 these 28 that 30 were 29 these 30 were 30 were 31 not 30 were 33 factors 32 primary 33 factors 33 factors 34 for 34 for 38 stature 35 their 38 stature 36 relative 38 stature 37 short 38 stature objective : since the telefolmin people have experienced recent socioeconomic changes , they were [re] - evaluated in 2008 , to examine height , weight , and body mass index ( bmi ) , [for] insight into relative contributions of environment and other factors that modulate stature in children and adults . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 6 people 2 : 12 , 3 since 5 telefolmin 3 since 6 people 4 the 5 telefolmin 6 people 7 have 7 have 11 changes 8 experienced 11 changes 9 recent 11 changes 10 socioeconomic 11 changes 12 , 13 they 13 they 14 were 14 were 17 evaluated 14 were 21 to 16 - 17 evaluated 17 evaluated 18 in 17 evaluated 20 , 18 in 19 2008 21 to 22 examine 22 examine 27 and 22 examine 29 mass 23 height 24 , 24 , 25 weight 24 , 27 and 26 , 27 and 27 and 28 body 27 and 29 mass 29 mass 30 index 30 index 32 bmi 30 index 42 and 31 ( 32 bmi 32 bmi 33 ) 34 , 42 and 36 insight 37 into 36 insight 42 and 37 into 39 contributions 38 relative 39 contributions 39 contributions 40 of 40 of 41 environment 42 and 44 factors 42 and 45 that 42 and 46 modulate 42 and 52 . 43 other 44 factors 45 that 46 modulate 46 modulate 47 stature 46 modulate 48 in 48 in 50 and 49 children 50 and 50 and 51 adults study design and setting : cross - sectional anthropometric data were collected from 474 individuals at telefomin in 2008 , and compared with anthropometric data from 342 individuals measured in 1983 . 0 ###LEFT-WALL### 4 setting 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 7 - 1 study 2 design 2 design 3 and 3 and 4 setting 4 setting 5 : 5 : 6 cross 7 - 10 data 7 - 21 and 7 - 32 . 8 sectional 10 data 9 anthropometric 10 data 10 data 21 and 11 were 12 collected 11 were 21 and 12 collected 13 from 12 collected 16 at 13 from 15 individuals 14 474 15 individuals 16 at 17 telefomin 17 telefomin 18 in 18 in 19 2008 20 , 21 and 21 and 22 compared 21 and 23 with 21 and 26 from 23 with 25 data 24 anthropometric 25 data 26 from 28 individuals 27 342 28 individuals 28 individuals 29 measured 29 measured 30 in 30 in 31 1983 results : the height of telefolmin subjects , below the fifth percentile in 1983 , remained below the fifth percentile in 2008 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 height 2 : 16 remained 2 : 23 . 3 the 4 height 4 height 5 of 4 height 9 below 4 height 16 remained 5 of 7 subjects 6 telefolmin 7 subjects 8 , 9 below 9 below 11 fifth 9 below 15 , 10 the 11 fifth 11 fifth 12 percentile 12 percentile 13 in 13 in 14 1983 16 remained 17 below 16 remained 21 in 17 below 20 percentile 18 the 20 percentile 19 fifth 20 percentile 21 in 22 2008 weight and bmi of peripubertal and adult age groups increased from 1983 to 2008 . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 age 0 ###LEFT-WALL### 15 . 1 weight 2 and 2 and 3 bmi 2 and 4 of 2 and 8 age 4 of 6 and 5 peripubertal 6 and 6 and 7 adult 8 age 9 groups 8 age 13 to 9 groups 10 increased 11 from 13 to 12 1983 13 to 13 to 14 2008 male and female heights at peripubertal ages were significantly greater in 2008 . 0 ###LEFT-WALL### 4 heights 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 13 . 1 male 2 and 2 and 3 female 2 and 4 heights 4 heights 5 at 4 heights 8 were 5 at 7 ages 6 peripubertal 7 ages 8 were 9 significantly 8 were 10 greater 10 greater 11 in 11 in 12 2008 nevertheless , final adult height did not change significantly over the 25 years . 0 ###LEFT-WALL### 5 height 0 ###LEFT-WALL### 8 change 0 ###LEFT-WALL### 14 . 1 nevertheless 2 , 1 nevertheless 5 height 3 final 4 adult 4 adult 5 height 5 height 6 did 6 did 7 not 6 did 8 change 8 change 9 significantly 8 change 10 over 10 over 13 years 11 the 12 25 12 25 13 years conclusions : recent socioeconomic changes appear to contribute to increased weight , bmi , and stature at younger ages in the mt ok at telefomin . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 contribute 0 ###LEFT-WALL### 26 . 2 : 3 recent 3 recent 5 changes 3 recent 8 contribute 4 socioeconomic 5 changes 5 changes 6 appear 6 appear 7 to 6 appear 8 contribute 7 to 8 contribute 8 contribute 9 to 8 contribute 17 at 8 contribute 20 in 8 contribute 24 at 9 to 15 and 10 increased 11 weight 11 weight 12 , 12 , 13 bmi 12 , 15 and 14 , 15 and 15 and 16 stature 17 at 19 ages 18 younger 19 ages 20 in 23 ok 21 the 23 ok 22 mt 23 ok 24 at 25 telefomin in contrast , unchanging adult stature may reflect a delay in the impact of socioeconomic changes , or genetic influences that modulate responsiveness to other growth regulators . 0 ###LEFT-WALL### 6 stature 0 ###LEFT-WALL### 8 reflect 0 ###LEFT-WALL### 28 . 1 in 2 contrast 1 in 3 , 1 in 6 stature 4 unchanging 5 adult 5 adult 6 stature 6 stature 7 may 7 may 8 reflect 8 reflect 10 delay 8 reflect 11 in 9 a 10 delay 11 in 13 impact 12 the 13 impact 13 impact 14 of 14 of 18 or 15 socioeconomic 16 changes 16 changes 18 or 17 , 18 or 18 or 20 influences 18 or 21 that 18 or 22 modulate 19 genetic 20 influences 21 that 22 modulate 22 modulate 23 responsiveness 22 modulate 24 to 24 to 27 regulators 25 other 27 regulators 26 growth 27 regulators objectives : we present the first review and meta - analysis of the association between adult stature and age at menarche over a broad range of human societies . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 3 we 2 : 18 and 3 we 18 and 4 present 8 and 4 present 15 between 4 present 18 and 5 the 6 first 5 the 7 review 7 review 8 and 8 and 11 analysis 8 and 12 of 9 meta 10 - 9 meta 11 analysis 12 of 14 association 13 the 14 association 15 between 17 stature 16 adult 17 stature 18 and 19 age 18 and 22 over 19 age 20 at 20 at 21 menarche 22 over 25 range 23 a 24 broad 23 a 25 range 24 broad 25 range 25 range 26 of 26 of 28 societies 27 human 28 societies we then outline possible biological explanations for observed empirical associations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 outline 0 ###LEFT-WALL### 11 . 1 we 3 outline 2 then 3 outline 3 outline 6 explanations 4 possible 6 explanations 5 biological 6 explanations 6 explanations 7 for 7 for 10 associations 8 observed 10 associations 9 empirical 10 associations methods : we analyzed the association between adult stature and age at menarche in 141 samples from published reports , including 35 samples for which the [within] [-] sample association was also reported . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 analyzed 2 : 3 we 3 we 4 analyzed 4 analyzed 6 association 4 analyzed 7 between 5 the 6 association 7 between 10 and 8 adult 9 stature 9 stature 10 and 10 and 11 age 11 age 12 at 12 at 13 menarche 13 menarche 14 in 13 menarche 17 from 13 menarche 23 samples 14 in 16 samples 15 141 16 samples 17 from 19 reports 18 published 19 reports 20 , 23 samples 21 including 23 samples 22 35 23 samples 23 samples 24 for 23 samples 33 reported 23 samples 34 . 24 for 25 which 25 which 29 sample 25 which 33 reported 26 the 29 sample 29 sample 30 association 29 sample 31 was 29 sample 33 reported 30 association 31 was 31 was 32 also results : overall and in small - scale societies , later age at menarche is associated with shorter adult stature . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 21 . 1 results 2 : 2 : 3 overall 4 and 12 age 4 and 16 associated 5 in 9 societies 5 in 10 , 5 in 12 age 6 small 7 - 6 small 8 scale 8 scale 9 societies 11 later 12 age 12 age 13 at 12 age 15 is 13 at 14 menarche 15 is 16 associated 16 associated 17 with 17 with 20 stature 18 shorter 19 adult 19 adult 20 stature however , both [between] and [within] samples from industrialized societies , later age at menarche is associated with taller adult stature . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 17 associated 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 5 and 3 both 5 and 5 and 7 samples 5 and 11 , 5 and 13 age 5 and 16 is 5 and 17 associated 7 samples 8 from 8 from 10 societies 9 industrialized 10 societies 12 later 13 age 13 age 14 at 13 age 16 is 14 at 15 menarche 17 associated 18 with 18 with 21 stature 19 taller 20 adult 20 adult 21 stature conclusions : the pattern of associations between adult stature and age at menarche may be explicable as a norm of reaction that evolved according to predictions of life history theory . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 31 . 1 conclusions 2 : 2 : 4 pattern 3 the 4 pattern 4 pattern 5 of 5 of 6 associations 6 associations 7 between 7 between 9 stature 8 adult 9 stature 10 and 11 age 10 and 15 be 11 age 12 at 11 age 14 may 12 at 13 menarche 14 may 15 be 15 be 16 explicable 16 explicable 17 as 17 as 19 norm 18 a 19 norm 19 norm 20 of 19 norm 22 that 19 norm 23 evolved 19 norm 27 of 20 of 21 reaction 22 that 23 evolved 23 evolved 25 to 24 according 25 to 25 to 26 predictions 27 of 30 theory 28 life 29 history 29 history 30 theory however , nonadaptive explanations are also plausible , especially for the positive association observed in industrialized societies . 0 ###LEFT-WALL### 4 explanations 0 ###LEFT-WALL### 5 are 1 however 2 , 1 however 4 explanations 3 nonadaptive 4 explanations 4 explanations 5 are 5 are 6 also 5 are 7 plausible 7 plausible 10 for 8 , 9 especially 8 , 10 for 10 for 13 association 10 for 18 . 11 the 13 association 12 positive 13 association 13 association 14 observed 14 observed 15 in 15 in 17 societies 16 industrialized 17 societies purpose : mild to moderate chest trauma is a common disease , although its clinical characteristics are not well known . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 20 known 0 ###LEFT-WALL### 21 . 1 purpose 2 : 2 : 3 mild 4 to 5 moderate 4 to 8 is 5 moderate 7 trauma 6 chest 7 trauma 8 is 11 disease 8 is 13 although 9 a 10 common 9 a 11 disease 10 common 11 disease 12 , 13 although 13 although 16 characteristics 14 its 16 characteristics 15 clinical 16 characteristics 16 characteristics 17 are 17 are 18 not 17 are 19 well 17 are 20 known we investigated the clinical profiles and the early and long - term outcome of hospitalized patients with chest trauma , focusing particularly on elderly patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 1 we 2 investigated 2 investigated 9 and 2 investigated 17 with 3 the 5 profiles 4 clinical 5 profiles 5 profiles 6 and 6 and 8 early 6 and 9 and 7 the 8 early 9 and 13 outcome 9 and 14 of 10 long 11 - 10 long 12 term 12 term 13 outcome 14 of 16 patients 15 hospitalized 16 patients 17 with 19 trauma 18 chest 19 trauma 19 trauma 21 focusing 20 , 21 focusing 21 focusing 22 particularly 21 focusing 26 . 22 particularly 23 on 23 on 25 patients 24 elderly 25 patients methods : the clinical records of patients who were hospitalized in higashisumiyoshi morimoto hospital for chest trauma between january 2001 and december 2004 were retrospectively reviewed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 records 2 : 24 were 2 : 27 . 3 the 5 records 4 clinical 5 records 5 records 6 of 5 records 8 who 5 records 9 were 5 records 24 were 6 of 7 patients 8 who 9 were 9 were 10 hospitalized 10 hospitalized 11 in 10 hospitalized 15 for 10 hospitalized 18 between 11 in 14 hospital 12 higashisumiyoshi 13 morimoto 13 morimoto 14 hospital 15 for 17 trauma 16 chest 17 trauma 18 between 21 and 19 january 20 2001 19 january 21 and 21 and 22 december 22 december 23 2004 24 were 25 retrospectively 24 were 26 reviewed the clinical profiles , treatment methods , and outcomes were investigated . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 investigated 0 ###LEFT-WALL### 12 . 1 the 3 profiles 2 clinical 3 profiles 3 profiles 4 , 4 , 6 methods 4 , 8 and 5 treatment 6 methods 7 , 8 and 8 and 9 outcomes 8 and 10 were 10 were 11 investigated the primary endpoint was a repeat visit to the hospital for another traumatic condition after discharge , and the secondary endpoint was death . 0 ###LEFT-WALL### 3 endpoint 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 24 . 1 the 3 endpoint 2 primary 3 endpoint 3 endpoint 4 was 4 was 7 visit 5 a 7 visit 6 repeat 7 visit 7 visit 8 to 7 visit 15 after 8 to 10 hospital 9 the 10 hospital 10 hospital 11 for 11 for 14 condition 12 another 14 condition 13 traumatic 14 condition 15 after 16 discharge 17 , 18 and 18 and 21 endpoint 18 and 22 was 19 the 21 endpoint 20 secondary 21 endpoint 21 endpoint 22 was 22 was 23 death the patients were divided into two groups with respect to the age of 60 years , and differences were compared statistically . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 4 divided 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 22 . 1 the 2 patients 2 patients 3 were 3 were 4 divided 4 divided 5 into 4 divided 8 with 4 divided 10 to 5 into 7 groups 6 two 7 groups 8 with 9 respect 10 to 12 age 11 the 12 age 12 age 13 of 13 of 15 years 14 60 15 years 16 , 17 and 17 and 18 differences 17 and 20 compared 18 differences 19 were 19 were 20 compared 20 compared 21 statistically results : in all , 53 patients ( 34 men ) were hospitalized for chest trauma in our hospital between january 2001 and december 2004 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 26 . 1 results 2 : 2 : 3 in 3 in 4 all 5 , 7 patients 5 , 13 hospitalized 6 53 7 patients 7 patients 10 men 7 patients 12 were 8 ( 10 men 9 34 10 men 10 men 11 ) 12 were 13 hospitalized 13 hospitalized 14 for 13 hospitalized 17 in 14 for 16 trauma 15 chest 16 trauma 17 in 23 and 18 our 19 hospital 19 hospital 20 between 19 hospital 23 and 20 between 21 january 21 january 22 2001 23 and 24 december 24 december 25 2004 the mean age was 54.9 years ( 17 - 85 years ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 13 . 1 the 3 age 2 mean 3 age 3 age 4 was 4 was 6 years 5 54.9 6 years 6 years 9 - 7 ( 9 - 8 17 9 - 9 - 11 years 9 - 12 ) 10 85 11 years the distribution of age showed biphasic peaks - in the [tens] [to] twenties , [and] [sixties] [to] [seventies] . 0 ###LEFT-WALL### 2 distribution 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 19 . 1 the 2 distribution 2 distribution 3 of 2 distribution 5 showed 3 of 4 age 5 showed 7 peaks 6 biphasic 7 peaks 7 peaks 9 in 8 - 9 in 9 in 13 twenties 9 in 14 , 10 the 13 twenties injuries were significantly more likely to be caused by a fall in elderly patients than in younger patients ( p < 0.05 ) . 0 ###LEFT-WALL### 1 injuries 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 24 . 1 injuries 2 were 2 were 3 significantly 2 were 5 likely 4 more 5 likely 5 likely 6 to 5 likely 8 caused 6 to 7 be 7 be 8 caused 8 caused 9 by 8 caused 15 than 9 by 11 fall 10 a 11 fall 11 fall 12 in 12 in 14 patients 13 elderly 14 patients 15 than 16 in 16 in 18 patients 17 younger 18 patients 18 patients 21 < 19 ( 21 < 20 p 21 < 21 < 22 0.05 21 < 23 ) the elderly patients revisited our hospital with another trauma more frequently than did the younger patients ( p < 0.05 ) . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 4 revisited 0 ###LEFT-WALL### 22 . 1 the 3 patients 2 elderly 3 patients 3 patients 4 revisited 4 revisited 6 hospital 4 revisited 7 with 4 revisited 11 frequently 4 revisited 12 than 5 our 6 hospital 7 with 9 trauma 8 another 9 trauma 10 more 11 frequently 12 than 13 did 13 did 16 patients 14 the 16 patients 15 younger 16 patients 16 patients 19 < 17 ( 19 < 18 p 19 < 19 < 20 0.05 19 < 21 ) conclusion : elderly patients were likely to suffer both [falls] and a further traumatic condition . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 elderly 2 : 5 were 2 : 16 . 3 elderly 5 were 4 patients 5 were 5 were 6 likely 6 likely 7 to 6 likely 8 suffer 7 to 8 suffer 8 suffer 11 and 9 both 11 and 11 and 15 condition 12 a 15 condition 13 further 15 condition 14 traumatic 15 condition this probably reflects the general deterioration of physical abilities , such as lowered cognitive and somatic performances . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 reflects 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 18 . 1 this 3 reflects 2 probably 3 reflects 3 reflects 6 deterioration 4 the 6 deterioration 5 general 6 deterioration 6 deterioration 7 of 7 of 9 abilities 8 physical 9 abilities 10 , 17 performances 11 such 17 performances 12 as 13 lowered 13 lowered 17 performances 14 cognitive 15 and 15 and 16 somatic 15 and 17 performances benign prostatic hyperplasia ( bph ) is one of the most common conditions associated with the aging male . 0 ###LEFT-WALL### 3 hyperplasia 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 19 . 1 benign 3 hyperplasia 2 prostatic 3 hyperplasia 3 hyperplasia 5 bph 3 hyperplasia 7 is 4 ( 5 bph 5 bph 6 ) 7 is 8 one 7 is 15 with 8 one 9 of 8 one 14 associated 9 of 13 conditions 10 the 13 conditions 11 most 12 common 12 common 13 conditions 15 with 18 male 16 the 18 male 17 aging 18 male surgical management of lower urinary tract symptoms attributed to bph has progressed over time as urologic surgeons search for more innovative and less invasive forms of treatment . 0 ###LEFT-WALL### 1 surgical 0 ###LEFT-WALL### 12 progressed 0 ###LEFT-WALL### 28 . 1 surgical 2 management 1 surgical 11 has 1 surgical 12 progressed 2 management 3 of 2 management 11 has 3 of 7 symptoms 4 lower 6 tract 5 urinary 6 tract 6 tract 7 symptoms 7 symptoms 8 attributed 8 attributed 9 to 9 to 10 bph 12 progressed 13 over 12 progressed 19 for 13 over 14 time 14 time 17 surgeons 14 time 18 search 15 as 16 urologic 16 urologic 17 surgeons 17 surgeons 18 search 19 for 25 forms 20 more 25 forms 21 innovative 22 and 22 and 23 less 22 and 25 forms 24 invasive 25 forms 25 forms 26 of 26 of 27 treatment transurethral resection of the prostate ( turp ) has long been the " gold standard " to which all other forms of treatment are compared . 0 ###LEFT-WALL### 2 resection 0 ###LEFT-WALL### 11 been 0 ###LEFT-WALL### 26 . 1 transurethral 2 resection 2 resection 3 of 2 resection 7 turp 2 resection 9 has 3 of 5 prostate 4 the 5 prostate 6 ( 7 turp 7 turp 8 ) 9 has 11 been 10 long 11 been 11 been 15 standard 12 the 13 " 12 the 15 standard 14 gold 15 standard 15 standard 16 " 15 standard 17 to 15 standard 25 compared 17 to 18 which 17 to 21 forms 17 to 24 are 19 all 20 other 20 other 21 forms 21 forms 22 of 21 forms 24 are 22 of 23 treatment there are several different methods of surgical treatment of bph , including whole gland enucleation/intact removal , vaporization , and induction of necrosis with delayed reabsorption as well as hybrid techniques . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 32 . 1 there 2 are 2 are 5 methods 3 several 5 methods 4 different 5 methods 5 methods 6 of 5 methods 9 of 6 of 8 treatment 7 surgical 8 treatment 9 of 20 and 10 bph 12 including 10 bph 20 and 11 , 12 including 12 including 16 removal 12 including 19 , 13 whole 16 removal 14 gland 15 enucleation/intact 15 enucleation/intact 16 removal 16 removal 18 vaporization 17 , 18 vaporization 18 vaporization 19 , 20 and 21 induction 20 and 29 as 21 induction 22 of 22 of 23 necrosis 23 necrosis 24 with 24 with 26 reabsorption 25 delayed 26 reabsorption 27 as 28 well 28 well 29 as 29 as 31 techniques 30 hybrid 31 techniques as with any form of surgical intervention , long - term results define success . 0 ###LEFT-WALL### 12 results 0 ###LEFT-WALL### 13 define 0 ###LEFT-WALL### 15 . 1 as 2 with 1 as 8 , 1 as 12 results 2 with 4 form 3 any 4 form 4 form 5 of 5 of 7 intervention 6 surgical 7 intervention 9 long 10 - 9 long 11 term 11 term 12 results 12 results 13 define 13 define 14 success long - term [follow] - up [consists] [of] examining overall efficacy with attention to associated adverse events . 0 ###LEFT-WALL### 3 term 0 ###LEFT-WALL### 5 - 1 long 2 - 1 long 3 term 5 - 6 up 5 - 18 . 6 up 11 efficacy 6 up 12 with 6 up 14 to 9 examining 11 efficacy 10 overall 11 efficacy 12 with 13 attention 14 to 17 events 15 associated 17 events 16 adverse 17 events turp has the luxury of the longest follow - up , while less invasive forms of treatment starting to acquire long - term data . 0 ###LEFT-WALL### 1 turp 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 25 . 1 turp 2 has 2 has 4 luxury 2 has 8 follow 3 the 4 luxury 4 luxury 5 of 5 of 7 longest 6 the 7 longest 8 follow 10 up 8 follow 12 while 8 follow 15 forms 8 follow 19 to 9 - 10 up 10 up 11 , 12 while 14 invasive 13 less 14 invasive 15 forms 16 of 15 forms 18 starting 16 of 17 treatment 19 to 20 acquire 20 acquire 24 data 21 long 22 - 21 long 23 term 23 term 24 data there are several surgical options for bph ; newer methods do [show] promise , while the " gold standard " continues to demonstrate excellent surgical results . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 8 ; 1 there 2 are 2 are 5 options 3 several 5 options 4 surgical 5 options 5 options 6 for 6 for 7 bph 8 ; 10 methods 8 ; 13 promise 9 newer 10 methods 10 methods 11 do 11 do 13 promise 13 promise 15 while 14 , 15 while 15 while 19 standard 15 while 21 continues 15 while 27 . 16 the 17 " 16 the 19 standard 18 gold 19 standard 19 standard 20 " 19 standard 21 continues 21 continues 22 to 21 continues 23 demonstrate 22 to 23 demonstrate 23 demonstrate 26 results 24 excellent 26 results 25 surgical 26 results unlabelled : a comprehensive review of literature was conducted to investigate variation in hip fracture incident rates around the world . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 5 review 2 : 9 conducted 3 a 4 comprehensive 3 a 5 review 4 comprehensive 5 review 5 review 6 of 5 review 8 was 6 of 7 literature 8 was 9 conducted 9 conducted 10 to 9 conducted 13 in 9 conducted 18 around 10 to 11 investigate 11 investigate 12 variation 13 in 17 rates 14 hip 15 fracture 15 fracture 17 rates 16 incident 17 rates 18 around 20 world 19 the 20 world the original crude incidence rates were standardized for age and sex for comparability . 0 ###LEFT-WALL### 5 rates 0 ###LEFT-WALL### 7 standardized 0 ###LEFT-WALL### 14 . 1 the 5 rates 2 original 4 incidence 3 crude 4 incidence 4 incidence 5 rates 5 rates 6 were 6 were 7 standardized 7 standardized 8 for 8 for 10 and 9 age 10 and 10 and 11 sex 10 and 12 for 12 for 13 comparability after standardization , the highest rates [of] hip fracture were found in scandinavia and the lowest rates in africa . 0 ###LEFT-WALL### 9 fracture 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 20 . 1 after 2 standardization 1 after 3 , 1 after 9 fracture 4 the 5 highest 4 the 9 fracture 6 rates 9 fracture 8 hip 9 fracture 9 fracture 10 were 10 were 11 found 11 found 12 in 11 found 18 in 12 in 14 and 13 scandinavia 14 and 14 and 17 rates 15 the 16 lowest 15 the 17 rates 18 in 19 africa introduction : this study was conducted to investigate the geographic trends of the incidence of osteoporotic hip fractures through a comprehensive review of literature . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 6 conducted 2 : 25 . 3 this 4 study 4 study 5 was 5 was 6 conducted 6 conducted 7 to 7 to 8 investigate 8 investigate 11 trends 8 investigate 19 through 9 the 11 trends 10 geographic 11 trends 11 trends 12 of 12 of 14 incidence 13 the 14 incidence 14 incidence 15 of 15 of 18 fractures 16 osteoporotic 18 fractures 17 hip 18 fractures 19 through 22 review 20 a 21 comprehensive 20 a 22 review 21 comprehensive 22 review 22 review 23 of 23 of 24 literature methods : studies were identified for inclusion in the review by searching the medline database via pubmed and applying strict inclusion and exclusion criteria . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 3 studies 2 : 5 identified 3 studies 4 were 4 were 5 identified 5 identified 6 for 5 identified 8 in 5 identified 11 by 5 identified 16 via 6 for 7 inclusion 8 in 10 review 9 the 10 review 11 by 12 searching 12 searching 15 database 13 the 15 database 14 medline 15 database 16 via 22 and 17 pubmed 18 and 18 and 21 inclusion 18 and 22 and 19 applying 21 inclusion 20 strict 21 inclusion 22 and 24 criteria 23 exclusion 24 criteria age - specific incidence rates were extracted from the articles , and in order to provide a common platform for analysis , we used directly age - standardized and age - sex - standardized rates ( [using] the 2005 united nations estimates of the world population as standard [ )(to complete the analysis . 0 ###LEFT-WALL### 5 rates 0 ###LEFT-WALL### 7 extracted 0 ###LEFT-WALL### 12 and 1 age 2 - 1 age 5 rates 3 specific 4 incidence 4 incidence 5 rates 5 rates 6 were 6 were 7 extracted 7 extracted 8 from 8 from 10 articles 9 the 10 articles 11 , 12 and 12 and 23 we 13 in 14 order 13 in 23 we 14 order 15 to 14 order 16 provide 15 to 16 provide 16 provide 19 platform 17 a 19 platform 18 common 19 platform 20 for 21 analysis 20 for 22 , 20 for 23 we 23 we 29 and 24 used 25 directly 24 used 26 age 24 used 29 and 26 age 28 standardized 27 - 28 standardized 29 and 30 age 29 and 33 - 31 - 33 - 32 sex 33 - 33 - 35 rates 34 standardized 35 rates 35 rates 42 estimates 36 ( 42 estimates 38 the 39 2005 39 2005 42 estimates 40 united 42 estimates 41 nations 42 estimates 42 estimates 43 of 42 estimates 54 . 43 of 46 population 44 the 46 population 45 world 46 population 46 population 48 standard 47 as 48 standard 48 standard 50 )(to 48 standard 51 complete 50 )(to 51 complete 51 complete 53 analysis 52 the 53 analysis results : forty - six full text articles spanning 33 countries/regions were included in the review . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 articles 2 : 13 included 2 : 17 . 3 forty 4 - 4 - 5 six 4 - 8 articles 6 full 8 articles 7 text 8 articles 8 articles 9 spanning 8 articles 12 were 9 spanning 11 countries/regions 10 33 11 countries/regions 12 were 13 included 13 included 14 in 14 in 16 review 15 the 16 review for ease of comparison , the results were analyzed by geographic regions : north america , latin america , scandinavia , europe ( excluding scandinavia ) , africa , asia , and australia . 0 ###LEFT-WALL### 7 results 0 ###LEFT-WALL### 9 analyzed 0 ###LEFT-WALL### 13 : 1 for 2 ease 1 for 5 , 1 for 7 results 2 ease 3 of 3 of 4 comparison 6 the 7 results 7 results 8 were 8 were 9 analyzed 9 analyzed 10 by 10 by 12 regions 11 geographic 12 regions 13 : 32 and 13 : 34 . 14 north 15 america 15 america 16 , 16 , 18 america 16 , 19 , 17 latin 18 america 19 , 20 scandinavia 19 , 21 , 21 , 22 europe 21 , 27 , 22 europe 24 excluding 23 ( 24 excluding 24 excluding 25 scandinavia 24 excluding 26 ) 27 , 28 africa 27 , 29 , 29 , 30 asia 29 , 32 and 31 , 32 and 32 and 33 australia the highest hip fracture rates were found in scandinavia and the lowest [in] africa . 0 ###LEFT-WALL### 5 rates 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 15 . 1 the 2 highest 1 the 5 rates 3 hip 4 fracture 4 fracture 5 rates 5 rates 6 were 6 were 7 found 7 found 8 in 8 in 10 and 9 scandinavia 10 and 10 and 14 africa 11 the 12 lowest 11 the 14 africa we found comparable rates from countries in north america , australia , and europe outside of scandinavia . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 18 . 1 we 2 found 2 found 4 rates 2 found 7 in 2 found 16 of 3 comparable 4 rates 4 rates 5 from 5 from 6 countries 7 in 13 and 8 north 9 america 9 america 10 , 10 , 11 australia 10 , 13 and 12 , 13 and 13 and 14 europe 15 outside 16 of 16 of 17 scandinavia the diverse makeup of the asian continent also resulted in quite variable hip fracture rates : ranging from relatively high rates in iran to low rates , comparable to those from africa , in mainland china . 0 ###LEFT-WALL### 3 makeup 0 ###LEFT-WALL### 9 resulted 0 ###LEFT-WALL### 16 : 0 ###LEFT-WALL### 37 . 1 the 3 makeup 2 diverse 3 makeup 3 makeup 4 of 3 makeup 9 resulted 4 of 7 continent 5 the 7 continent 6 asian 7 continent 8 also 9 resulted 9 resulted 10 in 10 in 15 rates 11 quite 12 variable 12 variable 13 hip 13 hip 15 rates 14 fracture 15 rates 16 : 17 ranging 17 ranging 18 from 17 ranging 22 in 18 from 21 rates 19 relatively 20 high 20 high 21 rates 22 in 23 iran 23 iran 24 to 23 iran 34 in 24 to 26 rates 25 low 26 rates 26 rates 28 comparable 27 , 28 comparable 28 comparable 29 to 28 comparable 31 from 28 comparable 33 , 29 to 30 those 31 from 32 africa 34 in 36 china 35 mainland 36 china conclusions : given the aging of populations globally , and in the industrialized countries specifically , hip fractures will become a progressively larger public health burden . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 3 given 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 27 . 1 conclusions 2 : 2 : 3 given 3 given 5 aging 3 given 8 globally 4 the 5 aging 5 aging 6 of 6 of 7 populations 9 , 10 and 10 and 18 fractures 10 and 20 become 11 in 14 countries 11 in 18 fractures 12 the 14 countries 13 industrialized 14 countries 15 specifically 16 , 15 specifically 18 fractures 17 hip 18 fractures 18 fractures 19 will 19 will 20 become 20 become 26 burden 21 a 22 progressively 21 a 26 burden 22 progressively 23 larger 23 larger 24 public 24 public 26 burden 25 health 26 burden the geographic trends observed in hip fracture incidence rates can provide important clues to etiology and prevention . 0 ###LEFT-WALL### 3 trends 0 ###LEFT-WALL### 11 provide 0 ###LEFT-WALL### 18 . 1 the 3 trends 2 geographic 3 trends 3 trends 4 observed 3 trends 10 can 4 observed 5 in 5 in 9 rates 6 hip 7 fracture 7 fracture 9 rates 8 incidence 9 rates 10 can 11 provide 11 provide 13 clues 11 provide 14 to 12 important 13 clues 14 to 16 and 15 etiology 16 and 16 and 17 prevention the inability of cells to maintain protein folding homeostasis is implicated in the development of neurodegenerative diseases , malignant transformation , and aging . 0 ###LEFT-WALL### 2 inability 0 ###LEFT-WALL### 11 implicated 0 ###LEFT-WALL### 24 . 1 the 2 inability 2 inability 3 of 2 inability 5 to 2 inability 6 maintain 2 inability 10 is 3 of 4 cells 5 to 6 maintain 6 maintain 7 protein 7 protein 8 folding 8 folding 9 homeostasis 10 is 11 implicated 11 implicated 12 in 12 in 14 development 13 the 14 development 14 development 15 of 15 of 22 and 16 neurodegenerative 17 diseases 17 diseases 18 , 18 , 20 transformation 18 , 22 and 19 malignant 20 transformation 21 , 22 and 22 and 23 aging we find that multiphoton fluorescence imaging of 1 - anilinonaphthalene - 8 - [sulfonate] ( ans ) can be used to assess cellular responses to protein misfolding stresses . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 find 0 ###LEFT-WALL### 28 stresses 1 we 2 find 2 find 6 imaging 2 find 20 used 3 that 6 imaging 4 multiphoton 5 fluorescence 5 fluorescence 6 imaging 6 imaging 7 of 6 imaging 10 anilinonaphthalene 6 imaging 18 can 7 of 8 1 9 - 10 anilinonaphthalene 10 anilinonaphthalene 12 8 10 anilinonaphthalene 16 ans 10 anilinonaphthalene 17 ) 11 - 12 8 12 8 13 - 15 ( 16 ans 16 ans 17 ) 18 can 19 be 19 be 20 used 20 used 21 to 20 used 28 stresses 21 to 22 assess 22 assess 24 responses 22 assess 25 to 23 cellular 24 responses 25 to 26 protein 27 misfolding 28 stresses 28 stresses 29 . ans is relatively nontoxic and enters live cells and cells or tissues fixed in formalin . 0 ###LEFT-WALL### 1 ans 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 16 . 1 ans 5 and 2 is 3 relatively 2 is 4 nontoxic 2 is 5 and 5 and 6 enters 5 and 8 cells 7 live 8 cells 9 and 11 or 9 and 13 fixed 10 cells 11 or 11 or 12 tissues 11 or 13 fixed 13 fixed 14 in 13 fixed 15 formalin in an animal model of alzheimer 's disease , ans fluorescence imaging of brain tissue sections reveals the binding of ans to fibrillar deposits of amyloid [peptide] ( aβ ) in amyloid plaques and in cerebrovascular amyloid . 0 ###LEFT-WALL### 12 imaging 0 ###LEFT-WALL### 17 reveals 0 ###LEFT-WALL### 38 . 1 in 4 model 1 in 9 , 1 in 12 imaging 2 an 4 model 3 animal 4 model 4 model 5 of 5 of 8 disease 6 alzheimer 7 's 7 's 8 disease 10 ans 12 imaging 11 fluorescence 12 imaging 12 imaging 13 of 12 imaging 17 reveals 13 of 16 sections 14 brain 16 sections 15 tissue 16 sections 17 reveals 19 binding 18 the 19 binding 19 binding 20 of 19 binding 22 to 20 of 21 ans 22 to 24 deposits 23 fibrillar 24 deposits 24 deposits 25 of 24 deposits 34 and 25 of 26 amyloid 26 amyloid 29 aβ 28 ( 29 aβ 29 aβ 30 ) 31 in 33 plaques 31 in 34 and 32 amyloid 33 plaques 34 and 35 in 35 in 37 amyloid 36 cerebrovascular 37 amyloid ans imaging also highlights [non] [-] amyloid deposits of glial fibrillary acidic protein in brain tumors . 0 ###LEFT-WALL### 1 ans 0 ###LEFT-WALL### 7 amyloid 0 ###LEFT-WALL### 17 . 1 ans 2 imaging 1 ans 7 amyloid 2 imaging 3 also 2 imaging 4 highlights 7 amyloid 8 deposits 7 amyloid 14 in 8 deposits 9 of 9 of 13 protein 10 glial 13 protein 11 fibrillary 13 protein 12 acidic 13 protein 14 in 16 tumors 15 brain 16 tumors cultured cells under normal growth conditions possess a number of ans - binding structures . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 7 possess 1 cultured 2 cells 2 cells 3 under 2 cells 7 possess 3 under 6 conditions 4 normal 5 growth 5 growth 6 conditions 7 possess 11 ans 7 possess 13 binding 8 a 9 number 9 number 10 of 9 number 11 ans 10 of 11 ans 12 - 13 binding 13 binding 14 structures 13 binding 15 . high levels of ans fluorescence are associated with the endoplasmic reticulum ( er ) , golgi , and lysosomes - regions of protein folding and degradation . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 27 . 1 high 2 levels 2 levels 3 of 2 levels 6 are 3 of 5 fluorescence 4 ans 5 fluorescence 6 are 18 and 7 associated 8 with 7 associated 18 and 8 with 16 golgi 9 the 16 golgi 10 endoplasmic 16 golgi 11 reticulum 13 er 11 reticulum 15 , 11 reticulum 16 golgi 12 ( 13 er 13 er 14 ) 17 , 18 and 18 and 19 lysosomes 20 - 25 and 21 regions 22 of 21 regions 25 and 22 of 23 protein 23 protein 24 folding 25 and 26 degradation nuclei are virtually devoid [of] ans binding sites . 0 ###LEFT-WALL### 1 nuclei 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 9 . 1 nuclei 2 are 2 are 6 ans 2 are 7 binding 3 virtually 4 devoid 4 devoid 6 ans 7 binding 8 sites additional ans binding is triggered by hyperthermia , thermal lesioning , proteasome inhibition , and induction of er stress . 0 ###LEFT-WALL### 2 ans 0 ###LEFT-WALL### 5 triggered 0 ###LEFT-WALL### 20 . 1 additional 2 ans 2 ans 3 binding 2 ans 4 is 4 is 5 triggered 5 triggered 6 by 6 by 15 and 7 hyperthermia 8 , 8 , 10 lesioning 8 , 11 , 9 thermal 10 lesioning 11 , 13 inhibition 11 , 15 and 12 proteasome 13 inhibition 14 , 15 and 15 and 16 induction 16 induction 17 of 17 of 19 stress 18 er 19 stress we also use multiphoton imaging of ans binding to follow [the] in vivo recovery of cells from protein - damaging insults over time . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 use 1 we 3 use 2 also 3 use 3 use 5 imaging 3 use 9 to 3 use 10 follow 4 multiphoton 5 imaging 5 imaging 6 of 5 imaging 8 binding 6 of 7 ans 9 to 10 follow 10 follow 13 vivo 10 follow 14 recovery 10 follow 20 damaging 12 in 13 vivo 14 recovery 15 of 14 recovery 17 from 15 of 16 cells 17 from 18 protein 19 - 20 damaging 20 damaging 21 insults 20 damaging 22 over 20 damaging 24 . 22 over 23 time we find that ans fluorescence tracks with the binding of the molecular chaperone hsp70 in compartments where hsp70 is present . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 find 0 ###LEFT-WALL### 21 . 1 we 2 find 2 find 3 that 3 that 6 tracks 3 that 13 chaperone 4 ans 6 tracks 5 fluorescence 6 tracks 6 tracks 7 with 6 tracks 13 chaperone 7 with 9 binding 8 the 9 binding 9 binding 10 of 10 of 12 molecular 11 the 12 molecular 13 chaperone 14 hsp70 14 hsp70 15 in 15 in 16 compartments 16 compartments 17 where 17 where 18 hsp70 17 where 19 is 18 hsp70 19 is 19 is 20 present ans highlights the sensitivity of specific cellular targets , including the nucleus and particularly the nucleolus , to thermal stress and proteasome inhibition . 0 ###LEFT-WALL### 1 ans 0 ###LEFT-WALL### 2 highlights 0 ###LEFT-WALL### 24 . 1 ans 2 highlights 2 highlights 4 sensitivity 2 highlights 18 to 3 the 4 sensitivity 4 sensitivity 5 of 5 of 8 targets 6 specific 8 targets 7 cellular 8 targets 8 targets 10 including 9 , 10 including 10 including 13 and 10 including 17 , 11 the 12 nucleus 12 nucleus 13 and 13 and 14 particularly 13 and 16 nucleolus 13 and 17 , 15 the 16 nucleolus 18 to 21 and 19 thermal 20 stress 20 stress 21 and 21 and 23 inhibition 22 proteasome 23 inhibition multiphoton imaging of ans binding should be a useful probe for monitoring protein misfolding stress in cells . 0 ###LEFT-WALL### 2 imaging 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 18 . 1 multiphoton 2 imaging 2 imaging 3 of 2 imaging 6 should 3 of 4 ans 4 ans 5 binding 6 should 7 be 7 be 10 probe 8 a 10 probe 9 useful 10 probe 10 probe 11 for 10 probe 14 misfolding 10 probe 16 in 11 for 12 monitoring 12 monitoring 13 protein 14 misfolding 15 stress 16 in 17 cells objectives : to examine the association of life events and social support in the broadly defined category of depression in late life . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 to 2 : 4 examine 3 to 4 examine 4 examine 6 association 4 examine 13 in 4 examine 20 in 5 the 6 association 6 association 7 of 7 of 10 and 8 life 9 events 9 events 10 and 10 and 12 support 11 social 12 support 13 in 17 category 14 the 17 category 15 broadly 16 defined 16 defined 17 category 17 category 18 of 18 of 19 depression 20 in 22 life 21 late 22 life introduction : negative life events and lack of social support are associated with depression in the elderly . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 6 and 2 : 12 associated 2 : 18 . 3 negative 4 life 4 life 5 events 5 events 6 and 6 and 7 lack 6 and 8 of 6 and 11 are 8 of 10 support 9 social 10 support 11 are 12 associated 12 associated 13 with 12 associated 15 in 13 with 14 depression 15 in 17 elderly 16 the 17 elderly currently , there are limited studies examining the association between life events , social support and late - life depression in brazil . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 23 . 1 currently 2 , 1 currently 3 there 3 there 4 are 4 are 6 studies 4 are 21 in 5 limited 6 studies 6 studies 7 examining 7 examining 9 association 7 examining 10 between 8 the 9 association 10 between 16 and 11 life 12 events 12 events 13 , 13 , 15 support 13 , 16 and 14 social 15 support 16 and 20 depression 17 late 18 - 17 late 19 life 19 life 20 depression 21 in 22 brazil methods : we estimated the frequency of late - life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 we 2 : 4 estimated 3 we 4 estimated 4 estimated 6 frequency 4 estimated 12 within 4 estimated 23 or 5 the 6 frequency 6 frequency 7 of 7 of 11 depression 8 late 9 - 8 late 10 life 10 life 11 depression 12 within 16 sample 13 a 16 sample 14 household 16 sample 15 community 16 sample 16 sample 17 of 17 of 19 subjects 18 367 19 subjects 19 subjects 20 aged 20 aged 21 60 22 years 23 or 23 or 24 greater 24 greater 25 with 25 with 27 factors 26 associated 27 factors ['] ['] [old] age symptomatic depression ['] ['] was defined using the composite international diagnostic interview 1.1 tool . 0 ###LEFT-WALL### 6 depression 0 ###LEFT-WALL### 10 defined 0 ###LEFT-WALL### 19 . 4 age 6 depression 5 symptomatic 6 depression 6 depression 9 was 9 was 10 defined 10 defined 11 using 11 using 18 tool 12 the 18 tool 13 composite 14 international 14 international 15 diagnostic 15 diagnostic 16 interview 16 interview 17 1.1 16 interview 18 tool this diagnostic category included only late - life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression , termed ['] ['] late subthreshold depression ['] ['] . 0 ###LEFT-WALL### 3 category 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 36 . 1 this 3 category 2 diagnostic 3 category 3 category 10 and 4 included 5 only 4 included 9 symptoms 4 included 10 and 6 late 7 - 6 late 8 life 8 life 9 symptoms 10 and 11 consisted 11 consisted 12 of 12 of 14 diagnoses 13 the 14 diagnoses 14 diagnoses 15 of 14 diagnoses 21 as 15 of 17 and 16 depression 17 and 17 and 18 dysthymia 19 as 20 well 20 well 21 as 21 as 24 definition 22 a 23 subsyndromal 22 a 24 definition 23 subsyndromal 24 definition 24 definition 25 of 25 of 26 depression 27 , 33 depression 28 termed 32 subthreshold 31 late 32 subthreshold 32 subthreshold 33 depression social support and life events were assessed using the comprehensive assessment and referral evaluation ( short - care ) inventory . 0 ###LEFT-WALL### 2 support 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 21 . 1 social 2 support 3 and 5 events 3 and 7 assessed 4 life 5 events 5 events 6 were 6 were 7 assessed 7 assessed 8 using 8 using 12 and 9 the 11 assessment 10 comprehensive 11 assessment 11 assessment 12 and 12 and 20 inventory 13 referral 14 evaluation 14 evaluation 16 short 15 ( 16 short 16 short 18 care 17 - 18 care 18 care 19 ) 18 care 20 inventory results : ['] ['] [old] age symptomatic depression ['] ['] occurred in 18.8 % of the patients in the tested sample . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 depression 2 : 11 occurred 2 : 22 . 6 age 8 depression 7 symptomatic 8 depression 8 depression 11 occurred 11 occurred 12 in 11 occurred 18 in 12 in 14 % 13 18.8 14 % 14 % 15 of 15 of 17 patients 16 the 17 patients 18 in 21 sample 19 the 21 sample 20 tested 21 sample in univariate analyses , this condition was associated with female gender , lifetime anxiety disorder and living alone . 0 ###LEFT-WALL### 6 condition 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 19 . 1 in 3 analyses 1 in 4 , 1 in 6 condition 2 univariate 3 analyses 5 this 6 condition 6 condition 7 was 7 was 8 associated 8 associated 9 with 8 associated 18 alone 9 with 16 and 10 female 11 gender 11 gender 12 , 12 , 15 disorder 12 , 16 and 13 lifetime 15 disorder 14 anxiety 15 disorder 16 and 17 living in multivariate models , ['] ['] old age symptomatic depression ['] ['] was associated with a perceived lack of social support in men and life events in women . 0 ###LEFT-WALL### 8 age 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 29 . 1 in 3 models 1 in 4 , 1 in 8 age 2 multivariate 3 models 7 old 8 age 8 age 10 depression 8 age 13 was 8 age 14 associated 9 symptomatic 10 depression 10 depression 13 was 14 associated 15 with 14 associated 22 in 15 with 18 lack 16 a 18 lack 17 perceived 18 lack 18 lack 19 of 19 of 21 support 20 social 21 support 22 in 24 and 23 men 24 and 24 and 26 events 24 and 27 in 25 life 26 events 27 in 28 women discussion : social support and life events were determined to be associated with late - life depression , but it is important to keep in mind the differences between genders . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 determined 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 24 keep 0 ###LEFT-WALL### 31 . 1 discussion 2 : 2 : 3 social 4 support 5 and 5 and 6 life 5 and 7 events 5 and 8 were 5 and 9 determined 7 events 8 were 9 determined 10 to 9 determined 18 , 10 to 11 be 11 be 12 associated 12 associated 13 with 13 with 17 depression 14 late 15 - 14 late 16 life 16 life 17 depression 19 but 20 it 19 but 21 is 20 it 21 is 21 is 22 important 22 important 23 to 23 to 24 keep 24 keep 26 mind 24 keep 28 differences 24 keep 29 between 25 in 26 mind 27 the 28 differences 29 between 30 genders also , further exploration of the role of lifetime anxiety disorder in late - life depression may be of future importance . 0 ###LEFT-WALL### 4 exploration 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 22 . 1 also 2 , 1 also 4 exploration 3 further 4 exploration 4 exploration 5 of 4 exploration 17 may 5 of 7 role 6 the 7 role 7 role 8 of 8 of 11 disorder 9 lifetime 11 disorder 10 anxiety 11 disorder 11 disorder 12 in 12 in 16 depression 13 late 14 - 13 late 15 life 15 life 16 depression 17 may 18 be 18 be 19 of 19 of 21 importance 20 future 21 importance conclusions : we believe that this study helps to provide insight into the role of psychosocial factors in late - life depression . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 we 2 : 4 believe 3 we 4 believe 4 believe 5 that 5 that 7 study 5 that 8 helps 6 this 7 study 7 study 8 helps 8 helps 9 to 8 helps 10 provide 9 to 10 provide 10 provide 11 insight 10 provide 12 into 12 into 14 role 13 the 14 role 14 role 15 of 14 role 18 in 15 of 17 factors 16 psychosocial 17 factors 18 in 22 depression 19 late 20 - 19 late 21 life 21 life 22 depression background : skeletal muscle [mass] is controlled by myostatin and akt - dependent signaling on mammalian target of rapamycin ( mtor ) , glycogen synthase kinase 3β ( gsk3β ) and forkhead box o ( foxo [ )(pathways , [but] it is unknown how these pathways are regulated in critically ill human muscle [.] 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 muscle 2 : 7 controlled 2 : 12 - 3 skeletal 4 muscle 4 muscle 6 is 6 is 7 controlled 7 controlled 8 by 8 by 10 and 9 myostatin 10 and 10 and 11 akt 12 - 14 signaling 12 - 23 , 13 dependent 14 signaling 14 signaling 15 on 15 on 17 target 16 mammalian 17 target 17 target 18 of 17 target 21 mtor 18 of 19 rapamycin 20 ( 21 mtor 21 mtor 22 ) 23 , 24 glycogen 23 , 31 and 24 glycogen 27 3β 25 synthase 26 kinase 26 kinase 27 3β 27 3β 29 gsk3β 28 ( 29 gsk3β 29 gsk3β 30 ) 31 and 39 , 31 and 41 it 31 and 42 is 32 forkhead 33 box 33 box 34 o 33 box 38 )(pathways 35 ( 38 )(pathways 36 foxo 38 )(pathways 38 )(pathways 39 , 41 it 42 is 42 is 43 unknown 43 unknown 44 how 44 how 46 pathways 44 how 48 regulated 45 these 46 pathways 46 pathways 47 are 47 are 48 regulated 48 regulated 49 in 49 in 53 muscle 50 critically 51 ill 51 ill 53 muscle 52 human 53 muscle to describe factors involved in muscle mass regulation , we investigated the phosphorylation and expression of key factors in these protein synthesis and breakdown signaling pathways in thigh skeletal muscle of critically ill intensive care [unit] ( icu ) patients compared with healthy controls . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 describe 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 41 compared 0 ###LEFT-WALL### 45 . 1 to 2 describe 2 describe 3 factors 2 describe 5 in 3 factors 4 involved 5 in 8 regulation 6 muscle 8 regulation 7 mass 8 regulation 9 , 10 we 9 , 11 investigated 10 we 11 investigated 11 investigated 14 and 11 investigated 19 in 12 the 14 and 13 phosphorylation 14 and 14 and 15 expression 14 and 16 of 16 of 18 factors 17 key 18 factors 19 in 23 and 20 these 22 synthesis 21 protein 22 synthesis 22 synthesis 23 and 23 and 24 breakdown 23 and 25 signaling 23 and 27 in 25 signaling 26 pathways 27 in 30 muscle 28 thigh 30 muscle 29 skeletal 30 muscle 30 muscle 31 of 30 muscle 40 patients 30 muscle 41 compared 31 of 35 care 32 critically 33 ill 33 ill 35 care 34 intensive 35 care 35 care 38 icu 37 ( 38 icu 38 icu 39 ) 40 patients 41 compared 41 compared 42 with 42 with 44 controls 43 healthy 44 controls methodology/principal findings : icu patients were systemically inflamed , moderately hyperglycemic , received insulin therapy , and showed a tendency to lower plasma branched chain amino acids compared with controls . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 31 . 1 methodology/principal 2 findings 2 findings 3 : 3 : 4 icu 4 icu 5 patients 4 icu 18 showed 5 patients 12 , 6 were 8 inflamed 6 were 12 , 7 systemically 8 inflamed 8 inflamed 9 , 8 inflamed 11 hyperglycemic 10 moderately 11 hyperglycemic 12 , 17 and 13 received 15 therapy 13 received 17 and 14 insulin 15 therapy 16 , 17 and 17 and 18 showed 18 showed 20 tendency 18 showed 27 acids 19 a 20 tendency 20 tendency 21 to 21 to 25 chain 22 lower 25 chain 23 plasma 24 branched 24 branched 25 chain 26 amino 27 acids 27 acids 28 compared 28 compared 29 with 29 with 30 controls unexpectedly , in critically ill icu patients akt - mtor - s6k signaling was substantially higher compared with controls . 0 ###LEFT-WALL### 12 s6k 0 ###LEFT-WALL### 17 compared 0 ###LEFT-WALL### 20 . 1 unexpectedly 2 , 1 unexpectedly 12 s6k 3 in 7 patients 3 in 12 s6k 4 critically 5 ill 5 ill 7 patients 6 icu 7 patients 8 akt 9 - 8 akt 12 s6k 10 mtor 11 - 10 mtor 12 s6k 12 s6k 13 signaling 12 s6k 14 was 14 was 16 higher 14 was 17 compared 15 substantially 16 higher 17 compared 18 with 18 with 19 controls foxo1 mrna was higher in patients , whereas foxo3 , atrogin1 and myostatin mrnas and murf1 protein were lower compared with controls . 0 ###LEFT-WALL### 2 mrna 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 23 . 1 foxo1 2 mrna 2 mrna 3 was 3 was 4 higher 4 higher 5 in 5 in 6 patients 7 , 15 and 7 , 20 compared 8 whereas 9 foxo3 8 whereas 10 , 8 whereas 15 and 11 atrogin1 12 and 12 and 14 mrnas 12 and 15 and 13 myostatin 14 mrnas 15 and 17 protein 15 and 18 were 16 murf1 17 protein 18 were 19 lower 18 were 20 compared 20 compared 21 with 21 with 22 controls a moderate correlation [(] r2=0.36 , p<0.05 ) [between] insulin infusion dose and phosphorylated akt was demonstrated . 0 ###LEFT-WALL### 12 dose 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 18 . 1 a 2 moderate 1 a 12 dose 2 moderate 3 correlation 3 correlation 12 dose 5 r2=0.36 6 , 5 r2=0.36 10 insulin 7 p<0.05 8 ) 7 p<0.05 10 insulin 10 insulin 12 dose 11 infusion 12 dose 13 and 15 akt 13 and 17 demonstrated 14 phosphorylated 15 akt 15 akt 16 was 16 was 17 demonstrated conclusions/significance : we present for the first time muscle protein turnover signaling in critically ill icu patients , and we show signaling pathway activity towards [a] stimulation of muscle protein synthesis and [a] somewhat inhibited proteolysis . 0 ###LEFT-WALL### 1 conclusions/significance 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 1 conclusions/significance 2 : 2 : 4 present 2 : 5 for 3 we 4 present 5 for 11 turnover 6 the 7 first 6 the 11 turnover 8 time 9 muscle 9 muscle 11 turnover 10 protein 11 turnover 11 turnover 12 signaling 11 turnover 13 in 11 turnover 22 signaling 13 in 16 icu 14 critically 15 ill 15 ill 16 icu 16 icu 19 and 16 icu 21 show 17 patients 19 and 18 , 19 and 19 and 20 we 19 and 21 show 22 signaling 24 activity 23 pathway 24 activity 24 activity 25 towards 24 activity 28 of 25 towards 27 stimulation 28 of 32 and 29 muscle 30 protein 30 protein 31 synthesis 31 synthesis 32 and 32 and 36 proteolysis 34 somewhat 35 inhibited 35 inhibited 36 proteolysis background : it has been shown previously that it is possible to obtain growth of plasmodium falciparum in human erythrocytes grafted in mice lacking adaptive immune responses by controlling , to a certain extent , innate defences with liposomes containing clodronate ( clo - [lip] ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 lacking 0 ###LEFT-WALL### 47 . 2 : 3 it 2 : 10 is 3 it 4 has 4 has 5 been 5 been 6 shown 6 shown 7 previously 6 shown 8 that 9 it 10 is 10 is 11 possible 11 possible 12 to 11 possible 24 lacking 12 to 13 obtain 13 obtain 14 growth 13 obtain 18 in 13 obtain 22 in 14 growth 15 of 15 of 17 falciparum 16 plasmodium 17 falciparum 18 in 20 erythrocytes 19 human 20 erythrocytes 20 erythrocytes 21 grafted 22 in 23 mice 23 mice 24 lacking 24 lacking 27 responses 25 adaptive 27 responses 26 immune 27 responses 27 responses 28 by 27 responses 31 to 27 responses 37 defences 28 by 29 controlling 30 , 31 to 31 to 34 extent 31 to 35 , 32 a 34 extent 33 certain 34 extent 35 , 37 defences 36 innate 37 defences 37 defences 38 with 37 defences 40 containing 37 defences 46 ) 38 with 39 liposomes 40 containing 41 clodronate 41 clodronate 43 clo 42 ( 43 clo 43 clo 44 - however , the reproducibility of those models is limited , with [only] a proportion of animals supporting longstanding parasitemia , due to strong inflammation induced by p [.] [falciparum] . 0 ###LEFT-WALL### 4 reproducibility 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 4 reproducibility 3 the 4 reproducibility 4 reproducibility 5 of 4 reproducibility 8 is 5 of 7 models 6 those 7 models 8 is 9 limited 9 limited 11 with 9 limited 22 to 9 limited 26 by 10 , 11 with 11 with 14 proportion 11 with 20 , 13 a 14 proportion 14 proportion 15 of 14 proportion 17 supporting 15 of 16 animals 17 supporting 19 parasitemia 18 longstanding 19 parasitemia 21 due 22 to 22 to 24 inflammation 23 strong 24 inflammation 24 inflammation 25 induced 26 by 27 p optimisation of the model is much needed for the study of new anti - malarial drugs , drug combinations , and candidate vaccines . 0 ###LEFT-WALL### 1 optimisation 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 24 . 1 optimisation 2 of 1 optimisation 5 is 2 of 4 model 3 the 4 model 5 is 6 much 6 much 7 needed 7 needed 8 for 8 for 10 study 9 the 10 study 10 study 11 of 11 of 21 and 12 new 16 drugs 13 anti 14 - 13 anti 16 drugs 15 malarial 16 drugs 16 drugs 17 , 17 , 19 combinations 17 , 21 and 18 drug 19 combinations 20 , 21 and 21 and 23 vaccines 22 candidate 23 vaccines materials/methods : we investigated the possibility of improving previous models by employing the intravenous route ( iv ) for delivery of both human erythrocytes ( hurbc ) and p [.] falciparum , instead of the intraperitoneal route ( ip ) , [by] testing various immunosuppressive drugs that might help to control innate mouse defences , and by exploring the potential benefits of using immunodeficient mice with additional genetic defects , such as those with il - 2rγ deficiency ( nsg mice ) . 0 ###LEFT-WALL### 1 materials/methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 investigated 3 we 4 investigated 4 investigated 6 possibility 4 investigated 11 by 5 the 6 possibility 6 possibility 7 of 7 of 8 improving 8 improving 10 models 9 previous 10 models 11 by 12 employing 12 employing 15 route 12 employing 19 for 13 the 15 route 14 intravenous 15 route 15 route 17 iv 16 ( 17 iv 17 iv 18 ) 19 for 31 falciparum 20 delivery 21 of 20 delivery 28 and 21 of 24 erythrocytes 22 both 24 erythrocytes 23 human 24 erythrocytes 24 erythrocytes 26 hurbc 25 ( 26 hurbc 26 hurbc 27 ) 28 and 29 p 28 and 31 falciparum 31 falciparum 43 testing 32 , 34 of 33 instead 34 of 34 of 37 route 34 of 41 , 34 of 43 testing 35 the 37 route 36 intraperitoneal 37 route 37 route 39 ip 38 ( 39 ip 39 ip 40 ) 43 testing 46 drugs 44 various 46 drugs 45 immunosuppressive 46 drugs 46 drugs 47 that 46 drugs 48 might 47 that 48 might 48 might 49 help 49 help 56 and 50 to 54 defences 50 to 56 and 51 control 54 defences 52 innate 53 mouse 53 mouse 54 defences 55 , 56 and 56 and 57 by 57 by 58 exploring 58 exploring 61 benefits 59 the 61 benefits 60 potential 61 benefits 61 benefits 62 of 61 benefits 66 with 61 benefits 72 as 62 of 65 mice 63 using 65 mice 64 immunodeficient 65 mice 66 with 69 defects 67 additional 69 defects 68 genetic 69 defects 70 , 72 as 71 such 72 as 72 as 73 those 72 as 83 . 73 those 74 with 73 those 78 deficiency 74 with 75 il 76 - 78 deficiency 77 2rγ 78 deficiency 78 deficiency 81 mice 78 deficiency 82 ) 79 ( 81 mice 80 nsg 81 mice 81 mice 82 ) results : we demonstrate here the role of aging , of inosine and [of] the il - 2 [receptor] γ mutation in controlling p . falciparum induced inflammation . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 3 we 2 : 4 demonstrate 2 : 17 - 3 we 4 demonstrate 4 demonstrate 5 here 4 demonstrate 7 role 6 the 7 role 7 role 8 of 7 role 11 of 8 of 9 aging 10 , 11 of 11 of 13 and 11 of 17 - 12 inosine 13 and 13 and 16 il 15 the 16 il 17 - 21 mutation 18 2 20 γ 20 γ 21 mutation 21 mutation 22 in 22 in 23 controlling 23 controlling 24 p 25 . 26 falciparum 25 . 27 induced 25 . 29 . 26 falciparum 27 induced 27 induced 28 inflammation iv delivery of hurbc and p . falciparum in clo - lip treated nsg mice led to successful infection in 100 % of inoculated mice , rapid rise [of] parasitemia to high levels ( up to 40 % ) , long - lasting parasitemia , and consistent results [from] mouse - [to] - mouse . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 . 0 ###LEFT-WALL### 55 . 1 iv 2 delivery 2 delivery 3 of 2 delivery 5 and 3 of 4 hurbc 5 and 6 p 7 . 8 falciparum 7 . 16 led 7 . 40 , 8 falciparum 9 in 8 falciparum 16 led 9 in 15 mice 10 clo 11 - 10 clo 15 mice 12 lip 13 treated 13 treated 15 mice 14 nsg 15 mice 16 led 17 to 16 led 20 in 17 to 19 infection 18 successful 19 infection 20 in 22 % 21 100 22 % 22 % 23 of 22 % 30 parasitemia 23 of 25 mice 24 inoculated 25 mice 26 , 30 parasitemia 27 rapid 30 parasitemia 28 rise 30 parasitemia 30 parasitemia 31 to 30 parasitemia 40 , 31 to 33 levels 32 high 33 levels 33 levels 35 up 34 ( 35 up 35 up 36 to 35 up 39 ) 36 to 38 % 37 40 38 % 40 , 54 mouse 41 long 46 and 41 long 53 - 41 long 54 mouse 42 - 46 and 43 lasting 44 parasitemia 44 parasitemia 46 and 45 , 46 and 46 and 50 mouse 46 and 51 - 47 consistent 48 results 48 results 50 mouse characteristics were closer to human infection than in previous models , with evidence of synchronisation , partial sequestration , and receptivity to [various] p . falciparum strains without preliminary adaptation . 0 ###LEFT-WALL### 1 characteristics 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 characteristics 2 were 2 were 3 closer 3 closer 4 to 3 closer 7 than 4 to 6 infection 5 human 6 infection 7 than 8 in 8 in 10 models 9 previous 10 models 10 models 12 with 11 , 12 with 12 with 13 evidence 12 with 16 , 13 evidence 14 of 14 of 15 synchronisation 16 , 20 and 17 partial 18 sequestration 18 sequestration 20 and 19 , 20 and 20 and 21 receptivity 20 and 22 to 22 to 24 p 25 . 26 falciparum 25 . 27 strains 25 . 31 . 26 falciparum 27 strains 27 strains 28 without 28 without 30 adaptation 29 preliminary 30 adaptation however , results show that a major [il] - 12p70 inflammatory response remains prevalent . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 15 . 1 however 2 , 1 however 3 results 3 results 4 show 4 show 5 that 5 that 12 response 5 that 13 remains 6 a 12 response 7 major 9 - 7 major 12 response 10 12p70 12 response 11 inflammatory 12 response 12 response 13 remains 13 remains 14 prevalent conclusion : the combination of the nsg mouse , clodronate loaded liposomes , and iv delivery of hurbc has produced a reliable and more relevant model that better meets the needs of malaria research . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 1 conclusion 2 : 2 : 4 combination 3 the 4 combination 4 combination 5 of 4 combination 16 delivery 4 combination 20 produced 5 of 14 and 6 the 8 mouse 7 nsg 8 mouse 8 mouse 9 , 9 , 12 liposomes 9 , 14 and 10 clodronate 11 loaded 11 loaded 12 liposomes 13 , 14 and 14 and 15 iv 16 delivery 17 of 16 delivery 19 has 17 of 18 hurbc 19 has 20 produced 20 produced 26 model 21 a 26 model 22 reliable 23 and 23 and 25 relevant 23 and 26 model 24 more 25 relevant 26 model 27 that 26 model 29 meets 27 that 29 meets 28 better 29 meets 29 meets 31 needs 30 the 31 needs 31 needs 32 of 32 of 34 research 33 malaria 34 research in this study , curvilinear regression was applied to the relationship between bmi and body fat percentage , and an analysis was done to see whether there are characteristic changes in that curvilinear regression from elementary [to] middle school . 0 ###LEFT-WALL### 6 regression 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 40 . 1 in 3 study 1 in 4 , 1 in 6 regression 2 this 3 study 5 curvilinear 6 regression 6 regression 7 was 7 was 19 and 8 applied 9 to 8 applied 12 between 8 applied 19 and 9 to 11 relationship 10 the 11 relationship 12 between 14 and 13 bmi 14 and 14 and 17 percentage 15 body 17 percentage 16 fat 17 percentage 18 , 19 and 19 and 25 see 19 and 26 whether 20 an 21 analysis 21 analysis 22 was 22 was 23 done 23 done 24 to 24 to 25 see 26 whether 27 there 26 whether 28 are 27 there 28 are 28 are 30 changes 28 are 31 in 28 are 35 from 29 characteristic 30 changes 31 in 34 regression 32 that 33 curvilinear 33 curvilinear 34 regression 35 from 39 school 36 elementary 39 school 38 middle 39 school then , by simultaneously investigating the changes with age in bmi and body fat percentage , the essential differences in bmi and body fat percentage were demonstrated . 0 ###LEFT-WALL### 19 differences 0 ###LEFT-WALL### 26 were 0 ###LEFT-WALL### 28 . 1 then 2 , 1 then 19 differences 2 , 3 by 3 by 5 investigating 3 by 16 , 3 by 19 differences 4 simultaneously 5 investigating 5 investigating 7 changes 5 investigating 8 with 5 investigating 10 in 6 the 7 changes 8 with 9 age 10 in 12 and 11 bmi 12 and 12 and 15 percentage 13 body 15 percentage 14 fat 15 percentage 17 the 19 differences 18 essential 19 differences 19 differences 20 in 19 differences 26 were 20 in 22 and 21 bmi 22 and 22 and 25 percentage 23 body 25 percentage 24 fat 25 percentage 26 were 27 demonstrated the subjects were 789 boys and girls ( 469 boys , 320 girls ) aged 7.5 to 14.5 years from all parts of japan who participated in regular sports activities . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 31 . 1 the 2 subjects 2 subjects 3 were 3 were 5 boys 4 789 5 boys 6 and 7 girls 6 and 15 aged 7 girls 10 boys 7 girls 13 girls 7 girls 15 aged 8 ( 10 boys 9 469 10 boys 10 boys 11 , 11 , 13 girls 12 320 13 girls 13 girls 14 ) 15 aged 17 to 15 aged 20 from 16 7.5 17 to 17 to 18 14.5 18 14.5 19 years 19 years 20 from 20 from 22 parts 21 all 22 parts 22 parts 23 of 22 parts 25 who 22 parts 26 participated 23 of 24 japan 25 who 26 participated 26 participated 27 in 27 in 30 activities 28 regular 29 sports 29 sports 30 activities body [weight] , total body water ( tbw ) , soft lean mass [(] slm ) , body fat percentage , and fat mass were measured with a body composition analyzer ( tanita bc - 521 inner scan ) , using segmental bioelectrical impedance analysis [&] multi - frequency bioelectrical impedance analysis . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 25 were 0 ###LEFT-WALL### 53 . 1 body 6 water 1 body 17 , 3 , 6 water 4 total 6 water 5 body 6 water 6 water 8 tbw 6 water 15 slm 6 water 16 ) 7 ( 8 tbw 8 tbw 9 ) 10 , 15 slm 11 soft 15 slm 12 lean 15 slm 13 mass 15 slm 15 slm 16 ) 17 , 20 percentage 17 , 22 and 18 body 19 fat 19 fat 20 percentage 21 , 22 and 22 and 24 mass 22 and 25 were 23 fat 24 mass 25 were 26 measured 26 measured 27 with 26 measured 41 using 27 with 31 analyzer 28 a 31 analyzer 29 body 30 composition 30 composition 31 analyzer 31 analyzer 34 bc 32 ( 34 bc 33 tanita 34 bc 34 bc 38 scan 34 bc 40 , 35 - 38 scan 36 521 38 scan 37 inner 38 scan 38 scan 39 ) 41 using 52 analysis 42 segmental 44 impedance 43 bioelectrical 44 impedance 44 impedance 45 analysis 45 analysis 52 analysis 47 multi 48 - 47 multi 49 frequency 49 frequency 52 analysis 50 bioelectrical 51 impedance 51 impedance 52 analysis height was measured with a digital height measurer . 0 ###LEFT-WALL### 1 height 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 9 . 1 height 2 was 2 was 3 measured 3 measured 4 with 4 with 8 measurer 5 a 6 digital 5 a 8 measurer 6 digital 7 height 7 height 8 measurer body [mass] [index] ( bmi ) was calculated as body weight ( [km] [ )(divided by the square of height [(] [m] ) . 0 ###LEFT-WALL### 5 bmi 0 ###LEFT-WALL### 8 calculated 0 ###LEFT-WALL### 24 . 1 body 5 bmi 4 ( 5 bmi 5 bmi 6 ) 5 bmi 7 was 7 was 8 calculated 8 calculated 9 as 9 as 11 weight 10 body 11 weight 11 weight 15 )(divided 12 ( 15 )(divided 15 )(divided 16 by 15 )(divided 23 ) 16 by 18 square 17 the 18 square 18 square 19 of 19 of 20 height the results for the validity of regression polynomials of body fat [percentage] against bmi showed that , for both boys and girls , first - order polynomials were valid in all school years . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 15 showed 0 ###LEFT-WALL### 34 . 1 the 2 results 2 results 3 for 2 results 9 of 2 results 15 showed 3 for 5 validity 4 the 5 validity 5 validity 6 of 6 of 8 polynomials 7 regression 8 polynomials 9 of 11 fat 10 body 11 fat 11 fat 13 against 13 against 14 bmi 15 showed 16 that 15 showed 27 polynomials 15 showed 28 were 17 , 18 for 18 for 21 and 18 for 23 , 18 for 27 polynomials 19 both 21 and 20 boys 21 and 21 and 22 girls 23 , 24 first 24 first 25 - 24 first 27 polynomials 26 order 27 polynomials 27 polynomials 28 were 28 were 29 valid 29 valid 30 in 30 in 33 years 31 all 33 years 32 school 33 years with regard to changes with age in bmi and body fat percentage , the results showed a temporary drop at 9 years in the aging distance curve in boys , followed by an increasing trend . 0 ###LEFT-WALL### 15 results 0 ###LEFT-WALL### 16 showed 0 ###LEFT-WALL### 36 . 1 with 9 and 1 with 13 , 1 with 15 results 2 regard 3 to 2 regard 9 and 3 to 4 changes 4 changes 5 with 4 changes 7 in 5 with 6 age 7 in 8 bmi 9 and 12 percentage 10 body 11 fat 11 fat 12 percentage 14 the 15 results 15 results 16 showed 16 showed 19 drop 16 showed 22 years 16 showed 30 , 17 a 18 temporary 17 a 19 drop 18 temporary 19 drop 19 drop 20 at 20 at 21 9 22 years 23 in 22 years 30 , 23 in 26 distance 24 the 26 distance 25 aging 26 distance 27 curve 28 in 27 curve 30 , 28 in 29 boys 30 , 31 followed 30 , 32 by 32 by 35 trend 33 an 35 trend 34 increasing 35 trend peaks were seen in the velocity curve at 9.7 and 11.9 years , but the mpv was presumed to be at 11.9 years . 0 ###LEFT-WALL### 1 peaks 0 ###LEFT-WALL### 3 seen 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 20 be 0 ###LEFT-WALL### 24 . 1 peaks 2 were 2 were 3 seen 3 seen 4 in 3 seen 8 at 4 in 7 curve 5 the 7 curve 6 velocity 7 curve 8 at 12 years 9 9.7 10 and 10 and 11 11.9 10 and 12 years 13 , 14 but 14 but 16 mpv 14 but 18 presumed 15 the 16 mpv 16 mpv 17 was 17 was 18 presumed 18 presumed 19 to 19 to 20 be 20 be 21 at 21 at 23 years 22 11.9 23 years among girls , a decreasing trend was seen in the aging distance curve , which was opposite to the changes in the aging distance curve for body fat [percentage] . 0 ###LEFT-WALL### 6 trend 0 ###LEFT-WALL### 8 seen 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 30 . 1 among 2 girls 1 among 3 , 1 among 6 trend 4 a 6 trend 5 decreasing 6 trend 6 trend 7 was 7 was 8 seen 8 seen 9 in 9 in 13 curve 10 the 13 curve 11 aging 12 distance 12 distance 13 curve 14 , 15 which 14 , 16 was 15 which 16 was 16 was 17 opposite 17 opposite 18 to 17 opposite 21 in 18 to 20 changes 19 the 20 changes 21 in 25 curve 22 the 25 curve 23 aging 24 distance 24 distance 25 curve 25 curve 26 for 26 for 28 fat 27 body 28 fat biliverdin reductase [-] a ( bvr - a ) is a pleiotropic enzyme and plays pivotal role in the antioxidant defense against free radicals as well as in cell homeostasis . 0 ###LEFT-WALL### 2 reductase 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 31 . 1 biliverdin 2 reductase 2 reductase 4 a 2 reductase 7 - 2 reductase 10 is 5 ( 7 - 6 bvr 7 - 7 - 8 a 7 - 9 ) 10 is 17 role 10 is 18 in 10 is 22 against 10 is 27 as 11 a 12 pleiotropic 11 a 17 role 12 pleiotropic 13 enzyme 13 enzyme 14 and 14 and 15 plays 14 and 17 role 16 pivotal 17 role 18 in 21 defense 19 the 21 defense 20 antioxidant 21 defense 22 against 24 radicals 23 free 24 radicals 24 radicals 25 as 25 as 26 well 27 as 28 in 28 in 30 homeostasis 29 cell 30 homeostasis together with heme oxygenase , bvr [-] a forms a powerful system involved in the cell stress response during neurodegenerative disorders including alzheimer 's disease ( ad ) , whereas due to the serine/threonine/tyrosine kinase activity the enzyme regulates glucose metabolism and cell proliferation . 0 ###LEFT-WALL### 6 bvr 0 ###LEFT-WALL### 39 regulates 0 ###LEFT-WALL### 45 . 1 together 2 with 2 with 4 oxygenase 2 with 5 , 2 with 6 bvr 3 heme 4 oxygenase 6 bvr 8 a 6 bvr 9 forms 9 forms 12 system 10 a 12 system 11 powerful 12 system 12 system 13 involved 13 involved 14 in 13 involved 19 during 14 in 18 response 15 the 18 response 16 cell 17 stress 17 stress 18 response 19 during 21 disorders 20 neurodegenerative 21 disorders 21 disorders 22 including 22 including 25 disease 22 including 30 whereas 23 alzheimer 24 's 24 's 25 disease 25 disease 27 ad 26 ( 27 ad 27 ad 28 ) 29 , 30 whereas 30 whereas 38 enzyme 31 due 32 to 32 to 36 activity 32 to 38 enzyme 33 the 36 activity 34 serine/threonine/tyrosine 35 kinase 35 kinase 36 activity 37 the 38 enzyme 38 enzyme 39 regulates 39 regulates 42 and 40 glucose 41 metabolism 41 metabolism 42 and 42 and 44 proliferation 43 cell 44 proliferation in this paper , we report results that demonstrate bvr - a [undergoes] post - translational oxidative and nitrosative modifications in the hippocampus , but not cerebellum , of subjects with ad and amnestic mild cognitive impairment ( mci ) . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 report 0 ###LEFT-WALL### 41 . 1 in 3 paper 1 in 4 , 1 in 5 we 2 this 3 paper 5 we 6 report 6 report 7 results 7 results 8 that 7 results 9 demonstrate 7 results 20 modifications 8 that 9 demonstrate 9 demonstrate 10 bvr 10 bvr 14 post 11 - 14 post 12 a 14 post 14 post 15 - 15 - 20 modifications 16 translational 20 modifications 17 oxidative 18 and 18 and 19 nitrosative 18 and 20 modifications 20 modifications 21 in 20 modifications 29 of 20 modifications 40 ) 21 in 23 hippocampus 22 the 23 hippocampus 23 hippocampus 25 but 24 , 25 but 25 but 26 not 25 but 27 cerebellum 25 but 28 , 28 , 29 of 29 of 30 subjects 29 of 40 ) 30 subjects 31 with 31 with 33 and 32 ad 33 and 33 and 37 impairment 33 and 39 mci 34 amnestic 37 impairment 35 mild 37 impairment 36 cognitive 37 impairment 38 ( 39 mci 39 mci 40 ) a significant increase of nitrated bvr [-] a was demonstrated only in ad and [mci] hippocampi , whereas no significant modifications were found in cerebellar tissue . 0 ###LEFT-WALL### 3 increase 0 ###LEFT-WALL### 23 found 0 ###LEFT-WALL### 27 . 1 a 2 significant 1 a 3 increase 2 significant 3 increase 3 increase 4 of 3 increase 9 was 4 of 6 bvr 5 nitrated 6 bvr 6 bvr 8 a 9 was 10 demonstrated 10 demonstrated 11 only 10 demonstrated 18 whereas 11 only 12 in 12 in 14 and 13 ad 14 and 14 and 16 hippocampi 17 , 18 whereas 18 whereas 21 modifications 19 no 21 modifications 20 significant 21 modifications 21 modifications 22 were 22 were 23 found 23 found 24 in 24 in 26 tissue 25 cerebellar 26 tissue in addition , a significant reduction in protein carbonyl - derivatives of bvr - [a] was found in both ad and [mci] hippocampi ( 15 [%] and 18 % , respectively ) . 0 ###LEFT-WALL### 6 reduction 0 ###LEFT-WALL### 17 found 0 ###LEFT-WALL### 33 . 1 in 2 addition 1 in 3 , 1 in 6 reduction 4 a 6 reduction 5 significant 6 reduction 6 reduction 7 in 6 reduction 11 derivatives 6 reduction 16 was 7 in 9 carbonyl 8 protein 9 carbonyl 10 - 11 derivatives 11 derivatives 12 of 11 derivatives 14 - 12 of 13 bvr 16 was 17 found 17 found 18 in 17 found 31 respectively 18 in 21 and 19 both 21 and 20 ad 21 and 21 and 23 hippocampi 21 and 29 % 24 ( 29 % 25 15 27 and 27 and 28 18 27 and 29 % 29 % 30 , 30 , 31 respectively 31 respectively 32 ) biliverdin reductase - bound 4 - hydroxynonenals were not modified in hippocampi and cerebella from ad and [mci] subjects . 0 ###LEFT-WALL### 1 biliverdin 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 20 . 1 biliverdin 2 reductase 1 biliverdin 7 hydroxynonenals 1 biliverdin 17 and 2 reductase 4 bound 2 reductase 7 hydroxynonenals 3 - 4 bound 4 bound 5 4 4 bound 6 - 8 were 9 not 8 were 11 in 8 were 17 and 9 not 10 modified 11 in 13 and 12 hippocampi 13 and 13 and 14 cerebella 13 and 15 from 15 from 16 ad 17 and 19 subjects these results supported the hypothesis of a prevalence of nitrosative stress - induced modifications on bvr - a structure , and this evidence was confirmed by a significant upregulation of inducible nitric oxide synthase in hippocampal tissue of subjects with ad and mci [that] was not present in cerebellum . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 supported 0 ###LEFT-WALL### 25 confirmed 0 ###LEFT-WALL### 42 and 0 ###LEFT-WALL### 50 . 1 these 2 results 2 results 3 supported 3 supported 5 hypothesis 4 the 5 hypothesis 5 hypothesis 6 of 5 hypothesis 9 of 5 hypothesis 14 modifications 6 of 8 prevalence 7 a 8 prevalence 9 of 11 stress 10 nitrosative 11 stress 12 - 14 modifications 13 induced 14 modifications 14 modifications 15 on 14 modifications 17 - 15 on 16 bvr 17 - 25 confirmed 18 a 19 structure 19 structure 21 and 20 , 21 and 21 and 22 this 21 and 23 evidence 21 and 24 was 21 and 25 confirmed 23 evidence 24 was 25 confirmed 26 by 25 confirmed 35 in 26 by 29 upregulation 27 a 28 significant 27 a 29 upregulation 28 significant 29 upregulation 29 upregulation 30 of 30 of 34 synthase 31 inducible 33 oxide 32 nitric 33 oxide 33 oxide 34 synthase 35 in 37 tissue 36 hippocampal 37 tissue 37 tissue 38 of 38 of 39 subjects 39 subjects 40 with 40 with 41 ad 42 and 43 mci 42 and 45 was 43 mci 45 was 45 was 46 not 45 was 47 present 47 present 48 in 48 in 49 cerebellum in conclusion , nitrosative stress - induced modifications on hippocampal bvr [-] a are an early event in the pathogenesis of ad [since] they appear also in mci subjects and could contribute to the antioxidant and metabolic derangement characteristic of these neurodegenerative disorders . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 32 contribute 0 ###LEFT-WALL### 44 . 1 in 2 conclusion 3 , 5 stress 3 , 6 - 4 nitrosative 5 stress 6 - 8 modifications 6 - 14 are 7 induced 8 modifications 8 modifications 9 on 8 modifications 14 are 9 on 11 bvr 10 hippocampal 11 bvr 11 bvr 13 a 14 are 17 event 14 are 18 in 15 an 17 event 16 early 17 event 18 in 20 pathogenesis 19 the 20 pathogenesis 20 pathogenesis 21 of 20 pathogenesis 28 mci 20 pathogenesis 30 and 21 of 22 ad 22 ad 24 they 22 ad 27 in 24 they 25 appear 25 appear 26 also 25 appear 27 in 28 mci 30 and 29 subjects 30 and 30 and 31 could 30 and 32 contribute 31 could 32 contribute 32 contribute 33 to 33 to 39 characteristic 34 the 39 characteristic 35 antioxidant 36 and 36 and 37 metabolic 36 and 39 characteristic 38 derangement 39 characteristic 39 characteristic 40 of 40 of 43 disorders 41 these 43 disorders 42 neurodegenerative 43 disorders previous studies have reported immunoglobulin - positive neurons in alzheimer 's disease ( ad ) brains , an observation [indicative] of blood - brain barrier [(] bbb ) breakdown . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 reported 0 ###LEFT-WALL### 30 . 1 previous 2 studies 2 studies 3 have 3 have 4 reported 4 reported 5 immunoglobulin 4 reported 16 brains 5 immunoglobulin 8 neurons 5 immunoglobulin 16 brains 6 - 8 neurons 7 positive 8 neurons 8 neurons 9 in 8 neurons 14 ad 8 neurons 15 ) 9 in 12 disease 10 alzheimer 11 's 11 's 12 disease 13 ( 14 ad 14 ad 15 ) 16 brains 23 - 16 brains 29 breakdown 17 , 23 - 18 an 19 observation 19 observation 21 of 19 observation 23 - 21 of 22 blood 23 - 27 bbb 23 - 28 ) 24 brain 25 barrier 25 barrier 27 bbb recently , we demonstrated the nearly ubiquitous presence of brain - reactive autoantibodies in human sera . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 demonstrated 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 17 . 1 recently 2 , 1 recently 3 we 3 we 4 demonstrated 4 demonstrated 8 presence 5 the 8 presence 6 nearly 7 ubiquitous 7 ubiquitous 8 presence 8 presence 9 of 9 of 10 brain 11 - 13 autoantibodies 12 reactive 13 autoantibodies 13 autoantibodies 14 in 14 in 16 sera 15 human 16 sera the significance of these observations to ad pathology is unknown . 0 ###LEFT-WALL### 2 significance 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 11 . 1 the 2 significance 2 significance 3 of 2 significance 9 is 3 of 5 observations 4 these 5 observations 5 observations 6 to 6 to 8 pathology 7 ad 8 pathology 9 is 10 unknown here , we show that igg - immunopositive neurons are abundant in brain regions exhibiting ad pathology , including intraneuronal amyloid - β ( 42 ) ( aβ ( 42 ) ) and amyloid plaques , [and] confirm by western analysis that brain - reactive autoantibodies are nearly ubiquitous in human serum . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 53 . 1 here 2 , 1 here 3 we 3 we 4 show 4 show 5 that 4 show 6 igg 7 - 9 neurons 7 - 10 are 7 - 36 , 7 - 44 - 8 immunopositive 9 neurons 9 neurons 10 are 10 are 33 and 11 abundant 12 in 11 abundant 33 and 12 in 17 pathology 13 brain 17 pathology 14 regions 17 pathology 15 exhibiting 17 pathology 16 ad 17 pathology 17 pathology 19 including 17 pathology 28 aβ 18 , 19 including 19 including 21 amyloid 19 including 26 ) 20 intraneuronal 21 amyloid 21 amyloid 23 β 22 - 23 β 23 β 25 42 23 β 26 ) 24 ( 25 42 25 42 26 ) 27 ( 28 aβ 28 aβ 30 42 28 aβ 32 ) 29 ( 30 42 30 42 31 ) 33 and 35 plaques 34 amyloid 35 plaques 36 , 38 confirm 38 confirm 39 by 38 confirm 43 brain 39 by 41 analysis 40 western 41 analysis 42 that 43 brain 44 - 46 autoantibodies 44 - 47 are 45 reactive 46 autoantibodies 46 autoantibodies 47 are 47 are 49 ubiquitous 48 nearly 49 ubiquitous 49 ubiquitous 50 in 50 in 52 serum 51 human 52 serum to investigate a possible interrelationship between neuronal antibody binding and aβ pathology , we tested the effects of human serum autoantibodies on the intraneuronal deposition of soluble aβ ( 42 ) peptide [in] adult mouse neurons [in] [vitro] ( organotypic brain slice cultures ) . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 investigate 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 45 . 1 to 2 investigate 2 investigate 5 interrelationship 2 investigate 6 between 3 a 5 interrelationship 4 possible 5 interrelationship 6 between 10 and 7 neuronal 9 binding 8 antibody 9 binding 9 binding 10 and 10 and 12 pathology 11 aβ 12 pathology 13 , 14 we 13 , 15 tested 14 we 15 tested 15 tested 17 effects 16 the 17 effects 17 effects 18 of 17 effects 26 of 18 of 21 autoantibodies 19 human 20 serum 20 serum 21 autoantibodies 21 autoantibodies 22 on 22 on 25 deposition 23 the 25 deposition 24 intraneuronal 25 deposition 26 of 36 neurons 27 soluble 34 adult 28 aβ 30 42 28 aβ 32 peptide 29 ( 30 42 30 42 31 ) 32 peptide 34 adult 34 adult 36 neurons 35 mouse 36 neurons 36 neurons 43 cultures 39 ( 43 cultures 40 organotypic 42 slice 41 brain 42 slice 42 slice 43 cultures 43 cultures 44 ) binding of human autoantibodies to mouse neurons dramatically increased the rate and extent of intraneuronal aβ ( 42 ) accumulation in the mouse cerebral cortex and hippocampus . 0 ###LEFT-WALL### 1 binding 0 ###LEFT-WALL### 9 increased 0 ###LEFT-WALL### 28 . 1 binding 2 of 1 binding 9 increased 2 of 4 autoantibodies 3 human 4 autoantibodies 4 autoantibodies 5 to 5 to 7 neurons 6 mouse 7 neurons 8 dramatically 9 increased 9 increased 20 accumulation 9 increased 21 in 10 the 11 rate 11 rate 12 and 12 and 13 extent 12 and 14 of 12 and 20 accumulation 14 of 16 aβ 15 intraneuronal 16 aβ 16 aβ 18 42 17 ( 18 42 18 42 19 ) 21 in 26 and 22 the 25 cortex 23 mouse 25 cortex 24 cerebral 25 cortex 25 cortex 26 and 26 and 27 hippocampus additionally , individual sera exhibited variable potency related to their capacity to enhance intraneuronal aβ ( 42 ) peptide accumulation and immunolabel neurons in ad brain sections . 0 ###LEFT-WALL### 4 sera 0 ###LEFT-WALL### 5 exhibited 0 ###LEFT-WALL### 28 . 1 additionally 2 , 1 additionally 4 sera 3 individual 4 sera 4 sera 5 exhibited 5 exhibited 7 potency 5 exhibited 24 in 6 variable 7 potency 7 potency 8 related 7 potency 12 to 7 potency 21 and 8 related 9 to 9 to 11 capacity 10 their 11 capacity 12 to 21 and 13 enhance 20 accumulation 13 enhance 21 and 14 intraneuronal 20 accumulation 15 aβ 17 42 15 aβ 20 accumulation 16 ( 17 42 17 42 18 ) 19 peptide 20 accumulation 21 and 22 immunolabel 22 immunolabel 23 neurons 24 in 27 sections 25 ad 26 brain 26 brain 27 sections replacement of human sera with antibodies targeting abundant neuronal surface proteins resulted in a comparable enhancement [of] aβ ( 42 ) accumulation in mouse neurons . 0 ###LEFT-WALL### 1 replacement 0 ###LEFT-WALL### 12 resulted 0 ###LEFT-WALL### 26 . 1 replacement 2 of 1 replacement 5 with 1 replacement 12 resulted 2 of 4 sera 3 human 4 sera 5 with 6 antibodies 6 antibodies 7 targeting 7 targeting 11 proteins 8 abundant 10 surface 9 neuronal 10 surface 10 surface 11 proteins 12 resulted 13 in 12 resulted 23 in 13 in 22 accumulation 14 a 15 comparable 14 a 22 accumulation 15 comparable 16 enhancement 16 enhancement 22 accumulation 18 aβ 20 42 18 aβ 22 accumulation 19 ( 20 42 20 42 21 ) 23 in 25 neurons 24 mouse 25 neurons overall , results suggest that brain - reactive autoantibodies are ubiquitous in the blood and that a defective bbb allows these antibodies to access the brain interstitium , bind to neuronal surfaces and enhance intraneuronal deposition of aβ ( 42 ) in ad brains . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 suggest 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 45 . 1 overall 2 , 1 overall 3 results 3 results 4 suggest 4 suggest 6 brain 5 that 6 brain 7 - 9 autoantibodies 7 - 24 access 7 - 28 , 8 reactive 9 autoantibodies 9 autoantibodies 10 are 10 are 11 ubiquitous 11 ubiquitous 12 in 12 in 15 and 13 the 14 blood 14 blood 15 and 15 and 16 that 15 and 19 bbb 15 and 24 access 17 a 19 bbb 18 defective 19 bbb 19 bbb 20 allows 20 allows 22 antibodies 20 allows 23 to 20 allows 24 access 21 these 22 antibodies 23 to 24 access 24 access 27 interstitium 25 the 27 interstitium 26 brain 27 interstitium 28 , 33 and 29 bind 30 to 29 bind 33 and 30 to 32 surfaces 31 neuronal 32 surfaces 33 and 34 enhance 34 enhance 36 deposition 34 enhance 42 in 35 intraneuronal 36 deposition 36 deposition 37 of 36 deposition 40 42 37 of 38 aβ 39 ( 40 42 40 42 41 ) 42 in 44 brains 43 ad 44 brains thus , in the context of bbb compromise , brain - reactive autoantibodies may be an important risk factor for the initiation [and/or] progression of ad as well as other neurodegenerative diseases . 0 ###LEFT-WALL### 13 autoantibodies 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 33 . 1 thus 2 , 1 thus 13 autoantibodies 3 in 5 context 3 in 13 autoantibodies 4 the 5 context 5 context 6 of 6 of 8 compromise 7 bbb 8 compromise 8 compromise 10 brain 9 , 10 brain 10 brain 11 - 12 reactive 13 autoantibodies 13 autoantibodies 14 may 14 may 15 be 15 be 19 factor 16 an 17 important 16 an 19 factor 17 important 19 factor 18 risk 19 factor 19 factor 20 for 19 factor 25 of 20 for 24 progression 21 the 24 progression 22 initiation 24 progression 25 of 26 ad 26 ad 29 as 27 as 28 well 28 well 29 as 29 as 32 diseases 30 other 32 diseases 31 neurodegenerative 32 diseases none [none] [we] have recently found that , at a young age , transient receptor potential vanilloid - 1 ( trpv1 ) [knockout] [(] - [/] - ) mice have a higher locomotor activity than their wild - type littermates ( +/+ ) . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 8 , 1 none 4 have 4 have 6 found 5 recently 6 found 6 found 7 that 8 , 29 mice 8 , 30 have 8 , 38 - 9 at 12 age 9 at 28 ) 9 at 29 mice 10 a 12 age 11 young 12 age 12 age 16 potential 13 , 16 potential 14 transient 15 receptor 15 receptor 16 potential 16 potential 17 vanilloid 16 potential 19 1 16 potential 27 - 18 - 19 1 19 1 21 trpv1 19 1 25 - 20 ( 21 trpv1 21 trpv1 22 ) 29 mice 30 have 30 have 34 activity 30 have 35 than 31 a 34 activity 32 higher 34 activity 33 locomotor 34 activity 35 than 37 wild 36 their 37 wild 38 - 39 type 38 - 44 . 39 type 40 littermates 40 littermates 42 +/+ 41 ( 42 +/+ 42 +/+ 43 ) we have also found that , with age , trpv1 [(] - [/] [-] ) mice become substantially heavier than trpv1 ( +/+ ) controls , thus forming a paradoxical association between locomotor hyperactivity and overweight . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 35 and 0 ###LEFT-WALL### 37 . 1 we 35 and 2 have 4 found 2 have 35 and 3 also 4 found 4 found 5 that 4 found 7 with 4 found 16 mice 6 , 7 with 7 with 8 age 7 with 15 ) 8 age 10 trpv1 9 , 10 trpv1 10 trpv1 12 - 16 mice 17 become 16 mice 19 heavier 16 mice 28 forming 18 substantially 19 heavier 19 heavier 20 than 20 than 21 trpv1 21 trpv1 25 controls 22 ( 25 controls 23 +/+ 24 ) 23 +/+ 25 controls 25 controls 26 , 27 thus 28 forming 28 forming 31 association 28 forming 32 between 29 a 30 paradoxical 29 a 31 association 30 paradoxical 31 association 32 between 34 hyperactivity 33 locomotor 34 hyperactivity 35 and 36 overweight the present study solves this contradiction . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 solves 0 ###LEFT-WALL### 7 . 1 the 3 study 2 present 3 study 3 study 4 solves 4 solves 6 contradiction 5 this 6 contradiction [by] using two experimental paradigms , we show that aged trpv1 [(] - [/] - [ )(mice have not [an] increased , but a decreased [,] locomotor activity , as compared to age - matched trpv1 ( +/+ ) controls . 0 ###LEFT-WALL### 5 paradigms 0 ###LEFT-WALL### 6 , 2 using 5 paradigms 3 two 5 paradigms 4 experimental 5 paradigms 6 , 7 we 6 , 13 - 7 we 8 show 8 show 9 that 8 show 10 aged 9 that 10 aged 10 aged 11 trpv1 13 - 15 - 15 - 17 )(mice 17 )(mice 18 have 18 have 19 not 18 have 21 increased 21 increased 23 but 21 increased 32 to 22 , 23 but 23 but 28 activity 23 but 29 , 24 a 28 activity 25 decreased 28 activity 27 locomotor 28 activity 29 , 31 compared 30 as 31 compared 32 to 33 age 33 age 36 trpv1 34 - 36 trpv1 35 matched 36 trpv1 36 trpv1 40 controls 36 trpv1 41 . 37 ( 40 controls 38 +/+ 39 ) 38 +/+ 40 controls 40 controls 41 . we also confirm that aged trpv1 [(] - [/] - [ )(mice are overweight . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 confirm 0 ###LEFT-WALL### 8 - 1 we 3 confirm 2 also 3 confirm 3 confirm 4 that 3 confirm 5 aged 4 that 5 aged 5 aged 6 trpv1 8 - 10 - 8 - 13 are 8 - 15 . 10 - 12 )(mice 12 )(mice 13 are 13 are 14 overweight we conclude that trpv1 channels are involved in the regulation of both general locomotor activity and body mass in an age - dependent manner . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 22 - 1 we 2 conclude 2 conclude 3 that 3 that 5 channels 3 that 7 involved 4 trpv1 5 channels 5 channels 6 are 6 are 7 involved 7 involved 8 in 8 in 10 regulation 9 the 10 regulation 10 regulation 11 of 10 regulation 19 in 11 of 16 and 12 both 16 and 13 general 15 activity 14 locomotor 15 activity 15 activity 16 and 16 and 18 mass 17 body 18 mass 19 in 21 age 20 an 21 age 22 - 24 manner 22 - 25 . 23 dependent 24 manner skeletal muscle aging is associated with increased inflammation and oxidative stress , a decrease in the ability to rebuild muscle after injury and in response to exercise . 0 ###LEFT-WALL### 2 muscle 0 ###LEFT-WALL### 5 associated 1 skeletal 2 muscle 2 muscle 3 aging 2 muscle 4 is 4 is 5 associated 5 associated 6 with 6 with 9 and 7 increased 8 inflammation 8 inflammation 9 and 9 and 11 stress 9 and 14 decrease 10 oxidative 11 stress 12 , 14 decrease 13 a 14 decrease 14 decrease 15 in 14 decrease 26 to 14 decrease 28 . 15 in 17 ability 16 the 17 ability 17 ability 18 to 17 ability 19 rebuild 18 to 19 rebuild 19 rebuild 20 muscle 20 muscle 23 and 21 after 22 injury 21 after 23 and 23 and 25 response 24 in 25 response 26 to 27 exercise in this perspective , we discuss the mechanisms regulating sirt1 activity and expression in skeletal muscles , emphasizing their implications in muscle physiology and the impairment of muscle function with age . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 discuss 1 in 3 perspective 1 in 4 , 1 in 5 we 2 this 3 perspective 5 we 6 discuss 6 discuss 12 and 6 discuss 14 in 6 discuss 18 emphasizing 7 the 8 mechanisms 8 mechanisms 9 regulating 8 mechanisms 12 and 9 regulating 11 activity 10 sirt1 11 activity 12 and 13 expression 14 in 16 muscles 15 skeletal 16 muscles 17 , 18 emphasizing 18 emphasizing 20 implications 18 emphasizing 29 function 18 emphasizing 32 . 19 their 20 implications 20 implications 21 in 20 implications 27 of 20 implications 29 function 21 in 24 and 22 muscle 23 physiology 23 physiology 24 and 24 and 26 impairment 25 the 26 impairment 27 of 28 muscle 29 function 30 with 30 with 31 age age - related alterations in the cellular composition of the [b] lineage are a major cause of the poor antibody response to vaccination and to infectious agents among the elderly population . 0 ###LEFT-WALL### 4 alterations 0 ###LEFT-WALL### 13 are 0 ###LEFT-WALL### 32 . 1 age 2 - 1 age 4 alterations 3 related 4 alterations 4 alterations 5 in 4 alterations 9 of 4 alterations 13 are 5 in 8 composition 6 the 8 composition 7 cellular 8 composition 9 of 12 lineage 10 the 12 lineage 13 are 16 cause 14 a 15 major 14 a 16 cause 15 major 16 cause 16 cause 17 of 17 of 21 response 18 the 21 response 19 poor 20 antibody 20 antibody 21 response 21 response 24 and 22 to 23 vaccination 22 to 24 and 24 and 25 to 25 to 27 agents 26 infectious 27 agents 27 agents 28 among 28 among 31 population 29 the 31 population 30 elderly 31 population the mechanisms leading to these changes are poorly understood . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 9 understood 0 ###LEFT-WALL### 10 . 1 the 2 mechanisms 2 mechanisms 3 leading 2 mechanisms 7 are 3 leading 4 to 4 to 6 changes 5 these 6 changes 7 are 9 understood 8 poorly 9 understood recently , we have shown that these changes reflect , at least [in] part , homeostatic pressures imposed by long - [lived] [b] cells that accumulate with aging , and that aging in [the] b lineage can be reversed upon alteration of b cell homeostasis by depletion . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 48 . 1 recently 2 , 1 recently 3 we 3 we 4 have 4 have 5 shown 5 shown 6 that 6 that 8 changes 6 that 9 reflect 7 these 8 changes 8 changes 9 reflect 10 , 30 and 10 , 39 reversed 11 at 12 least 12 least 30 and 14 part 15 , 15 , 17 pressures 15 , 30 and 16 homeostatic 17 pressures 17 pressures 18 imposed 18 imposed 19 by 18 imposed 27 with 19 by 24 cells 20 long 21 - 20 long 24 cells 24 cells 25 that 24 cells 26 accumulate 25 that 26 accumulate 27 with 28 aging 29 , 30 and 30 and 31 that 30 and 32 aging 30 and 36 lineage 30 and 38 be 30 and 39 reversed 32 aging 33 in 33 in 35 b 36 lineage 37 can 37 can 38 be 39 reversed 40 upon 39 reversed 45 homeostasis 40 upon 41 alteration 41 alteration 42 of 42 of 43 b 44 cell 45 homeostasis 45 homeostasis 46 by 46 by 47 depletion here we discuss homeostatic causes for [b] lineage immunosenescence , and the potential for its rejuvenation . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 17 . 1 here 2 we 2 we 3 discuss 3 discuss 5 causes 4 homeostatic 5 causes 5 causes 6 for 6 for 11 and 8 lineage 9 immunosenescence 9 immunosenescence 11 and 10 , 11 and 11 and 13 potential 11 and 14 for 12 the 13 potential 14 for 16 rejuvenation 15 its 16 rejuvenation the term laminopathies defines a group of genetic disorders caused by defects in the nuclear envelope , mostly [the] lamins . 0 ###LEFT-WALL### 3 laminopathies 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 21 . 1 the 3 laminopathies 2 term 3 laminopathies 3 laminopathies 17 , 4 defines 9 disorders 4 defines 13 in 4 defines 17 , 5 a 6 group 6 group 7 of 6 group 9 disorders 7 of 9 disorders 8 genetic 9 disorders 9 disorders 10 caused 10 caused 11 by 11 by 12 defects 13 in 16 envelope 14 the 16 envelope 15 nuclear 16 envelope 17 , 20 lamins 18 mostly 20 lamins lamins are the main constituents of the nuclear lamina , a filamentous meshwork associated with the inner nuclear membrane that provides mechanical stability and plays important roles in processes such as transcription , dna replication and chromatin organization . 0 ###LEFT-WALL### 1 lamins 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 39 . 1 lamins 2 are 2 are 5 constituents 3 the 4 main 3 the 5 constituents 5 constituents 6 of 6 of 9 lamina 7 the 9 lamina 8 nuclear 9 lamina 10 , 13 meshwork 10 , 24 and 11 a 12 filamentous 11 a 13 meshwork 12 filamentous 13 meshwork 13 meshwork 24 and 14 associated 15 with 14 associated 23 stability 14 associated 24 and 15 with 19 membrane 16 the 19 membrane 17 inner 19 membrane 18 nuclear 19 membrane 19 membrane 20 that 19 membrane 21 provides 20 that 21 provides 22 mechanical 23 stability 24 and 25 plays 25 plays 27 roles 25 plays 31 as 26 important 27 roles 27 roles 28 in 28 in 29 processes 30 such 31 as 31 as 36 and 32 transcription 33 , 33 , 35 replication 33 , 36 and 34 dna 35 replication 36 and 38 organization 37 chromatin 38 organization more than 300 mutations [inlamin] [a/c] have been associated with diverse clinical [phenotypes] , understanding the molecular basis of these diseases may provide a rationale for treating them . 0 ###LEFT-WALL### 4 mutations 0 ###LEFT-WALL### 9 associated 0 ###LEFT-WALL### 29 . 1 more 2 than 2 than 3 300 3 300 4 mutations 4 mutations 7 have 7 have 8 been 8 been 9 associated 9 associated 10 with 10 with 15 understanding 11 diverse 15 understanding 12 clinical 14 , 12 clinical 15 understanding 15 understanding 18 basis 15 understanding 23 provide 16 the 18 basis 17 molecular 18 basis 18 basis 19 of 18 basis 22 may 19 of 21 diseases 20 these 21 diseases 22 may 23 provide 23 provide 25 rationale 24 a 25 rationale 25 rationale 26 for 26 for 27 treating 27 treating 28 them here we describe the generation of induced pluripotent stem cells ( ipscs ) from a patient with inherited dilated cardiomiopathy and 2 patients with distinct accelerated forms of aging , atypical werner syndrome and hutchinson gilford progeria , all of which are caused by mutations in lamin a/c . these cell lines were pluripotent and displayed normal nuclear membrane morphology compared to donor fibroblasts . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 describe 0 ###LEFT-WALL### 49 . 0 ###LEFT-WALL### 65 . 1 here 2 we 2 we 3 describe 3 describe 21 and 3 describe 24 with 3 describe 39 all 3 describe 46 in 4 the 5 generation 5 generation 6 of 5 generation 14 from 5 generation 17 with 5 generation 21 and 6 of 10 cells 7 induced 9 stem 8 pluripotent 9 stem 9 stem 10 cells 10 cells 12 ipscs 11 ( 12 ipscs 12 ipscs 13 ) 14 from 16 patient 15 a 16 patient 17 with 20 cardiomiopathy 18 inherited 20 cardiomiopathy 19 dilated 20 cardiomiopathy 21 and 23 patients 22 2 23 patients 24 with 34 and 25 distinct 27 forms 26 accelerated 27 forms 27 forms 28 of 27 forms 30 , 28 of 29 aging 30 , 33 syndrome 30 , 34 and 31 atypical 33 syndrome 32 werner 33 syndrome 34 and 37 progeria 34 and 38 , 35 hutchinson 36 gilford 36 gilford 37 progeria 39 all 40 of 40 of 41 which 41 which 42 are 42 are 43 caused 43 caused 44 by 44 by 45 mutations 46 in 48 a/c 47 lamin 48 a/c 49 . 54 pluripotent 49 . 55 and 50 these 52 lines 51 cell 52 lines 52 lines 53 were 53 were 54 pluripotent 55 and 60 morphology 55 and 61 compared 56 displayed 59 membrane 57 normal 59 membrane 58 nuclear 59 membrane 59 membrane 60 morphology 60 morphology 61 compared 61 compared 62 to 62 to 64 fibroblasts 63 donor 64 fibroblasts their differentiated progeny reproduced the disease phenotype , reinforcing the idea that they represent excellent tools for understanding the role of lamin a/c in normal physiology and the clinical diversity associated with these diseases . 0 ###LEFT-WALL### 3 progeny 0 ###LEFT-WALL### 4 reproduced 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 35 . 1 their 3 progeny 2 differentiated 3 progeny 3 progeny 4 reproduced 4 reproduced 7 phenotype 5 the 7 phenotype 6 disease 7 phenotype 8 , 9 reinforcing 8 , 31 associated 9 reinforcing 11 idea 9 reinforcing 24 in 9 reinforcing 31 associated 10 the 11 idea 11 idea 12 that 12 that 13 they 12 that 14 represent 13 they 14 represent 14 represent 16 tools 15 excellent 16 tools 16 tools 17 for 17 for 18 understanding 18 understanding 20 role 19 the 20 role 20 role 21 of 21 of 23 a/c 22 lamin 23 a/c 24 in 27 and 25 normal 26 physiology 26 physiology 27 and 27 and 30 diversity 28 the 30 diversity 29 clinical 30 diversity 31 associated 32 with 32 with 34 diseases 33 these 34 diseases reduction of body temperature has been proposed to contribute to the increased lifespan in calorie restricted animals and mice overexpressing the uncoupling protein - 2 in hypocretin neurons . 0 ###LEFT-WALL### 1 reduction 0 ###LEFT-WALL### 7 proposed 0 ###LEFT-WALL### 29 . 1 reduction 2 of 1 reduction 5 has 2 of 4 temperature 3 body 4 temperature 5 has 6 been 6 been 7 proposed 7 proposed 8 to 7 proposed 10 to 8 to 9 contribute 10 to 18 and 11 the 13 lifespan 12 increased 13 lifespan 13 lifespan 14 in 13 lifespan 18 and 14 in 17 animals 15 calorie 16 restricted 16 restricted 17 animals 18 and 19 mice 19 mice 20 overexpressing 20 overexpressing 28 neurons 21 the 28 neurons 22 uncoupling 28 neurons 23 protein 28 neurons 24 - 25 2 25 2 26 in 26 in 28 neurons 27 hypocretin 28 neurons however , nothing is [known] regarding the long - term effects [of] calorie restriction ( cr ) with adequate nutrition on body temperature in humans . 0 ###LEFT-WALL### 3 nothing 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 26 . 1 however 2 , 1 however 3 nothing 3 nothing 4 is 4 is 6 regarding 6 regarding 14 restriction 6 regarding 18 with 6 regarding 21 on 7 the 14 restriction 8 long 9 - 8 long 10 term 10 term 14 restriction 11 effects 13 calorie 13 calorie 14 restriction 14 restriction 16 cr 15 ( 16 cr 16 cr 17 ) 18 with 20 nutrition 19 adequate 20 nutrition 21 on 23 temperature 22 body 23 temperature 23 temperature 24 in 24 in 25 humans the cr and ex groups were significantly leaner than the wd group . 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 13 . 1 the 5 groups 2 cr 3 and 3 and 4 ex 4 ex 5 groups 5 groups 6 were 6 were 8 leaner 7 significantly 8 leaner 8 leaner 9 than 9 than 12 group 10 the 12 group 11 wd 12 group energy intake was lower in the cr group [(] 1769 ± 348 kcal / [d] [ )(than in [the] wd ( 2302 ± 668 kcal / [d] ) and ex ( 2798 ± 760 kcal / [d] ) groups ( p < 0.0001 ) . 0 ###LEFT-WALL### 2 intake 0 ###LEFT-WALL### 3 was 1 energy 2 intake 2 intake 3 was 3 was 4 lower 4 lower 5 in 5 in 14 / 6 the 14 / 7 cr 8 group 8 group 11 ± 10 1769 11 ± 11 ± 14 / 12 348 13 kcal 13 kcal 14 / 14 / 17 )(than 14 / 18 in 18 in 29 and 20 wd 26 / 20 wd 29 and 21 ( 26 / 22 2302 26 / 23 ± 26 / 24 668 25 kcal 25 kcal 26 / 26 / 28 ) 29 and 30 ex 30 ex 39 groups 31 ( 39 groups 32 2798 39 groups 33 ± 39 groups 34 760 35 kcal 35 kcal 39 groups 36 / 38 ) 36 / 39 groups 39 groups 42 < 39 groups 45 . 40 ( 42 < 41 p 42 < 42 < 43 0.0001 42 < 44 ) mean 24 - hour [,] day - time and night - time core body temperatures were all significantly lower in the cr group than in the wd and ex groups ( [p] ≤ 0.01 ) . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 11 - 1 mean 2 24 2 24 6 day 2 24 9 and 3 - 6 day 4 hour 6 day 6 day 7 - 7 - 9 and 8 time 9 and 9 and 10 night 9 and 11 - 11 - 15 temperatures 11 - 16 were 11 - 36 . 12 time 13 core 13 core 14 body 14 body 15 temperatures 15 temperatures 16 were 16 were 28 and 17 all 19 lower 17 all 28 and 18 significantly 19 lower 19 lower 20 in 19 lower 24 than 20 in 23 group 21 the 23 group 22 cr 23 group 24 than 25 in 25 in 27 wd 26 the 27 wd 28 and 30 groups 28 and 33 ≤ 29 ex 30 groups 31 ( 33 ≤ 33 ≤ 34 0.01 33 ≤ 35 ) long - term cr with adequate nutrition in lean and weight - stable healthy humans is associated with a sustained reduction in core body temperature , similar to that found in cr rodents and monkeys . 0 ###LEFT-WALL### 4 cr 0 ###LEFT-WALL### 17 associated 0 ###LEFT-WALL### 36 . 1 long 2 - 1 long 3 term 3 term 4 cr 4 cr 5 with 4 cr 16 is 5 with 15 humans 6 adequate 7 nutrition 7 nutrition 8 in 7 nutrition 10 and 8 in 9 lean 10 and 11 weight 10 and 12 - 10 and 13 stable 13 stable 15 humans 14 healthy 15 humans 16 is 17 associated 17 associated 18 with 17 associated 26 , 17 associated 27 similar 18 with 21 reduction 18 with 22 in 19 a 21 reduction 20 sustained 21 reduction 22 in 25 temperature 23 core 25 temperature 24 body 25 temperature 27 similar 28 to 28 to 34 and 29 that 30 found 29 that 34 and 30 found 31 in 31 in 33 rodents 32 cr 33 rodents 34 and 35 monkeys this adaptation is likely due to cr itself , rather than to leanness , and may be involved in slowing the rate of aging . 0 ###LEFT-WALL### 2 adaptation 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 25 . 1 this 2 adaptation 2 adaptation 15 and 3 is 4 likely 3 is 15 and 4 likely 6 to 4 likely 8 itself 4 likely 11 than 5 due 6 to 6 to 7 cr 9 , 11 than 10 rather 11 than 11 than 12 to 11 than 14 , 12 to 13 leanness 14 , 15 and 15 and 16 may 16 may 17 be 17 be 18 involved 18 involved 19 in 19 in 20 slowing 20 slowing 22 rate 21 the 22 rate 22 rate 23 of 23 of 24 aging background : effective antiretroviral therapy has reduced the risk of aids and dramatically prolonged the survival of hiv - infected people in the united states . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 therapy 2 : 12 and 2 : 19 - 2 : 26 . 3 effective 5 therapy 4 antiretroviral 5 therapy 5 therapy 6 has 6 has 12 and 7 reduced 9 risk 7 reduced 12 and 8 the 9 risk 9 risk 10 of 10 of 11 aids 12 and 14 prolonged 13 dramatically 14 prolonged 14 prolonged 16 survival 15 the 16 survival 16 survival 17 of 17 of 18 hiv 19 - 21 people 20 infected 21 people 21 people 22 in 22 in 25 states 23 the 25 states 24 united 25 states consequently , an increasing number of hiv [-] infected people are at risk [of] [non] - aids - defining cancers that typically occur at older ages . 0 ###LEFT-WALL### 10 people 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 27 . 1 consequently 2 , 1 consequently 10 people 3 an 5 number 4 increasing 5 number 5 number 6 of 5 number 10 people 6 of 10 people 7 hiv 9 infected 9 infected 10 people 10 people 11 are 11 are 12 at 11 are 19 defining 12 at 13 risk 13 risk 17 aids 16 - 17 aids 17 aids 18 - 19 defining 20 cancers 20 cancers 21 that 20 cancers 23 occur 21 that 23 occur 22 typically 23 occur 23 occur 24 at 24 at 26 ages 25 older 26 ages we estimated the annual number of cancers in the hiv - infected population , both [with] and [without] aids , in the united states . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 estimated 0 ###LEFT-WALL### 25 . 1 we 2 estimated 2 estimated 7 cancers 2 estimated 8 in 2 estimated 21 in 3 the 5 number 4 annual 5 number 5 number 6 of 5 number 7 cancers 6 of 7 cancers 8 in 10 hiv 9 the 10 hiv 10 hiv 17 and 11 - 17 and 12 infected 13 population 13 population 14 , 14 , 15 both 14 , 17 and 17 and 19 aids 17 and 20 , 21 in 24 states 22 the 24 states 23 united 24 states methods : incidence rates for individual cancer types were obtained from the hiv/aids cancer match study by linking 15 hiv and cancer registries in the united states . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 21 and 3 incidence 4 rates 4 rates 5 for 4 rates 21 and 5 for 7 cancer 6 individual 7 cancer 7 cancer 8 types 7 cancer 18 linking 8 types 9 were 9 were 10 obtained 10 obtained 11 from 10 obtained 17 by 11 from 16 study 12 the 16 study 13 hiv/aids 14 cancer 14 cancer 15 match 15 match 16 study 17 by 18 linking 18 linking 20 hiv 19 15 20 hiv 21 and 23 registries 21 and 24 in 22 cancer 23 registries 24 in 27 states 25 the 27 states 26 united 27 states estimated counts of the us hiv [-] infected and aids populations were obtained from centers for disease control and prevention surveillance data . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 13 obtained 0 ###LEFT-WALL### 23 . 1 estimated 2 counts 2 counts 3 of 2 counts 9 and 3 of 5 us 4 the 5 us 5 us 6 hiv 5 us 8 infected 6 hiv 8 infected 9 and 11 populations 9 and 12 were 10 aids 11 populations 12 were 13 obtained 13 obtained 14 from 14 from 19 and 15 centers 16 for 15 centers 19 and 16 for 18 control 17 disease 18 control 19 and 22 data 20 prevention 22 data 21 surveillance 22 data we obtained estimated counts of aids - defining ( ie , kaposi sarcoma , [non] - hodgkin lymphoma , and cervical cancer ) [and] [non] - aids - defining cancers in the us aids population during 1991 - 2005 by multiplying cancer incidence rates and aids population counts , stratified by year [,] age , sex , race and ethnicity , transmission category , and aids - relative time . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 obtained 1 we 2 obtained 2 obtained 4 counts 2 obtained 8 defining 3 estimated 4 counts 4 counts 5 of 5 of 6 aids 7 - 8 defining 8 defining 16 - 8 defining 20 and 9 ( 16 - 10 ie 13 sarcoma 10 ie 16 - 11 , 13 sarcoma 12 kaposi 13 sarcoma 13 sarcoma 14 , 16 - 17 hodgkin 18 lymphoma 20 and 19 , 20 and 20 and 22 cancer 20 and 23 ) 20 and 28 - 21 cervical 22 cancer 26 - 28 - 27 aids 28 - 28 - 30 cancers 29 defining 30 cancers 30 cancers 31 in 30 cancers 36 during 31 in 35 population 32 the 35 population 33 us 34 aids 34 aids 35 population 36 during 38 - 37 1991 38 - 38 - 39 2005 38 - 40 by 40 by 45 and 41 multiplying 42 cancer 42 cancer 44 rates 43 incidence 44 rates 44 rates 45 and 45 and 46 aids 45 and 47 population 45 and 49 , 45 and 51 by 47 population 49 , 48 counts 49 , 49 , 50 stratified 51 by 59 and 52 year 54 age 54 age 55 , 55 , 56 sex 55 , 57 , 57 , 58 race 57 , 59 and 59 and 60 ethnicity 59 and 65 and 61 , 65 and 62 transmission 63 category 63 category 65 and 64 , 65 and 65 and 66 aids 65 and 70 . 66 aids 69 time 67 - 69 time 68 relative 69 time 69 time 70 . we tested trends in counts and standardized incidence rates using linear regression models . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 tested 0 ###LEFT-WALL### 14 . 1 we 2 tested 2 tested 3 trends 2 tested 4 in 4 in 6 and 5 counts 6 and 6 and 7 standardized 6 and 9 rates 6 and 10 using 8 incidence 9 rates 10 using 13 models 11 linear 12 regression 12 regression 13 models we multiplied overall cancer rates and hiv - only [(] hiv infected , without aids ) population counts , available from 34 us states during 2004 - 2007 , to estimate cancers in the hiv - only population . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 multiplied 1 we 2 multiplied 2 multiplied 3 overall 2 multiplied 6 and 4 cancer 5 rates 5 rates 6 and 6 and 11 hiv 6 and 12 infected 6 and 17 population 6 and 18 counts 6 and 20 available 7 hiv 11 hiv 8 - 9 only 8 - 11 hiv 12 infected 14 without 13 , 14 without 14 without 15 aids 14 without 16 ) 17 population 18 counts 19 , 20 available 20 available 21 from 20 available 25 during 20 available 39 . 21 from 22 34 22 34 23 us 22 34 24 states 23 us 24 states 25 during 27 - 26 2004 27 - 27 - 28 2007 27 - 30 to 29 , 30 to 30 to 31 estimate 30 to 39 . 31 estimate 32 cancers 32 cancers 33 in 33 in 35 hiv 34 the 35 hiv 35 hiv 38 population 36 - 37 only 36 - 38 population 38 population 39 . all statistical tests were two [-] [sided] . 0 ###LEFT-WALL### 3 tests 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 8 . 1 all 3 tests 2 statistical 3 tests 3 tests 4 were 4 were 5 two results : the us aids population expanded fourfold from 1991 to 2005 ( 96,179 to 413,080 ) largely because of an increase in the number of people aged 40 years or older . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 6 population 2 : 7 expanded 3 the 6 population 4 us 5 aids 5 aids 6 population 6 population 7 expanded 7 expanded 8 fourfold 7 expanded 9 from 7 expanded 18 largely 9 from 11 to 10 1991 11 to 11 to 12 2005 11 to 15 to 13 ( 15 to 14 96,179 15 to 15 to 16 413,080 15 to 17 ) 18 largely 19 because 19 because 20 of 20 of 22 increase 21 an 22 increase 22 increase 23 in 22 increase 28 aged 23 in 25 number 24 the 25 number 25 number 26 of 26 of 27 people 28 aged 31 or 29 40 30 years 30 years 31 or 31 or 32 older during 1991 - 2005 , an estimated 79 656 cancers occurred in the aids population . 0 ###LEFT-WALL### 10 cancers 0 ###LEFT-WALL### 11 occurred 0 ###LEFT-WALL### 16 . 1 during 3 - 1 during 5 , 1 during 10 cancers 2 1991 3 - 3 - 4 2005 6 an 7 estimated 7 estimated 8 79 8 79 10 cancers 9 656 10 cancers 10 cancers 11 occurred 11 occurred 12 in 12 in 15 population 13 the 15 population 14 aids 15 population from 1991 - 1995 to 2001 - 2005 , estimated counts increased for anal ( 206 to 1564 cancers ) , liver ( 116 to 583 cancers ) , prostate [(] 87 to 759 cancers ) , and lung cancers ( 875 to 1882 cancers ) , and hodgkin lymphoma ( 426 to 897 cancers ) . 0 ###LEFT-WALL### 5 to 0 ###LEFT-WALL### 10 estimated 0 ###LEFT-WALL### 57 . 1 from 2 1991 1 from 3 - 1 from 5 to 4 1995 5 to 5 to 6 2001 5 to 8 2005 5 to 10 estimated 7 - 8 2005 8 2005 9 , 10 estimated 48 and 11 counts 12 increased 11 counts 38 and 12 increased 13 for 13 for 22 liver 14 anal 19 cancers 14 anal 21 , 14 anal 22 liver 15 ( 19 cancers 16 206 17 to 17 to 18 1564 17 to 19 cancers 19 cancers 20 ) 22 liver 27 cancers 22 liver 35 cancers 23 ( 27 cancers 24 116 25 to 25 to 26 583 25 to 27 cancers 27 cancers 28 ) 29 , 35 cancers 30 prostate 33 to 30 prostate 35 cancers 32 87 33 to 33 to 34 759 35 cancers 36 ) 37 , 38 and 38 and 40 cancers 38 and 45 cancers 38 and 48 and 39 lung 40 cancers 41 ( 45 cancers 42 875 43 to 43 to 44 1882 43 to 45 cancers 45 cancers 46 ) 47 , 48 and 48 and 50 lymphoma 48 and 55 cancers 49 hodgkin 50 lymphoma 51 ( 55 cancers 52 426 53 to 53 to 54 897 53 to 55 cancers 55 cancers 56 ) in the hiv - only population in 34 us states , an estimated 2191 [non] - aids - defining cancers occurred during 2004 - 2007 , including 454 lung , 166 breast , [and] 154 anal cancers . 0 ###LEFT-WALL### 19 defining 0 ###LEFT-WALL### 26 , 0 ###LEFT-WALL### 38 . 1 in 3 hiv 1 in 19 defining 2 the 3 hiv 3 hiv 6 population 4 - 5 only 4 - 6 population 6 population 7 in 6 population 14 2191 6 population 16 - 7 in 10 states 8 34 10 states 9 us 10 states 11 , 14 2191 12 an 13 estimated 13 estimated 14 2191 14 2191 16 - 17 aids 18 - 17 aids 19 defining 19 defining 20 cancers 19 defining 21 occurred 21 occurred 22 during 22 during 24 - 23 2004 24 - 24 - 25 2007 26 , 29 lung 26 , 30 , 27 including 29 lung 28 454 29 lung 30 , 32 breast 30 , 33 , 31 166 32 breast 33 , 37 cancers 35 154 37 cancers 36 anal 37 cancers conclusions : over a 15 [-] year period ( 1991 - 2005 ) , increases in [non] - aids - defining cancers were mainly driven by growth and aging of the aids population . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 34 . 1 conclusions 2 : 2 : 3 over 3 over 7 year 4 a 7 year 5 15 7 year 7 year 8 period 7 year 16 in 7 year 19 aids 8 period 10 1991 8 period 15 increases 9 ( 10 1991 10 1991 12 2005 10 1991 14 , 11 - 12 2005 12 2005 13 ) 15 increases 16 in 18 - 19 aids 19 aids 20 - 20 - 21 defining 20 - 25 driven 21 defining 22 cancers 21 defining 23 were 23 were 25 driven 24 mainly 25 driven 25 driven 26 by 26 by 28 and 27 growth 28 and 28 and 29 aging 29 aging 30 of 30 of 33 population 31 the 33 population 32 aids 33 population this growing burden requires targeted cancer prevention and treatment strategies . 0 ###LEFT-WALL### 3 burden 0 ###LEFT-WALL### 4 requires 0 ###LEFT-WALL### 11 . 1 this 2 growing 2 growing 3 burden 3 burden 4 requires 4 requires 8 and 5 targeted 6 cancer 6 cancer 7 prevention 7 prevention 8 and 8 and 10 strategies 9 treatment 10 strategies objective : temporal lobe resection is an established treatment for medication - resistant temporal lobe epilepsy , which in recent years has increasingly been performed in children . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 5 resection 2 : 6 is 2 : 28 . 3 temporal 5 resection 4 lobe 5 resection 5 resection 6 is 6 is 9 treatment 7 an 9 treatment 8 established 9 treatment 9 treatment 10 for 9 treatment 18 which 9 treatment 22 has 10 for 11 medication 11 medication 16 epilepsy 12 - 16 epilepsy 13 resistant 16 epilepsy 14 temporal 15 lobe 15 lobe 16 epilepsy 16 epilepsy 17 , 18 which 19 in 18 which 22 has 19 in 21 years 20 recent 21 years 22 has 24 been 23 increasingly 24 been 24 been 25 performed 25 performed 26 in 26 in 27 children however , little is known about the long - term outcome in these children . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 15 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 5 known 5 known 6 about 5 known 12 in 6 about 11 outcome 7 the 11 outcome 8 long 9 - 8 long 10 term 10 term 11 outcome 12 in 14 children 13 these 14 children the aim of this study was to characterize intellectual and psychosocial functioning of children after temporal lobe resection as [they] progress into late adolescence and adulthood . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 27 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 19 as 7 to 8 characterize 8 characterize 10 and 8 characterize 12 functioning 9 intellectual 10 and 10 and 11 psychosocial 12 functioning 13 of 13 of 14 children 14 children 15 after 15 after 18 resection 16 temporal 17 lobe 17 lobe 18 resection 19 as 25 and 21 progress 22 into 21 progress 25 and 22 into 24 adolescence 23 late 24 adolescence 25 and 26 adulthood methods : we report the long - term [follow] - up [of] 42 children who underwent temporal lobe surgery after an average postoperative period of 9 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 we 2 : 4 report 2 : 10 - 3 we 4 report 4 report 8 term 5 the 8 term 6 long 7 - 6 long 8 term 10 - 11 up 11 up 14 children 11 up 20 after 13 42 14 children 14 children 15 who 14 children 16 underwent 15 who 16 underwent 16 underwent 19 surgery 17 temporal 18 lobe 18 lobe 19 surgery 20 after 24 period 21 an 22 average 21 an 24 period 22 average 24 period 23 postoperative 24 period 24 period 25 of 25 of 27 years 26 9 27 years longitudinal change in iq was documented , psychosocial outcome including quality of life was assessed , and preoperative and postoperative t1 - weighted mri brain scans were evaluated quantitatively . 0 ###LEFT-WALL### 2 change 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 30 . 1 longitudinal 2 change 2 change 3 in 2 change 5 was 3 in 4 iq 5 was 6 documented 7 , 11 quality 7 , 15 assessed 7 , 17 and 8 psychosocial 9 outcome 9 outcome 11 quality 10 including 11 quality 11 quality 12 of 11 quality 14 was 12 of 13 life 14 was 15 assessed 16 , 17 and 17 and 19 and 17 and 28 evaluated 18 preoperative 19 and 19 and 21 t1 19 and 22 - 19 and 23 weighted 19 and 25 brain 19 and 26 scans 19 and 27 were 20 postoperative 21 t1 24 mri 25 brain 25 brain 26 scans 27 were 28 evaluated 28 evaluated 29 quantitatively a well [-] matched nonsurgical comparison group of 11 children with similar clinical characteristics was also assessed . 0 ###LEFT-WALL### 7 group 0 ###LEFT-WALL### 17 assessed 0 ###LEFT-WALL### 18 . 1 a 7 group 2 well 7 group 4 matched 6 comparison 5 nonsurgical 6 comparison 6 comparison 7 group 7 group 8 of 7 group 15 was 8 of 10 children 9 11 10 children 10 children 11 with 11 with 14 characteristics 12 similar 14 characteristics 13 clinical 14 characteristics 15 was 17 assessed 16 also 17 assessed results : at [follow] - up , 86 % of the surgical group were seizure - free , and 57 % were no longer taking antiepileptic medication . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 9 % 2 : 14 were 2 : 19 and 2 : 28 . 3 at 6 up 3 at 7 , 3 at 9 % 5 - 6 up 8 86 9 % 9 % 10 of 9 % 14 were 10 of 13 group 11 the 13 group 12 surgical 13 group 14 were 15 seizure 14 were 17 free 16 - 17 free 17 free 18 , 18 , 19 and 19 and 21 % 19 and 22 were 20 57 21 % 21 % 22 were 22 were 25 taking 23 no 24 longer 24 longer 25 taking 25 taking 27 medication 26 antiepileptic 27 medication a significant increase in iq was found in the surgical group after an extended [follow] [-] up period of >5 years . 0 ###LEFT-WALL### 3 increase 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 22 . 1 a 2 significant 1 a 3 increase 2 significant 3 increase 3 increase 4 in 3 increase 6 was 4 in 5 iq 6 was 7 found 7 found 8 in 7 found 12 after 8 in 11 group 9 the 11 group 10 surgical 11 group 12 after 18 period 13 an 18 period 14 extended 18 period 17 up 18 period 18 period 19 of 19 of 21 years 20 >5 21 years this iq change was not found in the nonsurgical comparison group . 0 ###LEFT-WALL### 3 change 0 ###LEFT-WALL### 6 found 0 ###LEFT-WALL### 12 . 1 this 3 change 2 iq 3 change 3 change 4 was 4 was 5 not 4 was 6 found 6 found 7 in 7 in 11 group 8 the 11 group 9 nonsurgical 10 comparison 10 comparison 11 group iq increases were associated with cessation of antiepileptic medication and changes in mri - derived gray matter volume . 0 ###LEFT-WALL### 2 increases 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 14 - 1 iq 2 increases 2 increases 10 and 3 were 4 associated 3 were 10 and 4 associated 5 with 5 with 6 cessation 6 cessation 7 of 7 of 9 medication 8 antiepileptic 9 medication 10 and 11 changes 11 changes 12 in 12 in 13 mri 14 - 18 volume 14 - 19 . 15 derived 17 matter 16 gray 17 matter 17 matter 18 volume the surgical group also reported better psychosocial outcome including quality of life , which was more strongly associated with seizure freedom rather than surgery per se . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 6 better 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 27 . 1 the 3 group 2 surgical 3 group 3 group 5 reported 3 group 6 better 4 also 5 reported 6 better 10 quality 7 psychosocial 8 outcome 8 outcome 10 quality 9 including 10 quality 10 quality 11 of 11 of 12 life 13 , 14 which 13 , 18 associated 14 which 15 was 15 was 16 more 15 was 18 associated 17 strongly 18 associated 18 associated 19 with 18 associated 23 than 18 associated 26 se 19 with 21 freedom 20 seizure 21 freedom 22 rather 23 than 23 than 24 surgery 25 per 26 se conclusions : surgery for temporal lobe epilepsy performed in childhood results in excellent long - term seizure control and favorable cognitive outcome along with positive effects on brain development . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 surgery 2 : 11 results 3 surgery 4 for 3 surgery 11 results 4 for 7 epilepsy 5 temporal 6 lobe 6 lobe 7 epilepsy 7 epilepsy 8 performed 8 performed 9 in 9 in 10 childhood 11 results 12 in 11 results 24 with 11 results 27 on 12 in 19 and 13 excellent 16 term 14 long 15 - 14 long 16 term 16 term 18 control 17 seizure 18 control 18 control 19 and 19 and 22 outcome 20 favorable 22 outcome 21 cognitive 22 outcome 23 along 24 with 24 with 26 effects 25 positive 26 effects 27 on 29 development 28 brain 29 development classification of evidence : this study provides class iii evidence that temporal lobectomy in children with temporal lobe epilepsy is associated with improved long - term intellectual outcomes compared with those undergoing standard medical treatment . 0 ###LEFT-WALL### 3 evidence 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 29 compared 0 ###LEFT-WALL### 36 . 1 classification 2 of 2 of 3 evidence 4 : 6 study 4 : 21 associated 5 this 6 study 6 study 7 provides 7 provides 8 class 8 class 9 iii 10 evidence 11 that 10 evidence 20 is 10 evidence 21 associated 11 that 13 lobectomy 11 that 20 is 12 temporal 13 lobectomy 13 lobectomy 14 in 13 lobectomy 16 with 13 lobectomy 20 is 14 in 15 children 16 with 19 epilepsy 17 temporal 18 lobe 18 lobe 19 epilepsy 21 associated 22 with 22 with 28 outcomes 22 with 29 compared 23 improved 27 intellectual 24 long 25 - 24 long 27 intellectual 26 term 27 intellectual 27 intellectual 28 outcomes 29 compared 30 with 30 with 31 those 30 with 32 undergoing 32 undergoing 35 treatment 33 standard 35 treatment 34 medical 35 treatment objective : to identify age - related changes in human meibomian glands that may be associated with meibomian gland dysfunction ( mgd ) . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 related 0 ###LEFT-WALL### 24 . 1 objective 2 : 2 : 3 to 3 to 4 identify 4 identify 5 age 6 - 7 related 7 related 8 changes 7 related 9 in 7 related 23 ) 9 in 12 glands 10 human 12 glands 11 meibomian 12 glands 12 glands 13 that 12 glands 14 may 12 glands 22 mgd 13 that 14 may 14 may 15 be 15 be 16 associated 16 associated 17 with 17 with 20 dysfunction 18 meibomian 19 gland 19 gland 20 dysfunction 21 ( 22 mgd 22 mgd 23 ) dermatologic history , age , and presence of mgd were recorded . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 recorded 0 ###LEFT-WALL### 12 . 1 dermatologic 2 history 2 history 3 , 3 , 4 age 3 , 6 and 5 , 6 and 6 and 7 presence 6 and 8 of 6 and 10 were 8 of 9 mgd 10 were 11 recorded samples were frozen , sectioned , and stained with specific antibodies against peroxisome [proliferator] - activated receptor [γ] [(] pparγ ) to identify meibocyte differentiation , ki67 nuclear antigen to identify cycling cells , and cd45 to identify inflammatory cell infiltration . 0 ###LEFT-WALL### 35 and 0 ###LEFT-WALL### 42 . 1 samples 7 and 1 samples 35 and 2 were 3 frozen 2 were 7 and 3 frozen 5 sectioned 4 , 5 sectioned 5 sectioned 6 , 7 and 8 stained 7 and 9 with 7 and 12 against 7 and 22 to 9 with 11 antibodies 10 specific 11 antibodies 12 against 13 peroxisome 13 peroxisome 20 pparγ 15 - 20 pparγ 16 activated 17 receptor 17 receptor 20 pparγ 20 pparγ 21 ) 22 to 23 identify 23 identify 25 differentiation 24 meibocyte 25 differentiation 25 differentiation 29 antigen 26 , 29 antigen 27 ki67 29 antigen 28 nuclear 29 antigen 29 antigen 30 to 29 antigen 31 identify 29 antigen 34 , 30 to 31 identify 31 identify 33 cells 32 cycling 33 cells 35 and 36 cd45 35 and 37 to 35 and 38 identify 37 to 38 identify 38 identify 41 infiltration 39 inflammatory 41 infiltration 40 cell 41 infiltration results : staining for pparγ showed cytoplasmic and nuclear localization in the 2 youngest subjects ( ages , 18 and 44 years ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 3 staining 2 : 6 showed 3 staining 4 for 3 staining 6 showed 4 for 5 pparγ 6 showed 10 localization 6 showed 11 in 7 cytoplasmic 8 and 8 and 9 nuclear 8 and 10 localization 11 in 15 subjects 12 the 13 2 13 2 14 youngest 13 2 15 subjects 15 subjects 17 ages 15 subjects 22 years 16 ( 17 ages 17 ages 18 , 18 , 22 years 19 18 20 and 20 and 21 44 20 and 22 years 22 years 23 ) older individuals ( >60 years ) showed predominantly nuclear staining , with cytoplasmic staining limited to the basal acinar cells in 17 of 31 subjects . 0 ###LEFT-WALL### 2 individuals 0 ###LEFT-WALL### 7 showed 1 older 2 individuals 2 individuals 5 years 2 individuals 7 showed 3 ( 5 years 4 >60 5 years 5 years 6 ) 7 showed 10 staining 8 predominantly 9 nuclear 9 nuclear 10 staining 10 staining 12 with 11 , 12 with 12 with 14 staining 12 with 26 . 13 cytoplasmic 14 staining 14 staining 15 limited 15 limited 16 to 15 limited 21 in 16 to 20 cells 17 the 20 cells 18 basal 20 cells 19 acinar 20 cells 21 in 22 17 22 17 23 of 23 of 25 subjects 24 31 25 subjects the number of ki67 positively stained basal cells were significantly elevated in the younger compared [with] older subjects based on linear regression analysis [(] r ( 2 [ )(= 0.35 ; p < . 001 [ )( 0 ###LEFT-WALL### 8 cells 0 ###LEFT-WALL### 11 elevated 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 34 . 1 the 2 number 2 number 3 of 2 number 8 cells 3 of 8 cells 4 ki67 8 cells 5 positively 6 stained 6 stained 7 basal 7 basal 8 cells 8 cells 9 were 9 were 11 elevated 10 significantly 11 elevated 11 elevated 12 in 11 elevated 20 on 12 in 18 subjects 13 the 18 subjects 14 younger 18 subjects 15 compared 18 subjects 17 older 18 subjects 18 subjects 19 based 20 on 23 analysis 21 linear 22 regression 22 regression 23 analysis 23 analysis 29 )(= 25 r 29 )(= 26 ( 29 )(= 27 2 29 )(= 29 )(= 30 0.35 31 ; 32 p 32 p 33 < 34 . 35 001 34 . 37 )( there was also a significant correlation between mg expression grade and cd45 cell infiltration ( r = 0.414 ; p = . 05 [ )( 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 19 ; 0 ###LEFT-WALL### 22 . 1 there 2 was 2 was 3 also 2 was 6 correlation 4 a 6 correlation 5 significant 6 correlation 6 correlation 7 between 7 between 11 and 8 mg 9 expression 9 expression 10 grade 10 grade 11 and 11 and 14 infiltration 11 and 17 = 12 cd45 14 infiltration 13 cell 14 infiltration 15 ( 17 = 16 r 17 = 17 = 18 0.414 17 = 19 ; 19 ; 20 p 19 ; 21 = 20 p 21 = 22 . 23 05 22 . 25 )( conclusions : these results indicate that aging human meibomian glands show decreased meibocyte differentiation and cell cycling that is associated with the development of mgd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 associated 0 ###LEFT-WALL### 26 . 2 : 4 results 2 : 5 indicate 3 these 4 results 4 results 5 indicate 5 indicate 9 meibomian 6 that 7 aging 7 aging 9 meibomian 8 human 9 meibomian 9 meibomian 10 glands 9 meibomian 20 associated 10 glands 11 show 11 show 13 meibocyte 11 show 15 and 11 show 20 associated 12 decreased 13 meibocyte 14 differentiation 15 and 15 and 16 cell 15 and 17 cycling 15 and 20 associated 18 that 19 is 19 is 20 associated 20 associated 21 with 21 with 23 development 22 the 23 development 23 development 24 of 24 of 25 mgd findings also suggest that altered pparγ signaling may lead to acinar atrophy and development of an age - related hyposecretory mgd . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 19 related 0 ###LEFT-WALL### 22 . 1 findings 3 suggest 2 also 3 suggest 3 suggest 4 that 3 suggest 5 altered 4 that 5 altered 5 altered 6 pparγ 6 pparγ 7 signaling 6 pparγ 9 lead 7 signaling 8 may 8 may 9 lead 9 lead 10 to 10 to 13 and 11 acinar 12 atrophy 12 atrophy 13 and 13 and 14 development 13 and 15 of 15 of 17 age 16 an 17 age 18 - 19 related 19 related 21 mgd 20 hyposecretory 21 mgd clinical relevance : meibomian gland dysfunction and evaporative dry eye are common [age] - related eyelid disorders . 0 ###LEFT-WALL### 2 relevance 0 ###LEFT-WALL### 3 : 1 clinical 2 relevance 3 : 7 and 3 : 11 are 3 : 15 related 3 : 18 . 4 meibomian 6 dysfunction 5 gland 6 dysfunction 6 dysfunction 7 and 7 and 10 eye 7 and 11 are 8 evaporative 10 eye 9 dry 10 eye 11 are 12 common 14 - 15 related 15 related 17 disorders 16 eyelid 17 disorders understanding the underlying mechanism of mgd may lead to the development of novel therapeutic strategies to treat this disease . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 8 lead 0 ###LEFT-WALL### 20 . 1 understanding 4 mechanism 1 understanding 7 may 2 the 4 mechanism 3 underlying 4 mechanism 4 mechanism 5 of 5 of 6 mgd 7 may 8 lead 8 lead 9 to 8 lead 16 to 9 to 11 development 10 the 11 development 11 development 12 of 12 of 15 strategies 13 novel 15 strategies 14 therapeutic 15 strategies 16 to 17 treat 17 treat 19 disease 18 this 19 disease human aging is accompanied by dramatic changes in daily sleep - wake behavior : activity shifts to an earlier phase , and the consolidation of sleep and wake is disturbed . 0 ###LEFT-WALL### 1 human 0 ###LEFT-WALL### 4 accompanied 0 ###LEFT-WALL### 14 : 1 human 2 aging 1 human 3 is 3 is 4 accompanied 4 accompanied 5 by 4 accompanied 8 in 5 by 7 changes 6 dramatic 7 changes 8 in 10 sleep 9 daily 10 sleep 10 sleep 13 behavior 11 - 13 behavior 12 wake 13 behavior 13 behavior 14 : 14 : 15 activity 14 : 16 shifts 14 : 22 and 14 : 31 . 15 activity 16 shifts 16 shifts 17 to 17 to 20 phase 18 an 20 phase 19 earlier 20 phase 21 , 22 and 22 and 24 consolidation 22 and 29 is 23 the 24 consolidation 24 consolidation 25 of 24 consolidation 29 is 25 of 27 and 26 sleep 27 and 27 and 28 wake 29 is 30 disturbed although this daily circadian rhythm is brain - controlled , its mechanism is encoded by cell [-] autonomous circadian clocks functioning in nearly every cell of the body . 0 ###LEFT-WALL### 12 mechanism 0 ###LEFT-WALL### 14 encoded 0 ###LEFT-WALL### 29 . 1 although 5 rhythm 1 although 6 is 1 although 8 - 1 although 12 mechanism 2 this 3 daily 3 daily 5 rhythm 4 circadian 5 rhythm 5 rhythm 6 is 6 is 7 brain 9 controlled 10 , 9 controlled 12 mechanism 11 its 12 mechanism 12 mechanism 13 is 13 is 14 encoded 14 encoded 15 by 14 encoded 22 in 15 by 20 clocks 16 cell 20 clocks 18 autonomous 20 clocks 19 circadian 20 clocks 20 clocks 21 functioning 22 in 25 cell 23 nearly 24 every 24 every 25 cell 25 cell 26 of 26 of 28 body 27 the 28 body in fact , human clock properties measured in peripheral cells such as fibroblasts closely mimic those measured physiologically and behaviorally [in] the same subjects . 0 ###LEFT-WALL### 6 properties 0 ###LEFT-WALL### 15 mimic 0 ###LEFT-WALL### 25 . 1 in 2 fact 2 fact 3 , 2 fact 6 properties 4 human 5 clock 5 clock 6 properties 6 properties 7 measured 6 properties 15 mimic 7 measured 8 in 7 measured 12 as 7 measured 14 closely 8 in 10 cells 9 peripheral 10 cells 11 such 12 as 12 as 13 fibroblasts 15 mimic 19 and 16 those 17 measured 16 those 19 and 17 measured 18 physiologically 19 and 20 behaviorally 19 and 24 subjects 22 the 23 same 23 same 24 subjects to understand better the molecular mechanisms by which human aging affects circadian clocks , we characterized the clock properties of fibroblasts cultivated from dermal [biopsies] [of] young and older subjects . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 31 . 1 to 2 understand 2 understand 3 better 2 understand 6 mechanisms 4 the 6 mechanisms 5 molecular 6 mechanisms 6 mechanisms 7 by 7 by 8 which 7 by 9 human 7 by 10 aging 7 by 11 affects 8 which 9 human 10 aging 11 affects 11 affects 13 clocks 12 circadian 13 clocks 14 , 15 we 14 , 22 cultivated 15 we 16 characterized 16 characterized 18 clock 17 the 18 clock 18 clock 19 properties 18 clock 22 cultivated 19 properties 20 of 19 properties 22 cultivated 20 of 21 fibroblasts 22 cultivated 23 from 23 from 30 subjects 24 dermal 30 subjects 27 young 28 and 28 and 29 older 28 and 30 subjects fibroblast period length , amplitude , and phase were identical in the two groups even though behavior was not , thereby suggesting that basic clock properties of peripheral cells do not change during aging . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 9 were 1 fibroblast 2 period 2 period 3 length 3 length 4 , 4 , 5 amplitude 4 , 7 and 6 , 7 and 7 and 8 phase 7 and 9 were 9 were 10 identical 10 identical 11 in 10 identical 16 though 11 in 14 groups 12 the 13 two 13 two 14 groups 15 even 16 though 16 though 17 behavior 16 though 18 was 17 behavior 18 was 18 was 19 not 18 was 22 suggesting 20 , 22 suggesting 21 thereby 22 suggesting 22 suggesting 26 properties 22 suggesting 32 change 22 suggesting 35 . 23 that 24 basic 24 basic 25 clock 25 clock 26 properties 26 properties 27 of 26 properties 30 do 27 of 29 cells 28 peripheral 29 cells 30 do 31 not 30 do 32 change 32 change 33 during 33 during 34 aging interestingly , measurement of the same cells in the presence of human serum from older donors shortened period length and advanced the phase of cellular circadian rhythms compared with treatment with serum from young subjects , indicating that a circulating factor might alter human chronotype . 0 ###LEFT-WALL### 3 measurement 0 ###LEFT-WALL### 28 compared 1 interestingly 2 , 1 interestingly 3 measurement 3 measurement 4 of 3 measurement 14 from 3 measurement 28 compared 4 of 7 cells 5 the 6 same 6 same 7 cells 7 cells 8 in 7 cells 11 of 8 in 10 presence 9 the 10 presence 11 of 13 serum 12 human 13 serum 14 from 16 donors 15 older 16 donors 16 donors 20 and 17 shortened 19 length 17 shortened 20 and 18 period 19 length 20 and 21 advanced 20 and 23 phase 22 the 23 phase 23 phase 24 of 24 of 27 rhythms 25 cellular 27 rhythms 26 circadian 27 rhythms 28 compared 29 with 28 compared 31 with 29 with 30 treatment 31 with 32 serum 32 serum 33 from 33 from 35 subjects 34 young 35 subjects 35 subjects 37 indicating 36 , 37 indicating 37 indicating 38 that 37 indicating 46 . 38 that 41 factor 38 that 43 alter 39 a 41 factor 40 circulating 41 factor 41 factor 42 might 42 might 43 alter 43 alter 45 chronotype 44 human 45 chronotype further experiments demonstrated that this effect is caused by a thermolabile factor present in serum of older individuals . 0 ###LEFT-WALL### 2 experiments 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 19 . 1 further 2 experiments 2 experiments 3 demonstrated 3 demonstrated 4 that 4 that 6 effect 4 that 8 caused 5 this 6 effect 6 effect 7 is 7 is 8 caused 8 caused 9 by 9 by 12 factor 10 a 11 thermolabile 10 a 12 factor 11 thermolabile 12 factor 12 factor 13 present 12 factor 16 of 13 present 14 in 14 in 15 serum 16 of 18 individuals 17 older 18 individuals thus , even though the molecular machinery of peripheral circadian clocks does not change with age , some age - related circadian dysfunction observed in vivo might be of hormonal origin and therefore might be pharmacologically remediable . 0 ###LEFT-WALL### 19 age 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 38 . 1 thus 2 , 1 thus 19 age 2 , 3 even 3 even 4 though 3 even 17 , 3 even 19 age 4 though 7 machinery 4 though 14 change 5 the 7 machinery 6 molecular 7 machinery 7 machinery 8 of 7 machinery 12 does 8 of 11 clocks 9 peripheral 11 clocks 10 circadian 11 clocks 12 does 13 not 12 does 14 change 14 change 15 with 15 with 16 age 18 some 19 age 19 age 24 observed 19 age 27 might 20 - 21 related 21 related 23 dysfunction 21 related 24 observed 22 circadian 23 dysfunction 25 in 26 vivo 26 vivo 27 might 27 might 32 and 28 be 29 of 28 be 32 and 29 of 31 origin 30 hormonal 31 origin 32 and 34 might 33 therefore 34 might 34 might 35 be 35 be 36 pharmacologically 35 be 37 remediable multitasking negatively influences the retention of information over brief periods of time . 0 ###LEFT-WALL### 1 multitasking 0 ###LEFT-WALL### 3 influences 0 ###LEFT-WALL### 13 . 1 multitasking 3 influences 2 negatively 3 influences 3 influences 5 retention 3 influences 8 over 4 the 5 retention 5 retention 6 of 6 of 7 information 8 over 10 periods 9 brief 10 periods 10 periods 11 of 11 of 12 time this impact of interference on working memory is exacerbated with normal aging . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 9 exacerbated 0 ###LEFT-WALL### 13 . 1 this 2 impact 2 impact 3 of 2 impact 8 is 3 of 4 interference 4 interference 5 on 5 on 6 working 6 working 7 memory 8 is 9 exacerbated 9 exacerbated 10 with 10 with 12 aging 11 normal 12 aging we used functional mri to investigate the neural basis by which an interruption is more disruptive to working memory performance in older individuals . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 0 ###LEFT-WALL### 24 . 1 we 2 used 2 used 4 mri 2 used 5 to 2 used 17 to 3 functional 4 mri 5 to 6 investigate 6 investigate 9 basis 7 the 9 basis 8 neural 9 basis 9 basis 10 by 10 by 11 which 10 by 13 interruption 10 by 14 is 12 an 13 interruption 13 interruption 14 is 14 is 15 more 14 is 16 disruptive 17 to 18 working 18 working 20 performance 18 working 21 in 19 memory 20 performance 21 in 23 individuals 22 older 23 individuals younger and older adults engaged in delayed recognition tasks both with [and] [without] interruption by a secondary task . 0 ###LEFT-WALL### 4 adults 0 ###LEFT-WALL### 5 engaged 0 ###LEFT-WALL### 19 . 1 younger 2 and 2 and 3 older 2 and 4 adults 4 adults 5 engaged 5 engaged 6 in 5 engaged 10 both 6 in 9 tasks 7 delayed 8 recognition 8 recognition 9 tasks 10 both 11 with 11 with 14 interruption 14 interruption 15 by 15 by 18 task 16 a 17 secondary 16 a 18 task 17 secondary 18 task behavioral analysis revealed that working memory performance was more impaired by interruptions in older compared [with] younger adults . 0 ###LEFT-WALL### 7 performance 0 ###LEFT-WALL### 19 . 1 behavioral 6 memory 2 analysis 3 revealed 3 revealed 6 memory 4 that 5 working 5 working 6 memory 6 memory 7 performance 7 performance 8 was 8 was 9 more 8 was 10 impaired 10 impaired 11 by 10 impaired 13 in 11 by 12 interruptions 13 in 18 adults 14 older 18 adults 15 compared 18 adults 17 younger 18 adults functional connectivity analyses showed that when interrupted , older adults disengaged from a memory maintenance network and reallocated attentional resources toward the interrupting stimulus in a manner consistent with younger adults . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 32 . 1 functional 11 disengaged 1 functional 12 from 1 functional 17 and 2 connectivity 3 analyses 3 analyses 4 showed 4 showed 5 that 5 that 10 adults 5 that 11 disengaged 6 when 7 interrupted 6 when 10 adults 7 interrupted 8 , 7 interrupted 9 older 10 adults 11 disengaged 12 from 16 network 13 a 14 memory 13 a 16 network 14 memory 16 network 15 maintenance 16 network 17 and 20 resources 17 and 21 toward 18 reallocated 20 resources 19 attentional 20 resources 21 toward 24 stimulus 22 the 24 stimulus 23 interrupting 24 stimulus 24 stimulus 25 in 24 stimulus 28 consistent 25 in 27 manner 26 a 27 manner 28 consistent 29 with 29 with 31 adults 30 younger 31 adults however , unlike younger individuals , older adults failed to both disengage from the interruption and reestablish functional connections associated with the disrupted memory network . 0 ###LEFT-WALL### 25 network 0 ###LEFT-WALL### 26 . 1 however 8 adults 1 however 16 and 1 however 25 network 2 , 3 unlike 3 unlike 5 individuals 3 unlike 6 , 3 unlike 8 adults 4 younger 5 individuals 7 older 8 adults 8 adults 16 and 9 failed 10 to 9 failed 12 disengage 9 failed 16 and 10 to 12 disengage 11 both 12 disengage 12 disengage 13 from 13 from 15 interruption 14 the 15 interruption 16 and 17 reestablish 17 reestablish 19 connections 17 reestablish 21 with 18 functional 19 connections 19 connections 20 associated 21 with 24 memory 22 the 24 memory 23 disrupted 24 memory these results suggest that multitasking leads to more significant working memory disruption in older adults because of an interruption recovery failure , manifest as a deficient ability to dynamically switch between functional brain networks . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 35 . 1 these 2 results 2 results 22 , 3 suggest 4 that 3 suggest 22 , 4 that 5 multitasking 4 that 6 leads 5 multitasking 6 leads 6 leads 7 to 6 leads 13 in 6 leads 17 of 7 to 12 disruption 8 more 9 significant 9 significant 12 disruption 10 working 12 disruption 11 memory 12 disruption 13 in 15 adults 14 older 15 adults 16 because 17 of 17 of 21 failure 18 an 21 failure 19 interruption 20 recovery 20 recovery 21 failure 22 , 23 manifest 22 , 24 as 22 , 28 to 22 , 31 between 24 as 27 ability 25 a 27 ability 26 deficient 27 ability 28 to 30 switch 29 dynamically 30 switch 31 between 34 networks 32 functional 33 brain 33 brain 34 networks objectives : despite the rapidly increasing prevalence of cohabitation among older adults , the caregiving literature has exclusively focused on formally married individuals . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 16 literature 2 : 19 focused 2 : 24 . 3 despite 7 prevalence 3 despite 13 , 3 despite 16 literature 4 the 7 prevalence 5 rapidly 6 increasing 6 increasing 7 prevalence 7 prevalence 8 of 8 of 9 cohabitation 9 cohabitation 10 among 10 among 12 adults 11 older 12 adults 14 the 16 literature 15 caregiving 16 literature 16 literature 17 has 17 has 19 focused 18 exclusively 19 focused 19 focused 20 on 20 on 23 individuals 21 formally 22 married 22 married 23 individuals extending prior work [on] [intra] - couple care , this study contrasts frail cohabitors ' patterns of care receipt from a partner to that of frail spouses . 0 ###LEFT-WALL### 7 couple 1 extending 3 work 1 extending 6 - 1 extending 7 couple 2 prior 3 work 7 couple 8 care 8 care 11 study 9 , 11 study 10 this 11 study 11 study 16 patterns 11 study 19 receipt 11 study 28 . 12 contrasts 14 cohabitors 13 frail 14 cohabitors 14 cohabitors 15 ' 15 ' 16 patterns 16 patterns 17 of 16 patterns 19 receipt 17 of 18 care 19 receipt 20 from 20 from 22 partner 21 a 22 partner 22 partner 23 to 22 partner 25 of 23 to 24 that 25 of 27 spouses 26 frail 27 spouses methods : using nationally representative panel data from the health and retirement study ( 2000 , 2002 , 2004 [,] and 2006 ) , we estimate random effects cross - sectional times series models predicting frail cohabitors ' likelihood of receiving partner care compared with their married counterparts ' . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 25 we 2 : 26 estimate 2 : 30 - 3 using 7 data 3 using 8 from 3 using 24 , 3 using 25 we 4 nationally 5 representative 5 representative 6 panel 6 panel 7 data 8 from 13 study 9 the 13 study 10 health 11 and 11 and 12 retirement 12 retirement 13 study 13 study 15 2000 13 study 17 2002 13 study 21 and 14 ( 15 2000 15 2000 16 , 16 , 17 2002 17 2002 18 , 18 , 21 and 19 2004 21 and 21 and 22 2006 21 and 23 ) 25 we 26 estimate 26 estimate 28 effects 26 estimate 29 cross 27 random 28 effects 28 effects 29 cross 30 - 34 models 30 - 42 partner 30 - 50 . 31 sectional 33 series 32 times 33 series 33 series 34 models 34 models 35 predicting 34 models 40 of 34 models 42 partner 35 predicting 39 likelihood 36 frail 37 cohabitors 37 cohabitors 38 ' 38 ' 39 likelihood 40 of 41 receiving 42 partner 43 care 43 care 44 compared 44 compared 45 with 45 with 49 ' 46 their 48 counterparts 47 married 48 counterparts 48 counterparts 49 ' conditional on the receipt of [intra] [-] couple care , we also examine differences in marital and nonmarital partners ' caregiving hours and caregiving involvement relative to other helpers . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 13 examine 0 ###LEFT-WALL### 30 . 1 conditional 2 on 1 conditional 10 , 1 conditional 11 we 2 on 4 receipt 3 the 4 receipt 4 receipt 5 of 5 of 9 care 8 couple 9 care 11 we 13 examine 12 also 13 examine 13 examine 23 and 14 differences 15 in 14 differences 23 and 15 in 22 hours 16 marital 17 and 17 and 18 nonmarital 17 and 19 partners 19 partners 20 ' 20 ' 22 hours 21 caregiving 22 hours 23 and 25 involvement 23 and 26 relative 24 caregiving 25 involvement 26 relative 27 to 27 to 29 helpers 28 other 29 helpers results : net of sociodemographic , disability , and comorbidity factors , we find that cohabitors are less likely to receive partner care than married individuals . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 net 2 : 12 , 3 net 4 of 4 of 9 and 5 sociodemographic 6 , 5 sociodemographic 7 disability 7 disability 9 and 8 , 9 and 9 and 11 factors 9 and 12 , 10 comorbidity 11 factors 12 , 13 we 12 , 14 find 13 we 14 find 14 find 15 that 15 that 16 cohabitors 15 that 17 are 16 cohabitors 17 are 17 are 18 less 17 are 19 likely 19 likely 20 to 19 likely 24 than 20 to 21 receive 21 receive 23 care 22 partner 23 care 24 than 26 individuals 25 married 26 individuals however , caregiving nonmarital partners provide as many hours of care as spouses while providing a substantially larger share of disabled respondents ' care than marital partners . 0 ###LEFT-WALL### 5 partners 0 ###LEFT-WALL### 6 provide 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 5 partners 3 caregiving 5 partners 4 nonmarital 5 partners 5 partners 6 provide 6 provide 9 hours 6 provide 12 as 6 provide 14 while 7 as 8 many 8 many 9 hours 9 hours 10 of 10 of 11 care 12 as 13 spouses 14 while 15 providing 15 providing 19 share 15 providing 25 than 16 a 19 share 17 substantially 18 larger 18 larger 19 share 19 share 20 of 20 of 24 care 21 disabled 22 respondents 22 respondents 23 ' 23 ' 24 care 25 than 27 partners 26 marital 27 partners discussion : cohabitation and marriage have distinct implications for older adults ' patterns of partner care receipt . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 6 have 2 : 18 . 3 cohabitation 4 and 4 and 5 marriage 4 and 6 have 6 have 8 implications 7 distinct 8 implications 8 implications 9 for 8 implications 13 patterns 8 implications 17 receipt 9 for 12 ' 10 older 11 adults 11 adults 12 ' 13 patterns 14 of 13 patterns 17 receipt 14 of 16 care 15 partner 16 care this study adds weight to a growing body of research emphasizing the importance of accounting for older adults ' nontraditional union forms [and] of examining the ramifications of cohabitation for older adults ' well - being . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 adds 0 ###LEFT-WALL### 35 - 1 this 2 study 2 study 3 adds 3 adds 4 weight 3 adds 30 for 4 weight 5 to 4 weight 9 of 5 to 8 body 6 a 8 body 7 growing 8 body 9 of 10 research 10 research 11 emphasizing 10 research 14 of 11 emphasizing 13 importance 12 the 13 importance 14 of 15 accounting 15 accounting 16 for 16 for 22 forms 17 older 18 adults 18 adults 19 ' 19 ' 22 forms 20 nontraditional 21 union 21 union 22 forms 22 forms 24 of 22 forms 28 of 24 of 25 examining 25 examining 27 ramifications 26 the 27 ramifications 28 of 29 cohabitation 30 for 34 well 31 older 32 adults 32 adults 33 ' 33 ' 34 well 35 - 36 being 35 - 37 . this article introduces the special issue of ['] social cognitive and affective neuroscience ['] on aging research , and offers a broad conceptual and methodological framework for considering advances in life course research in social neuroscience and neuroeconomics . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 39 . 1 this 2 article 2 article 19 and 3 introduces 6 issue 3 introduces 15 on 3 introduces 19 and 4 the 6 issue 5 special 6 issue 6 issue 7 of 7 of 11 and 9 social 10 cognitive 10 cognitive 11 and 11 and 13 neuroscience 12 affective 13 neuroscience 15 on 17 research 16 aging 17 research 18 , 19 and 19 and 20 offers 19 and 27 for 20 offers 26 framework 21 a 22 broad 21 a 26 framework 22 broad 26 framework 23 conceptual 24 and 24 and 25 methodological 24 and 26 framework 27 for 28 considering 28 considering 29 advances 28 considering 37 and 29 advances 30 in 30 in 31 life 32 course 33 research 33 research 34 in 33 research 37 and 34 in 36 neuroscience 35 social 36 neuroscience 37 and 38 neuroeconomics the authors highlight key areas of inquiry where aging research is raising new insights about how to conceptualize and examine critical questions about the links between cognition , emotion and motivation in social and economic behavior , as well as challenges that need to be addressed when taking a life course perspective in these fields . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 highlight 1 the 2 authors 2 authors 3 highlight 3 highlight 5 areas 4 key 5 areas 5 areas 6 of 5 areas 8 where 5 areas 12 raising 6 of 7 inquiry 8 where 10 research 8 where 11 is 9 aging 10 research 10 research 11 is 12 raising 14 insights 12 raising 15 about 12 raising 40 as 13 new 14 insights 15 about 16 how 16 how 17 to 16 how 19 and 17 to 19 and 18 conceptualize 19 and 19 and 20 examine 19 and 23 about 20 examine 22 questions 21 critical 22 questions 23 about 30 and 24 the 25 links 25 links 26 between 25 links 28 , 26 between 27 cognition 28 , 29 emotion 28 , 30 and 30 and 31 motivation 30 and 37 , 31 motivation 32 in 32 in 36 behavior 33 social 34 and 34 and 35 economic 34 and 36 behavior 38 as 39 well 39 well 40 as 40 as 41 challenges 41 challenges 42 that 41 challenges 43 need 42 that 43 need 43 need 44 to 43 need 56 . 44 to 45 be 45 be 46 addressed 46 addressed 47 when 46 addressed 53 in 47 when 48 taking 48 taking 52 perspective 49 a 50 life 49 a 52 perspective 50 life 51 course 51 course 52 perspective 53 in 55 fields 54 these 55 fields neuroplasticity can be defined as the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure , function and connections . 0 ###LEFT-WALL### 1 neuroplasticity 0 ###LEFT-WALL### 4 defined 0 ###LEFT-WALL### 13 respond 1 neuroplasticity 2 can 2 can 3 be 3 be 4 defined 4 defined 5 as 5 as 7 ability 6 the 7 ability 7 ability 8 of 7 ability 12 to 7 ability 13 respond 8 of 11 system 9 the 11 system 10 nervous 11 system 12 to 13 respond 13 respond 14 to 13 respond 27 . 14 to 25 and 15 intrinsic 16 or 16 or 17 extrinsic 16 or 18 stimuli 18 stimuli 19 by 18 stimuli 23 , 19 by 20 reorganizing 20 reorganizing 22 structure 21 its 22 structure 23 , 24 function 23 , 25 and 25 and 26 connections major advances in the understanding of neuroplasticity have to date [yielded] few established interventions . 0 ###LEFT-WALL### 2 advances 0 ###LEFT-WALL### 8 have 0 ###LEFT-WALL### 15 . 1 major 2 advances 2 advances 3 in 2 advances 8 have 3 in 5 understanding 4 the 5 understanding 5 understanding 6 of 6 of 7 neuroplasticity 8 have 9 to 8 have 10 date 9 to 10 date 10 date 14 interventions 12 few 14 interventions 13 established 14 interventions to advance the translation of neuroplasticity research towards clinical applications , the national institutes of health blueprint for neuroscience research sponsored a workshop in 2009 . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 advance 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 26 . 1 to 2 advance 2 advance 4 translation 2 advance 8 towards 3 the 4 translation 4 translation 5 of 5 of 7 research 6 neuroplasticity 7 research 8 towards 10 applications 9 clinical 10 applications 11 , 14 institutes 11 , 21 sponsored 12 the 14 institutes 13 national 14 institutes 14 institutes 15 of 14 institutes 21 sponsored 15 of 17 blueprint 16 health 17 blueprint 17 blueprint 18 for 18 for 20 research 19 neuroscience 20 research 21 sponsored 23 workshop 21 sponsored 24 in 22 a 23 workshop 24 in 25 2009 basic and clinical researchers in disciplines from central nervous system injury/stroke , mental/addictive disorders , paediatric/developmental disorders and neurodegeneration/ageing identified cardinal examples of neuroplasticity , underlying mechanisms , therapeutic implications and common denominators . 0 ###LEFT-WALL### 4 researchers 0 ###LEFT-WALL### 20 identified 0 ###LEFT-WALL### 34 . 1 basic 2 and 2 and 3 clinical 2 and 4 researchers 4 researchers 5 in 4 researchers 7 from 4 researchers 20 identified 5 in 6 disciplines 7 from 18 and 8 central 10 system 9 nervous 10 system 10 system 11 injury/stroke 11 injury/stroke 12 , 12 , 14 disorders 12 , 15 , 13 mental/addictive 14 disorders 15 , 17 disorders 15 , 18 and 16 paediatric/developmental 17 disorders 18 and 19 neurodegeneration/ageing 20 identified 22 examples 21 cardinal 22 examples 22 examples 23 of 23 of 31 and 24 neuroplasticity 25 , 25 , 27 mechanisms 25 , 28 , 26 underlying 27 mechanisms 28 , 30 implications 28 , 31 and 29 therapeutic 30 implications 31 and 33 denominators 32 common 33 denominators promising therapies that may enhance training - induced cognitive and motor learning , such as brain stimulation and neuropharmacological interventions , were identified , along with questions of how best to use this body of information to reduce human disability . 0 ###LEFT-WALL### 1 promising 0 ###LEFT-WALL### 21 , 1 promising 2 therapies 1 promising 3 that 1 promising 21 , 4 may 5 enhance 4 may 21 , 5 enhance 6 training 5 enhance 15 as 6 training 8 induced 7 - 8 induced 8 induced 10 and 8 induced 13 , 9 cognitive 10 and 10 and 12 learning 11 motor 12 learning 14 such 15 as 15 as 18 and 16 brain 17 stimulation 17 stimulation 18 and 18 and 20 interventions 19 neuropharmacological 20 interventions 21 , 22 were 21 , 26 with 22 were 23 identified 24 , 26 with 25 along 26 with 26 with 27 questions 26 with 41 . 27 questions 28 of 27 questions 31 to 27 questions 38 reduce 28 of 29 how 30 best 31 to 31 to 32 use 32 use 34 body 32 use 37 to 32 use 38 reduce 33 this 34 body 34 body 35 of 35 of 36 information 37 to 38 reduce 38 reduce 40 disability 39 human 40 disability improved understanding of adaptive mechanisms at every level , from molecules to synapses , [to] networks , to behaviour , can be gained from iterative collaborations between basic and clinical researchers . 0 ###LEFT-WALL### 2 understanding 0 ###LEFT-WALL### 23 gained 0 ###LEFT-WALL### 32 . 1 improved 2 understanding 2 understanding 3 of 2 understanding 21 can 3 of 5 mechanisms 4 adaptive 5 mechanisms 5 mechanisms 6 at 6 at 8 level 7 every 8 level 8 level 10 from 8 level 18 to 9 , 10 from 10 from 11 molecules 10 from 17 , 11 molecules 12 to 11 molecules 14 , 12 to 14 , 13 synapses 14 , 14 , 16 networks 17 , 18 to 18 to 19 behaviour 18 to 20 , 21 can 22 be 22 be 23 gained 23 gained 24 from 23 gained 27 between 24 from 26 collaborations 25 iterative 26 collaborations 27 between 31 researchers 28 basic 29 and 29 and 30 clinical 29 and 31 researchers lessons can be gleaned from studying fields related to plasticity , such as development , critical periods , learning and response to disease . 0 ###LEFT-WALL### 1 lessons 0 ###LEFT-WALL### 4 gleaned 0 ###LEFT-WALL### 24 . 1 lessons 2 can 2 can 3 be 3 be 4 gleaned 4 gleaned 5 from 5 from 6 studying 6 studying 20 and 6 studying 22 to 7 fields 8 related 7 fields 19 learning 7 fields 20 and 8 related 9 to 9 to 10 plasticity 10 plasticity 13 as 10 plasticity 17 periods 11 , 13 as 12 such 13 as 13 as 14 development 13 as 15 , 15 , 17 periods 16 critical 17 periods 17 periods 18 , 20 and 21 response 22 to 23 disease improved means of assessing neuroplasticity in humans , including biomarkers for predicting and monitoring treatment response , are needed . 0 ###LEFT-WALL### 2 means 0 ###LEFT-WALL### 19 needed 0 ###LEFT-WALL### 20 . 1 improved 2 means 2 means 3 of 2 means 18 are 3 of 4 assessing 4 assessing 5 neuroplasticity 4 assessing 6 in 4 assessing 9 including 6 in 7 humans 8 , 9 including 9 including 10 biomarkers 9 including 17 , 10 biomarkers 11 for 11 for 13 and 12 predicting 13 and 13 and 16 response 14 monitoring 15 treatment 15 treatment 16 response 18 are 19 needed neuroplasticity occurs with many variations , in many forms , and in many contexts . 0 ###LEFT-WALL### 1 neuroplasticity 0 ###LEFT-WALL### 2 occurs 0 ###LEFT-WALL### 15 . 1 neuroplasticity 2 occurs 2 occurs 11 and 3 with 5 variations 3 with 11 and 4 many 5 variations 5 variations 7 in 6 , 7 in 7 in 9 forms 7 in 10 , 8 many 9 forms 10 , 11 and 11 and 12 in 12 in 14 contexts 13 many 14 contexts however , common themes in plasticity that emerge across diverse central nervous system conditions include experience dependence , time sensitivity and the importance of motivation and attention . 0 ###LEFT-WALL### 4 themes 0 ###LEFT-WALL### 15 include 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 4 themes 3 common 4 themes 4 themes 5 in 4 themes 7 that 4 themes 8 emerge 4 themes 15 include 5 in 6 plasticity 7 that 8 emerge 8 emerge 9 across 9 across 14 conditions 10 diverse 13 system 11 central 13 system 12 nervous 13 system 13 system 14 conditions 15 include 21 and 16 experience 17 dependence 17 dependence 18 , 18 , 20 sensitivity 18 , 21 and 19 time 20 sensitivity 21 and 23 importance 21 and 24 of 22 the 23 importance 24 of 26 and 25 motivation 26 and 26 and 27 attention integration of information across disciplines should enhance opportunities for the translation of neuroplasticity and circuit retraining research into effective clinical therapies . 0 ###LEFT-WALL### 1 integration 0 ###LEFT-WALL### 7 enhance 0 ###LEFT-WALL### 22 . 1 integration 2 of 1 integration 6 should 2 of 3 information 3 information 4 across 4 across 5 disciplines 6 should 7 enhance 7 enhance 8 opportunities 7 enhance 9 for 9 for 14 and 10 the 11 translation 11 translation 12 of 11 translation 14 and 12 of 13 neuroplasticity 14 and 15 circuit 14 and 16 retraining 16 retraining 17 research 16 retraining 18 into 18 into 21 therapies 19 effective 21 therapies 20 clinical 21 therapies previous twin studies report no heritability of parkinson 's disease ( pd ) based on cross sectional information . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 19 . 1 previous 2 twin 2 twin 3 studies 3 studies 4 report 4 report 6 heritability 5 no 6 heritability 6 heritability 7 of 6 heritability 14 based 7 of 10 disease 8 parkinson 9 's 9 's 10 disease 10 disease 12 pd 11 ( 12 pd 12 pd 13 ) 14 based 15 on 15 on 18 information 16 cross 18 information 17 sectional 18 information here , we apply a longitudinal design and [re] [-] evaluate cross sectional data in the population - based swedish twin registry ( str ) using clinical as well as hospital discharge and cause of death diagnoses . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 38 . 1 here 2 , 1 here 3 we 3 we 8 and 4 apply 7 design 4 apply 8 and 5 a 6 longitudinal 5 a 7 design 6 longitudinal 7 design 8 and 11 evaluate 8 and 26 using 8 and 37 diagnoses 11 evaluate 14 data 11 evaluate 15 in 12 cross 14 data 13 sectional 14 data 15 in 17 population 16 the 17 population 17 population 24 str 18 - 24 str 19 based 24 str 20 swedish 24 str 21 twin 22 registry 22 registry 24 str 23 ( 24 str 24 str 25 ) 26 using 33 and 27 clinical 30 as 27 clinical 33 and 28 as 29 well 29 well 30 as 30 as 32 discharge 31 hospital 32 discharge 33 and 34 cause 33 and 35 of 35 of 36 death in the longitudinal analyses ( based on 46,436 individuals ) , we identified 542 twins with pd and 65 twins with parkinsonism . 0 ###LEFT-WALL### 12 we 0 ###LEFT-WALL### 13 identified 0 ###LEFT-WALL### 23 . 1 in 4 analyses 1 in 11 , 1 in 12 we 2 the 4 analyses 3 longitudinal 4 analyses 4 analyses 6 based 5 ( 6 based 6 based 7 on 6 based 10 ) 7 on 9 individuals 8 46,436 9 individuals 12 we 13 identified 13 identified 15 twins 13 identified 16 with 13 identified 21 with 14 542 15 twins 16 with 18 and 17 pd 18 and 18 and 20 twins 19 65 20 twins 21 with 22 parkinsonism concordance rates for pd were 11 % for [monozygotic] [and] 4 % for same - sexed dizygotic twin pairs , with a heritability estimate of 34 % . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 28 . 1 concordance 2 rates 2 rates 3 for 2 rates 5 were 3 for 4 pd 5 were 7 % 5 were 8 for 6 11 7 % 8 for 12 % 11 4 12 % 12 % 13 for 12 % 21 with 12 % 25 of 13 for 14 same 14 same 19 pairs 15 - 19 pairs 16 sexed 18 twin 17 dizygotic 18 twin 18 twin 19 pairs 19 pairs 20 , 21 with 24 estimate 22 a 24 estimate 23 heritability 24 estimate 25 of 27 % 26 34 27 % concordance rates for pd or parkinsonism were 13 % for [monozygotic] [and] 5 % for same - sexed dizygotic twin pairs , with a heritability estimate of 40 % . 0 ###LEFT-WALL### 5 or 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 30 . 1 concordance 2 rates 2 rates 3 for 2 rates 5 or 3 for 4 pd 5 or 6 parkinsonism 5 or 7 were 7 were 9 % 7 were 23 with 8 13 9 % 9 % 10 for 9 % 21 pairs 10 for 14 % 13 5 14 % 14 % 15 for 15 for 16 same 17 - 21 pairs 18 sexed 20 twin 19 dizygotic 20 twin 20 twin 21 pairs 21 pairs 22 , 23 with 26 estimate 24 a 26 estimate 25 heritability 26 estimate 26 estimate 27 of 27 of 29 % 28 40 29 % in the cross sectional analyses ( based on 49,814 individuals ) , we identified 287 twins with pd and 79 twins with parkinsonism . 0 ###LEFT-WALL### 13 we 0 ###LEFT-WALL### 14 identified 0 ###LEFT-WALL### 24 . 1 in 5 analyses 1 in 12 , 1 in 13 we 2 the 5 analyses 3 cross 5 analyses 4 sectional 5 analyses 5 analyses 7 based 6 ( 7 based 7 based 8 on 7 based 11 ) 8 on 10 individuals 9 49,814 10 individuals 13 we 14 identified 14 identified 16 twins 14 identified 17 with 14 identified 22 with 15 287 16 twins 17 with 19 and 18 pd 19 and 19 and 21 twins 20 79 21 twins 22 with 23 parkinsonism concordance rates for pd were 4 % for monozygotic and [same] [-] sexed dizygotic twin pairs and 0 for opposite - sexed twin pairs . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 25 . 1 concordance 2 rates 2 rates 3 for 2 rates 5 were 3 for 4 pd 5 were 17 and 6 4 7 % 6 4 17 and 7 % 8 for 7 % 16 pairs 8 for 10 and 9 monozygotic 10 and 10 and 15 twin 13 sexed 15 twin 14 dizygotic 15 twin 17 and 18 0 17 and 19 for 19 for 24 pairs 20 opposite 21 - 20 opposite 24 pairs 22 sexed 23 twin 23 twin 24 pairs concordance rates for pd or parkinsonism were somewhat higher but the heritability estimate was nonsignificant . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 16 . 1 concordance 2 rates 2 rates 3 for 2 rates 7 were 3 for 5 or 4 pd 5 or 5 or 6 parkinsonism 7 were 8 somewhat 7 were 9 higher 10 but 13 estimate 10 but 15 nonsignificant 11 the 13 estimate 12 heritability 13 estimate 13 estimate 14 was 14 was 15 nonsignificant our longitudinal analyses demonstrate that pd and parkinsonism are modestly heritable . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 4 demonstrate 0 ###LEFT-WALL### 12 . 1 our 3 analyses 2 longitudinal 3 analyses 3 analyses 4 demonstrate 4 demonstrate 5 that 5 that 7 and 5 that 9 are 6 pd 7 and 7 and 8 parkinsonism 7 and 9 are 9 are 10 modestly 9 are 11 heritable epigenetic modifications help orchestrate sweeping developmental , aging , and disease - causing changes in phenotype by altering transcriptional activity in multiple genes spanning multiple biologic pathways . 0 ###LEFT-WALL### 2 modifications 0 ###LEFT-WALL### 3 help 0 ###LEFT-WALL### 28 . 1 epigenetic 2 modifications 2 modifications 3 help 3 help 4 orchestrate 4 orchestrate 5 sweeping 5 sweeping 10 and 5 sweeping 16 phenotype 6 developmental 7 , 7 , 8 aging 7 , 10 and 9 , 10 and 10 and 11 disease 10 and 12 - 10 and 13 causing 10 and 14 changes 10 and 16 phenotype 13 causing 14 changes 14 changes 15 in 16 phenotype 17 by 16 phenotype 21 in 17 by 18 altering 18 altering 20 activity 19 transcriptional 20 activity 21 in 23 genes 22 multiple 23 genes 23 genes 24 spanning 24 spanning 27 pathways 25 multiple 27 pathways 26 biologic 27 pathways although previous epigenetic research has focused primarily on dividing cells , particularly in cancer , recent studies have shown rapid , dynamic , and persistent epigenetic modifications in neurons that have significant neuroendocrine , neurophysiologic , and neurodegenerative consequences . 0 ###LEFT-WALL### 17 studies 0 ###LEFT-WALL### 19 shown 0 ###LEFT-WALL### 34 , 0 ###LEFT-WALL### 40 . 1 although 4 research 1 although 6 focused 1 although 11 , 1 although 17 studies 2 previous 4 research 3 epigenetic 4 research 4 research 5 has 5 has 6 focused 6 focused 7 primarily 7 primarily 8 on 8 on 9 dividing 9 dividing 10 cells 11 , 12 particularly 11 , 13 in 13 in 14 cancer 13 in 15 , 13 in 17 studies 16 recent 17 studies 17 studies 18 have 18 have 19 shown 19 shown 24 and 19 shown 27 modifications 19 shown 28 in 20 rapid 21 , 21 , 22 dynamic 21 , 24 and 23 , 24 and 24 and 25 persistent 26 epigenetic 27 modifications 28 in 29 neurons 29 neurons 30 that 29 neurons 31 have 30 that 31 have 31 have 33 neuroendocrine 32 significant 33 neuroendocrine 34 , 39 consequences 35 neurophysiologic 37 and 36 , 37 and 37 and 38 neurodegenerative 37 and 39 consequences here , we provide a review of the major mechanisms for epigenetic modification and how they are reportedly altered in aging and alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 29 . 1 here 2 , 1 here 3 we 3 we 4 provide 4 provide 22 and 5 a 6 review 6 review 7 of 6 review 14 and 7 of 10 mechanisms 8 the 10 mechanisms 9 major 10 mechanisms 10 mechanisms 11 for 11 for 13 modification 12 epigenetic 13 modification 14 and 15 how 14 and 16 they 14 and 21 aging 14 and 22 and 16 they 17 are 17 are 19 altered 18 reportedly 19 altered 19 altered 20 in 20 in 21 aging 22 and 25 disease 22 and 27 ad 23 alzheimer 24 's 24 's 25 disease 26 ( 27 ad 27 ad 28 ) because of their reach across the genome , epigenetic mechanisms may provide a unique integrative framework for the pathologic diversity and complexity of ad . 0 ###LEFT-WALL### 10 mechanisms 0 ###LEFT-WALL### 12 provide 0 ###LEFT-WALL### 25 . 1 because 2 of 1 because 8 , 1 because 10 mechanisms 2 of 4 reach 3 their 4 reach 4 reach 5 across 5 across 7 genome 6 the 7 genome 9 epigenetic 10 mechanisms 10 mechanisms 11 may 11 may 12 provide 12 provide 16 framework 12 provide 17 for 13 a 16 framework 14 unique 16 framework 15 integrative 16 framework 17 for 21 and 18 the 20 diversity 19 pathologic 20 diversity 20 diversity 21 and 21 and 22 complexity 21 and 23 of 23 of 24 ad we examined the associations between extracerebral markers of cholesterol homeostasis and cognitive decline over 6 years of follow - up , and studied the modifying effect of apolipoprotein e ( apoe ) [e4] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 34 . 1 we 22 and 2 examined 4 associations 2 examined 18 follow 2 examined 22 and 3 the 4 associations 4 associations 5 between 4 associations 8 of 4 associations 11 and 4 associations 17 of 4 associations 18 follow 5 between 7 markers 6 extracerebral 7 markers 8 of 9 cholesterol 10 homeostasis 11 and 11 and 12 cognitive 11 and 13 decline 13 decline 16 years 14 over 15 6 15 6 16 years 16 years 17 of 18 follow 20 up 19 - 20 up 20 up 21 , 21 , 22 and 22 and 23 studied 23 studied 26 effect 24 the 26 effect 25 modifying 26 effect 26 effect 27 of 26 effect 31 apoe 27 of 28 apolipoprotein 28 apolipoprotein 29 e 30 ( 31 apoe 31 apoe 32 ) data were collected in the longitudinal aging study amsterdam ( n = 967 , with longitudinal data on cognition , ages ≥ 65 years ) and analyzed using linear mixed models . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 32 . 1 data 26 and 2 were 3 collected 2 were 26 and 3 collected 4 in 3 collected 12 = 3 collected 15 with 3 collected 18 on 4 in 9 amsterdam 5 the 9 amsterdam 6 longitudinal 7 aging 7 aging 8 study 8 study 9 amsterdam 10 ( 12 = 11 n 12 = 12 = 13 967 12 = 14 , 15 with 17 data 16 longitudinal 17 data 18 on 19 cognition 19 cognition 24 years 20 , 24 years 21 ages 24 years 22 ≥ 24 years 23 65 24 years 24 years 25 ) 26 and 27 analyzed 26 and 28 using 28 using 31 models 29 linear 31 models 30 mixed 31 models general cognition [(] mini - mental state examination ; mmse [ )(, memory ( auditory verbal learning test ) , and information processing speed ( coding [task] ) were measured . 0 ###LEFT-WALL### 4 mini 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 31 . 1 general 4 mini 2 cognition 4 mini 5 - 8 examination 5 - 9 ; 6 mental 7 state 7 state 8 examination 9 ; 21 and 9 ; 29 were 10 mmse 13 memory 10 mmse 21 and 12 )(, 13 memory 13 memory 18 test 13 memory 20 , 14 ( 18 test 15 auditory 16 verbal 16 verbal 17 learning 17 learning 18 test 18 test 19 ) 21 and 22 information 21 and 23 processing 21 and 26 coding 21 and 29 were 23 processing 24 speed 25 ( 26 coding 26 coding 28 ) 29 were 30 measured the results show that apoe e4 was a significant effect modifier . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 12 . 1 the 2 results 2 results 3 show 3 show 4 that 4 that 6 e4 4 that 7 was 5 apoe 6 e4 6 e4 7 was 7 was 11 modifier 8 a 9 significant 8 a 11 modifier 9 significant 10 effect 10 effect 11 modifier significant associations were found only in apoe e4 noncarriers ( n = 718 ) . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 15 . 1 significant 2 associations 2 associations 3 were 3 were 4 found 4 found 5 only 5 only 6 in 6 in 9 noncarriers 7 apoe 9 noncarriers 8 e4 9 noncarriers 9 noncarriers 12 = 10 ( 12 = 11 n 12 = 12 = 13 718 12 = 14 ) we found a nonlinear negative association between the ratio of lanosterol to cholesterol ( [≤] 189.96 ng/mg ) , a marker for cholesterol synthesis , and general cognition . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 29 . 1 we 2 found 2 found 6 association 2 found 7 between 2 found 12 to 3 a 4 nonlinear 3 a 6 association 4 nonlinear 6 association 5 negative 6 association 7 between 9 ratio 8 the 9 ratio 9 ratio 10 of 10 of 11 lanosterol 12 to 13 cholesterol 13 cholesterol 17 ng/mg 14 ( 17 ng/mg 16 189.96 17 ng/mg 17 ng/mg 18 ) 19 , 26 and 20 a 21 marker 21 marker 22 for 21 marker 26 and 22 for 24 synthesis 23 cholesterol 24 synthesis 25 , 26 and 26 and 28 cognition 27 general 28 cognition lower cholesterol absorption , i.e . [,] lower ratios of campesterol and sitosterol to cholesterol , as well as a higher rate of cholesterol synthesis relative to absorption were associated with lower information processing speed . 0 ###LEFT-WALL### 1 lower 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 5 i.e 0 ###LEFT-WALL### 6 . 1 lower 3 absorption 2 cholesterol 3 absorption 4 , 5 i.e 6 . 12 and 8 lower 9 ratios 9 ratios 10 of 9 ratios 12 and 10 of 11 campesterol 12 and 13 sitosterol 12 and 14 to 14 to 15 cholesterol 15 cholesterol 19 as 16 , 19 as 17 as 18 well 18 well 19 as 19 as 22 rate 19 as 36 . 20 a 22 rate 21 higher 22 rate 22 rate 23 of 22 rate 25 synthesis 22 rate 34 processing 23 of 24 cholesterol 25 synthesis 26 relative 25 synthesis 29 were 26 relative 27 to 27 to 28 absorption 29 were 30 associated 30 associated 31 with 31 with 33 information 32 lower 33 information 33 information 34 processing 34 processing 35 speed in apoe e4 carriers , the negative association between the ratio of campesterol to cholesterol and memory reached borderline significance . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 18 reached 0 ###LEFT-WALL### 21 . 1 in 2 apoe 1 in 16 and 3 e4 4 carriers 4 carriers 5 , 5 , 8 association 5 , 16 and 6 the 8 association 7 negative 8 association 8 association 9 between 8 association 12 of 9 between 11 ratio 10 the 11 ratio 12 of 13 campesterol 13 campesterol 14 to 14 to 15 cholesterol 16 and 17 memory 16 and 18 reached 18 reached 20 significance 19 borderline 20 significance future research should focus on the interaction [between] ( disturbed ) cholesterol homeostasis and apoe e4 status with respect to dementia . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 focus 0 ###LEFT-WALL### 22 . 1 future 2 research 2 research 3 should 3 should 4 focus 4 focus 5 on 4 focus 17 status 4 focus 18 with 4 focus 20 to 5 on 7 interaction 6 the 7 interaction 7 interaction 10 disturbed 9 ( 10 disturbed 10 disturbed 11 ) 12 cholesterol 16 e4 13 homeostasis 14 and 14 and 15 apoe 14 and 16 e4 16 e4 17 status 18 with 19 respect 20 to 21 dementia background : relationship between respiratory morbidity and influenza virus has been well - documented in infants , whatever their age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 background 2 : 2 : 3 relationship 3 relationship 4 between 4 between 7 and 5 respiratory 6 morbidity 6 morbidity 7 and 7 and 8 influenza 7 and 9 virus 7 and 12 well 9 virus 10 has 10 has 11 been 11 been 12 well 12 well 14 documented 12 well 18 whatever 13 - 14 documented 14 documented 15 in 14 documented 17 , 15 in 16 infants 18 whatever 19 their 18 whatever 20 age 19 their 20 age however , in spite of severe cardiac and respiratory events of central origin , autonomic dysfunction potentially induced by this virus is poorly understood . 0 ###LEFT-WALL### 16 dysfunction 0 ###LEFT-WALL### 24 understood 0 ###LEFT-WALL### 25 . 1 however 2 , 1 however 16 dysfunction 3 in 4 spite 3 in 14 , 3 in 16 dysfunction 4 spite 5 of 5 of 10 events 6 severe 10 events 7 cardiac 8 and 8 and 9 respiratory 8 and 10 events 10 events 11 of 11 of 13 origin 12 central 13 origin 15 autonomic 16 dysfunction 16 dysfunction 18 induced 16 dysfunction 22 is 17 potentially 18 induced 18 induced 19 by 19 by 21 virus 20 this 21 virus 22 is 24 understood 23 poorly 24 understood we thus explored the autonomic nervous [system] ( ans ) profile of infected infants during the 2009 pandemic influenza disease . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 explored 0 ###LEFT-WALL### 21 . 1 we 3 explored 2 thus 3 explored 3 explored 11 profile 3 explored 15 during 4 the 11 profile 5 autonomic 11 profile 6 nervous 9 ans 6 nervous 11 profile 8 ( 9 ans 9 ans 10 ) 11 profile 12 of 12 of 14 infants 13 infected 14 infants 15 during 20 disease 16 the 20 disease 17 2009 20 disease 18 pandemic 20 disease 19 influenza 20 disease the same recordings were performed in 10 control subjects , paired for gestational and postnatal age . 0 ###LEFT-WALL### 3 recordings 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 17 . 1 the 2 same 2 same 3 recordings 3 recordings 4 were 4 were 10 , 5 performed 6 in 5 performed 10 , 6 in 9 subjects 7 10 9 subjects 8 control 9 subjects 10 , 11 paired 10 , 12 for 12 for 16 age 13 gestational 14 and 14 and 15 postnatal 14 and 16 age hrv sympathetic and parasympathetic ( vlf , lf and hf ) indices were obtained using spectral - domain analysis , and spontaneous baroreflex sensitivity ( sbr ) using simultaneous [non] - invasive continuous measure [of] arterial pressure and heart rate . 0 ###LEFT-WALL### 12 indices 0 ###LEFT-WALL### 14 obtained 0 ###LEFT-WALL### 41 . 1 hrv 12 indices 2 sympathetic 3 and 3 and 4 parasympathetic 3 and 6 vlf 3 and 10 hf 3 and 12 indices 5 ( 6 vlf 6 vlf 7 , 7 , 10 hf 8 lf 9 and 9 and 10 hf 10 hf 11 ) 12 indices 13 were 13 were 14 obtained 14 obtained 15 using 14 obtained 28 using 15 using 24 sensitivity 16 spectral 17 - 16 spectral 24 sensitivity 18 domain 19 analysis 19 analysis 21 and 20 , 21 and 21 and 22 spontaneous 21 and 24 sensitivity 23 baroreflex 24 sensitivity 24 sensitivity 26 sbr 25 ( 26 sbr 26 sbr 27 ) 28 using 38 and 29 simultaneous 31 - 29 simultaneous 34 measure 32 invasive 34 measure 33 continuous 34 measure 34 measure 37 pressure 36 arterial 37 pressure 37 pressure 38 and 38 and 40 rate 39 heart 40 rate results : the group of infants less than 1 year had similar value as control group . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 results 2 : 2 : 6 infants 3 the 4 group 4 group 5 of 4 group 6 infants 5 of 6 infants 6 infants 10 year 6 infants 16 group 7 less 8 than 8 than 9 1 9 1 10 year 10 year 11 had 11 had 13 value 11 had 14 as 11 had 16 group 12 similar 13 value 14 as 15 control conclusion : nvh1n1 infection in child could be associated with severe central autonomic dysfunction . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 infection 2 : 9 associated 2 : 15 . 3 nvh1n1 4 infection 4 infection 5 in 4 infection 7 could 5 in 6 child 7 could 8 be 8 be 9 associated 9 associated 10 with 10 with 14 dysfunction 11 severe 14 dysfunction 12 central 14 dysfunction 13 autonomic 14 dysfunction due to potential severe consequences , a systematic evaluation of autonomic regulation should be performed in order to avoid dramatic events . 0 ###LEFT-WALL### 9 evaluation 0 ###LEFT-WALL### 15 performed 0 ###LEFT-WALL### 22 . 1 due 2 to 2 to 5 consequences 2 to 6 , 2 to 9 evaluation 3 potential 5 consequences 4 severe 5 consequences 7 a 8 systematic 7 a 9 evaluation 8 systematic 9 evaluation 9 evaluation 10 of 9 evaluation 13 should 10 of 12 regulation 11 autonomic 12 regulation 13 should 14 be 14 be 15 performed 15 performed 16 in 16 in 17 order 17 order 18 to 17 order 19 avoid 18 to 19 avoid 19 avoid 21 events 20 dramatic 21 events purpose : the aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of older adults ' wellness . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 8 is 2 : 25 . 3 the 4 aim 4 aim 5 of 4 aim 8 is 5 of 7 paper 6 this 7 paper 8 is 9 to 8 is 24 wellness 9 to 10 demonstrate 10 demonstrate 11 how 11 how 13 applications 11 how 15 support 12 informatics 13 applications 13 applications 14 can 14 can 15 support 15 support 18 and 16 the 17 assessment 17 assessment 18 and 18 and 19 visualization 18 and 20 of 20 of 23 ' 21 older 22 adults 22 adults 23 ' a theoretical framework [is] presented that informs the design of a technology enhanced screening platform [for] wellness . 0 ###LEFT-WALL### 3 framework 0 ###LEFT-WALL### 13 enhanced 0 ###LEFT-WALL### 18 . 1 a 2 theoretical 1 a 3 framework 2 theoretical 3 framework 3 framework 5 presented 3 framework 6 that 3 framework 7 informs 3 framework 13 enhanced 6 that 7 informs 7 informs 9 design 8 the 9 design 9 design 10 of 10 of 12 technology 11 a 12 technology 13 enhanced 17 wellness 14 screening 17 wellness 15 platform 17 wellness we highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies ( including a telehealth component to capture vital signs and customized questionnaires , a gait analysis component and cognitive assessment software ) to assess the multiple aspects of wellness of older adults . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 highlight 1 we 2 highlight 2 highlight 6 demonstration 2 highlight 7 in 2 highlight 23 for 3 an 4 ongoing 3 an 6 demonstration 4 ongoing 6 demonstration 5 pilot 6 demonstration 7 in 11 facility 8 an 11 facility 9 assisted 11 facility 10 living 11 facility 11 facility 12 where 12 where 15 room 12 where 18 converted 13 a 15 room 14 community 15 room 15 room 16 has 16 has 17 been 17 been 18 converted 18 converted 19 into 19 into 22 laboratory 20 a 22 laboratory 21 living 22 laboratory 23 for 25 use 24 the 25 use 25 use 26 of 25 use 30 including 26 of 28 technologies 27 diverse 28 technologies 29 ( 30 including 30 including 32 telehealth 30 including 51 to 30 including 61 . 31 a 32 telehealth 32 telehealth 33 component 32 telehealth 46 and 33 component 34 to 33 component 35 capture 34 to 35 capture 35 capture 38 and 36 vital 37 signs 37 signs 38 and 38 and 40 questionnaires 38 and 41 , 39 customized 40 questionnaires 41 , 46 and 42 a 45 component 43 gait 44 analysis 44 analysis 45 component 45 component 46 and 46 and 49 software 46 and 50 ) 47 cognitive 48 assessment 48 assessment 49 software 51 to 52 assess 52 assess 55 aspects 53 the 55 aspects 54 multiple 55 aspects 55 aspects 56 of 55 aspects 58 of 56 of 57 wellness 58 of 60 adults 59 older 60 adults methods : a demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for older adults . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 validate 0 ###LEFT-WALL### 26 . 2 : 5 project 2 : 7 introduced 3 a 5 project 4 demonstration 5 project 5 project 6 was 6 was 7 introduced 7 introduced 8 in 7 introduced 13 to 8 in 12 community 9 an 10 independent 9 an 12 community 10 independent 11 retirement 11 retirement 12 community 13 to 14 validate 14 validate 17 framework 15 our 17 framework 16 theoretical 17 framework 17 framework 18 of 18 of 20 and 19 informatics 20 and 20 and 22 assessment 20 and 23 for 21 wellness 22 assessment 23 for 25 adults 24 older 25 adults subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance , physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 45 . 1 subjects 2 are 2 are 3 being 3 being 4 recruited 4 recruited 5 to 4 recruited 12 in 4 recruited 27 as 5 to 10 and 6 attend 9 room 6 attend 10 and 7 a 9 room 8 community 9 room 10 and 11 engage 12 in 24 and 13 the 14 use 14 use 15 of 14 use 22 , 15 of 17 technologies 16 diverse 17 technologies 17 technologies 18 to 17 technologies 19 assess 18 to 19 assess 19 assess 21 performance 20 cognitive 21 performance 22 , 23 physiological 22 , 24 and 24 and 26 variables 25 gait 26 variables 27 as 28 well 28 well 29 as 28 well 31 pertaining 28 well 37 of 29 as 30 psychometrics 31 pertaining 32 to 32 to 36 components 33 social 34 and 34 and 35 spiritual 34 and 36 components 37 of 38 wellness 38 wellness 39 for 38 wellness 42 of 39 for 41 period 40 a 41 period 42 of 44 weeks 43 eight 44 weeks data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 integrated 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 31 . 1 data 2 are 2 are 3 integrated 3 integrated 4 from 3 integrated 7 into 4 from 6 sources 5 various 6 sources 7 into 10 database 8 one 10 database 9 study 10 database 11 and 14 approaches 11 and 16 pursued 12 different 13 visualization 13 visualization 14 approaches 14 approaches 15 are 15 are 16 pursued 16 pursued 17 to 17 to 25 and 18 efficiently 19 display 19 display 21 correlations 19 display 22 between 19 display 25 and 20 potential 21 correlations 22 between 24 parameters 23 different 24 parameters 25 and 26 capture 25 and 27 overall 25 and 28 trends 28 trends 29 of 29 of 30 wellness results : preliminary findings indicate that older adults are willing to participate in technology - enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 43 . 1 results 2 : 2 : 3 preliminary 2 : 6 that 3 preliminary 4 findings 3 preliminary 5 indicate 4 findings 5 indicate 6 that 8 adults 6 that 9 are 7 older 8 adults 8 adults 9 are 9 are 10 willing 10 willing 11 to 10 willing 13 in 11 to 12 participate 13 in 14 technology 15 - 31 and 16 enhanced 17 interventions 17 interventions 18 and 18 and 21 information 18 and 23 applications 18 and 25 appropriate 18 and 26 and 19 embrace 21 information 20 different 21 information 22 technology 23 applications 23 applications 24 given 23 applications 25 appropriate 26 and 28 training 26 and 29 and 27 customized 28 training 29 and 30 hardware 29 and 31 and 31 and 33 features 31 and 34 that 31 and 35 address 32 software 33 features 34 that 35 address 35 address 39 and 36 potential 38 limitations 37 functional 38 limitations 38 limitations 39 and 39 and 40 inexperience 39 and 41 with 41 with 42 computers conclusion : informatics can advance health care for older adults and support a holistic assessment of older adults ' wellness . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 informatics 2 : 11 and 2 : 21 . 3 informatics 11 and 4 can 5 advance 4 can 11 and 5 advance 7 care 5 advance 8 for 6 health 7 care 8 for 10 adults 9 older 10 adults 11 and 12 support 12 support 15 assessment 13 a 14 holistic 13 a 15 assessment 14 holistic 15 assessment 15 assessment 16 of 16 of 20 wellness 17 older 18 adults 18 adults 19 ' 19 ' 20 wellness the described framework can support decision making , link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events . 0 ###LEFT-WALL### 3 framework 0 ###LEFT-WALL### 25 reduce 0 ###LEFT-WALL### 29 . 1 the 3 framework 2 described 3 framework 3 framework 19 and 3 framework 24 could 4 can 8 , 4 can 19 and 5 support 7 making 5 support 8 , 6 decision 7 making 8 , 15 and 9 link 14 networks 9 link 15 and 10 formal 11 and 11 and 12 informal 11 and 14 networks 13 caregiving 14 networks 15 and 16 identify 16 identify 18 trends 17 early 18 trends 19 and 20 patterns 19 and 21 that 19 and 22 if 22 if 23 addressed 24 could 25 reduce 25 reduce 28 events 26 adverse 27 health 27 health 28 events the present study examines the prediction that emotion can facilitate short - term memory . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 examines 0 ###LEFT-WALL### 15 . 1 the 3 study 2 present 3 study 3 study 4 examines 4 examines 6 prediction 5 the 6 prediction 6 prediction 7 that 6 prediction 10 facilitate 7 that 8 emotion 7 that 10 facilitate 8 emotion 9 can 9 can 10 facilitate 10 facilitate 14 memory 11 short 12 - 11 short 13 term 13 term 14 memory nevertheless , emotion also recruits attention to process information , thereby disrupting short - term memory when tasks involve high attentional resources . 0 ###LEFT-WALL### 3 emotion 0 ###LEFT-WALL### 5 recruits 1 nevertheless 2 , 1 nevertheless 3 emotion 3 emotion 5 recruits 4 also 5 recruits 5 recruits 6 attention 5 recruits 7 to 5 recruits 12 disrupting 7 to 9 information 8 process 9 information 10 , 12 disrupting 11 thereby 12 disrupting 12 disrupting 16 memory 12 disrupting 23 . 13 short 14 - 13 short 15 term 15 term 16 memory 16 memory 17 when 17 when 18 tasks 17 when 19 involve 18 tasks 19 involve 19 involve 22 resources 20 high 22 resources 21 attentional 22 resources in this way , we aimed to determine whether there is a differential influence of emotional information on short - term memory in ageing and alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 aimed 0 ###LEFT-WALL### 8 determine 1 in 3 way 1 in 4 , 1 in 5 we 2 this 3 way 5 we 6 aimed 6 aimed 7 to 6 aimed 8 determine 7 to 8 determine 8 determine 9 whether 8 determine 18 on 8 determine 32 . 9 whether 10 there 9 whether 11 is 10 there 11 is 11 is 14 influence 12 a 13 differential 12 a 14 influence 13 differential 14 influence 14 influence 15 of 15 of 17 information 16 emotional 17 information 18 on 22 memory 19 short 20 - 19 short 21 term 21 term 22 memory 22 memory 23 in 23 in 25 and 24 ageing 25 and 25 and 28 disease 25 and 30 ad 26 alzheimer 27 's 27 's 28 disease 29 ( 30 ad 30 ad 31 ) fourteen patients with mild ad , 14 healthy older participants ( nc ) , and 14 younger adults ( ya ) performed two tasks . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 22 performed 0 ###LEFT-WALL### 25 . 1 fourteen 2 patients 2 patients 3 with 2 patients 15 and 3 with 5 ad 4 mild 5 ad 5 ad 10 participants 6 , 10 participants 7 14 10 participants 8 healthy 10 participants 9 older 10 participants 10 participants 12 nc 10 participants 14 , 11 ( 12 nc 12 nc 13 ) 14 , 15 and 15 and 18 adults 15 and 20 ya 15 and 22 performed 16 14 18 adults 17 younger 18 adults 19 ( 20 ya 20 ya 21 ) 22 performed 24 tasks 23 two 24 tasks in the first task , involving visual short - term memory , participants were asked to remember a picture among four different pictures ( negative or neutral ) following a brief delay . 0 ###LEFT-WALL### 13 participants 0 ###LEFT-WALL### 15 asked 0 ###LEFT-WALL### 33 . 1 in 4 task 1 in 13 participants 2 the 3 first 2 the 4 task 4 task 6 involving 5 , 6 involving 6 involving 11 memory 6 involving 12 , 7 visual 10 term 8 short 9 - 8 short 10 term 10 term 11 memory 13 participants 14 were 14 were 15 asked 15 asked 16 to 16 to 17 remember 17 remember 19 picture 18 a 19 picture 19 picture 20 among 19 picture 29 following 20 among 23 pictures 21 four 23 pictures 22 different 23 pictures 23 pictures 26 or 24 ( 26 or 25 negative 26 or 26 or 27 neutral 26 or 28 ) 29 following 32 delay 30 a 32 delay 31 brief 32 delay the second task , a binding memory task , required the recognition by participants of a picture according to its spatial location . 0 ###LEFT-WALL### 3 task 0 ###LEFT-WALL### 10 required 0 ###LEFT-WALL### 23 . 1 the 2 second 1 the 3 task 3 task 8 task 3 task 10 required 4 , 8 task 5 a 8 task 6 binding 7 memory 7 memory 8 task 8 task 9 , 10 required 12 recognition 10 required 13 by 10 required 19 to 11 the 12 recognition 13 by 14 participants 14 participants 15 of 15 of 17 picture 16 a 17 picture 18 according 19 to 19 to 22 location 20 its 22 location 21 spatial 22 location the attentional cost involved was higher than for the first task . 0 ###LEFT-WALL### 3 cost 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 12 . 1 the 3 cost 2 attentional 3 cost 3 cost 4 involved 3 cost 5 was 5 was 6 higher 6 higher 7 than 7 than 8 for 8 for 11 task 9 the 10 first 9 the 11 task the pattern of results showed that visual memory performance was better for negative stimuli than for neutral ones , irrespective of the group . 0 ###LEFT-WALL### 2 pattern 0 ###LEFT-WALL### 5 showed 1 the 2 pattern 2 pattern 3 of 2 pattern 5 showed 3 of 4 results 5 showed 8 memory 5 showed 9 performance 5 showed 10 was 6 that 7 visual 7 visual 8 memory 9 performance 10 was 10 was 11 better 11 better 12 for 11 better 15 than 11 better 21 of 12 for 14 stimuli 13 negative 14 stimuli 15 than 16 for 16 for 18 ones 17 neutral 18 ones 19 , 21 of 20 irrespective 21 of 21 of 23 group 21 of 24 . 22 the 23 group in contrast , binding memory performance was essentially poorer for the location of negative pictures in the nc group , and for the location of both negative and neutral stimuli in the ad group , in comparison to the ya group . 0 ###LEFT-WALL### 6 performance 0 ###LEFT-WALL### 7 was 1 in 2 contrast 1 in 3 , 1 in 6 performance 4 binding 6 performance 5 memory 6 performance 6 performance 7 was 7 was 8 essentially 7 was 9 poorer 9 poorer 10 for 9 poorer 21 and 9 poorer 31 in 10 for 12 location 11 the 12 location 12 location 13 of 13 of 15 pictures 14 negative 15 pictures 16 in 19 group 16 in 21 and 17 the 19 group 18 nc 19 group 20 , 21 and 21 and 22 for 22 for 24 location 23 the 24 location 24 location 25 of 25 of 30 stimuli 26 both 30 stimuli 27 negative 28 and 28 and 29 neutral 28 and 30 stimuli 31 in 34 group 32 the 34 group 33 ad 34 group 34 group 36 in 35 , 36 in 36 in 37 comparison 36 in 42 . 37 comparison 38 to 38 to 41 group 39 the 41 group 40 ya 41 group taken together , these results show that emotion has beneficial effects on visual short - term memory in ageing and ad . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 6 show 0 ###LEFT-WALL### 22 . 1 taken 2 together 1 taken 3 , 1 taken 5 results 4 these 5 results 5 results 6 show 6 show 7 that 7 that 8 emotion 7 that 9 has 8 emotion 9 has 9 has 11 effects 10 beneficial 11 effects 11 effects 12 on 12 on 17 memory 13 visual 16 term 14 short 15 - 14 short 16 term 16 term 17 memory 17 memory 18 in 18 in 20 and 19 ageing 20 and 20 and 21 ad in contrast , emotion does not improve their performances in the binding condition . 0 ###LEFT-WALL### 4 emotion 0 ###LEFT-WALL### 7 improve 0 ###LEFT-WALL### 14 . 1 in 2 contrast 1 in 3 , 1 in 4 emotion 4 emotion 5 does 5 does 6 not 5 does 7 improve 7 improve 9 performances 7 improve 10 in 8 their 9 performances 10 in 13 condition 11 the 13 condition 12 binding 13 condition the soc is an important determinant of life satisfaction of elderly people . 0 ###LEFT-WALL### 2 soc 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 13 . 1 the 2 soc 2 soc 3 is 3 is 6 determinant 4 an 5 important 4 an 6 determinant 5 important 6 determinant 6 determinant 7 of 7 of 9 satisfaction 8 life 9 satisfaction 9 satisfaction 10 of 10 of 12 people 11 elderly 12 people it determines the level of coping with various difficult situations , which accompany an old age stage . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 determines 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 18 . 1 it 2 determines 2 determines 4 level 3 the 4 level 4 level 5 of 5 of 6 coping 6 coping 7 with 7 with 10 situations 8 various 10 situations 9 difficult 10 situations 11 , 12 which 11 , 13 accompany 12 which 13 accompany 13 accompany 17 stage 14 an 15 old 14 an 17 stage 15 old 16 age 16 age 17 stage the aim of the study was to determine the connection between the soc levels and life satisfaction among the u3a students . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 22 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 the 5 study 6 was 7 to 6 was 8 determine 7 to 8 determine 8 determine 10 connection 8 determine 11 between 8 determine 18 among 9 the 10 connection 11 between 15 and 12 the 14 levels 13 soc 14 levels 14 levels 15 and 15 and 17 satisfaction 16 life 17 satisfaction 18 among 21 students 19 the 21 students 20 u3a 21 students another analyzed relationship was the soc level against the background of socio - demographic factors . 0 ###LEFT-WALL### 3 relationship 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 16 . 1 another 3 relationship 2 analyzed 3 relationship 3 relationship 4 was 4 was 6 soc 5 the 6 soc 6 soc 7 level 7 level 8 against 8 against 10 background 9 the 10 background 10 background 11 of 11 of 15 factors 12 socio 13 - 12 socio 15 factors 14 demographic 15 factors the study comprised 257 students of the u3a in poland , located in the city of bydgoszcz . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 18 . 1 the 2 study 2 study 11 , 3 comprised 5 students 3 comprised 9 in 3 comprised 11 , 4 257 5 students 5 students 6 of 6 of 8 u3a 7 the 8 u3a 9 in 10 poland 11 , 12 located 11 , 13 in 13 in 15 city 14 the 15 city 15 city 16 of 16 of 17 bydgoszcz the study group consisted of 237 women and 20 men , at the average age of 64.54 ± 6.01 years . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 consisted 1 the 3 group 2 study 3 group 3 group 4 consisted 4 consisted 5 of 5 of 8 and 6 237 7 women 7 women 8 and 8 and 10 men 8 and 12 at 9 20 10 men 11 , 12 at 12 at 15 age 12 at 21 . 13 the 15 age 14 average 15 age 15 age 16 of 16 of 20 years 17 64.54 20 years 18 ± 20 years 19 6.01 20 years the vast majority of the study group included individuals at the secondary education level , as well as married individuals . 0 ###LEFT-WALL### 9 individuals 0 ###LEFT-WALL### 14 level 1 the 3 majority 2 vast 3 majority 3 majority 4 of 3 majority 9 individuals 4 of 9 individuals 5 the 9 individuals 6 study 8 included 7 group 8 included 8 included 9 individuals 9 individuals 10 at 9 individuals 14 level 10 at 13 education 11 the 13 education 12 secondary 13 education 14 level 18 as 15 , 18 as 16 as 17 well 17 well 18 as 18 as 20 individuals 18 as 21 . 19 married 20 individuals just over half of the group claimed to be in good health , and have no afflictions . 0 ###LEFT-WALL### 3 half 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 18 . 1 just 2 over 2 over 3 half 3 half 4 of 3 half 14 and 4 of 6 group 5 the 6 group 7 claimed 8 to 7 claimed 9 be 7 claimed 14 and 8 to 9 be 9 be 10 in 10 in 12 health 11 good 12 health 13 , 14 and 14 and 15 have 15 have 17 afflictions 16 no 17 afflictions all of the respondents were fully mobile . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 8 . 1 all 2 of 1 all 5 were 2 of 4 respondents 3 the 4 respondents 5 were 7 mobile 6 fully 7 mobile the study was conducted with the diagnostic poll method , using the standardized questionnaires : the scale soc - 29 , whoqol - bref , and the geriatric depression scale ( gds - bref version ) . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 37 . 1 the 2 study 2 study 3 was 3 was 4 conducted 4 conducted 5 with 5 with 9 method 6 the 9 method 7 diagnostic 8 poll 8 poll 9 method 10 , 11 using 10 , 15 : 11 using 14 questionnaires 11 using 15 : 12 the 14 questionnaires 13 standardized 14 questionnaires 15 : 18 soc 16 the 18 soc 17 scale 18 soc 18 soc 20 29 19 - 20 29 20 29 22 whoqol 20 29 36 ) 21 , 22 whoqol 22 whoqol 26 and 22 whoqol 36 ) 23 - 26 and 24 bref 26 and 25 , 26 and 26 and 35 version 26 and 36 ) 27 the 35 version 28 geriatric 29 depression 29 depression 30 scale 30 scale 32 gds 31 ( 32 gds 32 gds 33 - 32 gds 35 version 34 bref 35 version the average value of global soc was 128.77 ; the standard deviation [21.04] ; discrepancy 153 [(] minimum 50 and maximum 203 ) . 0 ###LEFT-WALL### 3 value 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 24 . 1 the 3 value 2 average 3 value 3 value 4 of 3 value 7 was 4 of 6 soc 5 global 6 soc 7 was 8 128.77 9 ; 12 deviation 9 ; 14 ; 10 the 12 deviation 11 standard 12 deviation 14 ; 20 and 15 discrepancy 18 minimum 16 153 18 minimum 18 minimum 19 50 18 minimum 20 and 20 and 21 maximum 20 and 23 ) 21 maximum 22 203 the soc indicated significant relationship with quality of life ( qol ) in the mental domain , social relationships , and environmental domain ; no significant correlation in the physical domain was observed . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 24 ; 0 ###LEFT-WALL### 34 . 1 the 5 relationship 2 soc 3 indicated 3 indicated 5 relationship 4 significant 5 relationship 5 relationship 6 with 5 relationship 17 , 6 with 7 quality 7 quality 8 of 7 quality 13 in 8 of 9 life 9 life 11 qol 10 ( 11 qol 11 qol 12 ) 13 in 16 domain 14 the 16 domain 15 mental 16 domain 17 , 19 relationships 17 , 21 and 18 social 19 relationships 20 , 21 and 21 and 23 domain 22 environmental 23 domain 24 ; 27 correlation 24 ; 33 observed 25 no 27 correlation 26 significant 27 correlation 27 correlation 28 in 27 correlation 32 was 28 in 31 domain 29 the 31 domain 30 physical 31 domain 32 was 33 observed the qol reached about 70 % of maximum result value , showing equal levels in its specific areas . 0 ###LEFT-WALL### 2 qol 0 ###LEFT-WALL### 3 reached 1 the 2 qol 2 qol 3 reached 3 reached 4 about 4 about 6 % 5 70 6 % 6 % 7 of 6 % 12 showing 7 of 10 value 8 maximum 10 value 9 result 10 value 11 , 12 showing 12 showing 14 levels 12 showing 15 in 12 showing 19 . 13 equal 14 levels 15 in 18 areas 16 its 18 areas 17 specific 18 areas a moderately decreasing [(] r= - 0.375 , p<0.01 ) relation η=0.376 , between global soc values and depression occurrence , as well as its [non] [-] existence was shown in the study . 0 ###LEFT-WALL### 11 relation 0 ###LEFT-WALL### 30 shown 0 ###LEFT-WALL### 34 . 1 a 11 relation 2 moderately 3 decreasing 3 decreasing 11 relation 5 r= 7 0.375 5 r= 11 relation 6 - 7 0.375 7 0.375 8 , 9 p<0.01 10 ) 9 p<0.01 11 relation 11 relation 12 η=0.376 11 relation 29 was 12 η=0.376 14 between 12 η=0.376 24 as 13 , 14 between 14 between 18 and 14 between 21 , 15 global 17 values 16 soc 17 values 17 values 18 and 18 and 20 occurrence 19 depression 20 occurrence 22 as 23 well 23 well 24 as 24 as 28 existence 25 its 28 existence 29 was 30 shown 30 shown 31 in 31 in 33 study 32 the 33 study individual soc components were also negatively correlated with depression . 0 ###LEFT-WALL### 3 components 0 ###LEFT-WALL### 7 correlated 0 ###LEFT-WALL### 10 . 1 individual 2 soc 2 soc 3 components 3 components 4 were 4 were 5 also 4 were 7 correlated 6 negatively 7 correlated 7 correlated 8 with 8 with 9 depression another observation was weak [correlation] between the sense of coherence and the individuals ' level of education . 0 ###LEFT-WALL### 2 observation 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 18 . 1 another 2 observation 2 observation 3 was 3 was 4 weak 4 weak 6 between 6 between 8 sense 7 the 8 sense 8 sense 9 of 9 of 11 and 10 coherence 11 and 11 and 15 level 11 and 16 of 12 the 13 individuals 13 individuals 14 ' 14 ' 15 level 16 of 17 education no statistically significant effect of age , gender and marital status on the soc levels of u3a students was found . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 20 found 0 ###LEFT-WALL### 21 . 1 no 4 effect 2 statistically 3 significant 3 significant 4 effect 4 effect 5 of 4 effect 12 on 4 effect 19 was 5 of 9 and 6 age 7 , 7 , 8 gender 7 , 9 and 9 and 11 status 10 marital 11 status 12 on 15 levels 13 the 15 levels 14 soc 15 levels 15 levels 16 of 16 of 18 students 17 u3a 18 students 19 was 20 found higher parameters of soc and level of education shape significantly higher effects of life satisfaction , and result in better adaptation to old age stage as a phase of multiple challenges , and increasing life difficulties . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 shape 0 ###LEFT-WALL### 37 . 1 higher 2 parameters 2 parameters 3 of 2 parameters 5 and 3 of 4 soc 5 and 6 level 5 and 7 of 5 and 9 shape 7 of 8 education 9 shape 10 significantly 9 shape 12 effects 9 shape 26 as 11 higher 12 effects 12 effects 13 of 13 of 14 life 14 life 17 and 14 life 25 stage 15 satisfaction 17 and 16 , 17 and 17 and 18 result 17 and 19 in 17 and 22 to 17 and 25 stage 19 in 21 adaptation 20 better 21 adaptation 22 to 24 age 23 old 24 age 26 as 33 and 27 a 28 phase 28 phase 29 of 28 phase 33 and 29 of 31 challenges 30 multiple 31 challenges 32 , 33 and 33 and 36 difficulties 34 increasing 36 difficulties 35 life 36 difficulties introduction : over the past decade the developments made in treating people with human immune deficiency virus ( hiv ) have greatly improved quality of life and life expectancy . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 8 developments 2 : 23 improved 3 over 6 decade 3 over 8 developments 4 the 5 past 4 the 6 decade 7 the 8 developments 8 developments 9 made 8 developments 19 hiv 8 developments 21 have 9 made 10 in 9 made 13 with 10 in 12 people 11 treating 12 people 13 with 17 virus 14 human 17 virus 15 immune 16 deficiency 16 deficiency 17 virus 18 ( 19 hiv 19 hiv 20 ) 21 have 23 improved 22 greatly 23 improved 23 improved 27 and 24 quality 25 of 24 quality 27 and 25 of 26 life 27 and 29 expectancy 28 life 29 expectancy however , the nature of asymptomatic hiv - associated minor neurocognitive disorder ( hand ) remains unclear . 0 ###LEFT-WALL### 4 nature 0 ###LEFT-WALL### 16 remains 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 4 nature 3 the 4 nature 4 nature 5 of 4 nature 16 remains 5 of 7 hiv 6 asymptomatic 7 hiv 7 hiv 12 disorder 8 - 12 disorder 9 associated 12 disorder 10 minor 12 disorder 11 neurocognitive 12 disorder 12 disorder 14 hand 12 disorder 15 ) 13 ( 14 hand 14 hand 15 ) 16 remains 17 unclear in this study we explored the occurrence of neuropsychological and neuroimaging changes in medically and psychiatrically stable hiv - 1 infected patients on highly active antiretroviral treatment ( haart ) from two separate age groups . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 36 . 1 in 3 study 1 in 10 and 2 this 3 study 3 study 4 we 3 study 8 of 4 we 5 explored 5 explored 7 occurrence 6 the 7 occurrence 7 occurrence 8 of 9 neuropsychological 10 and 10 and 11 neuroimaging 10 and 15 and 12 changes 13 in 12 changes 14 medically 12 changes 15 and 15 and 17 stable 16 psychiatrically 17 stable 17 stable 18 hiv 19 - 22 patients 20 1 22 patients 21 infected 22 patients 22 patients 23 on 22 patients 31 from 23 on 27 treatment 24 highly 25 active 25 active 27 treatment 26 antiretroviral 27 treatment 27 treatment 29 haart 28 ( 29 haart 29 haart 30 ) 31 from 35 groups 32 two 35 groups 33 separate 34 age 34 age 35 groups methods : participants included 20 hiv - 1 infected younger ( aged 20 - 40 ) and 20 hiv - 1 older patients ( aged 50 - 75 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 4 included 2 : 30 . 3 participants 4 included 4 included 17 and 5 20 17 and 6 hiv 9 infected 6 hiv 10 younger 6 hiv 17 and 7 - 8 1 8 1 9 infected 10 younger 12 aged 11 ( 12 aged 12 aged 14 - 12 aged 16 ) 13 20 14 - 14 - 15 40 17 and 19 hiv 17 and 23 patients 18 20 19 hiv 20 - 23 patients 21 1 23 patients 22 older 23 patients 23 patients 25 aged 23 patients 29 ) 24 ( 25 aged 25 aged 27 - 25 aged 29 ) 26 50 27 - 27 - 28 75 comparisons were made with 20 age - and education - matched younger and 22 matched older healthy seronegative males . 0 ###LEFT-WALL### 1 comparisons 0 ###LEFT-WALL### 3 made 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 . 1 comparisons 2 were 2 were 3 made 3 made 4 with 3 made 12 younger 4 with 8 and 5 20 6 age 6 age 8 and 7 - 8 and 8 and 9 education 8 and 10 - 8 and 11 matched 13 and 14 22 13 and 15 matched 14 22 15 matched 15 matched 19 males 16 older 19 males 17 healthy 19 males 18 seronegative 19 males participants were stable on treatment and asymptomatic at study [onset] with undetectable hiv - 1 viral loads , and free of medical or psychiatric co - morbidity , alcohol or substance misuse . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 33 . 1 participants 2 were 2 were 6 and 3 stable 4 on 3 stable 6 and 4 on 5 treatment 6 and 19 and 7 asymptomatic 8 at 7 asymptomatic 11 with 7 asymptomatic 19 and 8 at 9 study 11 with 13 hiv 12 undetectable 13 hiv 13 hiv 16 viral 13 hiv 17 loads 14 - 15 1 15 1 16 viral 16 viral 17 loads 18 , 19 and 19 and 20 free 20 free 21 of 21 of 30 or 22 medical 23 or 23 or 29 alcohol 23 or 30 or 24 psychiatric 29 alcohol 25 co 27 morbidity 25 co 29 alcohol 26 - 27 morbidity 27 morbidity 28 , 30 or 32 misuse 31 substance 32 misuse a detailed neuropsychological assessment was used [and] volumetric - magnetic resonance imaging ( mri ) and diffusion tensor imaging ( dti ) performed to assess grey and white - matter integrity . 0 ###LEFT-WALL### 4 assessment 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 assess 0 ###LEFT-WALL### 32 . 1 a 2 detailed 1 a 4 assessment 2 detailed 4 assessment 3 neuropsychological 4 assessment 4 assessment 5 was 5 was 12 imaging 6 used 11 resonance 8 volumetric 9 - 8 volumetric 11 resonance 10 magnetic 11 resonance 11 resonance 12 imaging 12 imaging 14 mri 13 ( 14 mri 14 mri 15 ) 16 and 19 imaging 16 and 23 performed 17 diffusion 19 imaging 18 tensor 19 imaging 19 imaging 21 dti 19 imaging 23 performed 20 ( 21 dti 21 dti 22 ) 23 performed 24 to 24 to 25 assess 25 assess 27 and 26 grey 27 and 27 and 31 integrity 28 white 29 - 28 white 30 matter 30 matter 31 integrity results : we found significant effects of ageing on memory , grey and white matter measures . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 3 we 2 : 11 , 3 we 11 , 4 found 6 effects 4 found 9 on 4 found 11 , 5 significant 6 effects 6 effects 7 of 7 of 8 ageing 9 on 10 memory 11 , 13 and 12 grey 13 and 13 and 14 white 14 white 16 measures 15 matter 16 measures comparison of the hiv - positive and hiv - negative groups did not show significant differences on the neuropsychological tests after bonferroni correction , and there were no significant age by hiv status interactions . 0 ###LEFT-WALL### 1 comparison 0 ###LEFT-WALL### 14 show 0 ###LEFT-WALL### 35 . 1 comparison 2 of 1 comparison 12 did 2 of 11 groups 3 the 11 groups 4 hiv 7 and 4 hiv 11 groups 5 - 7 and 6 positive 7 and 7 and 8 hiv 7 and 9 - 10 negative 11 groups 12 did 13 not 12 did 14 show 14 show 16 differences 14 show 27 were 15 significant 16 differences 16 differences 17 on 16 differences 25 and 16 differences 27 were 17 on 20 tests 18 the 20 tests 19 neuropsychological 20 tests 21 after 23 correction 21 after 25 and 22 bonferroni 23 correction 24 , 25 and 25 and 26 there 27 were 30 age 28 no 30 age 29 significant 30 age 30 age 31 by 31 by 34 interactions 32 hiv 34 interactions 33 status 34 interactions however , we did find reduced grey matter volume on mri in our hiv - positive participants within the medial and superior frontal gyri . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 5 find 1 however 2 , 1 however 3 we 3 we 4 did 4 did 5 find 5 find 8 matter 5 find 9 volume 6 reduced 8 matter 7 grey 8 matter 9 volume 10 on 10 on 11 mri 11 mri 12 in 12 in 14 hiv 13 our 14 hiv 14 hiv 17 participants 15 - 17 participants 16 positive 17 participants 17 participants 18 within 17 participants 25 . 18 within 24 gyri 19 the 24 gyri 20 medial 21 and 21 and 22 superior 21 and 24 gyri 23 frontal 24 gyri we also found significant ageing effects in fronto - temporal grey and white matter , [independent] of the effect of hiv . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 found 1 we 3 found 2 also 3 found 3 found 5 ageing 3 found 6 effects 3 found 7 in 4 significant 5 ageing 7 in 14 matter 8 fronto 9 - 8 fronto 14 matter 10 temporal 11 grey 11 grey 12 and 12 and 13 white 12 and 14 matter 14 matter 17 of 15 , 17 of 17 of 19 effect 17 of 22 . 18 the 19 effect 19 effect 20 of 20 of 21 hiv conclusions : the results from this study suggest that hiv - 1 disease by itself does not significantly impair [cognitive] function when patients are otherwise asymptomatic . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 8 suggest 2 : 27 . 3 the 4 results 4 results 5 from 4 results 8 suggest 5 from 7 study 6 this 7 study 8 suggest 9 that 9 that 10 hiv 9 that 21 function 10 hiv 13 disease 10 hiv 19 impair 11 - 12 1 12 1 13 disease 13 disease 14 by 13 disease 16 does 14 by 15 itself 16 does 17 not 16 does 19 impair 18 significantly 19 impair 21 function 22 when 22 when 23 patients 22 when 24 are 23 patients 24 are 24 are 25 otherwise 24 are 26 asymptomatic nevertheless , the imaging techniques were sensitive enough to detect subtle grey matter changes not normally evident until much later in the disease . 0 ###LEFT-WALL### 5 techniques 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 24 . 1 nevertheless 2 , 1 nevertheless 5 techniques 3 the 5 techniques 4 imaging 5 techniques 5 techniques 6 were 6 were 7 sensitive 7 sensitive 8 enough 7 sensitive 9 to 7 sensitive 10 detect 9 to 10 detect 10 detect 14 changes 11 subtle 13 matter 12 grey 13 matter 13 matter 14 changes 14 changes 15 not 15 not 17 evident 16 normally 17 evident 17 evident 18 until 17 evident 21 in 18 until 19 much 19 much 20 later 21 in 23 disease 22 the 23 disease if confirmed in a longitudinal study this frontal grey matter change could represent an important biomarker for trials in hiv disease . 0 ###LEFT-WALL### 11 change 0 ###LEFT-WALL### 13 represent 0 ###LEFT-WALL### 22 . 1 if 2 confirmed 1 if 11 change 2 confirmed 3 in 2 confirmed 8 frontal 3 in 6 study 4 a 5 longitudinal 4 a 6 study 5 longitudinal 6 study 7 this 8 frontal 9 grey 10 matter 10 matter 11 change 11 change 12 could 12 could 13 represent 13 represent 16 biomarker 13 represent 19 in 14 an 15 important 14 an 16 biomarker 15 important 16 biomarker 16 biomarker 17 for 17 for 18 trials 19 in 21 disease 20 hiv 21 disease malnutrition [after] hip [fracture] is [common] and associated with poor outcomes and protracted recovery . 0 ###LEFT-WALL### 1 malnutrition 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 . 1 malnutrition 7 and 3 hip 5 is 5 is 7 and 7 and 8 associated 7 and 9 with 9 with 12 and 10 poor 11 outcomes 11 outcomes 12 and 12 and 14 recovery 13 protracted 14 recovery low concentrations of vitamin e have been associated with incident decline [in] physical function [among] older adults and may , therefore , be particularly important [to] functionally compromised patients hip fracture patients . 0 ###LEFT-WALL### 2 concentrations 0 ###LEFT-WALL### 28 compromised 0 ###LEFT-WALL### 33 . 1 low 2 concentrations 2 concentrations 3 of 2 concentrations 28 compromised 3 of 4 vitamin 4 vitamin 5 e 4 vitamin 18 and 6 have 7 been 6 have 18 and 7 been 8 associated 8 associated 9 with 9 with 17 adults 10 incident 17 adults 11 decline 17 adults 13 physical 14 function 14 function 17 adults 16 older 17 adults 18 and 19 may 19 may 23 be 20 , 21 therefore 21 therefore 22 , 21 therefore 23 be 23 be 24 particularly 23 be 25 important 27 functionally 28 compromised 28 compromised 32 patients 29 patients 32 patients 30 hip 32 patients 31 fracture 32 patients serum concentrations of α - tocopherol and [γ] [-] tocopherol , the 2 major forms of vitamin e , were assessed in 148 female hip fracture patients 65 years or older from the baltimore hip studies cohort 4 around the time of fracture ( baseline ) and at 2 [,] 6 [,] and 12 month postfracture follow - up visits ( recovery ) . 0 ###LEFT-WALL### 7 and 1 serum 2 concentrations 2 concentrations 3 of 2 concentrations 7 and 3 of 6 tocopherol 4 α 5 - 4 α 6 tocopherol 7 and 10 tocopherol 7 and 11 , 7 and 13 2 7 and 19 , 12 the 13 2 13 2 19 , 14 major 15 forms 14 major 19 , 15 forms 16 of 16 of 17 vitamin 17 vitamin 18 e 19 , 20 were 20 were 21 assessed 21 assessed 22 in 21 assessed 30 or 21 assessed 32 from 22 in 23 148 24 female 29 years 25 hip 29 years 26 fracture 27 patients 27 patients 29 years 28 65 29 years 29 years 30 or 30 or 31 older 32 from 37 cohort 33 the 37 cohort 34 baltimore 35 hip 35 hip 36 studies 36 studies 37 cohort 37 cohort 38 4 37 cohort 47 and 39 around 41 time 39 around 47 and 40 the 41 time 41 time 42 of 41 time 45 baseline 42 of 43 fracture 44 ( 45 baseline 45 baseline 46 ) 47 and 48 at 48 at 49 2 49 2 53 and 49 2 57 follow 51 6 53 and 53 and 54 12 53 and 57 follow 54 12 55 month 55 month 56 postfracture 57 follow 59 up 58 - 59 up 59 up 60 visits 59 up 64 . 60 visits 62 recovery 61 ( 62 recovery 62 recovery 63 ) it was hypothesized that mean concentrations of both forms of vitamin e among these hip fracture patients would be [lowest] at the baseline visit and increase at each study visit during the year [after] fracture . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 hypothesized 0 ###LEFT-WALL### 36 . 1 it 2 was 2 was 3 hypothesized 3 hypothesized 4 that 4 that 6 concentrations 4 that 25 and 5 mean 6 concentrations 6 concentrations 7 of 6 concentrations 10 of 6 concentrations 18 would 7 of 9 forms 8 both 9 forms 10 of 11 vitamin 11 vitamin 12 e 11 vitamin 13 among 13 among 17 patients 14 these 17 patients 15 hip 17 patients 16 fracture 17 patients 18 would 25 and 19 be 21 at 19 be 25 and 21 at 24 visit 22 the 24 visit 23 baseline 24 visit 25 and 26 increase 26 increase 27 at 27 at 30 visit 28 each 30 visit 29 study 30 visit 30 visit 31 during 31 during 35 fracture 32 the 35 fracture 33 year 35 fracture linear regression and generalized estimating equations were used to assess changes in vitamin e concentrations after adjustment for covariates and to determine predictors of vitamin e concentrations at baseline [and] throughout recovery . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 33 . 1 linear 2 regression 3 and 6 equations 3 and 20 and 4 generalized 6 equations 5 estimating 6 equations 6 equations 20 and 7 were 8 used 7 were 20 and 8 used 9 to 8 used 10 assess 9 to 10 assess 10 assess 11 changes 10 assess 12 in 10 assess 16 after 12 in 15 concentrations 13 vitamin 14 e 13 vitamin 15 concentrations 16 after 17 adjustment 17 adjustment 18 for 18 for 19 covariates 20 and 21 to 20 and 22 determine 20 and 28 at 20 and 31 throughout 21 to 22 determine 22 determine 23 predictors 23 predictors 24 of 24 of 27 concentrations 25 vitamin 26 e 25 vitamin 27 concentrations 28 at 29 baseline 31 throughout 32 recovery it was also hypothesized that vitamin e concentrations shortly [after] [hip] fracture would be lower than those in nonfracture controls after adjustment for covariates . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 hypothesized 0 ###LEFT-WALL### 25 . 1 it 2 was 2 was 4 hypothesized 3 also 4 hypothesized 4 hypothesized 5 that 5 that 6 vitamin 5 that 14 be 6 vitamin 7 e 6 vitamin 8 concentrations 6 vitamin 12 fracture 6 vitamin 13 would 8 concentrations 12 fracture 9 shortly 12 fracture 13 would 14 be 14 be 15 lower 14 be 16 than 16 than 17 those 16 than 21 after 17 those 18 in 18 in 20 controls 19 nonfracture 20 controls 21 after 22 adjustment 22 adjustment 23 for 23 for 24 covariates to evaluate this hypothesis , linear regression was used to perform adjusted comparisons of baseline vitamin e concentrations among baltimore hip studies cohort 4 participants to 1076 older women without history of hip [fracture] from the women 's health and aging study i , invecchiare in chianti study , and the national health and nutrition examination surveys . 0 ###LEFT-WALL### 7 regression 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 44 , 0 ###LEFT-WALL### 58 . 1 to 2 evaluate 1 to 5 , 1 to 7 regression 2 evaluate 4 hypothesis 3 this 4 hypothesis 6 linear 7 regression 7 regression 8 was 8 was 9 used 9 used 10 to 9 used 19 among 9 used 30 without 10 to 11 perform 11 perform 13 comparisons 12 adjusted 13 comparisons 13 comparisons 14 of 14 of 18 concentrations 15 baseline 16 vitamin 16 vitamin 17 e 16 vitamin 18 concentrations 19 among 25 participants 20 baltimore 21 hip 21 hip 22 studies 22 studies 25 participants 23 cohort 25 participants 24 4 25 participants 25 participants 26 to 26 to 29 women 27 1076 29 women 28 older 29 women 30 without 31 history 31 history 32 of 32 of 40 and 33 hip 35 from 33 hip 40 and 35 from 39 health 36 the 37 women 37 women 38 's 38 's 39 health 40 and 42 study 40 and 44 , 41 aging 42 study 42 study 43 i 44 , 54 and 45 invecchiare 46 in 45 invecchiare 50 and 46 in 48 study 47 chianti 48 study 49 , 50 and 50 and 53 health 50 and 54 and 51 the 53 health 52 national 53 health 54 and 57 surveys 55 nutrition 56 examination 56 examination 57 surveys mean α - tocopherol was [lowest] at baseline , and time from fracture [to] blood [draw] was positively associated with baseline α - tocopherol ( p = [.] 005 ) . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 31 . 1 mean 4 tocopherol 1 mean 5 was 2 α 3 - 2 α 4 tocopherol 4 tocopherol 5 was 5 was 7 at 7 at 8 baseline 9 , 10 and 10 and 11 time 10 and 19 associated 11 time 12 from 11 time 17 was 12 from 15 blood 13 fracture 15 blood 17 was 19 associated 18 positively 19 associated 19 associated 20 with 20 with 21 baseline 20 with 24 tocopherol 22 α 23 - 22 α 24 tocopherol 24 tocopherol 27 = 25 ( 27 = 26 p 27 = 27 = 29 005 27 = 30 ) mean [γ] - tocopherol did not change appreciably throughout the year [after] fracture , although it fluctuated widely within individuals . 0 ###LEFT-WALL### 4 tocopherol 0 ###LEFT-WALL### 17 fluctuated 0 ###LEFT-WALL### 21 . 1 mean 3 - 1 mean 4 tocopherol 4 tocopherol 5 did 5 did 6 not 5 did 7 change 7 change 8 appreciably 7 change 9 throughout 7 change 15 although 9 throughout 13 fracture 10 the 13 fracture 11 year 13 fracture 14 , 15 although 15 although 16 it 16 it 17 fluctuated 17 fluctuated 18 widely 17 fluctuated 19 within 19 within 20 individuals serum concentrations of α - tocopherol [and] [γ] - tocopherol were [highest] among the hip fracture population after adjustment ( p < [.] 0001 ) . 0 ###LEFT-WALL### 2 concentrations 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 26 . 1 serum 2 concentrations 2 concentrations 3 of 2 concentrations 11 were 3 of 10 tocopherol 4 α 6 tocopherol 4 α 10 tocopherol 5 - 6 tocopherol 6 tocopherol 9 - 11 were 13 among 11 were 18 after 13 among 17 population 14 the 17 population 15 hip 16 fracture 16 fracture 17 population 18 after 19 adjustment 19 adjustment 22 < 20 ( 22 < 21 p 22 < 22 < 24 0001 22 < 25 ) in general , highly cognitively [and] physically functioning hip fracture patients demonstrated higher vitamin e concentrations . 0 ###LEFT-WALL### 11 patients 0 ###LEFT-WALL### 12 demonstrated 0 ###LEFT-WALL### 17 . 1 in 10 fracture 2 general 3 , 2 general 9 hip 4 highly 8 functioning 5 cognitively 8 functioning 7 physically 8 functioning 8 functioning 9 hip 9 hip 10 fracture 10 fracture 11 patients 11 patients 12 demonstrated 12 demonstrated 16 concentrations 13 higher 14 vitamin 14 vitamin 15 e 14 vitamin 16 concentrations thus , the relatively high degree [of] function among this cohort of hip fracture patients may explain their higher - than [-] expected vitamin e concentrations . 0 ###LEFT-WALL### 8 function 0 ###LEFT-WALL### 17 explain 0 ###LEFT-WALL### 27 . 1 thus 2 , 1 thus 8 function 3 the 8 function 4 relatively 5 high 5 high 6 degree 6 degree 8 function 8 function 9 among 8 function 16 may 9 among 11 cohort 10 this 11 cohort 11 cohort 12 of 12 of 15 patients 13 hip 14 fracture 14 fracture 15 patients 16 may 17 explain 17 explain 26 concentrations 18 their 26 concentrations 19 higher 20 - 19 higher 24 vitamin 21 than 23 expected 23 expected 24 vitamin 24 vitamin 25 e 24 vitamin 26 concentrations background : " the graying of the globe " has resulted in exponential rise in health care expenses [,] over [-] worked health care professionals and a growing patient base suffering from multiple chronic diseases , one of which is diabetes . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 " 2 : 5 graying 2 : 11 resulted 4 the 5 graying 5 graying 6 of 5 graying 10 has 6 of 8 globe 7 the 8 globe 8 globe 9 " 10 has 11 resulted 11 resulted 12 in 12 in 14 rise 13 exponential 14 rise 14 rise 15 in 15 in 26 and 16 health 17 care 17 care 18 expenses 18 expenses 20 over 18 expenses 26 and 20 over 25 professionals 22 worked 25 professionals 23 health 25 professionals 24 care 25 professionals 26 and 30 base 26 and 36 , 26 and 37 one 27 a 30 base 28 growing 30 base 29 patient 30 base 30 base 31 suffering 30 base 32 from 32 from 35 diseases 33 multiple 35 diseases 34 chronic 35 diseases 36 , 37 one 37 one 38 of 37 one 42 . 38 of 39 which 39 which 40 is 40 is 41 diabetes consumer health technologies ( cht ) are considered important catalysts for empowering health care consumers to take a proactive role in managing their health and related costs . 0 ###LEFT-WALL### 3 technologies 0 ###LEFT-WALL### 8 considered 0 ###LEFT-WALL### 28 . 1 consumer 3 technologies 2 health 3 technologies 3 technologies 5 cht 3 technologies 7 are 4 ( 5 cht 5 cht 6 ) 7 are 8 considered 8 considered 10 catalysts 9 important 10 catalysts 10 catalysts 11 for 11 for 12 empowering 12 empowering 15 consumers 12 empowering 16 to 13 health 14 care 14 care 15 consumers 16 to 25 and 17 take 20 role 17 take 21 in 17 take 25 and 18 a 20 role 19 proactive 20 role 21 in 22 managing 22 managing 24 health 23 their 24 health 25 and 26 related 26 related 27 costs adoption rate and usability of such devices among the aging is far from being satisfactory . 0 ###LEFT-WALL### 2 rate 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 16 . 1 adoption 2 rate 3 and 4 usability 3 and 11 is 4 usability 5 of 4 usability 11 is 5 of 7 devices 6 such 7 devices 7 devices 8 among 8 among 10 aging 9 the 10 aging 11 is 12 far 12 far 13 from 13 from 14 being 14 being 15 satisfactory past studies noted the motivation for adoption by the aging is dependent on the suitability/relevance , perceived usability and anticipated benefits associated with usage of technological innovation . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 28 . 1 past 2 studies 2 studies 16 , 3 noted 5 motivation 3 noted 11 is 3 noted 16 , 4 the 5 motivation 5 motivation 6 for 5 motivation 11 is 6 for 7 adoption 7 adoption 8 by 8 by 10 aging 9 the 10 aging 11 is 12 dependent 12 dependent 13 on 13 on 15 suitability/relevance 14 the 15 suitability/relevance 16 , 19 and 16 , 23 with 17 perceived 18 usability 17 perceived 19 and 19 and 20 anticipated 20 anticipated 21 benefits 20 anticipated 22 associated 21 benefits 22 associated 23 with 24 usage 24 usage 25 of 25 of 27 innovation 26 technological 27 innovation traditional information technology ( it ) [development] adopts a systematic approach without necessarily using a specific user model that personalizes the system to the aging user groups . 0 ###LEFT-WALL### 3 technology 0 ###LEFT-WALL### 8 adopts 0 ###LEFT-WALL### 28 . 1 traditional 3 technology 2 information 3 technology 3 technology 5 it 3 technology 8 adopts 4 ( 5 it 5 it 6 ) 8 adopts 11 approach 8 adopts 12 without 8 adopts 23 to 9 a 10 systematic 9 a 11 approach 10 systematic 11 approach 12 without 14 using 13 necessarily 14 using 14 using 18 model 15 a 16 specific 15 a 18 model 16 specific 17 user 17 user 18 model 18 model 19 that 18 model 20 personalizes 19 that 20 personalizes 20 personalizes 22 system 21 the 22 system 23 to 27 groups 24 the 27 groups 25 aging 26 user 26 user 27 groups the aging patient population has unique needs arising from progressive deterioration in both physiological and psychological abilities . 0 ###LEFT-WALL### 4 population 0 ###LEFT-WALL### 5 has 0 ###LEFT-WALL### 18 . 1 the 4 population 2 aging 4 population 3 patient 4 population 4 population 5 has 5 has 7 needs 5 has 9 from 5 has 12 in 6 unique 7 needs 7 needs 8 arising 9 from 11 deterioration 10 progressive 11 deterioration 12 in 17 abilities 13 both 17 abilities 14 physiological 15 and 15 and 16 psychological 15 and 17 abilities these needs are often ignored in the design , development , trial and adoption of consumer health products resulting in low adoption and usage . 0 ###LEFT-WALL### 2 needs 0 ###LEFT-WALL### 5 ignored 0 ###LEFT-WALL### 25 . 1 these 2 needs 2 needs 3 are 3 are 4 often 3 are 5 ignored 5 ignored 6 in 6 in 13 and 7 the 8 design 8 design 9 , 9 , 10 development 9 , 11 , 11 , 12 trial 11 , 13 and 13 and 14 adoption 13 and 15 of 15 of 18 products 16 consumer 18 products 17 health 18 products 18 products 19 resulting 19 resulting 20 in 20 in 23 and 21 low 22 adoption 22 adoption 23 and 23 and 24 usage objectives : the main objective of this research is to investigate the user - centered design ( ucd ) , specifically user profiles and personas , as methodological tools to inform the design and development of cht devices for an aging population . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 43 . 1 objectives 2 : 2 : 5 objective 3 the 4 main 3 the 5 objective 5 objective 6 of 5 objective 8 research 5 objective 9 is 6 of 7 this 8 research 9 is 9 is 10 to 10 to 11 investigate 11 investigate 13 user 11 investigate 27 as 11 investigate 30 to 12 the 13 user 13 user 16 design 14 - 16 design 15 centered 16 design 16 design 18 ucd 16 design 24 and 16 design 26 , 17 ( 18 ucd 18 ucd 19 ) 20 , 21 specifically 20 , 24 and 22 user 23 profiles 23 profiles 24 and 24 and 25 personas 24 and 26 , 27 as 29 tools 28 methodological 29 tools 30 to 31 inform 31 inform 34 and 31 inform 36 of 31 inform 39 for 32 the 34 and 33 design 34 and 34 and 35 development 36 of 38 devices 37 cht 38 devices 39 for 42 population 40 an 42 population 41 aging 42 population the adoption of user profile and persona has not received much attention in health care informatics research and [,] in particular , research involving cht . 0 ###LEFT-WALL### 2 adoption 0 ###LEFT-WALL### 10 received 0 ###LEFT-WALL### 26 . 1 the 2 adoption 2 adoption 3 of 2 adoption 8 has 3 of 6 and 4 user 5 profile 5 profile 6 and 6 and 7 persona 8 has 9 not 8 has 10 received 10 received 12 attention 11 much 12 attention 12 attention 18 and 12 attention 24 involving 13 in 15 care 13 in 18 and 14 health 15 care 15 care 16 informatics 15 care 17 research 16 informatics 17 research 18 and 20 in 20 in 23 research 21 particular 22 , 21 particular 23 research 24 involving 25 cht our work begins to fill this void in three ways . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 3 begins 0 ###LEFT-WALL### 11 . 1 our 2 work 2 work 3 begins 3 begins 4 to 3 begins 5 fill 4 to 5 fill 5 fill 7 void 5 fill 8 in 6 this 7 void 8 in 10 ways 9 three 10 ways methodology : to exemplify process and application , we use an action - research methodology , where user profiles and personas of an aging patient population were developed . 0 ###LEFT-WALL### 1 methodology 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 3 to 2 : 4 exemplify 2 : 8 , 3 to 4 exemplify 4 exemplify 6 and 5 process 6 and 6 and 7 application 8 , 9 we 8 , 10 use 9 we 10 use 10 use 12 action 10 use 17 where 11 an 12 action 12 action 15 methodology 13 - 15 methodology 14 research 15 methodology 15 methodology 16 , 17 where 20 and 17 where 27 were 18 user 19 profiles 19 profiles 20 and 20 and 21 personas 20 and 27 were 21 personas 22 of 22 of 26 population 23 an 26 population 24 aging 26 population 25 patient 26 population 27 were 28 developed the resultant profiles and personas were leveraged to improve the design , development and implementation plans of a smart phone application to assist chronically ill aging chinese diabetic population capable of disease self [-] management . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 leveraged 0 ###LEFT-WALL### 36 . 1 the 3 profiles 2 resultant 3 profiles 3 profiles 4 and 4 and 5 personas 4 and 6 were 6 were 7 leveraged 7 leveraged 8 to 7 leveraged 22 to 8 to 9 improve 9 improve 14 and 10 the 11 design 11 design 12 , 12 , 13 development 12 , 14 and 14 and 16 plans 14 and 17 of 15 implementation 16 plans 17 of 21 application 18 a 21 application 19 smart 20 phone 20 phone 21 application 22 to 23 assist 23 assist 29 population 24 chronically 25 ill 25 ill 27 chinese 26 aging 27 chinese 27 chinese 29 population 28 diabetic 29 population 29 population 30 capable 30 capable 31 of 31 of 35 management 32 disease 33 self 33 self 35 management results : the results from the study show that user profile and persona can be a valuable methodological approach in capturing the conceptual model of the aging and informing the design and development decisions of cht . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 28 and 2 : 37 . 3 the 4 results 4 results 5 from 4 results 28 and 5 from 8 show 6 the 8 show 7 study 8 show 8 show 9 that 8 show 21 capturing 9 that 12 and 9 that 15 be 10 user 11 profile 11 profile 12 and 12 and 13 persona 12 and 14 can 14 can 15 be 15 be 19 approach 16 a 17 valuable 16 a 19 approach 17 valuable 19 approach 18 methodological 19 approach 19 approach 20 in 20 in 21 capturing 21 capturing 24 model 22 the 24 model 23 conceptual 24 model 24 model 25 of 25 of 27 aging 26 the 27 aging 28 and 34 decisions 28 and 35 of 29 informing 34 decisions 30 the 31 design 31 design 32 and 32 and 33 development 32 and 34 decisions 35 of 36 cht the demonstration of techniques used in this study can serve as a guideline to cht developers in bringing conceptual user modeling into the design of software interfaces targeted for users with specific health care needs . 0 ###LEFT-WALL### 2 demonstration 0 ###LEFT-WALL### 10 serve 0 ###LEFT-WALL### 36 . 1 the 2 demonstration 2 demonstration 3 of 2 demonstration 9 can 3 of 4 techniques 4 techniques 5 used 4 techniques 6 in 6 in 8 study 7 this 8 study 9 can 10 serve 10 serve 11 as 10 serve 14 to 10 serve 17 in 10 serve 22 into 10 serve 31 with 11 as 13 guideline 12 a 13 guideline 14 to 16 developers 15 cht 16 developers 17 in 18 bringing 18 bringing 21 modeling 19 conceptual 20 user 20 user 21 modeling 22 into 24 design 23 the 24 design 24 design 25 of 25 of 27 interfaces 26 software 27 interfaces 27 interfaces 28 targeted 28 targeted 29 for 29 for 30 users 31 with 35 needs 32 specific 33 health 33 health 34 care 34 care 35 needs specifically , the study provides guidance on the creation and use of profiles and personas to tap into the conceptual models of the targeted elderly population reflecting their preferences , capabilities and attitudes towards using technology in self [-] management care in general and the smart phone diabetes management application in particular . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 provides 0 ###LEFT-WALL### 53 . 1 specifically 2 , 1 specifically 4 study 3 the 4 study 4 study 5 provides 5 provides 6 guidance 5 provides 7 on 5 provides 16 to 5 provides 18 into 7 on 14 and 8 the 9 creation 9 creation 10 and 10 and 11 use 10 and 12 of 10 and 14 and 12 of 13 profiles 14 and 15 personas 16 to 17 tap 18 into 21 models 19 the 21 models 20 conceptual 21 models 21 models 22 of 21 models 34 towards 22 of 32 and 23 the 26 population 24 targeted 26 population 25 elderly 26 population 26 population 27 reflecting 26 population 30 , 27 reflecting 29 preferences 28 their 29 preferences 30 , 31 capabilities 30 , 32 and 32 and 33 attitudes 34 towards 35 using 35 using 44 and 36 technology 37 in 36 technology 44 and 37 in 41 care 38 self 40 management 40 management 41 care 41 care 43 general 42 in 43 general 44 and 50 application 44 and 52 particular 45 the 50 application 46 smart 47 phone 47 phone 48 diabetes 48 diabetes 50 application 49 management 50 application 51 in 52 particular insight into the mental model of the aging group has been shown to inform later stages of ucd development ( e.g [.] , the creation of prototypes and usability testing ) as well as implementation and adoption strategies . 0 ###LEFT-WALL### 1 insight 0 ###LEFT-WALL### 14 inform 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 39 . 1 insight 2 into 1 insight 6 of 1 insight 10 has 2 into 5 model 3 the 5 model 4 mental 5 model 6 of 9 group 7 the 9 group 8 aging 9 group 10 has 11 been 11 been 12 shown 12 shown 13 to 13 to 14 inform 14 inform 16 stages 15 later 16 stages 16 stages 17 of 16 stages 21 e.g 17 of 19 development 18 ucd 19 development 20 ( 21 e.g 21 e.g 23 , 23 , 36 and 24 the 25 creation 25 creation 26 of 25 creation 28 and 26 of 27 prototypes 28 and 30 testing 28 and 31 ) 28 and 34 as 28 and 36 and 29 usability 30 testing 32 as 33 well 33 well 34 as 34 as 35 implementation 36 and 38 strategies 37 adoption 38 strategies the world health organization ( who ) predicts that by 2025 , 80 % of all new cases of diabetes are expected to appear in the developing countries . 0 ###LEFT-WALL### 6 who 0 ###LEFT-WALL### 8 predicts 0 ###LEFT-WALL### 29 . 1 the 6 who 2 world 3 health 3 health 4 organization 4 organization 6 who 5 ( 6 who 6 who 7 ) 6 who 8 predicts 8 predicts 9 that 9 that 14 % 9 that 22 expected 10 by 11 2025 10 by 12 , 10 by 14 % 13 80 14 % 14 % 15 of 14 % 21 are 15 of 18 cases 16 all 18 cases 17 new 18 cases 18 cases 19 of 19 of 20 diabetes 21 are 22 expected 22 expected 23 to 22 expected 24 appear 23 to 24 appear 24 appear 25 in 25 in 28 countries 26 the 28 countries 27 developing 28 countries in fact , the number of diabetic patients in china is estimated to rise to 42.3 million in 2030 from 20.8 million in 2000 . 0 ###LEFT-WALL### 5 number 0 ###LEFT-WALL### 12 estimated 0 ###LEFT-WALL### 25 . 1 in 2 fact 2 fact 3 , 2 fact 5 number 4 the 5 number 5 number 6 of 5 number 11 is 6 of 8 patients 7 diabetic 8 patients 8 patients 9 in 9 in 10 china 11 is 12 estimated 12 estimated 13 to 13 to 14 rise 14 rise 15 to 14 rise 18 in 14 rise 23 in 15 to 17 million 16 42.3 17 million 18 in 19 2030 19 2030 20 from 20 from 22 million 21 20.8 22 million 23 in 24 2000 thus , we investigate the chinese aging population in order to demonstrate the process of developing and using user profile and persona . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 investigate 0 ###LEFT-WALL### 23 . 1 thus 2 , 1 thus 3 we 3 we 4 investigate 4 investigate 8 population 4 investigate 11 to 5 the 8 population 6 chinese 7 aging 7 aging 8 population 8 population 9 in 9 in 10 order 11 to 12 demonstrate 12 demonstrate 21 and 13 the 14 process 14 process 15 of 14 process 17 and 15 of 16 developing 17 and 20 profile 17 and 21 and 18 using 19 user 19 user 20 profile 21 and 22 persona we hope that the resultant conceptual model of the chinese aging diabetic population can be used in future research to guide cht designers interested in designing health care devices for this vulnerable user group . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 35 . 1 we 2 hope 2 hope 3 that 3 that 7 model 3 that 21 guide 4 the 7 model 5 resultant 7 model 6 conceptual 7 model 7 model 8 of 7 model 11 aging 7 model 14 can 8 of 10 chinese 9 the 10 chinese 11 aging 13 population 12 diabetic 13 population 14 can 15 be 15 be 16 used 16 used 17 in 16 used 20 to 17 in 19 research 18 future 19 research 20 to 21 guide 21 guide 23 designers 22 cht 23 designers 23 designers 24 interested 23 designers 25 in 25 in 26 designing 26 designing 28 care 27 health 28 care 28 care 29 devices 28 care 34 group 29 devices 30 for 29 devices 34 group 30 for 33 user 31 this 33 user 32 vulnerable 33 user osteoporosis is a common condition associated with aging but has been considered to primarily affect women because of the substantial effect [of] menopause on osteoporosis . 0 ###LEFT-WALL### 1 osteoporosis 0 ###LEFT-WALL### 12 considered 0 ###LEFT-WALL### 26 . 1 osteoporosis 9 but 2 is 5 condition 2 is 9 but 3 a 4 common 3 a 5 condition 4 common 5 condition 5 condition 6 associated 6 associated 7 with 7 with 8 aging 9 but 10 has 10 has 11 been 11 been 12 considered 12 considered 13 to 12 considered 15 affect 13 to 15 affect 14 primarily 15 affect 15 affect 16 women 15 affect 17 because 15 affect 24 on 17 because 18 of 18 of 23 menopause 19 the 23 menopause 20 substantial 21 effect 21 effect 23 menopause 24 on 25 osteoporosis bone density can decrease with aging in men but occurs more gradually than in postmenopausal women . 0 ###LEFT-WALL### 2 density 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 17 . 1 bone 2 density 2 density 3 can 3 can 9 but 4 decrease 5 with 4 decrease 9 but 5 with 6 aging 6 aging 7 in 7 in 8 men 9 but 10 occurs 10 occurs 12 gradually 10 occurs 13 than 11 more 12 gradually 13 than 14 in 14 in 16 women 15 postmenopausal 16 women with improvements in healthcare and extended life expectancy , it is becoming more apparent that osteoporosis affects men and can have serious consequences . 0 ###LEFT-WALL### 10 it 0 ###LEFT-WALL### 21 have 0 ###LEFT-WALL### 24 . 1 with 2 improvements 1 with 9 , 1 with 10 it 2 improvements 3 in 3 in 5 and 4 healthcare 5 and 5 and 8 expectancy 6 extended 8 expectancy 7 life 8 expectancy 10 it 11 is 11 is 12 becoming 12 becoming 14 apparent 13 more 14 apparent 14 apparent 15 that 15 that 16 osteoporosis 15 that 19 and 16 osteoporosis 19 and 17 affects 18 men 17 affects 19 and 19 and 20 can 20 can 21 have 21 have 23 consequences 22 serious 23 consequences recently , a greater number of osteoporosis studies are either including men or focusing specifically on them . 0 ###LEFT-WALL### 8 studies 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 18 . 1 recently 2 , 1 recently 8 studies 3 a 5 number 4 greater 5 number 5 number 6 of 5 number 8 studies 6 of 8 studies 7 osteoporosis 8 studies 8 studies 9 are 9 are 11 including 10 either 11 including 11 including 13 or 11 including 15 specifically 11 including 16 on 12 men 13 or 13 or 14 focusing 16 on 17 them the majority of medication trials in men , however , used bone density as the primary outcome rather than fractures . 0 ###LEFT-WALL### 5 trials 0 ###LEFT-WALL### 12 bone 0 ###LEFT-WALL### 21 . 1 the 2 majority 2 majority 3 of 2 majority 5 trials 3 of 5 trials 4 medication 5 trials 5 trials 6 in 5 trials 12 bone 6 in 7 men 7 men 11 used 8 , 9 however 9 however 10 , 9 however 11 used 12 bone 13 density 12 bone 14 as 12 bone 19 than 14 as 17 outcome 15 the 17 outcome 16 primary 17 outcome 18 rather 19 than 19 than 20 fractures therefore , treatment data for men is still rather limited , and there is also very little information in the oldest subset of this population . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 26 . 1 therefore 2 , 1 therefore 4 data 3 treatment 4 data 4 data 5 for 4 data 7 is 5 for 6 men 7 is 8 still 7 is 10 limited 9 rather 10 limited 11 , 12 and 12 and 13 there 12 and 14 is 13 there 14 is 14 is 15 also 14 is 18 information 16 very 17 little 17 little 18 information 18 information 19 in 18 information 23 of 19 in 22 subset 20 the 21 oldest 20 the 22 subset 23 of 25 population 24 this 25 population the more recent guidelines for treating osteoporosis now include men , but the recommendations for screening and treatment are not necessarily [gender] specific . 0 ###LEFT-WALL### 4 guidelines 0 ###LEFT-WALL### 9 include 0 ###LEFT-WALL### 12 but 0 ###LEFT-WALL### 24 . 1 the 4 guidelines 2 more 3 recent 3 recent 4 guidelines 4 guidelines 5 for 4 guidelines 9 include 5 for 6 treating 6 treating 7 osteoporosis 8 now 9 include 9 include 10 men 11 , 12 but 12 but 14 recommendations 12 but 19 are 13 the 14 recommendations 14 recommendations 15 for 14 recommendations 19 are 15 for 17 and 16 screening 17 and 17 and 18 treatment 19 are 20 not 19 are 21 necessarily 19 are 23 specific despite the limited data , some osteoporosis treatments have received approval to treat or prevent osteoporosis specifically in men . 0 ###LEFT-WALL### 7 osteoporosis 0 ###LEFT-WALL### 14 or 0 ###LEFT-WALL### 20 . 1 despite 4 data 1 despite 5 , 1 despite 7 osteoporosis 2 the 4 data 3 limited 4 data 6 some 7 osteoporosis 7 osteoporosis 8 treatments 7 osteoporosis 12 to 7 osteoporosis 14 or 8 treatments 9 have 9 have 10 received 10 received 11 approval 10 received 12 to 13 treat 14 or 14 or 15 prevent 15 prevent 16 osteoporosis 15 prevent 17 specifically 15 prevent 18 in 18 in 19 men future studies must provide greater information on fracture prevention in men and also must include a greater population of the oldest geriatric patients , who are typically not well represented in osteoporosis trials , to evaluate any differences in both efficacy and side effects . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 34 , 0 ###LEFT-WALL### 45 . 1 future 2 studies 2 studies 12 and 3 must 4 provide 3 must 12 and 4 provide 6 information 4 provide 10 in 5 greater 6 information 6 information 7 on 7 on 9 prevention 8 fracture 9 prevention 10 in 11 men 12 and 14 must 12 and 23 patients 13 also 14 must 14 must 15 include 15 include 18 population 16 a 18 population 17 greater 18 population 18 population 19 of 19 of 21 oldest 20 the 21 oldest 22 geriatric 23 patients 23 patients 25 who 24 , 25 who 25 who 26 are 25 who 34 , 26 are 28 not 26 are 29 well 26 are 30 represented 27 typically 28 not 30 represented 31 in 31 in 33 trials 32 osteoporosis 33 trials 34 , 35 to 34 , 36 evaluate 35 to 36 evaluate 36 evaluate 38 differences 37 any 38 differences 38 differences 39 in 39 in 42 and 40 both 42 and 41 efficacy 42 and 42 and 44 effects 43 side 44 effects the oldest group is important because they are at the highest risk for both osteoporosis - related complications and treatment - related adverse events . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 17 related 0 ###LEFT-WALL### 21 - 0 ###LEFT-WALL### 25 . 1 the 2 oldest 1 the 3 group 3 group 4 is 4 is 5 important 5 important 6 because 6 because 7 they 6 because 8 are 7 they 8 are 8 are 9 at 9 at 12 risk 10 the 11 highest 10 the 12 risk 12 risk 13 for 13 for 15 osteoporosis 14 both 15 osteoporosis 16 - 17 related 17 related 19 and 17 related 21 - 18 complications 19 and 19 and 20 treatment 21 - 24 events 22 related 24 events 23 adverse 24 events [none] [the] modern western - type diet is deficient in fruits and vegetables and contains excessive animal products , generating the accumulation of [non] [-] metabolizable anions and a lifespan state of overlooked metabolic acidosis , [whose] magnitude increases [progressively] with aging due to the physiological decline in kidney function . 0 ###LEFT-WALL### 4 western 0 ###LEFT-WALL### 5 - 3 modern 4 western 5 - 7 diet 6 type 7 diet 7 diet 14 and 8 is 9 deficient 8 is 14 and 9 deficient 10 in 10 in 12 and 11 fruits 12 and 12 and 13 vegetables 14 and 15 contains 14 and 20 generating 15 contains 18 products 16 excessive 18 products 17 animal 18 products 19 , 20 generating 20 generating 28 and 21 the 22 accumulation 22 accumulation 23 of 22 accumulation 28 and 23 of 27 anions 26 metabolizable 27 anions 28 and 31 state 28 and 36 , 28 and 39 increases 29 a 31 state 30 lifespan 31 state 31 state 32 of 32 of 35 acidosis 33 overlooked 35 acidosis 34 metabolic 35 acidosis 36 , 39 increases 38 magnitude 39 increases 39 increases 41 with 39 increases 51 . 41 with 42 aging 42 aging 44 to 42 aging 48 in 43 due 44 to 44 to 47 decline 45 the 47 decline 46 physiological 47 decline 48 in 50 function 49 kidney 50 function in response to this state [of] diet - derived metabolic acidosis , the kidney implements compensating mechanisms aimed to restore the acid - base balance , such as the removal of the [non] [-] metabolizable anions , the conservation of citrate , and the enhancement of kidney ammoniagenesis and urinary excretion of ammonium ions . 0 ###LEFT-WALL### 14 kidney 0 ###LEFT-WALL### 15 implements 1 in 2 response 2 response 3 to 3 to 7 diet 3 to 12 , 3 to 14 kidney 4 this 7 diet 5 state 7 diet 7 diet 11 acidosis 8 - 11 acidosis 9 derived 11 acidosis 10 metabolic 11 acidosis 11 acidosis 12 , 13 the 14 kidney 14 kidney 15 implements 15 implements 43 and 16 compensating 17 mechanisms 17 mechanisms 18 aimed 17 mechanisms 28 as 17 mechanisms 43 and 18 aimed 19 to 19 to 20 restore 20 restore 22 acid 21 the 22 acid 22 acid 25 balance 23 - 25 balance 24 base 25 balance 25 balance 26 , 27 such 28 as 28 as 30 removal 29 the 30 removal 30 removal 31 of 30 removal 39 conservation 31 of 36 anions 32 the 36 anions 35 metabolizable 36 anions 37 , 39 conservation 38 the 39 conservation 39 conservation 40 of 39 conservation 42 , 40 of 41 citrate 42 , 43 and 43 and 45 enhancement 43 and 46 of 44 the 45 enhancement 46 of 49 and 47 kidney 48 ammoniagenesis 48 ammoniagenesis 49 and 49 and 51 excretion 49 and 55 . 50 urinary 51 excretion 51 excretion 52 of 52 of 54 ions 53 ammonium 54 ions these adaptive processes lower the urine ph and induce an extensive change in urine composition , including hypocitraturia , hypercalciuria , and nitrogen and phosphate wasting . 0 ###LEFT-WALL### 3 processes 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 27 . 1 these 3 processes 2 adaptive 3 processes 3 processes 8 and 4 lower 7 ph 4 lower 8 and 5 the 7 ph 6 urine 7 ph 8 and 9 induce 8 and 13 in 8 and 15 composition 9 induce 12 change 10 an 11 extensive 10 an 12 change 11 extensive 12 change 13 in 14 urine 15 composition 17 including 16 , 17 including 17 including 18 hypocitraturia 17 including 19 , 19 , 24 and 20 hypercalciuria 22 and 21 , 22 and 22 and 23 nitrogen 22 and 24 and 24 and 26 wasting 25 phosphate 26 wasting low urine ph predisposes to uric acid stone formation . 0 ###LEFT-WALL### 1 low 0 ###LEFT-WALL### 10 . 1 low 2 urine 2 urine 3 ph 2 urine 4 predisposes 3 ph 4 predisposes 4 predisposes 5 to 5 to 9 formation 6 uric 7 acid 7 acid 9 formation 8 stone 9 formation hypocitraturia and hypercalciuria are risk factors for calcium stone disease . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 11 . 1 hypocitraturia 2 and 2 and 3 hypercalciuria 2 and 4 are 4 are 6 factors 5 risk 6 factors 6 factors 7 for 7 for 10 disease 8 calcium 10 disease 9 stone 10 disease even a very mild degree of metabolic acidosis induces skeletal muscle resistance to the insulin action and dietary acid load may be an important variable in predicting the metabolic abnormalities and the cardiovascular risk of the general population , the overweight and obese persons , and other patient populations including diabetes and chronic kidney failure . 0 ###LEFT-WALL### 1 even 0 ###LEFT-WALL### 9 induces 0 ###LEFT-WALL### 39 , 0 ###LEFT-WALL### 56 . 1 even 5 degree 2 a 3 very 2 a 5 degree 3 very 4 mild 4 mild 5 degree 5 degree 6 of 5 degree 9 induces 6 of 8 acidosis 7 metabolic 8 acidosis 9 induces 12 resistance 9 induces 13 to 9 induces 26 in 10 skeletal 11 muscle 11 muscle 12 resistance 13 to 15 insulin 14 the 15 insulin 15 insulin 17 and 15 insulin 22 be 16 action 17 and 17 and 20 load 17 and 21 may 18 dietary 20 load 19 acid 20 load 21 may 22 be 22 be 25 variable 23 an 24 important 23 an 25 variable 24 important 25 variable 26 in 27 predicting 27 predicting 31 and 28 the 31 and 29 metabolic 30 abnormalities 30 abnormalities 31 and 31 and 34 risk 31 and 39 , 32 the 34 risk 33 cardiovascular 34 risk 34 risk 35 of 35 of 38 population 36 the 38 population 37 general 38 population 39 , 52 and 40 the 41 overweight 41 overweight 42 and 42 and 44 persons 42 and 46 and 43 obese 44 persons 45 , 46 and 46 and 49 populations 46 and 50 including 46 and 52 and 47 other 49 populations 48 patient 49 populations 50 including 51 diabetes 52 and 55 failure 53 chronic 54 kidney 54 kidney 55 failure high dietary acid [load] is more likely to result in diabetes and systemic hypertension and may increase the cardiovascular risk . 0 ###LEFT-WALL### 3 acid 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 21 . 1 high 3 acid 2 dietary 3 acid 3 acid 15 and 5 is 7 likely 5 is 15 and 6 more 7 likely 7 likely 8 to 7 likely 9 result 8 to 9 result 9 result 10 in 10 in 12 and 11 diabetes 12 and 12 and 14 hypertension 13 systemic 14 hypertension 15 and 16 may 16 may 17 increase 17 increase 20 risk 18 the 20 risk 19 cardiovascular 20 risk results of recent observational studies confirm an association between insulin resistance and metabolic acidosis markers , including low serum bicarbonate , high serum anion gap , hypocitraturia , and low urine ph . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 6 confirm 1 results 2 of 1 results 6 confirm 2 of 5 studies 3 recent 5 studies 4 observational 5 studies 6 confirm 8 association 6 confirm 9 between 6 confirm 17 including 7 an 8 association 9 between 15 markers 10 insulin 11 resistance 11 resistance 12 and 12 and 14 acidosis 12 and 15 markers 13 metabolic 14 acidosis 16 , 17 including 17 including 29 and 17 including 33 . 18 low 19 serum 19 serum 20 bicarbonate 20 bicarbonate 21 , 21 , 25 gap 21 , 26 , 22 high 25 gap 23 serum 24 anion 24 anion 25 gap 26 , 27 hypocitraturia 26 , 29 and 28 , 29 and 29 and 32 ph 30 low 31 urine 31 urine 32 ph the national institute of child health and human development has conducted a series of vision workshops to set an ambitious but tenable broad agenda , transcending traditional organizational and disciplinary boundaries . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 18 set 1 the 3 institute 2 national 3 institute 3 institute 4 of 3 institute 7 and 4 of 6 health 5 child 6 health 7 and 8 human 7 and 9 development 7 and 17 to 7 and 18 set 9 development 10 has 10 has 11 conducted 11 conducted 13 series 11 conducted 17 to 12 a 13 series 13 series 14 of 14 of 16 workshops 15 vision 16 workshops 18 set 24 agenda 18 set 26 transcending 19 an 24 agenda 20 ambitious 21 but 21 but 22 tenable 21 but 24 agenda 23 broad 24 agenda 25 , 26 transcending 26 transcending 31 boundaries 26 transcending 32 . 27 traditional 31 boundaries 28 organizational 29 and 29 and 30 disciplinary 29 and 31 boundaries this presentation sets forth a vision regarding [how] the aspects of a woman 's reproductive lifespan are interrelated , likely starting from childhood all the way to the later reproductive years . 0 ###LEFT-WALL### 2 presentation 0 ###LEFT-WALL### 3 sets 1 this 2 presentation 2 presentation 3 sets 3 sets 4 forth 3 sets 6 vision 5 a 6 vision 6 vision 7 regarding 6 vision 18 interrelated 7 regarding 10 aspects 7 regarding 17 are 7 regarding 18 interrelated 9 the 10 aspects 10 aspects 11 of 10 aspects 17 are 11 of 16 lifespan 12 a 13 woman 13 woman 14 's 14 's 16 lifespan 15 reproductive 16 lifespan 18 interrelated 21 starting 19 , 21 starting 20 likely 21 starting 21 starting 22 from 21 starting 26 way 21 starting 27 to 21 starting 32 . 22 from 23 childhood 24 all 25 the 25 the 26 way 27 to 31 years 28 the 31 years 29 later 31 years 30 reproductive 31 years as a woman propagates , this circular interaction is then transmitted to the next generation . 0 ###LEFT-WALL### 8 interaction 0 ###LEFT-WALL### 11 transmitted 0 ###LEFT-WALL### 16 . 1 as 3 woman 1 as 4 propagates 1 as 5 , 1 as 8 interaction 2 a 3 woman 3 woman 4 propagates 6 this 7 circular 7 circular 8 interaction 8 interaction 9 is 9 is 10 then 9 is 11 transmitted 11 transmitted 12 to 12 to 15 generation 13 the 14 next 13 the 15 generation we need an understanding of the clinical processes , the time course , the natural history , and disruptors of these processes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 need 0 ###LEFT-WALL### 23 . 1 we 2 need 2 need 4 understanding 3 an 4 understanding 4 understanding 5 of 5 of 18 and 6 the 8 processes 7 clinical 8 processes 8 processes 9 , 9 , 12 course 9 , 13 , 10 the 12 course 11 time 12 course 13 , 16 history 13 , 18 and 14 the 16 history 15 natural 16 history 17 , 18 and 18 and 19 disruptors 18 and 20 of 20 of 22 processes 21 these 22 processes with that understanding , we can then bring tools to bear to assess these issues , whether these tools are epidemiology , demography , social science , molecular biology , proteomics , genomics , or epigenomics . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 11 bear 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 37 . 1 with 3 understanding 1 with 4 , 1 with 5 we 2 that 3 understanding 5 we 6 can 6 can 8 bring 7 then 8 bring 8 bring 9 tools 8 bring 10 to 10 to 11 bear 11 bear 12 to 11 bear 13 assess 12 to 13 assess 13 assess 15 issues 14 these 15 issues 16 , 21 epidemiology 16 , 32 , 17 whether 19 tools 17 whether 20 are 17 whether 21 epidemiology 18 these 19 tools 19 tools 20 are 21 epidemiology 23 demography 21 epidemiology 26 science 21 epidemiology 32 , 22 , 23 demography 23 demography 24 , 24 , 26 science 25 social 26 science 26 science 29 biology 26 science 30 , 27 , 29 biology 28 molecular 29 biology 29 biology 30 , 31 proteomics 32 , 32 , 35 or 33 genomics 35 or 34 , 35 or 35 or 36 epigenomics our future research agenda should investigate [how] reproduction [affects] health and how health affects reproduction . 0 ###LEFT-WALL### 4 agenda 0 ###LEFT-WALL### 6 investigate 0 ###LEFT-WALL### 16 . 1 our 4 agenda 2 future 3 research 3 research 4 agenda 4 agenda 5 should 5 should 6 investigate 6 investigate 11 and 8 reproduction 10 health 10 health 11 and 11 and 12 how 11 and 13 health 11 and 14 affects 13 health 14 affects 14 affects 15 reproduction streptococcus pneumoniae is a major human pathogen , causing high morbidity and mortality in children , and also in the elderly , who are particularly susceptible to [s] [.] pneumoniae infections due to the dysregulated function of the aged immune system . 0 ###LEFT-WALL### 2 pneumoniae 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 42 . 1 streptococcus 2 pneumoniae 2 pneumoniae 3 is 3 is 12 and 4 a 7 pathogen 5 major 7 pathogen 6 human 7 pathogen 7 pathogen 8 , 8 , 11 morbidity 8 , 12 and 9 causing 11 morbidity 10 high 11 morbidity 12 and 13 mortality 13 mortality 17 and 14 in 15 children 14 in 17 and 16 , 17 and 17 and 18 also 17 and 19 in 19 in 21 elderly 20 the 21 elderly 22 , 23 who 22 , 24 are 23 who 24 are 24 are 25 particularly 24 are 26 susceptible 26 susceptible 27 to 26 susceptible 33 to 27 to 31 infections 30 pneumoniae 31 infections 32 due 33 to 33 to 36 function 34 the 36 function 35 dysregulated 36 function 36 function 37 of 37 of 41 system 38 the 41 system 39 aged 41 system 40 immune 41 system as the current generation [of] polysaccharide vaccines do not provide sufficient protection for elderly , new vaccination strategies are urgently needed . 0 ###LEFT-WALL### 18 strategies 0 ###LEFT-WALL### 21 needed 0 ###LEFT-WALL### 22 . 1 as 7 vaccines 1 as 10 provide 1 as 18 strategies 2 the 7 vaccines 3 current 4 generation 4 generation 7 vaccines 6 polysaccharide 7 vaccines 7 vaccines 8 do 8 do 9 not 8 do 10 provide 10 provide 12 protection 10 provide 13 for 11 sufficient 12 protection 13 for 17 vaccination 14 elderly 15 , 14 elderly 17 vaccination 16 new 17 vaccination 18 strategies 19 are 19 are 21 needed 20 urgently 21 needed to learn whether pneumococcal proteins are able to induce adaptive immune responses in adults in different age groups [,] we determined serum igg antibody titers and t cell immunity ( ifn - [γ] , il - 17a and il - 5 production ) to three pneumococcal antigens , pcsb , stkp and psaa , that are components of an investigational protein - based pneumococcal vaccine , ic47 . 0 ###LEFT-WALL### 1 to 1 to 2 learn 2 learn 3 whether 3 whether 5 proteins 3 whether 6 are 4 pneumococcal 5 proteins 5 proteins 6 are 6 are 7 able 7 able 8 to 7 able 9 induce 8 to 9 induce 9 induce 12 responses 9 induce 13 in 9 induce 15 in 10 adaptive 12 responses 11 immune 12 responses 13 in 14 adults 15 in 18 groups 16 different 17 age 17 age 18 groups 18 groups 20 we 18 groups 21 determined 20 we 21 determined 21 determined 29 immunity 22 serum 29 immunity 23 igg 25 titers 24 antibody 25 titers 25 titers 26 and 26 and 27 t 26 and 29 immunity 28 cell 29 immunity 29 immunity 31 ifn 29 immunity 36 - 30 ( 31 ifn 31 ifn 32 - 34 , 36 - 35 il 36 - 36 - 38 and 37 17a 38 and 38 and 39 il 38 and 44 to 39 il 42 production 40 - 42 production 41 5 42 production 42 production 43 ) 44 to 47 antigens 45 three 47 antigens 46 pneumococcal 47 antigens 47 antigens 57 components 48 , 57 components 49 pcsb 50 , 50 , 51 stkp 50 , 52 and 52 and 53 psaa 52 and 55 that 52 and 56 are 52 and 57 components 54 , 55 that 55 that 56 are 57 components 58 of 57 components 67 ic47 57 components 68 . 58 of 61 protein 59 an 60 investigational 59 an 61 protein 60 investigational 61 protein 61 protein 65 vaccine 62 - 65 vaccine 63 based 65 vaccine 64 pneumococcal 65 vaccine 65 vaccine 66 , 66 , 67 ic47 67 ic47 68 . therefore , sera and pbmcs of 108 healthy adults in three different age groups ( young , middle - aged and elderly ) were analyzed by elisa and elispot , respectively . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 25 analyzed 1 therefore 2 , 1 therefore 4 and 3 sera 4 and 4 and 5 pbmcs 4 and 24 were 5 pbmcs 6 of 6 of 7 108 7 108 9 adults 7 108 18 middle 7 108 21 and 8 healthy 9 adults 9 adults 10 in 9 adults 13 age 9 adults 14 groups 9 adults 18 middle 10 in 11 three 12 different 13 age 13 age 14 groups 14 groups 16 young 15 ( 16 young 16 young 17 , 19 - 21 and 20 aged 21 and 21 and 22 elderly 21 and 23 ) 24 were 25 analyzed 25 analyzed 26 by 25 analyzed 31 respectively 26 by 28 and 27 elisa 28 and 28 and 29 elispot 30 , 31 respectively 31 respectively 32 . we found naturally acquired antibodies to all three proteins in all age groups against all three antigens . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 18 . 1 we 2 found 2 found 5 antibodies 2 found 6 to 2 found 10 in 2 found 14 against 3 naturally 4 acquired 4 acquired 5 antibodies 6 to 9 proteins 7 all 8 three 8 three 9 proteins 10 in 13 groups 11 all 13 groups 12 age 13 groups 14 against 17 antigens 15 all 16 three 16 three 17 antigens however , elderly individuals had significantly lower igg levels to pcsb and psaa compared to those of younger donors . 0 ###LEFT-WALL### 4 individuals 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 20 . 1 however 2 , 1 however 4 individuals 3 elderly 4 individuals 4 individuals 5 had 5 had 9 levels 5 had 10 to 5 had 15 to 6 significantly 7 lower 7 lower 9 levels 8 igg 9 levels 10 to 13 psaa 11 pcsb 12 and 12 and 13 psaa 13 psaa 14 compared 15 to 16 those 16 those 17 of 17 of 19 donors 18 younger 19 donors there was no significant age [-] related difference in the overall rate of [t] cell immunity for the three pneumococcal proteins . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 22 . 1 there 2 was 2 was 8 difference 3 no 8 difference 4 significant 5 age 5 age 7 related 7 related 8 difference 8 difference 9 in 9 in 12 rate 10 the 12 rate 11 overall 12 rate 12 rate 13 of 13 of 16 immunity 15 cell 16 immunity 16 immunity 17 for 17 for 21 proteins 18 the 19 three 19 three 21 proteins 20 pneumococcal 21 proteins we found that the th17 response was dominant in all age groups and was frequently combined with a th1 or th2 response in young and middle - aged subjects . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 1 we 2 found 2 found 3 that 3 that 6 response 3 that 13 and 4 the 6 response 5 th17 6 response 6 response 13 and 7 was 8 dominant 7 was 13 and 8 dominant 9 in 9 in 12 groups 10 all 12 groups 11 age 12 groups 13 and 14 was 14 was 16 combined 15 frequently 16 combined 16 combined 17 with 17 with 20 or 18 a 19 th1 19 th1 20 or 20 or 22 response 20 or 23 in 21 th2 22 response 23 in 25 and 24 young 25 and 25 and 26 middle 25 and 29 subjects 27 - 29 subjects 28 aged 29 subjects 29 subjects 30 . however , in elderly persons there was a lower percentage of pbmc samples producing more than one cytokine upon antigenic stimulation . 0 ###LEFT-WALL### 6 there 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 6 there 3 in 5 persons 3 in 6 there 4 elderly 5 persons 6 there 7 was 7 was 10 percentage 8 a 10 percentage 9 lower 10 percentage 10 percentage 11 of 10 percentage 14 producing 11 of 13 samples 12 pbmc 13 samples 14 producing 18 cytokine 14 producing 19 upon 15 more 16 than 16 than 17 one 17 one 18 cytokine 19 upon 21 stimulation 20 antigenic 21 stimulation the narrow cytokine secretion pattern was the most striking difference between elderly and younger adult age groups . 0 ###LEFT-WALL### 5 pattern 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 18 . 1 the 5 pattern 2 narrow 3 cytokine 3 cytokine 4 secretion 4 secretion 5 pattern 5 pattern 6 was 6 was 10 difference 7 the 10 difference 8 most 9 striking 9 striking 10 difference 10 difference 11 between 11 between 17 groups 12 elderly 13 and 13 and 14 younger 13 and 16 age 15 adult 16 age 16 age 17 groups our results demonstrate that in the majority of adults there is a naturally acquired humoral and cellular immune response to the three pneumococcal proteins tested . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 26 . 1 our 2 results 2 results 3 demonstrate 3 demonstrate 4 that 4 that 10 there 4 that 11 is 5 in 7 majority 5 in 10 there 6 the 7 majority 7 majority 8 of 8 of 9 adults 10 there 11 is 11 is 19 response 12 a 19 response 13 naturally 14 acquired 14 acquired 19 response 15 humoral 16 and 16 and 17 cellular 16 and 19 response 18 immune 19 response 19 response 20 to 19 response 25 tested 20 to 24 proteins 21 the 22 three 22 three 24 proteins 23 pneumococcal 24 proteins the dominance of the th17 response is especially interesting in the light of new insights regarding the role of th17 cells in mucosal protection against this pathogen . 0 ###LEFT-WALL### 2 dominance 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 28 . 1 the 2 dominance 2 dominance 3 of 2 dominance 7 is 3 of 6 response 4 the 6 response 5 th17 6 response 7 is 8 especially 7 is 9 interesting 9 interesting 10 in 10 in 12 light 11 the 12 light 12 light 13 of 13 of 15 insights 14 new 15 insights 15 insights 16 regarding 16 regarding 18 role 16 regarding 22 in 16 regarding 25 against 17 the 18 role 18 role 19 of 19 of 21 cells 20 th17 21 cells 22 in 24 protection 23 mucosal 24 protection 25 against 27 pathogen 26 this 27 pathogen none background : fractional carbon dioxide laser resurfacing ( fxcr ) has shown considerable efficacy in reducing wrinkles , although complications such as scarring and prolonged erythema are more common and down - time is longer than with nonablative laser treatment . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 28 are 0 ###LEFT-WALL### 31 and 0 ###LEFT-WALL### 42 . 1 none 2 background 1 none 17 reducing 1 none 18 wrinkles 2 background 3 : 3 : 5 carbon 4 fractional 5 carbon 5 carbon 8 resurfacing 5 carbon 13 shown 6 dioxide 8 resurfacing 7 laser 8 resurfacing 8 resurfacing 10 fxcr 8 resurfacing 12 has 9 ( 10 fxcr 10 fxcr 11 ) 12 has 13 shown 13 shown 15 efficacy 14 considerable 15 efficacy 15 efficacy 16 in 16 in 17 reducing 18 wrinkles 20 although 19 , 20 although 20 although 25 and 21 complications 23 as 21 complications 25 and 22 such 23 as 23 as 24 scarring 25 and 27 erythema 25 and 28 are 26 prolonged 27 erythema 28 are 29 more 28 are 30 common 31 and 34 time 31 and 35 is 32 down 33 - 32 down 34 time 34 time 35 is 35 is 36 longer 36 longer 37 than 36 longer 38 with 38 with 41 treatment 39 nonablative 40 laser 40 laser 41 treatment platelet - rich plasma ( prp ) , a high concentration of platelets in a small volume of plasma , is known to enhance tissue healing . 0 ###LEFT-WALL### 1 platelet 0 ###LEFT-WALL### 22 known 0 ###LEFT-WALL### 27 . 1 platelet 4 plasma 1 platelet 11 concentration 1 platelet 21 is 2 - 4 plasma 3 rich 4 plasma 4 plasma 6 prp 4 plasma 7 ) 5 ( 6 prp 6 prp 7 ) 8 , 11 concentration 9 a 10 high 9 a 11 concentration 10 high 11 concentration 11 concentration 12 of 11 concentration 20 , 12 of 13 platelets 13 platelets 14 in 14 in 17 volume 15 a 16 small 15 a 17 volume 16 small 17 volume 17 volume 18 of 18 of 19 plasma 21 is 22 known 22 known 23 to 22 known 24 enhance 23 to 24 enhance 24 enhance 25 tissue 25 tissue 26 healing objective : to evaluate the benefits of prp in the wound healing process after fxcr . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 16 . 3 to 4 evaluate 4 evaluate 6 benefits 5 the 6 benefits 6 benefits 7 of 7 of 8 prp 8 prp 9 in 8 prp 12 healing 9 in 11 wound 10 the 11 wound 12 healing 13 process 12 healing 14 after 14 after 15 fxcr materials and methods : twenty - five subjects were treated with fxcr on the bilateral inner arms . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 18 . 1 materials 2 and 2 and 3 methods 4 : 8 subjects 4 : 10 treated 5 twenty 6 - 6 - 7 five 6 - 8 subjects 8 subjects 9 were 9 were 10 treated 10 treated 11 with 10 treated 13 on 11 with 12 fxcr 13 on 17 arms 14 the 17 arms 15 bilateral 17 arms 16 inner 17 arms prp was prepared from 10 ml of whole blood and applied on a randomly allocated side , with normal saline being used as the contralateral control . 0 ###LEFT-WALL### 1 prp 0 ###LEFT-WALL### 10 and 1 prp 2 was 2 was 10 and 3 prepared 4 from 3 prepared 10 and 4 from 6 ml 5 10 6 ml 6 ml 7 of 7 of 9 blood 8 whole 9 blood 10 and 11 applied 10 and 18 with 11 applied 12 on 12 on 16 side 13 a 16 side 14 randomly 15 allocated 15 allocated 16 side 17 , 18 with 18 with 20 saline 18 with 21 being 18 with 27 . 19 normal 20 saline 21 being 22 used 22 used 23 as 23 as 26 control 24 the 26 control 25 contralateral 26 control transepidermal water loss ( tewl ) and skin color were measured on both sides . 0 ###LEFT-WALL### 2 water 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 . 1 transepidermal 2 water 2 water 3 loss 3 loss 5 tewl 4 ( 5 tewl 5 tewl 6 ) 7 and 9 color 7 and 10 were 8 skin 9 color 9 color 10 were 10 were 11 measured 11 measured 12 on 12 on 14 sides 13 both 14 sides skin [biopsies] were also taken from five subjects on day 28 . 0 ###LEFT-WALL### 1 skin 0 ###LEFT-WALL### 5 taken 0 ###LEFT-WALL### 12 . 1 skin 3 were 3 were 5 taken 4 also 5 taken 5 taken 6 from 5 taken 9 on 6 from 8 subjects 7 five 8 subjects 9 on 10 day 10 day 11 28 results : significantly faster recovery of tewl was seen on the prp - treated side . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 recovery 2 : 9 seen 2 : 13 - 2 : 16 . 3 significantly 4 faster 4 faster 5 recovery 5 recovery 6 of 5 recovery 8 was 6 of 7 tewl 8 was 9 seen 9 seen 10 on 10 on 12 prp 11 the 12 prp 13 - 15 side 14 treated 15 side the erythema index and melanin index on the prp [-] treated side were lower than on the control side . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 13 were 0 ###LEFT-WALL### 20 . 1 the 3 index 2 erythema 3 index 3 index 4 and 4 and 6 index 4 and 7 on 4 and 13 were 5 melanin 6 index 7 on 12 side 8 the 12 side 9 prp 11 treated 11 treated 12 side 13 were 14 lower 14 lower 15 than 15 than 16 on 16 on 19 side 17 the 19 side 18 control 19 side biopsy specimens from the prp - treated side [showed] thicker collagen bundles than those from the control side . 0 ###LEFT-WALL### 1 biopsy 0 ###LEFT-WALL### 6 - 1 biopsy 2 specimens 2 specimens 3 from 3 from 5 prp 4 the 5 prp 6 - 12 bundles 6 - 13 than 6 - 19 . 7 treated 8 side 8 side 12 bundles 10 thicker 11 collagen 11 collagen 12 bundles 13 than 14 those 13 than 18 side 14 those 15 from 14 those 18 side 15 from 17 control 16 the 17 control conclusion : application of autologous prp is an effective method for enhancing wound healing and reducing transient adverse effects after fxcr treatment . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 application 2 : 7 is 3 application 4 of 3 application 7 is 4 of 6 prp 5 autologous 6 prp 7 is 15 and 8 an 10 method 9 effective 10 method 10 method 11 for 10 method 15 and 11 for 12 enhancing 12 enhancing 14 healing 13 wound 14 healing 15 and 19 effects 15 and 20 after 16 reducing 19 effects 17 transient 19 effects 18 adverse 19 effects 20 after 22 treatment 21 fxcr 22 treatment introduction : the growing and aging of the end - stage kidney disease population , and improvements in short - term kidney transplant outcomes , have increased the number of patients receiving and living with kidney transplants who are at risk for the long - term complications of transplantation . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 50 . 2 : 5 and 2 : 25 , 3 the 4 growing 4 growing 5 and 5 and 6 aging 5 and 16 and 6 aging 7 of 7 of 9 end 8 the 9 end 10 - 16 and 11 stage 12 kidney 12 kidney 13 disease 13 disease 14 population 14 population 16 and 15 , 16 and 16 and 17 improvements 16 and 18 in 16 and 25 , 18 in 24 outcomes 19 short 20 - 19 short 21 term 21 term 24 outcomes 22 kidney 23 transplant 23 transplant 24 outcomes 25 , 26 have 26 have 27 increased 27 increased 33 and 27 increased 35 with 28 the 29 number 29 number 30 of 29 number 33 and 30 of 33 and 31 patients 32 receiving 31 patients 33 and 33 and 34 living 35 with 37 transplants 36 kidney 37 transplants 37 transplants 38 who 37 transplants 39 are 38 who 39 are 39 are 40 at 39 are 42 for 40 at 41 risk 42 for 47 complications 43 the 47 complications 44 long 45 - 44 long 46 term 46 term 47 complications 47 complications 48 of 48 of 49 transplantation cancer has become a major cause of death following kidney transplantation , increasing the need to better understand the risk of post [-] transplant malignancy and to adapt patient management to minimize that risk . 0 ###LEFT-WALL### 1 cancer 0 ###LEFT-WALL### 3 become 1 cancer 2 has 2 has 3 become 3 become 6 cause 4 a 5 major 4 a 6 cause 5 major 6 cause 6 cause 7 of 6 cause 9 following 6 cause 13 increasing 7 of 8 death 9 following 11 transplantation 10 kidney 11 transplantation 12 , 13 increasing 13 increasing 15 need 13 increasing 35 . 14 the 15 need 15 need 16 to 15 need 26 and 16 to 26 and 17 better 18 understand 18 understand 20 risk 18 understand 26 and 19 the 20 risk 20 risk 21 of 21 of 25 malignancy 22 post 25 malignancy 24 transplant 25 malignancy 26 and 27 to 26 and 28 adapt 26 and 31 to 27 to 28 adapt 28 adapt 30 management 29 patient 30 management 31 to 32 minimize 32 minimize 34 risk 33 that 34 risk areas covered : this paper reviews the scope of the problem of post - transplant malignancy , its pathogenesis , and strategies for prevention , with attention to the impact of various immunosuppressive strategies . 0 ###LEFT-WALL### 2 covered 0 ###LEFT-WALL### 3 : 1 areas 2 covered 3 : 5 paper 3 : 6 reviews 3 : 35 . 4 this 5 paper 5 paper 6 reviews 6 reviews 8 scope 6 reviews 26 with 7 the 8 scope 8 scope 9 of 8 scope 12 of 8 scope 16 malignancy 8 scope 21 and 9 of 11 problem 10 the 11 problem 12 of 13 post 14 - 16 malignancy 15 transplant 16 malignancy 16 malignancy 17 , 17 , 21 and 18 its 19 pathogenesis 19 pathogenesis 21 and 20 , 21 and 21 and 22 strategies 21 and 23 for 21 and 25 , 23 for 24 prevention 26 with 27 attention 26 with 28 to 28 to 30 impact 29 the 30 impact 30 impact 31 of 31 of 34 strategies 32 various 34 strategies 33 immunosuppressive 34 strategies a medline search was conducted , reviewing english - language publications from 1948 to february 2011 . 0 ###LEFT-WALL### 3 search 0 ###LEFT-WALL### 5 conducted 1 a 3 search 2 medline 3 search 3 search 4 was 4 was 5 conducted 5 conducted 7 reviewing 6 , 7 reviewing 7 reviewing 11 publications 7 reviewing 14 to 7 reviewing 17 . 8 english 9 - 8 english 10 language 10 language 11 publications 11 publications 12 from 12 from 13 1948 14 to 15 february 15 february 16 2011 expert opinion : post - transplant malignancy , one of the most common causes of death following transplantation , is linked to both modifiable [and] [non] - modifiable risk factors . 0 ###LEFT-WALL### 1 expert 0 ###LEFT-WALL### 21 linked 0 ###LEFT-WALL### 31 . 1 expert 2 opinion 1 expert 4 post 1 expert 7 malignancy 1 expert 20 is 2 opinion 3 : 3 : 4 post 5 - 7 malignancy 6 transplant 7 malignancy 7 malignancy 9 one 7 malignancy 19 , 8 , 9 one 9 one 10 of 9 one 15 of 9 one 17 following 9 one 19 , 10 of 14 causes 11 the 12 most 12 most 14 causes 13 common 14 causes 15 of 16 death 17 following 18 transplantation 20 is 21 linked 21 linked 22 to 22 to 30 factors 23 both 30 factors 24 modifiable 27 - 24 modifiable 30 factors 28 modifiable 30 factors 29 risk 30 factors the current armamentarium of pharmacotherapy and the possibilities for immunologic monitoring in the future hold the potential for tailoring post - transplant care to minimize the risk of post - transplant malignancy without sacrificing graft survival to optimize outcomes following transplantation . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 15 hold 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 42 . 1 the 3 armamentarium 2 current 3 armamentarium 3 armamentarium 4 of 3 armamentarium 6 and 4 of 5 pharmacotherapy 6 and 8 possibilities 6 and 12 in 6 and 15 hold 7 the 8 possibilities 8 possibilities 9 for 9 for 11 monitoring 10 immunologic 11 monitoring 12 in 14 future 13 the 14 future 15 hold 17 potential 16 the 17 potential 17 potential 18 for 18 for 19 tailoring 19 tailoring 20 post 20 post 23 care 21 - 23 care 22 transplant 23 care 23 care 24 to 23 care 25 minimize 23 care 30 - 24 to 25 minimize 25 minimize 27 risk 26 the 27 risk 27 risk 28 of 28 of 29 post 30 - 31 transplant 31 transplant 32 malignancy 31 transplant 37 to 32 malignancy 33 without 33 without 36 survival 34 sacrificing 36 survival 35 graft 36 survival 37 to 38 optimize 38 optimize 39 outcomes 39 outcomes 40 following 40 following 41 transplantation the effect of daily ingestion of collagen hydrolysate ( ch ) on skin extracellular matrix proteins was investigated . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 18 investigated 0 ###LEFT-WALL### 19 . 1 the 2 effect 2 effect 3 of 2 effect 17 was 3 of 5 ingestion 4 daily 5 ingestion 5 ingestion 6 of 5 ingestion 12 on 6 of 8 hydrolysate 7 collagen 8 hydrolysate 8 hydrolysate 10 ch 9 ( 10 ch 10 ch 11 ) 12 on 16 proteins 13 skin 16 proteins 14 extracellular 15 matrix 15 matrix 16 proteins 17 was 18 investigated four - week [-] old male wistar rats were fed a modified ain - 93 diet containing 12 % casein as the reference group or ch as the treatment group . 0 ###LEFT-WALL### 1 four 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 30 group 0 ###LEFT-WALL### 31 . 2 - 7 wistar 2 - 10 fed 2 - 14 - 3 week 7 wistar 5 old 7 wistar 6 male 7 wistar 7 wistar 8 rats 7 wistar 9 were 7 wistar 10 fed 8 rats 9 were 10 fed 13 ain 11 a 13 ain 12 modified 13 ain 14 - 20 casein 15 93 16 diet 16 diet 20 casein 17 containing 20 casein 18 12 19 % 19 % 20 casein 20 casein 21 as 20 casein 25 or 20 casein 30 group 21 as 23 reference 22 the 23 reference 24 group 25 or 25 or 26 ch 25 or 27 as 25 or 30 group 27 as 29 treatment 28 the 29 treatment a control group [was] established in which animals were fed a [non] [-] protein - modified ain - 93 diet . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 21 . 1 a 2 control 1 a 3 group 2 control 3 group 3 group 5 established 3 group 6 in 3 group 10 fed 6 in 7 which 6 in 8 animals 6 in 9 were 8 animals 9 were 10 fed 14 protein 11 a 14 protein 15 - 17 ain 15 - 18 - 16 modified 17 ain 18 - 20 diet 19 93 20 diet the diets were administered continuously for 4 weeks when six fresh skin samples from each group were assembled and subjected to extraction of protein . 0 ###LEFT-WALL### 2 diets 0 ###LEFT-WALL### 4 administered 0 ###LEFT-WALL### 25 . 1 the 2 diets 2 diets 3 were 3 were 4 administered 4 administered 5 continuously 4 administered 6 for 4 administered 9 when 6 for 8 weeks 7 4 8 weeks 9 when 13 samples 9 when 19 and 10 six 13 samples 11 fresh 12 skin 12 skin 13 samples 13 samples 14 from 13 samples 17 were 14 from 16 group 15 each 16 group 17 were 19 and 18 assembled 19 and 19 and 20 subjected 19 and 21 to 21 to 22 extraction 22 extraction 23 of 23 of 24 protein type i and iv collagens were studied by [immunoblot] , and activities of matrix metalloproteinase ( mmp ) 2 and 9 were assessed by zymography . 0 ###LEFT-WALL### 1 type 0 ###LEFT-WALL### 26 . 1 type 11 and 2 i 3 and 3 and 4 iv 3 and 5 collagens 3 and 8 by 3 and 11 and 5 collagens 6 were 6 were 7 studied 7 studied 8 by 10 , 11 and 11 and 12 activities 11 and 13 of 11 and 20 and 11 and 22 were 11 and 23 assessed 13 of 15 metalloproteinase 14 matrix 15 metalloproteinase 15 metalloproteinase 17 mmp 16 ( 17 mmp 17 mmp 18 ) 19 2 20 and 20 and 21 9 20 and 22 were 23 assessed 24 by 24 by 25 zymography the relative amount of type i and iv collagens was [significantly] ( p < .05[!] ) increased after ch intake compared with the reference diet group ( casein ) . 0 ###LEFT-WALL### 3 amount 0 ###LEFT-WALL### 17 increased 0 ###LEFT-WALL### 30 . 1 the 3 amount 2 relative 3 amount 3 amount 4 of 3 amount 10 was 4 of 9 collagens 5 type 9 collagens 6 i 7 and 7 and 8 iv 7 and 9 collagens 10 was 14 < 10 was 17 increased 12 ( 14 < 13 p 14 < 14 < 15 .05[!] 14 < 16 ) 17 increased 18 after 18 after 20 intake 18 after 21 compared 19 ch 20 intake 20 intake 21 compared 21 compared 22 with 22 with 26 group 23 the 26 group 24 reference 26 group 25 diet 26 group 26 group 28 casein 27 ( 28 casein 28 casein 29 ) moreover , ch uptake significantly decreased both proenzyme and active forms of mmp2 compared with casein and control groups ( p < .05[!] ) . 0 ###LEFT-WALL### 4 uptake 0 ###LEFT-WALL### 6 decreased 0 ###LEFT-WALL### 25 . 1 moreover 2 , 1 moreover 4 uptake 3 ch 4 uptake 4 uptake 6 decreased 5 significantly 6 decreased 6 decreased 11 forms 7 both 11 forms 8 proenzyme 9 and 9 and 10 active 9 and 11 forms 11 forms 12 of 11 forms 14 compared 11 forms 22 < 12 of 13 mmp2 14 compared 15 with 15 with 17 and 16 casein 17 and 17 and 19 groups 18 control 19 groups 20 ( 22 < 21 p 22 < 22 < 23 .05[!] 22 < 24 ) in contrast , ch ingestion did not influence on mmp9 activity . 0 ###LEFT-WALL### 5 ingestion 0 ###LEFT-WALL### 8 influence 0 ###LEFT-WALL### 12 . 1 in 2 contrast 1 in 3 , 1 in 5 ingestion 4 ch 5 ingestion 5 ingestion 6 did 6 did 7 not 6 did 8 influence 8 influence 9 on 8 influence 11 activity 9 on 10 mmp9 these results suggest that ch may reduce aging - related changes of the extracellular matrix by stimulating anabolic processes in skin tissue . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 10 related 1 these 2 results 2 results 3 suggest 3 suggest 4 that 4 that 5 ch 4 that 7 reduce 5 ch 6 may 6 may 7 reduce 7 reduce 8 aging 9 - 10 related 10 related 11 changes 10 related 16 by 10 related 20 in 10 related 23 . 11 changes 12 of 12 of 15 matrix 13 the 15 matrix 14 extracellular 15 matrix 16 by 19 processes 17 stimulating 19 processes 18 anabolic 19 processes 20 in 22 tissue 21 skin 22 tissue differences in the time [of] onset and magnitude [of] terminal decline were examined in three cognitive domains : processing speed , episodic memory , and global function . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 13 examined 0 ###LEFT-WALL### 18 : 0 ###LEFT-WALL### 28 . 1 differences 2 in 1 differences 7 and 2 in 6 onset 3 the 6 onset 4 time 6 onset 7 and 11 decline 7 and 12 were 8 magnitude 11 decline 10 terminal 11 decline 12 were 13 examined 13 examined 14 in 14 in 17 domains 15 three 17 domains 16 cognitive 17 domains 18 : 25 and 18 : 27 function 19 processing 20 speed 19 processing 21 , 19 processing 25 and 22 episodic 23 memory 23 memory 25 and 24 , 25 and 25 and 26 global 25 and 27 function in addition , cognitive reserve was investigated by testing whether education affected the onset or rate of [decline] across these domains . 0 ###LEFT-WALL### 5 reserve 0 ###LEFT-WALL### 7 investigated 0 ###LEFT-WALL### 22 . 1 in 2 addition 1 in 3 , 1 in 5 reserve 4 cognitive 5 reserve 5 reserve 6 was 6 was 7 investigated 7 investigated 8 by 8 by 9 testing 9 testing 10 whether 10 whether 11 education 10 whether 12 affected 11 education 12 affected 12 affected 15 or 13 the 14 onset 14 onset 15 or 15 or 16 rate 15 or 17 of 17 of 19 across 19 across 21 domains 20 these 21 domains eight hundred ninety - six community [-] dwelling australian adults aged ≥ 70 years were assessed up to four times over 12 years , with vital status followed for 17 years . 0 ###LEFT-WALL### 3 ninety 0 ###LEFT-WALL### 12 ≥ 1 eight 2 hundred 2 hundred 3 ninety 3 ninety 10 adults 3 ninety 11 aged 3 ninety 12 ≥ 4 - 5 six 5 six 10 adults 6 community 8 dwelling 8 dwelling 10 adults 9 australian 10 adults 10 adults 11 aged 12 ≥ 20 times 13 70 14 years 13 70 18 to 14 years 15 were 15 were 16 assessed 16 assessed 17 up 18 to 19 four 18 to 20 times 20 times 21 over 21 over 23 years 22 12 23 years 23 years 25 with 24 , 25 with 25 with 27 status 25 with 28 followed 25 with 32 . 26 vital 27 status 28 followed 29 for 29 for 31 years 30 17 31 years change points were then assessed separately for high - and low - education groups . 0 ###LEFT-WALL### 2 points 0 ###LEFT-WALL### 5 assessed 0 ###LEFT-WALL### 15 . 1 change 2 points 2 points 3 were 3 were 4 then 3 were 5 assessed 5 assessed 6 separately 5 assessed 7 for 7 for 10 and 8 high 10 and 9 - 10 and 10 and 14 groups 11 low 12 - 11 low 14 groups 13 education 14 groups the change points were 8.5 years for processing speed ( 95 % ci : 6.0 - 11.2 years ) , 7.1 years for global function [(] 6.2 - 9.3 ) , and 6.6 years for episodic memory ( 5.3 - 7.1 ) . 0 ###LEFT-WALL### 3 points 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 43 . 1 the 3 points 2 change 3 points 3 points 4 were 4 were 6 years 5 8.5 6 years 6 years 7 for 7 for 9 speed 8 processing 9 speed 9 speed 18 years 10 ( 18 years 11 95 13 ci 12 % 13 ci 13 ci 14 : 14 : 16 - 15 6.0 16 - 16 - 17 11.2 17 11.2 18 years 18 years 19 ) 20 , 32 and 21 7.1 22 years 22 years 23 for 22 years 29 9.3 22 years 32 and 23 for 25 function 24 global 25 function 25 function 27 6.2 28 - 29 9.3 29 9.3 30 ) 31 , 32 and 32 and 34 years 32 and 35 for 33 6.6 34 years 35 for 37 memory 36 episodic 37 memory 37 memory 40 - 38 ( 40 - 39 5.3 40 - 40 - 41 7.1 40 - 42 ) the rate [of] decline was two to four times greater in the terminal phase relative to the preterminal phase , depending on the domain . 0 ###LEFT-WALL### 4 decline 0 ###LEFT-WALL### 5 was 1 the 4 decline 2 rate 4 decline 4 decline 5 was 5 was 10 greater 6 two 7 to 7 to 8 four 7 to 9 times 9 times 10 greater 10 greater 11 in 11 in 14 phase 12 the 14 phase 13 terminal 14 phase 14 phase 15 relative 15 relative 16 to 16 to 19 phase 17 the 19 phase 18 preterminal 19 phase 19 phase 21 depending 20 , 21 depending 21 depending 22 on 21 depending 25 . 22 on 24 domain 23 the 24 domain increased education changed the terminal decline effect differently for each of the three tests , either [by] significantly hastening the onset of terminal decline [and] decreasing the rate of decline , [or] by increasing the rate of either preterminal or terminal decline . 0 ###LEFT-WALL### 2 education 0 ###LEFT-WALL### 3 changed 1 increased 2 education 2 education 3 changed 3 changed 7 effect 3 changed 8 differently 4 the 7 effect 5 terminal 7 effect 6 decline 7 effect 8 differently 9 for 9 for 14 tests 10 each 11 of 10 each 14 tests 11 of 14 tests 12 the 14 tests 13 three 14 tests 14 tests 19 hastening 15 , 19 hastening 16 either 19 hastening 18 significantly 19 hastening 19 hastening 21 onset 20 the 21 onset 21 onset 22 of 21 onset 26 decreasing 21 onset 33 by 22 of 24 decline 23 terminal 24 decline 26 decreasing 28 rate 27 the 28 rate 28 rate 29 of 29 of 30 decline 31 , 33 by 33 by 34 increasing 33 by 43 . 34 increasing 36 rate 35 the 36 rate 36 rate 37 of 37 of 40 or 38 either 40 or 39 preterminal 40 or 40 or 42 decline 40 or 43 . 41 terminal 42 decline analyses were repeated excluding participants diagnosed with dementia , with no substantive change to the outcomes . 0 ###LEFT-WALL### 1 analyses 0 ###LEFT-WALL### 2 were 1 analyses 2 were 2 were 5 participants 3 repeated 5 participants 4 excluding 5 participants 5 participants 6 diagnosed 5 participants 7 with 5 participants 10 with 7 with 8 dementia 9 , 10 with 10 with 13 change 10 with 17 . 11 no 13 change 12 substantive 13 change 13 change 14 to 14 to 16 outcomes 15 the 16 outcomes in conclusion , the rate and onset [of] terminal decline varied somewhat across cognitive domains . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 16 . 1 in 2 conclusion 2 conclusion 3 , 3 , 5 rate 3 , 6 and 4 the 5 rate 6 and 10 decline 6 and 11 varied 7 onset 10 decline 9 terminal 10 decline 11 varied 12 somewhat 11 varied 13 across 13 across 15 domains 14 cognitive 15 domains education affected terminal [decline] differently across the domains , but this modification was not consistent with the predictions of cognitive reserve theory . 0 ###LEFT-WALL### 1 education 0 ###LEFT-WALL### 2 affected 0 ###LEFT-WALL### 23 . 1 education 2 affected 2 affected 22 theory 3 terminal 5 differently 3 terminal 10 but 5 differently 6 across 6 across 8 domains 7 the 8 domains 9 , 10 but 10 but 15 consistent 10 but 22 theory 11 this 12 modification 12 modification 13 was 13 was 14 not 14 not 15 consistent 15 consistent 16 with 16 with 18 predictions 17 the 18 predictions 18 predictions 19 of 19 of 21 reserve 20 cognitive 21 reserve self - referencing has been identified as an advantageous mnemonic strategy for young and older adults . 0 ###LEFT-WALL### 3 referencing 0 ###LEFT-WALL### 6 identified 0 ###LEFT-WALL### 17 . 1 self 2 - 1 self 3 referencing 3 referencing 4 has 4 has 5 been 5 been 6 identified 6 identified 7 as 7 as 11 strategy 8 an 9 advantageous 8 an 11 strategy 9 advantageous 11 strategy 10 mnemonic 11 strategy 11 strategy 12 for 12 for 16 adults 13 young 14 and 14 and 15 older 14 and 16 adults however , little research has investigated the ways in which [self] - referencing may influence older adults ' memory for details , which is typically impaired with age , beyond memory for the item itself . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 36 . 1 however 2 , 1 however 3 little 3 little 4 research 3 little 5 has 3 little 6 investigated 4 research 5 has 6 investigated 8 ways 7 the 8 ways 8 ways 9 in 9 in 10 which 12 - 13 referencing 12 - 15 influence 13 referencing 14 may 14 may 15 influence 15 influence 19 memory 15 influence 30 beyond 15 influence 32 for 15 influence 35 itself 16 older 17 adults 17 adults 18 ' 18 ' 19 memory 19 memory 20 for 19 memory 23 which 20 for 21 details 22 , 23 which 23 which 24 is 23 which 29 , 24 is 25 typically 24 is 27 with 25 typically 26 impaired 27 with 28 age 30 beyond 31 memory 32 for 34 item 33 the 34 item experiment 1 assessed the effects [of] self - and other - referencing on memory for visually detailed pictures of objects in thirty - two young and thirty - two older adults . 0 ###LEFT-WALL### 1 experiment 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 32 . 1 experiment 2 1 1 experiment 3 assessed 3 assessed 9 and 4 the 7 self 5 effects 7 self 7 self 9 and 8 - 9 and 9 and 10 other 9 and 11 - 9 and 12 referencing 12 referencing 13 on 12 referencing 21 in 12 referencing 31 adults 13 on 14 memory 14 memory 15 for 15 for 18 pictures 16 visually 17 detailed 17 detailed 18 pictures 18 pictures 19 of 19 of 20 objects 21 in 23 - 22 thirty 23 - 23 - 24 two 25 young 26 and 26 and 30 older 26 and 31 adults 27 thirty 28 - 28 - 29 two 28 - 30 older results indicate that self - and close [other] - referencing similarly [enhance] general ( [item] [ )(and specific ( detail ) recognition for both young and older adults relative to the distant other condition . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 35 . 1 results 6 and 2 indicate 4 self 2 indicate 6 and 3 that 4 self 5 - 6 and 6 and 7 close 6 and 34 condition 7 close 10 referencing 7 close 22 recognition 9 - 10 referencing 10 referencing 11 similarly 10 referencing 17 )(and 10 referencing 21 ) 13 general 17 )(and 14 ( 17 )(and 17 )(and 18 specific 17 )(and 20 detail 19 ( 20 detail 20 detail 21 ) 22 recognition 23 for 23 for 28 adults 24 both 28 adults 25 young 26 and 26 and 27 older 26 and 28 adults 28 adults 29 relative 29 relative 30 to 30 to 32 distant 31 the 32 distant 33 other 34 condition experiment 2 extended these findings to source memory , with young and older adults encoding verbal information in self [-] referent , semantic , and structural conditions . 0 ###LEFT-WALL### 1 experiment 0 ###LEFT-WALL### 7 source 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 28 . 1 experiment 2 2 1 experiment 3 extended 3 extended 5 findings 3 extended 6 to 4 these 5 findings 6 to 7 source 7 source 8 memory 8 memory 10 with 9 , 10 with 10 with 12 and 10 with 22 , 11 young 12 and 12 and 14 adults 12 and 15 encoding 13 older 14 adults 15 encoding 17 information 15 encoding 18 in 16 verbal 17 information 18 in 21 referent 19 self 21 referent 22 , 25 and 23 semantic 25 and 24 , 25 and 25 and 27 conditions 26 structural 27 conditions findings suggest that self - referencing provides an age [-] equivalent boost in general memory and specific memory for specific source details . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 23 . 1 findings 2 suggest 2 suggest 4 self 3 that 4 self 5 - 6 referencing 5 - 7 provides 6 referencing 7 provides 7 provides 12 boost 7 provides 13 in 8 an 9 age 8 an 12 boost 9 age 12 boost 11 equivalent 12 boost 13 in 16 and 14 general 15 memory 15 memory 16 and 16 and 18 memory 16 and 19 for 17 specific 18 memory 19 for 22 details 20 specific 21 source 21 source 22 details we conclude that the mnemonic benefits of referencing the self extend to specific memory for visual and verbal information across the lifespan . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 23 . 1 we 2 conclude 2 conclude 3 that 3 that 6 benefits 3 that 11 extend 4 the 6 benefits 5 mnemonic 6 benefits 6 benefits 7 of 6 benefits 11 extend 7 of 8 referencing 8 referencing 10 self 9 the 10 self 11 extend 12 to 11 extend 20 across 12 to 14 memory 13 specific 14 memory 14 memory 15 for 15 for 17 and 16 visual 17 and 17 and 19 information 18 verbal 19 information 20 across 22 lifespan 21 the 22 lifespan face cognition is considered a specific human ability , clearly differentiable from general cognitive functioning . 0 ###LEFT-WALL### 2 cognition 0 ###LEFT-WALL### 4 considered 1 face 2 cognition 2 cognition 3 is 3 is 4 considered 4 considered 8 ability 5 a 6 specific 5 a 8 ability 6 specific 8 ability 7 human 8 ability 8 ability 11 differentiable 9 , 11 differentiable 10 clearly 11 differentiable 11 differentiable 12 from 11 differentiable 16 . 12 from 15 functioning 13 general 15 functioning 14 cognitive 15 functioning its specificity is primarily supported by cognitive - [experimental] and neuroimaging research , but recently also from an individual differences perspective . 0 ###LEFT-WALL### 2 specificity 0 ###LEFT-WALL### 5 supported 0 ###LEFT-WALL### 22 . 1 its 2 specificity 2 specificity 3 is 3 is 5 supported 4 primarily 5 supported 5 supported 6 by 5 supported 14 but 5 supported 16 also 5 supported 17 from 6 by 10 and 7 cognitive 10 and 8 - 10 and 10 and 12 research 10 and 13 , 11 neuroimaging 12 research 14 but 15 recently 17 from 21 perspective 18 an 19 individual 18 an 21 perspective 19 individual 20 differences 20 differences 21 perspective however , no comprehensive behavioral data are available , which would allow estimating lifespan changes of the covariance structure of face [-] cognition abilities and general cognitive functioning as well as age - differences in face cognition after accounting for interindividual variability in general cognition . 0 ###LEFT-WALL### 6 data 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 9 , 1 however 2 , 1 however 6 data 3 no 6 data 4 comprehensive 6 data 5 behavioral 6 data 6 data 7 are 7 are 8 available 9 , 10 which 9 , 12 allow 10 which 11 would 11 would 12 allow 12 allow 13 estimating 12 allow 15 changes 12 allow 25 and 14 lifespan 15 changes 15 changes 16 of 15 changes 20 of 16 of 19 structure 17 the 19 structure 18 covariance 19 structure 20 of 24 abilities 21 face 24 abilities 23 cognition 24 abilities 25 and 28 functioning 26 general 28 functioning 27 cognitive 28 functioning 28 functioning 31 as 29 as 30 well 30 well 31 as 31 as 32 age 32 age 34 differences 33 - 34 differences 34 differences 35 in 34 differences 43 in 34 differences 46 . 35 in 37 cognition 36 face 37 cognition 37 cognition 38 after 37 cognition 40 for 38 after 39 accounting 40 for 42 variability 41 interindividual 42 variability 43 in 45 cognition 44 general 45 cognition the present study aimed to fill this gap . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 aimed 0 ###LEFT-WALL### 9 . 1 the 3 study 2 present 3 study 3 study 4 aimed 4 aimed 5 to 4 aimed 6 fill 5 to 6 fill 6 fill 8 gap 7 this 8 gap in an age - heterogeneous ( 18 - 82 years ) sample [of] 448 adults , we found no factorial dedifferentiation between face cognition and general cognition . 0 ###LEFT-WALL### 17 we 0 ###LEFT-WALL### 18 found 0 ###LEFT-WALL### 28 . 1 in 3 age 1 in 16 , 1 in 17 we 2 an 3 age 3 age 15 adults 4 - 15 adults 5 heterogeneous 12 sample 6 ( 8 - 7 18 8 - 8 - 10 years 8 - 11 ) 8 - 12 sample 9 82 10 years 12 sample 15 adults 14 448 15 adults 15 adults 16 , 17 we 18 found 18 found 21 dedifferentiation 18 found 22 between 19 no 21 dedifferentiation 20 factorial 21 dedifferentiation 22 between 25 and 23 face 24 cognition 24 cognition 25 and 25 and 27 cognition 26 general 27 cognition age - related differences in face memory were still salient after taking into account changes in general cognitive functioning . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 20 . 1 age 8 were 2 - 3 related 3 related 4 differences 3 related 5 in 3 related 8 were 5 in 7 memory 6 face 7 memory 8 were 9 still 8 were 10 salient 10 salient 11 after 11 after 12 taking 11 after 15 changes 12 taking 14 account 12 taking 15 changes 13 into 14 account 15 changes 16 in 15 changes 19 functioning 17 general 19 functioning 18 cognitive 19 functioning face cognition thus remains a specific human ability compared with general cognition , even until old age . 0 ###LEFT-WALL### 2 cognition 0 ###LEFT-WALL### 4 remains 0 ###LEFT-WALL### 18 . 1 face 2 cognition 2 cognition 4 remains 3 thus 4 remains 4 remains 8 ability 5 a 6 specific 5 a 8 ability 6 specific 8 ability 7 human 8 ability 8 ability 9 compared 9 compared 10 with 9 compared 13 , 9 compared 14 even 10 with 12 cognition 11 general 12 cognition 14 even 15 until 15 until 17 age 16 old 17 age we discuss implications for models of cognitive aging and suggest that it is necessary to include more explicitly special social abilities in those models . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 25 . 1 we 9 and 2 discuss 3 implications 2 discuss 4 for 2 discuss 9 and 4 for 5 models 5 models 6 of 6 of 8 aging 7 cognitive 8 aging 9 and 10 suggest 9 and 18 explicitly 9 and 21 abilities 10 suggest 11 that 11 that 12 it 11 that 13 is 12 it 13 is 13 is 14 necessary 14 necessary 15 to 14 necessary 16 include 15 to 16 include 17 more 18 explicitly 19 special 21 abilities 20 social 21 abilities 21 abilities 22 in 22 in 24 models 23 those 24 models we charted daily variations in intrusive thoughts to gain access to adult age differences in affective reactivity to daily stressors . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 charted 0 ###LEFT-WALL### 21 . 1 we 2 charted 2 charted 4 variations 2 charted 5 in 2 charted 8 to 2 charted 11 to 2 charted 18 to 3 daily 4 variations 5 in 7 thoughts 6 intrusive 7 thoughts 8 to 9 gain 9 gain 10 access 11 to 14 differences 12 adult 14 differences 13 age 14 differences 14 differences 15 in 15 in 17 reactivity 16 affective 17 reactivity 18 to 20 stressors 19 daily 20 stressors on 100 days , 101 [younger] and 103 older adults reported stressors , intrusive thoughts , and negative [affect] . 0 ###LEFT-WALL### 10 adults 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 20 . 1 on 3 days 1 on 4 , 1 on 10 adults 2 100 3 days 5 101 7 and 7 and 8 103 7 and 10 adults 9 older 10 adults 10 adults 17 and 11 reported 12 stressors 11 reported 17 and 12 stressors 15 thoughts 13 , 15 thoughts 14 intrusive 15 thoughts 15 thoughts 16 , 16 , 17 and 17 and 18 negative although increments in intrusive thoughts were similar in both age groups on days with stressors , older adults ' negative [affect] increased less than younger adults ' on such days . 0 ###LEFT-WALL### 20 negative 0 ###LEFT-WALL### 22 increased 0 ###LEFT-WALL### 31 . 1 although 2 increments 1 although 6 were 1 although 16 , 1 although 20 negative 2 increments 3 in 2 increments 6 were 3 in 5 thoughts 4 intrusive 5 thoughts 6 were 7 similar 7 similar 8 in 7 similar 12 on 8 in 11 groups 9 both 11 groups 10 age 11 groups 12 on 13 days 13 days 14 with 14 with 15 stressors 17 older 18 adults 18 adults 19 ' 19 ' 20 negative 20 negative 22 increased 22 increased 23 less 22 increased 24 than 24 than 27 ' 24 than 28 on 25 younger 26 adults 26 adults 27 ' 28 on 30 days 29 such 30 days relative to younger adults , all three associations were reduced in older adults . 0 ###LEFT-WALL### 8 associations 0 ###LEFT-WALL### 10 reduced 0 ###LEFT-WALL### 14 . 1 relative 2 to 1 relative 5 , 1 relative 8 associations 2 to 4 adults 3 younger 4 adults 6 all 7 three 7 three 8 associations 8 associations 9 were 9 were 10 reduced 10 reduced 11 in 11 in 13 adults 12 older 13 adults we tentatively conclude that normal aging dampens the stress [-] induced link between intrusive thoughts and affect . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 18 . 1 we 16 and 2 tentatively 3 conclude 3 conclude 6 aging 3 conclude 7 dampens 3 conclude 16 and 4 that 6 aging 5 normal 6 aging 6 aging 7 dampens 7 dampens 12 link 7 dampens 13 between 8 the 12 link 9 stress 11 induced 11 induced 12 link 13 between 15 thoughts 14 intrusive 15 thoughts 16 and 17 affect this dampening may contribute to preserved affective well - being and reduced affective reactivity to daily stress in old age . 0 ###LEFT-WALL### 2 dampening 0 ###LEFT-WALL### 4 contribute 0 ###LEFT-WALL### 9 - 1 this 2 dampening 2 dampening 3 may 3 may 4 contribute 4 contribute 5 to 5 to 8 well 6 preserved 8 well 7 affective 8 well 9 - 11 and 9 - 21 . 10 being 11 and 11 and 14 reactivity 11 and 15 to 12 reduced 14 reactivity 13 affective 14 reactivity 15 to 17 stress 16 daily 17 stress 17 stress 18 in 18 in 20 age 19 old 20 age this study examined competing substantive hypotheses about dynamic ( i.e [.] , time - ordered ) links between memory and functional limitations in old age . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 26 . 1 this 2 study 2 study 3 examined 3 examined 6 hypotheses 4 competing 6 hypotheses 5 substantive 6 hypotheses 6 hypotheses 7 about 6 hypotheses 18 between 7 about 17 links 8 dynamic 13 time 8 dynamic 16 ) 8 dynamic 17 links 9 ( 13 time 10 i.e 12 , 10 i.e 13 time 13 time 15 ordered 13 time 16 ) 14 - 15 ordered 15 ordered 16 ) 18 between 20 and 19 memory 20 and 20 and 22 limitations 20 and 23 in 21 functional 22 limitations 23 in 25 age 24 old 25 age we applied the bivariate dual change score model to 13 - year longitudinal data from the asset and health dynamics among the oldest [old] study ( ahead [;] n = 6,990 [;] ages 70 - 95 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 applied 0 ###LEFT-WALL### 38 . 1 we 2 applied 2 applied 8 model 2 applied 9 to 3 the 8 model 4 bivariate 5 dual 5 dual 6 change 6 change 7 score 7 score 8 model 9 to 10 13 10 13 14 data 11 - 14 data 12 year 14 data 13 longitudinal 14 data 14 data 15 from 14 data 37 ) 15 from 21 among 16 the 21 among 17 asset 18 and 18 and 19 health 19 health 20 dynamics 20 dynamics 21 among 21 among 27 ahead 21 among 33 ages 22 the 27 ahead 23 oldest 25 study 25 study 27 ahead 26 ( 27 ahead 27 ahead 30 = 27 ahead 33 ages 29 n 30 = 30 = 31 6,990 33 ages 35 - 34 70 35 - 35 - 36 95 results revealed that better memory predicted shallower increases in functional limitations . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 revealed 0 ###LEFT-WALL### 12 . 1 results 2 revealed 2 revealed 3 that 3 that 5 memory 3 that 6 predicted 4 better 5 memory 5 memory 6 predicted 6 predicted 8 increases 6 predicted 9 in 7 shallower 8 increases 9 in 11 limitations 10 functional 11 limitations little evidence was found for the opposite direction that functional limitations predict ensuing changes in memory . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 17 . 1 little 2 evidence 2 evidence 3 was 3 was 4 found 4 found 5 for 4 found 15 in 5 for 8 direction 6 the 8 direction 7 opposite 8 direction 8 direction 9 that 8 direction 12 predict 9 that 11 limitations 9 that 12 predict 10 functional 11 limitations 11 limitations 12 predict 12 predict 14 changes 13 ensuing 14 changes 15 in 16 memory spline models indicated that dynamic associations between memory and functional limitations were substantively similar between participants aged 70 - 79 and those aged 80 - 95 . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 3 indicated 0 ###LEFT-WALL### 27 . 1 spline 2 models 2 models 3 indicated 3 indicated 4 that 4 that 9 and 4 that 12 were 5 dynamic 6 associations 6 associations 7 between 6 associations 9 and 7 between 8 memory 9 and 11 limitations 9 and 12 were 10 functional 11 limitations 12 were 13 substantively 12 were 14 similar 14 similar 15 between 15 between 21 and 16 participants 17 aged 16 participants 21 and 17 aged 19 - 18 70 19 - 19 - 20 79 21 and 22 those 21 and 23 aged 23 aged 25 - 24 80 25 - 25 - 26 95 potential covariates ( gender , education , health conditions , and depressive symptoms ) did not account for these differential lead - lag associations . 0 ###LEFT-WALL### 2 covariates 0 ###LEFT-WALL### 21 lead 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 25 . 1 potential 2 covariates 2 covariates 11 and 2 covariates 15 did 3 ( 11 and 4 gender 5 , 5 , 6 education 5 , 7 , 7 , 9 conditions 7 , 11 and 8 health 9 conditions 10 , 11 and 11 and 13 symptoms 11 and 14 ) 12 depressive 13 symptoms 15 did 16 not 15 did 17 account 17 account 18 for 18 for 20 differential 19 these 20 differential 20 differential 21 lead 22 - 24 associations 23 lag 24 associations applying a multivariate approach , our results suggest that late - life developments in two key components of successful aging are intrinsically interrelated . 0 ###LEFT-WALL### 7 results 0 ###LEFT-WALL### 8 suggest 0 ###LEFT-WALL### 24 . 1 applying 4 approach 1 applying 5 , 1 applying 7 results 2 a 4 approach 3 multivariate 4 approach 6 our 7 results 7 results 8 suggest 8 suggest 9 that 9 that 13 developments 9 that 23 interrelated 10 late 11 - 10 late 12 life 12 life 13 developments 13 developments 14 in 13 developments 18 of 13 developments 21 are 14 in 17 components 15 two 17 components 16 key 17 components 18 of 20 aging 19 successful 20 aging 21 are 23 interrelated 22 intrinsically 23 interrelated our discussion focuses on possible mechanisms [why] cognitive functioning may serve as a source of age - related changes in health [both] among the young - old and the old - old . 0 ###LEFT-WALL### 2 discussion 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 18 related 0 ###LEFT-WALL### 33 . 1 our 2 discussion 2 discussion 3 focuses 3 focuses 4 on 3 focuses 12 as 4 on 6 mechanisms 5 possible 6 mechanisms 6 mechanisms 9 functioning 6 mechanisms 11 serve 8 cognitive 9 functioning 9 functioning 10 may 10 may 11 serve 12 as 14 source 13 a 14 source 14 source 15 of 15 of 16 age 17 - 18 related 18 related 19 changes 19 changes 20 in 20 in 28 and 21 health 23 among 21 health 28 and 23 among 27 old 24 the 27 old 25 young 26 - 25 young 27 old 28 and 32 old 29 the 32 old 30 old 31 - 30 old 32 old how [do] [aging] and prior knowledge affect memory and metamemory ? 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 affect 0 ###LEFT-WALL### 11 ? 1 how 4 and 4 and 6 knowledge 4 and 7 affect 5 prior 6 knowledge 7 affect 9 and 8 memory 9 and 9 and 10 metamemory we explored this question in the context of a dual - process approach to judgments of learning ( jols ) , which require people to predict their ability to remember information at a later time . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 explored 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 36 . 1 we 2 explored 2 explored 4 question 2 explored 14 to 3 this 4 question 4 question 5 in 5 in 7 context 6 the 7 context 7 context 8 of 8 of 13 approach 9 a 10 dual 9 a 13 approach 10 dual 11 - 10 dual 13 approach 12 process 13 approach 14 to 15 judgments 15 judgments 16 of 15 judgments 19 jols 16 of 17 learning 18 ( 19 jols 19 jols 20 ) 21 , 22 which 21 , 23 require 22 which 23 require 23 require 24 people 23 require 25 to 23 require 29 to 23 require 30 remember 25 to 26 predict 26 predict 28 ability 27 their 28 ability 29 to 30 remember 30 remember 31 information 30 remember 32 at 32 at 35 time 33 a 35 time 34 later 35 time young and older adults ( n = 36 , mean ages [=] [20.2] [&] 73.1 ) studied the names of actors who were famous in [the] 1950 s or 1990 s , providing a jol for each . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 17 studied 1 young 2 and 2 and 4 adults 2 and 7 = 2 and 11 ages 2 and 17 studied 3 older 4 adults 5 ( 7 = 6 n 7 = 7 = 8 36 9 , 11 ages 10 mean 11 ages 11 ages 15 73.1 11 ages 16 ) 17 studied 19 names 18 the 19 names 19 names 20 of 20 of 21 actors 21 actors 22 who 21 actors 23 were 22 who 23 were 23 were 24 famous 24 famous 25 in 24 famous 33 providing 25 in 29 or 27 1950 28 s 28 s 29 or 29 or 31 s 30 1990 31 s 32 , 33 providing 33 providing 35 jol 33 providing 36 for 33 providing 38 . 34 a 35 jol 36 for 37 each recognition memory for studied [and] unstudied actors was then assessed using a recollect/know/no - memory ( r/k/n ) judgment task . 0 ###LEFT-WALL### 2 memory 0 ###LEFT-WALL### 10 assessed 0 ###LEFT-WALL### 21 . 1 recognition 2 memory 2 memory 3 for 2 memory 8 was 3 for 7 actors 4 studied 7 actors 6 unstudied 7 actors 8 was 9 then 8 was 10 assessed 10 assessed 11 using 11 using 20 task 12 a 20 task 13 recollect/know/no 15 memory 13 recollect/know/no 20 task 14 - 15 memory 15 memory 17 r/k/n 15 memory 18 ) 16 ( 17 r/k/n 17 r/k/n 18 ) 19 judgment 20 task results showed that prior knowledge increased recollection in both age groups such that older adults recollected significantly more 1950s actors than younger adults . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 showed 0 ###LEFT-WALL### 24 . 1 results 2 showed 2 showed 7 recollection 2 showed 8 in 2 showed 10 age 2 showed 11 groups 3 that 4 prior 4 prior 7 recollection 5 knowledge 6 increased 6 increased 7 recollection 8 in 9 both 10 age 11 groups 11 groups 13 that 11 groups 21 than 12 such 13 that 13 that 15 adults 13 that 16 recollected 14 older 15 adults 15 adults 16 recollected 16 recollected 20 actors 17 significantly 18 more 18 more 20 actors 19 1950s 20 actors 21 than 23 adults 22 younger 23 adults also , for both age groups and both decades , actors judged r at test garnered significantly higher jols at study than actors judged k or n . however , while the young showed benefits of prior knowledge on relative jol accuracy , older adults did not , showing lower levels of jol accuracy for 1950s actors despite having higher recollection [for] , and knowledge about , those actors . 0 ###LEFT-WALL### 1 also 0 ###LEFT-WALL### 22 than 0 ###LEFT-WALL### 28 . 1 also 11 actors 1 also 12 judged 2 , 3 for 3 for 7 and 3 for 10 , 3 for 11 actors 4 both 7 and 5 age 6 groups 6 groups 7 and 7 and 9 decades 8 both 9 decades 11 actors 12 judged 12 judged 13 r 12 judged 14 at 14 at 19 jols 15 test 16 garnered 16 garnered 19 jols 17 significantly 18 higher 18 higher 19 jols 19 jols 20 at 20 at 21 study 22 than 23 actors 22 than 24 judged 23 actors 24 judged 24 judged 26 or 25 k 26 or 26 or 27 n 28 . 45 adults 28 . 67 , 28 . 70 . 29 however 45 adults 30 , 31 while 31 while 33 young 31 while 34 showed 31 while 43 , 31 while 45 adults 32 the 33 young 33 young 34 showed 34 showed 35 benefits 34 showed 42 accuracy 35 benefits 36 of 36 of 38 knowledge 37 prior 38 knowledge 38 knowledge 39 on 39 on 41 jol 40 relative 41 jol 44 older 45 adults 45 adults 46 did 46 did 47 not 46 did 49 showing 48 , 49 showing 49 showing 51 levels 49 showing 55 for 49 showing 58 despite 49 showing 67 , 50 lower 51 levels 51 levels 52 of 52 of 54 accuracy 53 jol 54 accuracy 55 for 57 actors 56 1950s 57 actors 58 despite 59 having 59 having 64 and 59 having 66 about 60 higher 61 recollection 61 recollection 64 and 63 , 64 and 64 and 65 knowledge 67 , 69 actors 68 those 69 actors overall , the data suggest that prior knowledge can be a double - edged sword , increasing the availability of details that can support later recollection , but also increasing nondiagnostic feelings of familiarity that can reduce the accuracy of memory predictions . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 suggest 0 ###LEFT-WALL### 28 but 0 ###LEFT-WALL### 43 . 1 overall 2 , 1 overall 4 data 3 the 4 data 4 data 5 suggest 5 suggest 6 that 6 that 8 knowledge 6 that 10 be 7 prior 8 knowledge 8 knowledge 9 can 9 can 10 be 10 be 15 sword 11 a 12 double 11 a 15 sword 12 double 13 - 12 double 15 sword 14 edged 15 sword 15 sword 17 increasing 16 , 17 increasing 17 increasing 19 availability 17 increasing 27 , 18 the 19 availability 19 availability 20 of 20 of 21 details 21 details 22 that 21 details 23 can 22 that 23 can 23 can 24 support 24 support 26 recollection 25 later 26 recollection 27 , 28 but 28 but 32 feelings 28 but 37 reduce 29 also 32 feelings 30 increasing 32 feelings 31 nondiagnostic 32 feelings 32 feelings 33 of 32 feelings 35 that 32 feelings 36 can 32 feelings 37 reduce 33 of 34 familiarity 35 that 36 can 37 reduce 39 accuracy 38 the 39 accuracy 39 accuracy 40 of 40 of 42 predictions 41 memory 42 predictions two hundred participants , 50 in each of four age ranges ( 19 - 29 , 30 - 49 , 50 - 69 , 70 - 90 ) were tested for working memory , speed of processing , and the processing of sentences with relative clauses . 0 ###LEFT-WALL### 3 participants 0 ###LEFT-WALL### 47 . 1 two 2 hundred 2 hundred 3 participants 3 participants 5 50 3 participants 18 - 3 participants 29 were 4 , 5 50 5 50 6 in 5 50 8 of 5 50 10 age 5 50 11 ranges 5 50 14 - 5 50 16 , 6 in 7 each 8 of 9 four 10 age 11 ranges 12 ( 14 - 13 19 14 - 14 - 15 29 14 - 16 , 16 , 18 - 17 30 18 - 18 - 19 49 18 - 22 - 18 - 26 - 18 - 28 ) 20 , 22 - 21 50 22 - 22 - 23 69 22 - 24 , 24 , 26 - 25 70 26 - 26 - 27 90 26 - 28 ) 29 were 30 tested 30 tested 31 for 30 tested 44 with 31 for 32 working 32 working 39 and 33 memory 34 , 34 , 35 speed 34 , 39 and 35 speed 36 of 36 of 37 processing 38 , 39 and 39 and 41 processing 39 and 42 of 40 the 41 processing 42 of 43 sentences 44 with 46 clauses 45 relative 46 clauses in experiment 1 , participants read four sentence types ( cleft subject , cleft object , subject - subject , subject - object ) in a word - by [-] word , [non] - cumulative , self [-] paced reading task and made speeded plausibility judgments about them . 0 ###LEFT-WALL### 5 participants 0 ###LEFT-WALL### 6 read 1 in 2 experiment 1 in 4 , 1 in 5 participants 2 experiment 3 1 5 participants 6 read 6 read 7 four 7 four 9 types 7 four 17 subject 8 sentence 9 types 9 types 15 object 9 types 17 subject 10 ( 15 object 11 cleft 15 object 12 subject 13 , 12 subject 15 object 14 cleft 15 object 15 object 16 , 17 subject 22 - 17 subject 25 in 18 - 22 - 19 subject 20 , 19 subject 21 subject 21 subject 22 - 22 - 23 object 22 - 24 ) 25 in 27 word 26 a 27 word 27 word 29 by 27 word 37 self 28 - 29 by 29 by 31 word 29 by 32 , 34 - 37 self 35 cumulative 36 , 35 cumulative 37 self 37 self 42 and 37 self 47 about 37 self 49 . 39 paced 41 task 39 paced 42 and 40 reading 41 task 42 and 43 made 43 made 45 plausibility 43 made 46 judgments 44 speeded 45 plausibility 47 about 48 them in experiment 2 , participants read two types of sentences , one of which contained a doubly [center] embedded relative clause . 0 ###LEFT-WALL### 12 one 0 ###LEFT-WALL### 15 contained 0 ###LEFT-WALL### 22 . 1 in 2 experiment 1 in 12 one 2 experiment 3 2 2 experiment 5 participants 4 , 5 participants 5 participants 6 read 5 participants 11 , 6 read 8 types 7 two 8 types 8 types 9 of 9 of 10 sentences 12 one 13 of 12 one 15 contained 13 of 14 which 15 contained 21 clause 16 a 21 clause 17 doubly 19 embedded 19 embedded 21 clause 20 relative 21 clause older participants ' comprehension was less accurate and there was age - related slowing of online processing times in all but the simplest sentences , which increased in syntactically complex sentences in experiment 1 . 0 ###LEFT-WALL### 4 comprehension 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 8 and 1 older 2 participants 2 participants 3 ' 3 ' 4 comprehension 4 comprehension 5 was 5 was 6 less 5 was 7 accurate 8 and 9 there 8 and 10 was 9 there 10 was 10 was 11 age 11 age 17 processing 12 - 13 related 13 related 14 slowing 13 related 17 processing 14 slowing 15 of 15 of 16 online 17 processing 18 times 17 processing 19 in 19 in 20 all 20 all 21 but 21 but 24 sentences 22 the 23 simplest 22 the 24 sentences 24 sentences 26 which 25 , 26 which 26 which 27 increased 26 which 35 . 27 increased 28 in 27 increased 32 in 28 in 31 sentences 29 syntactically 30 complex 30 complex 31 sentences 32 in 33 experiment 33 experiment 34 1 this pattern suggests an age - related decrease in the efficiency of parsing and interpretation . 0 ###LEFT-WALL### 2 pattern 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 7 related 1 this 2 pattern 2 pattern 3 suggests 3 suggests 5 age 4 an 5 age 6 - 7 related 7 related 8 decrease 7 related 9 in 7 related 16 . 9 in 14 and 10 the 11 efficiency 11 efficiency 12 of 11 efficiency 14 and 12 of 13 parsing 14 and 15 interpretation slower speed of processing and lower working memory were associated with longer online processing times only in experiment 2 , suggesting that task - related operations are related to general speed of processing and working memory . 0 ###LEFT-WALL### 8 memory 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 37 . 1 slower 8 memory 2 speed 3 of 2 speed 5 and 3 of 4 processing 5 and 6 lower 5 and 8 memory 7 working 8 memory 8 memory 9 were 9 were 10 associated 10 associated 11 with 11 with 15 times 11 with 16 only 11 with 17 in 12 longer 15 times 13 online 15 times 14 processing 15 times 17 in 18 experiment 18 experiment 19 2 20 , 26 operations 20 , 27 are 21 suggesting 22 that 21 suggesting 23 task 21 suggesting 24 - 21 suggesting 26 operations 25 related 26 operations 26 operations 27 are 27 are 34 and 28 related 29 to 28 related 34 and 29 to 31 speed 30 general 31 speed 31 speed 32 of 32 of 33 processing 34 and 35 working 34 and 36 memory lower working memory was not associated with longer reading times in more complex sentences , consistent with the view that general working memory is not critically involved in online syntactic processing . 0 ###LEFT-WALL### 3 memory 0 ###LEFT-WALL### 6 associated 0 ###LEFT-WALL### 32 . 1 lower 3 memory 2 working 3 memory 3 memory 4 was 4 was 5 not 4 was 6 associated 6 associated 7 with 6 associated 15 , 6 associated 16 consistent 7 with 10 times 8 longer 9 reading 9 reading 10 times 10 times 11 in 11 in 14 sentences 12 more 14 sentences 13 complex 14 sentences 16 consistent 17 with 17 with 19 view 17 with 25 not 17 with 27 involved 18 the 19 view 19 view 20 that 20 that 23 memory 20 that 24 is 21 general 23 memory 22 working 23 memory 23 memory 24 is 25 not 26 critically 26 critically 27 involved 27 involved 28 in 28 in 31 processing 29 online 31 processing 30 syntactic 31 processing longer online processing at the most demanding point in the most demanding sentence was associated with better comprehension , indicating that it reflects effective processing under some certain circumstances . 0 ###LEFT-WALL### 3 processing 0 ###LEFT-WALL### 15 associated 1 longer 3 processing 2 online 3 processing 3 processing 4 at 3 processing 14 was 4 at 8 point 5 the 8 point 6 most 7 demanding 7 demanding 8 point 8 point 9 in 9 in 13 sentence 10 the 13 sentence 11 most 12 demanding 12 demanding 13 sentence 14 was 15 associated 15 associated 16 with 16 with 18 comprehension 17 better 18 comprehension 18 comprehension 20 indicating 19 , 20 indicating 20 indicating 21 that 20 indicating 30 . 21 that 22 it 21 that 23 reflects 22 it 23 reflects 23 reflects 25 processing 23 reflects 26 under 24 effective 25 processing 26 under 29 circumstances 27 some 29 circumstances 28 certain 29 circumstances however , the poorer comprehension performance of older individuals indicates that their slower online processing reflects inefficient processing even at these points . 0 ###LEFT-WALL### 6 performance 0 ###LEFT-WALL### 10 indicates 0 ###LEFT-WALL### 23 . 1 however 2 , 1 however 6 performance 3 the 6 performance 4 poorer 5 comprehension 5 comprehension 6 performance 6 performance 7 of 6 performance 10 indicates 7 of 9 individuals 8 older 9 individuals 10 indicates 11 that 11 that 15 processing 11 that 16 reflects 12 their 15 processing 13 slower 15 processing 14 online 15 processing 15 processing 16 reflects 16 reflects 18 processing 17 inefficient 18 processing 18 processing 19 even 19 even 20 at 20 at 22 points 21 these 22 points some wood substances such as ellagitannins can be extracted during wine aging in oak barrels . 0 ###LEFT-WALL### 3 substances 0 ###LEFT-WALL### 9 extracted 0 ###LEFT-WALL### 16 . 1 some 3 substances 2 wood 3 substances 3 substances 5 as 3 substances 7 can 4 such 5 as 5 as 6 ellagitannins 7 can 8 be 8 be 9 extracted 9 extracted 10 during 10 during 11 wine 11 wine 12 aging 12 aging 13 in 13 in 15 barrels 14 oak 15 barrels the level of these hydrolyzable tannins in wine [depends] of some parameters of oak wood . 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 6 tannins 0 ###LEFT-WALL### 16 . 1 the 2 level 2 level 3 of 2 level 6 tannins 3 of 5 hydrolyzable 4 these 5 hydrolyzable 6 tannins 7 in 7 in 8 wine 8 wine 10 of 10 of 12 parameters 11 some 12 parameters 12 parameters 13 of 13 of 15 wood 14 oak 15 wood their impact on the organoleptic perception of red wine is poorly known . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 12 known 0 ###LEFT-WALL### 13 . 1 their 2 impact 2 impact 3 on 2 impact 10 is 3 on 6 perception 4 the 6 perception 5 organoleptic 6 perception 6 perception 7 of 7 of 9 wine 8 red 9 wine 10 is 12 known 11 poorly 12 known in our research , oak staves were classified in three different groups according to their level of ellagitannins estimated by nirs ( near infrared spectroscopy ) online procedure ( oakscan ) . 0 ###LEFT-WALL### 5 oak 0 ###LEFT-WALL### 8 classified 0 ###LEFT-WALL### 32 . 1 in 3 research 1 in 4 , 1 in 5 oak 2 our 3 research 5 oak 6 staves 5 oak 7 were 5 oak 8 classified 6 staves 7 were 8 classified 9 in 8 classified 14 to 8 classified 28 procedure 9 in 12 groups 10 three 12 groups 11 different 12 groups 13 according 14 to 14 to 16 level 15 their 16 level 16 level 17 of 17 of 18 ellagitannins 18 ellagitannins 19 estimated 19 estimated 20 by 19 estimated 23 near 20 by 21 nirs 22 ( 23 near 23 near 25 spectroscopy 23 near 26 ) 24 infrared 25 spectroscopy 27 online 28 procedure 28 procedure 30 oakscan 29 ( 30 oakscan 30 oakscan 31 ) first , the ellagitannin level and composition were determine for each classified stave and an excellent correlation between the nirs classification ( low , medium and high potential level of ellagitannin ) and the ellagitannin content estimated by hplc - uv was found . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 44 . 1 first 2 , 1 first 6 and 3 the 5 level 4 ellagitannin 5 level 5 level 6 and 6 and 7 composition 6 and 8 were 8 were 9 determine 9 determine 10 for 9 determine 41 uv 9 determine 43 found 10 for 14 and 11 each 13 stave 12 classified 13 stave 13 stave 14 and 14 and 17 correlation 14 and 18 between 15 an 17 correlation 16 excellent 17 correlation 18 between 21 classification 19 the 21 classification 20 nirs 21 classification 21 classification 33 and 22 ( 33 and 23 low 24 , 24 , 25 medium 24 , 26 and 26 and 29 level 26 and 32 ) 26 and 33 and 27 high 29 level 28 potential 29 level 29 level 30 of 30 of 31 ellagitannin 33 and 36 content 33 and 40 - 34 the 36 content 35 ellagitannin 36 content 36 content 37 estimated 36 content 38 by 38 by 39 hplc 41 uv 42 was 42 was 43 found each different group of nirs classified staves was then added to red wine during its aging in a stainless tank , and the extraction and evolution of the ellagitannins were monitored . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 10 added 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 32 . 1 each 3 group 2 different 3 group 3 group 4 of 3 group 8 was 4 of 7 staves 5 nirs 6 classified 6 classified 7 staves 8 was 10 added 9 then 10 added 10 added 11 to 10 added 12 red 11 to 12 red 12 red 13 wine 13 wine 14 during 14 during 16 aging 15 its 16 aging 16 aging 17 in 17 in 20 tank 18 a 20 tank 19 stainless 20 tank 21 , 22 and 22 and 25 and 22 and 31 monitored 23 the 24 extraction 24 extraction 25 and 25 and 26 evolution 25 and 27 of 25 and 30 were 27 of 29 ellagitannins 28 the 29 ellagitannins 30 were 31 monitored a good correlation between the nirs classification and the concentration of ellagitannins in red wine aging in contact with the classified staves was observed . 0 ###LEFT-WALL### 3 correlation 0 ###LEFT-WALL### 24 observed 0 ###LEFT-WALL### 25 . 1 a 2 good 1 a 3 correlation 2 good 3 correlation 3 correlation 4 between 3 correlation 11 of 3 correlation 13 in 3 correlation 16 aging 3 correlation 23 was 4 between 8 and 5 the 7 classification 6 nirs 7 classification 7 classification 8 and 8 and 10 concentration 9 the 10 concentration 11 of 12 ellagitannins 13 in 15 wine 14 red 15 wine 16 aging 17 in 16 aging 19 with 17 in 18 contact 19 with 22 staves 20 the 22 staves 21 classified 22 staves 23 was 24 observed the influence of levels of ellagitannins on the resulting wine perception was estimated by a trained judge 's panel , and it reveals that the level of ellagitannins in wine has an impact on the roundness and amplitude of the red wine . 0 ###LEFT-WALL### 2 influence 0 ###LEFT-WALL### 13 estimated 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 43 . 1 the 2 influence 2 influence 3 of 2 influence 5 of 2 influence 12 was 3 of 4 levels 5 of 6 ellagitannins 6 ellagitannins 7 on 7 on 11 perception 8 the 11 perception 9 resulting 11 perception 10 wine 11 perception 12 was 13 estimated 13 estimated 14 by 14 by 19 panel 15 a 17 judge 16 trained 17 judge 17 judge 18 's 18 's 19 panel 20 , 21 and 21 and 22 it 21 and 23 reveals 22 it 23 reveals 23 reveals 24 that 24 that 26 level 24 that 31 has 25 the 26 level 26 level 27 of 26 level 31 has 27 of 28 ellagitannins 28 ellagitannins 29 in 29 in 30 wine 31 has 33 impact 31 has 34 on 32 an 33 impact 34 on 37 and 35 the 36 roundness 36 roundness 37 and 37 and 38 amplitude 37 and 39 of 39 of 42 wine 40 the 42 wine 41 red 42 wine the shortage of physicians and resultant lack of access to care [particularly] on the rural neighbor islands of hawaii has been well described . 0 ###LEFT-WALL### 2 shortage 0 ###LEFT-WALL### 21 been 0 ###LEFT-WALL### 24 . 1 the 2 shortage 2 shortage 3 of 2 shortage 20 has 3 of 5 and 4 physicians 5 and 5 and 7 lack 5 and 8 of 5 and 10 to 5 and 18 of 6 resultant 7 lack 8 of 9 access 10 to 11 care 11 care 13 on 13 on 17 islands 14 the 17 islands 15 rural 16 neighbor 16 neighbor 17 islands 18 of 19 hawaii 20 has 21 been 21 been 22 well 22 well 23 described a recent report in the december issue of this journal by withy , et al . documents a current shortage of 45 physicians on the big island . 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 17 documents 0 ###LEFT-WALL### 28 . 1 a 2 recent 1 a 3 report 2 recent 3 report 3 report 4 in 3 report 8 of 3 report 17 documents 4 in 7 issue 5 the 7 issue 6 december 7 issue 8 of 10 journal 9 this 10 journal 10 journal 11 by 11 by 15 al 12 withy 15 al 13 , 15 al 14 et 15 al 15 al 16 . 17 documents 20 shortage 17 documents 24 on 18 a 19 current 18 a 20 shortage 19 current 20 shortage 20 shortage 21 of 21 of 23 physicians 22 45 23 physicians 24 on 27 island 25 the 27 island 26 big 27 island [(] 1 [ )(similar reports suggest that hawaii 's physician workforce lags 20 % behind physician to population ratios in the continental us . 0 ###LEFT-WALL### 5 reports 0 ###LEFT-WALL### 6 suggest 0 ###LEFT-WALL### 24 . 2 1 5 reports 4 )(similar 5 reports 5 reports 6 suggest 6 suggest 16 physician 6 suggest 17 to 6 suggest 20 in 7 that 8 hawaii 8 hawaii 9 's 9 's 16 physician 10 physician 12 lags 11 workforce 12 lags 12 lags 15 behind 13 20 14 % 14 % 15 behind 15 behind 16 physician 17 to 19 ratios 18 population 19 ratios 20 in 23 us 21 the 23 us 22 continental 23 us it is projected that the aging population and the heavy burden of chronic disease will increase demand for health services by 40 % by 2020 and even higher for specialties that focus on the care of elders . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 projected 0 ###LEFT-WALL### 38 . 1 it 2 is 2 is 3 projected 3 projected 26 and 4 that 17 demand 5 the 7 population 6 aging 7 population 7 population 8 and 8 and 11 burden 8 and 12 of 8 and 17 demand 9 the 11 burden 10 heavy 11 burden 12 of 15 will 13 chronic 14 disease 14 disease 15 will 16 increase 17 demand 17 demand 18 for 17 demand 24 by 17 demand 26 and 18 for 20 services 19 health 20 services 20 services 21 by 21 by 23 % 22 40 23 % 24 by 25 2020 26 and 28 higher 27 even 28 higher 28 higher 29 for 28 higher 33 on 29 for 30 specialties 30 specialties 31 that 30 specialties 32 focus 31 that 32 focus 33 on 35 care 34 the 35 care 35 care 36 of 36 of 37 elders the existing physician shortage is heightened by the high percentage of doctors reaching retirement age . 0 ###LEFT-WALL### 4 shortage 0 ###LEFT-WALL### 6 heightened 0 ###LEFT-WALL### 16 . 1 the 4 shortage 2 existing 3 physician 3 physician 4 shortage 4 shortage 5 is 5 is 6 heightened 6 heightened 7 by 7 by 10 percentage 8 the 10 percentage 9 high 10 percentage 10 percentage 11 of 11 of 12 doctors 12 doctors 13 reaching 13 reaching 15 age 14 retirement 15 age high business and living costs coupled with low reimbursement for health services makes it difficult to be competitive when recruiting physicians to hawaii . 0 ###LEFT-WALL### 1 high 0 ###LEFT-WALL### 13 makes 0 ###LEFT-WALL### 24 . 1 high 3 and 1 high 6 coupled 1 high 13 makes 2 business 3 and 3 and 5 costs 3 and 6 coupled 4 living 5 costs 6 coupled 7 with 6 coupled 10 for 7 with 9 reimbursement 8 low 9 reimbursement 10 for 12 services 11 health 12 services 13 makes 14 it 13 makes 23 hawaii 14 it 15 difficult 15 difficult 16 to 15 difficult 22 to 16 to 17 be 17 be 18 competitive 18 competitive 19 when 19 when 20 recruiting 20 recruiting 21 physicians 20 recruiting 22 to are there evidence based solutions to the state rural primary care workforce crisis ? 0 ###LEFT-WALL### 1 are 0 ###LEFT-WALL### 14 ? 1 are 5 solutions 2 there 5 solutions 3 evidence 4 based 4 based 5 solutions 5 solutions 6 to 6 to 13 crisis 7 the 13 crisis 8 state 13 crisis 9 rural 10 primary 10 primary 13 crisis 11 care 13 crisis 12 workforce 13 crisis this article describes what is currently in place as well as new initiatives and a ten point plan to lay the framework for an improved state rural training pipeline . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 describes 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 30 . 1 this 2 article 2 article 3 describes 3 describes 4 what 4 what 5 is 5 is 6 currently 5 is 7 in 5 is 11 as 7 in 8 place 9 as 10 well 10 well 11 as 11 as 13 initiatives 12 new 13 initiatives 14 and 17 point 14 and 18 plan 15 a 17 point 16 ten 17 point 17 point 18 plan 18 plan 19 to 18 plan 23 for 19 to 20 lay 20 lay 22 framework 21 the 22 framework 23 for 29 pipeline 24 an 29 pipeline 25 improved 26 state 26 state 29 pipeline 27 rural 28 training 28 training 29 pipeline age - related macular degeneration ( amd ) is one of the major causes of blindness in aging population that progresses with death of retinal pigment epithelium ( rpe ) and photoreceptor degeneration inducing impairment of central vision . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 39 . 1 age 5 degeneration 1 age 9 is 2 - 5 degeneration 3 related 5 degeneration 4 macular 5 degeneration 5 degeneration 7 amd 5 degeneration 8 ) 6 ( 7 amd 7 amd 8 ) 9 is 10 one 10 one 11 of 10 one 15 of 10 one 17 in 11 of 14 causes 12 the 14 causes 13 major 14 causes 15 of 16 blindness 17 in 18 aging 18 aging 19 population 18 aging 22 with 19 population 20 that 19 population 21 progresses 20 that 21 progresses 22 with 31 and 22 with 34 inducing 23 death 24 of 23 death 31 and 24 of 27 epithelium 25 retinal 27 epithelium 26 pigment 27 epithelium 27 epithelium 29 rpe 28 ( 29 rpe 29 rpe 30 ) 31 and 33 degeneration 32 photoreceptor 33 degeneration 34 inducing 35 impairment 35 impairment 36 of 36 of 38 vision 37 central 38 vision discovery of human induced pluripotent [stem] ( hips ) cells has opened new avenues for the treatment of degenerative diseases using patient - specific stem cells to generate tissues and cells for autologous cell [-] based therapy . 0 ###LEFT-WALL### 1 discovery 0 ###LEFT-WALL### 11 has 0 ###LEFT-WALL### 38 . 1 discovery 2 of 1 discovery 11 has 2 of 10 cells 3 human 4 induced 4 induced 10 cells 5 pluripotent 8 hips 5 pluripotent 9 ) 5 pluripotent 10 cells 7 ( 8 hips 8 hips 9 ) 11 has 14 avenues 11 has 21 using 12 opened 14 avenues 13 new 14 avenues 14 avenues 15 for 15 for 17 treatment 16 the 17 treatment 17 treatment 18 of 18 of 20 diseases 19 degenerative 20 diseases 21 using 26 cells 21 using 27 to 21 using 32 for 22 patient 23 - 22 patient 25 stem 24 specific 25 stem 25 stem 26 cells 27 to 28 generate 28 generate 30 and 29 tissues 30 and 30 and 31 cells 32 for 37 therapy 33 autologous 34 cell 34 cell 36 based 36 based 37 therapy recently , rpe cells were generated from hips cells . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 6 generated 0 ###LEFT-WALL### 10 . 1 recently 2 , 1 recently 4 cells 3 rpe 4 cells 4 cells 5 were 5 were 6 generated 6 generated 7 from 7 from 9 cells 8 hips 9 cells however , there is no evidence that those hips - derived rpe possess specific rpe functions that fully distinguish them from other types of cells . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 26 . 1 however 2 , 1 however 3 there 3 there 4 is 4 is 6 evidence 4 is 21 from 5 no 6 evidence 6 evidence 7 that 6 evidence 13 possess 7 that 12 rpe 7 that 13 possess 8 those 12 rpe 9 hips 10 - 9 hips 12 rpe 11 derived 12 rpe 12 rpe 13 possess 13 possess 16 functions 14 specific 16 functions 15 rpe 16 functions 16 functions 17 that 16 functions 19 distinguish 17 that 19 distinguish 18 fully 19 distinguish 19 distinguish 20 them 21 from 25 cells 22 other 23 types 23 types 24 of 23 types 25 cells 24 of 25 cells here , we show for the first time that rpe generated from hips cells under defined conditions exhibit ion transport , membrane potential , polarized vascular endothelial growth factor secretion , and gene expression profile similar to those of native rpe . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 42 . 1 here 2 , 1 here 3 we 3 we 4 show 4 show 5 for 5 for 8 time 6 the 7 first 6 the 8 time 8 time 9 that 8 time 18 exhibit 9 that 10 rpe 9 that 18 exhibit 10 rpe 11 generated 10 rpe 12 from 10 rpe 18 exhibit 12 from 14 cells 13 hips 14 cells 14 cells 15 under 15 under 17 conditions 16 defined 17 conditions 18 exhibit 32 and 19 ion 20 transport 20 transport 21 , 21 , 30 secretion 21 , 32 and 22 membrane 30 secretion 23 potential 24 , 23 potential 28 growth 25 polarized 28 growth 26 vascular 28 growth 27 endothelial 28 growth 28 growth 30 secretion 29 factor 30 secretion 31 , 32 and 32 and 35 profile 32 and 39 of 33 gene 34 expression 34 expression 35 profile 35 profile 36 similar 36 similar 37 to 37 to 38 those 39 of 41 rpe 40 native 41 rpe the hips - rpe could therefore be a very good candidate for rpe replacement therapy in amd . 0 ###LEFT-WALL### 4 rpe 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 18 . 1 the 4 rpe 2 hips 3 - 2 hips 4 rpe 4 rpe 5 could 5 could 7 be 6 therefore 7 be 7 be 11 candidate 8 a 9 very 8 a 11 candidate 9 very 10 good 10 good 11 candidate 11 candidate 12 for 12 for 15 therapy 13 rpe 15 therapy 14 replacement 15 therapy 15 therapy 16 in 16 in 17 amd however , these cells show rapid telomere shortening , dna chromosomal damage , and increased p21 expression that cause cell growth arrest . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 23 . 1 however 2 , 1 however 4 cells 3 these 4 cells 4 cells 5 show 5 show 7 telomere 6 rapid 7 telomere 7 telomere 8 shortening 9 , 14 and 10 dna 12 damage 11 chromosomal 12 damage 12 damage 14 and 13 , 14 and 14 and 17 expression 14 and 18 that 14 and 19 cause 15 increased 17 expression 16 p21 17 expression 18 that 19 cause 19 cause 22 arrest 20 cell 22 arrest 21 growth 22 arrest this rapid senescence might affect the survival of the transplanted cells in vivo and therefore , only the very early passages should be used for regeneration therapies . 0 ###LEFT-WALL### 3 senescence 0 ###LEFT-WALL### 5 affect 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 28 . 1 this 2 rapid 2 rapid 3 senescence 3 senescence 4 might 4 might 5 affect 5 affect 7 survival 5 affect 13 vivo 6 the 7 survival 7 survival 8 of 8 of 11 cells 9 the 11 cells 10 transplanted 11 cells 12 in 13 vivo 14 and 17 only 14 and 24 used 15 therefore 16 , 15 therefore 17 only 17 only 21 passages 18 the 21 passages 19 very 20 early 20 early 21 passages 21 passages 22 should 22 should 23 be 23 be 24 used 24 used 25 for 25 for 27 therapies 26 regeneration 27 therapies future research needs to focus on the generation of " safe " as well as viable hips - derived somatic cells . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 needs 0 ###LEFT-WALL### 22 . 1 future 2 research 2 research 3 needs 3 needs 4 to 3 needs 5 focus 4 to 5 focus 5 focus 6 on 6 on 8 generation 7 the 8 generation 8 generation 9 of 9 of 10 " 9 of 21 cells 11 safe 12 " 11 safe 21 cells 13 as 14 well 14 well 16 viable 15 as 16 viable 16 viable 21 cells 17 hips 18 - 17 hips 21 cells 19 derived 21 cells 20 somatic 21 cells oxidative stress is caused by an imbalance between the antioxidant and the reactive oxygen species , which results in damage to cells or tissues . 0 ###LEFT-WALL### 2 stress 0 ###LEFT-WALL### 4 caused 0 ###LEFT-WALL### 25 . 1 oxidative 2 stress 2 stress 3 is 3 is 4 caused 4 caused 5 by 4 caused 8 between 4 caused 21 to 5 by 7 imbalance 6 an 7 imbalance 8 between 11 and 9 the 10 antioxidant 10 antioxidant 11 and 11 and 15 species 11 and 16 , 11 and 17 which 11 and 18 results 12 the 15 species 13 reactive 14 oxygen 14 oxygen 15 species 17 which 18 results 18 results 19 in 19 in 20 damage 21 to 23 or 22 cells 23 or 23 or 24 tissues recent studies have reported that oxidative stress is involved in obesity , in addition to many other human diseases and aging . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 reported 1 recent 2 studies 2 studies 3 have 3 have 4 reported 4 reported 5 that 5 that 7 stress 5 that 9 involved 6 oxidative 7 stress 7 stress 8 is 8 is 9 involved 9 involved 10 in 9 involved 13 in 10 in 11 obesity 12 , 13 in 13 in 20 and 13 in 22 . 14 addition 15 to 14 addition 20 and 15 to 19 diseases 16 many 17 other 17 other 19 diseases 18 human 19 diseases 20 and 21 aging [a] prospective , randomized , double - blind study was performed to investigate the effect of astaxanthin ( asx ) , which is known to be a potent antioxidant , on oxidative stress in overweight and obese adults in korea . 0 ###LEFT-WALL### 9 study 0 ###LEFT-WALL### 11 performed 0 ###LEFT-WALL### 41 . 2 prospective 3 , 2 prospective 9 study 4 randomized 5 , 4 randomized 9 study 6 double 7 - 6 double 9 study 8 blind 9 study 9 study 10 was 10 was 11 performed 11 performed 12 to 11 performed 31 on 11 performed 39 in 12 to 13 investigate 13 investigate 15 effect 14 the 15 effect 15 effect 16 of 16 of 17 astaxanthin 17 astaxanthin 19 asx 17 astaxanthin 22 which 18 ( 19 asx 19 asx 20 ) 21 , 22 which 22 which 23 is 22 which 30 , 23 is 24 known 24 known 25 to 24 known 26 be 25 to 26 be 26 be 29 antioxidant 27 a 28 potent 27 a 29 antioxidant 28 potent 29 antioxidant 31 on 33 stress 32 oxidative 33 stress 33 stress 34 in 34 in 38 adults 35 overweight 36 and 36 and 37 obese 36 and 38 adults 39 in 40 korea twenty - three adults with [bmi] > 25.0 kg/m ( 2 ) enrolled in this study and were randomly assigned to two dose groups [:] asx 5 mg and 20 mg once daily for 3 weeks . 0 ###LEFT-WALL### 4 adults 0 ###LEFT-WALL### 37 . 1 twenty 2 - 2 - 3 three 2 - 4 adults 4 adults 5 with 4 adults 11 2 4 adults 17 and 5 with 9 kg/m 7 > 8 25.0 8 25.0 9 kg/m 10 ( 11 2 11 2 12 ) 13 enrolled 14 in 13 enrolled 17 and 14 in 16 study 15 this 16 study 17 and 18 were 18 were 20 assigned 19 randomly 20 assigned 20 assigned 21 to 20 assigned 29 and 20 assigned 32 once 20 assigned 33 daily 20 assigned 34 for 21 to 26 asx 22 two 26 asx 23 dose 26 asx 24 groups 26 asx 27 5 28 mg 28 mg 29 and 29 and 31 mg 30 20 31 mg 34 for 36 weeks 35 3 36 weeks malondialdehyde ( mda [ )(, isoprostane ( isp ) , superoxide dismutase ( sod ) and total antioxidant capacity ( tac ) , as oxidative stress biomarkers , were measured at baseline [and] 1 , 2 and 3 weeks after asx administration . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 30 measured 1 malondialdehyde 3 mda 1 malondialdehyde 16 and 2 ( 3 mda 3 mda 12 dismutase 3 mda 15 ) 5 )(, 12 dismutase 6 isoprostane 8 isp 6 isoprostane 10 , 6 isoprostane 11 superoxide 7 ( 8 isp 8 isp 9 ) 11 superoxide 12 dismutase 12 dismutase 14 sod 12 dismutase 15 ) 13 ( 14 sod 14 sod 15 ) 16 and 19 capacity 16 and 21 tac 17 total 19 capacity 18 antioxidant 19 capacity 20 ( 21 tac 21 tac 22 ) 23 , 26 stress 23 , 28 , 24 as 25 oxidative 25 oxidative 26 stress 26 stress 28 , 27 biomarkers 28 , 28 , 29 were 29 were 30 measured 30 measured 31 at 31 at 32 baseline 32 baseline 34 1 32 baseline 40 after 35 , 40 after 36 2 37 and 37 and 38 3 37 and 39 weeks 39 weeks 40 after 40 after 42 administration 40 after 43 . 41 asx 42 administration this study revealed that supplemental asx for 3 weeks improved oxidative stress biomarkers by suppressing lipid peroxidation and stimulating the activity of the antioxidant defense system . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 13 biomarkers 0 ###LEFT-WALL### 27 . 1 this 2 study 2 study 12 stress 2 study 13 biomarkers 3 revealed 6 asx 4 that 5 supplemental 5 supplemental 6 asx 6 asx 7 for 6 asx 10 improved 6 asx 12 stress 7 for 9 weeks 8 3 9 weeks 10 improved 11 oxidative 13 biomarkers 14 by 13 biomarkers 21 activity 14 by 15 suppressing 15 suppressing 18 and 16 lipid 17 peroxidation 17 peroxidation 18 and 18 and 19 stimulating 20 the 21 activity 21 activity 22 of 22 of 26 system 23 the 26 system 24 antioxidant 25 defense 25 defense 26 system objective : to test our hypotheses that happiness declines with age , and that age moderates the relationship of other influences on happiness , so that they vary in different age groups . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 13 and 1 objective 2 : 2 : 3 to 2 : 4 test 3 to 4 test 4 test 6 hypotheses 5 our 6 hypotheses 6 hypotheses 7 that 7 that 8 happiness 7 that 9 declines 8 happiness 9 declines 9 declines 10 with 10 with 11 age 12 , 13 and 13 and 15 age 13 and 16 moderates 14 that 15 age 15 age 16 moderates 16 moderates 18 relationship 16 moderates 22 on 16 moderates 26 that 17 the 18 relationship 18 relationship 19 of 19 of 21 influences 20 other 21 influences 22 on 23 happiness 24 , 26 that 25 so 26 that 26 that 27 they 26 that 28 vary 26 that 33 . 27 they 28 vary 28 vary 29 in 29 in 32 groups 30 different 31 age 31 age 32 groups methods : we analysed data from adults interviewed for the 2007 english national psychiatric morbidity survey , representative of people living in private homes . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 analysed 2 : 25 . 3 we 4 analysed 4 analysed 5 data 5 data 6 from 6 from 7 adults 7 adults 8 interviewed 7 adults 19 of 7 adults 21 living 8 interviewed 9 for 8 interviewed 17 , 8 interviewed 18 representative 9 for 16 survey 10 the 11 2007 11 2007 16 survey 12 english 16 survey 13 national 14 psychiatric 14 psychiatric 15 morbidity 15 morbidity 16 survey 19 of 20 people 21 living 22 in 22 in 24 homes 23 private 24 homes we compared happiness between younger adults ( aged 16 - 59 ) and those aged 60 - 69 [,] 70 - 79 and 80+ . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 0 ###LEFT-WALL### 25 . 1 we 2 compared 2 compared 13 and 2 compared 23 and 3 happiness 4 between 3 happiness 13 and 4 between 6 adults 5 younger 6 adults 6 adults 8 aged 7 ( 8 aged 8 aged 10 - 8 aged 12 ) 9 16 10 - 10 - 11 59 13 and 14 those 15 aged 17 - 15 aged 21 - 15 aged 23 and 16 60 17 - 17 - 18 69 20 70 21 - 21 - 22 79 23 and 24 80+ results : 2746 ( 39.6 % [ )(of people said that they were currently ['] very happy ['] , 3956 ( 52.4 % ) were ['] fairly happy ['] and 697 ( 8.0 % ) were ['] not too happy ['] . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 42 . 1 results 2 : 2 : 3 2746 3 2746 6 % 4 ( 6 % 5 39.6 6 % 6 % 8 )(of 6 % 19 , 8 )(of 9 people 9 people 10 said 9 people 11 that 9 people 13 were 11 that 12 they 11 that 13 were 12 they 13 were 13 were 14 currently 13 were 17 happy 16 very 17 happy 19 , 20 3956 19 , 25 were 19 , 30 and 20 3956 23 % 20 3956 25 were 21 ( 23 % 22 52.4 23 % 23 % 24 ) 25 were 27 fairly 25 were 28 happy 30 and 31 697 30 and 36 were 31 697 34 % 31 697 36 were 32 ( 34 % 33 8.0 34 % 34 % 35 ) 36 were 38 not 38 not 39 too 39 too 40 happy levels of happiness did not vary with age . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 6 vary 0 ###LEFT-WALL### 9 . 1 levels 2 of 1 levels 4 did 2 of 3 happiness 4 did 5 not 4 did 6 vary 6 vary 7 with 7 with 8 age social capital and participation predicted happiness across the age span . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 5 predicted 0 ###LEFT-WALL### 11 . 1 social 2 capital 2 capital 3 and 3 and 4 participation 3 and 5 predicted 5 predicted 6 happiness 5 predicted 7 across 7 across 10 span 8 the 10 span 9 age 10 span however , the impact of several variables was moderated by age . 0 ###LEFT-WALL### 4 impact 0 ###LEFT-WALL### 9 moderated 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 4 impact 3 the 4 impact 4 impact 5 of 4 impact 8 was 5 of 7 variables 6 several 7 variables 8 was 9 moderated 9 moderated 10 by 10 by 11 age compared with younger people , living with a partner more strongly predicted happiness in people in their 70 [s] . 0 ###LEFT-WALL### 6 living 0 ###LEFT-WALL### 12 predicted 0 ###LEFT-WALL### 20 . 1 compared 2 with 1 compared 5 , 1 compared 6 living 2 with 4 people 3 younger 4 people 6 living 7 with 6 living 12 predicted 7 with 9 partner 8 a 9 partner 10 more 11 strongly 11 strongly 12 predicted 12 predicted 13 happiness 12 predicted 14 in 12 predicted 16 in 14 in 15 people 16 in 18 70 17 their 18 70 attendance at religious services or places and having qualifications were more important predictors of happiness in the oldest old , whereas having a social network of at least three people was relatively less important in this age group . 0 ###LEFT-WALL### 5 or 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 31 was 0 ###LEFT-WALL### 39 . 1 attendance 2 at 1 attendance 5 or 2 at 4 services 3 religious 4 services 5 or 6 places 7 and 9 qualifications 7 and 10 were 8 having 9 qualifications 9 qualifications 10 were 10 were 13 predictors 10 were 21 whereas 11 more 13 predictors 12 important 13 predictors 13 predictors 14 of 14 of 15 happiness 15 happiness 16 in 16 in 19 old 17 the 18 oldest 17 the 19 old 20 , 21 whereas 21 whereas 22 having 22 having 25 network 22 having 31 was 23 a 25 network 24 social 25 network 25 network 26 of 26 of 30 people 27 at 28 least 28 least 29 three 29 three 30 people 31 was 32 relatively 31 was 34 important 33 less 34 important 34 important 35 in 35 in 38 group 36 this 38 group 37 age 38 group conclusion : four out of 10 people reported being very happy , and five out of 10 were fairly happy . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 21 . 1 conclusion 2 : 2 : 3 four 2 : 5 of 4 out 5 of 5 of 7 people 6 10 7 people 7 people 8 reported 7 people 9 being 9 being 11 happy 10 very 11 happy 12 , 13 and 13 and 14 five 13 and 18 were 14 five 16 of 14 five 18 were 15 out 16 of 16 of 17 10 18 were 20 happy 19 fairly 20 happy this is higher than levels reported in earlier surveys . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 this 2 is 2 is 3 higher 3 higher 4 than 4 than 5 levels 5 levels 6 reported 6 reported 7 in 7 in 9 surveys 8 earlier 9 surveys our findings suggest that interventions that increase social capital and participation may augment general happiness , health and recovery from illness and this would be an interesting area for future study . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 32 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 5 interventions 4 that 25 be 5 interventions 6 that 5 interventions 10 and 5 interventions 24 would 6 that 10 and 7 increase 9 capital 7 increase 10 and 8 social 9 capital 10 and 13 augment 11 participation 12 may 12 may 13 augment 13 augment 18 and 14 general 15 happiness 15 happiness 16 , 16 , 17 health 16 , 18 and 18 and 19 recovery 18 and 20 from 20 from 22 and 21 illness 22 and 22 and 23 this 24 would 25 be 25 be 28 area 26 an 27 interesting 26 an 28 area 27 interesting 28 area 28 area 29 for 29 for 31 study 30 future 31 study objectives : to explore whether it is possible to [detect] decline in global scores of cognitive [function] in the proximity of death whilst simultaneously investigating potential risk profiles . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 1 objectives 2 : 2 : 3 to 2 : 16 cognitive 3 to 4 explore 4 explore 5 whether 5 whether 6 it 5 whether 7 is 6 it 7 is 7 is 8 possible 8 possible 9 to 8 possible 15 of 9 to 11 decline 11 decline 12 in 12 in 14 scores 13 global 14 scores 14 scores 15 of 16 cognitive 18 in 16 cognitive 23 whilst 18 in 20 proximity 19 the 20 proximity 20 proximity 21 of 21 of 22 death 23 whilst 25 investigating 24 simultaneously 25 investigating 25 investigating 28 profiles 26 potential 28 profiles 27 risk 28 profiles methods : using the mini mental state examination in a population study of the oldest old in which 99 % of participants have died [,] a linear and quadratic time - [to] - [death] repeated measures random effects models were used to detect decline and potential factors which might indicate individual variation . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 1 methods 2 : 2 : 3 using 3 using 8 examination 3 using 9 in 4 the 8 examination 5 mini 6 mental 6 mental 7 state 7 state 8 examination 9 in 12 study 10 a 11 population 10 a 12 study 11 population 12 study 12 study 13 of 13 of 16 old 14 the 15 oldest 14 the 16 old 16 old 17 in 17 in 18 which 17 in 20 % 17 in 24 died 19 99 20 % 20 % 21 of 20 % 23 have 21 of 22 participants 23 have 24 died 24 died 30 time 26 a 30 time 27 linear 28 and 28 and 29 quadratic 28 and 30 time 30 time 41 used 31 - 41 used 33 - 35 repeated 35 repeated 38 effects 35 repeated 41 used 36 measures 38 effects 37 random 38 effects 38 effects 39 models 38 effects 40 were 39 models 40 were 41 used 42 to 41 used 50 indicate 41 used 53 . 42 to 43 detect 43 detect 45 and 44 decline 45 and 45 and 46 potential 45 and 47 factors 45 and 50 indicate 47 factors 48 which 47 factors 49 might 47 factors 50 indicate 48 which 49 might 50 indicate 52 variation 51 individual 52 variation results : decline and acceleration of this decline were detectable in the period before death . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 9 were 2 : 16 . 3 decline 4 and 4 and 5 acceleration 4 and 6 of 4 and 9 were 6 of 8 decline 7 this 8 decline 9 were 10 detectable 10 detectable 11 in 10 detectable 14 before 11 in 13 period 12 the 13 period 14 before 15 death conclusion : using an extension of existing methods for exploring terminal decline [,] the phenomenon of decline in global cognition measures in the proximity [of] death was clearly detected as well as potential variables which could influence that pattern . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 1 conclusion 2 : 2 : 3 using 2 : 9 for 3 using 5 extension 4 an 5 extension 5 extension 6 of 6 of 8 methods 7 existing 8 methods 9 for 10 exploring 10 exploring 12 decline 10 exploring 22 in 11 terminal 12 decline 12 decline 15 phenomenon 12 decline 21 measures 14 the 15 phenomenon 15 phenomenon 16 of 15 phenomenon 18 in 15 phenomenon 21 measures 16 of 17 decline 18 in 20 cognition 19 global 20 cognition 22 in 24 proximity 23 the 24 proximity 24 proximity 26 death 24 proximity 27 was 24 proximity 29 detected 26 death 27 was 28 clearly 29 detected 29 detected 30 as 29 detected 40 . 30 as 34 variables 30 as 37 influence 31 well 33 potential 32 as 33 potential 33 potential 34 variables 34 variables 35 which 34 variables 36 could 34 variables 37 influence 35 which 36 could 37 influence 39 pattern 38 that 39 pattern further work is required to explore whether similar methods can be used to detect the onset of the acceleration of this decline in each individual together with the potential to identify individual level factors that can allow clinicians to distinguish between the normal and preterminal phases of change in extreme old age . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 4 required 0 ###LEFT-WALL### 53 . 1 further 2 work 2 work 3 is 3 is 4 required 4 required 5 to 4 required 13 to 4 required 14 detect 5 to 6 explore 6 explore 7 whether 7 whether 9 methods 7 whether 12 used 8 similar 9 methods 9 methods 10 can 10 can 11 be 11 be 12 used 13 to 14 detect 14 detect 16 onset 15 the 16 onset 16 onset 17 of 16 onset 20 of 17 of 19 acceleration 18 the 19 acceleration 20 of 22 decline 21 this 22 decline 22 decline 23 in 22 decline 25 individual 23 in 24 each 25 individual 26 together 25 individual 27 with 25 individual 30 to 25 individual 31 identify 27 with 29 potential 28 the 29 potential 30 to 31 identify 31 identify 34 factors 31 identify 39 to 31 identify 41 between 31 identify 49 in 32 individual 34 factors 33 level 34 factors 34 factors 35 that 34 factors 36 can 35 that 36 can 36 can 37 allow 37 allow 38 clinicians 39 to 40 distinguish 41 between 44 and 42 the 43 normal 43 normal 44 and 44 and 46 phases 44 and 47 of 45 preterminal 46 phases 47 of 48 change 49 in 52 age 50 extreme 52 age 51 old 52 age motor overflow [is] involuntary overt movement or covert muscle activity that cooccurs with voluntary movement . 0 ###LEFT-WALL### 7 or 0 ###LEFT-WALL### 9 muscle 0 ###LEFT-WALL### 16 . 1 motor 2 overflow 2 overflow 6 movement 4 involuntary 6 movement 5 overt 6 movement 6 movement 7 or 7 or 8 covert 7 or 9 muscle 9 muscle 10 activity 9 muscle 13 with 10 activity 11 that 10 activity 12 cooccurs 11 that 12 cooccurs 13 with 15 movement 14 voluntary 15 movement overflow is present in several pathological conditions , as well as in neurologically healthy children and older adults , and can be induced in healthy young adults under effortful conditions . 0 ###LEFT-WALL### 1 overflow 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 31 . 1 overflow 20 and 2 is 3 present 2 is 20 and 3 present 4 in 4 in 7 conditions 5 several 7 conditions 6 pathological 7 conditions 7 conditions 9 as 8 , 9 as 9 as 16 and 9 as 19 , 10 well 11 as 10 well 16 and 11 as 12 in 12 in 15 children 13 neurologically 14 healthy 14 healthy 15 children 16 and 18 adults 17 older 18 adults 19 , 20 and 20 and 21 can 20 and 30 conditions 21 can 22 be 22 be 23 induced 23 induced 24 in 23 induced 28 under 24 in 27 adults 25 healthy 27 adults 26 young 27 adults 28 under 29 effortful this motor phenomenon may provide insight into the underlying mechanisms and kinetic characteristics of voluntary and involuntary motor control in various populations . 0 ###LEFT-WALL### 3 phenomenon 0 ###LEFT-WALL### 23 . 1 this 3 phenomenon 2 motor 3 phenomenon 3 phenomenon 4 may 4 may 5 provide 5 provide 6 insight 5 provide 7 into 5 provide 20 in 7 into 11 and 8 the 10 mechanisms 9 underlying 10 mechanisms 10 mechanisms 11 and 11 and 13 characteristics 11 and 14 of 12 kinetic 13 characteristics 14 of 19 control 15 voluntary 16 and 16 and 17 involuntary 16 and 18 motor 18 motor 19 control 20 in 22 populations 21 various 22 populations [although] often measured behaviorally using force transduction techniques , different methods of calculating and presenting such overflow data have resulted in seemingly contradictory findings , with limited discussion of the advantages and limitations of different approaches . 0 ###LEFT-WALL### 11 methods 0 ###LEFT-WALL### 20 resulted 2 often 11 methods 3 measured 4 behaviorally 3 measured 5 using 3 measured 9 , 3 measured 11 methods 5 using 8 techniques 6 force 8 techniques 7 transduction 8 techniques 10 different 11 methods 11 methods 12 of 11 methods 20 resulted 12 of 14 and 13 calculating 14 and 14 and 15 presenting 14 and 18 data 14 and 19 have 16 such 18 data 17 overflow 18 data 18 data 19 have 20 resulted 21 in 20 resulted 26 with 21 in 24 findings 22 seemingly 23 contradictory 23 contradictory 24 findings 25 , 26 with 26 with 28 discussion 26 with 37 . 27 limited 28 discussion 28 discussion 29 of 29 of 32 and 30 the 31 advantages 31 advantages 32 and 32 and 33 limitations 32 and 34 of 34 of 36 approaches 35 different 36 approaches in this article , the authors examined the relevant literature to highlight significant methodological considerations for authors and readers conducting or appraising this type of research . 0 ###LEFT-WALL### 6 authors 0 ###LEFT-WALL### 7 examined 0 ###LEFT-WALL### 27 . 1 in 3 article 1 in 4 , 1 in 6 authors 2 this 3 article 5 the 6 authors 6 authors 7 examined 7 examined 10 literature 7 examined 11 to 8 the 10 literature 9 relevant 10 literature 11 to 12 highlight 12 highlight 21 or 12 highlight 26 research 13 significant 15 considerations 14 methodological 15 considerations 15 considerations 16 for 15 considerations 18 and 16 for 17 authors 18 and 19 readers 18 and 20 conducting 20 conducting 21 or 21 or 22 appraising 23 this 24 type 24 type 25 of 24 type 26 research 25 of 26 research issues regarding the interpretation and reporting of findings are also discussed . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 11 discussed 0 ###LEFT-WALL### 12 . 1 issues 2 regarding 1 issues 5 and 2 regarding 4 interpretation 3 the 4 interpretation 5 and 6 reporting 5 and 9 are 6 reporting 7 of 7 of 8 findings 9 are 10 also 9 are 11 discussed researchers are encouraged to continue using behavioral measures to create well - defined variables that enable the study of the kinematic characteristics [of] overflow , as these may offer promising new ways forward in better characterizing and understanding this intriguing movement phenomenon . 0 ###LEFT-WALL### 1 researchers 0 ###LEFT-WALL### 3 encouraged 0 ###LEFT-WALL### 5 continue 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 43 . 1 researchers 2 are 2 are 3 encouraged 3 encouraged 4 to 3 encouraged 5 continue 4 to 5 continue 5 continue 6 using 6 using 8 measures 6 using 9 to 6 using 10 create 7 behavioral 8 measures 9 to 10 create 10 create 11 well 12 - 14 variables 13 defined 14 variables 14 variables 15 that 14 variables 16 enable 14 variables 30 promising 15 that 16 enable 16 enable 18 study 17 the 18 study 18 study 19 of 18 study 22 characteristics 18 study 29 offer 19 of 21 kinematic 20 the 21 kinematic 22 characteristics 24 overflow 24 overflow 26 as 25 , 26 as 26 as 27 these 26 as 29 offer 27 these 28 may 28 may 29 offer 30 promising 32 ways 30 promising 33 forward 30 promising 34 in 31 new 32 ways 34 in 37 and 35 better 36 characterizing 36 characterizing 37 and 37 and 42 phenomenon 38 understanding 41 movement 39 this 40 intriguing 40 intriguing 41 movement 41 movement 42 phenomenon phosphatidylserine ( ps ) , which is normally located on the inner leaflet of the plasma membrane , translocates [to] the outer leaflet at the early stage of apoptosis . 0 ###LEFT-WALL### 1 phosphatidylserine 0 ###LEFT-WALL### 19 translocates 0 ###LEFT-WALL### 30 . 1 phosphatidylserine 3 ps 1 phosphatidylserine 6 which 1 phosphatidylserine 19 translocates 2 ( 3 ps 3 ps 4 ) 5 , 6 which 6 which 7 is 6 which 18 , 7 is 9 located 8 normally 9 located 9 located 10 on 10 on 13 leaflet 11 the 13 leaflet 12 inner 13 leaflet 13 leaflet 14 of 14 of 17 membrane 15 the 17 membrane 16 plasma 17 membrane 19 translocates 23 leaflet 19 translocates 24 at 21 the 23 leaflet 22 outer 23 leaflet 24 at 27 stage 25 the 27 stage 26 early 27 stage 27 stage 28 of 28 of 29 apoptosis the ps externalization provides a signal for phagocytes to initiate uptake of apoptotic cells . 0 ###LEFT-WALL### 3 externalization 0 ###LEFT-WALL### 4 provides 0 ###LEFT-WALL### 15 . 1 the 3 externalization 2 ps 3 externalization 3 externalization 4 provides 4 provides 6 signal 4 provides 9 to 5 a 6 signal 6 signal 7 for 7 for 8 phagocytes 9 to 10 initiate 10 initiate 11 uptake 11 uptake 12 of 12 of 14 cells 13 apoptotic 14 cells after phagocytosis of apoptotic cells , phagocytes induce the secretion of anti - inflammatory mediators including prostaglandin e ( 2 ) ( pge ( 2 ) ) . 0 ###LEFT-WALL### 7 phagocytes 0 ###LEFT-WALL### 8 induce 0 ###LEFT-WALL### 28 . 1 after 2 phagocytosis 1 after 6 , 1 after 7 phagocytes 2 phagocytosis 3 of 3 of 5 cells 4 apoptotic 5 cells 7 phagocytes 8 induce 8 induce 10 secretion 9 the 10 secretion 10 secretion 11 of 11 of 15 mediators 12 anti 13 - 12 anti 15 mediators 14 inflammatory 15 mediators 15 mediators 16 including 16 including 17 prostaglandin 17 prostaglandin 18 e 17 prostaglandin 20 2 17 prostaglandin 23 pge 19 ( 20 2 20 2 21 ) 22 ( 23 pge 23 pge 25 2 23 pge 27 ) 24 ( 25 2 25 2 26 ) ps - containing liposomes ( psls ) can mimic the effects of apoptotic cells on phagocytes to induce the secretion of pge ( 2 ) . 0 ###LEFT-WALL### 1 ps 0 ###LEFT-WALL### 9 mimic 0 ###LEFT-WALL### 26 . 1 ps 3 containing 1 ps 8 can 2 - 3 containing 3 containing 4 liposomes 3 containing 7 ) 4 liposomes 6 psls 5 ( 6 psls 6 psls 7 ) 8 can 9 mimic 9 mimic 11 effects 9 mimic 15 on 9 mimic 17 to 10 the 11 effects 11 effects 12 of 12 of 14 cells 13 apoptotic 14 cells 15 on 16 phagocytes 17 to 18 induce 18 induce 20 secretion 19 the 20 secretion 20 secretion 21 of 21 of 22 pge 22 pge 24 2 23 ( 24 2 24 2 25 ) psls induce the pge ( 2 ) secretion from microglia without induction of either cyclooxygenase ( cox ) - [2] or microsomal prostaglandin e synthase ( mpges ) - 1 . 0 ###LEFT-WALL### 1 psls 0 ###LEFT-WALL### 2 induce 0 ###LEFT-WALL### 29 - 0 ###LEFT-WALL### 31 . 1 psls 2 induce 2 induce 8 secretion 2 induce 11 without 3 the 8 secretion 4 pge 6 2 4 pge 8 secretion 5 ( 6 2 6 2 7 ) 8 secretion 9 from 9 from 10 microglia 11 without 21 or 12 induction 13 of 12 induction 21 or 13 of 15 cyclooxygenase 14 either 15 cyclooxygenase 15 cyclooxygenase 17 cox 16 ( 17 cox 17 cox 18 ) 19 - 21 or 21 or 25 synthase 21 or 27 mpges 22 microsomal 23 prostaglandin 23 prostaglandin 24 e 23 prostaglandin 25 synthase 26 ( 27 mpges 27 mpges 28 ) 29 - 30 1 psls are found to [rather] utilize cox - 1/mpges - 2 system to produce pge ( 2 ) secretion and then shift microglia and macrophages from pro - [to] anti - inflammatory phenotype by an autocrine action of pge ( 2 ) . 0 ###LEFT-WALL### 1 psls 0 ###LEFT-WALL### 3 found 1 psls 2 are 2 are 3 found 3 found 4 to 3 found 12 system 3 found 13 to 4 to 6 utilize 6 utilize 7 cox 7 cox 9 1/mpges 8 - 9 1/mpges 9 1/mpges 10 - 11 2 12 system 13 to 24 and 14 produce 20 and 14 produce 24 and 15 pge 17 2 15 pge 19 secretion 16 ( 17 2 17 2 18 ) 19 secretion 20 and 20 and 21 then 20 and 23 microglia 22 shift 23 microglia 24 and 25 macrophages 24 and 26 from 26 from 27 pro 27 pro 33 phenotype 28 - 33 phenotype 30 anti 31 - 30 anti 33 phenotype 32 inflammatory 33 phenotype 33 phenotype 34 by 33 phenotype 38 of 33 phenotype 41 2 33 phenotype 43 . 34 by 37 action 35 an 37 action 36 autocrine 37 action 38 of 39 pge 40 ( 41 2 41 2 42 ) moreover , psls inhibit the maturation of dendritic cells and osteoclast precursors . 0 ###LEFT-WALL### 3 psls 0 ###LEFT-WALL### 4 inhibit 0 ###LEFT-WALL### 13 . 1 moreover 2 , 1 moreover 3 psls 3 psls 4 inhibit 4 inhibit 6 maturation 5 the 6 maturation 6 maturation 7 of 7 of 10 and 8 dendritic 9 cells 9 cells 10 and 10 and 12 precursors 11 osteoclast 12 precursors therefore , psls will be potential pharmacological interventions for inflammatory and immune diseases through feedback mechanism utilizing pge ( 2 ) . 0 ###LEFT-WALL### 3 psls 0 ###LEFT-WALL### 5 be 0 ###LEFT-WALL### 22 . 1 therefore 2 , 1 therefore 3 psls 3 psls 4 will 4 will 5 be 5 be 8 interventions 6 potential 8 interventions 7 pharmacological 8 interventions 8 interventions 9 for 9 for 11 and 10 inflammatory 11 and 11 and 16 mechanism 11 and 17 utilizing 12 immune 13 diseases 13 diseases 16 mechanism 14 through 15 feedback 15 feedback 16 mechanism 17 utilizing 18 pge 18 pge 20 2 19 ( 20 2 20 2 21 ) the effect of continuous visual flow on the ability to regain and [maintain] postural orientation was examined . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 17 examined 0 ###LEFT-WALL### 18 . 1 the 2 effect 2 effect 3 of 2 effect 16 was 3 of 12 and 4 continuous 6 flow 5 visual 6 flow 6 flow 7 on 6 flow 12 and 7 on 9 ability 8 the 9 ability 9 ability 10 to 9 ability 11 regain 10 to 11 regain 12 and 15 orientation 14 postural 15 orientation 16 was 17 examined fourteen young ( 20 - 39 years old [ )(and 14 older women ( 60 - 79 years old ) stood quietly during 3 ° ( 30°/s ) [dorsiflexion] tilt [of] the support surface combined with 30 ° and 45°/s upward or [downward] pitch rotations of the visual field . 0 ###LEFT-WALL### 8 old 0 ###LEFT-WALL### 10 )(and 0 ###LEFT-WALL### 50 . 1 fourteen 8 old 2 young 4 20 2 young 5 - 2 young 8 old 3 ( 4 20 4 20 5 - 6 39 7 years 7 years 8 old 10 )(and 11 14 10 )(and 42 or 11 14 13 women 11 14 21 stood 11 14 27 30°/s 11 14 42 or 12 older 13 women 13 women 15 60 13 women 19 old 13 women 21 stood 14 ( 15 60 15 60 16 - 16 - 19 old 17 79 18 years 18 years 19 old 19 old 20 ) 21 stood 22 quietly 21 stood 23 during 23 during 25 ° 24 3 25 ° 26 ( 27 30°/s 27 30°/s 28 ) 30 tilt 34 surface 30 tilt 42 or 32 the 34 surface 33 support 34 surface 34 surface 39 and 35 combined 36 with 35 combined 39 and 36 with 38 ° 37 30 38 ° 39 and 40 45°/s 39 and 41 upward 42 or 44 pitch 44 pitch 45 rotations 45 rotations 46 of 46 of 49 field 47 the 49 field 48 visual 49 field the support surface was [held] tilted for 30 s and then returned [to] neutral over a 30 - s period while the visual field continued to rotate . 0 ###LEFT-WALL### 3 surface 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 28 . 1 the 3 surface 2 support 3 surface 3 surface 4 was 4 was 10 and 6 tilted 7 for 6 tilted 10 and 7 for 9 s 8 30 9 s 10 and 12 returned 10 and 15 over 10 and 21 while 11 then 12 returned 12 returned 14 neutral 15 over 20 period 16 a 20 period 17 30 18 - 18 - 19 s 18 - 20 period 21 while 24 field 21 while 25 continued 22 the 24 field 23 visual 24 field 24 field 25 continued 25 continued 26 to 25 continued 27 rotate 26 to 27 rotate segmental displacement and bilateral tibialis anterior and gastrocnemius muscle emg responses were recorded . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 13 recorded 0 ###LEFT-WALL### 14 . 1 segmental 2 displacement 2 displacement 3 and 3 and 5 tibialis 3 and 7 and 3 and 9 muscle 3 and 12 were 4 bilateral 5 tibialis 6 anterior 7 and 7 and 8 gastrocnemius 7 and 9 muscle 9 muscle 11 responses 10 emg 11 responses 12 were 13 recorded continuous wavelet transforms were calculated for each muscle emg response . 0 ###LEFT-WALL### 1 continuous 0 ###LEFT-WALL### 5 calculated 0 ###LEFT-WALL### 11 . 1 continuous 2 wavelet 1 continuous 3 transforms 1 continuous 4 were 2 wavelet 3 transforms 4 were 5 calculated 5 calculated 6 for 6 for 10 response 7 each 10 response 8 muscle 10 response 9 emg 10 response an instantaneous mean frequency curve [(] imnf [ )(of muscle activity , center [of] mass [(] com ) , [center] of pressure ( cop ) , and angular excursion at the hip and ankle were used in a functional principal component analysis ( fpca ) . 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 36 used 0 ###LEFT-WALL### 46 . 1 an 2 instantaneous 1 an 7 imnf 2 instantaneous 3 mean 3 mean 7 imnf 4 frequency 7 imnf 5 curve 7 imnf 7 imnf 9 )(of 7 imnf 27 and 9 )(of 11 activity 10 muscle 11 activity 11 activity 17 com 11 activity 21 of 12 , 17 com 13 center 17 com 15 mass 17 com 17 com 18 ) 19 , 21 of 21 of 22 pressure 21 of 25 ) 22 pressure 24 cop 23 ( 24 cop 24 cop 25 ) 26 , 27 and 27 and 29 excursion 27 and 30 at 27 and 35 were 28 angular 29 excursion 30 at 33 and 31 the 32 hip 32 hip 33 and 33 and 34 ankle 35 were 36 used 36 used 37 in 37 in 42 analysis 38 a 39 functional 38 a 42 analysis 39 functional 42 analysis 40 principal 42 analysis 41 component 42 analysis 42 analysis 44 fpca 43 ( 44 fpca 44 fpca 45 ) functional component weights were calculated and compared with mixed model repeated measures anovas . 0 ###LEFT-WALL### 3 weights 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 14 . 1 functional 3 weights 2 component 3 weights 3 weights 4 were 4 were 6 and 5 calculated 6 and 6 and 7 compared 6 and 13 anovas 7 compared 8 with 8 with 12 measures 9 mixed 10 model 10 model 11 repeated 11 repeated 12 measures the fpca revealed [greatest] mathematical differences in com and cop responses between groups or conditions during the period that the platform transitioned from the sustained tilt to a return to [neutral] position . 0 ###LEFT-WALL### 2 fpca 0 ###LEFT-WALL### 14 or 0 ###LEFT-WALL### 33 . 1 the 2 fpca 2 fpca 14 or 3 revealed 6 differences 3 revealed 7 in 3 revealed 12 between 3 revealed 14 or 5 mathematical 6 differences 7 in 11 responses 8 com 9 and 9 and 10 cop 10 cop 11 responses 12 between 13 groups 14 or 15 conditions 14 or 16 during 14 or 23 from 16 during 18 period 17 the 18 period 18 period 19 that 18 period 22 transitioned 19 that 21 platform 19 that 22 transitioned 20 the 21 platform 21 platform 22 transitioned 23 from 26 tilt 24 the 26 tilt 25 sustained 26 tilt 26 tilt 27 to 26 tilt 30 to 26 tilt 32 position 27 to 29 return 28 a 29 return 30 to 32 position muscle emg responses differed most in the period following support surface tilt indicating that muscle activity increased to support stabilization against the visual flow . 0 ###LEFT-WALL### 1 muscle 0 ###LEFT-WALL### 25 . 1 muscle 2 emg 1 muscle 18 to 1 muscle 21 against 2 emg 17 increased 3 responses 4 differed 4 differed 5 most 5 most 6 in 6 in 12 tilt 7 the 12 tilt 8 period 9 following 9 following 10 support 10 support 12 tilt 11 surface 12 tilt 12 tilt 13 indicating 13 indicating 14 that 14 that 16 activity 14 that 17 increased 15 muscle 16 activity 16 activity 17 increased 18 to 20 stabilization 19 support 20 stabilization 21 against 24 flow 22 the 24 flow 23 visual 24 flow older women exhibited significantly larger com and cop responses in the direction of visual field motion and less muscle modulation when the platform returned to neutral than younger women . 0 ###LEFT-WALL### 2 women 0 ###LEFT-WALL### 3 exhibited 0 ###LEFT-WALL### 30 . 1 older 2 women 2 women 3 exhibited 3 exhibited 7 and 3 exhibited 10 in 4 significantly 5 larger 5 larger 6 com 6 com 7 and 7 and 9 responses 8 cop 9 responses 10 in 17 and 11 the 12 direction 12 direction 13 of 12 direction 17 and 13 of 16 motion 14 visual 15 field 15 field 16 motion 17 and 20 modulation 17 and 21 when 17 and 25 to 18 less 20 modulation 19 muscle 20 modulation 21 when 23 platform 21 when 24 returned 22 the 23 platform 23 platform 24 returned 25 to 29 women 26 neutral 29 women 27 than 28 younger 28 younger 29 women results on a rod and frame test indicated that older women were significantly more visually dependent than the younger women . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 8 indicated 0 ###LEFT-WALL### 21 . 1 results 2 on 1 results 8 indicated 2 on 5 and 3 a 4 rod 4 rod 5 and 5 and 7 test 6 frame 7 test 8 indicated 9 that 9 that 11 women 9 that 12 were 10 older 11 women 11 women 12 were 12 were 13 significantly 12 were 15 visually 12 were 16 dependent 14 more 15 visually 16 dependent 17 than 17 than 20 women 18 the 20 women 19 younger 20 women we concluded that a stiffer body combined with heightened visual sensitivity in older women critically interferes with their ability to counteract posturally destabilizing environments . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 concluded 0 ###LEFT-WALL### 25 . 1 we 2 concluded 2 concluded 3 that 3 that 6 body 3 that 16 interferes 4 a 6 body 5 stiffer 6 body 6 body 7 combined 6 body 12 in 6 body 16 interferes 7 combined 8 with 8 with 11 sensitivity 9 heightened 11 sensitivity 10 visual 11 sensitivity 12 in 14 women 13 older 14 women 15 critically 16 interferes 16 interferes 17 with 16 interferes 20 to 17 with 19 ability 18 their 19 ability 20 to 21 counteract 21 counteract 24 environments 22 posturally 23 destabilizing 23 destabilizing 24 environments age - related mechanisms that lead to sarcopenia are not entirely understood . 0 ###LEFT-WALL### 4 mechanisms 0 ###LEFT-WALL### 12 understood 0 ###LEFT-WALL### 13 . 1 age 2 - 1 age 4 mechanisms 3 related 4 mechanisms 4 mechanisms 5 that 4 mechanisms 6 lead 4 mechanisms 9 are 5 that 6 lead 6 lead 7 to 7 to 8 sarcopenia 9 are 10 not 9 are 12 understood 11 entirely 12 understood basal leg blood flow declines with aging by augmented sympathetic vasoconstriction and arterial stiffening , thus a dysfunction in blood vessel dynamics may have an independent role on sarcopenia . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 30 . 1 basal 2 leg 2 leg 4 flow 3 blood 4 flow 4 flow 5 declines 5 declines 6 with 5 declines 12 and 6 with 7 aging 7 aging 8 by 8 by 11 vasoconstriction 9 augmented 11 vasoconstriction 10 sympathetic 11 vasoconstriction 12 and 13 arterial 12 and 14 stiffening 15 , 18 dysfunction 15 , 24 have 16 thus 18 dysfunction 17 a 18 dysfunction 18 dysfunction 19 in 18 dysfunction 23 may 19 in 22 dynamics 20 blood 22 dynamics 21 vessel 22 dynamics 23 may 24 have 24 have 27 role 25 an 27 role 26 independent 27 role 27 role 28 on 28 on 29 sarcopenia we determined whether pulse wave velocity ( pwv ) , [marker] of arterial stiffness , was associated with skeletal muscle [decline] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 determined 0 ###LEFT-WALL### 22 . 1 we 2 determined 2 determined 3 whether 3 whether 6 velocity 3 whether 17 associated 4 pulse 6 velocity 5 wave 6 velocity 6 velocity 8 pwv 6 velocity 12 of 6 velocity 16 was 7 ( 8 pwv 8 pwv 9 ) 10 , 12 of 12 of 14 stiffness 12 of 15 , 13 arterial 14 stiffness 16 was 17 associated 17 associated 18 with 18 with 20 muscle 19 skeletal 20 muscle observational cohort study of older adults ( 70 - 79 years ) living in pittsburgh , pa , usa or memphis , tn , usa . 0 ###LEFT-WALL### 20 or 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 26 . 1 observational 2 cohort 2 cohort 3 study 3 study 4 of 3 study 13 living 3 study 16 , 4 of 6 adults 5 older 6 adults 6 adults 9 - 7 ( 9 - 8 70 9 - 9 - 11 years 9 - 12 ) 10 79 11 years 13 living 14 in 14 in 15 pittsburgh 16 , 17 pa 16 , 18 , 18 , 19 usa 18 , 20 or 20 or 21 memphis 22 , 23 tn 22 , 24 , 24 , 25 usa analyses included 2,405 participants . 0 ###LEFT-WALL### 1 analyses 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 5 . 1 analyses 2 included 2 included 4 participants 3 2,405 4 participants correlations among muscle parameters including skeletal muscle density and intermuscular adipose tissue using mid - thigh ct scans were assessed . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 20 assessed 0 ###LEFT-WALL### 21 . 1 correlations 2 among 1 correlations 9 and 2 among 4 parameters 3 muscle 4 parameters 4 parameters 5 including 5 including 8 density 6 skeletal 8 density 7 muscle 8 density 9 and 12 tissue 9 and 13 using 9 and 18 scans 9 and 19 were 10 intermuscular 12 tissue 11 adipose 12 tissue 13 using 17 ct 13 using 18 scans 14 mid 15 - 14 mid 16 thigh 16 thigh 17 ct 19 were 20 assessed linear mixed models tested the association between the change in the sarcopenic index ( si ) ( assessed by dual energy x - ray absorptiometry ) over time and baseline pwv independently of multiple confounders . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 4 tested 0 ###LEFT-WALL### 36 . 1 linear 3 models 2 mixed 3 models 3 models 4 tested 4 tested 6 association 4 tested 7 between 4 tested 10 in 4 tested 27 over 4 tested 32 independently 5 the 6 association 7 between 9 change 8 the 9 change 10 in 13 index 11 the 13 index 12 sarcopenic 13 index 13 index 15 si 13 index 18 assessed 14 ( 15 si 15 si 16 ) 17 ( 18 assessed 18 assessed 19 by 18 assessed 26 ) 19 by 21 energy 20 dual 21 energy 21 energy 22 x 21 energy 25 absorptiometry 23 - 25 absorptiometry 24 ray 25 absorptiometry 25 absorptiometry 26 ) 27 over 29 and 28 time 29 and 29 and 31 pwv 30 baseline 31 pwv 32 independently 33 of 33 of 35 confounders 34 multiple 35 confounders si was defined : appendicular lean mass/squared height and calculated at [every] [follow] - up ( n = 6 ) . 0 ###LEFT-WALL### 1 si 0 ###LEFT-WALL### 3 defined 0 ###LEFT-WALL### 4 : 1 si 2 was 2 was 3 defined 4 : 6 lean 4 : 9 and 4 : 21 . 5 appendicular 6 lean 6 lean 9 and 7 mass/squared 8 height 7 mass/squared 9 and 9 and 10 calculated 9 and 11 at 9 and 18 = 11 at 15 up 14 - 15 up 16 ( 18 = 17 n 18 = 18 = 19 6 18 = 20 ) baseline pwv was significantly higher in black women compared to white women [(] 930 ± 431 vs [.] 843 ± 366 [;] p = 0.0001 [ )(, while there were no significant differences between black and white men ( 943 ± 402 vs [.] 911 ± 375 [;] p = 0.1786 ) . 1 baseline 2 pwv 1 baseline 3 was 1 baseline 5 higher 1 baseline 9 compared 2 pwv 3 was 3 was 4 significantly 5 higher 6 in 6 in 8 women 7 black 8 women 9 compared 10 to 9 compared 15 ± 10 to 11 white 11 white 12 women 12 women 14 930 15 ± 16 431 15 ± 20 ± 16 431 17 vs 16 431 20 ± 17 vs 19 843 20 ± 24 = 20 ± 28 while 21 366 24 = 23 p 24 = 24 = 25 0.0001 24 = 27 )(, 28 while 29 there 28 while 30 were 29 there 30 were 30 were 33 differences 30 were 34 between 31 no 33 differences 32 significant 33 differences 34 between 38 men 35 black 36 and 36 and 37 white 36 and 38 men 38 men 41 ± 39 ( 41 ± 40 943 41 ± 41 ± 42 402 41 ± 43 vs 41 ± 50 = 41 ± 53 . 43 vs 46 ± 45 911 46 ± 46 ± 47 375 49 p 50 = 50 = 51 0.1786 50 = 52 ) baseline analyses showed an independent negative association between pwv and muscle parameters after adjusting for confounders in both genders . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 20 . 1 baseline 2 analyses 2 analyses 10 and 3 showed 7 association 3 showed 8 between 3 showed 10 and 4 an 7 association 5 independent 7 association 6 negative 7 association 8 between 9 pwv 10 and 11 muscle 10 and 13 after 10 and 17 in 11 muscle 12 parameters 13 after 14 adjusting 14 adjusting 15 for 15 for 16 confounders 17 in 19 genders 18 both 19 genders the pwv - [by] - race interaction was significant in women and analyses are reported separately by race . 0 ###LEFT-WALL### 2 pwv 0 ###LEFT-WALL### 3 - 1 the 2 pwv 3 - 5 - 3 - 8 was 3 - 12 and 3 - 19 . 5 - 7 interaction 6 race 7 interaction 7 interaction 8 was 8 was 9 significant 9 significant 10 in 10 in 11 women 12 and 13 analyses 12 and 15 reported 13 analyses 14 are 14 are 15 reported 15 reported 16 separately 15 reported 17 by 17 by 18 race prospective mixed models showed that pwv was an independent determinant of the si in all men ( β [=] - 0.1043 [;] p = 0.0065 ) and in white women [(] β = - 0.1091 [;] p = 0.0192 ) . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 41 . 1 prospective 3 models 2 mixed 3 models 3 models 4 showed 4 showed 5 that 5 that 6 pwv 5 that 7 was 6 pwv 7 was 7 was 10 determinant 7 was 24 = 8 an 10 determinant 9 independent 10 determinant 10 determinant 11 of 10 determinant 18 β 11 of 13 si 12 the 13 si 13 si 14 in 14 in 16 men 15 all 16 men 17 ( 18 β 18 β 20 - 21 0.1043 24 = 23 p 24 = 24 = 25 0.0065 24 = 26 ) 27 and 32 β 27 and 33 = 28 in 30 women 28 in 32 β 29 white 30 women 32 β 33 = 33 = 35 0.1091 34 - 35 0.1091 35 0.1091 38 = 37 p 38 = 38 = 39 0.0192 38 = 40 ) in analyses examining the effect of arterial stiffness on limb lean mass over time , pwv correlated with lower leg ( β [=] - 0.2196 [;] p = 0.0002 )and arm mass [(] β = - [0.0985] [;] p = 0.0011 ) in all men and lower leg mass [(] β = - 0.1608 [;] p = 0.0027 )in white women . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 12 mass 1 in 2 analyses 2 analyses 3 examining 2 analyses 12 mass 3 examining 5 effect 3 examining 9 on 4 the 5 effect 5 effect 6 of 6 of 8 stiffness 7 arterial 8 stiffness 9 on 11 lean 10 limb 11 lean 12 mass 13 over 12 mass 18 with 13 over 14 time 14 time 17 correlated 15 , 17 correlated 16 pwv 17 correlated 18 with 20 leg 19 lower 20 leg 20 leg 24 - 20 leg 28 = 21 ( 24 - 22 β 24 - 24 - 25 0.2196 27 p 28 = 28 = 29 0.0002 29 0.0002 34 β 29 0.0002 35 = 30 )and 34 β 31 arm 34 β 32 mass 34 β 34 β 35 = 35 = 40 = 35 = 43 in 36 - 40 = 39 p 40 = 40 = 41 0.0011 40 = 42 ) 43 in 46 and 44 all 45 men 45 men 46 and 46 and 49 mass 46 and 51 β 46 and 52 = 46 and 54 0.1608 47 lower 48 leg 48 leg 49 mass 51 β 52 = 53 - 54 0.1608 54 0.1608 57 = 54 0.1608 62 . 56 p 57 = 57 = 61 women 58 0.0027 61 women 59 )in 61 women 60 white 61 women in older persons , arterial stiffening is associated with skeletal muscle [mass] [decline] differently for race and gender . 0 ###LEFT-WALL### 6 stiffening 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 19 . 1 in 3 persons 1 in 4 , 1 in 6 stiffening 2 older 3 persons 5 arterial 6 stiffening 6 stiffening 7 is 7 is 8 associated 8 associated 9 with 8 associated 14 differently 9 with 11 muscle 10 skeletal 11 muscle 14 differently 15 for 15 for 17 and 16 race 17 and 17 and 18 gender this study investigated the fracture resistance of three different zirconia fixed partial dentures ( fpds ) with different cementation methods . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 21 . 1 this 2 study 2 study 3 investigated 3 investigated 6 resistance 3 investigated 17 with 4 the 6 resistance 5 fracture 6 resistance 6 resistance 7 of 7 of 13 dentures 8 three 13 dentures 9 different 13 dentures 10 zirconia 13 dentures 11 fixed 13 dentures 12 partial 13 dentures 13 dentures 15 fpds 14 ( 15 fpds 15 fpds 16 ) 17 with 20 methods 18 different 19 cementation 19 cementation 20 methods forty - eight three [-] unit fpds were adhesively bonded ( [ab] [ )(or conventionally cemented ( cc ) . 0 ###LEFT-WALL### 1 forty 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 20 . 2 - 4 three 3 eight 4 three 4 three 7 fpds 4 three 14 )(or 4 three 18 cc 6 unit 7 fpds 7 fpds 14 )(or 8 were 10 bonded 8 were 14 )(or 9 adhesively 10 bonded 11 ( 14 )(or 14 )(or 16 cemented 15 conventionally 16 cemented 17 ( 18 cc 18 cc 19 ) sixteen glass - infiltrated zirconia fpds were used as a control . 0 ###LEFT-WALL### 2 glass 0 ###LEFT-WALL### 3 - 1 sixteen 2 glass 3 - 6 fpds 3 - 8 used 3 - 12 . 4 infiltrated 6 fpds 5 zirconia 6 fpds 6 fpds 7 were 7 were 8 used 8 used 9 as 9 as 11 control 10 a 11 control fracture resistance was determined after aging . 0 ###LEFT-WALL### 2 resistance 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 7 . 1 fracture 2 resistance 2 resistance 3 was 3 was 4 determined 4 determined 5 after 5 after 6 aging the zirconia systems [showed] no significant different fracture [forces] with the different bonding methods [(] cc : [cercon] [[] [1,231.5] [±] [410.1] [n] []] [,] [ceramill] [[] [1,311.3] ± 318.3 n []] [,] vita yz [[] 1,269.0 ± 317.4 n []] [;] ab : [cercon] [ 1,072.3 ± 516.7 [n] []] , ceramill [ 1,358.6 ± [176.4] n ] , [vita] [yz] [[] [1,270.6] [±] [267.6n] []] [ )( [between] [the] [different] [materials] [.] 1 the 8 fracture 2 zirconia 8 fracture 3 systems 8 fracture 5 no 8 fracture 6 significant 8 fracture 7 different 8 fracture 8 fracture 10 with 8 fracture 13 bonding 8 fracture 17 : 10 with 12 different 11 the 12 different 13 bonding 14 methods 14 methods 16 cc 17 : 29 ± 29 ± 38 ± 30 318.3 31 n 31 n 38 ± 34 vita 38 ± 35 yz 37 1,269.0 35 yz 38 ± 38 ± 43 ab 38 ± 44 : 38 ± 48 ± 39 317.4 40 n 40 n 43 ab 43 ab 44 : 46 [ 48 ± 47 1,072.3 48 ± 48 ± 49 516.7 48 ± 53 ceramill 48 ± 60 , 52 , 53 ceramill 53 ceramill 58 n 53 ceramill 59 ] 54 [ 58 n 55 1,358.6 58 n 56 ± 58 n 58 n 59 ] the control group provided significantly lower fracture strength . 0 ###LEFT-WALL### 8 strength 0 ###LEFT-WALL### 9 . 1 the 8 strength 2 control 4 provided 3 group 4 provided 4 provided 7 fracture 5 significantly 6 lower 6 lower 7 fracture 7 fracture 8 strength regarding fracture resistance , adhesive bonding or conventional cementation of zirconia fpds showed no restrictions for posterior application . 0 ###LEFT-WALL### 7 or 0 ###LEFT-WALL### 13 showed 0 ###LEFT-WALL### 19 . 1 regarding 3 resistance 1 regarding 4 , 1 regarding 7 or 2 fracture 3 resistance 5 adhesive 6 bonding 5 adhesive 7 or 7 or 9 cementation 7 or 10 of 7 or 13 showed 8 conventional 9 cementation 10 of 12 fpds 11 zirconia 12 fpds 13 showed 15 restrictions 14 no 15 restrictions 15 restrictions 16 for 16 for 18 application 17 posterior 18 application despite a growing interest in the ways spiritual beliefs and practices are reflected in brain activity , there have been relatively few studies using neuroimaging data to assess potential relationships between religious factors and structural neuroanatomy . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 13 reflected 0 ###LEFT-WALL### 17 , 1 despite 4 interest 1 despite 10 and 2 a 4 interest 3 growing 4 interest 5 in 7 ways 5 in 10 and 6 the 7 ways 8 spiritual 9 beliefs 9 beliefs 10 and 10 and 11 practices 10 and 12 are 12 are 13 reflected 13 reflected 14 in 14 in 16 activity 15 brain 16 activity 17 , 18 there 17 , 20 been 18 there 19 have 19 have 20 been 20 been 34 and 21 relatively 22 few 22 few 23 studies 23 studies 24 using 23 studies 34 and 24 using 26 data 24 using 27 to 24 using 28 assess 25 neuroimaging 26 data 27 to 28 assess 28 assess 30 relationships 28 assess 31 between 29 potential 30 relationships 31 between 33 factors 32 religious 33 factors 34 and 36 neuroanatomy 34 and 37 . 35 structural 36 neuroanatomy this study examined prospective relationships between religious factors and hippocampal volume change using high - resolution mri data of a sample of 268 older adults . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 26 . 1 this 2 study 2 study 3 examined 3 examined 5 relationships 3 examined 12 change 4 prospective 5 relationships 5 relationships 6 between 5 relationships 12 change 6 between 9 and 7 religious 8 factors 8 factors 9 and 9 and 11 volume 10 hippocampal 11 volume 12 change 13 using 13 using 18 data 14 high 15 - 14 high 16 resolution 16 resolution 18 data 17 mri 18 data 18 data 19 of 18 data 22 of 19 of 21 sample 20 a 21 sample 22 of 25 adults 23 268 25 adults 24 older 25 adults religious factors assessed included life - changing religious experiences , spiritual practices , and religious group membership . 0 ###LEFT-WALL### 1 religious 0 ###LEFT-WALL### 2 factors 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 18 . 1 religious 2 factors 2 factors 5 life 2 factors 7 changing 3 assessed 5 life 4 included 5 life 6 - 7 changing 7 changing 9 experiences 7 changing 10 , 8 religious 9 experiences 10 , 14 and 11 spiritual 12 practices 12 practices 14 and 13 , 14 and 14 and 17 membership 15 religious 16 group 16 group 17 membership hippocampal volumes were analyzed using the grid program , which is based on a manual point - counting method and allows for semi - automated determination of region [of] interest volumes . 0 ###LEFT-WALL### 1 hippocampal 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 32 . 1 hippocampal 2 volumes 1 hippocampal 3 were 1 hippocampal 20 and 2 volumes 3 were 4 analyzed 5 using 4 analyzed 19 method 4 analyzed 20 and 5 using 8 program 6 the 8 program 7 grid 8 program 8 program 10 which 9 , 10 which 10 which 11 is 10 which 17 - 11 is 12 based 12 based 13 on 13 on 16 point 14 a 15 manual 14 a 16 point 15 manual 16 point 18 counting 19 method 20 and 21 allows 20 and 22 for 22 for 26 determination 23 semi 24 - 23 semi 26 determination 25 automated 26 determination 26 determination 27 of 27 of 31 volumes 28 region 31 volumes 30 interest 31 volumes significantly greater hippocampal atrophy was observed for participants reporting a life - changing religious experience . 0 ###LEFT-WALL### 4 atrophy 0 ###LEFT-WALL### 6 observed 1 significantly 2 greater 2 greater 4 atrophy 3 hippocampal 4 atrophy 4 atrophy 5 was 5 was 6 observed 6 observed 7 for 7 for 8 participants 8 participants 9 reporting 9 reporting 11 life 10 a 11 life 11 life 13 changing 12 - 13 changing 13 changing 15 experience 13 changing 16 . 14 religious 15 experience significantly greater hippocampal atrophy was also observed from baseline to final assessment among born - [again] protestants , catholics , and those with no religious affiliation , compared with protestants not identifying as born - again . 0 ###LEFT-WALL### 4 atrophy 0 ###LEFT-WALL### 7 observed 1 significantly 4 atrophy 2 greater 4 atrophy 3 hippocampal 4 atrophy 4 atrophy 5 was 5 was 6 also 5 was 7 observed 7 observed 8 from 7 observed 10 to 8 from 9 baseline 10 to 21 and 11 final 12 assessment 12 assessment 13 among 12 assessment 21 and 13 among 17 protestants 14 born 15 - 14 born 17 protestants 17 protestants 19 catholics 18 , 19 catholics 19 catholics 20 , 21 and 22 those 21 and 27 , 21 and 28 compared 22 those 23 with 23 with 26 affiliation 24 no 26 affiliation 25 religious 26 affiliation 28 compared 29 with 28 compared 34 born 29 with 30 protestants 29 with 31 not 29 with 32 identifying 33 as 34 born 34 born 36 again 35 - 36 again 36 again 37 . these associations were not explained by psychosocial or demographic factors , or baseline cerebral volume . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 16 . 1 these 2 associations 2 associations 3 were 3 were 4 not 3 were 6 by 4 not 5 explained 6 by 12 or 7 psychosocial 8 or 8 or 9 demographic 8 or 10 factors 10 factors 12 or 11 , 12 or 12 or 15 volume 13 baseline 15 volume 14 cerebral 15 volume hippocampal volume has been linked to clinical outcomes , such as depression , dementia , and alzheimer 's disease . 0 ###LEFT-WALL### 2 volume 0 ###LEFT-WALL### 5 linked 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 18 's 0 ###LEFT-WALL### 20 . 1 hippocampal 2 volume 2 volume 3 has 3 has 4 been 4 been 5 linked 5 linked 6 to 6 to 8 outcomes 7 clinical 8 outcomes 8 outcomes 11 as 8 outcomes 14 dementia 9 , 11 as 10 such 11 as 11 as 12 depression 11 as 13 , 13 , 14 dementia 14 dementia 15 , 16 and 17 alzheimer 16 and 18 's 17 alzheimer 18 's 18 's 19 disease the findings of this study indicate that hippocampal atrophy in late life may be uniquely influenced by certain types of religious factors . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 6 indicate 0 ###LEFT-WALL### 23 . 1 the 2 findings 2 findings 3 of 2 findings 6 indicate 3 of 5 study 4 this 5 study 6 indicate 7 that 7 that 9 atrophy 7 that 16 influenced 8 hippocampal 9 atrophy 9 atrophy 10 in 9 atrophy 13 may 10 in 12 life 11 late 12 life 13 may 14 be 14 be 15 uniquely 14 be 16 influenced 16 influenced 17 by 17 by 22 factors 18 certain 19 types 19 types 20 of 19 types 22 factors 20 of 22 factors 21 religious 22 factors background : mutations that disrupt the conversion of prelamin a to mature lamin a cause the rare genetic disorder hutchinson [-] gilford progeria syndrome and a group of laminopathies . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 mutations 2 : 15 cause 3 mutations 4 that 3 mutations 5 disrupt 3 mutations 15 cause 4 that 5 disrupt 5 disrupt 7 conversion 6 the 7 conversion 7 conversion 8 of 7 conversion 11 to 8 of 9 prelamin 9 prelamin 10 a 11 to 13 lamin 12 mature 13 lamin 13 lamin 14 a 15 cause 25 and 16 the 24 syndrome 17 rare 19 disorder 18 genetic 19 disorder 19 disorder 23 progeria 20 hutchinson 22 gilford 22 gilford 23 progeria 23 progeria 24 syndrome 24 syndrome 25 and 25 and 27 group 25 and 28 of 26 a 27 group 28 of 29 laminopathies our understanding of [how] a - type lamins function in vivo during early vertebrate development through aging remains limited , and would benefit from a suitable experimental model . 0 ###LEFT-WALL### 2 understanding 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 29 . 1 our 2 understanding 2 understanding 8 lamins 2 understanding 9 function 2 understanding 21 and 3 of 5 a 3 of 6 - 3 of 8 lamins 7 type 8 lamins 8 lamins 9 function 9 function 11 vivo 9 function 12 during 9 function 16 through 10 in 11 vivo 12 during 15 development 13 early 14 vertebrate 14 vertebrate 15 development 16 through 17 aging 18 remains 19 limited 18 remains 21 and 20 , 21 and 21 and 22 would 22 would 23 benefit 23 benefit 24 from 24 from 28 model 25 a 26 suitable 25 a 28 model 26 suitable 28 model 27 experimental 28 model the zebrafish has proven to be a tractable model organism for studying both development and aging at the molecular genetic level . 0 ###LEFT-WALL### 2 zebrafish 0 ###LEFT-WALL### 4 proven 0 ###LEFT-WALL### 22 . 1 the 2 zebrafish 2 zebrafish 3 has 3 has 4 proven 4 proven 5 to 4 proven 6 be 5 to 6 be 6 be 10 organism 7 a 10 organism 8 tractable 9 model 9 model 10 organism 10 organism 11 for 10 organism 17 at 11 for 12 studying 12 studying 15 and 13 both 15 and 14 development 15 and 15 and 16 aging 17 at 21 level 18 the 21 level 19 molecular 21 level 20 genetic 21 level zebrafish show an array of senescence symptoms resembling those in humans , which can be targeted to specific aging pathways conserved in vertebrates . 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 24 . 1 zebrafish 2 show 2 show 4 array 2 show 7 symptoms 2 show 10 in 3 an 4 array 4 array 5 of 5 of 6 senescence 7 symptoms 8 resembling 8 resembling 9 those 10 in 11 humans 12 , 13 which 12 , 16 targeted 13 which 14 can 14 can 15 be 15 be 16 targeted 16 targeted 17 to 16 targeted 22 in 17 to 20 pathways 18 specific 20 pathways 19 aging 20 pathways 20 pathways 21 conserved 22 in 23 vertebrates however , no zebrafish models bearing human premature senescence currently exist . 0 ###LEFT-WALL### 5 models 0 ###LEFT-WALL### 11 exist 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 5 models 3 no 5 models 4 zebrafish 5 models 5 models 6 bearing 5 models 11 exist 6 bearing 9 senescence 7 human 9 senescence 8 premature 9 senescence 10 currently 11 exist principal findings : we describe the induction of embryonic senescence and laminopathies in zebrafish harboring disturbed expressions of the lamin a gene ( lmna ) . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 principal 2 findings 3 : 4 we 3 : 5 describe 3 : 26 . 4 we 5 describe 5 describe 11 and 6 the 11 and 7 induction 8 of 7 induction 11 and 8 of 10 senescence 9 embryonic 10 senescence 11 and 12 laminopathies 11 and 13 in 11 and 15 harboring 11 and 18 of 13 in 14 zebrafish 15 harboring 17 expressions 16 disturbed 17 expressions 18 of 22 gene 19 the 22 gene 20 lamin 21 a 20 lamin 22 gene 22 gene 24 lmna 23 ( 24 lmna 24 lmna 25 ) impairments in these fish arise in the skin , muscle and adipose tissue , and [sometimes] in the cartilage . 0 ###LEFT-WALL### 1 impairments 0 ###LEFT-WALL### 5 arise 0 ###LEFT-WALL### 20 . 1 impairments 2 in 1 impairments 5 arise 2 in 4 fish 3 these 4 fish 5 arise 15 and 6 in 11 and 6 in 15 and 7 the 8 skin 8 skin 9 , 9 , 10 muscle 9 , 11 and 11 and 13 tissue 12 adipose 13 tissue 14 , 15 and 15 and 17 in 17 in 19 cartilage 18 the 19 cartilage reduced function [of] lamin a/c by translational blocking of the lmna gene induced apoptosis , cell - cycle arrest , and craniofacial abnormalities/cartilage defects . 0 ###LEFT-WALL### 5 a/c 0 ###LEFT-WALL### 13 induced 0 ###LEFT-WALL### 15 , 1 reduced 2 function 2 function 4 lamin 4 lamin 5 a/c 5 a/c 6 by 5 a/c 13 induced 6 by 8 blocking 7 translational 8 blocking 8 blocking 9 of 9 of 12 gene 10 the 12 gene 11 lmna 12 gene 13 induced 14 apoptosis 15 , 16 cell 15 , 17 - 17 - 21 and 17 - 25 . 18 cycle 19 arrest 19 arrest 21 and 20 , 21 and 21 and 24 defects 22 craniofacial 24 defects 23 abnormalities/cartilage 24 defects by contrast , induced cryptic splicing of lmna , which generates the deletion of 8 amino acid residues lamin a ( zlamin a - δ8 ) , showed embryonic senescence and s - phase accumulation/arrest . 0 ###LEFT-WALL### 6 splicing 0 ###LEFT-WALL### 28 showed 0 ###LEFT-WALL### 33 - 1 by 2 contrast 1 by 3 , 1 by 6 splicing 4 induced 6 splicing 5 cryptic 6 splicing 6 splicing 7 of 6 splicing 10 which 6 splicing 28 showed 7 of 8 lmna 9 , 10 which 10 which 11 generates 10 which 27 , 11 generates 13 deletion 12 the 13 deletion 13 deletion 14 of 14 of 19 lamin 15 8 17 acid 16 amino 17 acid 17 acid 19 lamin 18 residues 19 lamin 19 lamin 20 a 19 lamin 22 zlamin 21 ( 22 zlamin 22 zlamin 23 a 22 zlamin 25 δ8 22 zlamin 27 , 24 - 25 δ8 25 δ8 26 ) 28 showed 30 senescence 28 showed 31 and 29 embryonic 30 senescence 31 and 32 s 33 - 34 phase 33 - 36 . 34 phase 35 accumulation/arrest interestingly , the abnormal muscle and lipodystrophic [phenotypes] were common in both cases . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 14 . 1 interestingly 2 , 1 interestingly 6 and 3 the 5 muscle 4 abnormal 5 muscle 5 muscle 6 and 6 and 7 lipodystrophic 6 and 9 were 9 were 10 common 10 common 11 in 11 in 13 cases 12 both 13 cases hence , both decrease - [of] - [function] of lamin a/c and gain - [of] - function [of] aberrant lamin a protein induced laminopathies that are associated with mesenchymal cell lineages during zebrafish early development . 0 ###LEFT-WALL### 4 decrease 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 36 . 1 hence 2 , 1 hence 4 decrease 3 both 4 decrease 5 - 22 protein 5 - 23 induced 7 - 9 of 9 of 12 and 9 of 16 - 9 of 22 protein 10 lamin 11 a/c 11 a/c 12 and 12 and 13 gain 12 and 14 - 17 function 22 protein 19 aberrant 20 lamin 20 lamin 21 a 20 lamin 22 protein 22 protein 23 induced 23 induced 24 laminopathies 24 laminopathies 25 that 24 laminopathies 26 are 25 that 26 are 26 are 27 associated 27 associated 28 with 28 with 31 lineages 29 mesenchymal 30 cell 30 cell 31 lineages 31 lineages 32 during 32 during 35 development 33 zebrafish 35 development 34 early 35 development visualization of individual cells expressing zebrafish progerin ( zprogerin/zlamin a - δ37 ) fused to green fluorescent protein further revealed misshapen nuclear membrane . 0 ###LEFT-WALL### 1 visualization 0 ###LEFT-WALL### 20 revealed 0 ###LEFT-WALL### 24 . 1 visualization 2 of 1 visualization 5 expressing 1 visualization 14 fused 1 visualization 20 revealed 2 of 4 cells 3 individual 4 cells 5 expressing 7 progerin 6 zebrafish 7 progerin 7 progerin 9 zprogerin/zlamin 8 ( 9 zprogerin/zlamin 9 zprogerin/zlamin 10 a 9 zprogerin/zlamin 12 δ37 9 zprogerin/zlamin 13 ) 11 - 12 δ37 12 δ37 13 ) 14 fused 15 to 15 to 16 green 16 green 18 protein 16 green 19 further 17 fluorescent 18 protein 20 revealed 23 membrane 21 misshapen 23 membrane 22 nuclear 23 membrane a farnesyltransferase inhibitor reduced these nuclear abnormalities and significantly prevented embryonic senescence and muscle fiber damage induced by zprogerin . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 . 1 a 3 inhibitor 2 farnesyltransferase 3 inhibitor 3 inhibitor 8 and 3 inhibitor 13 and 4 reduced 7 abnormalities 4 reduced 8 and 5 these 7 abnormalities 6 nuclear 7 abnormalities 8 and 10 prevented 8 and 12 senescence 9 significantly 10 prevented 11 embryonic 12 senescence 13 and 16 damage 13 and 17 induced 14 muscle 16 damage 15 fiber 16 damage 17 induced 18 by 18 by 19 zprogerin importantly , the adult progerin fish survived and remained [fertile] [with] relatively mild [phenotypes] only , but had shortened lifespan with obvious distortion of body shape . 0 ###LEFT-WALL### 6 fish 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 27 . 1 importantly 2 , 1 importantly 6 fish 3 the 6 fish 4 adult 6 fish 5 progerin 6 fish 6 fish 8 and 7 survived 8 and 8 and 17 but 9 remained 13 mild 9 remained 17 but 12 relatively 13 mild 13 mild 15 only 16 , 17 but 17 but 18 had 18 had 19 shortened 19 shortened 20 lifespan 19 shortened 21 with 21 with 23 distortion 22 obvious 23 distortion 23 distortion 24 of 24 of 26 shape 25 body 26 shape conclusion : we generated new zebrafish models for a human premature aging disorder , and further demonstrated the utility for studying laminopathies . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 15 and 2 : 23 . 3 we 15 and 4 generated 7 models 4 generated 15 and 5 new 6 zebrafish 6 zebrafish 7 models 7 models 8 for 8 for 13 disorder 9 a 10 human 9 a 13 disorder 10 human 13 disorder 11 premature 13 disorder 12 aging 13 disorder 14 , 15 and 15 and 17 demonstrated 15 and 20 for 16 further 17 demonstrated 17 demonstrated 19 utility 18 the 19 utility 20 for 21 studying 21 studying 22 laminopathies premature aging could also be modeled in zebrafish embryos . 0 ###LEFT-WALL### 1 premature 0 ###LEFT-WALL### 6 modeled 0 ###LEFT-WALL### 10 . 1 premature 2 aging 1 premature 3 could 3 could 5 be 4 also 5 be 5 be 6 modeled 6 modeled 7 in 7 in 9 embryos 8 zebrafish 9 embryos this genetic model may thus provide a new platform for future drug screening as well as genetic analyses aimed at identifying modifier genes that influence not only progeria and laminopathies but also other age - associated human diseases common in vertebrates . 0 ###LEFT-WALL### 3 model 0 ###LEFT-WALL### 6 provide 1 this 3 model 2 genetic 3 model 3 model 4 may 4 may 6 provide 5 thus 6 provide 6 provide 9 platform 6 provide 15 well 6 provide 16 as 7 a 9 platform 8 new 9 platform 9 platform 10 for 10 for 13 screening 11 future 13 screening 12 drug 13 screening 14 as 15 well 16 as 18 analyses 17 genetic 18 analyses 18 analyses 19 aimed 18 analyses 20 at 20 at 21 identifying 21 identifying 23 genes 22 modifier 23 genes 23 genes 24 that 23 genes 25 influence 23 genes 38 diseases 24 that 25 influence 25 influence 32 also 26 not 27 only 27 only 32 also 28 progeria 29 and 29 and 30 laminopathies 29 and 32 also 31 but 32 also 32 also 34 age 33 other 34 age 35 - 38 diseases 36 associated 37 human 37 human 38 diseases 38 diseases 39 common 38 diseases 42 . 39 common 40 in 40 in 41 vertebrates the decline in serum testosterone in ageing men may be mediated in part by obesity ; however , it is uncertain which measure of adiposity is most closely associated with testosterone levels . 0 ###LEFT-WALL### 2 decline 0 ###LEFT-WALL### 11 mediated 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 33 . 1 the 2 decline 2 decline 3 in 2 decline 5 testosterone 2 decline 9 may 3 in 4 serum 5 testosterone 6 in 6 in 8 men 7 ageing 8 men 9 may 10 be 10 be 11 mediated 11 mediated 13 part 12 in 13 part 13 part 14 by 14 by 15 obesity 16 ; 19 it 16 ; 20 is 17 however 18 , 17 however 19 it 19 it 20 is 20 is 21 uncertain 21 uncertain 22 which 22 which 23 measure 23 measure 24 of 23 measure 26 is 24 of 25 adiposity 26 is 27 most 27 most 29 associated 27 most 30 with 28 closely 29 associated 30 with 32 levels 31 testosterone 32 levels we have examined the relationships of age , adiposity and testosterone levels in ageing men with symptoms consistent with hypoandrogenism but who were otherwise in good health . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 21 but 0 ###LEFT-WALL### 28 . 1 we 2 have 2 have 3 examined 3 examined 10 and 3 examined 13 in 4 the 10 and 5 relationships 6 of 5 relationships 8 , 6 of 7 age 8 , 9 adiposity 8 , 10 and 10 and 12 levels 11 testosterone 12 levels 13 in 15 men 14 ageing 15 men 15 men 16 with 16 with 17 symptoms 17 symptoms 18 consistent 18 consistent 19 with 19 with 20 hypoandrogenism 21 but 22 who 21 but 23 were 22 who 23 were 23 were 24 otherwise 23 were 25 in 25 in 27 health 26 good 27 health we conducted a cross - sectional study [of] [non] - smoking men aged ≥ 54 years recruited from the community and who were free of cancer or serious medical illness . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conducted 0 ###LEFT-WALL### 10 - 1 we 2 conducted 2 conducted 4 cross 3 a 4 cross 4 cross 7 study 5 - 7 study 6 sectional 7 study 7 study 10 - 10 - 12 men 10 - 23 were 10 - 31 . 11 smoking 12 men 12 men 13 aged 12 men 18 from 12 men 23 were 13 aged 17 recruited 14 ≥ 17 recruited 15 54 16 years 16 years 17 recruited 18 from 21 and 19 the 20 community 20 community 21 and 21 and 22 who 23 were 27 or 24 free 25 of 24 free 27 or 25 of 26 cancer 27 or 30 illness 28 serious 30 illness 29 medical 30 illness height ( ht ) , weight and waist circumference ( wc ) were measured , and body mass index ( bmi ) and waist - [to] - height ( wht ) [ratio] were calculated . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 13 were 0 ###LEFT-WALL### 25 - 1 height 3 ht 1 height 5 , 2 ( 3 ht 3 ht 4 ) 5 , 6 weight 5 , 7 and 7 and 9 circumference 7 and 11 wc 7 and 13 were 8 waist 9 circumference 10 ( 11 wc 11 wc 12 ) 13 were 23 and 14 measured 16 and 15 , 16 and 16 and 19 index 16 and 21 bmi 16 and 23 and 17 body 19 index 18 mass 19 index 20 ( 21 bmi 21 bmi 22 ) 23 and 24 waist 25 - 27 - 25 - 34 calculated 25 - 35 . 27 - 28 height 28 height 30 wht 28 height 33 were 29 ( 30 wht 30 wht 31 ) 33 were 34 calculated two morning blood samples were collected for measurement of total testosterone ( tt ) , sex hormone binding globulin ( shbg ) and luteinizing hormone ( lh ) . 0 ###LEFT-WALL### 4 samples 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 29 . 1 two 4 samples 2 morning 3 blood 3 blood 4 samples 4 samples 5 were 5 were 23 and 6 collected 7 for 6 collected 23 and 7 for 8 measurement 8 measurement 9 of 8 measurement 19 globulin 9 of 11 testosterone 10 total 11 testosterone 11 testosterone 13 tt 12 ( 13 tt 13 tt 14 ) 15 , 19 globulin 16 sex 18 binding 17 hormone 18 binding 18 binding 19 globulin 19 globulin 21 shbg 19 globulin 22 ) 20 ( 21 shbg 21 shbg 22 ) 23 and 25 hormone 23 and 27 lh 24 luteinizing 25 hormone 26 ( 27 lh 27 lh 28 ) free testosterone ( cft ) was calculated . 0 ###LEFT-WALL### 2 testosterone 0 ###LEFT-WALL### 7 calculated 0 ###LEFT-WALL### 8 . 1 free 2 testosterone 2 testosterone 4 cft 2 testosterone 6 was 3 ( 4 cft 4 cft 5 ) 6 was 7 calculated multivariate linear regression analysis was performed to assess their relationship with measures of adiposity . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 6 performed 0 ###LEFT-WALL### 15 . 1 multivariate 4 analysis 2 linear 3 regression 3 regression 4 analysis 4 analysis 5 was 5 was 6 performed 6 performed 7 to 7 to 8 assess 8 assess 10 relationship 8 assess 11 with 9 their 10 relationship 11 with 12 measures 12 measures 13 of 13 of 14 adiposity two hundred and seven men aged 54 - 86 years were studied . 0 ###LEFT-WALL### 5 men 0 ###LEFT-WALL### 6 aged 0 ###LEFT-WALL### 13 . 1 two 2 hundred 2 hundred 3 and 3 and 4 seven 4 seven 5 men 5 men 6 aged 6 aged 8 - 7 54 8 - 8 - 9 86 9 86 10 years 10 years 11 were 11 were 12 studied on univariate analysis wht [ratio] was more strongly correlated with tt and cft than either wc or bmi . 0 ###LEFT-WALL### 4 wht 0 ###LEFT-WALL### 9 correlated 0 ###LEFT-WALL### 19 . 1 on 3 analysis 1 on 4 wht 2 univariate 3 analysis 4 wht 6 was 6 was 9 correlated 7 more 8 strongly 8 strongly 9 correlated 9 correlated 10 with 9 correlated 14 than 10 with 12 and 11 tt 12 and 12 and 13 cft 14 than 17 or 15 either 17 or 16 wc 17 or 17 or 18 bmi in conclusion , wht [ratio] is the best anthropometric predictor of both tt and cft in this group of healthy but symptomatic ageing men . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 25 . 1 in 2 conclusion 3 , 4 wht 3 , 6 is 4 wht 6 is 6 is 10 predictor 6 is 16 in 7 the 8 best 7 the 10 predictor 9 anthropometric 10 predictor 10 predictor 11 of 11 of 14 and 12 both 14 and 13 tt 14 and 14 and 15 cft 16 in 24 men 17 this 18 group 18 group 19 of 18 group 24 men 19 of 24 men 20 healthy 21 but 21 but 22 symptomatic 21 but 24 men 23 ageing 24 men objective : the purpose of the present study was to examine the effects of age and visual content [on] cross - modal enhancement of auditory speech detection . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 examine 2 : 4 purpose 3 the 4 purpose 4 purpose 5 of 4 purpose 8 study 4 purpose 11 examine 5 of 7 present 6 the 7 present 8 study 9 was 9 was 10 to 9 was 11 examine 10 to 11 examine 11 examine 13 effects 12 the 13 effects 13 effects 14 of 13 effects 23 enhancement 14 of 16 and 15 age 16 and 16 and 20 cross 17 visual 20 cross 18 content 20 cross 21 - 23 enhancement 22 modal 23 enhancement 23 enhancement 24 of 23 enhancement 28 . 24 of 27 detection 25 auditory 26 speech 26 speech 27 detection visual content consisted of three clearly distinct types of visual information : an unaltered video clip of a talker 's face , a low - contrast version of the same clip , and a mouth - like lissajous figure . 0 ###LEFT-WALL### 2 content 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 12 : 0 ###LEFT-WALL### 40 . 1 visual 2 content 2 content 3 consisted 3 consisted 4 of 4 of 11 information 5 three 8 types 6 clearly 7 distinct 7 distinct 8 types 8 types 9 of 8 types 11 information 9 of 11 information 10 visual 11 information 12 : 16 clip 12 : 22 , 13 an 14 unaltered 13 an 16 clip 14 unaltered 15 video 15 video 16 clip 16 clip 17 of 17 of 21 face 18 a 19 talker 19 talker 20 's 20 's 21 face 22 , 39 figure 23 a 24 low 23 a 27 version 24 low 25 - 24 low 26 contrast 26 contrast 27 version 27 version 28 of 27 version 33 and 28 of 31 clip 29 the 30 same 30 same 31 clip 32 , 33 and 33 and 35 mouth 33 and 36 - 33 and 37 like 33 and 39 figure 34 a 35 mouth 37 like 38 lissajous [it] was [hypothesized] that both young and older adults would exhibit reduced enhancement as visual content [diverged] from the original clip of the talker 's face , but that the decrease would be greater for older participants . 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 38 . 2 was 4 that 2 was 5 both 2 was 9 adults 2 was 11 exhibit 2 was 14 as 2 was 18 from 6 young 7 and 7 and 8 older 7 and 9 adults 9 adults 10 would 10 would 11 exhibit 11 exhibit 13 enhancement 12 reduced 13 enhancement 14 as 16 content 15 visual 16 content 18 from 21 clip 19 the 21 clip 20 original 21 clip 21 clip 22 of 22 of 26 face 23 the 24 talker 24 talker 25 's 25 's 26 face 27 , 31 decrease 27 , 33 be 28 but 29 that 28 but 31 decrease 30 the 31 decrease 31 decrease 32 would 32 would 33 be 33 be 34 greater 34 greater 35 for 35 for 37 participants 36 older 37 participants design : nineteen young adults and 19 older adults were asked to detect a single spoken syllable ( /ba/ ) in speech - shaped noise , and the level of the signal was adaptively varied to establish the signal - to [-] noise [ratio] ( snr ) at [threshold] . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 50 . 2 : 6 and 2 : 11 asked 2 : 27 and 3 nineteen 5 adults 4 young 5 adults 5 adults 6 and 6 and 9 adults 6 and 10 were 7 19 9 adults 8 older 9 adults 10 were 11 asked 11 asked 12 to 11 asked 13 detect 12 to 13 detect 13 detect 17 syllable 13 detect 21 in 14 a 17 syllable 15 single 17 syllable 16 spoken 17 syllable 17 syllable 19 /ba/ 18 ( 19 /ba/ 19 /ba/ 20 ) 21 in 22 speech 22 speech 25 noise 23 - 25 noise 24 shaped 25 noise 25 noise 26 , 26 , 27 and 27 and 29 level 27 and 33 was 28 the 29 level 29 level 30 of 29 level 33 was 30 of 32 signal 31 the 32 signal 33 was 34 adaptively 33 was 35 varied 35 varied 36 to 35 varied 48 at 36 to 37 establish 37 establish 39 signal 37 establish 48 at 38 the 39 signal 39 signal 41 to 40 - 41 to 41 to 43 noise 41 to 47 ) 43 noise 46 snr 45 ( 46 snr 46 snr 47 ) there was an auditory - [only] baseline condition and three audiovisual conditions in which the syllable was accompanied by one of the three visual signals ( the unaltered clip of the talker 's face , the low - contrast version of that clip , or the lissajous figure ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 7 baseline 3 an 7 baseline 4 auditory 5 - 4 auditory 7 baseline 7 baseline 9 and 7 baseline 18 accompanied 8 condition 9 and 9 and 12 conditions 9 and 13 in 9 and 18 accompanied 10 three 12 conditions 11 audiovisual 12 conditions 13 in 14 which 13 in 16 syllable 13 in 17 was 15 the 16 syllable 16 syllable 17 was 18 accompanied 19 by 19 by 20 one 20 one 21 of 20 one 29 clip 21 of 25 signals 22 the 23 three 23 three 25 signals 24 visual 25 signals 26 ( 29 clip 27 the 29 clip 28 unaltered 29 clip 29 clip 30 of 29 clip 45 or 29 clip 50 . 30 of 34 face 31 the 32 talker 32 talker 33 's 33 's 34 face 35 , 45 or 36 the 40 version 37 low 38 - 37 low 39 contrast 39 contrast 40 version 40 version 41 of 40 version 45 or 41 of 43 clip 42 that 43 clip 44 , 45 or 45 or 48 figure 45 or 49 ) 46 the 48 figure 47 lissajous 48 figure for each audiovisual condition , the snr [at] threshold was compared with the snr [at] threshold for the auditory - only condition to measure the amount of [cross] - modal enhancement . 0 ###LEFT-WALL### 9 threshold 0 ###LEFT-WALL### 11 compared 0 ###LEFT-WALL### 32 . 1 for 4 condition 1 for 5 , 1 for 9 threshold 2 each 4 condition 3 audiovisual 4 condition 6 the 9 threshold 7 snr 9 threshold 9 threshold 10 was 10 was 11 compared 11 compared 12 with 12 with 16 threshold 13 the 16 threshold 14 snr 16 threshold 16 threshold 17 for 17 for 31 enhancement 18 the 31 enhancement 19 auditory 22 condition 19 auditory 31 enhancement 20 - 21 only 20 - 22 condition 22 condition 23 to 22 condition 27 of 22 condition 29 - 23 to 24 measure 24 measure 26 amount 25 the 26 amount 26 amount 27 of 30 modal 31 enhancement results : young adults exhibited significant cross - modal enhancement with all three types of visual stimuli , with the greatest amount of enhancement observed for the unaltered clip of the talker 's face . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 adults 2 : 7 cross 2 : 8 - 3 young 4 adults 4 adults 5 exhibited 4 adults 7 cross 5 exhibited 6 significant 8 - 10 enhancement 9 modal 10 enhancement 10 enhancement 11 with 10 enhancement 15 of 10 enhancement 19 with 11 with 14 types 12 all 13 three 13 three 14 types 15 of 17 stimuli 16 visual 17 stimuli 18 , 19 with 19 with 22 amount 19 with 35 . 20 the 21 greatest 20 the 22 amount 22 amount 23 of 23 of 24 enhancement 24 enhancement 25 observed 24 enhancement 30 of 25 observed 26 for 26 for 29 clip 27 the 29 clip 28 unaltered 29 clip 30 of 34 face 31 the 32 talker 32 talker 33 's 33 's 34 face older adults , in contrast , exhibited significant [cross] - modal enhancement only with the unaltered face . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 7 exhibited 0 ###LEFT-WALL### 18 . 1 older 2 adults 2 adults 4 in 2 adults 7 exhibited 3 , 4 in 4 in 5 contrast 4 in 6 , 7 exhibited 12 enhancement 7 exhibited 13 only 8 significant 10 - 8 significant 12 enhancement 11 modal 12 enhancement 13 only 14 with 14 with 17 face 15 the 17 face 16 unaltered 17 face conclusions : results of this study suggest that visual signal content affects cross - modal enhancement of speech detection in both young and older adults . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 results 2 : 7 suggest 2 : 14 - 2 : 26 . 3 results 4 of 3 results 7 suggest 4 of 6 study 5 this 6 study 7 suggest 10 signal 7 suggest 13 cross 8 that 10 signal 9 visual 10 signal 10 signal 11 content 10 signal 12 affects 11 content 12 affects 14 - 16 enhancement 15 modal 16 enhancement 16 enhancement 17 of 17 of 19 detection 18 speech 19 detection 19 detection 20 in 20 in 25 adults 21 both 25 adults 22 young 23 and 23 and 24 older 23 and 25 adults they also support a hypothesized age [-] related deficit in processing low - contrast visual speech stimuli , even in older adults with normal contrast sensitivity . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 27 . 1 they 18 , 2 also 3 support 3 support 9 deficit 3 support 10 in 3 support 18 , 4 a 9 deficit 5 hypothesized 9 deficit 6 age 8 related 8 related 9 deficit 10 in 11 processing 11 processing 17 stimuli 12 low 13 - 12 low 14 contrast 14 contrast 17 stimuli 15 visual 16 speech 16 speech 17 stimuli 18 , 19 even 18 , 26 sensitivity 19 even 20 in 19 even 23 with 20 in 22 adults 21 older 22 adults 23 with 25 contrast 24 normal 25 contrast purpose of review : levels of dehydroepiandrosterone ( dhea ) are known to decline with age . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 4 : 1 purpose 2 of 2 of 3 review 4 : 5 levels 4 : 12 known 4 : 17 . 5 levels 6 of 5 levels 11 are 6 of 7 dehydroepiandrosterone 7 dehydroepiandrosterone 9 dhea 8 ( 9 dhea 9 dhea 10 ) 11 are 12 known 12 known 13 to 12 known 14 decline 13 to 14 decline 14 decline 15 with 15 with 16 age in an era of increasing use of supplements to better life , the benefits of dhea in the aging female population are controversial . 0 ###LEFT-WALL### 14 benefits 0 ###LEFT-WALL### 22 are 0 ###LEFT-WALL### 24 . 1 in 3 era 1 in 12 , 1 in 14 benefits 2 an 3 era 3 era 4 of 4 of 5 increasing 5 increasing 6 use 5 increasing 9 to 6 use 7 of 7 of 8 supplements 9 to 10 better 10 better 11 life 13 the 14 benefits 14 benefits 15 of 14 benefits 22 are 15 of 16 dhea 16 dhea 17 in 17 in 21 population 18 the 21 population 19 aging 21 population 20 female 21 population 22 are 23 controversial the goal of this article is to critically review published studies to determine if there is a role for dhea supplementation in postmenopausal women . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 25 . 1 the 2 goal 2 goal 3 of 2 goal 6 is 3 of 5 article 4 this 5 article 6 is 7 to 6 is 13 determine 7 to 9 review 8 critically 9 review 9 review 11 studies 9 review 12 to 10 published 11 studies 12 to 13 determine 13 determine 14 if 13 determine 22 in 14 if 15 there 14 if 16 is 15 there 16 is 16 is 18 role 17 a 18 role 18 role 19 for 19 for 21 supplementation 20 dhea 21 supplementation 22 in 24 women 23 postmenopausal 24 women recent findings : daily administration of oral dhea achieves serum concentrations similar to those of women in [their] 20 s . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 recent 2 findings 3 : 5 administration 3 : 9 achieves 3 : 21 . 4 daily 5 administration 5 administration 6 of 5 administration 9 achieves 6 of 8 dhea 7 oral 8 dhea 9 achieves 11 concentrations 10 serum 11 concentrations 11 concentrations 12 similar 12 similar 13 to 12 similar 17 in 13 to 14 those 14 those 15 of 15 of 16 women 17 in 20 s 19 20 20 s several observational studies have shown that lower dhea levels are associated with increased cardiovascular risk in women ; however , interventional trials show no improvement in atherosclerosis or cardiovascular risk factors , and a lowering of hdl cholesterol levels . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 18 ; 0 ###LEFT-WALL### 40 . 1 several 3 studies 2 observational 3 studies 3 studies 4 have 4 have 5 shown 5 shown 8 dhea 5 shown 9 levels 5 shown 11 associated 6 that 8 dhea 7 lower 8 dhea 9 levels 10 are 10 are 11 associated 11 associated 12 with 11 associated 16 in 12 with 15 risk 13 increased 15 risk 14 cardiovascular 15 risk 16 in 17 women 18 ; 22 trials 18 ; 23 show 18 ; 33 and 19 however 20 , 19 however 22 trials 21 interventional 22 trials 22 trials 23 show 23 show 25 improvement 24 no 25 improvement 25 improvement 26 in 26 in 28 or 27 atherosclerosis 28 or 28 or 31 factors 28 or 32 , 29 cardiovascular 31 factors 30 risk 31 factors 33 and 35 lowering 33 and 39 levels 34 a 35 lowering 35 lowering 36 of 35 lowering 39 levels 36 of 38 cholesterol 37 hdl 38 cholesterol dhea supplementation modestly increases bone mineral density in conjunction with adjuvant therapies and improves cognition in those [with] mild - to [-] moderate cognitive impairment , but does not affect cognition in unimpaired women . 0 ###LEFT-WALL### 2 supplementation 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 35 . 1 dhea 2 supplementation 2 supplementation 13 and 3 modestly 4 increases 4 increases 7 density 4 increases 8 in 4 increases 10 with 4 increases 13 and 5 bone 6 mineral 6 mineral 7 density 8 in 9 conjunction 10 with 12 therapies 11 adjuvant 12 therapies 13 and 27 but 13 and 32 in 14 improves 15 cognition 14 improves 16 in 14 improves 21 to 14 improves 27 but 16 in 19 mild 17 those 19 mild 20 - 21 to 21 to 23 moderate 21 to 26 , 23 moderate 25 impairment 24 cognitive 25 impairment 27 but 28 does 28 does 29 not 28 does 30 affect 30 affect 31 cognition 32 in 34 women 33 unimpaired 34 women use of intravaginal dhea , but not oral dhea , alleviates vaginal atrophy and [improves] sexual function in postmenopausal women . 0 ###LEFT-WALL### 6 but 0 ###LEFT-WALL### 11 alleviates 0 ###LEFT-WALL### 21 . 1 use 2 of 1 use 6 but 2 of 4 dhea 3 intravaginal 4 dhea 5 , 6 but 6 but 7 not 6 but 9 dhea 6 but 10 , 6 but 11 alleviates 7 not 8 oral 11 alleviates 14 and 12 vaginal 13 atrophy 13 atrophy 14 and 14 and 17 function 14 and 18 in 16 sexual 17 function 18 in 20 women 19 postmenopausal 20 women summary : on the basis of current evidence , there is no role for oral dhea supplementation in healthy , postmenopausal women . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 23 . 1 summary 2 : 2 : 3 on 3 on 5 basis 4 the 5 basis 5 basis 6 of 6 of 8 evidence 7 current 8 evidence 9 , 10 there 9 , 11 is 10 there 11 is 11 is 13 role 12 no 13 role 13 role 14 for 14 for 17 supplementation 15 oral 17 supplementation 16 dhea 17 supplementation 17 supplementation 18 in 18 in 22 women 19 healthy 20 , 19 healthy 22 women 21 postmenopausal 22 women where benefits have been shown , long - term studies are needed to confirm these benefits and verify the safety profile of dhea . 0 ###LEFT-WALL### 10 studies 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 24 . 1 where 2 benefits 1 where 5 shown 1 where 10 studies 2 benefits 3 have 3 have 4 been 4 been 5 shown 5 shown 6 , 7 long 8 - 7 long 9 term 9 term 10 studies 10 studies 11 are 11 are 12 needed 12 needed 13 to 13 to 17 and 14 confirm 16 benefits 14 confirm 17 and 15 these 16 benefits 17 and 18 verify 18 verify 21 profile 19 the 21 profile 20 safety 21 profile 21 profile 22 of 22 of 23 dhea purpose of review : the world population is aging and a rapid increase is being seen in the very elderly ( aged >80 years ) . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 4 : 1 purpose 2 of 2 of 3 review 4 : 7 population 4 : 8 is 4 : 10 and 4 : 26 . 5 the 7 population 6 world 7 population 7 population 8 is 8 is 9 aging 10 and 13 increase 10 and 14 is 11 a 12 rapid 11 a 13 increase 12 rapid 13 increase 13 increase 14 is 14 is 15 being 15 being 16 seen 15 being 17 in 15 being 24 years 17 in 20 elderly 18 the 19 very 18 the 20 elderly 21 ( 24 years 22 aged 24 years 23 >80 24 years 24 years 25 ) cholesterol levels in general rise with age and high cholesterol has been associated with extreme longevity . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 5 rise 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 17 . 1 cholesterol 2 levels 2 levels 4 general 2 levels 5 rise 3 in 4 general 5 rise 6 with 6 with 7 age 8 and 10 cholesterol 8 and 13 associated 9 high 10 cholesterol 10 cholesterol 11 has 11 has 12 been 12 been 13 associated 13 associated 14 with 14 with 16 longevity 15 extreme 16 longevity the relationship between lipids and cardiovascular events in the extreme [elderly] is unclear . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 14 . 1 the 2 relationship 2 relationship 3 between 2 relationship 12 is 3 between 5 and 4 lipids 5 and 5 and 7 events 5 and 8 in 6 cardiovascular 7 events 8 in 10 extreme 9 the 10 extreme 12 is 13 unclear recent findings : a number of genetic factors associated with lipid metabolism have also been described as having potential antiaging roles , including the genes encoding lipoprotein - associated factors - apolipoprotein e and cholesterol ester transfer protein [;] adipose tissue metabolism - adiponectin , leptin , glycaemia [;] and blood pressure - angiotensinogen . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 recent 2 findings 3 : 8 factors 4 a 5 number 5 number 6 of 5 number 8 factors 6 of 8 factors 7 genetic 8 factors 8 factors 9 associated 8 factors 10 with 8 factors 13 have 10 with 12 metabolism 11 lipid 12 metabolism 13 have 15 been 14 also 15 been 15 been 16 described 16 described 17 as 17 as 18 having 18 having 19 potential 18 having 23 including 19 potential 20 antiaging 20 antiaging 21 roles 22 , 23 including 23 including 34 and 24 the 34 and 25 genes 26 encoding 25 genes 34 and 26 encoding 27 lipoprotein 26 encoding 31 - 28 - 31 - 29 associated 30 factors 30 factors 31 - 31 - 32 apolipoprotein 32 apolipoprotein 33 e 34 and 42 metabolism 34 and 43 - 34 and 44 adiponectin 35 cholesterol 36 ester 36 ester 37 transfer 37 transfer 41 tissue 38 protein 40 adipose 40 adipose 41 tissue 41 tissue 42 metabolism 43 - 44 adiponectin 44 adiponectin 53 - 44 adiponectin 55 . 45 , 53 - 46 leptin 47 , 47 , 48 glycaemia 47 , 50 and 50 and 52 pressure 50 and 53 - 51 blood 52 pressure 53 - 54 angiotensinogen clinical trials of lipid [-] lowering therapies have recruited subgroups of moderately elderly patients , but only the prospective study of pravastatin in the elderly at risk ( prosper ) trial specifically recruited an elderly population . 0 ###LEFT-WALL### 2 trials 0 ###LEFT-WALL### 8 have 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 37 . 1 clinical 2 trials 2 trials 3 of 2 trials 8 have 3 of 7 therapies 4 lipid 7 therapies 6 lowering 7 therapies 8 have 10 subgroups 9 recruited 10 subgroups 10 subgroups 11 of 11 of 14 patients 12 moderately 13 elderly 13 elderly 14 patients 15 , 16 but 16 but 17 only 16 but 31 trial 16 but 33 recruited 18 the 31 trial 19 prospective 20 study 20 study 21 of 20 study 29 prosper 21 of 22 pravastatin 22 pravastatin 23 in 22 pravastatin 26 at 23 in 25 elderly 24 the 25 elderly 26 at 27 risk 28 ( 29 prosper 29 prosper 30 ) 29 prosper 31 trial 31 trial 33 recruited 32 specifically 33 recruited 33 recruited 36 population 34 an 35 elderly 34 an 36 population 35 elderly 36 population [there] is no direct equivalent of the hypertension in the very elderly trial ( hyvet ) study of antihypertensive patients in the extreme [elderly] . 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 25 . 2 is 5 equivalent 2 is 17 study 2 is 21 in 3 no 5 equivalent 4 direct 5 equivalent 5 equivalent 6 of 5 equivalent 9 in 5 equivalent 15 hyvet 6 of 8 hypertension 7 the 8 hypertension 9 in 13 trial 10 the 13 trial 11 very 13 trial 12 elderly 13 trial 14 ( 15 hyvet 15 hyvet 16 ) 17 study 18 of 18 of 20 patients 19 antihypertensive 20 patients 21 in 23 extreme 22 the 23 extreme no heterogeneity has been seen with the effects of statin therapy in the elderly compared with younger age groups on classical cardiovascular endpoints of coronary heart disease and stroke . 0 ###LEFT-WALL### 2 heterogeneity 0 ###LEFT-WALL### 15 compared 0 ###LEFT-WALL### 30 . 1 no 2 heterogeneity 2 heterogeneity 3 has 3 has 4 been 4 been 5 seen 5 seen 6 with 6 with 8 effects 6 with 15 compared 7 the 8 effects 8 effects 9 of 9 of 11 therapy 10 statin 11 therapy 11 therapy 12 in 12 in 14 elderly 13 the 14 elderly 15 compared 16 with 15 compared 20 on 16 with 19 groups 17 younger 18 age 18 age 19 groups 20 on 23 endpoints 21 classical 23 endpoints 22 cardiovascular 23 endpoints 23 endpoints 24 of 24 of 28 and 25 coronary 26 heart 26 heart 27 disease 27 disease 28 and 28 and 29 stroke summary : the optimal cholesterol target , long - term tolerability and the specific effects of statins on other vascular - associated diseases of aging , for example arterial aneurysms , microvascular renal and cerebral disease ( dementias ) , remain to be determined . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 45 . 1 summary 2 : 2 : 6 target 3 the 6 target 4 optimal 5 cholesterol 5 cholesterol 6 target 7 , 12 and 7 , 26 , 8 long 9 - 8 long 11 tolerability 10 term 11 tolerability 11 tolerability 12 and 12 and 15 effects 12 and 24 of 13 the 15 effects 14 specific 15 effects 15 effects 16 of 16 of 17 statins 17 statins 18 on 18 on 23 diseases 19 other 23 diseases 20 vascular 21 - 20 vascular 23 diseases 22 associated 23 diseases 24 of 25 aging 26 , 30 aneurysms 26 , 41 remain 27 for 28 example 28 example 29 arterial 29 arterial 30 aneurysms 30 aneurysms 36 disease 30 aneurysms 41 remain 31 , 36 disease 32 microvascular 36 disease 33 renal 34 and 34 and 35 cerebral 34 and 36 disease 36 disease 38 dementias 36 disease 40 , 37 ( 38 dementias 38 dementias 39 ) 41 remain 42 to 42 to 43 be 43 be 44 determined patient safety is an overarching theme inherent in hospital care . 0 ###LEFT-WALL### 2 safety 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 11 . 1 patient 2 safety 2 safety 3 is 3 is 6 theme 4 an 6 theme 5 overarching 6 theme 6 theme 7 inherent 7 inherent 8 in 8 in 10 care 9 hospital 10 care the aging of the population increases the potential for serious consequences from a lapse in safety . 0 ###LEFT-WALL### 2 aging 0 ###LEFT-WALL### 6 increases 0 ###LEFT-WALL### 17 . 1 the 2 aging 2 aging 3 of 2 aging 6 increases 3 of 5 population 4 the 5 population 6 increases 8 potential 6 increases 15 in 7 the 8 potential 8 potential 9 for 9 for 11 consequences 10 serious 11 consequences 11 consequences 12 from 12 from 14 lapse 13 a 14 lapse 15 in 16 safety educating intensive care unit nursing team members in early recognition of delirium and other fall risk factors can improve patient safety outcomes . 0 ###LEFT-WALL### 1 educating 0 ###LEFT-WALL### 19 improve 0 ###LEFT-WALL### 23 . 1 educating 7 members 1 educating 8 in 1 educating 18 can 2 intensive 3 care 3 care 5 nursing 4 unit 5 nursing 5 nursing 7 members 6 team 7 members 8 in 13 and 9 early 10 recognition 10 recognition 11 of 10 recognition 13 and 11 of 12 delirium 13 and 17 factors 14 other 17 factors 15 fall 17 factors 16 risk 17 factors 18 can 19 improve 19 improve 22 outcomes 20 patient 21 safety 21 safety 22 outcomes the geriatric resource nurse model was used to achieve a reduction in [falls] through standardized delirium screening and implementation of fall prevention strategies . 0 ###LEFT-WALL### 5 model 0 ###LEFT-WALL### 7 used 0 ###LEFT-WALL### 24 . 1 the 5 model 2 geriatric 3 resource 3 resource 5 model 4 nurse 5 model 5 model 6 was 6 was 7 used 7 used 8 to 7 used 9 achieve 8 to 9 achieve 9 achieve 11 reduction 9 achieve 12 in 10 a 11 reduction 12 in 18 and 14 through 16 delirium 15 standardized 16 delirium 16 delirium 17 screening 17 screening 18 and 18 and 19 implementation 18 and 20 of 20 of 23 strategies 21 fall 22 prevention 22 prevention 23 strategies the aim of this study was to assess the independent contributions of plasma levels of lipoprotein ( a [ )( lp [(] [a] ) [ )(, lp ( [a] [ )(cholesterol , and [of] apo ( a [ )(isoform size to prospective coronary heart disease ( chd ) risk . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 26 )(, 0 ###LEFT-WALL### 50 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 assess 7 to 8 assess 8 assess 11 contributions 9 the 11 contributions 10 independent 11 contributions 11 contributions 12 of 11 contributions 15 of 11 contributions 21 lp 12 of 14 levels 13 plasma 14 levels 15 of 16 lipoprotein 17 ( 21 lp 18 a 21 lp 21 lp 24 ) 26 )(, 33 and 27 lp 31 )(cholesterol 27 lp 33 and 28 ( 31 )(cholesterol 31 )(cholesterol 32 , 32 , 33 and 33 and 49 risk 35 apo 40 size 35 apo 48 ) 35 apo 49 risk 36 ( 40 size 37 a 40 size 39 )(isoform 40 size 40 size 41 to 40 size 47 chd 40 size 48 ) 41 to 45 disease 42 prospective 44 heart 43 coronary 44 heart 44 heart 45 disease 46 ( 47 chd 47 chd 48 ) plasma lp ( [a] [ )(and lp ( [a] [ )(cholesterol levels , and apo ( a [ )(isoform size were measured at examination cycle 5 in subjects participating in the framingham offspring study who were free of chd . 0 ###LEFT-WALL### 14 and 1 plasma 2 lp 2 lp 6 )(and 3 ( 6 )(and 6 )(and 7 lp 6 )(and 12 levels 6 )(and 14 and 8 ( 12 levels 11 )(cholesterol 12 levels 12 levels 13 , 13 , 14 and 14 and 15 apo 14 and 19 )(isoform 16 ( 19 )(isoform 17 a 19 )(isoform 19 )(isoform 20 size 19 )(isoform 21 were 19 )(isoform 22 measured 19 )(isoform 40 . 20 size 21 were 22 measured 23 at 22 measured 27 in 23 at 25 cycle 24 examination 25 cycle 25 cycle 26 5 27 in 28 subjects 28 subjects 29 participating 28 subjects 35 who 28 subjects 36 were 29 participating 30 in 30 in 34 study 31 the 34 study 32 framingham 33 offspring 33 offspring 34 study 35 who 36 were 36 were 37 free 37 free 38 of 38 of 39 chd after a mean follow - up of 12.3 years , 98 men and 47 women developed new chd events . 0 ###LEFT-WALL### 4 follow 0 ###LEFT-WALL### 5 - 1 after 3 mean 1 after 4 follow 2 a 3 mean 5 - 13 and 5 - 16 developed 5 - 20 . 6 up 7 of 6 up 10 , 7 of 9 years 8 12.3 9 years 10 , 12 men 10 , 13 and 11 98 12 men 13 and 15 women 13 and 16 developed 14 47 15 women 16 developed 19 events 17 new 19 events 18 chd 19 events in multivariate analysis , the hazard ratio of chd was approximately two - fold greater [in] men in the upper tertile of plasma lp ( a [ )(levels [,] relative to those in the bottom tertile ( p < 0.002 ) . 0 ###LEFT-WALL### 7 ratio 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 42 . 1 in 3 analysis 1 in 4 , 1 in 7 ratio 2 multivariate 3 analysis 5 the 7 ratio 6 hazard 7 ratio 7 ratio 8 of 7 ratio 10 was 8 of 9 chd 10 was 12 two 11 approximately 12 two 12 two 17 men 13 - 17 men 14 fold 17 men 15 greater 17 men 17 men 18 in 17 men 22 of 17 men 41 ) 18 in 21 tertile 19 the 21 tertile 20 upper 21 tertile 22 of 24 lp 23 plasma 24 lp 24 lp 30 relative 25 ( 30 relative 26 a 30 relative 28 )(levels 30 relative 30 relative 31 to 30 relative 33 in 30 relative 39 < 30 relative 41 ) 31 to 32 those 33 in 36 tertile 34 the 36 tertile 35 bottom 36 tertile 37 ( 39 < 38 p 39 < 39 < 40 0.002 39 < 41 ) the apo [(] [a] ) isoform size contributed only modestly to the association between lp ( [a] [ )(and chd and was not an independent predictor of chd . 0 ###LEFT-WALL### 7 size 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 29 . 1 the 7 size 2 apo 5 ) 2 apo 7 size 6 isoform 7 size 7 size 21 and 8 contributed 9 only 8 contributed 10 modestly 8 contributed 11 to 8 contributed 14 between 8 contributed 21 and 11 to 13 association 12 the 13 association 14 between 19 )(and 15 lp 19 )(and 16 ( 19 )(and 19 )(and 20 chd 21 and 22 was 22 was 23 not 22 was 26 predictor 24 an 25 independent 24 an 26 predictor 25 independent 26 predictor 26 predictor 27 of 27 of 28 chd in multivariate analysis , lp [(] [a] ) cholesterol was not significantly associated with chd risk in men . 0 ###LEFT-WALL### 9 cholesterol 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 19 . 1 in 3 analysis 1 in 9 cholesterol 2 multivariate 3 analysis 3 analysis 5 lp 4 , 5 lp 5 lp 8 ) 9 cholesterol 10 was 10 was 11 not 10 was 13 associated 12 significantly 13 associated 13 associated 14 with 13 associated 17 in 14 with 16 risk 15 chd 16 risk 17 in 18 men in women , no association between lp ( [a] [ )(and chd risk was observed . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 14 was 0 ###LEFT-WALL### 16 . 1 in 11 )(and 1 in 14 was 2 women 3 , 3 , 5 association 3 , 11 )(and 4 no 5 association 5 association 6 between 6 between 7 lp 8 ( 11 )(and 11 )(and 12 chd 13 risk 14 was 14 was 15 observed elevated plasma lp [(] [a] [ )(levels are a significant and independent predictor of chd risk in men . 0 ###LEFT-WALL### 7 )(levels 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 19 . 1 elevated 2 plasma 2 plasma 7 )(levels 3 lp 7 )(levels 7 )(levels 8 are 8 are 13 predictor 9 a 13 predictor 10 significant 11 and 11 and 12 independent 11 and 13 predictor 13 predictor 14 of 14 of 16 risk 15 chd 16 risk 16 risk 17 in 17 in 18 men the assessment of apo [(] [a] ) isoform size in this cohort does not add significant information about chd risk . 0 ###LEFT-WALL### 2 assessment 0 ###LEFT-WALL### 15 add 0 ###LEFT-WALL### 21 . 1 the 2 assessment 2 assessment 3 of 2 assessment 13 does 3 of 9 size 4 apo 7 ) 4 apo 9 size 8 isoform 9 size 9 size 10 in 10 in 12 cohort 11 this 12 cohort 13 does 14 not 13 does 15 add 15 add 17 information 15 add 18 about 16 significant 17 information 18 about 20 risk 19 chd 20 risk in addition , the cholesterol content in lp [(] [a] ) is not a significant predictor of chd risk . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 20 . 1 in 2 addition 2 addition 5 cholesterol 2 addition 12 is 3 , 5 cholesterol 4 the 5 cholesterol 5 cholesterol 6 content 5 cholesterol 11 ) 6 content 7 in 7 in 8 lp 12 is 13 not 12 is 16 predictor 14 a 15 significant 14 a 16 predictor 15 significant 16 predictor 16 predictor 17 of 17 of 19 risk 18 chd 19 risk background : glycosaminoglycans ( gags ) have various structural and physiological regulatory functions in skin , including tissue water maintenance , due to their high water - holding capacity . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 glycosaminoglycans 2 : 7 have 3 glycosaminoglycans 5 gags 3 glycosaminoglycans 7 have 4 ( 5 gags 5 gags 6 ) 7 have 13 functions 8 various 13 functions 9 structural 10 and 10 and 11 physiological 10 and 13 functions 12 regulatory 13 functions 13 functions 14 in 13 functions 28 holding 14 in 15 skin 15 skin 17 including 16 , 17 including 17 including 20 maintenance 17 including 27 - 18 tissue 20 maintenance 19 water 20 maintenance 20 maintenance 23 to 21 , 23 to 22 due 23 to 23 to 26 water 23 to 27 - 24 their 26 water 25 high 26 water 28 holding 29 capacity objective : to investigate changes of gags during intrinsic aging and photoaging of human skin and their correlations with water content . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 to 2 : 4 investigate 3 to 4 investigate 4 investigate 5 changes 4 investigate 8 during 5 changes 6 of 6 of 7 gags 8 during 11 and 9 intrinsic 10 aging 9 intrinsic 11 and 11 and 12 photoaging 11 and 13 of 11 and 19 with 13 of 16 and 14 human 15 skin 15 skin 16 and 16 and 18 correlations 17 their 18 correlations 19 with 21 content 20 water 21 content ha content was determined by enzyme - linked immunosorbent assay using ha - binding protein , tsgag by the sulfated gag assay kit using 1,9 - dimethylmethylene blue , tua by carbazole reaction , and tissue water by subtraction of tissue dry weight from wet weight . 0 ###LEFT-WALL### 2 content 0 ###LEFT-WALL### 4 determined 0 ###LEFT-WALL### 7 - 1 ha 2 content 2 content 3 was 3 was 4 determined 4 determined 5 by 5 by 6 enzyme 7 - 35 and 7 - 37 water 7 - 47 . 8 linked 17 tsgag 9 immunosorbent 10 assay 10 assay 17 tsgag 11 using 17 tsgag 12 ha 15 protein 12 ha 17 tsgag 13 - 15 protein 14 binding 15 protein 15 protein 16 , 17 tsgag 18 by 17 tsgag 35 and 18 by 23 kit 19 the 23 kit 20 sulfated 22 assay 21 gag 22 assay 22 assay 23 kit 23 kit 24 using 23 kit 30 tua 24 using 25 1,9 26 - 30 tua 27 dimethylmethylene 28 blue 28 blue 29 , 28 blue 30 tua 30 tua 31 by 30 tua 34 , 31 by 33 reaction 32 carbazole 33 reaction 35 and 36 tissue 35 and 37 water 37 water 38 by 37 water 42 dry 37 water 43 weight 38 by 39 subtraction 39 subtraction 40 of 40 of 41 tissue 43 weight 44 from 44 from 46 weight 45 wet 46 weight results : in the buttock , ha was higher in dermis than in epidermis , while tsgag and tua were higher in epidermis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 1 results 2 : 2 : 3 in 3 in 5 buttock 4 the 5 buttock 6 , 7 ha 6 , 8 was 7 ha 8 was 8 was 9 higher 9 higher 10 in 9 higher 12 than 9 higher 16 while 10 in 11 dermis 12 than 13 in 13 in 14 epidermis 15 , 16 while 16 while 18 and 16 while 20 were 16 while 24 . 17 tsgag 18 and 18 and 19 tua 18 and 20 were 20 were 21 higher 21 higher 22 in 22 in 23 epidermis in intrinsically aged buttock , epidermal ha and dermal tsgag and tua decreased . 0 ###LEFT-WALL### 4 buttock 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 14 . 1 in 4 buttock 2 intrinsically 3 aged 3 aged 4 buttock 5 , 7 ha 5 , 8 and 6 epidermal 7 ha 8 and 11 and 8 and 13 decreased 9 dermal 10 tsgag 10 tsgag 11 and 11 and 12 tua 11 and 13 decreased however , when analyzed for each gender , epidermal tsgag , tua , and tissue water decreased only in females . 0 ###LEFT-WALL### 16 water 0 ###LEFT-WALL### 17 decreased 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 16 water 3 when 4 analyzed 3 when 16 water 4 analyzed 5 for 5 for 14 and 6 each 7 gender 7 gender 8 , 8 , 10 tsgag 8 , 11 , 9 epidermal 10 tsgag 11 , 12 tua 11 , 14 and 13 , 14 and 14 and 15 tissue 16 water 17 decreased 17 decreased 18 only 18 only 19 in 19 in 20 females forearm/buttock ratios of each molecule were compared for determination of photoaging - dependent changes . 0 ###LEFT-WALL### 2 ratios 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 12 - 1 forearm/buttock 2 ratios 2 ratios 3 of 2 ratios 6 were 3 of 5 molecule 4 each 5 molecule 6 were 7 compared 7 compared 8 for 8 for 9 determination 9 determination 10 of 10 of 11 photoaging 12 - 14 changes 12 - 15 . 13 dependent 14 changes forearm/buttock ratios of ha , tsgag , tua , and tissue water increased in aged dermis , but showed no change in aged epidermis . 0 ###LEFT-WALL### 2 ratios 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 25 . 1 forearm/buttock 2 ratios 2 ratios 3 of 2 ratios 18 but 3 of 10 and 4 ha 5 , 5 , 6 tsgag 5 , 7 , 7 , 8 tua 7 , 10 and 9 , 10 and 10 and 12 water 11 tissue 12 water 13 increased 14 in 13 increased 18 but 14 in 16 dermis 15 aged 16 dermis 17 , 18 but 18 but 19 showed 19 showed 21 change 19 showed 22 in 20 no 21 change 22 in 24 epidermis 23 aged 24 epidermis when analyzed for each gender , ratios of epidermal ha and tissue water increased only in aged females , while ratios of epidermal tsgag , tua , and tissue water decreased only in aged males . 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 31 decreased 0 ###LEFT-WALL### 36 . 1 when 2 analyzed 1 when 19 , 1 when 28 and 2 analyzed 3 for 3 for 11 and 4 each 5 gender 5 gender 6 , 6 , 7 ratios 6 , 11 and 7 ratios 8 of 8 of 10 ha 9 epidermal 10 ha 11 and 13 water 11 and 14 increased 12 tissue 13 water 14 increased 15 only 15 only 16 in 16 in 18 females 17 aged 18 females 19 , 20 while 20 while 21 ratios 20 while 25 , 20 while 28 and 21 ratios 22 of 22 of 24 tsgag 23 epidermal 24 tsgag 26 tua 28 and 27 , 28 and 28 and 30 water 28 and 31 decreased 29 tissue 30 water 31 decreased 32 only 31 decreased 33 in 33 in 35 males 34 aged 35 males correlations of water content with ha , tsgag , and tua were found in epidermis , but not with tsgag in dermis . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 13 found 0 ###LEFT-WALL### 23 . 1 correlations 2 of 1 correlations 7 , 2 of 3 water 3 water 4 content 4 content 5 with 5 with 6 ha 7 , 8 tsgag 7 , 10 and 9 , 10 and 10 and 11 tua 10 and 12 were 12 were 13 found 13 found 17 but 13 found 21 in 14 in 15 epidermis 14 in 17 but 16 , 17 but 17 but 18 not 17 but 19 with 19 with 20 tsgag 21 in 22 dermis conclusion : these intrinsic aging - and photoaging - dependent gag changes and their correlations with water content provide new insights into the pathophysiology of dry skin in the elderly . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 31 . 1 conclusion 2 : 2 : 7 and 3 these 4 intrinsic 4 intrinsic 5 aging 4 intrinsic 7 and 6 - 7 and 7 and 8 photoaging 9 - 12 changes 9 - 13 and 10 dependent 12 changes 11 gag 12 changes 13 and 15 correlations 13 and 19 provide 14 their 15 correlations 15 correlations 16 with 15 correlations 19 provide 16 with 18 content 17 water 18 content 19 provide 21 insights 19 provide 28 in 20 new 21 insights 21 insights 22 into 22 into 24 pathophysiology 23 the 24 pathophysiology 24 pathophysiology 25 of 25 of 27 skin 26 dry 27 skin 28 in 30 elderly 29 the 30 elderly morphological changes in the lips during ageing , including labial volume , area and thickness were assessed in healthy individuals . 0 ###LEFT-WALL### 1 morphological 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 21 . 1 morphological 2 changes 2 changes 3 in 2 changes 6 during 3 in 5 lips 4 the 5 lips 6 during 7 ageing 7 ageing 9 including 8 , 9 including 9 including 11 volume 9 including 12 , 10 labial 11 volume 12 , 14 and 12 , 17 assessed 13 area 14 and 14 and 15 thickness 14 and 16 were 16 were 17 assessed 17 assessed 18 in 18 in 20 individuals 19 healthy 20 individuals three - dimensional ( 3 d ) stone labial models [were] made , digitized , and 3 d virtual reproductions obtained . 0 ###LEFT-WALL### 1 three 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 22 . 2 - 8 stone 3 dimensional 6 d 3 dimensional 8 stone 4 ( 6 d 5 3 6 d 6 d 7 ) 8 stone 16 and 8 stone 21 obtained 9 labial 10 models 10 models 12 made 10 models 16 and 12 made 14 digitized 13 , 14 digitized 14 digitized 15 , 15 , 16 and 16 and 20 reproductions 16 and 21 obtained 17 3 18 d 18 d 20 reproductions 19 virtual 20 reproductions labial thickness , vermilion area , and volume of the upper and lower lips were measured from the digital reconstructions . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 were 0 ###LEFT-WALL### 21 . 1 labial 2 thickness 2 thickness 3 , 3 , 5 area 3 , 7 and 4 vermilion 5 area 6 , 7 and 7 and 8 volume 7 and 9 of 7 and 15 were 9 of 14 lips 10 the 11 upper 11 upper 12 and 12 and 13 lower 12 and 14 lips 15 were 16 measured 16 measured 17 from 17 from 20 reconstructions 18 the 20 reconstructions 19 digital 20 reconstructions the data were compared using three - way anova . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 compared 0 ###LEFT-WALL### 7 - 1 the 2 data 2 data 3 were 3 were 4 compared 4 compared 5 using 5 using 6 three 7 - 9 anova 7 - 10 . 8 way 9 anova all data were significantly larger in men than in women ( p<0.05 ) , the lower lip was thicker than the upper lip ( p<0.001 ) . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 27 . 1 all 2 data 2 data 3 were 3 were 4 significantly 3 were 5 larger 5 larger 6 in 5 larger 8 than 6 in 7 men 8 than 9 in 9 in 10 women 10 women 12 p<0.05 11 ( 12 p<0.05 12 p<0.05 13 ) 14 , 17 lip 14 , 18 was 15 the 17 lip 16 lower 17 lip 17 lip 18 was 18 was 19 thicker 19 thicker 20 than 20 than 23 lip 21 the 23 lip 22 upper 23 lip 23 lip 25 p<0.001 24 ( 25 p<0.001 25 p<0.001 26 ) a significant effect of age for labial thickness and area [were] found ( p<0.001 and p=0.014 ) : the youthful group had higher values than the aged group . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 18 : 0 ###LEFT-WALL### 29 . 1 a 3 effect 2 significant 3 effect 3 effect 4 of 3 effect 6 for 3 effect 9 and 4 of 5 age 6 for 8 thickness 7 labial 8 thickness 9 and 10 area 9 and 12 found 9 and 15 and 13 ( 15 and 14 p<0.001 15 and 15 and 16 p=0.014 15 and 17 ) 18 : 21 group 18 : 22 had 19 the 21 group 20 youthful 21 group 21 group 22 had 22 had 24 values 22 had 25 than 23 higher 24 values 25 than 28 group 26 the 28 group 27 aged 28 group upper [to] lower lip ratios were not significantly different between sexes or ages . 0 ###LEFT-WALL### 5 ratios 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 14 . 1 upper 4 lip 3 lower 4 lip 4 lip 5 ratios 5 ratios 6 were 6 were 7 not 6 were 9 different 7 not 8 significantly 8 significantly 9 different 9 different 10 between 10 between 12 or 11 sexes 12 or 12 or 13 ages generally , young people have a larger lip area and thickness than aged ones and men had larger lips than women . 0 ###LEFT-WALL### 4 people 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 22 . 1 generally 2 , 1 generally 4 people 3 young 4 people 4 people 5 have 5 have 10 and 5 have 12 than 5 have 20 than 6 a 9 area 7 larger 8 lip 8 lip 9 area 9 area 10 and 10 and 11 thickness 12 than 15 and 12 than 17 had 12 than 19 lips 13 aged 14 ones 14 ones 15 and 15 and 16 men 15 and 17 had 18 larger 19 lips 20 than 21 women the upper/lower lip ratios for area and volume were similar in the two genders . 0 ###LEFT-WALL### 4 ratios 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 15 . 1 the 4 ratios 2 upper/lower 4 ratios 3 lip 4 ratios 4 ratios 5 for 4 ratios 9 were 5 for 7 and 6 area 7 and 7 and 8 volume 9 were 10 similar 10 similar 11 in 11 in 14 genders 12 the 13 two 13 two 14 genders [none] none this study explored the reliability and validity of a nine [-] item screening tool [(] [co] - [occurring] joint action council [ cojac ] screening tool [[] [cst] ] ) for co - occurring disorders ( cod ) . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 explored 0 ###LEFT-WALL### 41 . 2 none 3 this 3 this 4 study 4 study 5 explored 5 explored 8 and 5 explored 33 for 6 the 7 reliability 7 reliability 8 and 8 and 9 validity 8 and 32 ) 9 validity 10 of 10 of 16 tool 11 a 16 tool 12 nine 14 item 14 item 16 tool 15 screening 16 tool 16 tool 28 tool 19 - 28 tool 21 joint 22 action 22 action 23 council 23 council 25 cojac 24 [ 25 cojac 25 cojac 26 ] 25 cojac 27 screening 27 screening 28 tool 28 tool 31 ] 33 for 34 co 34 co 37 disorders 35 - 37 disorders 36 occurring 37 disorders 37 disorders 39 cod 37 disorders 40 ) 38 ( 39 cod 39 cod 40 ) using a convenience sample ( n=1,951 ) , an online survey was conducted in multiple settings and included demographic questions , [the] [cst] , the global appraisal of individual needs - short screener ( gain - ss ) , and the posttraumatic stress disorder checklist - civilian version . 0 ###LEFT-WALL### 11 survey 0 ###LEFT-WALL### 13 conducted 0 ###LEFT-WALL### 46 - 1 using 4 sample 1 using 8 , 1 using 11 survey 2 a 4 sample 3 convenience 4 sample 4 sample 6 n=1,951 5 ( 6 n=1,951 6 n=1,951 7 ) 9 an 11 survey 10 online 11 survey 11 survey 12 was 12 was 13 conducted 13 conducted 14 in 14 in 17 and 15 multiple 16 settings 16 settings 17 and 17 and 20 questions 17 and 21 , 17 and 27 appraisal 17 and 33 screener 18 included 19 demographic 19 demographic 20 questions 24 , 27 appraisal 25 the 27 appraisal 26 global 27 appraisal 27 appraisal 28 of 27 appraisal 31 - 28 of 30 needs 29 individual 30 needs 31 - 33 screener 32 short 33 screener 33 screener 40 and 33 screener 46 - 34 ( 40 and 35 gain 37 ss 35 gain 40 and 36 - 37 ss 37 ss 38 ) 39 , 40 and 40 and 45 checklist 40 and 46 - 41 the 45 checklist 42 posttraumatic 43 stress 43 stress 44 disorder 44 disorder 45 checklist 46 - 48 version 46 - 49 . 47 civilian 48 version the [cst] substance abuse ( sa ) [scale] performed well with a cronbach 's alpha of [.] 84 and a correlation of [.] 71 with gain - ss sa [(] [past] [year] ) . 0 ###LEFT-WALL### 4 abuse 0 ###LEFT-WALL### 9 performed 0 ###LEFT-WALL### 34 . 1 the 4 abuse 3 substance 4 abuse 4 abuse 6 sa 4 abuse 9 performed 5 ( 6 sa 6 sa 7 ) 9 performed 10 well 9 performed 11 with 11 with 19 and 12 a 13 cronbach 13 cronbach 14 's 14 's 15 alpha 15 alpha 16 of 15 alpha 19 and 16 of 18 84 19 and 21 correlation 19 and 22 of 20 a 21 correlation 22 of 24 71 24 71 25 with 24 71 29 sa 25 with 26 gain 27 - 29 sa 28 ss 29 sa 29 sa 33 ) the [cst] mental health and trauma items did not perform well as scales with cronbach 's alphas of [.] 64 and [.] 56 , respectively . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 perform 1 the 4 health 3 mental 4 health 4 health 5 and 5 and 7 items 5 and 8 did 6 trauma 7 items 8 did 9 not 8 did 10 perform 10 perform 11 well 10 perform 12 as 10 perform 14 with 10 perform 25 respectively 12 as 13 scales 14 with 17 alphas 15 cronbach 16 's 16 's 17 alphas 17 alphas 18 of 18 of 21 and 20 64 21 and 21 and 23 56 24 , 25 respectively 25 respectively 26 . [the] [cst] - sa is a short , reliable , and valid measure of sa . 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 16 . 3 - 4 sa 4 sa 5 is 5 is 15 sa 6 a 13 measure 7 short 8 , 8 , 9 reliable 8 , 11 and 10 , 11 and 11 and 12 valid 11 and 13 measure 13 measure 14 of 13 measure 15 sa 14 of 15 sa further study is needed to determine the best evaluation tool for the mental health portion of the cod screening instrument . this pilot study compared basic neurocognitive functioning among older and younger cocaine abusers and control participants , as a preliminary assessment of whether specific cognitive deficits exist in [an] aged cocaine - abusing population . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 6 determine 0 ###LEFT-WALL### 21 . 1 further 2 study 2 study 3 is 3 is 4 needed 4 needed 5 to 5 to 6 determine 6 determine 10 tool 7 the 8 best 7 the 10 tool 9 evaluation 10 tool 10 tool 11 for 10 tool 16 of 11 for 15 portion 12 the 15 portion 13 mental 14 health 14 health 15 portion 16 of 20 instrument 17 the 20 instrument 18 cod 20 instrument 19 screening 20 instrument 21 . 35 and 22 this 28 functioning 23 pilot 24 study 24 study 25 compared 25 compared 28 functioning 26 basic 28 functioning 27 neurocognitive 28 functioning 28 functioning 29 among 28 functioning 35 and 29 among 34 abusers 30 older 31 and 31 and 32 younger 31 and 34 abusers 33 cocaine 34 abusers 35 and 37 participants 35 and 38 , 35 and 39 as 36 control 37 participants 38 , 39 as 39 as 42 assessment 39 as 56 . 40 a 41 preliminary 40 a 42 assessment 41 preliminary 42 assessment 42 assessment 43 of 43 of 44 whether 44 whether 47 deficits 44 whether 48 exist 45 specific 47 deficits 46 cognitive 47 deficits 47 deficits 48 exist 48 exist 49 in 48 exist 54 abusing 49 in 52 cocaine 51 aged 52 cocaine 53 - 54 abusing 54 abusing 55 population 54 abusing 56 . we hypothesized an interaction between aging and cocaine abuse , such that older cocaine abusers would exhibit decreased neuropsychological test performance relative to both younger cocaine abusers and older control participants . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 0 ###LEFT-WALL### 32 . 1 we 2 hypothesized 2 hypothesized 7 and 2 hypothesized 12 that 3 an 4 interaction 4 interaction 5 between 4 interaction 7 and 5 between 6 aging 7 and 9 abuse 7 and 10 , 8 cocaine 9 abuse 11 such 12 that 12 that 14 cocaine 12 that 18 decreased 13 older 14 cocaine 14 cocaine 15 abusers 14 cocaine 17 exhibit 14 cocaine 18 decreased 15 abusers 16 would 16 would 17 exhibit 18 decreased 21 performance 19 neuropsychological 20 test 20 test 21 performance 21 performance 22 relative 22 relative 23 to 23 to 31 participants 24 both 25 younger 25 younger 30 control 26 cocaine 27 abusers 27 abusers 28 and 28 and 29 older 28 and 30 control 30 control 31 participants four groups ( n = 20 [each] ) were examined : older cocaine abusers ( ages 51 - 70 ) , younger cocaine abusers ( ages 21 - 39 ) , and two [non] - illicit substance - [using] control groups . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 10 examined 0 ###LEFT-WALL### 11 : 0 ###LEFT-WALL### 42 . 1 four 2 groups 2 groups 5 = 2 groups 9 were 3 ( 5 = 4 n 5 = 5 = 6 20 5 = 8 ) 9 were 10 examined 11 : 14 abusers 11 : 32 and 12 older 13 cocaine 13 cocaine 14 abusers 14 abusers 16 ages 14 abusers 19 70 14 abusers 24 abusers 15 ( 16 ages 16 ages 17 51 16 ages 18 - 18 - 19 70 19 70 20 ) 21 , 24 abusers 22 younger 23 cocaine 23 cocaine 24 abusers 24 abusers 26 ages 24 abusers 31 , 25 ( 26 ages 26 ages 27 21 26 ages 29 39 26 ages 31 , 28 - 29 39 29 39 30 ) 31 , 32 and 32 and 33 two 32 and 40 control 33 two 37 substance 33 two 40 control 35 - 37 substance 36 illicit 37 substance 37 substance 38 - 40 control 41 groups basic neuropsychological and psychiatric measures were administered to all participants . 0 ###LEFT-WALL### 5 measures 0 ###LEFT-WALL### 7 administered 0 ###LEFT-WALL### 11 . 1 basic 5 measures 2 neuropsychological 3 and 3 and 4 psychiatric 3 and 5 measures 5 measures 6 were 6 were 7 administered 7 administered 8 to 8 to 10 participants 9 all 10 participants older participants performed more poorly than younger participants on the mini - mental state examination ( mmse , p < [.] 01 ) , digit span backward ( p < [.] 01 ) , and trail making test ( tmt ) parts a and b [(] [p] [<] ..y 01 [ )( 0 ###LEFT-WALL### 35 and 0 ###LEFT-WALL### 44 and 0 ###LEFT-WALL### 52 )( 1 older 2 participants 2 participants 3 performed 2 participants 9 on 2 participants 35 and 3 performed 5 poorly 3 performed 6 than 4 more 5 poorly 6 than 8 participants 7 younger 8 participants 9 on 11 mini 10 the 11 mini 11 mini 17 mmse 11 mini 27 backward 12 - 17 mmse 13 mental 14 state 14 state 15 examination 15 examination 17 mmse 16 ( 17 mmse 17 mmse 18 , 17 mmse 20 < 17 mmse 23 ) 19 p 20 < 20 < 22 01 24 , 27 backward 25 digit 26 span 26 span 27 backward 27 backward 30 < 27 backward 33 ) 28 ( 30 < 29 p 30 < 30 < 32 01 34 , 35 and 35 and 42 parts 36 trail 37 making 37 making 38 test 38 test 40 tmt 39 ( 40 tmt 40 tmt 41 ) 40 tmt 42 parts 42 parts 43 a 44 and 45 b 44 and 49 ..y 45 b 49 ..y 49 ..y 50 01 cocaine abusers performed more poorly than controls on tmt a ( [p] < [.] 01 ) . 0 ###LEFT-WALL### 2 abusers 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 17 . 1 cocaine 2 abusers 2 abusers 3 performed 3 performed 5 poorly 3 performed 6 than 3 performed 8 on 4 more 5 poorly 6 than 7 controls 8 on 9 tmt 9 tmt 10 a 9 tmt 15 01 11 ( 15 01 13 < 15 01 15 01 16 ) older and younger cocaine abusers used similar amounts of cocaine ( [p] > [.] 05 ) . 0 ###LEFT-WALL### 5 abusers 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 17 . 1 older 2 and 2 and 3 younger 2 and 4 cocaine 4 cocaine 5 abusers 5 abusers 6 used 6 used 8 amounts 7 similar 8 amounts 8 amounts 9 of 9 of 10 cocaine 10 cocaine 15 05 11 ( 15 05 13 > 15 05 15 05 16 ) older cocaine abusers performed more poorly than older control participants and younger cocaine abusers on the digit span forward ( p < [.] 0125 ) . 0 ###LEFT-WALL### 3 abusers 0 ###LEFT-WALL### 4 performed 0 ###LEFT-WALL### 7 than 0 ###LEFT-WALL### 26 . 1 older 2 cocaine 2 cocaine 3 abusers 3 abusers 4 performed 4 performed 6 poorly 4 performed 7 than 5 more 6 poorly 7 than 13 cocaine 7 than 14 abusers 8 older 13 cocaine 9 control 10 participants 10 participants 11 and 11 and 12 younger 11 and 13 cocaine 13 cocaine 14 abusers 14 abusers 15 on 14 abusers 22 < 15 on 19 forward 16 the 19 forward 17 digit 18 span 18 span 19 forward 20 ( 22 < 21 p 22 < 22 < 24 0125 22 < 25 ) older cocaine abusers also performed more poorly than younger cocaine abusers on tmt a ( p < [.] 0125 ) . 0 ###LEFT-WALL### 3 abusers 0 ###LEFT-WALL### 5 performed 0 ###LEFT-WALL### 21 . 1 older 2 cocaine 2 cocaine 3 abusers 3 abusers 5 performed 4 also 5 performed 5 performed 7 poorly 5 performed 8 than 6 more 7 poorly 8 than 10 cocaine 8 than 11 abusers 9 younger 10 cocaine 10 cocaine 11 abusers 11 abusers 12 on 12 on 13 tmt 13 tmt 14 a 13 tmt 17 < 15 ( 17 < 16 p 17 < 17 < 19 0125 17 < 20 ) this study provides preliminary evidence that older cocaine abusers use a significant amount of cocaine and that there is an interaction between aging and cocaine abuse on psychomotor speed , attention , and short - term memory . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 38 . 1 this 2 study 2 study 3 provides 3 provides 5 evidence 3 provides 22 between 4 preliminary 5 evidence 5 evidence 16 and 6 that 9 abusers 6 that 10 use 6 that 16 and 7 older 8 cocaine 8 cocaine 9 abusers 9 abusers 10 use 10 use 13 amount 11 a 13 amount 12 significant 13 amount 13 amount 14 of 14 of 15 cocaine 16 and 17 that 17 that 18 there 17 that 19 is 18 there 19 is 19 is 21 interaction 20 an 21 interaction 22 between 23 aging 24 and 33 and 24 and 36 term 25 cocaine 26 abuse 26 abuse 27 on 26 abuse 30 , 27 on 29 speed 28 psychomotor 29 speed 30 , 31 attention 30 , 33 and 32 , 33 and 33 and 34 short 33 and 35 - 33 and 36 term 36 term 37 memory future examination of neurocognitive function [in] older cocaine abusers is clearly warranted . advanced glycation endproducts ( ages ) are a group of heterogeneous compounds formed by the [non] enzymatic reactions between aldehydic group of reducing [sugars] with proteins , lipids or nucleic acids . 0 ###LEFT-WALL### 2 examination 0 ###LEFT-WALL### 12 warranted 0 ###LEFT-WALL### 13 . 0 ###LEFT-WALL### 45 . 1 future 2 examination 2 examination 3 of 2 examination 10 is 3 of 9 abusers 4 neurocognitive 5 function 5 function 8 cocaine 7 older 8 cocaine 8 cocaine 9 abusers 10 is 11 clearly 10 is 12 warranted 13 . 16 endproducts 13 . 20 are 14 advanced 15 glycation 15 glycation 16 endproducts 16 endproducts 18 ages 16 endproducts 20 are 17 ( 18 ages 18 ages 19 ) 20 are 22 group 21 a 22 group 22 group 23 of 22 group 26 formed 23 of 25 compounds 24 heterogeneous 25 compounds 26 formed 27 by 27 by 31 reactions 28 the 31 reactions 30 enzymatic 31 reactions 31 reactions 32 between 32 between 42 or 33 aldehydic 34 group 34 group 35 of 34 group 40 , 35 of 36 reducing 36 reducing 38 with 38 with 39 proteins 40 , 41 lipids 40 , 42 or 42 or 44 acids 43 nucleic 44 acids formation and accumulation of ages is related with the aging process and is accelerated in diabetes . 0 ###LEFT-WALL### 1 formation 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 17 . 2 and 3 accumulation 2 and 12 and 3 accumulation 4 of 3 accumulation 12 and 4 of 5 ages 6 is 7 related 6 is 12 and 7 related 8 with 8 with 11 process 9 the 11 process 10 aging 11 process 12 and 13 is 13 is 14 accelerated 14 accelerated 15 in 15 in 16 diabetes type 2 diabetes , the most common form of diabetes , is characterized by hyperglycaemia and insulin resistance associated to a progressive deterioration [of] beta cell function and mass . 0 ###LEFT-WALL### 3 diabetes 0 ###LEFT-WALL### 13 characterized 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 30 . 1 type 2 2 1 type 3 diabetes 3 diabetes 8 form 3 diabetes 12 is 4 , 8 form 5 the 8 form 6 most 7 common 7 common 8 form 8 form 9 of 8 form 11 , 9 of 10 diabetes 12 is 13 characterized 13 characterized 14 by 14 by 15 hyperglycaemia 16 and 18 resistance 16 and 19 associated 17 insulin 18 resistance 18 resistance 19 associated 19 associated 20 to 20 to 28 and 21 a 27 function 22 progressive 23 deterioration 23 deterioration 27 function 25 beta 26 cell 26 cell 27 function 27 function 28 and 28 and 29 mass the pathogenic role of ages in vascular diabetic complications is widely recognised . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 12 recognised 0 ###LEFT-WALL### 13 . 1 the 3 role 2 pathogenic 3 role 3 role 4 of 3 role 10 is 4 of 5 ages 5 ages 6 in 6 in 9 complications 7 vascular 9 complications 8 diabetic 9 complications 10 is 11 widely 10 is 12 recognised recently other aspects of the detrimental effects of ages in type 2 diabetes are emerged : ages interfere with the complex molecular pathway of insulin signaling , leading to insulin resistance ; ages modify the insulin molecule , and , consequently , its function ; ages decrease insulin secretion and insulin content . 0 ###LEFT-WALL### 3 aspects 0 ###LEFT-WALL### 15 emerged 0 ###LEFT-WALL### 16 : 0 ###LEFT-WALL### 53 . 1 recently 3 aspects 2 other 3 aspects 3 aspects 4 of 3 aspects 7 effects 3 aspects 14 are 3 aspects 15 emerged 4 of 6 detrimental 5 the 6 detrimental 7 effects 8 of 7 effects 14 are 8 of 9 ages 9 ages 10 in 10 in 13 diabetes 11 type 13 diabetes 12 2 13 diabetes 16 : 17 ages 16 : 18 interfere 16 : 32 ; 16 : 45 ; 17 ages 18 interfere 18 interfere 19 with 18 interfere 28 leading 19 with 23 pathway 19 with 26 signaling 20 the 23 pathway 21 complex 23 pathway 22 molecular 23 pathway 23 pathway 24 of 24 of 25 insulin 27 , 28 leading 28 leading 29 to 28 leading 32 ; 29 to 31 resistance 30 insulin 31 resistance 32 ; 33 ages 32 ; 34 modify 33 ages 34 modify 34 modify 39 and 35 the 37 molecule 36 insulin 37 molecule 37 molecule 39 and 38 , 39 and 39 and 41 consequently 39 and 44 function 39 and 45 ; 40 , 41 consequently 41 consequently 42 , 43 its 44 function 45 ; 52 content 46 ages 47 decrease 47 decrease 48 insulin 48 insulin 52 content 49 secretion 50 and 50 and 51 insulin 50 and 52 content in this article we review the role of ages in type 2 diabetes , beyond their involvement in vascular complications . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 review 1 in 3 article 1 in 4 we 2 this 3 article 4 we 5 review 5 review 7 role 5 review 10 in 6 the 7 role 7 role 8 of 8 of 9 ages 10 in 13 diabetes 11 type 13 diabetes 12 2 13 diabetes 13 diabetes 15 beyond 14 , 15 beyond 15 beyond 17 involvement 15 beyond 21 . 16 their 17 involvement 17 involvement 18 in 18 in 20 complications 19 vascular 20 complications obstructive sleep apnea ( osa ) is a growing public health hazard fueled by the obesity epidemic and an aging population . 0 ###LEFT-WALL### 3 apnea 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 22 . 1 obstructive 3 apnea 2 sleep 3 apnea 3 apnea 5 osa 3 apnea 7 is 4 ( 5 osa 5 osa 6 ) 7 is 12 hazard 8 a 12 hazard 9 growing 10 public 10 public 12 hazard 11 health 12 hazard 12 hazard 13 fueled 13 fueled 14 by 14 by 18 and 15 the 17 epidemic 16 obesity 17 epidemic 17 epidemic 18 and 18 and 21 population 19 an 21 population 20 aging 21 population untreated sleep apnea can result in significant consequences both in the short - term and long - term . 0 ###LEFT-WALL### 3 apnea 0 ###LEFT-WALL### 5 result 0 ###LEFT-WALL### 19 . 1 untreated 2 sleep 2 sleep 3 apnea 3 apnea 4 can 4 can 5 result 5 result 6 in 6 in 8 consequences 7 significant 8 consequences 8 consequences 9 both 8 consequences 18 term 9 both 10 in 9 both 18 term 10 in 15 and 11 the 14 term 12 short 13 - 12 short 14 term 14 term 15 and 15 and 16 long 15 and 17 - we need to educate the public to recognize the symptoms of sleep apnea and to publicize that effective treatments [are] available . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 22 . 1 we 14 and 2 need 3 to 2 need 7 to 2 need 8 recognize 2 need 14 and 3 to 4 educate 4 educate 6 public 5 the 6 public 7 to 8 recognize 8 recognize 10 symptoms 9 the 10 symptoms 10 symptoms 11 of 11 of 13 apnea 12 sleep 13 apnea 14 and 15 to 14 and 16 publicize 15 to 16 publicize 16 publicize 19 treatments 17 that 18 effective 18 effective 19 treatments 19 treatments 21 available positive airway pressure therapy remains the gold standard currently in treating osa . 0 ###LEFT-WALL### 4 therapy 0 ###LEFT-WALL### 5 remains 0 ###LEFT-WALL### 13 . 1 positive 2 airway 2 airway 4 therapy 3 pressure 4 therapy 4 therapy 5 remains 5 remains 7 gold 6 the 7 gold 7 gold 8 standard 8 standard 9 currently 8 standard 10 in 10 in 11 treating 11 treating 12 osa alternative treatments include an oral appliance or surgical options . 0 ###LEFT-WALL### 2 treatments 0 ###LEFT-WALL### 3 include 0 ###LEFT-WALL### 10 . 1 alternative 2 treatments 2 treatments 3 include 3 include 7 or 4 an 5 oral 4 an 6 appliance 5 oral 6 appliance 6 appliance 7 or 7 or 9 options 8 surgical 9 options this paper discusses the pharmacologic treatment of sleep apnea : goals include medications to address the ventilatory control of breathing , treat co - morbid diseases , treat associated health problems/complaints , address special issues , such as anesthetic precautions , and propose future targets . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 discusses 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 46 . 1 this 2 paper 2 paper 3 discusses 3 discusses 6 treatment 4 the 6 treatment 5 pharmacologic 6 treatment 6 treatment 7 of 7 of 9 apnea 8 sleep 9 apnea 10 : 11 goals 10 : 27 , 11 goals 27 , 12 include 13 medications 12 include 14 to 12 include 27 , 14 to 21 , 15 address 18 control 15 address 21 , 16 the 18 control 17 ventilatory 18 control 18 control 19 of 19 of 20 breathing 21 , 22 treat 21 , 26 diseases 23 co 24 - 23 co 26 diseases 25 morbid 26 diseases 27 , 42 and 28 treat 31 problems/complaints 28 treat 42 and 29 associated 31 problems/complaints 30 health 31 problems/complaints 31 problems/complaints 35 issues 32 , 35 issues 33 address 34 special 34 special 35 issues 35 issues 38 as 35 issues 41 , 36 , 38 as 37 such 38 as 38 as 40 precautions 38 as 41 , 39 anesthetic 40 precautions 42 and 43 propose 43 propose 45 targets 44 future 45 targets gene expression changes in the brain affect cognition during normal and pathological aging . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 7 affect 0 ###LEFT-WALL### 14 . 1 gene 3 changes 2 expression 3 changes 3 changes 4 in 3 changes 7 affect 4 in 6 brain 5 the 6 brain 7 affect 8 cognition 7 affect 9 during 9 during 11 and 10 normal 11 and 11 and 12 pathological 11 and 13 aging progress in understanding the cellular processes regulating gene expression networks in cognition is relevant to develop therapeutic interventions for age - related cognitive disorders . 0 ###LEFT-WALL### 1 progress 0 ###LEFT-WALL### 16 develop 0 ###LEFT-WALL### 22 related 0 ###LEFT-WALL### 25 . 1 progress 2 in 1 progress 7 regulating 1 progress 13 is 2 in 3 understanding 3 understanding 6 processes 4 the 6 processes 5 cellular 6 processes 7 regulating 10 networks 7 regulating 11 in 8 gene 10 networks 9 expression 10 networks 11 in 12 cognition 13 is 14 relevant 14 relevant 15 to 15 to 16 develop 16 develop 18 interventions 16 develop 19 for 17 therapeutic 18 interventions 19 for 20 age 21 - 22 related 22 related 24 disorders 23 cognitive 24 disorders synaptic efficacy mediating memory storage requires the activation of specific gene expression programs regulated , among others , by the transcription factor camp - response element binding protein ( creb ) . 0 ###LEFT-WALL### 5 storage 0 ###LEFT-WALL### 6 requires 0 ###LEFT-WALL### 32 . 1 synaptic 5 storage 2 efficacy 3 mediating 3 mediating 5 storage 4 memory 5 storage 5 storage 6 requires 6 requires 8 activation 6 requires 22 factor 7 the 8 activation 8 activation 9 of 8 activation 13 programs 8 activation 14 regulated 9 of 12 expression 10 specific 11 gene 11 gene 12 expression 13 programs 14 regulated 14 regulated 16 among 14 regulated 19 by 15 , 16 among 16 among 17 others 16 among 18 , 19 by 21 transcription 20 the 21 transcription 22 factor 28 protein 23 camp 24 - 23 camp 28 protein 25 response 27 binding 26 element 27 binding 27 binding 28 protein 28 protein 30 creb 29 ( 30 creb 30 creb 31 ) creb signaling is essential for long - lasting changes in synaptic plasticity that mediates the conversion of short - term memory to long - term memory . 0 ###LEFT-WALL### 1 creb 0 ###LEFT-WALL### 27 . 1 creb 2 signaling 1 creb 3 is 3 is 4 essential 4 essential 5 for 4 essential 10 in 5 for 9 changes 6 long 7 - 6 long 9 changes 8 lasting 9 changes 10 in 12 plasticity 11 synaptic 12 plasticity 12 plasticity 13 that 12 plasticity 14 mediates 13 that 14 mediates 14 mediates 16 conversion 14 mediates 22 to 15 the 16 conversion 16 conversion 17 of 17 of 21 memory 18 short 19 - 18 short 20 term 20 term 21 memory 22 to 26 memory 23 long 24 - 23 long 25 term 25 term 26 memory creb signaling has been recently involved in several brain pathological conditions including cognitive and neurodegenerative disorders . 0 ###LEFT-WALL### 1 creb 0 ###LEFT-WALL### 6 involved 0 ###LEFT-WALL### 17 . 1 creb 2 signaling 1 creb 4 been 1 creb 6 involved 2 signaling 3 has 3 has 4 been 5 recently 6 involved 6 involved 7 in 6 involved 12 including 7 in 11 conditions 8 several 11 conditions 9 brain 11 conditions 10 pathological 11 conditions 12 including 16 disorders 13 cognitive 14 and 14 and 15 neurodegenerative 14 and 16 disorders the β - amyloid ( aβ ) peptide , which plays a crucial role in the pathogenesis of alzheimer 's disease , alters hippocampal - dependent synaptic plasticity and memory and mediates [synapse] loss through the creb signaling pathway . 0 ###LEFT-WALL### 8 peptide 0 ###LEFT-WALL### 31 and 0 ###LEFT-WALL### 40 . 1 the 8 peptide 2 β 3 - 2 β 8 peptide 4 amyloid 6 aβ 4 amyloid 8 peptide 5 ( 6 aβ 6 aβ 7 ) 8 peptide 10 which 8 peptide 31 and 9 , 10 which 10 which 11 plays 10 which 22 , 11 plays 14 role 11 plays 15 in 12 a 13 crucial 12 a 14 role 13 crucial 14 role 15 in 17 pathogenesis 16 the 17 pathogenesis 17 pathogenesis 18 of 18 of 21 disease 19 alzheimer 20 's 20 's 21 disease 23 alters 29 and 23 alters 31 and 24 hippocampal 25 - 24 hippocampal 28 plasticity 26 dependent 28 plasticity 27 synaptic 28 plasticity 28 plasticity 29 and 29 and 30 memory 31 and 32 mediates 32 mediates 34 loss 32 mediates 35 through 35 through 39 pathway 36 the 39 pathway 37 creb 39 pathway 38 signaling 39 pathway the fact that altered creb signaling has been implicated in other cognitive disorders including huntington 's disease and rubinstein - taybi and coffin - lowry syndromes suggests a crucial role of creb signaling in cognitive dysfunction . 0 ###LEFT-WALL### 2 fact 0 ###LEFT-WALL### 27 suggests 0 ###LEFT-WALL### 37 . 1 the 2 fact 2 fact 3 that 2 fact 27 suggests 3 that 5 creb 3 that 9 implicated 4 altered 5 creb 5 creb 6 signaling 5 creb 7 has 7 has 8 been 8 been 9 implicated 9 implicated 10 in 10 in 26 syndromes 11 other 26 syndromes 12 cognitive 13 disorders 13 disorders 14 including 13 disorders 18 and 14 including 17 disease 15 huntington 16 's 16 's 17 disease 18 and 19 rubinstein 18 and 23 coffin 18 and 26 syndromes 20 - 23 coffin 21 taybi 22 and 22 and 23 coffin 23 coffin 24 - 25 lowry 26 syndromes 27 suggests 30 role 27 suggests 34 in 28 a 29 crucial 28 a 30 role 29 crucial 30 role 30 role 31 of 31 of 32 creb 32 creb 33 signaling 34 in 36 dysfunction 35 cognitive 36 dysfunction in this review paper , we summarize recent findings indicating a role of creb and its coactivators creb binding protein and creb - regulated transcription coactivator in cognition during normal and pathological aging . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 summarize 0 ###LEFT-WALL### 34 . 1 in 4 paper 1 in 5 , 1 in 6 we 2 this 4 paper 3 review 4 paper 6 we 7 summarize 7 summarize 9 findings 7 summarize 27 in 8 recent 9 findings 9 findings 10 indicating 10 indicating 12 role 11 a 12 role 12 role 13 of 13 of 15 and 14 creb 15 and 15 and 26 coactivator 16 its 26 coactivator 17 coactivators 18 creb 18 creb 19 binding 18 creb 21 and 19 binding 20 protein 21 and 22 creb 21 and 23 - 21 and 24 regulated 21 and 26 coactivator 25 transcription 26 coactivator 27 in 28 cognition 28 cognition 29 during 28 cognition 33 aging 29 during 31 and 30 normal 31 and 31 and 32 pathological we also discuss the development of novel therapeutic strategies based on creb targeting to ameliorate cognitive decline [in] aging and cognitive disorders . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 23 . 1 we 3 discuss 2 also 3 discuss 3 discuss 5 development 4 the 5 development 5 development 6 of 6 of 20 and 7 novel 9 strategies 8 therapeutic 9 strategies 9 strategies 10 based 9 strategies 20 and 10 based 11 on 10 based 19 aging 11 on 13 targeting 12 creb 13 targeting 13 targeting 14 to 13 targeting 15 ameliorate 14 to 15 ameliorate 16 cognitive 17 decline 17 decline 19 aging 20 and 22 disorders 21 cognitive 22 disorders autophagy is a critical pathway for the degradation of intracellular components by lysosomes . 0 ###LEFT-WALL### 1 autophagy 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 14 . 1 autophagy 2 is 2 is 5 pathway 3 a 4 critical 3 a 5 pathway 4 critical 5 pathway 5 pathway 6 for 6 for 8 degradation 7 the 8 degradation 8 degradation 9 of 9 of 11 components 10 intracellular 11 components 11 components 12 by 12 by 13 lysosomes established functions for both macroautophagy and chaperone - mediated autophagy in hepatic lipid metabolism , insulin sensitivity and cellular injury suggest a number of potential mechanistic roles for autophagy in nonalcoholic steatohepatitis ( nash ) . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 8 - 1 established 2 functions 1 established 5 macroautophagy 1 established 6 and 2 functions 3 for 2 functions 5 macroautophagy 3 for 4 both 6 and 7 chaperone 8 - 18 and 8 - 21 suggest 8 - 36 . 9 mediated 10 autophagy 10 autophagy 11 in 10 autophagy 15 , 11 in 14 metabolism 12 hepatic 13 lipid 13 lipid 14 metabolism 15 , 17 sensitivity 15 , 18 and 16 insulin 17 sensitivity 18 and 20 injury 18 and 21 suggest 19 cellular 20 injury 21 suggest 27 roles 21 suggest 30 in 22 a 23 number 23 number 24 of 23 number 27 roles 24 of 27 roles 25 potential 27 roles 26 mechanistic 27 roles 27 roles 28 for 28 for 29 autophagy 30 in 32 steatohepatitis 31 nonalcoholic 32 steatohepatitis 32 steatohepatitis 34 nash 33 ( 34 nash 34 nash 35 ) decreased autophagic function [in] particular [may] [promote] the initial development of hepatic steatosis and progression of steatosis to liver injury . 0 ###LEFT-WALL### 20 injury 0 ###LEFT-WALL### 21 . 1 decreased 3 function 2 autophagic 3 function 3 function 5 particular 5 particular 20 injury 8 the 10 development 9 initial 10 development 10 development 11 of 10 development 14 and 11 of 13 steatosis 12 hepatic 13 steatosis 14 and 15 progression 14 and 16 of 14 and 20 injury 16 of 17 steatosis 17 steatosis 18 to 18 to 19 liver additional functions of autophagy in immune responses and carcinogenesis may also contribute to the development of nash and its complications . 0 ###LEFT-WALL### 2 functions 0 ###LEFT-WALL### 12 contribute 0 ###LEFT-WALL### 21 . 1 additional 2 functions 2 functions 3 of 2 functions 10 may 3 of 4 autophagy 4 autophagy 5 in 5 in 8 and 6 immune 7 responses 7 responses 8 and 8 and 9 carcinogenesis 10 may 12 contribute 11 also 12 contribute 12 contribute 13 to 13 to 15 development 14 the 15 development 15 development 16 of 16 of 18 and 17 nash 18 and 18 and 20 complications 19 its 20 complications the impairment in autophagy that occurs with cellular lipid accumulation , obesity and aging may therefore have an important impact on this disease , and agents to augment hepatic autophagy have therapeutic potential in nash . 0 ###LEFT-WALL### 2 impairment 0 ###LEFT-WALL### 31 have 0 ###LEFT-WALL### 36 . 1 the 2 impairment 2 impairment 3 in 2 impairment 5 that 2 impairment 6 occurs 2 impairment 15 may 3 in 4 autophagy 5 that 6 occurs 6 occurs 7 with 7 with 13 and 8 cellular 9 lipid 9 lipid 10 accumulation 10 accumulation 11 , 11 , 12 obesity 11 , 13 and 13 and 14 aging 15 may 17 have 16 therefore 17 have 17 have 20 impact 17 have 21 on 17 have 27 to 17 have 31 have 18 an 19 important 18 an 20 impact 19 important 20 impact 21 on 25 and 22 this 23 disease 23 disease 25 and 24 , 25 and 25 and 26 agents 27 to 28 augment 28 augment 30 autophagy 29 hepatic 30 autophagy 31 have 33 potential 31 have 34 in 32 therapeutic 33 potential 34 in 35 nash cutaneous melanoma ( cm ) is a highly curable skin cancer of melanocytes if diagnosed early . 0 ###LEFT-WALL### 2 melanoma 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 17 . 1 cutaneous 2 melanoma 2 melanoma 4 cm 2 melanoma 6 is 3 ( 4 cm 4 cm 5 ) 6 is 11 cancer 6 is 14 if 7 a 8 highly 7 a 11 cancer 8 highly 9 curable 9 curable 10 skin 10 skin 11 cancer 11 cancer 12 of 12 of 13 melanocytes 14 if 15 diagnosed 15 diagnosed 16 early unfortunately , its invasion into the deeper dermis increases the risk of it spreading to the lymph nodes and distant organs . 0 ###LEFT-WALL### 4 invasion 0 ###LEFT-WALL### 9 increases 0 ###LEFT-WALL### 22 . 1 unfortunately 2 , 1 unfortunately 4 invasion 3 its 4 invasion 4 invasion 5 into 4 invasion 9 increases 5 into 8 dermis 6 the 8 dermis 7 deeper 8 dermis 9 increases 11 risk 10 the 11 risk 11 risk 12 of 11 risk 14 spreading 12 of 13 it 14 spreading 15 to 15 to 19 and 16 the 18 nodes 17 lymph 18 nodes 18 nodes 19 and 19 and 21 organs 20 distant 21 organs spread of metastatic melanoma [(] [mm] [ )(to other organs is among one of the most dangerous conditions that is almost uniformly fatal for the majority of patients with the currently available treatment modalities . 0 ###LEFT-WALL### 1 spread 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 35 . 1 spread 2 of 1 spread 8 )(to 1 spread 11 is 2 of 4 melanoma 3 metastatic 4 melanoma 8 )(to 10 organs 9 other 10 organs 11 is 12 among 11 is 24 for 12 among 13 one 13 one 14 of 13 one 19 that 13 one 20 is 14 of 18 conditions 15 the 16 most 16 most 18 conditions 17 dangerous 18 conditions 19 that 20 is 20 is 21 almost 20 is 22 uniformly 20 is 23 fatal 24 for 26 majority 25 the 26 majority 26 majority 27 of 26 majority 29 with 27 of 28 patients 29 with 34 modalities 30 the 34 modalities 31 currently 32 available 32 available 33 treatment 33 treatment 34 modalities since melanoma is an immunogenic tumor , developing novel immune strategies will continue to play a critical role in designing effective treatment modalities for those at high risk of recurrence and those with distant metastasis . 0 ###LEFT-WALL### 11 strategies 0 ###LEFT-WALL### 13 continue 0 ###LEFT-WALL### 36 . 1 since 2 melanoma 1 since 3 is 1 since 7 , 1 since 11 strategies 2 melanoma 3 is 3 is 6 tumor 4 an 6 tumor 5 immunogenic 6 tumor 8 developing 11 strategies 9 novel 11 strategies 10 immune 11 strategies 11 strategies 12 will 12 will 13 continue 13 continue 14 to 13 continue 15 play 14 to 15 play 15 play 18 role 15 play 24 for 16 a 18 role 17 critical 18 role 18 role 19 in 19 in 20 designing 20 designing 23 modalities 21 effective 23 modalities 22 treatment 23 modalities 24 for 31 and 25 those 26 at 25 those 31 and 26 at 28 risk 27 high 28 risk 28 risk 29 of 29 of 30 recurrence 31 and 32 those 32 those 33 with 33 with 35 metastasis 34 distant 35 metastasis while older age is believed to be a poor prognostic marker for cm , rapid expansion of the aging population and its projected increase in the coming decades is expected to result in a large number of elderly melanoma patients seeking treatment in all stages of disease . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 5 believed 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 32 result 0 ###LEFT-WALL### 48 . 1 while 2 older 1 while 3 age 3 age 4 is 4 is 5 believed 5 believed 6 to 5 believed 7 be 6 to 7 be 7 be 11 marker 8 a 11 marker 9 poor 11 marker 10 prognostic 11 marker 11 marker 12 for 12 for 13 cm 14 , 16 expansion 14 , 30 expected 15 rapid 16 expansion 16 expansion 17 of 16 expansion 25 in 16 expansion 29 is 17 of 21 and 18 the 20 population 19 aging 20 population 20 population 21 and 21 and 24 increase 22 its 24 increase 23 projected 24 increase 25 in 28 decades 26 the 28 decades 27 coming 28 decades 29 is 30 expected 30 expected 31 to 31 to 32 result 32 result 33 in 32 result 43 in 33 in 36 number 34 a 36 number 35 large 36 number 36 number 37 of 37 of 40 patients 38 elderly 40 patients 39 melanoma 40 patients 40 patients 41 seeking 41 seeking 42 treatment 43 in 45 stages 44 all 45 stages 45 stages 46 of 46 of 47 disease this will not only bring with it unique management challenges in this population , but also an increased burden on communities to provide financial and social resources . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 5 bring 0 ###LEFT-WALL### 28 . 1 this 2 will 2 will 3 not 2 will 5 bring 4 only 5 bring 5 bring 6 with 5 bring 20 on 5 bring 22 to 6 with 7 it 6 with 15 but 8 unique 9 management 9 management 10 challenges 10 challenges 11 in 10 challenges 15 but 11 in 13 population 12 this 13 population 14 , 15 but 15 but 16 also 15 but 19 burden 17 an 19 burden 18 increased 19 burden 20 on 21 communities 22 to 23 provide 23 provide 27 resources 24 financial 25 and 25 and 26 social 25 and 27 resources comprehensive efforts will need to be directed towards early diagnosis , as well as developing safe and effective treatment . 0 ###LEFT-WALL### 2 efforts 0 ###LEFT-WALL### 4 need 0 ###LEFT-WALL### 20 . 1 comprehensive 2 efforts 2 efforts 3 will 3 will 4 need 4 need 5 to 4 need 14 as 5 to 6 be 6 be 7 directed 7 directed 8 towards 7 directed 11 , 7 directed 13 well 8 towards 10 diagnosis 9 early 10 diagnosis 12 as 13 well 14 as 19 treatment 15 developing 19 treatment 16 safe 17 and 17 and 18 effective 17 and 19 treatment renewed interest in the cancer immune surveillance theory coupled with recognition of aging [-] associated weaknesses in the immune system has put the spotlight on immunsenescence as a important risk factor for the rising incidence of cm in the aging population . 0 ###LEFT-WALL### 2 interest 0 ###LEFT-WALL### 22 put 0 ###LEFT-WALL### 42 . 1 renewed 2 interest 2 interest 3 in 2 interest 10 with 2 interest 12 of 2 interest 21 has 3 in 8 theory 4 the 8 theory 5 cancer 8 theory 6 immune 7 surveillance 7 surveillance 8 theory 8 theory 9 coupled 10 with 11 recognition 12 of 13 aging 13 aging 16 weaknesses 13 aging 17 in 15 associated 16 weaknesses 17 in 20 system 18 the 20 system 19 immune 20 system 21 has 22 put 22 put 24 spotlight 22 put 25 on 23 the 24 spotlight 25 on 26 immunsenescence 26 immunsenescence 27 as 26 immunsenescence 36 of 27 as 31 factor 28 a 31 factor 29 important 31 factor 30 risk 31 factor 31 factor 32 for 32 for 35 incidence 33 the 35 incidence 34 rising 35 incidence 36 of 37 cm 37 cm 38 in 38 in 41 population 39 the 41 population 40 aging 41 population comprehensive assessment of the aging immune system might shed light , [not] only on weaknesses of individual components of the adaptive immune system , but also on the critical imbalances resulting from these weaknesses on anti - melanoma immunity . 0 ###LEFT-WALL### 2 assessment 0 ###LEFT-WALL### 9 shed 0 ###LEFT-WALL### 40 . 1 comprehensive 2 assessment 2 assessment 3 of 2 assessment 8 might 3 of 7 system 4 the 7 system 5 aging 7 system 6 immune 7 system 8 might 9 shed 9 shed 10 light 9 shed 25 but 9 shed 27 on 9 shed 35 on 10 light 14 on 11 , 13 only 11 , 14 on 14 on 15 weaknesses 14 on 24 , 15 weaknesses 16 of 16 of 18 components 17 individual 18 components 18 components 19 of 19 of 23 system 20 the 23 system 21 adaptive 23 system 22 immune 23 system 25 but 26 also 27 on 30 imbalances 28 the 30 imbalances 29 critical 30 imbalances 30 imbalances 31 resulting 30 imbalances 32 from 32 from 34 weaknesses 33 these 34 weaknesses 35 on 39 immunity 36 anti 37 - 36 anti 39 immunity 38 melanoma 39 immunity identifying these imbalances might help harness novel immune - based treatment of [mm] in selected elderly patients . 0 ###LEFT-WALL### 1 identifying 0 ###LEFT-WALL### 5 help 0 ###LEFT-WALL### 18 . 1 identifying 3 imbalances 1 identifying 4 might 2 these 3 imbalances 4 might 5 help 5 help 6 harness 6 harness 11 treatment 7 novel 11 treatment 8 immune 9 - 8 immune 11 treatment 10 based 11 treatment 11 treatment 12 of 12 of 14 in 14 in 17 patients 15 selected 17 patients 16 elderly 17 patients this article describes our experience of treating elderly patients with [mm] [and] the issues unique to them , with particular emphasis on insights into the aging immune system . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 describes 1 this 2 article 2 article 3 describes 3 describes 5 experience 3 describes 10 with 4 our 5 experience 5 experience 6 of 6 of 7 treating 7 treating 9 patients 8 elderly 9 patients 10 with 14 issues 13 the 14 issues 14 issues 15 unique 15 unique 16 to 15 unique 19 with 16 to 17 them 18 , 19 with 19 with 21 emphasis 19 with 29 . 20 particular 21 emphasis 21 emphasis 22 on 21 emphasis 24 into 22 on 23 insights 24 into 28 system 25 the 28 system 26 aging 28 system 27 immune 28 system the american occupational therapy association 's centennial vision articulates the strategic goals for the profession to be science driven and evidence based in major practice areas . 0 ###LEFT-WALL### 2 american 0 ###LEFT-WALL### 17 be 0 ###LEFT-WALL### 27 . 1 the 2 american 2 american 8 vision 2 american 16 to 2 american 17 be 3 occupational 4 therapy 4 therapy 5 association 5 association 6 's 6 's 8 vision 7 centennial 8 vision 8 vision 9 articulates 9 articulates 12 goals 9 articulates 16 to 10 the 12 goals 11 strategic 12 goals 12 goals 13 for 13 for 15 profession 14 the 15 profession 17 be 20 and 17 be 23 in 18 science 19 driven 18 science 20 and 20 and 21 evidence 20 and 22 based 23 in 26 areas 24 major 26 areas 25 practice 26 areas in the practice area of productive aging , a previous review of research published in the american journal of occupational therapy ( ajot ) found mostly basic research with far fewer effectiveness studies . 0 ###LEFT-WALL### 4 area 0 ###LEFT-WALL### 25 found 0 ###LEFT-WALL### 34 . 1 in 3 practice 1 in 4 area 2 the 3 practice 4 area 5 of 4 area 11 review 4 area 25 found 5 of 7 aging 6 productive 7 aging 8 , 11 review 9 a 11 review 10 previous 11 review 11 review 12 of 11 review 24 ) 12 of 13 research 13 research 14 published 14 published 15 in 15 in 18 journal 16 the 17 american 17 american 18 journal 18 journal 19 of 19 of 23 ajot 20 occupational 21 therapy 21 therapy 23 ajot 22 ( 23 ajot 25 found 28 research 26 mostly 27 basic 27 basic 28 research 28 research 29 with 29 with 33 studies 30 far 31 fewer 31 fewer 33 studies 32 effectiveness 33 studies the current review article is divided into two parts . 0 ###LEFT-WALL### 4 article 0 ###LEFT-WALL### 6 divided 0 ###LEFT-WALL### 10 . 1 the 4 article 2 current 3 review 3 review 4 article 4 article 5 is 5 is 6 divided 6 divided 7 into 7 into 9 parts 8 two 9 parts part 1 provides an update on the types of research published on productive aging in ajot in the past 2 yr ( 2009 - 2010 ) . 0 ###LEFT-WALL### 1 part 0 ###LEFT-WALL### 11 published 0 ###LEFT-WALL### 27 . 1 part 2 1 1 part 3 provides 1 part 11 published 2 1 3 provides 3 provides 5 update 3 provides 6 on 4 an 5 update 6 on 10 research 7 the 8 types 8 types 9 of 8 types 10 research 9 of 10 research 11 published 12 on 11 published 21 yr 11 published 24 - 12 on 14 aging 13 productive 14 aging 14 aging 15 in 15 in 16 ajot 16 ajot 17 in 17 in 19 past 18 the 19 past 20 2 21 yr 22 ( 24 - 23 2009 24 - 24 - 25 2010 24 - 26 ) part 2 examines the range and scope of occupational therapy effectiveness research on productive aging published in a similar time frame in other occupational therapy journals and outside of the discipline . 0 ###LEFT-WALL### 1 part 0 ###LEFT-WALL### 3 examines 0 ###LEFT-WALL### 32 . 1 part 2 2 1 part 3 examines 3 examines 6 and 4 the 5 range 5 range 6 and 6 and 7 scope 6 and 8 of 6 and 13 on 8 of 12 research 9 occupational 10 therapy 10 therapy 12 research 11 effectiveness 12 research 13 on 27 and 14 productive 15 aging 14 productive 16 published 14 productive 17 in 14 productive 22 in 14 productive 27 and 17 in 21 frame 18 a 21 frame 19 similar 21 frame 20 time 21 frame 22 in 26 journals 23 other 26 journals 24 occupational 25 therapy 25 therapy 26 journals 27 and 28 outside 27 and 29 of 29 of 31 discipline 30 the 31 discipline the paper describes the participation of parasites in the regulation of the physiology of development and reproduction of their hosts . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 describes 0 ###LEFT-WALL### 21 . 1 the 2 paper 2 paper 3 describes 3 describes 5 participation 3 describes 8 in 4 the 5 participation 5 participation 6 of 6 of 7 parasites 8 in 10 regulation 9 the 10 regulation 10 regulation 11 of 10 regulation 14 of 11 of 13 physiology 12 the 13 physiology 14 of 16 and 15 development 16 and 16 and 17 reproduction 16 and 18 of 18 of 20 hosts 19 their 20 hosts the observed increase in the hosts ' lifespan is shown to confer a significant selective advantage for a pathogen in some parasitic systems . 0 ###LEFT-WALL### 3 increase 0 ###LEFT-WALL### 10 shown 0 ###LEFT-WALL### 24 . 1 the 3 increase 2 observed 3 increase 3 increase 4 in 3 increase 9 is 4 in 8 lifespan 5 the 6 hosts 6 hosts 7 ' 7 ' 8 lifespan 9 is 10 shown 10 shown 11 to 11 to 12 confer 12 confer 16 advantage 12 confer 20 in 13 a 14 significant 13 a 16 advantage 14 significant 16 advantage 15 selective 16 advantage 16 advantage 17 for 17 for 19 pathogen 18 a 19 pathogen 20 in 23 systems 21 some 23 systems 22 parasitic 23 systems the parasite [-] induced increase in the longevity of a host is accompanied ( provided ) by its reduced reproduction . 0 ###LEFT-WALL### 5 increase 0 ###LEFT-WALL### 13 accompanied 0 ###LEFT-WALL### 21 . 1 the 5 increase 2 parasite 4 induced 4 induced 5 increase 5 increase 6 in 5 increase 12 is 6 in 8 longevity 7 the 8 longevity 8 longevity 9 of 9 of 11 host 10 a 11 host 12 is 13 accompanied 13 accompanied 15 provided 13 accompanied 17 by 14 ( 15 provided 15 provided 16 ) 17 by 20 reproduction 18 its 20 reproduction 19 reduced 20 reproduction the pointed parasite [-] induced increase in the life of an infected host may be caused by parasite genes in the context of the dawkin 's expended phenotype theory . 0 ###LEFT-WALL### 6 increase 0 ###LEFT-WALL### 16 caused 0 ###LEFT-WALL### 30 . 1 the 6 increase 2 pointed 3 parasite 3 parasite 5 induced 5 induced 6 increase 6 increase 7 in 6 increase 10 of 6 increase 14 may 7 in 9 life 8 the 9 life 10 of 13 host 11 an 13 host 12 infected 13 host 14 may 15 be 15 be 16 caused 16 caused 17 by 16 caused 20 in 17 by 19 genes 18 parasite 19 genes 20 in 22 context 21 the 22 context 22 context 23 of 23 of 29 theory 24 the 25 dawkin 25 dawkin 26 's 26 's 29 theory 27 expended 28 phenotype 28 phenotype 29 theory the natural product ginger ( zingiber officinale ) has active constituents gingerol , shogaol and zerumbone , while turmeric ( curcuma longa ) contains three active major curcuminoids , namely , curcumin , demethoxycurcumin , and bisdemethoxycurcumin . 0 ###LEFT-WALL### 4 ginger 0 ###LEFT-WALL### 9 has 1 the 4 ginger 2 natural 3 product 3 product 4 ginger 4 ginger 7 officinale 4 ginger 9 has 5 ( 7 officinale 6 zingiber 7 officinale 7 officinale 8 ) 9 has 15 and 9 has 18 while 10 active 11 constituents 11 constituents 12 gingerol 12 gingerol 13 , 13 , 14 shogaol 13 , 15 and 15 and 16 zerumbone 17 , 18 while 18 while 19 turmeric 18 while 24 contains 18 while 38 . 19 turmeric 22 longa 19 turmeric 24 contains 20 ( 22 longa 21 curcuma 22 longa 22 longa 23 ) 24 contains 28 curcuminoids 25 three 28 curcuminoids 26 active 28 curcuminoids 27 major 28 curcuminoids 28 curcuminoids 30 namely 28 curcuminoids 36 and 29 , 30 namely 30 namely 31 , 30 namely 32 curcumin 30 namely 33 , 33 , 36 and 34 demethoxycurcumin 36 and 35 , 36 and 36 and 37 bisdemethoxycurcumin 36 and 38 . they have the same scientific classification and [are] reported to have anti - inflammatory and [many] therapeutic effects . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 19 . 1 they 7 and 2 have 6 classification 2 have 7 and 3 the 4 same 4 same 6 classification 5 scientific 6 classification 7 and 9 reported 7 and 10 to 10 to 11 have 11 have 18 effects 12 anti 13 - 12 anti 18 effects 14 inflammatory 15 and 15 and 17 therapeutic 15 and 18 effects this article reviews the physiological and therapeutic effects of ginger and turmeric on some endocrine gland functions , and signal pathways involved to mediate their actions . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 24 mediate 0 ###LEFT-WALL### 27 . 1 this 2 article 2 article 3 reviews 3 reviews 11 and 3 reviews 13 on 3 reviews 23 to 4 the 11 and 5 physiological 6 and 6 and 7 therapeutic 6 and 8 effects 8 effects 9 of 8 effects 11 and 9 of 10 ginger 11 and 12 turmeric 13 on 19 and 14 some 17 functions 15 endocrine 16 gland 16 gland 17 functions 17 functions 19 and 18 , 19 and 19 and 21 pathways 19 and 22 involved 20 signal 21 pathways 23 to 24 mediate 24 mediate 26 actions 25 their 26 actions these multiple mechanisms of protection against inflammation and oxidative damage make ginger and curcumin particularly promising natural agents in fighting [the] ravages of aging and degenerative diseases , and need to be paid more attention by studies . 0 ###LEFT-WALL### 3 mechanisms 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 38 . 1 these 3 mechanisms 2 multiple 3 mechanisms 3 mechanisms 4 of 3 mechanisms 6 against 3 mechanisms 29 and 4 of 5 protection 6 against 8 and 7 inflammation 8 and 8 and 10 damage 9 oxidative 10 damage 11 make 25 and 11 make 27 diseases 11 make 29 and 12 ginger 13 and 13 and 14 curcumin 13 and 16 promising 13 and 22 ravages 13 and 23 of 13 and 25 and 15 particularly 16 promising 16 promising 18 agents 16 promising 19 in 16 promising 22 ravages 17 natural 18 agents 19 in 20 fighting 23 of 24 aging 25 and 26 degenerative 28 , 29 and 29 and 30 need 30 need 31 to 30 need 33 paid 31 to 32 be 32 be 33 paid 33 paid 35 attention 34 more 35 attention 35 attention 36 by 36 by 37 studies background : studies have shown that oxidative stress increases with increasing human age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 . 2 : 3 studies 2 : 5 shown 3 studies 4 have 4 have 5 shown 5 shown 8 stress 5 shown 9 increases 6 that 7 oxidative 7 oxidative 8 stress 8 stress 9 increases 9 increases 10 with 10 with 11 increasing 11 increasing 13 age 12 human 13 age protein carbonyl accumulation is an indicator of oxidative damage to proteins during aging in cells and tissues . 0 ###LEFT-WALL### 3 accumulation 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 18 . 1 protein 3 accumulation 2 carbonyl 3 accumulation 3 accumulation 4 is 4 is 6 indicator 4 is 10 to 4 is 12 during 4 is 14 in 5 an 6 indicator 6 indicator 7 of 7 of 9 damage 8 oxidative 9 damage 10 to 11 proteins 12 during 13 aging 14 in 16 and 15 cells 16 and 16 and 17 tissues the present study is focused on the relationship between human age and protein oxidation in erythrocyte membranes in a healthy indian population . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 5 focused 0 ###LEFT-WALL### 23 . 1 the 3 study 2 present 3 study 3 study 4 is 4 is 5 focused 5 focused 6 on 5 focused 9 between 5 focused 18 in 6 on 8 relationship 7 the 8 relationship 9 between 12 and 10 human 11 age 11 age 12 and 12 and 14 oxidation 12 and 15 in 13 protein 14 oxidation 15 in 17 membranes 16 erythrocyte 17 membranes 18 in 22 population 19 a 20 healthy 19 a 22 population 20 healthy 21 indian 21 indian 22 population materials and methods : the sample included healthy human subjects ( n = 49 ) between the ages of 17 to 80 years . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 materials 2 and 2 and 3 methods 4 : 6 sample 4 : 7 included 4 : 24 . 5 the 6 sample 6 sample 7 included 7 included 10 subjects 7 included 16 between 8 healthy 10 subjects 9 human 10 subjects 10 subjects 13 = 11 ( 13 = 12 n 13 = 13 = 14 49 13 = 15 ) 16 between 18 ages 17 the 18 ages 18 ages 19 of 19 of 23 years 20 17 21 to 21 to 22 80 21 to 23 years their blood was collected and assayed spectrophotometrically for oxidative protein damage in terms of protein carbonyls and plasma antioxidant capacity in terms of frap . 0 ###LEFT-WALL### 2 blood 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 25 . 1 their 2 blood 2 blood 5 and 3 was 4 collected 3 was 5 and 5 and 6 assayed 5 and 7 spectrophotometrically 5 and 8 for 5 and 12 in 5 and 20 capacity 8 for 11 damage 9 oxidative 10 protein 10 protein 11 damage 12 in 17 and 13 terms 14 of 13 terms 17 and 14 of 16 carbonyls 15 protein 16 carbonyls 17 and 18 plasma 19 antioxidant 20 capacity 20 capacity 21 in 20 capacity 23 of 21 in 22 terms 23 of 24 frap results : protein carbonyl content was found to increase in an age [-] related pattern indicating an increase in oxidative protein damage in older subjects ( p < 0.0001 , r = 0.8269 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 1 results 2 : 2 : 4 carbonyl 3 protein 4 carbonyl 4 carbonyl 5 content 4 carbonyl 16 indicating 5 content 6 was 6 was 7 found 7 found 8 to 7 found 10 in 8 to 9 increase 10 in 15 pattern 11 an 12 age 11 an 15 pattern 12 age 14 related 14 related 15 pattern 15 pattern 16 indicating 16 indicating 18 increase 16 indicating 23 in 17 an 18 increase 18 increase 19 in 19 in 22 damage 20 oxidative 21 protein 21 protein 22 damage 23 in 25 subjects 24 older 25 subjects 25 subjects 28 < 25 subjects 32 = 26 ( 28 < 27 p 28 < 28 < 29 0.0001 30 , 32 = 31 r 32 = 32 = 33 0.8269 32 = 34 ) there was also a significant negative correlation between protein oxidation and plasma antioxidant capacity measured in terms of ferric reducing antioxidant potential ( frap ) values ( p<0.0001 [;] r = - 0.8695 ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 35 . 1 there 2 was 2 was 3 also 2 was 7 correlation 2 was 8 between 4 a 7 correlation 5 significant 7 correlation 6 negative 7 correlation 8 between 10 oxidation 9 protein 10 oxidation 11 and 14 capacity 11 and 15 measured 12 plasma 14 capacity 13 antioxidant 14 capacity 14 capacity 15 measured 15 measured 16 in 15 measured 21 antioxidant 15 measured 32 - 16 in 17 terms 17 terms 18 of 18 of 20 reducing 19 ferric 20 reducing 21 antioxidant 22 potential 21 antioxidant 26 values 22 potential 24 frap 22 potential 26 values 23 ( 24 frap 24 frap 25 ) 27 ( 32 - 28 p<0.0001 31 = 30 r 31 = 31 = 32 - 32 - 33 0.8695 32 - 34 ) conclusion : our results substantiate the occurrence of oxidative stress during human aging . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 substantiate 2 : 14 . 3 our 4 results 4 results 5 substantiate 5 substantiate 7 occurrence 5 substantiate 11 during 6 the 7 occurrence 7 occurrence 8 of 8 of 10 stress 9 oxidative 10 stress 11 during 13 aging 12 human 13 aging elevated erythrocyte membrane carbonyl levels found with increasing age in this study may be viewed as a biomarker for aging . 0 ###LEFT-WALL### 14 be 0 ###LEFT-WALL### 21 . 1 elevated 3 membrane 2 erythrocyte 3 membrane 3 membrane 5 levels 4 carbonyl 5 levels 5 levels 6 found 5 levels 10 in 5 levels 13 may 6 found 7 with 7 with 8 increasing 8 increasing 9 age 10 in 12 study 11 this 12 study 13 may 14 be 14 be 15 viewed 15 viewed 16 as 15 viewed 19 for 16 as 18 biomarker 17 a 18 biomarker 19 for 20 aging none none background/aims : evidence suggests that patients with dementia with lewy bodies ( dlb ) may have more nocturnal sleep disturbance than patients with alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 6 suggests 0 ###LEFT-WALL### 32 . 1 none 3 background/aims 1 none 5 evidence 1 none 6 suggests 2 none 3 background/aims 3 background/aims 4 : 4 : 5 evidence 6 suggests 7 that 7 that 8 patients 7 that 18 have 8 patients 9 with 8 patients 11 with 8 patients 17 may 9 with 10 dementia 11 with 13 bodies 12 lewy 13 bodies 13 bodies 15 dlb 14 ( 15 dlb 15 dlb 16 ) 17 may 18 have 18 have 22 disturbance 18 have 23 than 18 have 25 with 19 more 20 nocturnal 20 nocturnal 21 sleep 21 sleep 22 disturbance 23 than 24 patients 25 with 28 disease 26 alzheimer 27 's 27 's 28 disease 28 disease 30 ad 29 ( 30 ad 30 ad 31 ) we sought to confirm such observations using a large , prospectively collected , standardized [,] multicenter - derived database , i.e . the national alzheimer 's coordinating center uniform data set . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 sought 0 ###LEFT-WALL### 22 . 0 ###LEFT-WALL### 32 . 1 we 2 sought 2 sought 3 to 2 sought 4 confirm 3 to 4 confirm 4 confirm 6 observations 5 such 6 observations 6 observations 7 using 7 using 21 i.e 8 a 21 i.e 9 large 19 database 9 large 21 i.e 10 , 19 database 11 prospectively 12 collected 12 collected 13 , 12 collected 19 database 14 standardized 19 database 16 multicenter 17 - 16 multicenter 19 database 18 derived 19 database 19 database 20 , 22 . 31 set 23 the 25 alzheimer 24 national 25 alzheimer 25 alzheimer 26 's 26 's 31 set 27 coordinating 28 center 28 center 29 uniform 29 uniform 30 data 30 data 31 set methods : nocturnal sleep disturbance ( nsd ) [data] , as characterized by the neuropsychiatric inventory questionnaire ( npi - q ) , were derived from 4,531 patients collected between september 2005 and november 2008 from 32 national institute on aging participating ad centers . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 45 . 2 : 5 disturbance 2 : 10 , 3 nocturnal 5 disturbance 4 sleep 5 disturbance 5 disturbance 7 nsd 6 ( 7 nsd 7 nsd 8 ) 10 , 17 questionnaire 10 , 25 derived 11 as 12 characterized 11 as 17 questionnaire 13 by 15 neuropsychiatric 13 by 17 questionnaire 14 the 15 neuropsychiatric 16 inventory 17 questionnaire 17 questionnaire 19 npi 17 questionnaire 24 were 18 ( 19 npi 19 npi 21 q 19 npi 23 , 20 - 21 q 21 q 22 ) 24 were 25 derived 25 derived 26 from 25 derived 30 between 26 from 28 patients 27 4,531 28 patients 28 patients 29 collected 30 between 33 and 31 september 32 2005 31 september 33 and 33 and 34 november 33 and 36 from 33 and 39 institute 33 and 44 centers 34 november 35 2008 36 from 38 national 37 32 38 national 39 institute 40 on 39 institute 42 participating 39 institute 44 centers 40 on 41 aging 42 participating 43 ad patient and informant characteristics were compared between those [with] and without nsd by dementia diagnosis ( dlb and probable ad ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 compared 0 ###LEFT-WALL### 22 . 1 patient 2 and 2 and 4 characteristics 2 and 5 were 3 informant 4 characteristics 5 were 6 compared 6 compared 10 and 6 compared 13 by 7 between 8 those 7 between 10 and 10 and 11 without 11 without 12 nsd 13 by 15 diagnosis 14 dementia 15 diagnosis 15 diagnosis 18 and 16 ( 18 and 17 dlb 18 and 18 and 20 ad 18 and 21 ) 19 probable 20 ad finally , a logistic regression model was created to quantify the association between nsd status and diagnosis while adjusting for these patient/informant characteristics , as well [as] center . 0 ###LEFT-WALL### 6 model 0 ###LEFT-WALL### 8 created 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 29 . 1 finally 2 , 1 finally 6 model 3 a 4 logistic 3 a 6 model 4 logistic 5 regression 5 regression 6 model 6 model 7 was 7 was 8 created 8 created 9 to 9 to 10 quantify 10 quantify 12 association 10 quantify 13 between 10 quantify 18 while 11 the 12 association 13 between 16 and 14 nsd 15 status 15 status 16 and 16 and 17 diagnosis 18 while 19 adjusting 19 adjusting 20 for 20 for 23 characteristics 21 these 23 characteristics 22 patient/informant 23 characteristics 24 , 28 center 25 as 26 well 26 well 28 center results : nsd was more frequent in clinically diagnosed dlb relative to clinically diagnosed ad ( odds ratio [=] 2.93 , 95 % confidence interval = 2.22 - 3.86 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 nsd 2 : 4 was 2 : 31 . 3 nsd 4 was 4 was 6 frequent 5 more 6 frequent 6 frequent 7 in 7 in 10 dlb 8 clinically 9 diagnosed 9 diagnosed 10 dlb 10 dlb 11 relative 11 relative 12 to 12 to 15 ad 13 clinically 14 diagnosed 14 diagnosed 15 ad 15 ad 18 ratio 15 ad 25 interval 16 ( 18 ratio 17 odds 18 ratio 18 ratio 20 2.93 18 ratio 21 , 21 , 25 interval 22 95 23 % 23 % 25 interval 24 confidence 25 interval 25 interval 28 - 25 interval 30 ) 26 = 27 2.22 27 2.22 28 - 28 - 29 3.86 these results were independent from the gender of the patient or informant , whether the informant lived with the patient , and other patient characteristics , such as dementia severity , depressive symptoms , and npi - q - derived measures of hallucinations , delusions , agitation and apathy . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 50 . 1 these 2 results 2 results 3 were 3 were 4 independent 4 independent 5 from 5 from 7 gender 6 the 7 gender 7 gender 8 of 8 of 11 or 9 the 10 patient 10 patient 11 or 11 or 12 informant 13 , 35 and 13 , 40 derived 14 whether 16 informant 14 whether 17 lived 14 whether 35 and 15 the 16 informant 16 informant 17 lived 17 lived 18 with 18 with 22 and 18 with 24 patient 19 the 20 patient 20 patient 22 and 21 , 22 and 22 and 23 other 25 characteristics 26 , 26 , 30 severity 26 , 31 , 27 such 30 severity 28 as 29 dementia 29 dementia 30 severity 31 , 33 symptoms 31 , 35 and 32 depressive 33 symptoms 34 , 35 and 35 and 36 npi 35 and 40 derived 36 npi 38 q 37 - 38 q 38 q 39 - 40 derived 48 and 41 measures 42 of 41 measures 44 , 42 of 43 hallucinations 44 , 45 delusions 44 , 46 , 46 , 47 agitation 46 , 48 and 48 and 49 apathy in ad , but not dlb , patients , nsd was associated with more advanced disease . 0 ###LEFT-WALL### 10 nsd 0 ###LEFT-WALL### 12 associated 0 ###LEFT-WALL### 17 . 1 in 2 ad 1 in 10 nsd 2 ad 4 but 3 , 4 but 4 but 5 not 4 but 6 dlb 4 but 9 , 6 dlb 8 patients 7 , 8 patients 8 patients 9 , 10 nsd 11 was 11 was 12 associated 12 associated 13 with 13 with 16 disease 14 more 15 advanced 15 advanced 16 disease comorbidity of nsd with hallucinations , agitation and apathy was higher in dlb than in ad . 0 ###LEFT-WALL### 1 comorbidity 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 17 . 1 comorbidity 2 of 1 comorbidity 10 was 2 of 3 nsd 3 nsd 4 with 4 with 8 and 5 hallucinations 6 , 6 , 7 agitation 6 , 8 and 8 and 9 apathy 10 was 11 higher 11 higher 12 in 11 higher 14 than 12 in 13 dlb 14 than 15 in 15 in 16 ad there was also evidence that the percentage of dlb cases with nsd showed wide variation across centers . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 18 . 1 there 2 was 2 was 3 also 2 was 4 evidence 4 evidence 5 that 4 evidence 13 showed 5 that 7 percentage 5 that 13 showed 6 the 7 percentage 7 percentage 8 of 7 percentage 13 showed 8 of 10 cases 9 dlb 10 cases 10 cases 11 with 11 with 12 nsd 13 showed 15 variation 14 wide 15 variation 15 variation 16 across 16 across 17 centers conclusion : as defined by the npi - q , endorsement of the nocturnal behavior item by informants is more likely in patients with dlb when compared to ad , even after the adjustment of key patient/informant characteristics . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 11 endorsement 2 : 19 is 3 as 4 defined 3 as 11 endorsement 5 by 7 npi 5 by 11 endorsement 6 the 7 npi 7 npi 9 q 8 - 9 q 9 q 10 , 11 endorsement 12 of 11 endorsement 19 is 12 of 16 item 13 the 16 item 14 nocturnal 16 item 15 behavior 16 item 16 item 17 by 17 by 18 informants 19 is 21 likely 20 more 21 likely 21 likely 22 in 21 likely 24 with 21 likely 26 when 22 in 23 patients 24 with 25 dlb 26 when 27 compared 27 compared 28 to 27 compared 30 , 27 compared 31 even 28 to 29 ad 31 even 32 after 32 after 34 adjustment 33 the 34 adjustment 34 adjustment 35 of 35 of 38 characteristics 36 key 37 patient/informant 37 patient/informant 38 characteristics background : recent clinical studies have suggested that serum surfactant protein ( sp ) [a] , sp [-] d and krebs von [den] lungen - 6 ( kl - 6 ) are potential biomarkers for interstitial lung diseases . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 5 studies 2 : 7 suggested 2 : 16 , 3 recent 5 studies 4 clinical 5 studies 5 studies 6 have 6 have 7 suggested 7 suggested 9 serum 7 suggested 10 surfactant 8 that 9 serum 10 surfactant 11 protein 11 protein 13 sp 12 ( 13 sp 13 sp 14 ) 16 , 24 lungen 16 , 25 - 17 sp 19 d 17 sp 20 and 20 and 21 krebs 21 krebs 22 von 22 von 24 lungen 25 - 26 6 25 - 32 are 26 6 28 kl 26 6 32 are 27 ( 28 kl 28 kl 30 6 28 kl 31 ) 29 - 30 6 30 6 31 ) 32 are 34 biomarkers 33 potential 34 biomarkers 34 biomarkers 35 for 35 for 38 diseases 36 interstitial 38 diseases 37 lung 38 diseases serum levels of sp [-] a and sp [-] d have also been found to be elevated in chronic obstructive pulmonary disease ( copd ) , but their significance has not been evaluated or compared in induced sputum samples obtained directly from the airways . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 27 but 0 ###LEFT-WALL### 45 . 1 serum 2 levels 2 levels 3 of 2 levels 7 and 3 of 4 sp 4 sp 6 a 7 and 8 sp 7 and 27 but 8 sp 10 d 11 have 13 been 11 have 27 but 12 also 13 been 13 been 14 found 14 found 15 to 14 found 18 in 15 to 16 be 16 be 17 elevated 18 in 22 disease 19 chronic 22 disease 20 obstructive 22 disease 21 pulmonary 22 disease 22 disease 24 copd 23 ( 24 copd 24 copd 25 ) 26 , 27 but 27 but 34 or 28 their 29 significance 29 significance 30 has 30 has 31 not 30 has 32 been 32 been 34 or 33 evaluated 34 or 34 or 35 compared 35 compared 36 in 35 compared 41 directly 35 compared 42 from 36 in 39 samples 37 induced 39 samples 38 sputum 39 samples 39 samples 40 obtained 42 from 44 airways 43 the 44 airways objective : a sequential sputum analysis was conducted to assess the value of sp - a , sp [-] d and kl - 6 levels in copd . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 6 analysis 2 : 8 conducted 2 : 15 - 2 : 23 - 3 a 4 sequential 3 a 6 analysis 4 sequential 5 sputum 5 sputum 6 analysis 6 analysis 7 was 7 was 8 conducted 8 conducted 9 to 9 to 10 assess 10 assess 12 value 11 the 12 value 12 value 13 of 13 of 14 sp 15 - 16 a 15 - 17 , 17 , 22 kl 18 sp 20 d 18 sp 21 and 21 and 22 kl 23 - 25 levels 24 6 25 levels 25 levels 26 in 26 in 27 copd methods : the study material consisted of induced sputum samples from 61 subjects , 28 with copd and 33 [with] prolonged cough ( cough lasting >3 weeks and normal spirometry ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 material 2 : 6 consisted 2 : 32 . 3 the 5 material 4 study 5 material 5 material 6 consisted 6 consisted 7 of 7 of 10 samples 8 induced 9 sputum 9 sputum 10 samples 10 samples 11 from 11 from 13 subjects 12 61 13 subjects 13 subjects 15 28 14 , 15 28 15 28 16 with 15 28 28 and 15 28 31 ) 16 with 18 and 17 copd 18 and 18 and 22 cough 19 33 21 prolonged 21 prolonged 22 cough 23 ( 28 and 24 cough 26 >3 25 lasting 26 >3 26 >3 27 weeks 27 weeks 28 and 28 and 30 spirometry 28 and 31 ) 29 normal 30 spirometry sputum was collected in 3 fractions ( 3 periods of 5 min [each] ) . 0 ###LEFT-WALL### 1 sputum 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 15 . 1 sputum 2 was 2 was 3 collected 3 collected 4 in 4 in 6 fractions 5 3 6 fractions 6 fractions 9 periods 7 ( 9 periods 8 3 9 periods 9 periods 10 of 9 periods 14 ) 10 of 12 min 11 5 12 min sputum levels of these proteins were measured , and receiver operating characteristic curve analysis was carried out to evaluate the sensitivity , specificity and area under the curve ( auc ) for each fraction . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 35 . 1 sputum 2 levels 2 levels 3 of 2 levels 9 and 3 of 5 proteins 4 these 5 proteins 6 were 7 measured 6 were 9 and 8 , 9 and 9 and 19 evaluate 10 receiver 11 operating 11 operating 14 analysis 12 characteristic 14 analysis 13 curve 14 analysis 14 analysis 15 was 15 was 16 carried 16 carried 17 out 16 carried 18 to 18 to 19 evaluate 19 evaluate 24 and 19 evaluate 26 under 19 evaluate 32 for 20 the 24 and 21 sensitivity 22 , 22 , 23 specificity 22 , 24 and 24 and 25 area 26 under 28 curve 27 the 28 curve 28 curve 30 auc 29 ( 30 auc 30 auc 31 ) 32 for 34 fraction 33 each 34 fraction results : the levels of sp - a , sp - [d] and kl - 6 were higher in patients with copd than in those with prolonged cough in each of the fractions . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 34 . 1 results 2 : 2 : 4 levels 3 the 4 levels 4 levels 5 of 5 of 6 sp 7 - 8 a 7 - 9 , 9 , 13 and 9 , 28 cough 10 sp 13 and 11 - 13 and 13 and 14 kl 13 and 16 6 13 and 26 with 13 and 27 prolonged 13 and 28 cough 15 - 16 6 16 6 17 were 17 were 18 higher 18 higher 19 in 18 higher 21 with 18 higher 23 than 18 higher 24 in 18 higher 26 with 19 in 20 patients 21 with 22 copd 24 in 25 those 28 cough 29 in 28 cough 33 fractions 30 each 31 of 30 each 33 fractions 31 of 33 fractions 32 the 33 fractions sputum levels of these proteins correlated inversely with obstruction and positively with ageing , smoking history , sputum macrophages and eosinophils . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 6 correlated 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 22 . 1 sputum 2 levels 2 levels 3 of 2 levels 6 correlated 3 of 5 proteins 4 these 5 proteins 6 correlated 7 inversely 6 correlated 8 with 8 with 9 obstruction 10 and 18 sputum 10 and 20 and 11 positively 18 sputum 12 with 13 ageing 12 with 17 , 12 with 18 sputum 13 ageing 15 smoking 14 , 15 smoking 15 smoking 16 history 15 smoking 17 , 18 sputum 20 and 19 macrophages 20 and 20 and 21 eosinophils sputum fractionation had a relatively minor effect on the levels and auc of these proteins . 0 ###LEFT-WALL### 2 fractionation 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 16 . 1 sputum 2 fractionation 2 fractionation 3 had 3 had 7 effect 3 had 8 on 4 a 5 relatively 4 a 7 effect 5 relatively 6 minor 6 minor 7 effect 8 on 11 and 9 the 10 levels 10 levels 11 and 11 and 12 auc 11 and 13 of 13 of 15 proteins 14 these 15 proteins conclusion : sequential sputum analysis from 3 consecutive fractions indicated a significant difference in the levels of sp - a , sp - [d] and kl - 6 between copd and prolonged cough . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 analysis 2 : 10 indicated 2 : 19 - 2 : 34 . 3 sequential 4 sputum 4 sputum 5 analysis 5 analysis 6 from 5 analysis 10 indicated 6 from 9 fractions 7 3 9 fractions 8 consecutive 9 fractions 10 indicated 13 difference 11 a 13 difference 12 significant 13 difference 13 difference 14 in 13 difference 17 of 14 in 16 levels 15 the 16 levels 17 of 18 sp 19 - 20 a 19 - 21 , 21 , 25 and 21 , 27 - 22 sp 25 and 23 - 25 and 25 and 26 kl 27 - 28 6 28 6 29 between 29 between 31 and 30 copd 31 and 31 and 33 cough 32 prolonged 33 cough however , sputum fractionation itself had a relatively minor effect on the levels of these proteins . 0 ###LEFT-WALL### 4 fractionation 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 4 fractionation 3 sputum 4 fractionation 4 fractionation 6 had 5 itself 6 had 6 had 10 effect 6 had 11 on 7 a 8 relatively 7 a 10 effect 8 relatively 9 minor 9 minor 10 effect 11 on 13 levels 12 the 13 levels 13 levels 14 of 14 of 16 proteins 15 these 16 proteins the cytoplasmic domain of band 3 serves as a center of erythrocyte membrane organization and constitutes the major substrate of erythrocyte tyrosine kinases . 0 ###LEFT-WALL### 3 domain 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 24 . 1 the 3 domain 2 cytoplasmic 3 domain 3 domain 4 of 3 domain 15 and 4 of 5 band 5 band 6 3 7 serves 8 as 7 serves 15 and 8 as 10 center 9 a 10 center 10 center 11 of 11 of 14 organization 12 erythrocyte 14 organization 13 membrane 14 organization 15 and 16 constitutes 16 constitutes 19 substrate 17 the 19 substrate 18 major 19 substrate 19 substrate 20 of 20 of 23 kinases 21 erythrocyte 23 kinases 22 tyrosine 23 kinases tyrosine phosphorylation of band 3 is induced by several physiologic stimuli , including malaria parasite invasion , cell shrinkage , normal cell aging , and oxidant stress ( thalassemias , sickle cell disease , glucose - 6 - phosphate dehydrogenase deficiency , etc ) . 0 ###LEFT-WALL### 2 phosphorylation 0 ###LEFT-WALL### 7 induced 0 ###LEFT-WALL### 12 , 1 tyrosine 2 phosphorylation 2 phosphorylation 3 of 2 phosphorylation 6 is 3 of 4 band 4 band 5 3 6 is 7 induced 7 induced 8 by 8 by 11 stimuli 9 several 11 stimuli 10 physiologic 11 stimuli 12 , 16 invasion 12 , 17 , 13 including 15 parasite 14 malaria 15 parasite 15 parasite 16 invasion 17 , 25 and 17 , 31 sickle 17 , 36 - 18 cell 19 shrinkage 19 shrinkage 20 , 20 , 23 aging 20 , 25 and 21 normal 22 cell 22 cell 23 aging 24 , 25 and 25 and 27 stress 25 and 29 thalassemias 25 and 31 sickle 26 oxidant 27 stress 28 ( 29 thalassemias 29 thalassemias 30 , 31 sickle 33 disease 32 cell 33 disease 33 disease 35 glucose 34 , 35 glucose 35 glucose 36 - 36 - 37 6 36 - 38 - 36 - 45 . 38 - 41 deficiency 39 phosphate 40 dehydrogenase 40 dehydrogenase 41 deficiency 41 deficiency 43 etc 42 , 43 etc 43 etc 44 ) in an effort to characterize the biologic sequelae of band 3 tyrosine phosphorylation , we looked for changes in the polypeptide 's function that accompany its phosphorylation . 0 ###LEFT-WALL### 15 we 0 ###LEFT-WALL### 16 looked 0 ###LEFT-WALL### 28 . 1 in 3 effort 1 in 14 , 1 in 15 we 2 an 3 effort 3 effort 4 to 3 effort 5 characterize 4 to 5 characterize 5 characterize 8 sequelae 6 the 8 sequelae 7 biologic 8 sequelae 8 sequelae 9 of 9 of 13 phosphorylation 10 band 13 phosphorylation 11 3 13 phosphorylation 12 tyrosine 13 phosphorylation 15 we 16 looked 16 looked 17 for 17 for 18 changes 18 changes 19 in 18 changes 24 that 18 changes 25 accompany 19 in 23 function 20 the 21 polypeptide 21 polypeptide 22 's 22 's 23 function 24 that 25 accompany 25 accompany 27 phosphorylation 26 its 27 phosphorylation because [release] of band 3 from its ankyrin and adducin linkages to the cytoskeleton can facilitate changes in multiple membrane properties , tyrosine phosphorylation of band 3 is argued to enable adaptive changes in erythrocyte biology that permit the cell to respond to the [above] stresses . 0 ###LEFT-WALL### 11 linkages 0 ###LEFT-WALL### 16 facilitate 0 ###LEFT-WALL### 29 argued 1 because 3 of 1 because 11 linkages 3 of 9 and 4 band 5 3 4 band 6 from 4 band 9 and 6 from 8 ankyrin 7 its 8 ankyrin 9 and 10 adducin 11 linkages 12 to 11 linkages 16 facilitate 12 to 15 can 13 the 15 can 14 cytoskeleton 15 can 16 facilitate 17 changes 16 facilitate 18 in 18 in 21 properties 19 multiple 21 properties 20 membrane 21 properties 22 , 29 argued 23 tyrosine 24 phosphorylation 23 tyrosine 28 is 23 tyrosine 29 argued 24 phosphorylation 25 of 24 phosphorylation 28 is 25 of 26 band 26 band 27 3 29 argued 30 to 29 argued 47 . 30 to 31 enable 31 enable 33 changes 31 enable 41 to 31 enable 42 respond 32 adaptive 33 changes 33 changes 34 in 33 changes 37 that 33 changes 38 permit 34 in 36 biology 35 erythrocyte 36 biology 37 that 38 permit 38 permit 40 cell 39 the 40 cell 41 to 42 respond 42 respond 43 to 43 to 46 stresses 44 the 46 stresses chronological age is a well [-] established risk factor for the development of cardiovascular diseases . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 16 . 1 chronological 2 age 2 age 3 is 3 is 9 factor 4 a 9 factor 5 well 7 established 7 established 9 factor 8 risk 9 factor 9 factor 10 for 10 for 12 development 11 the 12 development 12 development 13 of 13 of 15 diseases 14 cardiovascular 15 diseases the changes that accumulate in the vasculature with age , however , are highly variable . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 13 are 0 ###LEFT-WALL### 16 . 1 the 2 changes 2 changes 3 that 2 changes 4 accumulate 2 changes 13 are 3 that 4 accumulate 4 accumulate 5 in 4 accumulate 8 with 5 in 7 vasculature 6 the 7 vasculature 8 with 9 age 10 , 11 however 11 however 12 , 11 however 13 are 13 are 15 variable 14 highly 15 variable it is now increasingly recognized that indices of vascular health are more reliable than age per se in predicting adverse cardiovascular outcomes . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 5 recognized 0 ###LEFT-WALL### 23 . 1 it 2 is 2 is 3 now 2 is 5 recognized 4 increasingly 5 recognized 5 recognized 6 that 6 that 7 indices 6 that 11 are 7 indices 8 of 7 indices 11 are 8 of 10 health 9 vascular 10 health 11 are 13 reliable 12 more 13 reliable 13 reliable 14 than 13 reliable 17 se 13 reliable 18 in 14 than 15 age 16 per 17 se 18 in 19 predicting 19 predicting 22 outcomes 20 adverse 22 outcomes 21 cardiovascular 22 outcomes the variation in the accrual of [these] age - related vascular changes is a function of multiple genetic and environmental factors . 0 ###LEFT-WALL### 2 variation 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 22 . 1 the 2 variation 2 variation 3 in 2 variation 6 of 2 variation 13 is 3 in 5 accrual 4 the 5 accrual 6 of 8 age 9 - 10 related 10 related 12 changes 10 related 13 is 11 vascular 12 changes 13 is 15 function 14 a 15 function 15 function 16 of 16 of 21 factors 17 multiple 21 factors 18 genetic 19 and 19 and 20 environmental 19 and 21 factors in this review , we highlight some of the pathophysiological mechanisms that characterize the vascular aging phenotype . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 highlight 0 ###LEFT-WALL### 18 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 highlight 6 highlight 11 mechanisms 7 some 8 of 7 some 11 mechanisms 8 of 11 mechanisms 9 the 11 mechanisms 10 pathophysiological 11 mechanisms 11 mechanisms 12 that 11 mechanisms 13 characterize 12 that 13 characterize 13 characterize 17 phenotype 14 the 17 phenotype 15 vascular 17 phenotype 16 aging 17 phenotype furthermore , we provide an overview of the key outcome studies that address the value of these vascular health indices in general and discuss potential effects on perioperative cardiovascular outcomes . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 31 . 1 furthermore 2 , 1 furthermore 3 we 3 we 4 provide 4 provide 6 overview 5 an 6 overview 6 overview 7 of 7 of 11 studies 8 the 11 studies 9 key 11 studies 10 outcome 11 studies 11 studies 12 that 11 studies 23 and 12 that 23 and 13 address 15 value 13 address 22 general 13 address 23 and 14 the 15 value 15 value 16 of 16 of 20 indices 17 these 20 indices 18 vascular 19 health 19 health 20 indices 21 in 22 general 23 and 24 discuss 24 discuss 26 effects 24 discuss 27 on 25 potential 26 effects 27 on 30 outcomes 28 perioperative 30 outcomes 29 cardiovascular 30 outcomes background : the aging - suppressor gene klotho encodes a single - pass transmembrane protein that in mice is known to extend life [span] when overexpressed and resemble accelerated aging when expression is disrupted . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 1 background 2 : 2 : 4 aging 3 the 4 aging 5 - 8 klotho 5 - 9 encodes 5 - 35 . 6 suppressor 8 klotho 7 gene 8 klotho 8 klotho 9 encodes 9 encodes 15 protein 9 encodes 31 when 10 a 11 single 10 a 15 protein 11 single 12 - 11 single 13 pass 13 pass 15 protein 14 transmembrane 15 protein 15 protein 16 that 15 protein 27 and 15 protein 29 accelerated 16 that 17 in 16 that 19 is 17 in 18 mice 19 is 20 known 20 known 21 to 20 known 27 and 21 to 27 and 22 extend 23 life 22 extend 25 when 22 extend 27 and 25 when 26 overexpressed 27 and 28 resemble 29 accelerated 30 aging 31 when 32 expression 31 when 34 disrupted 32 expression 33 is 33 is 34 disrupted it is not known whether there is a relationship between plasma levels of secreted klotho protein and longevity in humans . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 known 0 ###LEFT-WALL### 21 . 1 it 2 is 2 is 3 not 2 is 4 known 4 known 5 whether 5 whether 6 there 5 whether 7 is 6 there 7 is 7 is 9 relationship 8 a 9 relationship 9 relationship 10 between 9 relationship 19 in 10 between 17 and 11 plasma 12 levels 12 levels 13 of 12 levels 17 and 13 of 16 protein 14 secreted 15 klotho 15 klotho 16 protein 17 and 18 longevity 19 in 20 humans methods : we measured plasma klotho in 804 adults , [greater] than or equal to 65 years , in the inchianti study , a longitudinal population - based study of aging in tuscany , italy . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 aging 2 : 3 we 2 : 13 or 3 we 13 or 4 measured 5 plasma 4 measured 13 or 5 plasma 6 klotho 6 klotho 7 in 7 in 9 adults 8 804 9 adults 10 , 12 than 10 , 13 or 13 or 14 equal 13 or 15 to 15 to 16 65 16 65 17 years 16 65 31 aging 17 years 19 in 17 years 28 based 18 , 19 in 19 in 22 study 19 in 27 - 20 the 22 study 21 inchianti 22 study 22 study 26 population 23 , 26 population 24 a 25 longitudinal 24 a 26 population 25 longitudinal 26 population 26 population 27 - 28 based 29 study 29 study 30 of 30 of 31 aging 31 aging 32 in 32 in 33 tuscany 33 tuscany 35 italy 34 , 35 italy 35 italy 36 . results [:] during 6 years of [follow] - up , 194 ( 24.1 % ) of the participants died . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 19 died 0 ###LEFT-WALL### 20 . 1 results 3 during 1 results 16 of 1 results 19 died 3 during 5 years 4 6 5 years 5 years 6 of 5 years 11 194 6 of 9 up 8 - 9 up 10 , 11 194 11 194 14 % 11 194 15 ) 12 ( 14 % 13 24.1 14 % 14 % 15 ) 16 of 18 participants 17 the 18 participants conclusions : in older community - dwelling adults , plasma klotho is an independent predictor of all - cause mortality . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 community 2 : 6 - 2 : 21 . 3 in 5 community 4 older 5 community 6 - 8 adults 6 - 9 , 7 dwelling 8 adults 9 , 11 klotho 9 , 12 is 9 , 18 - 10 plasma 11 klotho 11 klotho 12 is 12 is 15 predictor 13 an 14 independent 13 an 15 predictor 14 independent 15 predictor 15 predictor 16 of 16 of 17 all 18 - 19 cause 19 cause 20 mortality further studies are needed to elucidate the potential biological mechanisms by which circulating klotho could affect longevity in humans . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 6 elucidate 0 ###LEFT-WALL### 20 . 1 further 2 studies 2 studies 3 are 3 are 4 needed 4 needed 5 to 5 to 6 elucidate 6 elucidate 10 mechanisms 7 the 10 mechanisms 8 potential 10 mechanisms 9 biological 10 mechanisms 10 mechanisms 11 by 11 by 12 which 11 by 13 circulating 11 by 14 klotho 11 by 16 affect 12 which 13 circulating 14 klotho 15 could 15 could 16 affect 16 affect 17 longevity 16 affect 18 in 18 in 19 humans the objective of this study was ( [a] [ )(to investigate the accordance [of] self - reported and objectively assessed olfactory functioning and [(] [b] [ )(to compare performance on cognitive tests of individuals unaware of their olfactory dysfunction with individuals aware of their olfactory status . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 16 - 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 this 5 study 6 was 10 )(to 7 ( 10 )(to 10 )(to 11 investigate 10 )(to 16 - 11 investigate 15 self 12 the 15 self 13 accordance 15 self 16 - 18 and 16 - 47 . 17 reported 18 and 18 and 23 and 19 objectively 20 assessed 20 assessed 22 functioning 20 assessed 23 and 21 olfactory 22 functioning 23 and 27 )(to 23 and 28 compare 27 )(to 28 compare 28 compare 29 performance 29 performance 30 on 29 performance 33 of 29 performance 35 unaware 30 on 32 tests 31 cognitive 32 tests 33 of 34 individuals 35 unaware 36 of 35 unaware 40 with 36 of 39 dysfunction 37 their 39 dysfunction 38 olfactory 39 dysfunction 40 with 41 individuals 41 individuals 42 aware 42 aware 43 of 43 of 46 status 44 their 46 status 45 olfactory 46 status two hundred forty participants , constituting two age groups , were evaluated with the scandinavian odor identification test , a question [of] self - evaluated olfactory function , tests of cognitive [function] , and a memory questionnaire . 0 ###LEFT-WALL### 4 participants 0 ###LEFT-WALL### 12 evaluated 1 two 2 hundred 2 hundred 3 forty 3 forty 4 participants 4 participants 6 constituting 4 participants 11 were 5 , 6 constituting 6 constituting 9 groups 6 constituting 10 , 7 two 9 groups 8 age 9 groups 11 were 12 evaluated 12 evaluated 13 with 13 with 27 function 14 the 27 function 15 scandinavian 16 odor 16 odor 17 identification 17 identification 25 evaluated 18 test 23 self 18 test 25 evaluated 19 , 23 self 20 a 23 self 21 question 23 self 23 self 24 - 25 evaluated 27 function 26 olfactory 27 function 27 function 29 tests 28 , 29 tests 29 tests 30 of 29 tests 38 . 30 of 34 and 31 cognitive 34 and 33 , 34 and 34 and 37 questionnaire 35 a 36 memory 35 a 37 questionnaire 36 memory 37 questionnaire the proportion of individuals being unaware of an olfactory dysfunction was high in both middle aged ( 86 % ) [and] old ( 78 % ) participants . 0 ###LEFT-WALL### 2 proportion 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 28 . 1 the 2 proportion 2 proportion 3 of 2 proportion 5 being 2 proportion 11 was 3 of 4 individuals 5 being 6 unaware 6 unaware 7 of 7 of 10 dysfunction 8 an 9 olfactory 8 an 10 dysfunction 9 olfactory 10 dysfunction 11 was 12 high 12 high 13 in 13 in 27 participants 14 both 27 participants 15 middle 27 participants 16 aged 19 % 16 aged 27 participants 17 ( 19 % 18 86 19 % 19 % 20 ) 22 old 25 % 22 old 27 participants 23 ( 25 % 24 78 25 % 25 % 26 ) performance on neuropsychological tests showed that persons unaware of their olfactory dysfunction performed poorer on tests of verbal learning and memory and attention/processing speed compared to individuals aware of [a] normal olfactory status as well as individuals aware of their olfactory dysfunction . 0 ###LEFT-WALL### 1 performance 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 43 . 1 performance 2 on 1 performance 5 showed 2 on 4 tests 3 neuropsychological 4 tests 5 showed 6 that 5 showed 7 persons 5 showed 13 performed 7 persons 8 unaware 7 persons 13 performed 8 unaware 9 of 9 of 12 dysfunction 10 their 12 dysfunction 11 olfactory 12 dysfunction 13 performed 14 poorer 14 poorer 15 on 15 on 16 tests 16 tests 17 of 17 of 19 learning 18 verbal 19 learning 20 and 22 and 20 and 25 compared 21 memory 22 and 22 and 24 speed 22 and 25 compared 23 attention/processing 24 speed 25 compared 26 to 25 compared 35 well 25 compared 36 as 26 to 27 individuals 27 individuals 28 aware 28 aware 29 of 29 of 33 status 31 normal 33 status 32 olfactory 33 status 34 as 35 well 36 as 37 individuals 37 individuals 38 aware 38 aware 39 of 39 of 42 dysfunction 40 their 42 dysfunction 41 olfactory 42 dysfunction the clinical relevance of unawareness of olfactory dysfunction , as suggested earlier [,] needs further investigation and stresses the need of an extensive multi - modal and longitudinal assessment of unawareness of sensory and cognitive function to learn more about the facets of the concept of unawareness . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 48 . 1 the 3 relevance 2 clinical 3 relevance 3 relevance 4 of 3 relevance 11 suggested 3 relevance 17 and 4 of 5 unawareness 5 unawareness 6 of 6 of 8 dysfunction 7 olfactory 8 dysfunction 9 , 11 suggested 10 as 11 suggested 12 earlier 14 needs 14 needs 16 investigation 14 needs 17 and 15 further 16 investigation 17 and 18 stresses 17 and 37 to 18 stresses 20 need 19 the 20 need 20 need 21 of 21 of 29 assessment 22 an 23 extensive 22 an 29 assessment 23 extensive 29 assessment 24 multi 25 - 24 multi 29 assessment 26 modal 27 and 27 and 28 longitudinal 27 and 29 assessment 29 assessment 30 of 29 assessment 32 of 30 of 31 unawareness 32 of 34 and 33 sensory 34 and 34 and 36 function 35 cognitive 36 function 37 to 38 learn 38 learn 39 more 38 learn 40 about 38 learn 43 of 40 about 42 facets 41 the 42 facets 43 of 45 concept 44 the 45 concept 45 concept 46 of 46 of 47 unawareness in this paper , a new , fully automated [,] content - based system is proposed for knee bone segmentation from magnetic resonance images ( mri ) . 0 ###LEFT-WALL### 14 system 0 ###LEFT-WALL### 28 . 1 in 3 paper 1 in 4 , 1 in 14 system 2 this 3 paper 5 a 6 new 5 a 14 system 6 new 11 content 6 new 12 - 6 new 14 system 7 , 11 content 8 fully 9 automated 9 automated 11 content 11 content 12 - 13 based 14 system 14 system 15 is 15 is 16 proposed 16 proposed 17 for 16 proposed 21 from 17 for 20 segmentation 18 knee 20 segmentation 19 bone 20 segmentation 21 from 24 images 22 magnetic 24 images 23 resonance 24 images 24 images 26 mri 25 ( 26 mri 26 mri 27 ) the purpose of the bone segmentation is to support the discovery and characterization of imaging biomarkers for the incidence and progression of osteoarthritis , a debilitating joint disease , which affects a large portion of the aging population . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 39 . 1 the 2 purpose 2 purpose 3 of 2 purpose 12 and 3 of 5 bone 4 the 5 bone 5 bone 6 segmentation 5 bone 9 support 6 segmentation 7 is 7 is 8 to 7 is 9 support 8 to 9 support 9 support 11 discovery 10 the 11 discovery 12 and 13 characterization 12 and 14 of 12 and 20 and 14 of 15 imaging 15 imaging 16 biomarkers 16 biomarkers 17 for 17 for 19 incidence 18 the 19 incidence 20 and 21 progression 20 and 30 which 20 and 31 affects 21 progression 22 of 22 of 23 osteoarthritis 23 osteoarthritis 28 disease 24 , 28 disease 25 a 28 disease 26 debilitating 28 disease 27 joint 28 disease 28 disease 29 , 30 which 31 affects 31 affects 34 portion 32 a 33 large 32 a 34 portion 33 large 34 portion 34 portion 35 of 35 of 38 population 36 the 38 population 37 aging 38 population the segmentation algorithm includes a novel content - based , two - pass [disjoint] block discovery mechanism , which is designed to support automation , segmentation initialization , and post - processing . 0 ###LEFT-WALL### 3 algorithm 0 ###LEFT-WALL### 4 includes 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 33 . 1 the 3 algorithm 2 segmentation 3 algorithm 3 algorithm 4 includes 4 includes 7 content 5 a 7 content 6 novel 7 content 7 content 9 based 8 - 9 based 9 based 10 , 10 , 11 two 10 , 12 - 12 - 17 mechanism 12 - 18 , 13 pass 17 mechanism 15 block 17 mechanism 16 discovery 17 mechanism 18 , 19 which 18 , 21 designed 18 , 31 - 19 which 20 is 20 is 21 designed 21 designed 22 to 21 designed 23 support 22 to 23 support 23 support 29 and 24 automation 25 , 25 , 27 initialization 25 , 29 and 26 segmentation 27 initialization 28 , 29 and 29 and 30 post 31 - 32 processing the block discovery is achieved by classifying the image content to bone and background blocks according to their similarity to the categories in the training data collected from typical bone structures . 0 ###LEFT-WALL### 2 block 0 ###LEFT-WALL### 15 blocks 0 ###LEFT-WALL### 32 . 1 the 2 block 2 block 3 discovery 2 block 7 classifying 2 block 15 blocks 3 discovery 4 is 4 is 5 achieved 5 achieved 6 by 6 by 7 classifying 7 classifying 13 and 8 the 9 image 9 image 10 content 9 image 13 and 10 content 11 to 10 content 12 bone 11 to 12 bone 13 and 14 background 15 blocks 17 to 15 blocks 20 to 15 blocks 23 in 15 blocks 26 data 16 according 17 to 17 to 19 similarity 18 their 19 similarity 20 to 22 categories 21 the 22 categories 23 in 25 training 24 the 25 training 26 data 27 collected 27 collected 28 from 28 from 31 structures 29 typical 30 bone 30 bone 31 structures the classified blocks are then used to design an efficient graph - cut based segmentation algorithm . 0 ###LEFT-WALL### 3 blocks 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 12 - 1 the 3 blocks 2 classified 3 blocks 3 blocks 4 are 4 are 6 used 5 then 6 used 6 used 7 to 6 used 8 design 7 to 8 design 8 design 11 graph 9 an 10 efficient 9 an 11 graph 10 efficient 11 graph 12 - 16 algorithm 12 - 17 . 13 cut 14 based 14 based 15 segmentation 15 segmentation 16 algorithm this algorithm requires constructing a graph using image pixel data followed by applying a maximum - flow algorithm which generates a minimum graph [-] cut that corresponds to an initial image segmentation . 0 ###LEFT-WALL### 2 algorithm 0 ###LEFT-WALL### 3 requires 0 ###LEFT-WALL### 33 . 1 this 2 algorithm 2 algorithm 3 requires 3 requires 4 constructing 3 requires 11 followed 4 constructing 6 graph 4 constructing 11 followed 5 a 6 graph 6 graph 7 using 7 using 10 data 8 image 9 pixel 9 pixel 10 data 11 followed 12 by 11 followed 28 to 12 by 13 applying 13 applying 18 algorithm 14 a 15 maximum 14 a 18 algorithm 15 maximum 16 - 15 maximum 18 algorithm 17 flow 18 algorithm 18 algorithm 19 which 18 algorithm 20 generates 19 which 20 generates 20 generates 23 graph 21 a 23 graph 22 minimum 23 graph 23 graph 25 cut 23 graph 26 that 23 graph 27 corresponds 26 that 27 corresponds 28 to 32 segmentation 29 an 32 segmentation 30 initial 31 image 31 image 32 segmentation content - based refinements and morphological operations are then applied to obtain the final segmentation . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 applied 0 ###LEFT-WALL### 16 . 1 content 2 - 1 content 4 refinements 3 based 4 refinements 4 refinements 5 and 5 and 7 operations 5 and 8 are 6 morphological 7 operations 8 are 10 applied 9 then 10 applied 10 applied 11 to 11 to 12 obtain 12 obtain 15 segmentation 13 the 15 segmentation 14 final 15 segmentation the proposed segmentation technique does not require any user interaction and can distinguish between bone [and] highly similar adjacent structures , such as fat tissues with high accuracy . 0 ###LEFT-WALL### 4 technique 0 ###LEFT-WALL### 13 distinguish 1 the 4 technique 2 proposed 3 segmentation 3 segmentation 4 technique 4 technique 5 does 5 does 6 not 5 does 7 require 7 require 11 and 7 require 13 distinguish 8 any 10 interaction 9 user 10 interaction 10 interaction 11 and 11 and 12 can 13 distinguish 14 between 14 between 20 structures 15 bone 20 structures 17 highly 18 similar 18 similar 20 structures 19 adjacent 20 structures 20 structures 23 as 21 , 23 as 22 such 23 as 23 as 25 tissues 23 as 29 . 24 fat 25 tissues 25 tissues 26 with 26 with 28 accuracy 27 high 28 accuracy the performance of the proposed system is evaluated by testing it on 376 mr images from the osteoarthritis initiative ( oai ) database . 0 ###LEFT-WALL### 2 performance 0 ###LEFT-WALL### 8 evaluated 0 ###LEFT-WALL### 24 . 1 the 2 performance 2 performance 3 of 2 performance 7 is 3 of 6 system 4 the 6 system 5 proposed 6 system 7 is 8 evaluated 8 evaluated 9 by 8 evaluated 12 on 9 by 10 testing 10 testing 11 it 12 on 15 images 13 376 15 images 14 mr 15 images 15 images 16 from 16 from 23 database 17 the 23 database 18 osteoarthritis 19 initiative 19 initiative 21 oai 20 ( 21 oai 21 oai 22 ) 21 oai 23 database this database included a selection of single images containing the femur and tibia from 200 subjects with varying levels of osteoarthritis severity . 0 ###LEFT-WALL### 2 database 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 23 . 1 this 2 database 2 database 3 included 3 included 5 selection 3 included 14 from 4 a 5 selection 5 selection 6 of 6 of 12 and 7 single 8 images 8 images 9 containing 8 images 12 and 9 containing 11 femur 10 the 11 femur 12 and 13 tibia 14 from 16 subjects 15 200 16 subjects 16 subjects 17 with 17 with 18 varying 18 varying 19 levels 19 levels 20 of 20 of 22 severity 21 osteoarthritis 22 severity additionally , a full [three] - dimensional segmentation of the bones from ten subjects with 14 slices each , and synthetic images with background having [intensity] and spatial characteristics similar to those [of] bone are used to assess the robustness and consistency of the developed algorithm . 0 ###LEFT-WALL### 8 segmentation 0 ###LEFT-WALL### 17 slices 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 47 . 1 additionally 2 , 1 additionally 8 segmentation 3 a 4 full 3 a 8 segmentation 4 full 6 - 4 full 8 segmentation 7 dimensional 8 segmentation 8 segmentation 9 of 8 segmentation 17 slices 9 of 11 bones 10 the 11 bones 11 bones 12 from 11 bones 15 with 12 from 14 subjects 13 ten 14 subjects 15 with 16 14 17 slices 18 each 19 , 20 and 19 , 38 assess 20 and 22 images 20 and 36 used 21 synthetic 22 images 22 images 23 with 22 images 29 characteristics 22 images 34 bone 22 images 35 are 23 with 27 and 24 background 25 having 25 having 27 and 27 and 28 spatial 29 characteristics 30 similar 29 characteristics 34 bone 30 similar 31 to 31 to 32 those 35 are 36 used 36 used 37 to 37 to 38 assess 38 assess 41 and 39 the 41 and 40 robustness 41 and 41 and 42 consistency 41 and 43 of 43 of 46 algorithm 44 the 46 algorithm 45 developed 46 algorithm the results show an automatic bone detection rate of 0.99 and an average segmentation accuracy of 0.95 using the dice similarity index . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 23 . 1 the 2 results 2 results 3 show 3 show 8 rate 3 show 11 and 4 an 5 automatic 4 an 8 rate 5 automatic 6 bone 6 bone 7 detection 7 detection 8 rate 8 rate 9 of 9 of 10 0.99 11 and 13 average 11 and 15 accuracy 12 an 13 average 14 segmentation 15 accuracy 15 accuracy 16 of 16 of 17 0.95 17 0.95 18 using 18 using 22 index 19 the 22 index 20 dice 22 index 21 similarity 22 index parkinson 's disease ( pd ) is a late - onset neurodegenerative disease which occurs at more than 1 % in populations aging 65 - years [and] [over] . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 7 is 1 parkinson 2 's 2 's 3 disease 3 disease 5 pd 3 disease 7 is 4 ( 5 pd 5 pd 6 ) 7 is 13 disease 8 a 9 late 8 a 13 disease 9 late 10 - 9 late 11 onset 11 onset 13 disease 12 neurodegenerative 13 disease 13 disease 14 which 13 disease 15 occurs 13 disease 26 years 14 which 15 occurs 15 occurs 16 at 15 occurs 18 than 15 occurs 21 in 16 at 17 more 18 than 20 % 19 1 20 % 21 in 22 populations 22 populations 23 aging 23 aging 24 65 25 - 26 years 26 years 29 . recently , leucine - rich repeat kinase 2 ( lrrk2 ) has been identified as a causative gene for autosomal dominantly inherited familial pd cases . 0 ###LEFT-WALL### 3 leucine 0 ###LEFT-WALL### 14 identified 0 ###LEFT-WALL### 26 . 1 recently 2 , 1 recently 3 leucine 3 leucine 7 kinase 3 leucine 12 has 4 - 7 kinase 5 rich 6 repeat 6 repeat 7 kinase 7 kinase 8 2 7 kinase 10 lrrk2 7 kinase 11 ) 9 ( 10 lrrk2 10 lrrk2 11 ) 12 has 13 been 13 been 14 identified 14 identified 15 as 15 as 18 gene 16 a 17 causative 16 a 18 gene 17 causative 18 gene 18 gene 19 for 19 for 25 cases 20 autosomal 25 cases 21 dominantly 22 inherited 22 inherited 25 cases 23 familial 25 cases 24 pd 25 cases lrrk2 g2019s which is a prevalent mutant found in familial pd patients with lrrk2 mutations , exhibited kinase activity stronger than that of the wild type , suggesting the lrrk2 kinase inhibitor as a potential pd therapeutics . 0 ###LEFT-WALL### 2 g2019s 0 ###LEFT-WALL### 8 found 0 ###LEFT-WALL### 38 . 1 lrrk2 2 g2019s 2 g2019s 3 which 2 g2019s 4 is 2 g2019s 8 found 3 which 4 is 4 is 7 mutant 5 a 6 prevalent 5 a 7 mutant 6 prevalent 7 mutant 8 found 9 in 8 found 36 pd 8 found 37 therapeutics 9 in 12 patients 10 familial 12 patients 11 pd 12 patients 12 patients 13 with 12 patients 28 suggesting 13 with 15 mutations 14 lrrk2 15 mutations 15 mutations 19 activity 16 , 19 activity 17 exhibited 19 activity 18 kinase 19 activity 19 activity 20 stronger 19 activity 27 , 20 stronger 21 than 21 than 22 that 21 than 23 of 23 of 26 type 24 the 26 type 25 wild 26 type 28 suggesting 32 inhibitor 29 the 32 inhibitor 30 lrrk2 31 kinase 31 kinase 32 inhibitor 33 as 35 potential 33 as 36 pd 34 a 35 potential 36 pd 37 therapeutics to develop such therapeutics , we initially screened a small chemical library and selected compound 1 , whose ic ( 50 ) is about 13.2 μm . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 develop 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 27 . 1 to 2 develop 2 develop 4 therapeutics 3 such 4 therapeutics 5 , 6 we 5 , 13 and 5 , 17 , 6 we 13 and 7 initially 8 screened 8 screened 12 library 8 screened 13 and 9 a 10 small 9 a 12 library 10 small 11 chemical 11 chemical 12 library 13 and 14 selected 14 selected 15 compound 15 compound 16 1 17 , 18 whose 17 , 23 is 18 whose 19 ic 19 ic 21 50 19 ic 23 is 20 ( 21 50 21 50 22 ) 23 is 24 about 23 is 26 μm 24 about 25 13.2 to develop better inhibitors , we tested five of the compound 1 derivatives [and] found a slightly better inhibitor , compound 4 , whose ic ( 50 ) is 4.1 μm . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 develop 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 32 . 1 to 2 develop 2 develop 4 inhibitors 3 better 4 inhibitors 5 , 6 we 5 , 7 tested 6 we 7 tested 7 tested 8 five 7 tested 31 μm 8 five 9 of 8 five 13 derivatives 8 five 15 found 8 five 24 whose 8 five 31 μm 9 of 11 compound 10 the 11 compound 12 1 13 derivatives 13 derivatives 15 found 15 found 19 inhibitor 16 a 19 inhibitor 17 slightly 18 better 18 better 19 inhibitor 19 inhibitor 21 compound 20 , 21 compound 21 compound 22 4 21 compound 23 , 24 whose 25 ic 25 ic 27 50 25 ic 29 is 26 ( 27 50 27 50 28 ) 29 is 30 4.1 the cell [-] based assay showed that these two chemicals inhibited oxidative stress - induced neurotoxicity caused [by] [over] - expression of a pd - specific lrrk2 mutant , g2019s . 0 ###LEFT-WALL### 5 assay 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 25 - 0 ###LEFT-WALL### 31 . 1 the 5 assay 2 cell 4 based 4 based 5 assay 5 assay 6 showed 6 showed 7 that 6 showed 10 chemicals 6 showed 11 inhibited 8 these 9 two 9 two 10 chemicals 10 chemicals 11 inhibited 11 inhibited 13 stress 12 oxidative 13 stress 13 stress 16 neurotoxicity 13 stress 21 expression 14 - 16 neurotoxicity 15 induced 16 neurotoxicity 16 neurotoxicity 17 caused 16 neurotoxicity 20 - 20 - 21 expression 21 expression 22 of 21 expression 25 - 22 of 24 pd 23 a 24 pd 25 - 28 mutant 25 - 29 , 26 specific 28 mutant 27 lrrk2 28 mutant 29 , 30 g2019s in addition , the structural analysis of compound 4 suggested hydrogen bond interactions between compound 4 and ala 1950 residue in the backbone of the atp binding pocket of lrrk2 kinas domain . 0 ###LEFT-WALL### 32 domain 0 ###LEFT-WALL### 33 . 1 in 2 addition 2 addition 3 , 3 , 6 analysis 3 , 17 and 4 the 6 analysis 5 structural 6 analysis 6 analysis 7 of 7 of 13 interactions 8 compound 10 suggested 9 4 10 suggested 10 suggested 11 hydrogen 11 hydrogen 13 interactions 12 bond 13 interactions 13 interactions 14 between 14 between 15 compound 15 compound 16 4 17 and 20 residue 17 and 21 in 17 and 24 of 17 and 32 domain 18 ala 19 1950 18 ala 20 residue 21 in 23 backbone 22 the 23 backbone 24 of 28 pocket 25 the 28 pocket 26 atp 27 binding 27 binding 28 pocket 28 pocket 29 of 29 of 31 kinas 30 lrrk2 31 kinas therefore , compound 4 may be a promising lead compound to further develop a pd therapeutics based on lrrk2 kinase inhibition . 0 ###LEFT-WALL### 3 compound 0 ###LEFT-WALL### 6 be 0 ###LEFT-WALL### 22 . 1 therefore 2 , 1 therefore 3 compound 3 compound 4 4 3 compound 5 may 5 may 6 be 6 be 10 compound 6 be 11 to 6 be 18 on 7 a 8 promising 7 a 10 compound 8 promising 9 lead 9 lead 10 compound 11 to 13 develop 12 further 13 develop 13 develop 15 pd 14 a 15 pd 15 pd 16 therapeutics 15 pd 17 based 16 therapeutics 17 based 18 on 21 inhibition 19 lrrk2 21 inhibition 20 kinase 21 inhibition the current study aimed to examine the salience of anxiety - provoking social situations for older adults . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 aimed 1 the 3 study 2 current 3 study 3 study 4 aimed 4 aimed 5 to 4 aimed 6 examine 5 to 6 examine 6 examine 8 salience 7 the 8 salience 8 salience 9 of 8 salience 12 provoking 9 of 10 anxiety 11 - 12 provoking 12 provoking 14 situations 12 provoking 18 . 13 social 14 situations 14 situations 15 for 15 for 17 adults 16 older 17 adults a list of [potentially] anxiety [-] provoking situations was developed from a review of existing measures of social anxiety . 0 ###LEFT-WALL### 2 list 0 ###LEFT-WALL### 10 developed 0 ###LEFT-WALL### 20 . 1 a 2 list 2 list 3 of 2 list 9 was 3 of 5 anxiety 5 anxiety 7 provoking 7 provoking 8 situations 9 was 10 developed 10 developed 11 from 11 from 13 review 12 a 13 review 13 review 14 of 14 of 16 measures 15 existing 16 measures 16 measures 17 of 17 of 19 anxiety 18 social 19 anxiety in addition to items derived from existing measures , the investigators generated items thought to be particularly relevant for older adults . 0 ###LEFT-WALL### 11 investigators 0 ###LEFT-WALL### 12 generated 0 ###LEFT-WALL### 22 . 1 in 2 addition 1 in 9 , 1 in 11 investigators 2 addition 3 to 3 to 4 items 4 items 5 derived 4 items 6 from 6 from 8 measures 7 existing 8 measures 10 the 11 investigators 11 investigators 12 generated 12 generated 13 items 12 generated 15 to 13 items 14 thought 15 to 16 be 16 be 17 particularly 16 be 18 relevant 18 relevant 19 for 19 for 21 adults 20 older 21 adults one hundred and four older adults were asked , " please check all situations where you might feel uncomfortable , nervous , scared , worried , embarrassed , or anxious . " 0 ###LEFT-WALL### 6 adults 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 31 . 1 one 2 hundred 2 hundred 3 and 3 and 4 four 4 four 6 adults 5 older 6 adults 6 adults 7 were 7 were 9 , 8 asked 9 , 9 , 10 " 9 , 12 check 11 please 12 check 12 check 14 situations 12 check 15 where 13 all 14 situations 15 where 16 you 15 where 18 feel 16 you 17 might 17 might 18 feel 18 feel 29 or 19 uncomfortable 20 , 20 , 21 nervous 20 , 22 , 22 , 23 scared 22 , 24 , 24 , 25 worried 24 , 26 , 26 , 27 embarrassed 26 , 29 or 28 , 29 or 29 or 30 anxious 31 . 32 " participants were also prompted to record any additional situations in which they experienced anxiety . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 4 prompted 0 ###LEFT-WALL### 15 . 1 participants 2 were 2 were 4 prompted 3 also 4 prompted 4 prompted 5 to 4 prompted 6 record 5 to 6 record 6 record 9 situations 7 any 9 situations 8 additional 9 situations 9 situations 10 in 10 in 11 which 10 in 12 they 10 in 13 experienced 12 they 13 experienced 13 experienced 14 anxiety older adults endorsed items not included on typical measures of social anxiety at high rates . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 3 endorsed 0 ###LEFT-WALL### 16 . 1 older 2 adults 2 adults 3 endorsed 3 endorsed 4 items 4 items 5 not 5 not 6 included 6 included 7 on 6 included 13 at 7 on 9 measures 8 typical 9 measures 9 measures 10 of 10 of 12 anxiety 11 social 12 anxiety 13 at 15 rates 14 high 15 rates exploratory analyses of the effects of gender on item endorsement were examined and significant differences were found for several items . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 12 examined 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 21 . 1 exploratory 2 analyses 2 analyses 3 of 2 analyses 11 were 3 of 5 effects 4 the 5 effects 5 effects 6 of 6 of 7 gender 7 gender 8 on 8 on 10 endorsement 9 item 10 endorsement 11 were 12 examined 13 and 15 differences 13 and 17 found 14 significant 15 differences 15 differences 16 were 16 were 17 found 17 found 18 for 18 for 20 items 19 several 20 items the authors discuss these findings and their implications for the assessment of late - life social anxiety . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 18 . 1 the 2 authors 2 authors 3 discuss 3 discuss 6 and 4 these 6 and 5 findings 6 and 6 and 8 implications 6 and 9 for 7 their 8 implications 9 for 11 assessment 10 the 11 assessment 11 assessment 12 of 12 of 17 anxiety 13 late 14 - 13 late 15 life 15 life 17 anxiety 16 social 17 anxiety endocrine disruption is a concept and principle whose origins can be traced to the beginnings of the environmental movement in the 1960s . 0 ###LEFT-WALL### 2 disruption 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 23 . 1 endocrine 2 disruption 2 disruption 3 is 3 is 5 concept 4 a 5 concept 6 and 7 principle 6 and 12 traced 7 principle 8 whose 7 principle 12 traced 8 whose 9 origins 9 origins 10 can 10 can 11 be 12 traced 13 to 12 traced 20 in 13 to 15 beginnings 14 the 15 beginnings 15 beginnings 16 of 16 of 19 movement 17 the 19 movement 18 environmental 19 movement 20 in 22 1960s 21 the 22 1960s it began with puzzlement about [and] the flaring of research on the decline of wildlife , particularly avian species . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 began 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 20 . 1 it 2 began 2 began 3 with 2 began 5 about 3 with 4 puzzlement 5 about 8 flaring 7 the 8 flaring 8 flaring 9 of 8 flaring 11 on 9 of 10 research 11 on 13 decline 12 the 13 decline 13 decline 14 of 14 of 15 wildlife 16 , 19 species 17 particularly 18 avian 18 avian 19 species the proposed causes accented pesticides , especially persistent organochlorines such as ddt . 0 ###LEFT-WALL### 3 causes 0 ###LEFT-WALL### 4 accented 1 the 3 causes 2 proposed 3 causes 3 causes 4 accented 4 accented 5 pesticides 5 pesticides 9 organochlorines 6 , 9 organochlorines 7 especially 8 persistent 8 persistent 9 organochlorines 9 organochlorines 11 as 9 organochlorines 13 . 10 such 11 as 11 as 12 ddt its scope gradually widened beyond pesticides , and , as endocrine disruption offered an explanation for the wildlife phenomena , it seemed to explain , as well , changes in fertility and disorders of male reproduction such as testicular cancer . 0 ###LEFT-WALL### 2 scope 0 ###LEFT-WALL### 4 widened 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 41 . 1 its 2 scope 2 scope 4 widened 3 gradually 4 widened 4 widened 5 beyond 5 beyond 6 pesticides 7 , 8 and 8 and 9 , 8 and 12 disruption 8 and 13 offered 10 as 11 endocrine 11 endocrine 12 disruption 12 disruption 13 offered 13 offered 15 explanation 14 an 15 explanation 15 explanation 16 for 16 for 19 phenomena 17 the 19 phenomena 18 wildlife 19 phenomena 19 phenomena 32 and 19 phenomena 34 of 20 , 22 seemed 21 it 22 seemed 22 seemed 23 to 22 seemed 27 well 22 seemed 29 changes 23 to 24 explain 25 , 27 well 26 as 27 well 27 well 28 , 29 changes 30 in 29 changes 32 and 30 in 31 fertility 32 and 33 disorders 34 of 36 reproduction 35 male 36 reproduction 36 reproduction 38 as 37 such 38 as 38 as 40 cancer 39 testicular 40 cancer once disturbed gonadal hormone function [became] [the] most likely explanation , [it] provoked other questions . 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 16 . 1 once 2 disturbed 2 disturbed 10 explanation 2 disturbed 11 , 3 gonadal 4 hormone 4 hormone 10 explanation 5 function 10 explanation 8 most 9 likely 9 likely 10 explanation 11 , 13 provoked 13 provoked 15 questions 14 other 15 questions the most challenging arose because of how critical gonadal hormones are to brain function , especially as determinants of brain sexual differentiation . 0 ###LEFT-WALL### 2 most 0 ###LEFT-WALL### 14 function 1 the 2 most 2 most 3 challenging 2 most 13 brain 2 most 14 function 3 challenging 4 arose 4 arose 5 because 5 because 6 of 6 of 7 how 6 of 13 brain 7 how 8 critical 8 critical 11 are 9 gonadal 10 hormones 10 hormones 11 are 12 to 13 brain 14 function 17 as 15 , 16 especially 15 , 17 as 17 as 18 determinants 17 as 23 . 18 determinants 19 of 19 of 22 differentiation 20 brain 22 differentiation 21 sexual 22 differentiation pursuit of such connections has generated [a] robust literature embracing a broad swath of chemical classes . 0 ###LEFT-WALL### 1 pursuit 0 ###LEFT-WALL### 6 generated 0 ###LEFT-WALL### 17 . 1 pursuit 2 of 1 pursuit 5 has 2 of 4 connections 3 such 4 connections 5 has 6 generated 6 generated 9 literature 8 robust 9 literature 9 literature 10 embracing 10 embracing 13 swath 11 a 12 broad 11 a 13 swath 12 broad 13 swath 13 swath 14 of 14 of 16 classes 15 chemical 16 classes how endocrine disrupting chemicals influence the adult and aging brain is a question , so far mostly ignored because of the emphasis on early development , that warrants vigorous investigation . 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 31 . 1 how 4 chemicals 1 how 5 influence 1 how 11 is 2 endocrine 4 chemicals 3 disrupting 4 chemicals 4 chemicals 5 influence 5 influence 8 and 6 the 7 adult 7 adult 8 and 8 and 10 brain 9 aging 10 brain 11 is 13 question 12 a 13 question 14 , 27 that 14 , 28 warrants 15 so 16 far 16 far 27 that 17 mostly 18 ignored 18 ignored 19 because 18 ignored 23 on 18 ignored 26 , 18 ignored 27 that 19 because 20 of 20 of 22 emphasis 21 the 22 emphasis 23 on 25 development 24 early 25 development 27 that 28 warrants 28 warrants 30 investigation 29 vigorous 30 investigation gonadal hormones are crucial to optimal brain [function] during maturity and even senescence . 0 ###LEFT-WALL### 2 hormones 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 14 . 1 gonadal 2 hormones 2 hormones 3 are 3 are 4 crucial 4 crucial 5 to 4 crucial 9 during 5 to 7 brain 6 optimal 7 brain 9 during 11 and 10 maturity 11 and 11 and 13 senescence 12 even 13 senescence they are pivotal to the processes of neurogenesis . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 9 . 1 they 2 are 2 are 3 pivotal 3 pivotal 4 to 4 to 6 processes 5 the 6 processes 6 processes 7 of 7 of 8 neurogenesis they exert protective actions against neurodegenerative disorders such as dementia and support smoothly functioning cognitive activities . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 17 . 1 they 11 and 2 exert 4 actions 2 exert 5 against 2 exert 11 and 3 protective 4 actions 5 against 7 disorders 6 neurodegenerative 7 disorders 7 disorders 9 as 8 such 9 as 9 as 10 dementia 11 and 12 support 12 support 16 activities 13 smoothly 14 functioning 14 functioning 16 activities 15 cognitive 16 activities the limited research conducted so far on endocrine disruptors , aging , and neurogenesis argues that they should be overlooked no longer . 0 ###LEFT-WALL### 3 research 0 ###LEFT-WALL### 15 argues 0 ###LEFT-WALL### 23 . 1 the 3 research 2 limited 3 research 3 research 4 conducted 3 research 15 argues 4 conducted 6 far 5 so 6 far 6 far 7 on 7 on 13 and 8 endocrine 9 disruptors 9 disruptors 10 , 10 , 11 aging 10 , 13 and 12 , 13 and 13 and 14 neurogenesis 15 argues 16 that 16 that 17 they 16 that 20 overlooked 17 they 18 should 18 should 19 be 19 be 20 overlooked 20 overlooked 22 longer 21 no 22 longer vertigo , unsteadiness , and other balance - related symptoms are common among older adults . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 16 . 1 vertigo 2 , 2 , 3 unsteadiness 2 , 5 and 4 , 5 and 5 and 7 balance 5 and 11 are 6 other 7 balance 8 - 9 related 9 related 10 symptoms 9 related 11 are 11 are 12 common 12 common 13 among 13 among 15 adults 14 older 15 adults these complaints should be taken seriously because they can lead to [falls] [,] injuries , loss of independence , and even death . 0 ###LEFT-WALL### 2 complaints 0 ###LEFT-WALL### 5 taken 0 ###LEFT-WALL### 23 . 1 these 2 complaints 2 complaints 3 should 3 should 4 be 4 be 5 taken 5 taken 6 seriously 5 taken 7 because 7 because 8 they 7 because 20 and 8 they 20 and 9 can 10 lead 9 can 20 and 10 lead 11 to 11 to 14 injuries 14 injuries 16 loss 15 , 16 loss 16 loss 17 of 16 loss 19 , 17 of 18 independence 20 and 21 even 21 even 22 death this article provides a review of the underlying causes for the increased prevalence of dizziness with age , and discusses how specific test procedures may need to be modified for older individuals . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 33 . 1 this 2 article 2 article 19 and 3 provides 5 review 3 provides 10 for 3 provides 16 with 3 provides 19 and 4 a 5 review 5 review 6 of 6 of 9 causes 7 the 9 causes 8 underlying 9 causes 10 for 13 prevalence 11 the 13 prevalence 12 increased 13 prevalence 13 prevalence 14 of 14 of 15 dizziness 16 with 17 age 18 , 19 and 19 and 20 discusses 20 discusses 21 how 21 how 22 specific 22 specific 23 test 23 test 24 procedures 24 procedures 25 may 25 may 26 need 26 need 27 to 26 need 29 modified 27 to 28 be 28 be 29 modified 29 modified 30 for 30 for 32 individuals 31 older 32 individuals issues related to the management of these symptoms in the aging population are also considered . 0 ###LEFT-WALL### 1 issues 0 ###LEFT-WALL### 15 considered 0 ###LEFT-WALL### 16 . 1 issues 2 related 1 issues 6 of 1 issues 13 are 2 related 3 to 3 to 5 management 4 the 5 management 6 of 8 symptoms 7 these 8 symptoms 8 symptoms 9 in 9 in 12 population 10 the 12 population 11 aging 12 population 13 are 15 considered 14 also 15 considered automated accurate and consistent sulcal parcellation of longitudinal cortical surfaces is of great importance in studying longitudinal morphological and functional changes of human brains , since longitudinal cortical changes are normally very subtle , especially in aging brains . 0 ###LEFT-WALL### 6 parcellation 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 39 . 1 automated 6 parcellation 2 accurate 3 and 3 and 4 consistent 3 and 6 parcellation 5 sulcal 6 parcellation 6 parcellation 7 of 6 parcellation 11 is 7 of 10 surfaces 8 longitudinal 10 surfaces 9 cortical 10 surfaces 11 is 12 of 11 is 15 in 12 of 14 importance 13 great 14 importance 15 in 16 studying 16 studying 21 changes 16 studying 26 since 16 studying 35 especially 17 longitudinal 21 changes 18 morphological 19 and 19 and 20 functional 19 and 21 changes 21 changes 22 of 22 of 24 brains 23 human 24 brains 25 , 26 since 26 since 29 changes 26 since 30 are 26 since 34 , 27 longitudinal 29 changes 28 cortical 29 changes 29 changes 30 are 30 are 31 normally 30 are 33 subtle 32 very 33 subtle 35 especially 36 in 36 in 37 aging 37 aging 38 brains however , applying the existing methods ( which were typically developed for cortical sulcal parcellation of a single cortical surface ) independently to longitudinal cortical surfaces might generate longitudinally [-] inconsistent results . 0 ###LEFT-WALL### 3 applying 0 ###LEFT-WALL### 28 generate 0 ###LEFT-WALL### 33 . 1 however 2 , 1 however 3 applying 3 applying 6 methods 3 applying 22 independently 3 applying 27 might 4 the 6 methods 5 existing 6 methods 6 methods 8 which 7 ( 8 which 8 which 9 were 8 which 21 ) 9 were 11 developed 10 typically 11 developed 11 developed 12 for 12 for 15 parcellation 13 cortical 15 parcellation 14 sulcal 15 parcellation 15 parcellation 16 of 16 of 20 surface 17 a 18 single 17 a 20 surface 18 single 20 surface 19 cortical 20 surface 22 independently 23 to 23 to 26 surfaces 24 longitudinal 26 surfaces 25 cortical 26 surfaces 27 might 28 generate 28 generate 29 longitudinally 28 generate 32 results 31 inconsistent 32 results to overcome this limitation , this paper presents a novel energy function based method for accurate and consistent sulcal parcellation of longitudinal cortical surfaces . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 overcome 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 25 . 1 to 2 overcome 2 overcome 4 limitation 3 this 4 limitation 5 , 7 paper 5 , 8 presents 6 this 7 paper 7 paper 8 presents 8 presents 14 method 9 a 10 novel 9 a 14 method 10 novel 14 method 11 energy 13 based 12 function 13 based 13 based 14 method 14 method 15 for 15 for 20 parcellation 16 accurate 17 and 17 and 18 consistent 17 and 20 parcellation 19 sulcal 20 parcellation 20 parcellation 21 of 21 of 24 surfaces 22 longitudinal 24 surfaces 23 cortical 24 surfaces specifically , both spatial and temporal smoothness are imposed in the energy function to obtain consistent longitudinal sulcal parcellation results . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 imposed 0 ###LEFT-WALL### 21 . 1 specifically 2 , 1 specifically 5 and 3 both 5 and 4 spatial 5 and 5 and 7 smoothness 5 and 8 are 6 temporal 7 smoothness 8 are 9 imposed 9 imposed 10 in 9 imposed 14 to 10 in 13 function 11 the 13 function 12 energy 13 function 14 to 15 obtain 15 obtain 20 results 16 consistent 19 parcellation 17 longitudinal 19 parcellation 18 sulcal 19 parcellation 19 parcellation 20 results the energy function is efficiently minimized by a graph cut method . 0 ###LEFT-WALL### 3 function 0 ###LEFT-WALL### 6 minimized 0 ###LEFT-WALL### 12 . 1 the 3 function 2 energy 3 function 3 function 4 is 4 is 5 efficiently 4 is 6 minimized 6 minimized 7 by 7 by 11 method 8 a 11 method 9 graph 11 method 10 cut 11 method the proposed method has been successfully applied to sulcal parcellation of both real and simulated longitudinal inner cortical surfaces of human brain mr images . 0 ###LEFT-WALL### 3 method 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 the 3 method 2 proposed 3 method 3 method 14 and 4 has 5 been 4 has 14 and 5 been 6 successfully 5 been 7 applied 7 applied 8 to 7 applied 13 real 8 to 10 parcellation 9 sulcal 10 parcellation 10 parcellation 11 of 11 of 12 both 14 and 15 simulated 14 and 19 surfaces 16 longitudinal 19 surfaces 17 inner 19 surfaces 18 cortical 19 surfaces 19 surfaces 20 of 20 of 24 images 21 human 22 brain 22 brain 24 images 23 mr 24 images both qualitative and quantitative evaluation results demonstrate the validity of the proposed method . 0 ###LEFT-WALL### 6 results 0 ###LEFT-WALL### 7 demonstrate 0 ###LEFT-WALL### 14 . 1 both 6 results 2 qualitative 3 and 3 and 4 quantitative 3 and 5 evaluation 5 evaluation 6 results 6 results 7 demonstrate 7 demonstrate 9 validity 8 the 9 validity 9 validity 10 of 10 of 13 method 11 the 13 method 12 proposed 13 method osteoporosis is a major health problem in the elderly . 0 ###LEFT-WALL### 1 osteoporosis 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 osteoporosis 2 is 2 is 6 problem 3 a 4 major 3 a 6 problem 4 major 5 health 5 health 6 problem 6 problem 7 in 7 in 9 elderly 8 the 9 elderly epidemiological evidence has shown an association between tea consumption and the prevention of bone loss in the elderly population . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 4 shown 0 ###LEFT-WALL### 20 . 1 epidemiological 2 evidence 2 evidence 3 has 3 has 4 shown 4 shown 6 association 4 shown 7 between 4 shown 16 in 5 an 6 association 7 between 10 and 8 tea 9 consumption 9 consumption 10 and 10 and 12 prevention 10 and 13 of 11 the 12 prevention 13 of 15 loss 14 bone 15 loss 16 in 19 population 17 the 19 population 18 elderly 19 population ingestion of green tea and green tea bioactive compounds may be beneficial in mitigating bone loss of this population and [decreasing] their risk of osteoporotic fractures . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 27 . 1 ingestion 2 of 1 ingestion 5 and 2 of 4 tea 3 green 4 tea 5 and 7 tea 5 and 9 compounds 5 and 14 mitigating 5 and 20 and 6 green 7 tea 8 bioactive 9 compounds 9 compounds 10 may 10 may 11 be 11 be 12 beneficial 12 beneficial 13 in 13 in 14 mitigating 14 mitigating 16 loss 15 bone 16 loss 16 loss 17 of 17 of 19 population 18 this 19 population 20 and 23 risk 20 and 24 of 22 their 23 risk 24 of 26 fractures 25 osteoporotic 26 fractures combination antiretroviral therapy ( cart ) has significantly reduced morbidity and mortality of hiv - infected patients , yet their life expectancy remains reduced compared with the general population . 0 ###LEFT-WALL### 1 combination 0 ###LEFT-WALL### 23 remains 0 ###LEFT-WALL### 30 . 1 combination 3 therapy 1 combination 7 has 1 combination 9 reduced 2 antiretroviral 3 therapy 3 therapy 5 cart 3 therapy 7 has 4 ( 5 cart 5 cart 6 ) 8 significantly 9 reduced 9 reduced 11 and 9 reduced 19 yet 10 morbidity 11 and 11 and 12 mortality 12 mortality 13 of 13 of 14 hiv 14 hiv 17 patients 15 - 17 patients 16 infected 17 patients 17 patients 18 , 19 yet 22 expectancy 20 their 22 expectancy 21 life 22 expectancy 22 expectancy 23 remains 23 remains 24 reduced 23 remains 26 with 24 reduced 25 compared 26 with 29 population 27 the 29 population 28 general 29 population most hiv - infected patients receiving cart have some persistent immune dysfunction characterized by chronic immune activation and premature aging of the immune system . 0 ###LEFT-WALL### 2 hiv 0 ###LEFT-WALL### 3 - 1 most 2 hiv 3 - 5 patients 3 - 8 have 3 - 25 . 4 infected 5 patients 5 patients 6 receiving 5 patients 8 have 6 receiving 7 cart 8 have 20 aging 9 some 20 aging 10 persistent 12 dysfunction 11 immune 12 dysfunction 12 dysfunction 13 characterized 12 dysfunction 18 and 13 characterized 14 by 14 by 17 activation 15 chronic 17 activation 16 immune 17 activation 18 and 19 premature 18 and 20 aging 20 aging 21 of 21 of 24 system 22 the 24 system 23 immune 24 system here we review biomarkers of t - cell activation ( cd69 , - 25 and - 38 , hla - dr , and soluble cd26 [and] - 30 ) ; generalized immune activation ( c - reactive protein , il - 6 and d - dimer [ )( microbial translocation ( lipopolysaccharide , 16 s rdna , lipopolysaccharide - binding protein and soluble cd14 ) [;] and immune dysfunction of specific cellular subsets ( t [cells] , natural killer cells and monocytes ) in hiv - infected patients on cart and their relationship to adverse clinical outcomes including impaired cd4 t - cell recovery , as well as [non] [-] aids clinical events , such as cardiovascular disease . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 7 - 1 here 2 we 2 we 3 review 3 review 4 biomarkers 4 biomarkers 5 of 5 of 6 t 7 - 9 activation 7 - 13 - 8 cell 9 activation 9 activation 11 cd69 10 ( 11 cd69 11 cd69 12 , 13 - 14 25 13 - 15 and 13 - 18 , 15 and 16 - 16 - 17 38 18 , 19 hla 18 , 20 - 20 - 23 and 20 - 30 ; 21 dr 23 and 22 , 23 and 23 and 25 cd26 23 and 28 30 24 soluble 25 cd26 27 - 28 30 28 30 29 ) 30 ; 40 il 30 ; 41 - 31 generalized 40 il 32 immune 39 , 32 immune 40 il 33 activation 36 - 34 ( 36 - 35 c 36 - 36 - 38 protein 36 - 39 , 37 reactive 38 protein 41 - 42 6 41 - 43 and 41 - 46 dimer 43 and 44 d 43 and 45 - 44 d 45 - 45 - 46 dimer 46 dimer 50 translocation 49 microbial 50 translocation 50 translocation 52 lipopolysaccharide 50 translocation 59 - 51 ( 52 lipopolysaccharide 52 lipopolysaccharide 53 , 53 , 59 - 54 16 55 s 55 s 58 lipopolysaccharide 56 rdna 57 , 56 rdna 58 lipopolysaccharide 58 lipopolysaccharide 59 - 59 - 67 and 60 binding 61 protein 61 protein 62 and 62 and 64 cd14 62 and 65 ) 62 and 67 and 63 soluble 64 cd14 67 and 69 dysfunction 67 and 70 of 68 immune 69 dysfunction 70 of 81 and 71 specific 77 , 71 specific 78 natural 72 cellular 73 subsets 73 subsets 75 t 74 ( 75 t 75 t 77 , 78 natural 80 cells 79 killer 80 cells 80 cells 81 and 81 and 82 monocytes 81 and 83 ) 81 and 84 in 81 and 89 on 84 in 88 patients 85 hiv 87 infected 85 hiv 88 patients 86 - 87 infected 89 on 91 and 90 cart 91 and 91 and 93 relationship 92 their 93 relationship 93 relationship 94 to 93 relationship 98 including 94 to 97 outcomes 95 adverse 97 outcomes 96 clinical 97 outcomes 98 including 100 cd4 98 including 107 well 98 including 108 as 99 impaired 100 cd4 100 cd4 101 t 100 cd4 104 recovery 102 - 104 recovery 103 cell 104 recovery 104 recovery 105 , 106 as 107 well 108 as 113 events 111 aids 113 events 112 clinical 113 events 113 events 116 as 114 , 116 as 115 such 116 as 116 as 118 disease 116 as 119 . 117 cardiovascular 118 disease memory loss often signifies loss of independence , which is a growing concern for residents in assisted living ( al ) [facilities] . 0 ###LEFT-WALL### 2 loss 0 ###LEFT-WALL### 4 signifies 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 23 . 1 memory 2 loss 2 loss 4 signifies 3 often 4 signifies 4 signifies 5 loss 5 loss 6 of 6 of 7 independence 8 , 9 which 8 , 10 is 9 which 10 is 10 is 13 concern 11 a 13 concern 12 growing 13 concern 13 concern 14 for 14 for 15 residents 15 residents 16 in 16 in 18 living 17 assisted 18 living 18 living 20 al 19 ( 20 al 20 al 21 ) the purpose of this exploratory study was to characterize the memory experiences and concerns of al residents . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 18 . 1 the 2 purpose 2 purpose 3 of 2 purpose 7 was 3 of 6 study 4 this 5 exploratory 5 exploratory 6 study 7 was 8 to 7 was 9 characterize 8 to 9 characterize 9 characterize 11 memory 10 the 11 memory 11 memory 13 and 11 memory 15 of 12 experiences 13 and 13 and 14 concerns 15 of 17 residents 16 al 17 residents six residents voluntarily participated in 1 [-] hour recorded interviews focusing on memory and guided by eight open - ended questions . 0 ###LEFT-WALL### 2 residents 0 ###LEFT-WALL### 4 participated 0 ###LEFT-WALL### 22 . 1 six 2 residents 2 residents 4 participated 3 voluntarily 4 participated 4 participated 5 in 4 participated 16 by 5 in 8 hour 6 1 8 hour 8 hour 14 and 9 recorded 10 interviews 9 recorded 14 and 10 interviews 11 focusing 11 focusing 12 on 12 on 13 memory 14 and 15 guided 16 by 21 questions 17 eight 21 questions 18 open 19 - 18 open 21 questions 20 ended 21 questions interviews were transcribed and analyzed using qualitative content analysis . 0 ###LEFT-WALL### 1 interviews 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 10 . 1 interviews 2 were 2 were 4 and 3 transcribed 4 and 4 and 5 analyzed 4 and 6 using 6 using 9 analysis 7 qualitative 9 analysis 8 content 9 analysis subjects reported varying degrees of memory loss they found frightening and frustrating , but also accepted the loss as a natural part of the aging process . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 27 . 1 subjects 14 but 2 reported 4 degrees 2 reported 14 but 3 varying 4 degrees 4 degrees 5 of 4 degrees 8 they 4 degrees 9 found 5 of 7 loss 6 memory 7 loss 8 they 9 found 9 found 11 and 10 frightening 11 and 11 and 12 frustrating 13 , 14 but 14 but 16 accepted 15 also 16 accepted 16 accepted 18 loss 17 the 18 loss 18 loss 19 as 19 as 22 part 20 a 22 part 21 natural 22 part 22 part 23 of 23 of 26 process 24 the 26 process 25 aging 26 process concerns focused primarily on inability to recall staff and resident names and activities , schedules , and appointments . 0 ###LEFT-WALL### 1 concerns 0 ###LEFT-WALL### 2 focused 0 ###LEFT-WALL### 19 . 1 concerns 2 focused 2 focused 3 primarily 2 focused 6 to 3 primarily 4 on 4 on 5 inability 6 to 17 and 7 recall 8 staff 8 staff 9 and 9 and 11 names 9 and 12 and 10 resident 11 names 12 and 13 activities 12 and 15 schedules 12 and 17 and 14 , 15 schedules 15 schedules 16 , 16 , 17 and 17 and 18 appointments understanding memory experiences and concerns is important for nursing staff members who care for al residents . 0 ###LEFT-WALL### 2 memory 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 17 . 1 understanding 2 memory 2 memory 4 and 2 memory 6 is 3 experiences 4 and 4 and 5 concerns 6 is 7 important 7 important 8 for 8 for 9 nursing 9 nursing 11 members 10 staff 11 members 11 members 12 who 11 members 13 care 12 who 13 care 13 care 14 for 14 for 16 residents 15 al 16 residents memory challenges identified by these residents were used to develop a memory intervention for older adults residents of this and other al facilities . 0 ###LEFT-WALL### 2 challenges 0 ###LEFT-WALL### 24 . 1 memory 2 challenges 2 challenges 3 identified 2 challenges 7 were 3 identified 4 by 4 by 6 residents 5 these 6 residents 7 were 8 used 8 used 9 to 8 used 10 develop 9 to 10 develop 10 develop 13 intervention 10 develop 14 for 11 a 13 intervention 12 memory 13 intervention 14 for 17 residents 15 older 16 adults 16 adults 17 residents 17 residents 18 of 18 of 20 and 19 this 20 and 20 and 23 facilities 21 other 23 facilities 22 al 23 facilities improving cognitive skills may help al residents maintain their functional abilities , enabling them to " age in place " in al . 0 ###LEFT-WALL### 1 improving 0 ###LEFT-WALL### 5 help 1 improving 3 skills 1 improving 4 may 2 cognitive 3 skills 4 may 5 help 5 help 7 residents 5 help 8 maintain 6 al 7 residents 8 maintain 11 abilities 9 their 11 abilities 10 functional 11 abilities 11 abilities 13 enabling 12 , 13 enabling 13 enabling 14 them 13 enabling 15 to 13 enabling 17 age 13 enabling 23 . 15 to 16 " 15 to 17 age 17 age 18 in 17 age 21 in 18 in 19 place 19 place 20 " 21 in 22 al none many metal ions [(] lead , mercury , arsenic , cadmium , chromium , nickel , vanadium , copper , lithium ) exert a wide variety of adverse effects on reproduction and development , including influence on male and female subfertility or fertility , abortions , malformations , birth defects , and effects on the central nervous system . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 24 exert 0 ###LEFT-WALL### 60 . 1 none 4 ions 1 none 6 lead 1 none 8 mercury 1 none 12 cadmium 1 none 14 chromium 1 none 16 nickel 1 none 24 exert 2 many 3 metal 3 metal 4 ions 4 ions 6 lead 7 , 8 mercury 8 mercury 10 arsenic 8 mercury 11 , 9 , 10 arsenic 10 arsenic 11 , 11 , 12 cadmium 12 cadmium 13 , 13 , 14 chromium 14 chromium 15 , 15 , 16 nickel 16 nickel 18 vanadium 16 nickel 22 lithium 16 nickel 23 ) 17 , 18 vanadium 18 vanadium 20 copper 18 vanadium 21 , 19 , 20 copper 20 copper 21 , 21 , 22 lithium 22 lithium 23 ) 24 exert 27 variety 24 exert 31 on 25 a 26 wide 25 a 27 variety 26 wide 27 variety 27 variety 28 of 28 of 30 effects 29 adverse 30 effects 31 on 33 and 32 reproduction 33 and 33 and 34 development 33 and 35 , 33 and 36 including 36 including 37 influence 36 including 38 on 36 including 55 on 38 on 53 and 39 male 40 and 40 and 41 female 40 and 42 subfertility 42 subfertility 43 or 43 or 44 fertility 43 or 45 , 43 or 46 abortions 43 or 48 malformations 43 or 53 and 45 , 46 abortions 46 abortions 47 , 47 , 48 malformations 48 malformations 51 defects 48 malformations 52 , 49 , 51 defects 50 birth 51 defects 51 defects 52 , 53 and 54 effects 55 on 59 system 56 the 59 system 57 central 59 system 58 nervous 59 system the effects produced by metal ions depend on several factors , such as timing and duration of exposure , their distribution and accumulation in various organs ( e.g [.] , the nervous system ) , and on the interference with specific developmental processes . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 7 depend 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 44 . 1 the 2 effects 2 effects 3 produced 2 effects 4 by 2 effects 7 depend 4 by 6 ions 5 metal 6 ions 7 depend 8 on 8 on 10 factors 9 several 10 factors 10 factors 13 as 11 , 13 as 12 such 13 as 13 as 15 and 13 as 19 , 14 timing 15 and 15 and 16 duration 15 and 17 of 17 of 18 exposure 19 , 22 and 20 their 21 distribution 21 distribution 22 and 22 and 23 accumulation 22 and 36 and 24 in 26 organs 24 in 36 and 25 various 26 organs 26 organs 28 e.g 27 ( 28 e.g 28 e.g 33 system 28 e.g 34 ) 30 , 33 system 31 the 33 system 32 nervous 33 system 33 system 34 ) 35 , 36 and 36 and 37 on 37 on 39 interference 38 the 39 interference 39 interference 40 with 40 with 43 processes 41 specific 43 processes 42 developmental 43 processes neonatal and early postnatal periods are lifespan segments during which sensitivity to metals is high ; e.g . [,] lead toxicity on the developing organism is paradigmatic of related well known and still open questions . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 17 e.g 0 ###LEFT-WALL### 18 . 1 neonatal 2 and 2 and 5 periods 2 and 6 are 3 early 5 periods 4 postnatal 5 periods 6 are 8 segments 7 lifespan 8 segments 8 segments 9 during 9 during 10 which 9 during 11 sensitivity 9 during 14 is 11 sensitivity 12 to 11 sensitivity 14 is 12 to 13 metals 14 is 15 high 16 ; 17 e.g 18 . 21 toxicity 18 . 26 is 18 . 36 . 20 lead 21 toxicity 21 toxicity 22 on 21 toxicity 26 is 22 on 25 organism 23 the 25 organism 24 developing 25 organism 26 is 32 and 27 paradigmatic 28 of 27 paradigmatic 31 known 27 paradigmatic 32 and 28 of 30 well 29 related 30 well 32 and 33 still 32 and 35 questions 33 still 34 open 34 open 35 questions in more recent decades , important mechanisms of action have been suggested : the endocrine disruption via impact of metal ions on reproductive hormones and the oxidative stress . 0 ###LEFT-WALL### 7 mechanisms 0 ###LEFT-WALL### 12 suggested 0 ###LEFT-WALL### 13 : 1 in 4 decades 1 in 5 , 1 in 7 mechanisms 2 more 3 recent 3 recent 4 decades 6 important 7 mechanisms 7 mechanisms 8 of 7 mechanisms 10 have 8 of 9 action 10 have 11 been 11 been 12 suggested 13 : 25 and 13 : 29 . 14 the 16 disruption 15 endocrine 16 disruption 16 disruption 17 via 16 disruption 25 and 17 via 18 impact 18 impact 19 of 19 of 21 ions 20 metal 21 ions 21 ions 22 on 22 on 24 hormones 23 reproductive 24 hormones 25 and 28 stress 26 the 28 stress 27 oxidative 28 stress while experimental data provide clear evidence of effects of many metals , human data are scant and traditionally limited to high levels of a few metal ions , [like] lead on male fertility . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 34 . 1 while 2 experimental 1 while 3 data 3 data 4 provide 4 provide 6 evidence 5 clear 6 evidence 6 evidence 7 of 6 evidence 9 of 7 of 8 effects 9 of 11 metals 10 many 11 metals 12 , 14 data 12 , 15 are 12 , 28 , 13 human 14 data 14 data 15 are 15 are 17 and 16 scant 17 and 17 and 18 traditionally 17 and 19 limited 19 limited 20 to 20 to 22 levels 21 high 22 levels 22 levels 23 of 23 of 27 ions 24 a 25 few 25 few 27 ions 26 metal 27 ions 28 , 30 lead 30 lead 31 on 31 on 33 fertility 32 male 33 fertility less documented [are] reproductive effects for mercury , manganese , chromium , nickel , and arsenic for the same gender . 0 ###LEFT-WALL### 1 less 0 ###LEFT-WALL### 2 documented 0 ###LEFT-WALL### 21 . 1 less 2 documented 2 documented 5 effects 2 documented 6 for 4 reproductive 5 effects 6 for 15 and 7 mercury 8 , 8 , 9 manganese 8 , 10 , 10 , 11 chromium 10 , 12 , 12 , 13 nickel 12 , 15 and 14 , 15 and 15 and 16 arsenic 15 and 17 for 17 for 20 gender 18 the 19 same 19 same 20 gender more complex is the demonstration of effects on female reproduction and on pregnancy . 0 ###LEFT-WALL### 2 complex 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 14 . 1 more 2 complex 2 complex 3 is 3 is 5 demonstration 4 the 5 demonstration 5 demonstration 6 of 6 of 7 effects 7 effects 11 and 8 on 10 reproduction 8 on 11 and 9 female 10 reproduction 11 and 12 on 12 on 13 pregnancy the action [of] lead , arsenic , cadmium , chromium , and mercury may in fact be relevant in several stages , beginning in fetal life , during early development or maturity , and is characterized by subfertility , infertility , intrauterine growth retardation , spontaneous abortions , malformations , birth defects , postnatal death , learning and behavior deficits , and premature aging . 0 ###LEFT-WALL### 4 lead 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 36 characterized 1 the 4 lead 2 action 4 lead 5 , 6 arsenic 5 , 7 , 7 , 8 cadmium 7 , 9 , 9 , 10 chromium 9 , 12 and 11 , 12 and 12 and 13 mercury 12 and 34 and 13 mercury 34 and 14 may 17 be 14 may 34 and 15 in 16 fact 16 fact 17 be 17 be 18 relevant 18 relevant 19 in 18 relevant 23 beginning 19 in 21 stages 20 several 21 stages 22 , 23 beginning 23 beginning 24 in 23 beginning 28 during 23 beginning 33 , 24 in 26 life 25 fetal 26 life 27 , 28 during 28 during 31 or 28 during 33 , 29 early 30 development 30 development 31 or 31 or 32 maturity 33 , 34 and 34 and 35 is 35 is 36 characterized 36 characterized 37 by 37 by 38 subfertility 38 subfertility 40 infertility 38 subfertility 44 retardation 39 , 40 infertility 40 infertility 41 , 41 , 44 retardation 42 intrauterine 43 growth 43 growth 44 retardation 44 retardation 58 and 44 retardation 65 . 45 , 58 and 46 spontaneous 47 abortions 47 abortions 48 , 48 , 49 malformations 48 , 50 , 50 , 52 defects 50 , 53 , 51 birth 52 defects 53 , 55 death 53 , 56 , 54 postnatal 55 death 56 , 57 learning 56 , 58 and 58 and 64 aging 58 and 65 . 59 behavior 60 deficits 60 deficits 62 and 61 , 62 and 62 and 63 premature 62 and 64 aging also , for females the [evidences] [of] specific aspects such as fertility or abortions are usually higher and clearer from animal experiments than from human studies . 0 ###LEFT-WALL### 9 aspects 0 ###LEFT-WALL### 15 are 0 ###LEFT-WALL### 27 . 1 also 2 , 1 also 9 aspects 3 for 4 females 3 for 9 aspects 5 the 9 aspects 8 specific 9 aspects 9 aspects 11 as 9 aspects 15 are 10 such 11 as 11 as 13 or 12 fertility 13 or 13 or 14 abortions 15 are 16 usually 15 are 18 and 17 higher 18 and 18 and 19 clearer 19 clearer 20 from 19 clearer 23 than 20 from 22 experiments 21 animal 22 experiments 23 than 24 from 24 from 26 studies 25 human 26 studies patients with head [and] neck cancer experience significant treatment - related symptoms . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 7 experience 0 ###LEFT-WALL### 11 related 1 patients 2 with 1 patients 7 experience 2 with 6 cancer 3 head 6 cancer 5 neck 6 cancer 7 experience 9 treatment 8 significant 9 treatment 10 - 11 related 11 related 12 symptoms 11 related 13 . aging may predispose older patients to greater risk . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 3 predispose 0 ###LEFT-WALL### 9 . 1 aging 2 may 2 may 3 predispose 3 predispose 5 patients 3 predispose 6 to 4 older 5 patients 6 to 8 risk 7 greater 8 risk we examined the association of age with symptom burden . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 10 . 1 we 2 examined 2 examined 4 association 2 examined 7 with 3 the 4 association 4 association 5 of 5 of 6 age 7 with 9 burden 8 symptom 9 burden older patients may experience more symptom burden with swallowing , voice/speech , and nutrition . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 4 experience 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 15 . 1 older 2 patients 2 patients 3 may 3 may 4 experience 4 experience 7 burden 4 experience 8 with 5 more 7 burden 6 symptom 7 burden 8 with 9 swallowing 10 , 13 and 11 voice/speech 13 and 12 , 13 and 13 and 14 nutrition nurses need to be especially aware of and monitor for these problems . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 13 . 1 nurses 2 need 1 nurses 8 and 2 need 3 to 2 need 7 of 3 to 4 be 4 be 6 aware 5 especially 6 aware 6 aware 7 of 8 and 9 monitor 9 monitor 10 for 9 monitor 12 problems 10 for 11 these epigenetics , transcending genetics , genomics , and molecular biology , is now poised to be the avant - garde beacon of biological science . 0 ###LEFT-WALL### 1 epigenetics 0 ###LEFT-WALL### 16 be 0 ###LEFT-WALL### 25 . 1 epigenetics 3 transcending 1 epigenetics 8 and 1 epigenetics 12 is 2 , 3 transcending 3 transcending 4 genetics 3 transcending 5 , 5 , 8 and 6 genomics 8 and 7 , 8 and 8 and 10 biology 8 and 11 , 9 molecular 10 biology 12 is 14 poised 13 now 14 poised 14 poised 15 to 15 to 16 be 16 be 21 beacon 17 the 21 beacon 18 avant 19 - 18 avant 21 beacon 20 garde 21 beacon 21 beacon 22 of 22 of 24 science 23 biological 24 science the rise of dna methylation studies marks a new dawn in the field of epigenetics , which only a few decades ago [was] largely underestimated , but is now a dynamic area of research challenging and revising traditional paradigms of gene expression and behavior . 0 ###LEFT-WALL### 2 rise 0 ###LEFT-WALL### 27 but 0 ###LEFT-WALL### 45 . 1 the 2 rise 2 rise 3 of 2 rise 5 methylation 2 rise 6 studies 2 rise 27 but 3 of 4 dna 5 methylation 6 studies 7 marks 10 dawn 7 marks 11 in 7 marks 27 but 8 a 10 dawn 9 new 10 dawn 11 in 13 field 12 the 13 field 13 field 14 of 14 of 15 epigenetics 15 epigenetics 17 which 16 , 17 which 17 which 25 underestimated 17 which 26 , 18 only 20 few 19 a 20 few 20 few 22 ago 20 few 25 underestimated 21 decades 22 ago 24 largely 25 underestimated 27 but 28 is 28 is 29 now 28 is 43 and 30 a 32 area 31 dynamic 32 area 32 area 33 of 32 area 36 and 33 of 35 challenging 34 research 35 challenging 36 and 39 paradigms 36 and 40 of 36 and 43 and 37 revising 39 paradigms 38 traditional 39 paradigms 40 of 42 expression 41 gene 42 expression 43 and 44 behavior cancer research enjoys a major share of this attention to dna methylation and it has been widely accepted for some time now that cancer is as much an epigenetic phenomenon as it is genetic . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 enjoys 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 35 . 1 cancer 2 research 2 research 3 enjoys 3 enjoys 6 share 3 enjoys 10 to 4 a 6 share 5 major 6 share 6 share 7 of 7 of 9 attention 8 this 9 attention 10 to 12 methylation 11 dna 12 methylation 13 and 14 it 13 and 33 is 14 it 15 has 15 has 16 been 16 been 18 accepted 17 widely 18 accepted 18 accepted 19 for 19 for 21 time 20 some 21 time 21 time 22 now 21 time 23 that 21 time 33 is 23 that 24 cancer 23 that 25 is 24 cancer 25 is 25 is 27 much 25 is 30 phenomenon 26 as 27 much 28 an 29 epigenetic 28 an 30 phenomenon 29 epigenetic 30 phenomenon 30 phenomenon 31 as 31 as 32 it 33 is 34 genetic epigenetic lesions and perturbations are acquired [during] the life of an individual and accumulate with aging and represent the flip side of the same coin that bears genetic mutations . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 30 . 1 epigenetic 2 lesions 2 lesions 3 and 3 and 4 perturbations 3 and 5 are 5 are 13 and 6 acquired 9 life 6 acquired 13 and 8 the 9 life 9 life 10 of 10 of 12 individual 11 an 12 individual 13 and 17 and 14 accumulate 15 with 14 accumulate 17 and 15 with 16 aging 17 and 18 represent 18 represent 21 side 19 the 21 side 20 flip 21 side 21 side 22 of 22 of 25 coin 23 the 24 same 23 the 25 coin 25 coin 26 that 25 coin 27 bears 26 that 27 bears 27 bears 29 mutations 28 genetic 29 mutations both events , [either] [individually] [or] in cooperation , result in the development and progression of cancer . 0 ###LEFT-WALL### 2 events 0 ###LEFT-WALL### 10 result 0 ###LEFT-WALL### 18 . 1 both 2 events 2 events 7 in 2 events 10 result 3 , 7 in 7 in 8 cooperation 7 in 9 , 10 result 11 in 11 in 14 and 12 the 13 development 13 development 14 and 14 and 15 progression 14 and 16 of 16 of 17 cancer epigenetic research and the hunt for strong methylation markers has been ably mitigated by new and improved high throughput technology that has improved the efficacy and enabled the rapid progress of biomarker [evaluation] and validation . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 36 . 1 epigenetic 2 research 3 and 5 hunt 3 and 26 and 4 the 5 hunt 5 hunt 6 for 5 hunt 26 and 6 for 9 markers 7 strong 8 methylation 8 methylation 9 markers 10 has 11 been 10 has 26 and 11 been 13 mitigated 12 ably 13 mitigated 13 mitigated 14 by 14 by 16 and 15 new 16 and 16 and 20 technology 16 and 21 that 16 and 22 has 17 improved 18 high 18 high 19 throughput 19 throughput 20 technology 21 that 22 has 22 has 23 improved 23 improved 25 efficacy 24 the 25 efficacy 26 and 27 enabled 27 enabled 34 and 28 the 34 and 29 rapid 30 progress 30 progress 31 of 30 progress 34 and 31 of 32 biomarker 34 and 35 validation this review looks into some of the recent strides in biomarker research dealing exclusively with methylation markers and the potential key they may hold to the resilient door shut tight on cancer diagnostics and treatment . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 29 shut 0 ###LEFT-WALL### 36 . 1 this 2 review 2 review 3 looks 3 looks 4 into 3 looks 10 in 3 looks 15 with 4 into 9 strides 5 some 6 of 5 some 9 strides 6 of 9 strides 7 the 9 strides 8 recent 9 strides 10 in 12 research 11 biomarker 12 research 12 research 13 dealing 13 dealing 14 exclusively 15 with 18 and 15 with 29 shut 16 methylation 17 markers 17 markers 18 and 18 and 21 key 18 and 22 they 18 and 24 hold 19 the 21 key 20 potential 21 key 22 they 23 may 23 may 24 hold 24 hold 25 to 25 to 28 door 26 the 28 door 27 resilient 28 door 29 shut 30 tight 29 shut 31 on 31 on 34 and 32 cancer 33 diagnostics 33 diagnostics 34 and 34 and 35 treatment background : the goal of the current study was to investigate psychological resilience in the older adults ( >64 years ) compared with that of the young ones ( < 26 years ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 1 background 2 : 2 : 4 goal 3 the 4 goal 4 goal 5 of 5 of 7 current 6 the 7 current 7 current 8 study 7 current 22 compared 8 study 9 was 9 was 10 to 9 was 22 compared 10 to 11 investigate 12 psychological 13 resilience 13 resilience 14 in 13 resilience 20 years 13 resilience 22 compared 14 in 17 adults 15 the 17 adults 16 older 17 adults 18 ( 20 years 19 >64 20 years 20 years 21 ) 22 compared 23 with 23 with 24 that 24 that 25 of 25 of 28 ones 26 the 28 ones 27 young 28 ones 28 ones 32 years 29 ( 32 years 30 < 31 26 31 26 32 years 32 years 33 ) methods : questionnaire measures of depression , hopelessness , general health and resilience were administered to the participants . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 12 and 2 : 15 administered 2 : 19 . 3 questionnaire 4 measures 4 measures 5 of 4 measures 7 , 5 of 6 depression 7 , 8 hopelessness 7 , 9 , 9 , 11 health 9 , 12 and 10 general 11 health 12 and 13 resilience 12 and 14 were 14 were 15 administered 15 administered 16 to 16 to 18 participants 17 the 18 participants the resilience measure comprised three sub - scales of social support , emotional regulation and problem solving . 0 ###LEFT-WALL### 6 sub 0 ###LEFT-WALL### 7 - 1 the 6 sub 2 resilience 4 comprised 3 measure 4 comprised 4 comprised 6 sub 5 three 6 sub 7 - 15 and 7 - 18 . 8 scales 9 of 8 scales 12 , 9 of 11 support 10 social 11 support 12 , 14 regulation 12 , 15 and 13 emotional 14 regulation 15 and 17 solving 16 problem 17 solving results : the older adults were the more resilient group especially with respect to emotional regulation ability and problem solving . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 5 adults 2 : 6 were 3 the 5 adults 4 older 5 adults 5 adults 6 were 6 were 10 group 6 were 11 especially 6 were 14 to 7 the 10 group 8 more 9 resilient 9 resilient 10 group 11 especially 12 with 12 with 13 respect 14 to 18 and 15 emotional 16 regulation 16 regulation 17 ability 17 ability 18 and 18 and 20 solving 19 problem 20 solving the young ones had more resilience related to social support . 0 ###LEFT-WALL### 3 ones 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 11 . 1 the 3 ones 2 young 3 ones 3 ones 4 had 4 had 6 resilience 5 more 6 resilience 6 resilience 7 related 7 related 8 to 8 to 10 support 9 social 10 support poor perceptions of general health and low energy levels predicted low levels of resilience regardless of age . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 low 0 ###LEFT-WALL### 18 . 1 poor 2 perceptions 2 perceptions 3 of 2 perceptions 6 and 3 of 5 health 4 general 5 health 6 and 9 levels 6 and 10 predicted 6 and 11 low 7 low 9 levels 8 energy 9 levels 11 low 12 levels 11 low 16 of 12 levels 13 of 13 of 14 resilience 15 regardless 16 of 16 of 17 age low hopelessness scores also predicted greater resilience in both groups . 0 ###LEFT-WALL### 2 hopelessness 0 ###LEFT-WALL### 3 scores 0 ###LEFT-WALL### 11 . 1 low 2 hopelessness 2 hopelessness 3 scores 3 scores 7 resilience 3 scores 8 in 4 also 5 predicted 5 predicted 7 resilience 6 greater 7 resilience 8 in 10 groups 9 both 10 groups experiencing higher levels of mental illness and physical dysfunction predicted high resilience scores especially for the social support resilience scale in the older adults . 0 ###LEFT-WALL### 1 experiencing 0 ###LEFT-WALL### 10 predicted 0 ###LEFT-WALL### 25 . 1 experiencing 3 levels 1 experiencing 10 predicted 2 higher 3 levels 3 levels 4 of 4 of 7 and 5 mental 6 illness 6 illness 7 and 7 and 9 dysfunction 8 physical 9 dysfunction 10 predicted 12 resilience 10 predicted 13 scores 11 high 12 resilience 12 resilience 13 scores 13 scores 14 especially 13 scores 21 in 14 especially 15 for 15 for 20 scale 16 the 20 scale 17 social 20 scale 18 support 19 resilience 19 resilience 20 scale 21 in 24 adults 22 the 24 adults 23 older 24 adults the negative effects of depression on resilience related to emotional regulation were countered by low hopelessness but only in the young adults . 0 ###LEFT-WALL### 3 effects 0 ###LEFT-WALL### 13 countered 0 ###LEFT-WALL### 23 . 1 the 3 effects 2 negative 3 effects 3 effects 4 of 3 effects 12 were 4 of 5 depression 5 depression 6 on 5 depression 8 related 6 on 7 resilience 8 related 9 to 9 to 11 regulation 10 emotional 11 regulation 12 were 13 countered 13 countered 17 but 14 by 16 hopelessness 14 by 17 but 15 low 16 hopelessness 17 but 18 only 17 but 19 in 19 in 22 adults 20 the 22 adults 21 young 22 adults conclusions : these results highlight the importance of maintaining resilience - related coping skills in both young and older adults but indicate that different psychological processes underlie resilience across the lifespan . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 highlight 2 : 11 - 2 : 32 . 3 these 4 results 4 results 5 highlight 5 highlight 7 importance 6 the 7 importance 7 importance 8 of 8 of 9 maintaining 9 maintaining 10 resilience 11 - 21 but 12 related 14 skills 12 related 15 in 12 related 21 but 13 coping 14 skills 15 in 20 adults 16 both 20 adults 17 young 18 and 18 and 19 older 18 and 20 adults 21 but 22 indicate 22 indicate 26 processes 22 indicate 27 underlie 23 that 24 different 24 different 26 processes 25 psychological 26 processes 26 processes 27 underlie 27 underlie 28 resilience 27 underlie 29 across 29 across 31 lifespan 30 the 31 lifespan objective : the goal of this study was to investigate the role of endogenous amyloid - β [peptide] ( aβ ) in healthy brain . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 goal 2 : 8 was 2 : 25 . 3 the 4 goal 4 goal 5 of 4 goal 8 was 5 of 7 study 6 this 7 study 8 was 9 to 9 to 10 investigate 10 investigate 12 role 10 investigate 22 in 11 the 12 role 12 role 13 of 13 of 17 β 14 endogenous 17 β 15 amyloid 16 - 15 amyloid 17 β 17 β 20 aβ 19 ( 20 aβ 20 aβ 21 ) 22 in 24 brain 23 healthy 24 brain methods : long - term potentiation ( ltp ) , a type of synaptic plasticity that is thought to be associated with learning and memory , was examined through extracellular field recordings from the ca1 region of hippocampal slices , whereas behavioral techniques were used to assess contextual fear memory and reference memory . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 1 methods 2 : 2 : 3 long 3 long 6 potentiation 3 long 15 plasticity 4 - 6 potentiation 5 term 6 potentiation 6 potentiation 8 ltp 6 potentiation 9 ) 7 ( 8 ltp 8 ltp 9 ) 10 , 15 plasticity 11 a 12 type 12 type 13 of 12 type 15 plasticity 13 of 15 plasticity 14 synaptic 15 plasticity 15 plasticity 18 thought 15 plasticity 19 to 15 plasticity 26 , 15 plasticity 54 . 16 that 17 is 17 is 18 thought 19 to 20 be 20 be 26 , 21 associated 22 with 21 associated 26 , 22 with 24 and 23 learning 24 and 24 and 25 memory 26 , 27 was 27 was 32 recordings 27 was 41 whereas 28 examined 31 field 29 through 31 field 30 extracellular 31 field 31 field 32 recordings 32 recordings 33 from 33 from 36 region 34 the 36 region 35 ca1 36 region 36 region 37 of 37 of 39 slices 38 hippocampal 39 slices 40 , 41 whereas 41 whereas 43 techniques 41 whereas 51 and 41 whereas 54 . 42 behavioral 43 techniques 43 techniques 51 and 44 were 45 used 44 were 51 and 45 used 46 to 46 to 47 assess 47 assess 50 memory 48 contextual 50 memory 49 fear 50 memory 51 and 52 reference 51 and 53 memory amyloid precursor protein ( app ) [expression] was reduced through small interfering rna ( sirna ) technique . 0 ###LEFT-WALL### 3 protein 0 ###LEFT-WALL### 9 reduced 1 amyloid 3 protein 2 precursor 3 protein 3 protein 5 app 3 protein 8 was 4 ( 5 app 5 app 6 ) 8 was 9 reduced 9 reduced 10 through 10 through 13 rna 11 small 13 rna 12 interfering 13 rna 13 rna 17 technique 14 ( 17 technique 15 sirna 16 ) 15 sirna 17 technique 17 technique 18 . results : we found that both antirodent aβ antibody and sirna against murine app reduced ltp as well as contextual fear memory and reference memory . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 3 we 2 : 4 found 2 : 10 and 3 we 4 found 4 found 9 antibody 5 that 9 antibody 6 both 7 antirodent 7 antirodent 9 antibody 8 aβ 9 antibody 10 and 11 sirna 10 and 15 reduced 11 sirna 12 against 11 sirna 15 reduced 12 against 14 app 13 murine 14 app 15 reduced 16 ltp 15 reduced 19 as 17 as 18 well 18 well 19 as 19 as 23 and 20 contextual 22 memory 21 fear 22 memory 22 memory 23 and 23 and 25 memory 24 reference 25 memory these effects were rescued by the addition of human aβ₄₂ , suggesting that endogenously produced aβ is needed for normal ltp and memory . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 4 rescued 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 24 . 1 these 2 effects 2 effects 3 were 3 were 4 rescued 4 rescued 5 by 5 by 7 addition 6 the 7 addition 7 addition 8 of 8 of 10 aβ₄₂ 9 human 10 aβ₄₂ 11 , 12 suggesting 11 , 18 needed 12 suggesting 13 that 12 suggesting 15 produced 12 suggesting 17 is 13 that 15 produced 14 endogenously 15 produced 15 produced 16 aβ 17 is 18 needed 18 needed 19 for 19 for 22 and 20 normal 21 ltp 21 ltp 22 and 22 and 23 memory furthermore , the effect of endogenous aβ on plasticity and memory was likely due to regulation of transmitter release [,] activation of α7 - containing nicotinic acetylcholine receptors , and aβ₄₂ production . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 33 . 1 furthermore 2 , 1 furthermore 4 effect 3 the 4 effect 4 effect 5 of 4 effect 12 was 5 of 10 and 6 endogenous 7 aβ 7 aβ 8 on 7 aβ 10 and 8 on 9 plasticity 10 and 11 memory 12 was 13 likely 13 likely 15 to 14 due 15 to 15 to 30 and 16 regulation 17 of 16 regulation 30 and 17 of 21 activation 18 transmitter 21 activation 19 release 21 activation 21 activation 22 of 21 activation 25 containing 22 of 23 α7 24 - 25 containing 25 containing 28 receptors 25 containing 29 , 26 nicotinic 27 acetylcholine 27 acetylcholine 28 receptors 29 , 30 and 30 and 32 production 31 aβ₄₂ 32 production interpretation : endogenous aβ₄₂ is a critical player in synaptic plasticity and memory within the normal central nervous system . 0 ###LEFT-WALL### 1 interpretation 0 ###LEFT-WALL### 2 : 2 : 4 aβ₄₂ 2 : 5 is 2 : 20 . 3 endogenous 4 aβ₄₂ 4 aβ₄₂ 5 is 5 is 8 player 6 a 7 critical 6 a 8 player 7 critical 8 player 8 player 9 in 8 player 14 within 9 in 12 and 10 synaptic 11 plasticity 11 plasticity 12 and 12 and 13 memory 14 within 19 system 15 the 19 system 16 normal 19 system 17 central 19 system 18 nervous 19 system this needs to be taken into consideration when designing therapies aiming at reducing aβ levels to treat alzheimer disease . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 needs 0 ###LEFT-WALL### 20 . 1 this 2 needs 2 needs 3 to 2 needs 5 taken 3 to 4 be 4 be 5 taken 5 taken 6 into 5 taken 8 when 5 taken 16 to 6 into 7 consideration 8 when 9 designing 8 when 15 levels 9 designing 10 therapies 9 designing 12 at 9 designing 15 levels 10 therapies 11 aiming 12 at 13 reducing 13 reducing 14 aβ 16 to 17 treat 17 treat 19 disease 18 alzheimer 19 disease this study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 20 . 1 this 2 study 2 study 3 investigated 3 investigated 5 effects 4 the 5 effects 5 effects 6 of 5 effects 10 due 6 of 8 and 7 age 8 and 8 and 9 inactivity 10 due 11 to 11 to 12 being 12 being 14 bedridden 13 chronically 14 bedridden 14 bedridden 15 on 15 on 16 atrophy 16 atrophy 17 of 17 of 19 muscles 18 trunk 19 muscles the subjects comprised 33 young women ( young group [ )(and 41 elderly women who resided in nursing homes or chronic care institutions . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 comprised 1 the 2 subjects 2 subjects 3 comprised 3 comprised 6 women 4 33 6 women 5 young 6 women 6 women 20 or 7 ( 20 or 8 young 9 group 9 group 11 )(and 11 )(and 14 women 11 )(and 15 who 11 )(and 16 resided 11 )(and 20 or 12 41 14 women 13 elderly 14 women 15 who 16 resided 16 resided 17 in 17 in 18 nursing 18 nursing 19 homes 20 or 23 institutions 20 or 24 . 21 chronic 22 care 22 care 23 institutions the elderly subjects were divided into two groups : independent elderly group [who] [were] able to perform activities of daily living involving walking independently ( n = 28 ) and dependent elderly group who were chronically bedridden ( n = 13 ) . 0 ###LEFT-WALL### 3 subjects 0 ###LEFT-WALL### 5 divided 0 ###LEFT-WALL### 9 : 1 the 3 subjects 2 elderly 3 subjects 3 subjects 4 were 4 were 5 divided 5 divided 6 into 6 into 8 groups 7 two 8 groups 9 : 30 and 9 : 43 . 10 independent 12 group 11 elderly 12 group 12 group 15 able 12 group 19 of 12 group 30 and 15 able 16 to 15 able 17 perform 16 to 17 perform 17 perform 18 activities 19 of 21 living 20 daily 21 living 21 living 22 involving 22 involving 23 walking 23 walking 24 independently 23 walking 27 = 25 ( 27 = 26 n 27 = 27 = 28 28 27 = 29 ) 30 and 33 group 30 and 34 who 30 and 35 were 31 dependent 33 group 32 elderly 33 group 34 who 35 were 35 were 37 bedridden 36 chronically 37 bedridden 37 bedridden 40 = 38 ( 40 = 39 n 40 = 40 = 41 13 40 = 42 ) the thickness of the following six trunk muscles was measured by b - mode ultrasound : the rectus abdominis , external oblique , internal oblique , transversus abdominis , thoracic erector spinae ( longissimus [ )(and lumbar multifidus muscles . 0 ###LEFT-WALL### 2 thickness 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 13 - 1 the 2 thickness 2 thickness 3 of 2 thickness 9 was 3 of 8 muscles 4 the 5 following 4 the 8 muscles 6 six 7 trunk 7 trunk 8 muscles 9 was 10 measured 10 measured 11 by 11 by 12 b 13 - 15 ultrasound 13 - 16 : 14 mode 15 ultrasound 15 ultrasound 16 : 16 : 19 abdominis 17 the 19 abdominis 18 rectus 19 abdominis 19 abdominis 32 spinae 20 , 32 spinae 21 external 31 erector 22 oblique 23 , 22 oblique 31 erector 24 internal 31 erector 25 oblique 28 abdominis 25 oblique 29 , 25 oblique 31 erector 26 , 28 abdominis 27 transversus 28 abdominis 28 abdominis 29 , 30 thoracic 31 erector 31 erector 32 spinae 32 spinae 36 )(and 32 spinae 40 . 33 ( 36 )(and 34 longissimus 36 )(and 36 )(and 39 muscles 36 )(and 40 . 37 lumbar 38 multifidus 38 multifidus 39 muscles all muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group . 0 ###LEFT-WALL### 2 muscles 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 27 . 1 all 2 muscles 2 muscles 3 except 2 muscles 12 were 3 except 4 for 4 for 8 and 5 the 7 abdominis 6 transversus 7 abdominis 7 abdominis 8 and 8 and 11 muscles 9 lumbar 11 muscles 10 multifidus 11 muscles 12 were 14 thinner 13 significantly 14 thinner 14 thinner 15 in 14 thinner 23 in 15 in 19 group 16 the 19 group 17 independent 19 group 18 elderly 19 group 19 group 20 compared 19 group 21 with 21 with 22 those 23 in 26 group 24 the 26 group 25 young 26 group the thicknesses of all muscles in the dependent elderly group [was] significantly smaller than that in the young group , whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles . 0 ###LEFT-WALL### 2 thicknesses 0 ###LEFT-WALL### 19 group 1 the 2 thicknesses 2 thicknesses 3 of 2 thicknesses 16 in 2 thicknesses 19 group 3 of 5 muscles 4 all 5 muscles 5 muscles 6 in 6 in 10 group 7 the 10 group 8 dependent 10 group 9 elderly 10 group 10 group 13 smaller 12 significantly 13 smaller 13 smaller 14 than 14 than 15 that 16 in 18 young 17 the 18 young 19 group 21 whereas 20 , 21 whereas 21 whereas 22 there 21 whereas 23 were 21 whereas 46 . 22 there 23 were 23 were 25 differences 23 were 26 between 24 no 25 differences 26 between 33 groups 27 the 33 groups 28 dependent 33 groups 29 elderly 30 and 30 and 31 independent 30 and 33 groups 32 elderly 33 groups 33 groups 34 in 33 groups 38 of 34 in 37 thicknesses 35 the 37 thicknesses 36 muscle 37 thicknesses 38 of 42 and 39 the 41 abdominis 40 rectus 41 abdominis 41 abdominis 42 and 42 and 45 muscles 43 internal 45 muscles 44 oblique 45 muscles in conclusion , our results [suggest] that : ( 1 ) age - related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women [;] ( 2 ) atrophy associated with chronic bed rest was more marked in the antigravity muscles , such as the back and transversus abdominis . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 1 in 2 conclusion 3 , 5 results 3 , 12 age 3 , 13 - 4 our 5 results 5 results 7 that 5 results 8 : 5 results 10 1 5 results 12 age 7 that 8 : 9 ( 10 1 10 1 11 ) 13 - 15 atrophy 14 related 15 atrophy 15 atrophy 16 compared 15 atrophy 17 with 15 atrophy 20 was 17 with 19 women 18 young 19 women 20 was 21 less 20 was 22 in 20 was 28 than 22 in 27 muscles 23 the 27 muscles 24 deep 27 muscles 25 antigravity 26 trunk 26 trunk 27 muscles 28 than 31 muscles 29 the 31 muscles 30 superficial 31 muscles 31 muscles 32 in 31 muscles 41 atrophy 31 muscles 42 associated 32 in 36 women 33 the 36 women 34 independent 36 women 35 elderly 36 women 36 women 39 2 38 ( 39 2 39 2 40 ) 41 atrophy 42 associated 42 associated 43 with 43 with 45 bed 43 with 49 marked 44 chronic 45 bed 45 bed 46 rest 45 bed 47 was 46 rest 47 was 47 was 48 more 49 marked 50 in 50 in 53 muscles 51 the 53 muscles 52 antigravity 53 muscles 53 muscles 56 as 54 , 56 as 55 such 56 as 56 as 61 abdominis 56 as 62 . 57 the 58 back 58 back 59 and 59 and 60 transversus 59 and 61 abdominis the maintenance of genome stability is critical for the suppression of cancer and premature ageing . 0 ###LEFT-WALL### 2 maintenance 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 16 . 1 the 2 maintenance 2 maintenance 3 of 2 maintenance 6 is 3 of 5 stability 4 genome 5 stability 6 is 7 critical 7 critical 8 for 8 for 10 suppression 9 the 10 suppression 10 suppression 11 of 11 of 13 and 12 cancer 13 and 13 and 15 ageing 14 premature 15 ageing the maintenance of the human genome requires hundreds of proteins involved in dna repair , dna replication , chromosome segregation and cell cycle checkpoint responses . 0 ###LEFT-WALL### 2 maintenance 0 ###LEFT-WALL### 7 requires 0 ###LEFT-WALL### 26 . 1 the 2 maintenance 2 maintenance 3 of 2 maintenance 7 requires 3 of 6 genome 4 the 6 genome 5 human 6 genome 7 requires 10 proteins 7 requires 12 in 8 hundreds 9 of 8 hundreds 10 proteins 9 of 10 proteins 10 proteins 11 involved 12 in 21 and 13 dna 14 repair 14 repair 15 , 15 , 17 replication 15 , 18 , 16 dna 17 replication 18 , 20 segregation 18 , 21 and 19 chromosome 20 segregation 21 and 25 responses 22 cell 25 responses 23 cycle 25 responses 24 checkpoint 25 responses a number [of] genetic disorders exist in man where a breakdown in genome maintenance is associated with cancer [predisposition] . 0 ###LEFT-WALL### 2 number 0 ###LEFT-WALL### 16 associated 0 ###LEFT-WALL### 20 . 1 a 2 number 2 number 5 disorders 2 number 7 in 2 number 8 man 2 number 16 associated 4 genetic 5 disorders 5 disorders 6 exist 6 exist 7 in 8 man 9 where 9 where 11 breakdown 9 where 15 is 10 a 11 breakdown 11 breakdown 12 in 11 breakdown 15 is 12 in 14 maintenance 13 genome 14 maintenance 16 associated 17 with 17 with 18 cancer amongst these are bloom ['s] [syndrome] ( bs ) and fanconi anaemia ( fa ) . 0 ###LEFT-WALL### 1 amongst 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 16 . 1 amongst 2 these 1 amongst 3 are 3 are 10 and 4 bloom 8 bs 7 ( 8 bs 8 bs 9 ) 8 bs 10 and 10 and 12 anaemia 10 and 14 fa 11 fanconi 12 anaemia 13 ( 14 fa 14 fa 15 ) the bs and fa gene products co - operate in the repair of damaged dna . 0 ###LEFT-WALL### 6 products 0 ###LEFT-WALL### 7 co 0 ###LEFT-WALL### 8 - 1 the 6 products 2 bs 3 and 3 and 4 fa 4 fa 6 products 5 gene 6 products 6 products 7 co 8 - 9 operate 8 - 16 . 9 operate 10 in 10 in 12 repair 11 the 12 repair 12 repair 13 of 13 of 15 dna 14 damaged 15 dna in this review , we focus on interactions between bs and fa proteins that specifically occur during chromosome segregation in mitosis . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 focus 0 ###LEFT-WALL### 22 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 focus 6 focus 7 on 6 focus 9 between 6 focus 17 during 6 focus 20 in 7 on 8 interactions 9 between 13 proteins 10 bs 11 and 11 and 12 fa 12 fa 13 proteins 13 proteins 14 that 13 proteins 16 occur 14 that 16 occur 15 specifically 16 occur 17 during 19 segregation 18 chromosome 19 segregation 20 in 21 mitosis the bs protein , blm , was shown recently to define a novel class of anaphase dna bridge structures that , in some cases , also contain fa proteins . 0 ###LEFT-WALL### 3 protein 0 ###LEFT-WALL### 8 shown 0 ###LEFT-WALL### 30 . 1 the 3 protein 2 bs 3 protein 3 protein 5 blm 3 protein 7 was 4 , 5 blm 5 blm 6 , 7 was 8 shown 8 shown 10 to 9 recently 10 to 10 to 11 define 11 define 14 class 12 a 13 novel 12 a 14 class 13 novel 14 class 14 class 15 of 15 of 19 structures 16 anaphase 19 structures 17 dna 18 bridge 18 bridge 19 structures 19 structures 20 that 19 structures 27 contain 20 that 22 in 20 that 27 contain 21 , 22 in 22 in 24 cases 22 in 25 , 23 some 24 cases 26 also 27 contain 27 contain 29 proteins 28 fa 29 proteins we will discuss the possible source of these bridges and the role that fa proteins and blm might play in their removal . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 23 . 1 we 2 will 2 will 3 discuss 3 discuss 6 source 4 the 6 source 5 possible 6 source 6 source 7 of 7 of 10 and 8 these 9 bridges 9 bridges 10 and 10 and 12 role 10 and 13 that 10 and 19 play 11 the 12 role 13 that 16 and 13 that 19 play 14 fa 15 proteins 15 proteins 16 and 16 and 17 blm 16 and 18 might 18 might 19 play 19 play 20 in 20 in 22 removal 21 their 22 removal dispositional optimism and other positive personality traits have been associated with longevity . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 13 . 1 dispositional 2 optimism 2 optimism 3 and 3 and 7 traits 3 and 8 have 4 other 7 traits 5 positive 6 personality 6 personality 7 traits 8 have 9 been 9 been 10 associated 10 associated 11 with 11 with 12 longevity using a familial approach , we investigated the relationship between parental longevity and offspring ['s] dispositional optimism [among] community - dwelling older subjects . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 investigated 0 ###LEFT-WALL### 20 - 1 using 4 approach 1 using 5 , 1 using 6 we 2 a 3 familial 2 a 4 approach 3 familial 4 approach 6 we 7 investigated 7 investigated 9 relationship 7 investigated 10 between 8 the 9 relationship 10 between 13 and 11 parental 12 longevity 12 longevity 13 and 13 and 19 community 14 offspring 19 community 16 dispositional 17 optimism 17 optimism 19 community 20 - 23 subjects 20 - 24 . 21 dwelling 23 subjects 22 older 23 subjects parental age of death was assessed using structured questionnaires in two different population - based samples : the leiden longevity study [(] [n] = 1,252 , 52.2 % female , mean age 66 years , [sd] = 4 ) and the alpha omega trial ( n = 769 , 22.8 % female , mean age 69 years , [sd] = 6 ) . 1 parental 2 age 1 parental 5 was 1 parental 6 assessed 2 age 3 of 2 age 5 was 3 of 4 death 6 assessed 7 using 6 assessed 17 : 7 using 9 questionnaires 7 using 10 in 7 using 17 : 8 structured 9 questionnaires 10 in 11 two 11 two 13 population 11 two 16 samples 12 different 13 population 13 population 15 based 13 population 16 samples 14 - 15 based 17 : 21 study 18 the 21 study 19 leiden 20 longevity 20 longevity 21 study 21 study 25 1,252 21 study 31 mean 24 = 25 1,252 25 1,252 29 female 25 1,252 31 mean 26 , 29 female 27 52.2 29 female 28 % 29 female 29 female 30 , 31 mean 40 and 32 age 34 years 33 66 34 years 34 years 38 4 34 years 40 and 35 , 38 4 37 = 38 4 38 4 39 ) 40 and 44 trial 40 and 47 = 40 and 52 female 41 the 44 trial 42 alpha 43 omega 43 omega 44 trial 45 ( 47 = 46 n 47 = 47 = 48 769 49 , 52 female 50 22.8 51 % 51 % 52 female 52 female 57 years 52 female 63 . 53 , 57 years 54 mean 55 age 55 age 57 years 56 69 57 years 57 years 61 6 57 years 63 . 58 , 61 6 60 = 61 6 61 6 62 ) adult offspring ['s] dispositional optimism was assessed with the life orientation test - revised ( lot - r ) . 0 ###LEFT-WALL### 5 optimism 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 20 . 1 adult 5 optimism 2 offspring 5 optimism 4 dispositional 5 optimism 5 optimism 6 was 6 was 7 assessed 7 assessed 8 with 7 assessed 14 revised 8 with 12 test 9 the 12 test 10 life 11 orientation 11 orientation 12 test 13 - 14 revised 14 revised 17 - 14 revised 19 ) 15 ( 17 - 16 lot 17 - 17 - 18 r 17 - 19 ) the association between parental age of death and levels of optimism in the offspring was analysed using linear regression analysis within each sample and a meta - analysis for the overall effect . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 16 analysed 0 ###LEFT-WALL### 33 . 1 the 2 association 2 association 3 between 2 association 6 of 2 association 10 of 2 association 15 was 3 between 5 age 4 parental 5 age 6 of 8 and 7 death 8 and 8 and 9 levels 10 of 11 optimism 11 optimism 12 in 12 in 14 offspring 13 the 14 offspring 15 was 16 analysed 16 analysed 17 using 16 analysed 21 within 16 analysed 29 for 17 using 20 analysis 18 linear 19 regression 19 regression 20 analysis 21 within 24 and 22 each 23 sample 23 sample 24 and 24 and 28 analysis 25 a 26 meta 25 a 28 analysis 26 meta 27 - 26 meta 28 analysis 29 for 32 effect 30 the 32 effect 31 overall 32 effect in both samples , the parental mean age of death was positively associated with optimism scores of the offspring . 0 ###LEFT-WALL### 8 age 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 20 . 1 in 3 samples 1 in 4 , 1 in 8 age 2 both 3 samples 5 the 8 age 6 parental 8 age 7 mean 8 age 8 age 9 of 8 age 11 was 9 of 10 death 11 was 13 associated 12 positively 13 associated 13 associated 14 with 14 with 16 scores 15 optimism 16 scores 16 scores 17 of 17 of 19 offspring 18 the 19 offspring the association remained significant after adjustment for age , gender , living arrangement , body mass index , smoking status , education and self - rated health of the offspring . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 3 remained 0 ###LEFT-WALL### 31 . 1 the 2 association 2 association 3 remained 3 remained 4 significant 4 significant 5 after 5 after 23 and 5 after 26 rated 6 adjustment 7 for 6 adjustment 9 , 7 for 8 age 9 , 10 gender 9 , 11 , 11 , 13 arrangement 11 , 14 , 12 living 13 arrangement 14 , 17 index 14 , 18 , 15 body 16 mass 16 mass 17 index 18 , 20 status 18 , 21 , 19 smoking 20 status 21 , 22 education 21 , 23 and 23 and 24 self 23 and 25 - 23 and 26 rated 26 rated 27 health 27 health 28 of 28 of 30 offspring 29 the 30 offspring the pooled [b] coefficient ( [increase] in lot - [r] score [per] 10 - year increase [in] parental mean age of death ) was 0.30 ( se [=] 0.08 , p < 0.001 ) . 0 ###LEFT-WALL### 4 coefficient 0 ###LEFT-WALL### 24 was 1 the 4 coefficient 2 pooled 4 coefficient 4 coefficient 7 in 4 coefficient 20 age 4 coefficient 24 was 5 ( 7 in 7 in 8 lot 7 in 14 - 8 lot 11 score 9 - 11 score 11 score 13 10 11 score 14 - 14 - 20 age 15 year 20 age 16 increase 20 age 18 parental 19 mean 19 mean 20 age 20 age 21 of 20 age 23 ) 21 of 22 death 24 was 25 0.30 25 0.30 27 se 26 ( 27 se 27 se 29 0.08 27 se 32 < 27 se 35 . 30 , 32 < 31 p 32 < 32 < 33 0.001 32 < 34 ) in conclusion , parental longevity was positively associated with optimism in adult offspring , suggesting a partial linked heritability of longevity and optimism . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 1 in 2 conclusion 3 , 5 longevity 3 , 8 associated 4 parental 5 longevity 5 longevity 6 was 6 was 7 positively 6 was 8 associated 8 associated 9 with 8 associated 11 in 9 with 10 optimism 11 in 13 offspring 12 adult 13 offspring 13 offspring 15 suggesting 14 , 15 suggesting 15 suggesting 19 heritability 15 suggesting 24 . 16 a 17 partial 16 a 19 heritability 17 partial 19 heritability 18 linked 19 heritability 19 heritability 20 of 20 of 22 and 21 longevity 22 and 22 and 23 optimism the epidemiology of iatrogenic disease in the elderly has not been extensively reported . 0 ###LEFT-WALL### 2 epidemiology 0 ###LEFT-WALL### 13 reported 0 ###LEFT-WALL### 14 . 1 the 2 epidemiology 2 epidemiology 3 of 2 epidemiology 9 has 3 of 5 disease 4 iatrogenic 5 disease 5 disease 6 in 6 in 8 elderly 7 the 8 elderly 9 has 10 not 9 has 11 been 11 been 13 reported 12 extensively 13 reported risk factors of iatrogenic disease in the elderly [are] drug - induced iatrogenic disease , multiple chronic diseases , multiple physicians , hospitalization , and medical or surgical procedures . 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 30 . 1 risk 2 factors 2 factors 3 of 2 factors 25 and 3 of 5 disease 4 iatrogenic 5 disease 5 disease 6 in 6 in 10 drug 7 the 10 drug 8 elderly 10 drug 10 drug 14 disease 10 drug 18 diseases 11 - 14 disease 12 induced 14 disease 13 iatrogenic 14 disease 14 disease 15 , 15 , 18 diseases 16 multiple 18 diseases 17 chronic 18 diseases 18 diseases 21 physicians 18 diseases 23 hospitalization 18 diseases 24 , 19 , 21 physicians 20 multiple 21 physicians 21 physicians 22 , 22 , 23 hospitalization 23 hospitalization 24 , 24 , 25 and 25 and 29 procedures 26 medical 27 or 27 or 28 surgical 27 or 29 procedures iatrogenic disease can have a great psychomotor impact and important social consequences . 0 ###LEFT-WALL### 2 disease 0 ###LEFT-WALL### 4 have 0 ###LEFT-WALL### 13 . 1 iatrogenic 2 disease 2 disease 3 can 3 can 4 have 4 have 9 and 5 a 6 great 5 a 8 impact 6 great 7 psychomotor 7 psychomotor 8 impact 8 impact 9 and 9 and 12 consequences 10 important 12 consequences 11 social 12 consequences to [identify] patients at high risk is the first step in prevention as most of the iatrogenic diseases are preventable . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 21 . 1 to 3 patients 1 to 7 is 3 patients 4 at 4 at 6 risk 5 high 6 risk 7 is 10 step 7 is 20 preventable 8 the 9 first 8 the 10 step 10 step 11 in 10 step 13 as 11 in 12 prevention 13 as 14 most 14 most 15 of 14 most 18 diseases 14 most 19 are 15 of 17 iatrogenic 16 the 17 iatrogenic 18 diseases 19 are interventions that can prevent iatrogenic complications include specific interventions , the use of a geriatric interdisciplinary team , pharmacist consultation and acute care for the elderly units . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 7 include 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 28 . 1 interventions 2 that 1 interventions 3 can 1 interventions 7 include 2 that 3 can 3 can 4 prevent 4 prevent 6 complications 5 iatrogenic 6 complications 7 include 9 interventions 8 specific 9 interventions 10 , 21 and 11 the 12 use 12 use 13 of 12 use 18 , 13 of 17 team 14 a 17 team 15 geriatric 17 team 16 interdisciplinary 17 team 18 , 20 consultation 18 , 21 and 19 pharmacist 20 consultation 21 and 23 care 21 and 24 for 22 acute 23 care 24 for 27 units 25 the 27 units 26 elderly 27 units purpose : to determine the prevalence of sarcopenia and investigate relationships among body composition , muscle strength , and physical function in elderly women in low - level aged care . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 9 and 2 : 31 . 3 to 9 and 4 determine 6 prevalence 4 determine 9 and 5 the 6 prevalence 6 prevalence 7 of 7 of 8 sarcopenia 9 and 10 investigate 9 and 12 among 9 and 22 in 9 and 30 care 10 investigate 11 relationships 12 among 19 and 13 body 14 composition 14 composition 15 , 15 , 17 strength 15 , 19 and 16 muscle 17 strength 18 , 19 and 19 and 21 function 20 physical 21 function 22 in 24 women 23 elderly 24 women 24 women 25 in 25 in 28 level 26 low 27 - 26 low 28 level 29 aged 30 care body composition data from a female reference group ( n = 62 , mean age 29 years ) provided cut [-] off values for defining sarcopenia . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 20 cut 0 ###LEFT-WALL### 27 . 1 body 2 composition 2 composition 3 data 3 data 4 from 3 data 19 provided 3 data 20 cut 4 from 8 group 5 a 6 female 5 a 8 group 6 female 7 reference 7 reference 8 group 8 group 11 = 8 group 17 years 9 ( 11 = 10 n 11 = 11 = 12 62 11 = 13 , 13 , 17 years 14 mean 17 years 15 age 17 years 16 29 17 years 17 years 18 ) 20 cut 22 off 20 cut 23 values 20 cut 24 for 24 for 25 defining 25 defining 26 sarcopenia results : elderly women had higher [body] mass [index] ( p < 0.001 ) , lower lean [mass] ( p < 0.001 ) , and higher fat [mass] ( p < 0.01 ) than the young reference group . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 39 . 1 results 2 : 2 : 3 elderly 3 elderly 4 women 3 elderly 5 had 4 women 5 had 5 had 6 higher 5 had 8 mass 8 mass 12 < 10 ( 12 < 11 p 12 < 12 < 13 0.001 12 < 14 ) 15 , 16 lower 16 lower 27 fat 16 lower 34 than 17 lean 21 < 17 lean 25 and 19 ( 21 < 20 p 21 < 21 < 22 0.001 21 < 23 ) 24 , 25 and 25 and 26 higher 25 and 27 fat 27 fat 31 < 29 ( 31 < 30 p 31 < 31 < 32 0.01 31 < 33 ) 34 than 38 group 35 the 38 group 36 young 37 reference 37 reference 38 group only a small proportion ( 3.2 % ) had absolute sarcopenia ( defined by appendicular skeletal muscle mass/height squared ) whereas 37 % had relative sarcopenia class ii ( defined by percentage skeletal muscle [mass] ) . 0 ###LEFT-WALL### 1 only 0 ###LEFT-WALL### 9 had 0 ###LEFT-WALL### 37 . 1 only 4 proportion 2 a 3 small 2 a 4 proportion 3 small 4 proportion 4 proportion 7 % 4 proportion 9 had 5 ( 7 % 6 3.2 7 % 7 % 8 ) 9 had 11 sarcopenia 9 had 13 defined 9 had 21 whereas 10 absolute 11 sarcopenia 12 ( 13 defined 13 defined 14 by 13 defined 20 ) 14 by 18 mass/height 15 appendicular 17 muscle 16 skeletal 17 muscle 17 muscle 18 mass/height 18 mass/height 19 squared 21 whereas 23 % 21 whereas 24 had 22 37 23 % 23 % 24 had 24 had 27 class 24 had 30 defined 25 relative 27 class 26 sarcopenia 27 class 27 class 28 ii 29 ( 30 defined 30 defined 31 by 30 defined 36 ) 31 by 34 muscle 32 percentage 34 muscle 33 skeletal 34 muscle scores for tug and ws indicated relatively poor physical function , yet these measures were not associated with muscle [mass] or indices of sarcopenia . 0 ###LEFT-WALL### 10 function 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 25 . 1 scores 2 for 1 scores 4 and 2 for 3 tug 4 and 5 ws 5 ws 6 indicated 6 indicated 10 function 7 relatively 8 poor 8 poor 10 function 9 physical 10 function 11 , 12 yet 11 , 15 were 12 yet 14 measures 13 these 14 measures 14 measures 15 were 15 were 16 not 15 were 18 with 16 not 17 associated 18 with 21 or 19 muscle 21 or 21 or 22 indices 21 or 23 of 23 of 24 sarcopenia in multivariate analysis , only hip abductor strength predicted both tug and ws ( [both] p = 0.01 ) . 0 ###LEFT-WALL### 5 only 0 ###LEFT-WALL### 9 predicted 0 ###LEFT-WALL### 20 . 1 in 3 analysis 1 in 4 , 1 in 5 only 2 multivariate 3 analysis 5 only 8 strength 6 hip 7 abductor 7 abductor 8 strength 8 strength 9 predicted 9 predicted 12 and 10 both 12 and 11 tug 12 and 12 and 13 ws 12 and 17 = 14 ( 17 = 16 p 17 = 17 = 18 0.01 17 = 19 ) conclusion : hip strength is a more important indicator of physical functioning than lean mass . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 strength 2 : 5 is 2 : 16 . 3 hip 4 strength 4 strength 5 is 5 is 9 indicator 5 is 13 than 6 a 9 indicator 7 more 8 important 8 important 9 indicator 9 indicator 10 of 10 of 12 functioning 11 physical 12 functioning 13 than 15 mass 14 lean 15 mass measurement of hip strength may therefore be a useful screening tool to detect those at risk of functional decline [and] requirement for additional care . 0 ###LEFT-WALL### 1 measurement 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 25 . 1 measurement 2 of 1 measurement 5 may 2 of 4 strength 3 hip 4 strength 5 may 7 be 6 therefore 7 be 7 be 11 tool 7 be 12 to 8 a 11 tool 9 useful 11 tool 10 screening 11 tool 12 to 13 detect 13 detect 14 those 13 detect 15 at 15 at 16 risk 16 risk 17 of 16 risk 22 for 17 of 21 requirement 18 functional 19 decline 19 decline 21 requirement 22 for 24 care 23 additional 24 care further longitudinal studies with a range of other strength measures are warranted . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 12 warranted 0 ###LEFT-WALL### 13 . 1 further 3 studies 2 longitudinal 3 studies 3 studies 4 with 3 studies 11 are 4 with 6 range 5 a 6 range 6 range 7 of 7 of 10 measures 8 other 10 measures 9 strength 10 measures 11 are 12 warranted clinical question : is there evidence that hip protectors and vitamin d with calcium supplementation reduce hip fractures in the elderly ? 0 ###LEFT-WALL### 2 question 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 22 ? 1 clinical 2 question 3 : 4 is 4 is 5 there 4 is 6 evidence 6 evidence 7 that 7 that 10 and 7 that 16 reduce 8 hip 9 protectors 9 protectors 10 and 10 and 11 vitamin 10 and 13 with 10 and 16 reduce 11 vitamin 12 d 13 with 15 supplementation 14 calcium 15 supplementation 16 reduce 18 fractures 16 reduce 19 in 17 hip 18 fractures 19 in 21 elderly 20 the 21 elderly results : the results are that vitamin d and calcium supplementation [reduce] incidence of hip fractures . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 are 2 : 17 . 3 the 4 results 4 results 5 are 5 are 9 and 6 that 9 and 7 vitamin 8 d 7 vitamin 9 and 9 and 13 incidence 9 and 14 of 10 calcium 13 incidence 11 supplementation 13 incidence 14 of 16 fractures 15 hip 16 fractures hip protectors provide some benefit in reducing hip fractures in elderly patients in residential facilities . 0 ###LEFT-WALL### 2 protectors 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 16 . 1 hip 2 protectors 2 protectors 3 provide 3 provide 5 benefit 3 provide 6 in 3 provide 10 in 3 provide 13 in 4 some 5 benefit 6 in 7 reducing 7 reducing 9 fractures 8 hip 9 fractures 10 in 12 patients 11 elderly 12 patients 13 in 15 facilities 14 residential 15 facilities implementation : primary care providers should assess patients for the risk [of] hip fracture and consider using hip protectors and nutritional supplementation in selected individuals to prevent fractures . 0 ###LEFT-WALL### 1 implementation 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 consider 0 ###LEFT-WALL### 29 . 2 : 3 primary 3 primary 5 providers 3 primary 16 consider 4 care 5 providers 5 providers 6 should 6 should 15 and 7 assess 8 patients 7 assess 9 for 7 assess 15 and 9 for 14 fracture 10 the 14 fracture 11 risk 14 fracture 13 hip 14 fracture 15 and 16 consider 16 consider 17 using 16 consider 23 in 16 consider 26 to 16 consider 27 prevent 17 using 20 and 18 hip 19 protectors 19 protectors 20 and 20 and 22 supplementation 21 nutritional 22 supplementation 23 in 25 individuals 24 selected 25 individuals 26 to 27 prevent 27 prevent 28 fractures alzheimer 's disease ( ad ) is the most common neurodegenerative disorder , originating sporadically in the population aged over 65 years , and advanced age is the principal risk factor leading to ad development . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 36 . 1 alzheimer 2 's 2 's 3 disease 3 disease 5 ad 3 disease 7 is 4 ( 5 ad 5 ad 6 ) 7 is 12 disorder 8 the 12 disorder 9 most 10 common 10 common 12 disorder 11 neurodegenerative 12 disorder 12 disorder 14 originating 13 , 14 originating 14 originating 15 sporadically 14 originating 16 in 14 originating 20 over 14 originating 23 , 16 in 18 population 17 the 18 population 18 population 19 aged 20 over 22 years 21 65 22 years 24 and 26 age 24 and 27 is 25 advanced 26 age 26 age 27 is 27 is 32 leading 28 the 32 leading 29 principal 32 leading 30 risk 32 leading 31 factor 32 leading 32 leading 33 to 33 to 35 development 34 ad 35 development in spite of the large amount of research going on around the globe and all the information now available about ad [,] there is still no origin or triggering process known so far . 0 ###LEFT-WALL### 25 still 0 ###LEFT-WALL### 34 . 1 in 14 and 1 in 25 still 2 spite 3 of 2 spite 14 and 3 of 8 research 4 the 6 amount 5 large 6 amount 6 amount 7 of 6 amount 8 research 7 of 8 research 8 research 9 going 9 going 10 on 9 going 11 around 11 around 13 globe 12 the 13 globe 14 and 15 all 14 and 17 information 14 and 24 is 16 the 17 information 17 information 18 now 17 information 19 available 17 information 24 is 19 available 20 about 19 available 23 there 20 about 21 ad 25 still 28 or 25 still 33 far 26 no 27 origin 27 origin 28 or 28 or 30 process 28 or 31 known 29 triggering 30 process 32 so 33 far drugs approved for the treatment of ad include tacrine , donepezil , rivastigmine , galantamine , and memantine . 0 ###LEFT-WALL### 1 drugs 0 ###LEFT-WALL### 8 include 0 ###LEFT-WALL### 19 . 1 drugs 2 approved 1 drugs 3 for 1 drugs 8 include 3 for 5 treatment 4 the 5 treatment 5 treatment 6 of 6 of 7 ad 8 include 17 and 9 tacrine 10 , 10 , 11 donepezil 10 , 12 , 12 , 13 rivastigmine 12 , 14 , 14 , 15 galantamine 14 , 17 and 16 , 17 and 17 and 18 memantine these may delay or slow down the degenerative process for a while , but they can neither stop nor reverse its progression . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 4 or 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 23 . 1 these 4 or 2 may 3 delay 2 may 4 or 4 or 5 slow 5 slow 6 down 5 slow 9 process 7 the 9 process 8 degenerative 9 process 9 process 10 for 10 for 12 while 11 a 12 while 13 , 14 but 14 but 15 they 14 but 19 nor 15 they 16 can 16 can 19 nor 17 neither 18 stop 18 stop 19 nor 19 nor 20 reverse 20 reverse 22 progression 21 its 22 progression because that this might be due to a lack of effect of these drugs on degenerating neurons , even when they are able to potentiate the brain in nondegenerative conditions , we propose here an alternative therapy consisting of initial repair of neuronal membranes followed by conventional drug therapies . 0 ###LEFT-WALL### 1 because 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 45 followed 0 ###LEFT-WALL### 50 . 1 because 2 that 2 that 3 this 2 that 5 be 3 this 4 might 4 might 5 be 5 be 7 to 5 be 15 on 6 due 7 to 7 to 9 lack 8 a 9 lack 9 lack 10 of 10 of 11 effect 11 effect 12 of 12 of 14 drugs 13 these 14 drugs 15 on 17 neurons 16 degenerating 17 neurons 18 , 32 we 18 , 33 propose 19 even 20 when 19 even 32 we 20 when 21 they 20 when 22 are 21 they 22 are 22 are 23 able 23 able 24 to 24 to 25 potentiate 25 potentiate 27 brain 26 the 27 brain 28 in 30 conditions 28 in 31 , 28 in 32 we 29 nondegenerative 30 conditions 32 we 33 propose 33 propose 34 here 33 propose 36 alternative 35 an 36 alternative 36 alternative 37 therapy 36 alternative 45 followed 37 therapy 38 consisting 37 therapy 42 of 37 therapy 45 followed 38 consisting 39 of 39 of 41 repair 40 initial 41 repair 42 of 44 membranes 43 neuronal 44 membranes 45 followed 46 by 46 by 49 therapies 47 conventional 48 drug 48 drug 49 therapies the rehabilitation of neurons in a degeneration process would enable the drugs to act more effectively on them and improve the effects of treatment in ad patients . 0 ###LEFT-WALL### 2 rehabilitation 0 ###LEFT-WALL### 10 enable 0 ###LEFT-WALL### 28 . 1 the 2 rehabilitation 2 rehabilitation 3 of 2 rehabilitation 5 in 2 rehabilitation 9 would 3 of 4 neurons 5 in 8 process 6 a 7 degeneration 6 a 8 process 7 degeneration 8 process 9 would 10 enable 10 enable 12 drugs 10 enable 13 to 10 enable 19 and 11 the 12 drugs 13 to 19 and 14 act 16 effectively 14 act 17 on 14 act 19 and 15 more 16 effectively 17 on 18 them 19 and 20 improve 19 and 27 patients 20 improve 22 effects 20 improve 25 in 21 the 22 effects 22 effects 23 of 23 of 24 treatment 25 in 26 ad objective : to describe a practical method for family practitioners to stage chronic obstructive pulmonary disease ( copd ) by the use of office spirometry . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 describe 2 : 26 . 3 to 4 describe 4 describe 7 method 4 describe 11 to 5 a 6 practical 5 a 7 method 6 practical 7 method 7 method 8 for 8 for 10 practitioners 9 family 10 practitioners 11 to 12 stage 12 stage 16 disease 12 stage 20 by 13 chronic 16 disease 14 obstructive 16 disease 15 pulmonary 16 disease 16 disease 18 copd 17 ( 18 copd 18 copd 19 ) 20 by 22 use 21 the 22 use 22 use 23 of 23 of 25 spirometry 24 office 25 spirometry methods : this is a review of the lessons learned from evaluations of the use of office spirometry in the primary care setting to identify best practices using the most recent published evaluations of office spirometry and the analysis of preliminary data from a recent spirometry mass screening project . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 50 . 2 : 3 this 2 : 4 is 3 this 4 is 4 is 6 review 5 a 6 review 6 review 7 of 6 review 11 from 7 of 9 lessons 8 the 9 lessons 9 lessons 10 learned 11 from 12 evaluations 12 evaluations 13 of 12 evaluations 16 of 13 of 15 use 14 the 15 use 16 of 18 spirometry 17 office 18 spirometry 18 spirometry 19 in 18 spirometry 28 using 19 in 22 care 20 the 22 care 21 primary 22 care 22 care 23 setting 23 setting 24 to 24 to 25 identify 25 identify 26 best 25 identify 27 practices 28 using 37 and 29 the 37 and 30 most 31 recent 31 recent 33 evaluations 32 published 33 evaluations 33 evaluations 34 of 33 evaluations 37 and 34 of 36 spirometry 35 office 36 spirometry 37 and 39 analysis 37 and 40 of 38 the 39 analysis 40 of 42 data 41 preliminary 42 data 42 data 43 from 43 from 49 project 44 a 49 project 45 recent 49 project 46 spirometry 49 project 47 mass 49 project 48 screening 49 project a mass screening study by the american association for respiratory care and the copd foundation was used to identify the most effective way for general practitioners to implement office spirometry in order to stage copd . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 17 used 0 ###LEFT-WALL### 36 . 1 a 4 study 2 mass 4 study 3 screening 4 study 4 study 5 by 4 study 16 was 5 by 12 and 6 the 8 association 7 american 8 association 8 association 9 for 8 association 12 and 9 for 11 care 10 respiratory 11 care 12 and 15 foundation 13 the 15 foundation 14 copd 15 foundation 16 was 17 used 17 used 18 to 17 used 19 identify 18 to 19 identify 19 identify 23 way 20 the 23 way 21 most 22 effective 22 effective 23 way 23 way 24 for 23 way 26 practitioners 23 way 34 stage 24 for 25 general 26 practitioners 27 to 26 practitioners 33 to 26 practitioners 34 stage 27 to 28 implement 28 implement 30 spirometry 28 implement 33 to 29 office 30 spirometry 30 spirometry 31 in 31 in 32 order 34 stage 35 copd results : a simple [three] - step method is described to identify people with a high pre - test probability in an attempt to detect moderate to severe copd : copd questionnaire , measurement of peak expiratory flow , and office spirometry . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 12 identify 0 ###LEFT-WALL### 30 : 0 ###LEFT-WALL### 43 . 1 results 2 : 2 : 7 step 3 a 4 simple 3 a 7 step 4 simple 6 - 4 simple 7 step 7 step 8 method 7 step 12 identify 8 method 9 is 9 is 10 described 10 described 11 to 11 to 12 identify 12 identify 13 people 12 identify 14 with 14 with 17 pre 15 a 17 pre 16 high 17 pre 17 pre 20 probability 18 - 20 probability 19 test 20 probability 20 probability 21 in 20 probability 26 moderate 20 probability 30 : 21 in 23 attempt 22 an 23 attempt 23 attempt 24 to 23 attempt 25 detect 24 to 25 detect 26 moderate 27 to 27 to 29 copd 28 severe 29 copd 30 : 32 questionnaire 30 : 33 , 31 copd 32 questionnaire 33 , 40 and 33 , 42 spirometry 34 measurement 35 of 34 measurement 40 and 35 of 38 flow 36 peak 38 flow 37 expiratory 38 flow 39 , 40 and 40 and 41 office 40 and 42 spirometry clinical practice guidelines exist for office spirometry basics for safety , use of electronic peak flow devices , and portable spirometers . 0 ###LEFT-WALL### 3 guidelines 0 ###LEFT-WALL### 4 exist 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 22 . 1 clinical 2 practice 2 practice 3 guidelines 3 guidelines 4 exist 4 exist 5 for 4 exist 9 for 5 for 8 basics 6 office 7 spirometry 7 spirometry 8 basics 9 for 10 safety 11 , 19 and 12 use 13 of 12 use 19 and 13 of 17 devices 14 electronic 17 devices 15 peak 17 devices 16 flow 17 devices 18 , 19 and 19 and 21 spirometers 20 portable 21 spirometers conclusion : spirometry can be undertaken in primary care offices with acceptable levels of technical expertise . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 spirometry 2 : 6 undertaken 2 : 17 . 3 spirometry 4 can 4 can 5 be 5 be 6 undertaken 6 undertaken 7 in 6 undertaken 11 with 7 in 10 offices 8 primary 9 care 9 care 10 offices 11 with 13 levels 12 acceptable 13 levels 13 levels 14 of 14 of 16 expertise 15 technical 16 expertise using office spirometry , primary care physicians can diagnose the presence and severity of copd . 0 ###LEFT-WALL### 7 physicians 0 ###LEFT-WALL### 9 diagnose 0 ###LEFT-WALL### 16 . 1 using 3 spirometry 1 using 4 , 1 using 7 physicians 2 office 3 spirometry 5 primary 7 physicians 6 care 7 physicians 7 physicians 8 can 8 can 9 diagnose 9 diagnose 12 and 10 the 11 presence 11 presence 12 and 12 and 13 severity 12 and 14 of 14 of 15 copd spirometry can guide therapies for copd and predict outcomes when used in general practice . 0 ###LEFT-WALL### 1 spirometry 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 . 1 spirometry 2 can 2 can 7 and 3 guide 4 therapies 3 guide 7 and 4 therapies 5 for 5 for 6 copd 7 and 8 predict 8 predict 9 outcomes 8 predict 10 when 10 when 11 used 11 used 12 in 12 in 14 practice 13 general 14 practice background : gerontological research aims at understanding factors that are crucial for mediating " successful aging " . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 background 2 : 2 : 5 aims 3 gerontological 5 aims 4 research 5 aims 5 aims 6 at 5 aims 12 for 6 at 7 understanding 7 understanding 8 factors 8 factors 9 that 8 factors 10 are 9 that 10 are 10 are 11 crucial 12 for 13 mediating 13 mediating 14 " 13 mediating 16 aging 15 successful 16 aging 16 aging 17 " this term denotes the absence of significant disease and disabilities , maintenance of high levels of physical and cognitive function , and preservation of social and productive activities . 0 ###LEFT-WALL### 2 term 0 ###LEFT-WALL### 3 denotes 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 29 . 1 this 2 term 2 term 3 denotes 3 denotes 5 absence 4 the 5 absence 5 absence 6 of 6 of 9 and 7 significant 8 disease 8 disease 9 and 9 and 10 disabilities 11 , 22 and 12 maintenance 13 of 12 maintenance 22 and 13 of 15 levels 14 high 15 levels 15 levels 16 of 16 of 18 and 17 physical 18 and 18 and 20 function 19 cognitive 20 function 21 , 22 and 22 and 23 preservation 22 and 24 of 24 of 28 activities 25 social 26 and 26 and 27 productive 26 and 28 activities preservation of an active lifestyle is considered an effective means through which everyday competence can be attained . 0 ###LEFT-WALL### 1 preservation 0 ###LEFT-WALL### 7 considered 0 ###LEFT-WALL### 18 . 1 preservation 2 of 1 preservation 6 is 2 of 5 lifestyle 3 an 4 active 3 an 5 lifestyle 4 active 5 lifestyle 6 is 7 considered 7 considered 10 means 8 an 9 effective 8 an 10 means 9 effective 10 means 10 means 11 through 11 through 12 which 11 through 14 competence 11 through 17 attained 13 everyday 14 competence 14 competence 15 can 15 can 16 be 16 be 17 attained in this context , it is crucial to obtain ratings of modern [day] older adults ' everyday competence by means of appropriate assessments . 0 ###LEFT-WALL### 5 it 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 24 . 1 in 3 context 1 in 4 , 1 in 5 it 2 this 3 context 5 it 6 is 6 is 7 crucial 7 crucial 8 to 7 crucial 9 obtain 8 to 9 obtain 9 obtain 10 ratings 9 obtain 19 by 10 ratings 11 of 11 of 18 competence 12 modern 15 adults 14 older 15 adults 15 adults 16 ' 16 ' 18 competence 17 everyday 18 competence 19 by 20 means 20 means 21 of 21 of 23 assessments 22 appropriate 23 assessments here , we introduce the everyday competence questionnaire ( ecq ) , designed to assess healthy older adults ' everyday competence . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 22 . 1 here 2 , 1 here 3 we 3 we 12 , 4 introduce 10 ecq 4 introduce 12 , 5 the 10 ecq 6 everyday 7 competence 7 competence 8 questionnaire 8 questionnaire 10 ecq 9 ( 10 ecq 10 ecq 11 ) 12 , 13 designed 12 , 14 to 14 to 15 assess 15 assess 21 competence 16 healthy 18 adults 17 older 18 adults 18 adults 19 ' 19 ' 21 competence 20 everyday 21 competence methods : the ecq includes 17 items , covering housekeeping , leisure activities , sports , daily routines , manual skills , subjective well - being , and general linguistic usage . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 4 ecq 2 : 5 includes 2 : 25 - 3 the 4 ecq 4 ecq 5 includes 5 includes 7 items 6 17 7 items 7 items 9 covering 7 items 13 activities 7 items 18 routines 8 , 9 covering 9 covering 10 housekeeping 9 covering 11 , 11 , 13 activities 12 leisure 13 activities 13 activities 15 sports 13 activities 16 , 14 , 15 sports 15 sports 16 , 16 , 18 routines 17 daily 18 routines 18 routines 21 skills 18 routines 24 well 18 routines 25 - 19 , 21 skills 20 manual 21 skills 21 skills 22 , 22 , 24 well 23 subjective 24 well 24 well 25 - 25 - 28 and 26 being 28 and 27 , 28 and 28 and 31 usage 29 general 31 usage 30 linguistic 31 usage the ecq was administered to a population of 158 healthy subjects aged 60 - 91 years , who were divided into groups on the basis of their physical activity . 0 ###LEFT-WALL### 2 ecq 0 ###LEFT-WALL### 4 administered 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 30 . 1 the 2 ecq 2 ecq 3 was 3 was 4 administered 4 administered 5 to 5 to 16 years 6 a 7 population 7 population 8 of 7 population 12 aged 8 of 11 subjects 9 158 11 subjects 10 healthy 11 subjects 12 aged 14 - 13 60 14 - 14 - 15 91 15 91 16 years 17 , 18 who 17 , 20 divided 18 who 19 were 19 were 20 divided 20 divided 21 into 20 divided 23 on 21 into 22 groups 23 on 25 basis 24 the 25 basis 25 basis 26 of 26 of 29 activity 27 their 29 activity 28 physical 29 activity these groups were community [-] dwelling subjects , those living independently and [having] a sedentary lifestyle , those living independently [but] characterized by a general lifestyle without any noteworthy physical activity , and those living independently and exercising regularly . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 3 were 1 these 2 groups 2 groups 3 were 3 were 12 and 4 community 6 dwelling 6 dwelling 7 subjects 7 subjects 8 , 8 , 9 those 8 , 12 and 9 those 10 living 10 living 11 independently 12 and 16 lifestyle 12 and 18 those 14 a 16 lifestyle 15 sedentary 16 lifestyle 17 , 18 those 18 those 19 living 18 those 22 characterized 18 those 40 . 20 independently 22 characterized 22 characterized 23 by 22 characterized 27 without 22 characterized 39 regularly 23 by 26 lifestyle 24 a 26 lifestyle 25 general 26 lifestyle 27 without 37 and 28 any 31 activity 29 noteworthy 31 activity 30 physical 31 activity 31 activity 33 and 32 , 33 and 33 and 34 those 33 and 35 living 33 and 37 and 35 living 36 independently 37 and 38 exercising age , gender , and education levels were balanced between the groups . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 balanced 0 ###LEFT-WALL### 13 . 1 age 2 , 2 , 3 gender 2 , 5 and 4 , 5 and 5 and 7 levels 5 and 8 were 6 education 7 levels 8 were 9 balanced 9 balanced 10 between 10 between 12 groups 11 the 12 groups results : using the ecq , we could [identify] and [distinguish] different everyday competence levels between the groups tested : subjects characterized by an active lifestyle outperformed all other groups . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 we 2 : 8 could 2 : 10 and 2 : 20 : 3 using 5 ecq 3 using 6 , 3 using 7 we 4 the 5 ecq 7 we 8 could 10 and 14 competence 10 and 15 levels 12 different 14 competence 13 everyday 14 competence 14 competence 15 levels 15 levels 16 between 16 between 18 groups 17 the 18 groups 18 groups 19 tested 20 : 21 subjects 20 : 27 outperformed 20 : 31 . 21 subjects 22 characterized 21 subjects 23 by 21 subjects 27 outperformed 23 by 26 lifestyle 24 an 26 lifestyle 25 active 26 lifestyle 27 outperformed 30 groups 28 all 29 other 29 other 30 groups subjects characterized by a general lifestyle showed higher everyday competence than those with a sedentary lifestyle or subjects who needed care . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 7 showed 0 ###LEFT-WALL### 22 . 1 subjects 2 characterized 1 subjects 7 showed 2 characterized 3 by 3 by 6 lifestyle 4 a 5 general 4 a 6 lifestyle 5 general 6 lifestyle 7 showed 10 competence 7 showed 11 than 8 higher 10 competence 9 everyday 10 competence 11 than 17 or 12 those 13 with 12 those 17 or 13 with 16 lifestyle 14 a 16 lifestyle 15 sedentary 16 lifestyle 17 or 18 subjects 17 or 19 who 17 or 20 needed 19 who 20 needed 20 needed 21 care furthermore , the ecq data showed a significant positive correlation between individual physical activity and everyday competence . 0 ###LEFT-WALL### 5 data 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 18 . 1 furthermore 2 , 1 furthermore 5 data 3 the 5 data 4 ecq 5 data 5 data 6 showed 6 showed 10 correlation 6 showed 11 between 7 a 8 significant 7 a 10 correlation 8 significant 10 correlation 9 positive 10 correlation 11 between 15 and 12 individual 14 activity 13 physical 14 activity 14 activity 15 and 15 and 17 competence 16 everyday 17 competence conclusion : the ecq is a novel tool for the questionnaire [-] based evaluation of everyday competence among healthy subjects . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 ecq 2 : 5 is 2 : 21 . 3 the 4 ecq 4 ecq 5 is 5 is 8 tool 6 a 8 tool 7 novel 8 tool 8 tool 9 for 9 for 14 evaluation 10 the 14 evaluation 11 questionnaire 13 based 13 based 14 evaluation 14 evaluation 15 of 15 of 17 competence 16 everyday 17 competence 17 competence 18 among 18 among 20 subjects 19 healthy 20 subjects by including leisure activities , it considers the changed living conditions of modern - day older adults . 0 ###LEFT-WALL### 6 it 0 ###LEFT-WALL### 7 considers 0 ###LEFT-WALL### 18 . 1 by 2 including 1 by 5 , 1 by 6 it 2 including 4 activities 3 leisure 4 activities 6 it 7 considers 7 considers 11 conditions 7 considers 17 adults 8 the 11 conditions 9 changed 10 living 10 living 11 conditions 11 conditions 12 of 12 of 15 day 13 modern 14 - 13 modern 15 day 16 older 17 adults age is one of the strongest predictors of cardiovascular disease ( cvd ) risk . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 15 . 1 age 2 is 2 is 3 one 2 is 14 risk 3 one 4 of 4 of 7 predictors 5 the 6 strongest 5 the 7 predictors 7 predictors 8 of 8 of 10 disease 9 cardiovascular 10 disease 10 disease 12 cvd 11 ( 12 cvd 12 cvd 13 ) treatment with statins can significantly reduce cvd events and mortality in both primary and secondary prevention . 0 ###LEFT-WALL### 1 treatment 0 ###LEFT-WALL### 6 reduce 0 ###LEFT-WALL### 17 . 1 treatment 2 with 1 treatment 4 can 2 with 3 statins 4 can 6 reduce 5 significantly 6 reduce 6 reduce 9 and 6 reduce 11 in 7 cvd 8 events 8 events 9 and 9 and 10 mortality 11 in 14 and 12 both 14 and 13 primary 14 and 14 and 16 prevention 15 secondary 16 prevention yet despite the high cvd risk among the elderly , there is underutilization of statins in this population ( ie , the treatment - risk [paradox] ) . 0 ###LEFT-WALL### 1 yet 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 28 . 1 yet 11 there 2 despite 6 risk 2 despite 10 , 2 despite 11 there 3 the 6 risk 4 high 6 risk 5 cvd 6 risk 6 risk 7 among 7 among 9 elderly 8 the 9 elderly 11 there 12 is 12 is 13 underutilization 13 underutilization 14 of 14 of 15 statins 15 statins 16 in 15 statins 25 risk 16 in 18 population 17 this 18 population 19 ( 25 risk 20 ie 23 treatment 20 ie 24 - 20 ie 25 risk 21 , 23 treatment 22 the 23 treatment 23 treatment 24 - 25 risk 27 ) few studies have investigated the use of statins in the elderly , particularly [for] primary prevention and , as a result , guidelines for treating the elderly are limited . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 30 . 1 few 2 studies 2 studies 3 have 3 have 4 investigated 4 investigated 6 use 4 investigated 9 in 5 the 6 use 6 use 7 of 7 of 8 statins 9 in 16 prevention 10 the 16 prevention 11 elderly 12 , 11 elderly 16 prevention 13 particularly 15 primary 15 primary 16 prevention 17 and 18 , 17 and 23 guidelines 17 and 28 are 19 as 21 result 19 as 22 , 19 as 23 guidelines 20 a 21 result 23 guidelines 24 for 23 guidelines 28 are 24 for 25 treating 25 treating 27 elderly 26 the 27 elderly 28 are 29 limited this is likely due to [:] uncertainties of risk assessment in older individuals where the predictive value of individual risk factors is [decreased] [;] the need to balance the benefits of primary prevention with the risks of polypharmacy , health care costs , and adverse medication effects in a population with decreased life expectancy [;] the complexity of treating patients with many other comorbidities [;] and increasingly difficult social and economic concerns . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 1 this 2 is 2 is 3 likely 3 likely 5 to 3 likely 11 in 4 due 5 to 5 to 7 uncertainties 7 uncertainties 8 of 8 of 10 assessment 9 risk 10 assessment 11 in 13 individuals 12 older 13 individuals 13 individuals 14 where 14 where 17 value 14 where 22 is 15 the 17 value 16 predictive 17 value 17 value 18 of 17 value 22 is 18 of 21 factors 19 individual 21 factors 20 risk 21 factors 22 is 26 need 25 the 26 need 26 need 27 to 26 need 28 balance 27 to 28 balance 28 balance 30 benefits 28 balance 34 with 29 the 30 benefits 30 benefits 31 of 31 of 33 prevention 32 primary 33 prevention 34 with 44 and 35 the 36 risks 36 risks 37 of 36 risks 44 and 37 of 38 polypharmacy 38 polypharmacy 42 costs 39 , 42 costs 40 health 41 care 41 care 42 costs 42 costs 43 , 44 and 45 adverse 44 and 46 medication 44 and 47 effects 46 medication 47 effects 47 effects 48 in 47 effects 51 with 48 in 50 population 49 a 50 population 51 with 54 expectancy 51 with 57 complexity 52 decreased 54 expectancy 53 life 54 expectancy 56 the 57 complexity 57 complexity 58 of 58 of 60 patients 59 treating 60 patients 60 patients 61 with 61 with 70 and 62 many 63 other 63 other 64 comorbidities 64 comorbidities 66 and 66 and 69 social 66 and 70 and 67 increasingly 68 difficult 68 difficult 69 social 70 and 72 concerns 70 and 73 . 71 economic 72 concerns as life expectancy increases and the total elderly population grows , these issues become [increasingly] important . 0 ###LEFT-WALL### 9 population 0 ###LEFT-WALL### 10 grows 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 17 . 1 as 5 and 1 as 9 population 2 life 4 increases 3 expectancy 4 increases 4 increases 5 and 5 and 7 total 6 the 7 total 8 elderly 9 population 9 population 10 grows 11 , 13 issues 11 , 14 become 12 these 13 issues 13 issues 14 become 14 become 16 important jupiter ( justification for the use of statins in prevention [:] [an] intervention trial evaluating rosuvastatin ) is the largest primary prevention statin trial to date and enrolled a substantial number of elderly adults . 0 ###LEFT-WALL### 1 jupiter 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 35 . 1 jupiter 3 justification 1 jupiter 18 is 2 ( 3 justification 3 justification 4 for 3 justification 17 ) 4 for 6 use 5 the 6 use 6 use 7 of 7 of 8 statins 8 statins 9 in 9 in 16 rosuvastatin 10 prevention 13 intervention 13 intervention 14 trial 14 trial 15 evaluating 15 evaluating 16 rosuvastatin 18 is 24 trial 18 is 25 to 19 the 20 largest 19 the 24 trial 21 primary 24 trial 22 prevention 24 trial 23 statin 24 trial 25 to 27 and 26 date 27 and 27 and 28 enrolled 28 enrolled 31 number 29 a 31 number 30 substantial 31 number 31 number 32 of 32 of 34 adults 33 elderly 34 adults among the 5695 jupiter participants ≥ 70 years of age , the absolute cvd risk reduction associated with rosuvastatin was actually greater than for younger participants . 0 ###LEFT-WALL### 5 participants 0 ###LEFT-WALL### 6 ≥ 0 ###LEFT-WALL### 27 . 1 among 4 jupiter 1 among 5 participants 2 the 3 5695 3 5695 4 jupiter 5 participants 6 ≥ 6 ≥ 8 years 7 70 8 years 8 years 16 reduction 8 years 20 was 9 of 10 age 9 of 11 , 9 of 16 reduction 12 the 16 reduction 13 absolute 16 reduction 14 cvd 16 reduction 15 risk 16 reduction 16 reduction 17 associated 16 reduction 20 was 17 associated 18 with 18 with 19 rosuvastatin 20 was 21 actually 20 was 22 greater 22 greater 23 than 23 than 24 for 24 for 26 participants 25 younger 26 participants the implications of [this] jupiter subanalysis and [the] broader role of statins among older adults is the subject of this review . 0 ###LEFT-WALL### 10 role 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 22 . 1 the 10 role 2 implications 3 of 2 implications 7 and 3 of 6 subanalysis 5 jupiter 6 subanalysis 7 and 9 broader 7 and 10 role 10 role 11 of 10 role 16 is 11 of 12 statins 12 statins 13 among 13 among 15 adults 14 older 15 adults 16 is 18 subject 17 the 18 subject 18 subject 19 of 19 of 21 review 20 this 21 review [falls] [are] a major public health problem [in] [the] elderly population . 0 ###LEFT-WALL### 11 population 0 ###LEFT-WALL### 12 . 3 a 4 major 3 a 11 population 4 major 6 health 5 public 6 health 6 health 11 population 7 problem 11 population 10 elderly 11 population the associated health care cost is great . 0 ###LEFT-WALL### 5 cost 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 8 . 1 the 5 cost 2 associated 3 health 3 health 5 cost 4 care 5 cost 5 cost 6 is 6 is 7 great it has therefore become an important public health matter to evaluate those interventions that might be effective in reducing the risk of [falls] . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 become 0 ###LEFT-WALL### 24 . 1 it 2 has 2 has 4 become 3 therefore 4 become 4 become 9 matter 4 become 10 to 5 an 9 matter 6 important 7 public 7 public 9 matter 8 health 9 matter 10 to 11 evaluate 11 evaluate 13 interventions 12 those 13 interventions 13 interventions 14 that 13 interventions 22 of 14 that 15 might 15 might 16 be 16 be 17 effective 17 effective 18 in 18 in 19 reducing 19 reducing 21 risk 20 the 21 risk 21 risk 22 of risk factors that predict an increased risk of falling are described . 0 ###LEFT-WALL### 2 factors 0 ###LEFT-WALL### 11 described 0 ###LEFT-WALL### 12 . 1 risk 2 factors 2 factors 3 that 2 factors 4 predict 2 factors 10 are 3 that 4 predict 4 predict 7 risk 5 an 7 risk 6 increased 7 risk 7 risk 8 of 8 of 9 falling 10 are 11 described we discuss interventions that can be employed in the community to reduce the risk of [falls] and associated injuries by discipline , including physiotherapy , occupational therapy , and physician - led interventions . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 discuss 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 34 . 1 we 2 discuss 2 discuss 3 interventions 2 discuss 8 in 3 interventions 4 that 3 interventions 5 can 4 that 5 can 5 can 6 be 6 be 7 employed 8 in 10 community 9 the 10 community 10 community 11 to 10 community 15 of 11 to 12 reduce 12 reduce 14 risk 13 the 14 risk 14 risk 15 of 17 and 19 injuries 17 and 32 led 18 associated 19 injuries 19 injuries 20 by 19 injuries 29 and 19 injuries 32 led 20 by 21 discipline 22 , 29 and 23 including 24 physiotherapy 24 physiotherapy 25 , 25 , 27 therapy 25 , 29 and 26 occupational 27 therapy 28 , 29 and 29 and 30 physician 29 and 31 - 32 led 33 interventions we also discuss the cost - effectiveness of such interventions . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 11 . 1 we 3 discuss 2 also 3 discuss 3 discuss 5 cost 4 the 5 cost 6 - 7 effectiveness 7 effectiveness 8 of 8 of 10 interventions 9 such 10 interventions the purpose of this study was to examine if psychosocial intervention for family caregivers made any differences in describing symptoms of dementia in the persons they cared for . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 28 for 0 ###LEFT-WALL### 29 . 1 the 2 purpose 2 purpose 3 of 2 purpose 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 examine 7 to 8 examine 8 examine 9 if 8 examine 18 in 8 examine 26 they 8 examine 28 for 9 if 11 intervention 9 if 15 made 10 psychosocial 11 intervention 11 intervention 12 for 11 intervention 15 made 12 for 14 caregivers 13 family 14 caregivers 15 made 16 any 15 made 17 differences 18 in 19 describing 19 describing 20 symptoms 19 describing 23 in 20 symptoms 21 of 21 of 22 dementia 23 in 25 persons 24 the 25 persons 26 they 28 for 27 cared 28 for the study population comprised family caregivers of persons aged 70 years and older receiving social services and diagnosed with dementia disorders . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 22 . 1 the 2 study 2 study 3 population 2 study 4 comprised 2 study 7 of 2 study 17 and 3 population 4 comprised 4 comprised 6 caregivers 5 family 6 caregivers 7 of 8 persons 9 aged 12 and 9 aged 17 and 10 70 11 years 11 years 12 and 12 and 16 services 13 older 15 social 14 receiving 15 social 15 social 16 services 17 and 18 diagnosed 17 and 19 with 19 with 21 disorders 20 dementia 21 disorders a group of 129 family caregivers underwent psychosocial intervention including education , information , and provision of a support group , while 133 family caregivers did not and these formed the control group . 0 ###LEFT-WALL### 2 group 0 ###LEFT-WALL### 33 group 0 ###LEFT-WALL### 34 . 1 a 2 group 2 group 3 of 2 group 6 caregivers 2 group 10 including 2 group 33 group 3 of 5 family 4 129 5 family 6 caregivers 7 underwent 7 underwent 9 intervention 8 psychosocial 9 intervention 9 intervention 10 including 10 including 11 education 10 including 22 while 11 education 15 and 12 , 15 and 13 information 15 and 14 , 15 and 15 and 16 provision 15 and 17 of 15 and 21 , 17 of 20 group 18 a 19 support 18 a 20 group 19 support 20 group 22 while 28 and 22 while 30 formed 23 133 24 family 24 family 25 caregivers 25 caregivers 26 did 25 caregivers 28 and 26 did 27 not 28 and 29 these 29 these 30 formed 30 formed 32 control 31 the 32 control family caregivers were followed - up every 6 months for a total of 18 months . 0 ###LEFT-WALL### 2 caregivers 0 ###LEFT-WALL### 4 followed 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 16 . 1 family 2 caregivers 2 caregivers 3 were 3 were 4 followed 5 - 6 up 6 up 9 months 6 up 10 for 7 every 8 6 8 6 9 months 10 for 12 total 11 a 12 total 12 total 13 of 13 of 15 months 14 18 15 months they rated intellectual , emotional , and activity of daily living ( adl ) functions in persons with dementia using the gottfries - bråne - steen [scale] ( gbs - [scale] ) . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 rated 0 ###LEFT-WALL### 33 . 1 they 2 rated 2 rated 15 functions 2 rated 18 with 2 rated 20 using 3 intellectual 7 and 3 intellectual 15 functions 4 , 7 and 5 emotional 7 and 6 , 7 and 7 and 8 activity 7 and 9 of 7 and 13 adl 7 and 14 ) 9 of 11 living 10 daily 11 living 12 ( 13 adl 13 adl 14 ) 15 functions 16 in 16 in 17 persons 18 with 19 dementia 20 using 22 gottfries 21 the 22 gottfries 22 gottfries 24 bråne 22 gottfries 26 steen 23 - 24 bråne 24 bråne 25 - 25 - 26 steen 26 steen 29 gbs 26 steen 32 ) 28 ( 29 gbs 29 gbs 30 - family caregivers who underwent psychosocial intervention rated the intellectual and emotional symptoms of dementia significantly higher 6 months later compared to controls and the effect was sustained during the 18 [-] month [follow] - up irrespective of relationship [and] education . 0 ###LEFT-WALL### 2 caregivers 0 ###LEFT-WALL### 20 compared 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 41 . 1 family 2 caregivers 2 caregivers 3 who 2 caregivers 4 underwent 2 caregivers 20 compared 3 who 4 underwent 4 underwent 12 symptoms 4 underwent 16 higher 5 psychosocial 6 intervention 6 intervention 7 rated 7 rated 12 symptoms 8 the 9 intellectual 9 intellectual 10 and 10 and 11 emotional 10 and 12 symptoms 12 symptoms 13 of 13 of 14 dementia 15 significantly 16 higher 17 6 18 months 18 months 19 later 19 later 20 compared 20 compared 21 to 21 to 22 controls 23 and 25 effect 23 and 27 sustained 24 the 25 effect 25 effect 26 was 26 was 27 sustained 27 sustained 28 during 27 sustained 34 - 27 sustained 35 up 28 during 32 month 29 the 32 month 30 18 32 month 35 up 37 of 36 irrespective 37 of 37 of 40 education 38 relationship 40 education [most] notably , decrease in function [of] recent memory , ability to increase [tempo] , long - windedness , distractibility , and blunting were better identified . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 26 identified 0 ###LEFT-WALL### 27 . 2 notably 3 , 2 notably 22 and 4 decrease 5 in 4 decrease 22 and 5 in 9 memory 6 function 9 memory 8 recent 9 memory 9 memory 11 ability 9 memory 18 windedness 10 , 11 ability 11 ability 12 to 11 ability 13 increase 11 ability 15 , 12 to 13 increase 15 , 18 windedness 16 long 17 - 16 long 18 windedness 18 windedness 20 distractibility 18 windedness 21 , 19 , 20 distractibility 20 distractibility 21 , 21 , 22 and 22 and 23 blunting 22 and 24 were 24 were 25 better 24 were 26 identified our findings suggest that the family caregivers who underwent psychosocial intervention achieved better understanding of different symptoms and the behaviors of dementia . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 23 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 caregivers 4 that 13 better 5 the 7 caregivers 6 family 7 caregivers 7 caregivers 8 who 7 caregivers 9 underwent 8 who 9 underwent 9 underwent 11 intervention 10 psychosocial 11 intervention 11 intervention 12 achieved 13 better 14 understanding 14 understanding 15 of 15 of 18 and 16 different 17 symptoms 17 symptoms 18 and 18 and 20 behaviors 18 and 21 of 19 the 20 behaviors 21 of 22 dementia these findings may explain earlier findings of positive effects after psychosocial intervention on family caregivers ' sense of burden , satisfaction , and ability to delay nursing home placement . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 explain 0 ###LEFT-WALL### 30 . 1 these 2 findings 2 findings 3 may 3 may 4 explain 4 explain 6 findings 4 explain 10 after 4 explain 13 on 4 explain 25 to 5 earlier 6 findings 6 findings 7 of 7 of 9 effects 8 positive 9 effects 10 after 12 intervention 11 psychosocial 12 intervention 13 on 17 sense 14 family 15 caregivers 15 caregivers 16 ' 16 ' 17 sense 17 sense 18 of 18 of 23 and 19 burden 20 , 20 , 21 satisfaction 20 , 23 and 22 , 23 and 23 and 24 ability 25 to 26 delay 26 delay 29 placement 27 nursing 29 placement 28 home 29 placement as the world 's population ages , hip fractures pose a significant health care problem . 0 ###LEFT-WALL### 9 fractures 0 ###LEFT-WALL### 10 pose 0 ###LEFT-WALL### 16 . 1 as 5 population 1 as 6 ages 1 as 7 , 1 as 9 fractures 2 the 3 world 3 world 4 's 4 's 5 population 5 population 6 ages 8 hip 9 fractures 9 fractures 10 pose 10 pose 15 problem 11 a 12 significant 11 a 15 problem 12 significant 13 health 13 health 14 care 14 care 15 problem hip fractures in the elderly are associated with impaired mobility , and increased morbidity and mortality . 0 ###LEFT-WALL### 2 fractures 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 17 . 1 hip 2 fractures 2 fractures 3 in 2 fractures 6 are 3 in 5 elderly 4 the 5 elderly 6 are 7 associated 7 associated 8 with 8 with 15 and 9 impaired 10 mobility 10 mobility 12 and 11 , 12 and 12 and 14 morbidity 12 and 15 and 13 increased 14 morbidity 15 and 16 mortality associated conditions , such as osteoporosis , medical comorbidity , and dementia , pose a significant concern and determine optimal treatment . 0 ###LEFT-WALL### 2 conditions 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 22 . 1 associated 2 conditions 2 conditions 5 as 2 conditions 18 and 3 , 5 as 4 such 5 as 5 as 11 and 5 as 13 , 6 osteoporosis 7 , 7 , 9 comorbidity 7 , 11 and 8 medical 9 comorbidity 10 , 11 and 11 and 12 dementia 14 pose 17 concern 14 pose 18 and 15 a 16 significant 15 a 17 concern 16 significant 17 concern 18 and 19 determine 19 determine 21 treatment 20 optimal 21 treatment one - year mortality rates currently range from 14 % to 36 % , and care for these patients represents a major global economic burden . 0 ###LEFT-WALL### 1 one 0 ###LEFT-WALL### 2 - 2 - 5 rates 2 - 7 range 2 - 15 and 2 - 26 . 3 year 5 rates 4 mortality 5 rates 5 rates 7 range 6 currently 7 range 7 range 8 from 7 range 11 to 8 from 10 % 9 14 10 % 11 to 13 % 12 36 13 % 14 , 15 and 15 and 16 care 15 and 20 represents 16 care 17 for 16 care 20 represents 17 for 19 patients 18 these 19 patients 20 represents 25 burden 21 a 22 major 21 a 25 burden 22 major 25 burden 23 global 25 burden 24 economic 25 burden the incidence of hip fractures is bimodal in its distribution . 0 ###LEFT-WALL### 2 incidence 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 11 . 1 the 2 incidence 2 incidence 3 of 2 incidence 6 is 3 of 5 fractures 4 hip 5 fractures 6 is 7 bimodal 7 bimodal 8 in 8 in 10 distribution 9 its 10 distribution young adult hip fractures are the result of high energy trauma , and the larger peak seen in the elderly population is secondary to low - energy injuries . 0 ###LEFT-WALL### 4 fractures 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 29 . 1 young 3 hip 2 adult 3 hip 3 hip 4 fractures 4 fractures 5 are 5 are 7 result 6 the 7 result 7 result 8 of 8 of 11 trauma 9 high 11 trauma 10 energy 11 trauma 12 , 13 and 13 and 16 peak 13 and 22 is 14 the 16 peak 15 larger 16 peak 16 peak 17 seen 16 peak 22 is 17 seen 18 in 18 in 21 population 19 the 21 population 20 elderly 21 population 22 is 23 secondary 23 secondary 24 to 24 to 28 injuries 25 low 26 - 25 low 27 energy 27 energy 28 injuries the predilection for the site of [fracture] at the neck [of] femur falls into two major subgroups . 0 ###LEFT-WALL### 2 predilection 0 ###LEFT-WALL### 13 falls 0 ###LEFT-WALL### 18 . 1 the 2 predilection 2 predilection 3 for 2 predilection 13 falls 3 for 5 site 4 the 5 site 5 site 6 of 6 of 8 at 8 at 12 femur 9 the 12 femur 10 neck 12 femur 13 falls 14 into 14 into 17 subgroups 15 two 17 subgroups 16 major 17 subgroups pertrochanteric fractures occur when the injury is extracapsular and the blood supply to the head [of] femur is unaffected . 0 ###LEFT-WALL### 2 fractures 0 ###LEFT-WALL### 3 occur 0 ###LEFT-WALL### 20 . 1 pertrochanteric 2 fractures 2 fractures 3 occur 3 occur 4 when 4 when 9 and 4 when 18 is 5 the 6 injury 6 injury 7 is 6 injury 9 and 7 is 8 extracapsular 9 and 12 supply 10 the 12 supply 11 blood 12 supply 12 supply 13 to 12 supply 18 is 13 to 17 femur 14 the 17 femur 15 head 17 femur 18 is 19 unaffected the management of this group involves internal fixation through a sliding hip screw device or intramedullary fixation device , both of which have good results . 0 ###LEFT-WALL### 2 management 0 ###LEFT-WALL### 6 involves 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 26 . 1 the 2 management 2 management 3 of 2 management 6 involves 3 of 5 group 4 this 5 group 6 involves 8 fixation 7 internal 8 fixation 8 fixation 9 through 9 through 15 or 10 a 14 device 11 sliding 12 hip 12 hip 14 device 13 screw 14 device 14 device 15 or 15 or 18 device 16 intramedullary 17 fixation 17 fixation 18 device 19 , 20 both 20 both 21 of 21 of 22 which 21 of 23 have 22 which 23 have 23 have 25 results 24 good 25 results the other group of patients who sustain an intracapsular fracture at the femoral neck are at increased risk of nonunion and osteonecrosis . 0 ###LEFT-WALL### 5 patients 0 ###LEFT-WALL### 15 are 0 ###LEFT-WALL### 23 . 1 the 2 other 2 other 3 group 3 group 4 of 3 group 5 patients 4 of 5 patients 5 patients 6 who 5 patients 7 sustain 5 patients 15 are 6 who 7 sustain 7 sustain 10 fracture 7 sustain 11 at 8 an 9 intracapsular 8 an 10 fracture 9 intracapsular 10 fracture 11 at 14 neck 12 the 14 neck 13 femoral 14 neck 15 are 16 at 16 at 18 risk 17 increased 18 risk 18 risk 19 of 19 of 21 and 20 nonunion 21 and 21 and 22 osteonecrosis recent papers in the literature have shown better functional outcomes with a primary hip replacement over other treatment modalities . 0 ###LEFT-WALL### 2 papers 0 ###LEFT-WALL### 7 shown 0 ###LEFT-WALL### 20 . 1 recent 2 papers 2 papers 3 in 2 papers 6 have 3 in 5 literature 4 the 5 literature 6 have 7 shown 7 shown 10 outcomes 7 shown 11 with 8 better 10 outcomes 9 functional 10 outcomes 11 with 15 replacement 12 a 13 primary 12 a 15 replacement 13 primary 15 replacement 14 hip 15 replacement 15 replacement 16 over 16 over 19 modalities 17 other 19 modalities 18 treatment 19 modalities this article reviews the current literature and indications for a primary total hip replacement in these patients . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 reviews 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 18 . 1 this 2 article 2 article 3 reviews 3 reviews 6 literature 4 the 6 literature 5 current 6 literature 7 and 8 indications 7 and 12 total 8 indications 9 for 8 indications 12 total 9 for 11 primary 10 a 11 primary 12 total 14 replacement 12 total 15 in 13 hip 14 replacement 15 in 17 patients 16 these 17 patients background : deterioration in hearing after gamma knife radiosurgery of vestibular schwannomas is a well - documented risk . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 - 0 ###LEFT-WALL### 19 . 1 background 2 : 2 : 3 deterioration 3 deterioration 4 in 4 in 5 hearing 5 hearing 6 after 5 hearing 9 radiosurgery 5 hearing 13 is 6 after 8 knife 7 gamma 8 knife 9 radiosurgery 10 of 9 radiosurgery 13 is 10 of 12 schwannomas 11 vestibular 12 schwannomas 13 is 15 well 14 a 15 well 16 - 18 risk 17 documented 18 risk recent studies suggest a correlation between cochlear radiation [dose] and hearing preservation . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 13 . 1 recent 2 studies 2 studies 3 suggest 3 suggest 5 correlation 3 suggest 6 between 4 a 5 correlation 6 between 10 and 7 cochlear 8 radiation 8 radiation 10 and 10 and 12 preservation 11 hearing 12 preservation objective : this study identifies additional variables that predict hearing loss after radiosurgery . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 identifies 2 : 14 . 3 this 4 study 4 study 5 identifies 5 identifies 7 variables 6 additional 7 variables 7 variables 8 that 7 variables 9 predict 8 that 9 predict 9 predict 11 loss 9 predict 12 after 10 hearing 11 loss 12 after 13 radiosurgery methods : retrospective analysis of 53 patients with audiogram follow - up . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 - 1 methods 2 : 2 : 4 analysis 3 retrospective 4 analysis 4 analysis 5 of 5 of 6 53 6 53 7 patients 6 53 10 follow 7 patients 8 with 7 patients 10 follow 8 with 9 audiogram 11 - 12 up 11 - 13 . median marginal tumor dose [was] [12.5] [gy] . 0 ###LEFT-WALL### 4 dose 0 ###LEFT-WALL### 8 . 1 median 3 tumor 2 marginal 3 tumor 3 tumor 4 dose mean tumor volume was 1.11 cm . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 7 . 1 mean 3 volume 1 mean 4 was 2 tumor 3 volume 3 volume 4 was 4 was 6 cm 5 1.11 6 cm statistical analysis included multivariate stepwise [backward] linear regression and multivariate logistic regression . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 13 . 1 statistical 8 regression 2 analysis 3 included 3 included 8 regression 4 multivariate 8 regression 5 stepwise 8 regression 7 linear 8 regression 8 regression 9 and 9 and 12 regression 10 multivariate 12 regression 11 logistic 12 regression variables included age , prescription dose , tumor volume , intracanalicular length , and maximum and mean cochlear dose . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 20 . 1 variables 2 included 2 included 3 age 3 age 4 , 4 , 6 dose 4 , 7 , 5 prescription 6 dose 7 , 9 volume 7 , 10 , 8 tumor 9 volume 10 , 12 length 10 , 14 and 11 intracanalicular 12 length 13 , 14 and 14 and 15 maximum 14 and 16 and 16 and 19 dose 17 mean 19 dose 18 cochlear 19 dose dose volume histograms were generated . 0 ###LEFT-WALL### 3 histograms 0 ###LEFT-WALL### 5 generated 0 ###LEFT-WALL### 6 . 1 dose 3 histograms 2 volume 3 histograms 3 histograms 4 were 4 were 5 generated the percentage of the cochlear volume [that] received 3.6 gy or greater [,] 4.7 gy or greater [,] [and] 5.3 gy or greater was calculated . 0 ###LEFT-WALL### 2 percentage 0 ###LEFT-WALL### 26 . 1 the 2 percentage 2 percentage 3 of 2 percentage 8 received 2 percentage 24 was 3 of 6 volume 4 the 6 volume 5 cochlear 6 volume 8 received 11 or 9 3.6 10 gy 10 gy 11 or 11 or 12 greater 12 greater 16 or 14 4.7 15 gy 15 gy 16 or 16 or 17 greater 17 greater 22 or 20 5.3 21 gy 21 gy 22 or 22 or 23 greater 24 was 25 calculated plan conformality indicators were calculated . 0 ###LEFT-WALL### 1 plan 0 ###LEFT-WALL### 6 . 1 plan 3 indicators 1 plan 5 calculated 2 conformality 3 indicators 3 indicators 4 were 4 were 5 calculated results : forty - two patients had a less than 20 [-] db change in their pure tone average , with a hearing preservation rate of 79 % . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 patients 2 : 7 had 3 forty 4 - 4 - 5 two 4 - 6 patients 6 patients 7 had 7 had 14 change 8 a 14 change 9 less 10 than 10 than 11 20 11 20 13 db 13 db 14 change 14 change 15 in 15 in 19 average 16 their 19 average 17 pure 18 tone 18 tone 19 average 19 average 21 with 20 , 21 with 21 with 25 rate 21 with 29 . 22 a 25 rate 23 hearing 25 rate 24 preservation 25 rate 25 rate 26 of 26 of 28 % 27 79 28 % two statistically significant predictors of hearing loss were identified using multivariate analysis : tumor coverage ( odds [ratio] : 1.38 × 10 [ )(and age ( odds ratio [:] 1.1 per year ) . 0 ###LEFT-WALL### 4 predictors 0 ###LEFT-WALL### 9 identified 0 ###LEFT-WALL### 13 : 0 ###LEFT-WALL### 34 . 1 two 4 predictors 2 statistically 3 significant 3 significant 4 predictors 4 predictors 5 of 4 predictors 8 were 5 of 6 hearing 6 hearing 7 loss 8 were 9 identified 9 identified 10 using 10 using 12 analysis 11 multivariate 12 analysis 13 : 15 coverage 13 : 19 : 14 tumor 15 coverage 15 coverage 17 odds 16 ( 17 odds 17 odds 19 : 19 : 24 )(and 20 1.38 21 × 21 × 22 10 21 × 24 )(and 24 )(and 25 age 24 )(and 28 ratio 26 ( 28 ratio 27 odds 28 ratio 28 ratio 30 1.1 28 ratio 31 per 28 ratio 33 ) 31 per 32 year multivariate linear regression was used to predict change in pure tone [average] . 0 ###LEFT-WALL### 1 multivariate 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 13 . 1 multivariate 3 regression 1 multivariate 4 was 1 multivariate 5 used 2 linear 3 regression 3 regression 4 was 5 used 6 to 5 used 7 predict 6 to 7 predict 7 predict 8 change 7 predict 9 in 9 in 11 tone 10 pure 11 tone age and percentage of the cochlear volume receiving 5.3 gy or greater were found to be statistically significant predictor variables . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 16 be 0 ###LEFT-WALL### 21 . 1 age 2 and 2 and 3 percentage 2 and 4 of 2 and 8 receiving 2 and 13 were 4 of 7 volume 5 the 7 volume 6 cochlear 7 volume 8 receiving 9 5.3 8 receiving 11 or 10 gy 11 or 11 or 12 greater 13 were 14 found 14 found 15 to 15 to 16 be 16 be 17 statistically 16 be 20 variables 18 significant 20 variables 19 predictor 20 variables conclusion : older patients are more vulnerable to detrimental effects of gamma knife radiosurgery on hearing . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 patients 2 : 5 are 2 : 17 . 3 older 4 patients 4 patients 5 are 5 are 7 vulnerable 6 more 7 vulnerable 7 vulnerable 8 to 8 to 10 effects 9 detrimental 10 effects 10 effects 11 of 10 effects 14 radiosurgery 11 of 13 knife 12 gamma 13 knife 14 radiosurgery 15 on 15 on 16 hearing we propose that cochlear dose volume histograms be created and used to reduce the percentage of the cochlear volume exposed to radiation doses greater than 5.3 gy . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 . 1 we 10 and 2 propose 3 that 2 propose 10 and 3 that 7 histograms 3 that 8 be 4 cochlear 7 histograms 5 dose 7 histograms 6 volume 7 histograms 8 be 9 created 10 and 11 used 10 and 12 to 10 and 21 to 12 to 13 reduce 13 reduce 15 percentage 14 the 15 percentage 15 percentage 16 of 15 percentage 20 exposed 16 of 19 volume 17 the 19 volume 18 cochlear 19 volume 21 to 23 doses 22 radiation 23 doses 23 doses 24 greater 24 greater 25 than 25 than 27 gy 26 5.3 27 gy this is the first report to suggest that the conformity index tumor coverage may be an important predictor of hearing outcomes . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 22 . 1 this 2 is 2 is 5 report 2 is 6 to 3 the 4 first 3 the 5 report 6 to 7 suggest 7 suggest 8 that 8 that 13 coverage 8 that 15 be 9 the 13 coverage 10 conformity 13 coverage 11 index 13 coverage 12 tumor 13 coverage 13 coverage 14 may 14 may 15 be 15 be 18 predictor 16 an 17 important 16 an 18 predictor 17 important 18 predictor 18 predictor 19 of 19 of 20 hearing 20 hearing 21 outcomes longer cognitive tests , such as the alzheimer 's disease assessment scale ( adas - [cog] [ )(or the cambridge cognitive examination ( camcog ) , are more precise but less efficient than briefer tests , such as the mini mental state examination ( mmse ) . 0 ###LEFT-WALL### 3 tests 0 ###LEFT-WALL### 27 are 0 ###LEFT-WALL### 47 . 1 longer 3 tests 2 cognitive 3 tests 3 tests 6 as 3 tests 27 are 4 , 6 as 5 such 6 as 6 as 12 scale 6 as 26 , 7 the 8 alzheimer 8 alzheimer 9 's 9 's 12 scale 10 disease 12 scale 11 assessment 12 scale 12 scale 18 )(or 13 ( 18 )(or 14 adas 18 )(or 15 - 18 )(or 18 )(or 22 examination 18 )(or 24 camcog 18 )(or 26 , 19 the 22 examination 20 cambridge 22 examination 21 cognitive 22 examination 23 ( 24 camcog 24 camcog 25 ) 27 are 28 more 27 are 30 but 29 precise 30 but 30 but 32 efficient 31 less 32 efficient 32 efficient 33 than 33 than 35 tests 34 briefer 35 tests 35 tests 38 as 36 , 38 as 37 such 38 as 38 as 45 mmse 38 as 46 ) 39 the 45 mmse 40 mini 41 mental 41 mental 42 state 42 state 43 examination 43 examination 45 mmse 44 ( 45 mmse we examined if computerized adaptive testing ( cat [ )(of cognitive impairment can combine brevity with precision by tailoring a precise test to each individual patient . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 1 we 2 examined 2 examined 3 if 2 examined 6 testing 3 if 4 computerized 5 adaptive 6 testing 6 testing 8 cat 7 ( 8 cat 8 cat 10 )(of 8 cat 27 . 10 )(of 15 brevity 11 cognitive 12 impairment 12 impairment 15 brevity 13 can 15 brevity 14 combine 15 brevity 15 brevity 16 with 16 with 17 precision 17 precision 18 by 17 precision 23 to 18 by 19 tailoring 19 tailoring 22 test 20 a 21 precise 20 a 22 test 21 precise 22 test 23 to 26 patient 24 each 26 patient 25 individual 26 patient we conducted a prospective study of 84 participants [ normal [aging] , n = 41 [;] mild cognitive impairment ( mci ) , n = 21 [;] dementia , n = 22 ] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conducted 0 ###LEFT-WALL### 34 . 1 we 2 conducted 2 conducted 5 study 3 a 4 prospective 3 a 5 study 4 prospective 5 study 5 study 6 of 5 study 19 impairment 6 of 8 participants 7 84 8 participants 9 [ 19 impairment 10 normal 14 = 10 normal 19 impairment 12 , 14 = 13 n 14 = 14 = 15 41 17 mild 19 impairment 18 cognitive 19 impairment 19 impairment 21 mci 19 impairment 25 = 19 impairment 31 = 19 impairment 33 ] 20 ( 21 mci 21 mci 22 ) 23 , 25 = 24 n 25 = 25 = 28 dementia 26 21 28 dementia 29 , 31 = 30 n 31 = 31 = 32 22 cat estimated a participant 's ability during testing by selecting only items of appropriate difficulty from either the camcog or the camcog supplemented with adas - cog items and neuropsychological tests ( the camcog - plus ) . 0 ###LEFT-WALL### 1 cat 0 ###LEFT-WALL### 2 estimated 0 ###LEFT-WALL### 26 - 0 ###LEFT-WALL### 38 . 1 cat 2 estimated 2 estimated 4 participant 2 estimated 5 's 3 a 4 participant 4 participant 5 's 5 's 6 ability 5 's 9 by 6 ability 7 during 7 during 8 testing 9 by 10 selecting 10 selecting 11 only 10 selecting 12 items 10 selecting 16 from 12 items 13 of 13 of 15 difficulty 14 appropriate 15 difficulty 16 from 20 or 17 either 20 or 18 the 19 camcog 19 camcog 20 or 20 or 22 camcog 20 or 23 supplemented 21 the 22 camcog 23 supplemented 24 with 24 with 25 adas 26 - 29 and 27 cog 28 items 28 items 29 and 29 and 31 tests 29 and 34 camcog 30 neuropsychological 31 tests 32 ( 34 camcog 33 the 34 camcog 34 camcog 36 plus 34 camcog 37 ) 35 - 36 plus 36 plus 37 ) after tailored testing with cat , the remaining camcog and camcog - plus items not selected by cat were administered . 0 ###LEFT-WALL### 14 items 0 ###LEFT-WALL### 20 administered 0 ###LEFT-WALL### 21 . 1 after 3 testing 1 after 12 - 1 after 14 items 2 tailored 3 testing 3 testing 4 with 3 testing 11 camcog 4 with 5 cat 6 , 11 camcog 7 the 11 camcog 8 remaining 11 camcog 9 camcog 10 and 10 and 11 camcog 11 camcog 12 - 13 plus 14 items 14 items 15 not 14 items 17 by 14 items 19 were 15 not 16 selected 17 by 18 cat 19 were 20 administered the time needed to complete the cat was compared to that needed for the whole camcog and camcog - plus . 0 ###LEFT-WALL### 2 time 0 ###LEFT-WALL### 9 compared 0 ###LEFT-WALL### 21 . 1 the 2 time 2 time 3 needed 2 time 4 to 2 time 5 complete 2 time 8 was 4 to 5 complete 5 complete 7 cat 6 the 7 cat 8 was 9 compared 9 compared 10 to 9 compared 19 - 9 compared 20 plus 10 to 17 and 11 that 12 needed 11 that 13 for 11 that 17 and 13 for 16 camcog 14 the 16 camcog 15 whole 16 camcog 17 and 18 camcog results showed that testing time reductions achieved with cat were 37 % or [more] compared to the whole camcog and 55 % or more compared to the whole camcog - plus . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 showed 0 ###LEFT-WALL### 23 or 1 results 2 showed 2 showed 5 time 2 showed 19 camcog 2 showed 20 and 3 that 5 time 4 testing 5 time 5 time 6 reductions 5 time 13 or 6 reductions 7 achieved 6 reductions 13 or 7 achieved 8 with 8 with 9 cat 10 were 12 % 10 were 13 or 11 37 12 % 13 or 15 compared 13 or 16 to 16 to 18 whole 17 the 18 whole 20 and 22 % 21 55 22 % 23 or 24 more 23 or 25 compared 24 more 25 compared 25 compared 26 to 25 compared 29 camcog 26 to 28 whole 27 the 28 whole 29 camcog 31 plus 30 - 31 plus 31 plus 32 . estimated ability levels with cat were in excellent agreement with those based on the whole camcog and camcog - plus ( intraclass correlations 0.99 and 0.98 , respectively ) . 0 ###LEFT-WALL### 3 levels 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 30 . 1 estimated 2 ability 2 ability 3 levels 3 levels 4 with 3 levels 6 were 4 with 5 cat 6 were 7 in 6 were 13 on 6 were 28 respectively 7 in 9 agreement 8 excellent 9 agreement 9 agreement 10 with 9 agreement 12 based 10 with 11 those 13 on 17 and 14 the 16 camcog 15 whole 16 camcog 16 camcog 17 and 17 and 18 camcog 18 camcog 20 plus 19 - 20 plus 20 plus 23 correlations 20 plus 27 , 21 ( 23 correlations 22 intraclass 23 correlations 23 correlations 25 and 23 correlations 27 , 24 0.99 25 and 25 and 26 0.98 27 , 28 respectively 28 respectively 29 ) diagnostic accuracy of detecting mild dementia [and] mci seemed better for the cat administered tests than for the mmse , but the differences were not significant . 0 ###LEFT-WALL### 2 accuracy 0 ###LEFT-WALL### 9 seemed 0 ###LEFT-WALL### 21 but 0 ###LEFT-WALL### 27 . 1 diagnostic 2 accuracy 2 accuracy 3 of 2 accuracy 9 seemed 3 of 4 detecting 4 detecting 6 dementia 5 mild 6 dementia 6 dementia 8 mci 9 seemed 10 better 10 better 11 for 10 better 16 than 11 for 15 tests 12 the 15 tests 13 cat 14 administered 14 administered 15 tests 16 than 17 for 17 for 19 mmse 18 the 19 mmse 20 , 21 but 21 but 23 differences 21 but 24 were 22 the 23 differences 23 differences 24 were 24 were 25 not 24 were 26 significant we conclude that adaptive testing combines brevity with precision , especially in grading the severity of cognitive impairment . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 1 we 2 conclude 2 conclude 3 that 3 that 5 testing 3 that 6 combines 4 adaptive 5 testing 5 testing 6 combines 6 combines 7 brevity 6 combines 8 with 8 with 9 precision 9 precision 12 in 10 , 11 especially 10 , 12 in 12 in 13 grading 12 in 19 . 13 grading 15 severity 14 the 15 severity 15 severity 16 of 16 of 18 impairment 17 cognitive 18 impairment among individuals who were cognitively intact before death , autopsies may reveal some alzheimer 's disease - type pathology . 0 ###LEFT-WALL### 18 type 0 ###LEFT-WALL### 20 . 1 among 2 individuals 1 among 17 - 1 among 18 type 2 individuals 3 who 2 individuals 9 , 3 who 9 , 4 were 6 intact 4 were 9 , 5 cognitively 6 intact 6 intact 7 before 7 before 8 death 9 , 12 reveal 10 autopsies 11 may 11 may 12 reveal 12 reveal 16 disease 13 some 14 alzheimer 14 alzheimer 15 's 15 's 16 disease 18 type 19 pathology the presence of end [-] stage pathology in cognitively intact persons would support the hypothesis that pathological markers are epiphenomena . 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 13 support 0 ###LEFT-WALL### 21 . 1 the 2 presence 2 presence 3 of 2 presence 12 would 3 of 7 pathology 4 end 7 pathology 6 stage 7 pathology 7 pathology 8 in 8 in 11 persons 9 cognitively 10 intact 10 intact 11 persons 12 would 13 support 13 support 15 hypothesis 14 the 15 hypothesis 15 hypothesis 16 that 16 that 18 markers 16 that 19 are 17 pathological 18 markers 18 markers 19 are 19 are 20 epiphenomena we assessed advanced neurofibrillary ( braak stages [v] [and] vi ) pathology focusing on nondemented individuals . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 assessed 0 ###LEFT-WALL### 17 . 1 we 2 assessed 2 assessed 12 pathology 3 advanced 12 pathology 4 neurofibrillary 7 stages 4 neurofibrillary 12 pathology 5 ( 7 stages 6 braak 7 stages 7 stages 10 vi 7 stages 11 ) 12 pathology 13 focusing 13 focusing 14 on 14 on 16 individuals 15 nondemented 16 individuals data from the national alzheimer 's coordinating center database ( n = 4,690 included initially [ )(and from the nun study ( n = 526 included initially [ )(were analyzed , with antemortem information about global cognition and careful postmortem studies available from each case . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 29 )(were 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 46 . 1 data 17 )(and 1 data 29 )(were 2 from 8 center 2 from 17 )(and 3 the 5 alzheimer 4 national 5 alzheimer 5 alzheimer 6 's 6 's 8 center 7 coordinating 8 center 8 center 9 database 8 center 14 included 9 database 12 = 9 database 14 included 10 ( 12 = 11 n 12 = 12 = 13 4,690 14 included 15 initially 17 )(and 18 from 18 from 21 study 19 the 21 study 20 nun 21 study 21 study 24 = 22 ( 24 = 23 n 24 = 24 = 25 526 25 526 26 included 27 initially 29 )(were 29 )(were 30 analyzed 31 , 38 and 31 , 40 postmortem 32 with 33 antemortem 32 with 38 and 34 information 35 about 34 information 38 and 35 about 37 cognition 36 global 37 cognition 38 and 39 careful 38 and 40 postmortem 40 postmortem 41 studies 41 studies 42 available 42 available 43 from 43 from 45 case 44 each 45 case global cognition ( final mini - mental state examination [scores] ( mmse ) and clinical ['] dementia ['] status ) was correlated with neuropathology , including the severity of neurofibrillary pathology ( braak stages and neurofibrillary tangle counts in cerebral neocortex ) . 0 ###LEFT-WALL### 2 cognition 0 ###LEFT-WALL### 22 correlated 0 ###LEFT-WALL### 43 . 1 global 2 cognition 2 cognition 5 mini 2 cognition 21 was 3 ( 5 mini 4 final 5 mini 5 mini 14 and 5 mini 20 ) 6 - 14 and 7 mental 8 state 8 state 9 examination 9 examination 12 mmse 11 ( 12 mmse 12 mmse 13 ) 12 mmse 14 and 14 and 19 status 14 and 20 ) 15 clinical 17 dementia 17 dementia 19 status 21 was 22 correlated 22 correlated 23 with 22 correlated 26 including 23 with 24 neuropathology 25 , 26 including 26 including 28 severity 26 including 42 ) 27 the 28 severity 28 severity 29 of 29 of 31 pathology 30 neurofibrillary 31 pathology 31 pathology 35 and 32 ( 35 and 33 braak 34 stages 34 stages 35 and 35 and 38 counts 35 and 39 in 35 and 42 ) 36 neurofibrillary 37 tangle 37 tangle 38 counts 39 in 41 neocortex 40 cerebral 41 neocortex analyses support three major findings : 1 . 0 ###LEFT-WALL### 1 analyses 0 ###LEFT-WALL### 2 support 0 ###LEFT-WALL### 6 : 0 ###LEFT-WALL### 8 . 1 analyses 2 support 2 support 5 findings 3 three 5 findings 4 major 5 findings 6 : 7 1 braak stage v cases and braak vi cases are significantly different from each other in terms of associated antemortem cognition ; 2 . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 18 associated 0 ###LEFT-WALL### 21 ; 0 ###LEFT-WALL### 23 . 1 braak 4 cases 2 stage 3 v 2 stage 4 cases 4 cases 5 and 5 and 6 braak 5 and 8 cases 5 and 17 of 5 and 18 associated 6 braak 7 vi 8 cases 9 are 9 are 11 different 10 significantly 11 different 11 different 12 from 11 different 15 in 12 from 14 other 13 each 14 other 15 in 16 terms 16 terms 17 of 18 associated 20 cognition 19 antemortem 20 cognition 21 ; 22 2 there is an appreciable range of pathology within the category of braak stage vi based on tangle counts such that brains with the most neurofibrillary tangles in neocortex always had profound antemortem cognitive impairment ; [and] 3 . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 35 ; 0 ###LEFT-WALL### 38 . 1 there 2 is 2 is 5 range 3 an 4 appreciable 3 an 5 range 4 appreciable 5 range 5 range 6 of 5 range 8 within 6 of 7 pathology 8 within 10 category 9 the 10 category 10 category 11 of 11 of 13 stage 12 braak 13 stage 13 stage 14 vi 13 stage 15 based 15 based 16 on 15 based 20 that 16 on 18 counts 17 tangle 18 counts 19 such 20 that 20 that 21 brains 20 that 30 had 21 brains 22 with 21 brains 30 had 22 with 26 tangles 23 the 26 tangles 24 most 25 neurofibrillary 25 neurofibrillary 26 tangles 26 tangles 27 in 27 in 28 neocortex 29 always 30 had 30 had 34 impairment 31 profound 34 impairment 32 antemortem 34 impairment 33 cognitive 34 impairment 35 ; 37 3 there was no nondemented case with final mmse score [of] 30 within a year of life and braak stage vi pathology . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 22 . 1 there 2 was 2 was 5 case 3 no 5 case 4 nondemented 5 case 5 case 6 with 5 case 15 of 6 with 9 score 7 final 9 score 8 mmse 9 score 9 score 11 30 9 score 12 within 12 within 14 year 13 a 14 year 15 of 21 pathology 16 life 17 and 17 and 19 stage 17 and 21 pathology 18 braak 19 stage 19 stage 20 vi it may be inappropriate to combine braak stages v and vi cases , particularly in patients with early cognitive dysfunction , since the two pathological stages appear to differ dramatically in terms of both pathological severity and antemortem cognitive status . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 29 differ 0 ###LEFT-WALL### 41 . 1 it 2 may 2 may 3 be 3 be 4 inappropriate 4 inappropriate 5 to 5 to 8 stages 6 combine 8 stages 7 braak 8 stages 8 stages 9 v 10 and 11 vi 10 and 27 appear 11 vi 12 cases 12 cases 15 in 12 cases 22 since 12 cases 24 two 13 , 14 particularly 13 , 15 in 15 in 16 patients 15 in 21 , 16 patients 17 with 17 with 20 dysfunction 18 early 20 dysfunction 19 cognitive 20 dysfunction 23 the 24 two 25 pathological 26 stages 26 stages 27 appear 27 appear 28 to 28 to 29 differ 29 differ 30 dramatically 29 differ 31 in 31 in 37 and 32 terms 33 of 32 terms 37 and 33 of 36 severity 34 both 35 pathological 35 pathological 36 severity 37 and 40 status 38 antemortem 40 status 39 cognitive 40 status there is no documented example of [truly] end [-] stage neurofibrillary pathology coexisting with intact cognition . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 17 . 1 there 2 is 2 is 5 example 3 no 5 example 4 documented 5 example 5 example 6 of 6 of 13 coexisting 8 end 13 coexisting 10 stage 13 coexisting 11 neurofibrillary 12 pathology 12 pathology 13 coexisting 13 coexisting 14 with 14 with 16 cognition 15 intact 16 cognition background : diffusion - weighted imaging ( dwi ) and fluid - attenuated inversion recovery ( flair ) mri have high sensitivity and specificity for creutzfeldt - jakob disease ( cjd ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 33 . 1 background 2 : 2 : 3 diffusion 4 - 6 imaging 4 - 10 and 5 weighted 6 imaging 6 imaging 8 dwi 7 ( 8 dwi 8 dwi 9 ) 10 and 19 mri 10 and 20 have 11 fluid 15 recovery 11 fluid 19 mri 12 - 15 recovery 13 attenuated 14 inversion 14 inversion 15 recovery 15 recovery 17 flair 15 recovery 18 ) 16 ( 17 flair 17 flair 18 ) 19 mri 20 have 20 have 23 and 20 have 25 for 21 high 22 sensitivity 22 sensitivity 23 and 23 and 24 specificity 25 for 26 creutzfeldt 26 creutzfeldt 29 disease 27 - 29 disease 28 jakob 29 disease 29 disease 31 cjd 29 disease 32 ) 30 ( 31 cjd 31 cjd 32 ) no studies , however , have demonstrated how mri can distinguish cjd from nonprion causes of rapidly progressive dementia ( nprpd ) . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 7 demonstrated 0 ###LEFT-WALL### 23 . 1 no 2 studies 2 studies 6 have 3 , 4 however 4 however 5 , 4 however 6 have 6 have 7 demonstrated 7 demonstrated 8 how 8 how 9 mri 8 how 11 distinguish 9 mri 10 can 10 can 11 distinguish 11 distinguish 12 cjd 11 distinguish 13 from 13 from 15 causes 14 nonprion 15 causes 15 causes 16 of 16 of 19 dementia 17 rapidly 18 progressive 18 progressive 19 dementia 19 dementia 21 nprpd 20 ( 21 nprpd 21 nprpd 22 ) we sought to determine the diagnostic accuracy of mri for cjd compared to a cohort of nprpd subjects . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 sought 0 ###LEFT-WALL### 19 . 1 we 2 sought 2 sought 3 to 2 sought 4 determine 3 to 4 determine 4 determine 7 accuracy 5 the 7 accuracy 6 diagnostic 7 accuracy 7 accuracy 8 of 7 accuracy 13 to 8 of 9 mri 9 mri 10 for 10 for 11 cjd 11 cjd 12 compared 13 to 15 cohort 14 a 15 cohort 15 cohort 16 of 16 of 18 subjects 17 nprpd 18 subjects methods : two neuroradiologists blinded to diagnosis assessed dwi and flair images in 90 patients with nprpd ( n = 29 ) or prion disease ( sporadic cjd [ scjd ] , n = 48 , or genetic prion disease [ familial cjd , n = 6 , and gerstmann - sträussler - scheinker , n = 7 ] ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 61 . 2 : 49 and 2 : 51 - 3 two 4 neuroradiologists 4 neuroradiologists 5 blinded 4 neuroradiologists 10 and 5 blinded 6 to 6 to 9 dwi 7 diagnosis 8 assessed 8 assessed 9 dwi 10 and 12 images 10 and 37 or 11 flair 12 images 12 images 13 in 13 in 23 or 14 90 15 patients 15 patients 16 with 15 patients 23 or 16 with 17 nprpd 17 nprpd 20 = 18 ( 20 = 19 n 20 = 20 = 21 29 20 = 22 ) 23 or 25 disease 23 or 28 cjd 23 or 34 = 24 prion 25 disease 26 ( 28 cjd 27 sporadic 28 cjd 28 cjd 30 scjd 28 cjd 32 , 29 [ 30 scjd 30 scjd 31 ] 33 n 34 = 34 = 35 48 34 = 36 , 37 or 40 disease 37 or 43 cjd 37 or 49 and 38 genetic 39 prion 39 prion 40 disease 41 [ 43 cjd 42 familial 43 cjd 43 cjd 46 = 43 cjd 48 , 44 , 46 = 45 n 46 = 46 = 47 6 48 , 49 and 49 and 50 gerstmann 49 and 51 - 51 - 52 sträussler 52 sträussler 54 scheinker 53 - 54 scheinker 54 scheinker 57 = 54 scheinker 60 ) 55 , 57 = 56 n 57 = 57 = 58 7 57 = 59 ] thirty - one gray matter regions per hemisphere were assessed for abnormal hyperintensities . 0 ###LEFT-WALL### 1 thirty 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 14 . 2 - 5 matter 3 one 5 matter 4 gray 5 matter 5 matter 6 regions 5 matter 9 were 5 matter 10 assessed 6 regions 7 per 6 regions 9 were 7 per 8 hemisphere 10 assessed 11 for 11 for 13 hyperintensities 12 abnormal 13 hyperintensities the likelihood of cjd was assessed using our previously published criteria . 0 ###LEFT-WALL### 2 likelihood 0 ###LEFT-WALL### 6 assessed 0 ###LEFT-WALL### 12 . 1 the 2 likelihood 2 likelihood 3 of 2 likelihood 5 was 3 of 4 cjd 5 was 6 assessed 6 assessed 7 using 7 using 11 criteria 8 our 11 criteria 9 previously 10 published 10 published 11 criteria results : gray matter hyperintensities ( dwi [>] flair ) were found in all scjd cases , with certain regions preferentially involved , but never only in limbic regions , and rarely in the precentral gyrus . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 1 results 2 : 2 : 4 matter 3 gray 4 matter 4 matter 5 hyperintensities 4 matter 12 found 5 hyperintensities 9 flair 5 hyperintensities 11 were 6 ( 9 flair 7 dwi 9 flair 9 flair 10 ) 11 were 12 found 12 found 13 in 12 found 24 but 12 found 26 only 13 in 16 cases 14 all 16 cases 15 scjd 16 cases 16 cases 18 with 17 , 18 with 18 with 20 regions 18 with 23 , 19 certain 20 regions 20 regions 22 involved 21 preferentially 22 involved 24 but 25 never 26 only 31 and 27 in 29 regions 27 in 31 and 28 limbic 29 regions 30 , 31 and 31 and 32 rarely 31 and 33 in 33 in 36 gyrus 34 the 36 gyrus 35 precentral 36 gyrus in all scjd cases with basal ganglia or thalamic dwi hyperintensities , there was associated restricted diffusion ( apparent diffusion [coefficient] [ adc ] [map] ) . 0 ###LEFT-WALL### 13 there 0 ###LEFT-WALL### 14 was 0 ###LEFT-WALL### 27 . 1 in 4 cases 1 in 13 there 2 all 4 cases 3 scjd 4 cases 4 cases 5 with 5 with 8 or 6 basal 7 ganglia 7 ganglia 8 or 8 or 11 hyperintensities 8 or 12 , 9 thalamic 11 hyperintensities 10 dwi 11 hyperintensities 13 there 14 was 14 was 17 diffusion 15 associated 17 diffusion 16 restricted 17 diffusion 17 diffusion 20 diffusion 18 ( 20 diffusion 19 apparent 20 diffusion 20 diffusion 23 adc 20 diffusion 26 ) 22 [ 23 adc 23 adc 24 ] this restricted diffusion , however , was not seen in any nprpd cases , in whom isolated limbic hyperintensities ( flair [>] dwi ) were common . 0 ###LEFT-WALL### 3 diffusion 0 ###LEFT-WALL### 9 seen 1 this 2 restricted 2 restricted 3 diffusion 3 diffusion 7 was 4 , 5 however 5 however 6 , 5 however 7 was 7 was 8 not 7 was 9 seen 9 seen 10 in 10 in 13 cases 11 any 13 cases 12 nprpd 13 cases 13 cases 15 in 14 , 15 in 15 in 16 whom 15 in 19 hyperintensities 15 in 25 were 15 in 27 . 17 isolated 19 hyperintensities 18 limbic 19 hyperintensities 19 hyperintensities 23 dwi 19 hyperintensities 25 were 20 ( 23 dwi 21 flair 23 dwi 23 dwi 24 ) 25 were 26 common one reader 's sensitivity and specificity for scjd was 94 [%] and 100 % , respectively , the other 's [was] 92 [%] and 72 % . 0 ###LEFT-WALL### 4 sensitivity 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 20 's 0 ###LEFT-WALL### 27 . 1 one 2 reader 2 reader 3 's 3 's 4 sensitivity 5 and 6 specificity 5 and 20 's 6 specificity 7 for 6 specificity 9 was 7 for 8 scjd 9 was 14 % 9 was 16 respectively 10 94 12 and 12 and 13 100 12 and 14 % 15 , 16 respectively 16 respectively 17 , 18 the 19 other 19 other 20 's 20 's 26 % 22 92 24 and 24 and 25 72 24 and 26 % after consensus review , the readers ' combined mri sensitivity and specificity for scjd was 96 [%] and 93 % , respectively . 0 ###LEFT-WALL### 1 after 0 ###LEFT-WALL### 15 was 1 after 11 and 1 after 15 was 2 consensus 3 review 3 review 4 , 4 , 10 sensitivity 4 , 11 and 5 the 6 readers 6 readers 7 ' 7 ' 10 sensitivity 8 combined 10 sensitivity 9 mri 10 sensitivity 11 and 12 specificity 11 and 13 for 13 for 14 scjd 15 was 20 % 15 was 22 respectively 16 96 18 and 18 and 19 93 18 and 20 % 21 , 22 respectively 22 respectively 23 . familial cjd had overlapping mri features with scjd . 0 ###LEFT-WALL### 2 cjd 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 9 . 1 familial 2 cjd 2 cjd 3 had 3 had 6 features 3 had 7 with 4 overlapping 6 features 5 mri 6 features 7 with 8 scjd conclusions : the pattern of flair/dwi hyperintensity and restricted diffusion can differentiate scjd from other rpds with a high sensitivity and specificity . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 23 . 1 conclusions 2 : 2 : 4 pattern 3 the 4 pattern 4 pattern 5 of 5 of 7 hyperintensity 6 flair/dwi 7 hyperintensity 8 and 10 diffusion 8 and 12 differentiate 9 restricted 10 diffusion 10 diffusion 11 can 11 can 12 differentiate 12 differentiate 13 scjd 12 differentiate 14 from 14 from 21 and 15 other 16 rpds 16 rpds 17 with 16 rpds 21 and 17 with 20 sensitivity 18 a 20 sensitivity 19 high 20 sensitivity 21 and 22 specificity mri with dwi and adc should be included in scjd diagnostic criteria . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 8 included 0 ###LEFT-WALL### 13 . 1 mri 2 with 1 mri 4 and 2 with 3 dwi 4 and 5 adc 4 and 6 should 6 should 7 be 7 be 8 included 8 included 9 in 9 in 12 criteria 10 scjd 12 criteria 11 diagnostic 12 criteria new scjd mri criteria are proposed . 0 ###LEFT-WALL### 4 criteria 0 ###LEFT-WALL### 6 proposed 0 ###LEFT-WALL### 7 . 1 new 2 scjd 2 scjd 4 criteria 3 mri 4 criteria 4 criteria 5 are 5 are 6 proposed introduction : the survival of patients with chronic myelocytic leukemia ( cml ) has improved during the past decades . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 survival 2 : 15 improved 2 : 20 . 3 the 4 survival 4 survival 5 of 4 survival 14 has 5 of 6 patients 6 patients 7 with 7 with 10 leukemia 8 chronic 10 leukemia 9 myelocytic 10 leukemia 10 leukemia 12 cml 11 ( 12 cml 12 cml 13 ) 14 has 15 improved 15 improved 16 during 16 during 19 decades 17 the 18 past 17 the 19 decades however , there have been discrepancies between results reported from clinical trials and population - based studies . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 5 been 0 ###LEFT-WALL### 15 - 1 however 2 , 1 however 3 there 3 there 4 have 4 have 5 been 5 been 6 discrepancies 6 discrepancies 7 between 6 discrepancies 9 reported 6 discrepancies 10 from 7 between 8 results 10 from 13 and 11 clinical 12 trials 12 trials 13 and 13 and 14 population 15 - 17 studies 15 - 18 . 16 based 17 studies we aimed to elucidate the extent of these discrepancies . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 10 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 elucidate 3 to 4 elucidate 4 elucidate 6 extent 5 the 6 extent 6 extent 7 of 7 of 9 discrepancies 8 these 9 discrepancies results : twenty - nine trials were identified for data extraction . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 trials 2 : 8 identified 2 : 12 . 3 twenty 4 - 4 - 5 nine 4 - 6 trials 6 trials 7 were 7 were 8 identified 8 identified 9 for 9 for 11 extraction 10 data 11 extraction the survival rate calculated from seer data was lower than the survival rate in clinical trials in the corresponding period , with differences of 2.1 % - 50.7 % . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 8 was 1 the 3 rate 2 survival 3 rate 3 rate 4 calculated 3 rate 8 was 4 calculated 5 from 5 from 7 data 6 seer 7 data 8 was 9 lower 9 lower 10 than 9 lower 14 in 9 lower 17 in 10 than 13 rate 11 the 13 rate 12 survival 13 rate 14 in 16 trials 15 clinical 16 trials 17 in 20 period 18 the 20 period 19 corresponding 20 period 20 period 22 with 21 , 22 with 22 with 23 differences 22 with 30 . 23 differences 24 of 23 differences 29 % 24 of 26 % 25 2.1 26 % 27 - 29 % 28 50.7 29 % 29 % 30 . age - adapted survival was similar for four trials , but differences up to 35.8 % were seen in most . 0 ###LEFT-WALL### 4 survival 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 21 . 1 age 2 - 1 age 4 survival 3 adapted 4 survival 4 survival 5 was 5 was 6 similar 6 similar 7 for 7 for 9 trials 8 four 9 trials 10 , 11 but 11 but 12 differences 11 but 18 seen 12 differences 13 up 12 differences 17 were 13 up 14 to 14 to 16 % 15 35.8 16 % 17 were 18 seen 18 seen 19 in 19 in 20 most limitations of the study include the lack of information on chemotherapy in the seer database and possible heterogeneity of cases . 0 ###LEFT-WALL### 1 limitations 0 ###LEFT-WALL### 5 include 0 ###LEFT-WALL### 21 . 1 limitations 2 of 1 limitations 5 include 2 of 4 study 3 the 4 study 5 include 7 lack 5 include 10 on 5 include 12 in 6 the 7 lack 7 lack 8 of 8 of 9 information 10 on 11 chemotherapy 12 in 16 and 13 the 15 database 14 seer 15 database 15 database 16 and 16 and 18 heterogeneity 16 and 19 of 17 possible 18 heterogeneity 19 of 20 cases discussion : the survival rate in clinical trials of cml treatment is higher than the survival rate of all patients with cml . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 1 discussion 2 : 2 : 5 rate 3 the 5 rate 4 survival 5 rate 5 rate 6 in 5 rate 13 higher 6 in 8 trials 7 clinical 8 trials 8 trials 9 of 8 trials 11 treatment 8 trials 12 is 9 of 10 cml 11 treatment 12 is 13 higher 14 than 13 higher 21 with 14 than 17 rate 15 the 17 rate 16 survival 17 rate 17 rate 18 of 18 of 20 patients 19 all 20 patients 21 with 22 cml we speculate that the difference may be a result of access to better medications , selection of healthier patients for trials , and the time necessary for adoption of new treatments . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 speculate 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 32 . 1 we 2 speculate 2 speculate 3 that 3 that 5 difference 3 that 7 be 4 the 5 difference 5 difference 6 may 6 may 7 be 7 be 9 result 8 a 9 result 9 result 10 of 9 result 12 to 9 result 13 better 10 of 11 access 12 to 13 better 13 better 14 medications 15 , 23 and 16 selection 17 of 16 selection 23 and 17 of 19 patients 18 healthier 19 patients 19 patients 20 for 20 for 21 trials 22 , 23 and 23 and 25 time 23 and 26 necessary 24 the 25 time 26 necessary 27 for 27 for 28 adoption 28 adoption 29 of 29 of 31 treatments 30 new 31 treatments this finding underscores the need for population - based studies to give a more realistic idea of survival for patients with a given malignancy in the general population . 0 ###LEFT-WALL### 2 finding 0 ###LEFT-WALL### 3 underscores 1 this 2 finding 2 finding 3 underscores 3 underscores 5 need 4 the 5 need 5 need 6 for 5 need 10 studies 6 for 7 population 8 - 10 studies 9 based 10 studies 10 studies 11 to 10 studies 12 give 10 studies 29 . 11 to 12 give 12 give 16 idea 12 give 21 with 12 give 25 in 13 a 16 idea 14 more 15 realistic 15 realistic 16 idea 16 idea 17 of 16 idea 19 for 17 of 18 survival 19 for 20 patients 21 with 24 malignancy 22 a 24 malignancy 23 given 24 malignancy 25 in 28 population 26 the 28 population 27 general 28 population aggregation - prone polyglutamine ( polyq ) expansion proteins cause several neurodegenerative disorders , including huntington disease . 0 ###LEFT-WALL### 9 proteins 0 ###LEFT-WALL### 10 cause 1 aggregation 4 polyglutamine 1 aggregation 9 proteins 2 - 4 polyglutamine 3 prone 4 polyglutamine 4 polyglutamine 6 polyq 4 polyglutamine 7 ) 5 ( 6 polyq 6 polyq 7 ) 8 expansion 9 proteins 9 proteins 10 cause 10 cause 13 disorders 11 several 13 disorders 12 neurodegenerative 13 disorders 13 disorders 15 including 14 , 15 including 15 including 17 disease 15 including 18 . 16 huntington 17 disease the pharmacological activation of cellular stress responses could be a new strategy to combat protein conformational diseases . 0 ###LEFT-WALL### 3 activation 0 ###LEFT-WALL### 9 be 0 ###LEFT-WALL### 18 . 1 the 3 activation 2 pharmacological 3 activation 3 activation 4 of 3 activation 8 could 4 of 7 responses 5 cellular 6 stress 6 stress 7 responses 8 could 9 be 9 be 12 strategy 10 a 11 new 10 a 12 strategy 11 new 12 strategy 12 strategy 13 to 13 to 17 diseases 14 combat 17 diseases 15 protein 17 diseases 16 conformational 17 diseases hydroxylamine derivatives act as co - inducers of heat - shock proteins ( hsps ) and can enhance hsp expression in diseased cells , without significant adverse effects . 0 ###LEFT-WALL### 2 derivatives 0 ###LEFT-WALL### 16 and 1 hydroxylamine 2 derivatives 2 derivatives 16 and 3 act 4 as 3 act 16 and 4 as 7 inducers 5 co 6 - 5 co 7 inducers 7 inducers 8 of 8 of 9 heat 9 heat 12 proteins 10 - 12 proteins 11 shock 12 proteins 12 proteins 14 hsps 12 proteins 15 ) 13 ( 14 hsps 14 hsps 15 ) 16 and 17 can 16 and 20 expression 17 can 18 enhance 18 enhance 19 hsp 20 expression 21 in 20 expression 25 without 21 in 23 cells 22 diseased 23 cells 24 , 25 without 25 without 28 effects 25 without 29 . 26 significant 28 effects 27 adverse 28 effects here , we used caenorhabditis elegans expressing polyq expansions with 35 glutamines fused to the yellow fluorescent protein ( q35 - yfp ) in body wall muscle cells as a model system to investigate the effects of treatment with a novel hydroxylamine derivative , ng - 094 , on the progression of polyq diseases . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 55 . 1 here 2 , 1 here 3 we 3 we 4 used 4 used 6 elegans 5 caenorhabditis 6 elegans 6 elegans 7 expressing 6 elegans 13 fused 7 expressing 9 expansions 7 expressing 13 fused 8 polyq 9 expansions 9 expansions 10 with 10 with 12 glutamines 11 35 12 glutamines 13 fused 14 to 13 fused 24 in 13 fused 29 as 13 fused 33 to 13 fused 39 with 14 to 18 protein 15 the 18 protein 16 yellow 18 protein 17 fluorescent 18 protein 18 protein 20 q35 18 protein 22 yfp 19 ( 20 q35 20 q35 21 - 21 - 22 yfp 22 yfp 23 ) 24 in 28 cells 25 body 27 muscle 26 wall 27 muscle 27 muscle 28 cells 29 as 32 system 30 a 32 system 31 model 32 system 33 to 34 investigate 34 investigate 36 effects 35 the 36 effects 36 effects 37 of 37 of 38 treatment 39 with 42 hydroxylamine 40 a 42 hydroxylamine 41 novel 42 hydroxylamine 42 hydroxylamine 43 derivative 42 hydroxylamine 52 of 43 derivative 46 - 43 derivative 49 on 44 , 46 - 45 ng 46 - 46 - 47 094 46 - 48 , 49 on 51 progression 50 the 51 progression 52 of 54 diseases 53 polyq 54 diseases ng - 094 significantly ameliorated polyq - mediated animal paralysis , reduced the number of q35 - yfp aggregates and delayed polyq - dependent acceleration of aging . 0 ###LEFT-WALL### 3 094 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 28 . 1 ng 2 - 1 ng 3 094 3 094 11 , 4 significantly 5 ameliorated 5 ameliorated 10 paralysis 5 ameliorated 11 , 6 polyq 7 - 6 polyq 9 animal 8 mediated 9 animal 9 animal 10 paralysis 11 , 20 and 12 reduced 19 aggregates 12 reduced 20 and 13 the 14 number 14 number 15 of 14 number 19 aggregates 15 of 19 aggregates 16 q35 18 yfp 17 - 18 yfp 18 yfp 19 aggregates 20 and 21 delayed 21 delayed 25 acceleration 22 polyq 23 - 22 polyq 25 acceleration 24 dependent 25 acceleration 25 acceleration 26 of 26 of 27 aging micromolar concentrations of ng - 094 in animal tissues with only marginal effects on the nematode fitness sufficed to confer protection against polyq proteotoxicity , even when the drug was administered after disease [onset] . 0 ###LEFT-WALL### 2 concentrations 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 35 . 1 micromolar 2 concentrations 2 concentrations 3 of 2 concentrations 25 , 3 of 9 tissues 4 ng 9 tissues 5 - 6 094 6 094 7 in 7 in 9 tissues 8 animal 9 tissues 9 tissues 10 with 9 tissues 14 on 10 with 13 effects 11 only 12 marginal 12 marginal 13 effects 14 on 17 fitness 15 the 17 fitness 16 nematode 17 fitness 18 sufficed 19 to 18 sufficed 22 against 18 sufficed 25 , 19 to 20 confer 20 confer 21 protection 22 against 24 proteotoxicity 23 polyq 24 proteotoxicity 25 , 26 even 25 , 27 when 27 when 29 drug 27 when 31 administered 28 the 29 drug 29 drug 30 was 30 was 31 administered 31 administered 32 after 32 after 33 disease ng - 094 did not reduce insulin/insulin - like growth factor 1 - like signaling , but conferred cytoprotection by a mechanism involving the heat - shock transcription factor hsf - 1 that potentiated the expression of stress - inducible hsps . 0 ###LEFT-WALL### 3 094 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 31 - 0 ###LEFT-WALL### 42 . 1 ng 3 094 2 - 3 094 3 094 17 but 4 did 5 not 4 did 6 reduce 4 did 17 but 6 reduce 7 insulin/insulin 7 insulin/insulin 9 like 8 - 9 like 9 like 11 factor 9 like 16 , 10 growth 11 factor 11 factor 12 1 11 factor 14 like 13 - 14 like 14 like 15 signaling 14 like 16 , 16 , 17 but 17 but 18 conferred 18 conferred 19 cytoprotection 19 cytoprotection 20 by 19 cytoprotection 23 involving 20 by 22 mechanism 21 a 22 mechanism 23 involving 25 heat 24 the 25 heat 25 heat 30 hsf 26 - 30 hsf 27 shock 28 transcription 28 transcription 30 hsf 29 factor 30 hsf 30 hsf 31 - 31 - 32 1 31 - 39 - 32 1 33 that 32 1 34 potentiated 33 that 34 potentiated 34 potentiated 36 expression 35 the 36 expression 36 expression 37 of 37 of 38 stress 39 - 41 hsps 40 inducible 41 hsps ng [-] 094 is thus a promising candidate for tests on mammalian models of polyq and other protein conformational diseases . 0 ###LEFT-WALL### 1 ng 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 21 . 1 ng 3 094 1 ng 4 is 4 is 5 thus 4 is 8 candidate 6 a 7 promising 6 a 8 candidate 7 promising 8 candidate 8 candidate 9 for 8 candidate 14 of 9 for 10 tests 10 tests 11 on 11 on 13 models 12 mammalian 13 models 14 of 16 and 15 polyq 16 and 16 and 20 diseases 17 other 20 diseases 18 protein 20 diseases 19 conformational 20 diseases context : divergence between gh and igf1 values are often reported in treated acromegalic patients , but the mechanisms of this discrepancy have not been completely explored . 0 ###LEFT-WALL### 1 context 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 28 . 1 context 2 : 2 : 3 divergence 3 divergence 4 between 3 divergence 11 reported 4 between 7 igf1 5 gh 6 and 6 and 7 igf1 7 igf1 8 values 7 igf1 9 are 8 values 9 are 10 often 11 reported 11 reported 12 in 12 in 15 patients 13 treated 15 patients 14 acromegalic 15 patients 16 , 17 but 17 but 19 mechanisms 17 but 27 explored 18 the 19 mechanisms 19 mechanisms 20 of 19 mechanisms 23 have 20 of 22 discrepancy 21 this 22 discrepancy 23 have 24 not 23 have 25 been 25 been 26 completely 25 been 27 explored objective : to evaluate the frequency of divergence between gh and igf1 values and identify the role of clinical and metabolic factors in treated patients with acromegaly [,] according to the latest criteria of cure published in july 2010 . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 11 and 4 evaluate 14 and 5 the 6 frequency 6 frequency 7 of 6 frequency 9 between 6 frequency 11 and 7 of 8 divergence 9 between 10 gh 11 and 12 igf1 11 and 14 and 13 values 14 and 14 and 15 identify 14 and 37 in 14 and 39 2010 15 identify 17 role 16 the 17 role 17 role 18 of 18 of 22 factors 19 clinical 20 and 20 and 21 metabolic 20 and 22 factors 22 factors 23 in 22 factors 26 with 23 in 25 patients 24 treated 25 patients 26 with 29 according 27 acromegaly 29 according 29 according 30 to 29 according 33 criteria 30 to 32 latest 31 the 32 latest 33 criteria 34 of 33 criteria 36 published 34 of 35 cure 37 in 38 july design : retrospective study of patients ' records between october 2002 and march 2008 . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 . 1 design 2 : 2 : 4 study 3 retrospective 4 study 4 study 5 of 5 of 8 records 6 patients 7 ' 7 ' 8 records 8 records 9 between 9 between 12 and 10 october 11 2002 10 october 12 and 12 and 13 march 13 march 14 2008 patients were grouped according to their mean gh and igf1 values as ['] controlled ['] [(] normal gh and igf1 ) [,] ['] divergent ['] [(] high [igf1] and normal [gh] [ )(and ['] uncontrolled ['] ( high [gh] [and] [igf1] ) , [and] compared with respect to their clinical characteristics and metabolic markers . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 11 values 1 patients 2 were 2 were 3 grouped 3 grouped 5 to 4 according 5 to 5 to 7 mean 6 their 7 mean 7 mean 10 igf1 7 mean 11 values 8 gh 9 and 9 and 10 igf1 10 igf1 11 values 11 values 12 as 12 as 19 and 14 controlled 18 gh 17 normal 18 gh 18 gh 19 and 19 and 20 igf1 19 and 21 ) 19 and 24 divergent 24 divergent 29 and 27 high 29 and 29 and 33 )(and 30 normal 33 )(and 33 )(and 35 uncontrolled 35 uncontrolled 38 high 35 uncontrolled 45 compared 35 uncontrolled 46 with 37 ( 38 high 38 high 42 ) 43 , 45 compared 46 with 47 respect 47 respect 48 to 48 to 52 and 49 their 51 characteristics 50 clinical 51 characteristics 51 characteristics 52 and 52 and 54 markers 52 and 55 . 53 metabolic 54 markers results : patients ( n=104 ) were grouped as ['] controlled ['] [(] n=20 [ )(, ['] divergent ['] [(] n=43 [ )(and ['] uncontrolled ['] ( n=41 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 8 grouped 2 : 30 . 3 patients 5 n=104 3 patients 7 were 4 ( 5 n=104 5 n=104 6 ) 7 were 8 grouped 8 grouped 9 as 9 as 14 n=20 11 controlled 14 n=20 14 n=20 23 )(and 16 )(, 23 )(and 18 divergent 21 n=43 21 n=43 23 )(and 23 )(and 25 uncontrolled 23 )(and 28 n=41 23 )(and 29 ) 27 ( 28 n=41 28 n=41 29 ) more patients in the divergent group ( 93 % ) and uncontrolled group ( 98 % ) were treated with somatostatin analogs than in the controlled group ( 65 % ; p=0.001 for the comparison of the three groups [ )( 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 19 treated 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 41 )( 1 more 2 patients 2 patients 3 in 2 patients 11 and 3 in 6 group 4 the 6 group 5 divergent 6 group 6 group 9 % 7 ( 9 % 8 93 9 % 9 % 10 ) 11 and 13 group 11 and 16 % 11 and 18 were 12 uncontrolled 13 group 14 ( 16 % 15 98 16 % 16 % 17 ) 18 were 19 treated 19 treated 20 with 19 treated 23 than 20 with 22 analogs 21 somatostatin 22 analogs 23 than 24 in 24 in 27 group 25 the 27 group 26 controlled 27 group 27 group 30 % 28 ( 30 % 29 65 30 % 30 % 31 ; 31 ; 32 p=0.001 31 ; 39 groups 32 p=0.001 33 for 32 p=0.001 36 of 32 p=0.001 39 groups 33 for 35 comparison 34 the 35 comparison 36 of 38 three 37 the 38 three patients in the divergent group had higher fasting blood glucose ( 0.94 g/l [(] interquartile range [:] 0.83 - 1.17 [ )( )( systolic blood pressure ( 130 mmhg [(] 120 - 140 ) compared with the controlled group [(] 0.84 g/l ( 0.80 - 0.92 [ )( p=0.017 [ )(and 120 mmhg [(] interquartile range [:] 110 - 130 [;] p=0.029 [ )( 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 6 had 1 patients 2 in 1 patients 6 had 2 in 5 group 3 the 5 group 4 divergent 5 group 6 had 10 glucose 7 higher 10 glucose 8 fasting 10 glucose 9 blood 10 glucose 10 glucose 19 - 11 ( 19 - 12 0.94 13 g/l 13 g/l 16 range 15 interquartile 16 range 16 range 18 0.83 16 range 19 - 19 - 25 blood 20 1.17 25 blood 24 systolic 25 blood 25 blood 26 pressure 25 blood 35 compared 26 pressure 32 - 26 pressure 35 compared 27 ( 32 - 28 130 29 mmhg 28 130 32 - 29 mmhg 31 120 32 - 33 140 32 - 34 ) 35 compared 36 with 35 compared 45 - 36 with 39 group 36 with 42 g/l 37 the 39 group 38 controlled 39 group 41 0.84 42 g/l 43 ( 45 - 44 0.80 45 - 45 - 51 )(and 46 0.92 49 p=0.017 49 p=0.017 51 )(and 51 )(and 56 range 51 )(and 62 p=0.029 52 120 53 mmhg 53 mmhg 55 interquartile 55 interquartile 56 range 56 range 58 110 59 - 62 p=0.029 60 130 62 p=0.029 62 p=0.029 64 )( in patients with divergent igf1/gh levels , fasting glucose and gh were both strongly associated with igf1 . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 18 . 1 in 2 patients 1 in 10 and 2 patients 3 with 3 with 5 igf1/gh 4 divergent 5 igf1/gh 6 levels 7 , 7 , 9 glucose 7 , 10 and 8 fasting 9 glucose 10 and 11 gh 10 and 12 were 12 were 13 both 13 both 15 associated 14 strongly 15 associated 15 associated 16 with 16 with 17 igf1 conclusion : [totally] 41 % of treated acromegalic patients had a high igf1 and normal gh level . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 % 2 : 10 had 2 : 18 . 4 41 5 % 5 % 6 of 5 % 10 had 6 of 9 patients 7 treated 9 patients 8 acromegalic 9 patients 10 had 12 high 11 a 12 high 12 high 14 and 12 high 17 level 13 igf1 14 and 14 and 16 gh 14 and 17 level 15 normal 16 gh in these divergent patients treated with somatostatin analogs , these clinical and metabolic parameters might either play a causal role or be a marker for disease activity . 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 28 . 1 in 4 patients 1 in 9 , 2 these 4 patients 3 divergent 4 patients 5 treated 6 with 5 treated 9 , 6 with 8 analogs 7 somatostatin 8 analogs 9 , 21 or 10 these 14 parameters 11 clinical 12 and 12 and 13 metabolic 12 and 14 parameters 14 parameters 15 might 15 might 21 or 16 either 21 or 17 play 20 role 17 play 21 or 18 a 19 causal 18 a 20 role 19 causal 20 role 21 or 22 be 22 be 24 marker 23 a 24 marker 24 marker 25 for 25 for 27 activity 26 disease 27 activity background : active ageing is a key to healthy ageing ; shopping behaviour is an economically relevant activity of the elderly . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 ageing 2 : 5 is 2 : 11 ; 3 active 4 ageing 4 ageing 5 is 5 is 7 key 6 a 7 key 7 key 8 to 8 to 10 ageing 9 healthy 10 ageing 11 ; 13 behaviour 11 ; 14 is 12 shopping 13 behaviour 13 behaviour 14 is 14 is 18 activity 15 an 16 economically 15 an 18 activity 16 economically 17 relevant 17 relevant 18 activity 18 activity 19 of 19 of 21 elderly 20 the 21 elderly methods : analysis was based on the nahsit 1999 - 2000 dataset . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 analysis 2 : 5 based 2 : 13 . 3 analysis 4 was 4 was 5 based 5 based 6 on 6 on 12 dataset 7 the 12 dataset 8 nahsit 10 - 8 nahsit 12 dataset 9 1999 10 - 10 - 11 2000 a total of 1841 representative free - living elderly taiwanese people were selected and information included demographics , socioeconomic status , health behaviours , shopping frequencies , physical function and cognitive function . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 13 selected 0 ###LEFT-WALL### 14 and 1 a 2 total 2 total 3 of 2 total 12 were 3 of 11 people 4 1841 11 people 5 representative 11 people 6 free 7 - 6 free 11 people 8 living 11 people 9 elderly 11 people 10 taiwanese 11 people 12 were 13 selected 14 and 15 information 14 and 16 included 15 information 16 included 16 included 17 demographics 17 demographics 20 status 17 demographics 30 and 18 , 20 status 19 socioeconomic 20 status 20 status 21 , 21 , 30 and 22 health 23 behaviours 23 behaviours 24 , 24 , 26 frequencies 24 , 27 , 25 shopping 26 frequencies 27 , 29 function 27 , 30 and 28 physical 29 function 30 and 32 function 30 and 33 . 31 cognitive 32 function these data were linked to official death records . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 linked 0 ###LEFT-WALL### 9 . 1 these 2 data 2 data 3 were 3 were 4 linked 4 linked 5 to 5 to 8 records 6 official 7 death 7 death 8 records cox proportional hazard models were used to evaluate shopping frequency on death from 1999 - 2008 with possible covariate adjustment . 0 ###LEFT-WALL### 1 cox 0 ###LEFT-WALL### 21 . 1 cox 3 hazard 1 cox 17 with 2 proportional 3 hazard 3 hazard 4 models 3 hazard 8 evaluate 4 models 5 were 5 were 6 used 6 used 7 to 6 used 8 evaluate 7 to 8 evaluate 8 evaluate 10 frequency 8 evaluate 11 on 9 shopping 10 frequency 11 on 12 death 12 death 15 - 13 from 15 - 14 1999 15 - 15 - 16 2008 17 with 20 adjustment 18 possible 19 covariate 19 covariate 20 adjustment results : highly frequent shopping compared to never [or] rarely predicted survival ( hr 0.54 , 95 % ci 0.43 to 0.67 ) with adjustment for physical [function] and cognitive function and other covariates hr was 0.73 ( 95 % ci 0.56 to 0.93 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 frequent 2 : 46 . 3 highly 4 frequent 4 frequent 5 shopping 5 shopping 6 compared 6 compared 7 to 6 compared 24 with 7 to 12 survival 8 never 11 predicted 10 rarely 11 predicted 11 predicted 12 survival 12 survival 14 hr 12 survival 19 ci 13 ( 14 hr 14 hr 15 0.54 14 hr 16 , 16 , 19 ci 17 95 19 ci 18 % 19 ci 19 ci 21 to 19 ci 23 ) 20 0.43 21 to 21 to 22 0.67 24 with 32 and 24 with 37 0.73 25 adjustment 26 for 25 adjustment 32 and 26 for 29 and 27 physical 29 and 29 and 31 function 30 cognitive 31 function 32 and 34 covariates 32 and 35 hr 32 and 36 was 33 other 34 covariates 35 hr 36 was 37 0.73 41 ci 38 ( 41 ci 39 95 41 ci 40 % 41 ci 41 ci 43 to 41 ci 45 ) 42 0.56 43 to 43 to 44 0.93 [elderly] who [shopped] every day have 27 % less risk [of] death than the least frequent shoppers . 0 ###LEFT-WALL### 2 who 0 ###LEFT-WALL### 6 have 0 ###LEFT-WALL### 18 . 2 who 6 have 4 every 5 day 5 day 6 have 6 have 8 % 6 have 9 less 6 have 10 risk 7 27 8 % 10 risk 12 death 10 risk 13 than 13 than 17 shoppers 14 the 17 shoppers 15 least 16 frequent 16 frequent 17 shoppers men benefited more from everyday shopping than women with decreased hr 28 % versus 23 % compared to the least . 0 ###LEFT-WALL### 1 men 0 ###LEFT-WALL### 2 benefited 0 ###LEFT-WALL### 21 . 1 men 2 benefited 2 benefited 3 more 2 benefited 4 from 2 benefited 7 than 2 benefited 9 with 2 benefited 20 least 4 from 6 shopping 5 everyday 6 shopping 7 than 8 women 9 with 11 hr 10 decreased 11 hr 11 hr 13 % 11 hr 18 to 12 28 13 % 13 % 14 versus 13 % 17 compared 14 versus 16 % 15 23 16 % 17 compared 18 to 19 the 20 least conclusion : shopping behaviour favourably predicts survival . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 behaviour 2 : 6 predicts 2 : 8 . 3 shopping 4 behaviour 4 behaviour 6 predicts 5 favourably 6 predicts 6 predicts 7 survival highly frequent shopping may favour men more than women . 0 ###LEFT-WALL### 3 shopping 0 ###LEFT-WALL### 5 favour 0 ###LEFT-WALL### 10 . 1 highly 2 frequent 2 frequent 3 shopping 3 shopping 4 may 4 may 5 favour 5 favour 6 men 5 favour 7 more 5 favour 8 than 8 than 9 women shopping captures several dimensions of personal well - being , health and security as well as contributing to the community 's cohesiveness and economy and may [represent] [or] actually confer increased longevity . 0 ###LEFT-WALL### 1 shopping 0 ###LEFT-WALL### 2 captures 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 30 confer 0 ###LEFT-WALL### 33 . 1 shopping 2 captures 2 captures 4 dimensions 3 several 4 dimensions 4 dimensions 5 of 5 of 7 well 6 personal 7 well 8 - 9 being 8 - 10 , 8 - 12 and 10 , 11 health 12 and 13 security 12 and 25 and 13 security 16 as 13 security 25 and 14 as 15 well 15 well 16 as 16 as 17 contributing 17 contributing 18 to 18 to 20 community 19 the 20 community 21 's 23 and 21 's 25 and 22 cohesiveness 23 and 23 and 24 economy 25 and 26 may 26 may 30 confer 29 actually 30 confer 30 confer 32 longevity 31 increased 32 longevity [none] [in] this column orem 's self [-] care deficit model and holzkamp 's critical learning theory are used to discuss the story of an older adult haitian woman with an interview with a haitian nurse leader , mme [.] suze n'lemba . 0 ###LEFT-WALL### 4 column 0 ###LEFT-WALL### 19 used 3 this 4 column 4 column 12 and 4 column 18 are 4 column 19 used 5 orem 6 's 6 's 11 model 7 self 9 care 9 care 11 model 10 deficit 11 model 11 model 12 and 12 and 15 critical 12 and 16 learning 12 and 18 are 13 holzkamp 14 's 14 's 15 critical 16 learning 17 theory 19 used 20 to 19 used 21 discuss 20 to 21 discuss 21 discuss 23 story 21 discuss 30 with 21 discuss 33 with 22 the 23 story 23 story 24 of 24 of 29 woman 25 an 29 woman 26 older 27 adult 27 adult 29 woman 28 haitian 29 woman 30 with 32 interview 31 an 32 interview 33 with 37 leader 34 a 35 haitian 34 a 37 leader 35 haitian 37 leader 36 nurse 37 leader 37 leader 42 n'lemba 38 , 42 n'lemba 39 mme 41 suze 41 suze 42 n'lemba 42 n'lemba 43 . older adults in haiti today are seen as a group at very high risk due in part to the conditions in the country , and they are in need of considerable guidance in nursing . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 7 seen 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 35 . 1 older 2 adults 2 adults 3 in 2 adults 5 today 2 adults 6 are 3 in 4 haiti 6 are 7 seen 7 seen 8 as 7 seen 11 at 8 as 10 group 9 a 10 group 11 at 14 risk 12 very 13 high 13 high 14 risk 14 risk 15 due 15 due 17 part 16 in 17 part 17 part 18 to 18 to 20 conditions 19 the 20 conditions 20 conditions 21 in 21 in 23 country 22 the 23 country 24 , 25 and 25 and 26 they 25 and 27 are 26 they 27 are 27 are 28 in 27 are 33 in 28 in 29 need 29 need 30 of 30 of 32 guidance 31 considerable 32 guidance 33 in 34 nursing however the current number of nurses and nurse educators in haiti , and the extremely limited resources there , make it unlikely that the vast majority of these individuals will receive what they need . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 make 0 ###LEFT-WALL### 35 . 1 however 13 and 2 the 4 number 3 current 4 number 4 number 5 of 4 number 13 and 5 of 13 and 6 nurses 7 and 7 and 9 educators 7 and 10 in 7 and 13 and 8 nurse 9 educators 10 in 11 haiti 12 , 13 and 13 and 17 resources 13 and 19 , 13 and 20 make 14 the 17 resources 15 extremely 16 limited 16 limited 17 resources 17 resources 18 there 20 make 21 it 20 make 22 unlikely 22 unlikely 23 that 23 that 29 individuals 23 that 31 receive 24 the 26 majority 25 vast 26 majority 26 majority 27 of 26 majority 29 individuals 27 of 29 individuals 28 these 29 individuals 29 individuals 30 will 30 will 31 receive 31 receive 32 what 32 what 33 they 32 what 34 need 33 they 34 need therefore what is needed at this time are international nursing partnerships and assistance . 0 ###LEFT-WALL### 2 what 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 14 . 1 therefore 2 what 2 what 3 is 2 what 8 are 3 is 4 needed 4 needed 5 at 5 at 7 time 6 this 7 time 8 are 12 and 9 international 10 nursing 10 nursing 11 partnerships 11 partnerships 12 and 12 and 13 assistance introduction : changes in personality differ qualitatively and quantitatively among patients with different neurodegenerative diseases , likely due to divergent patterns of regional neurodegeneration . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 3 changes 2 : 6 differ 3 changes 4 in 3 changes 6 differ 4 in 5 personality 6 differ 8 and 6 differ 10 among 6 differ 12 with 7 qualitatively 8 and 8 and 9 quantitatively 10 among 11 patients 12 with 15 diseases 13 different 15 diseases 14 neurodegenerative 15 diseases 15 diseases 17 likely 16 , 17 likely 17 likely 19 to 17 likely 25 . 18 due 19 to 19 to 21 patterns 20 divergent 21 patterns 21 patterns 22 of 22 of 24 neurodegeneration 23 regional 24 neurodegeneration regional damage to circuits underlying various cognitive and emotional functions have been associated with interpersonal traits like dominance , extraversion , and warmth in patients with neurodegenerative diseases , suggesting that personality may [in] part be mediated by these more basic neuropsychological functions . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 37 mediated 0 ###LEFT-WALL### 44 . 1 regional 2 damage 2 damage 3 to 2 damage 19 , 3 to 4 circuits 4 circuits 10 functions 4 circuits 12 been 4 circuits 13 associated 4 circuits 17 like 5 underlying 10 functions 6 various 10 functions 7 cognitive 8 and 8 and 9 emotional 8 and 10 functions 10 functions 11 have 11 have 12 been 13 associated 14 with 14 with 16 traits 15 interpersonal 16 traits 17 like 18 dominance 19 , 20 extraversion 19 , 22 and 21 , 22 and 22 and 23 warmth 22 and 29 , 22 and 30 suggesting 22 and 32 personality 22 and 35 part 22 and 36 be 23 warmth 24 in 23 warmth 26 with 24 in 25 patients 26 with 28 diseases 27 neurodegenerative 28 diseases 30 suggesting 31 that 32 personality 33 may 33 may 35 part 36 be 37 mediated 37 mediated 38 by 38 by 43 functions 39 these 43 functions 40 more 41 basic 41 basic 43 functions 42 neuropsychological 43 functions in this study , we hypothesized that different combinations of cognitive , neuropsychiatric , and emotional measures would predict different interpersonal traits in patients with neurodegenerative diseases . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 hypothesized 0 ###LEFT-WALL### 28 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 hypothesized 6 hypothesized 9 combinations 6 hypothesized 19 predict 7 that 8 different 8 different 9 combinations 9 combinations 10 of 9 combinations 18 would 10 of 17 measures 11 cognitive 12 , 12 , 13 neuropsychiatric 12 , 15 and 14 , 15 and 15 and 16 emotional 15 and 17 measures 18 would 19 predict 19 predict 22 traits 19 predict 23 in 19 predict 25 with 20 different 22 traits 21 interpersonal 22 traits 23 in 24 patients 25 with 27 diseases 26 neurodegenerative 27 diseases methods : a battery of cognitive , neuropsychiatric , and emotional measures was administered to 286 patients with various neurodegenerative diseases such as alzheimer 's disease , behavioral variant frontotemporal dementia , semantic dementia , and progressive supranuclear palsy , and informants described patients ' dominance , extraversion , and warmth using the interpersonal adjective scales ( ias ) personality questionnaire . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 battery 2 : 14 administered 2 : 27 , 3 a 4 battery 4 battery 5 of 4 battery 13 was 5 of 12 measures 6 cognitive 7 , 7 , 8 neuropsychiatric 7 , 10 and 9 , 10 and 10 and 11 emotional 10 and 12 measures 13 was 14 administered 14 administered 15 to 14 administered 18 with 14 administered 23 as 15 to 17 patients 16 286 17 patients 18 with 21 diseases 19 various 21 diseases 20 neurodegenerative 21 diseases 22 such 23 as 23 as 26 disease 24 alzheimer 25 's 25 's 26 disease 27 , 34 dementia 27 , 36 and 28 behavioral 29 variant 29 variant 34 dementia 30 frontotemporal 34 dementia 31 dementia 32 , 31 dementia 34 dementia 33 semantic 34 dementia 35 , 36 and 36 and 41 and 36 and 43 described 37 progressive 39 palsy 38 supranuclear 39 palsy 39 palsy 41 and 40 , 41 and 41 and 42 informants 41 and 43 described 43 described 50 and 44 patients 45 ' 45 ' 46 dominance 46 dominance 47 , 47 , 48 extraversion 47 , 50 and 49 , 50 and 50 and 51 warmth 50 and 62 . 51 warmth 52 using 52 using 61 questionnaire 53 the 61 questionnaire 54 interpersonal 55 adjective 55 adjective 61 questionnaire 56 scales 58 ias 57 ( 58 ias 58 ias 59 ) 58 ias 60 personality 60 personality 61 questionnaire regression modeling was performed to identify [which] neuropsychological factors uniquely predicted current personality , controlling for age , gender , and premorbid personality . 0 ###LEFT-WALL### 1 regression 0 ###LEFT-WALL### 11 predicted 0 ###LEFT-WALL### 24 . 1 regression 2 modeling 1 regression 6 identify 1 regression 11 predicted 2 modeling 3 was 3 was 4 performed 4 performed 5 to 5 to 6 identify 6 identify 9 factors 6 identify 10 uniquely 8 neuropsychological 9 factors 11 predicted 21 and 12 current 13 personality 13 personality 14 , 14 , 15 controlling 14 , 21 and 15 controlling 16 for 16 for 17 age 17 age 19 gender 18 , 19 gender 19 gender 20 , 20 , 21 and 21 and 23 personality 22 premorbid 23 personality results : social dominance covaried with patients ' capacity for cognitive control and verbal fluency . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 4 dominance 2 : 5 covaried 3 social 4 dominance 4 dominance 5 covaried 5 covaried 6 with 5 covaried 10 for 6 with 9 capacity 7 patients 8 ' 8 ' 9 capacity 10 for 13 and 11 cognitive 12 control 12 control 13 and 13 and 15 fluency 14 verbal 15 fluency conversely , warmth did not rely on these executive or verbal skills , but covaried primarily with patients ' capacity for emotional responsiveness . 0 ###LEFT-WALL### 3 warmth 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 24 . 1 conversely 2 , 1 conversely 3 warmth 3 warmth 14 but 4 did 5 not 4 did 6 rely 4 did 14 but 6 rely 7 on 7 on 12 skills 8 these 12 skills 9 executive 10 or 10 or 11 verbal 10 or 12 skills 13 , 14 but 14 but 15 covaried 15 covaried 16 primarily 16 primarily 17 with 17 with 20 capacity 18 patients 19 ' 19 ' 20 capacity 20 capacity 21 for 21 for 23 responsiveness 22 emotional 23 responsiveness extraversion , representing a blend of dominance and warmth , demonstrated an intermediate degree [of] relationship to both executive/verbal and emotional functions . 0 ###LEFT-WALL### 1 extraversion 0 ###LEFT-WALL### 11 demonstrated 0 ###LEFT-WALL### 23 . 1 extraversion 3 representing 1 extraversion 11 demonstrated 2 , 3 representing 3 representing 5 blend 3 representing 10 , 4 a 5 blend 5 blend 6 of 6 of 8 and 7 dominance 8 and 8 and 9 warmth 11 demonstrated 16 relationship 11 demonstrated 17 to 12 an 13 intermediate 12 an 16 relationship 13 intermediate 14 degree 14 degree 16 relationship 17 to 22 functions 18 both 22 functions 19 executive/verbal 20 and 20 and 21 emotional 20 and 22 functions conclusions : these findings suggest that different personality traits are partly subserved by specific cognitive and emotional functions in neurodegenerative disease patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 5 suggest 2 : 23 . 3 these 4 findings 4 findings 5 suggest 5 suggest 8 personality 6 that 7 different 7 different 8 personality 8 personality 9 traits 8 personality 10 are 8 personality 12 subserved 9 traits 10 are 11 partly 12 subserved 12 subserved 13 by 12 subserved 19 in 13 by 18 functions 14 specific 18 functions 15 cognitive 16 and 16 and 17 emotional 16 and 18 functions 19 in 22 patients 20 neurodegenerative 21 disease 21 disease 22 patients while this study was performed in the context of brain damage , the results raise the question of whether individual differences in these neuropsychological abilities may also underlie variability in normal personality . 0 ###LEFT-WALL### 14 results 0 ###LEFT-WALL### 15 raise 0 ###LEFT-WALL### 33 . 1 while 3 study 1 while 5 performed 1 while 12 , 1 while 14 results 2 this 3 study 3 study 4 was 4 was 5 performed 5 performed 6 in 6 in 8 context 7 the 8 context 8 context 9 of 9 of 11 damage 10 brain 11 damage 13 the 14 results 14 results 15 raise 15 raise 17 question 16 the 17 question 17 question 18 of 18 of 19 whether 19 whether 21 differences 19 whether 28 underlie 20 individual 21 differences 21 differences 22 in 21 differences 26 may 22 in 25 abilities 23 these 25 abilities 24 neuropsychological 25 abilities 26 may 28 underlie 27 also 28 underlie 28 underlie 29 variability 28 underlie 30 in 30 in 32 personality 31 normal 32 personality this study examines the importance of variables from the theory of planned behaviour ( i.e [.] , attitudes toward behaviour , subjective norms , and perceived control ) for the prediction of consumption of anxiolytic and sedative - hypnotic ( ash ) medications in a sample of older persons , aged 69 years on average , 62 consumers and 92 [non] - consumers . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examines 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 64 . 1 this 2 study 2 study 3 examines 3 examines 5 importance 3 examines 8 from 4 the 5 importance 5 importance 6 of 6 of 7 variables 8 from 10 theory 9 the 10 theory 10 theory 11 of 10 theory 15 i.e 11 of 13 behaviour 12 planned 13 behaviour 14 ( 15 i.e 15 i.e 17 , 17 , 25 and 17 , 51 aged 17 , 56 , 18 attitudes 19 toward 18 attitudes 25 and 19 toward 20 behaviour 20 behaviour 23 norms 21 , 23 norms 22 subjective 23 norms 23 norms 24 , 24 , 25 and 25 and 27 control 25 and 28 ) 25 and 29 for 25 and 51 aged 26 perceived 27 control 29 for 31 prediction 30 the 31 prediction 31 prediction 32 of 31 prediction 43 medications 32 of 33 consumption 33 consumption 34 of 34 of 36 and 35 anxiolytic 36 and 36 and 37 sedative 38 - 43 medications 39 hypnotic 41 ash 39 hypnotic 43 medications 40 ( 41 ash 41 ash 42 ) 43 medications 44 in 43 medications 47 of 43 medications 50 , 44 in 46 sample 45 a 46 sample 47 of 49 persons 48 older 49 persons 51 aged 53 years 51 aged 55 average 52 69 53 years 54 on 55 average 56 , 58 consumers 56 , 59 and 57 62 58 consumers 59 and 60 92 59 and 62 - 60 92 62 - 62 - 63 consumers a favourable attitude toward ash and a sense of having less control regarding these drugs predict both current usage and intention to continue . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 24 . 1 a 2 favourable 1 a 3 attitude 2 favourable 3 attitude 3 attitude 4 toward 3 attitude 6 and 4 toward 5 ash 6 and 8 sense 6 and 20 and 7 a 8 sense 8 sense 9 of 9 of 10 having 10 having 12 control 10 having 16 predict 11 less 12 control 12 control 13 regarding 13 regarding 15 drugs 14 these 15 drugs 16 predict 19 usage 17 both 18 current 18 current 19 usage 20 and 21 intention 20 and 22 to 20 and 23 continue 22 to 23 continue perceived control predicts intention to start consumption of ash in current [non] - consumers . 0 ###LEFT-WALL### 2 control 0 ###LEFT-WALL### 3 predicts 0 ###LEFT-WALL### 15 . 1 perceived 2 control 2 control 3 predicts 3 predicts 4 intention 3 predicts 5 to 5 to 6 start 6 start 7 consumption 6 start 10 in 7 consumption 8 of 8 of 9 ash 10 in 14 consumers 11 current 13 - 11 current 14 consumers this study underlines the importance of considering the role of the older person 's decisional power in the consumption of these medications . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 underlines 0 ###LEFT-WALL### 23 . 1 this 2 study 2 study 3 underlines 3 underlines 5 importance 4 the 5 importance 5 importance 6 of 6 of 7 considering 7 considering 9 role 7 considering 17 in 8 the 9 role 9 role 10 of 10 of 16 power 11 the 13 person 12 older 13 person 13 person 14 's 14 's 16 power 15 decisional 16 power 17 in 19 consumption 18 the 19 consumption 19 consumption 20 of 20 of 22 medications 21 these 22 medications unlabelled : adipose tissue is the largest endocrine organ , producing various adipokines and many other substances . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 2 : 4 tissue 2 : 5 is 3 adipose 4 tissue 4 tissue 5 is 5 is 9 organ 6 the 7 largest 6 the 9 organ 8 endocrine 9 organ 9 organ 11 producing 10 , 11 producing 11 producing 14 and 11 producing 18 . 12 various 13 adipokines 13 adipokines 14 and 14 and 17 substances 15 many 16 other 16 other 17 substances almost all blood vessels are surrounded by perivascular adipose tissue ( pvat ) , which has not received research attention until recently . 0 ###LEFT-WALL### 4 vessels 0 ###LEFT-WALL### 6 surrounded 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 23 . 1 almost 2 all 2 all 4 vessels 3 blood 4 vessels 4 vessels 5 are 5 are 6 surrounded 6 surrounded 7 by 7 by 10 tissue 8 perivascular 9 adipose 9 adipose 10 tissue 10 tissue 12 pvat 11 ( 12 pvat 12 pvat 13 ) 14 , 15 which 14 , 18 received 15 which 16 has 16 has 17 not 16 has 18 received 18 received 20 attention 18 received 21 until 19 research 20 attention 21 until 22 recently this review will discuss the paracrine actions of pvat on the growth of underlying vascular smooth muscle cells ( vsmcs ) . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 4 discuss 0 ###LEFT-WALL### 22 . 1 this 2 review 2 review 3 will 3 will 4 discuss 4 discuss 7 actions 4 discuss 10 on 5 the 7 actions 6 paracrine 7 actions 7 actions 8 of 8 of 9 pvat 10 on 12 growth 11 the 12 growth 12 growth 13 of 13 of 14 underlying 14 underlying 18 cells 15 vascular 17 muscle 16 smooth 17 muscle 17 muscle 18 cells 18 cells 20 vsmcs 19 ( 20 vsmcs 20 vsmcs 21 ) pvat can release growth factors and inhibitors . 0 ###LEFT-WALL### 1 pvat 0 ###LEFT-WALL### 3 release 0 ###LEFT-WALL### 8 . 1 pvat 2 can 2 can 3 release 3 release 6 and 4 growth 5 factors 5 factors 6 and 6 and 7 inhibitors visfatin is the first identified growth factor derived from pvat . 0 ###LEFT-WALL### 1 visfatin 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 11 . 1 visfatin 2 is 2 is 4 first 3 the 4 first 4 first 5 identified 4 first 9 from 5 identified 8 derived 6 growth 8 derived 7 factor 8 derived 9 from 10 pvat decreased adiponectin and increased tumour necrosis factor - α in pvat play a pathological role for neointimal hyperplasia after endovascular injury . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 12 play 0 ###LEFT-WALL### 22 . 1 decreased 2 adiponectin 2 adiponectin 3 and 3 and 7 factor 3 and 8 - 3 and 9 α 3 and 12 play 4 increased 5 tumour 5 tumour 7 factor 6 necrosis 7 factor 9 α 10 in 10 in 11 pvat 12 play 15 role 12 play 19 after 13 a 14 pathological 13 a 15 role 14 pathological 15 role 15 role 16 for 16 for 18 hyperplasia 17 neointimal 18 hyperplasia 19 after 21 injury 20 endovascular 21 injury pvat - derived angiotensin ii , angiotensin 1 - 7 , reactive oxygen species , complement component 3 , no and [h] [(] 2 [ )(s have a paracrine action on vsmc contraction , endothelial or fibroblast function [;] however [,] their paracrine actions on vsmc growth remain to be directly verified . 0 ###LEFT-WALL### 1 pvat 0 ###LEFT-WALL### 2 - 2 - 4 angiotensin 2 - 11 , 3 derived 4 angiotensin 4 angiotensin 5 ii 4 angiotensin 7 angiotensin 6 , 7 angiotensin 7 angiotensin 9 - 7 angiotensin 11 , 8 1 9 - 9 - 10 7 11 , 14 species 11 , 15 , 12 reactive 13 oxygen 13 oxygen 14 species 15 , 16 complement 15 , 19 , 16 complement 17 component 17 component 18 3 19 , 20 no 19 , 21 and 21 and 26 )(s 21 and 27 have 24 2 26 )(s 26 )(s 27 have 27 have 36 or 27 have 38 function 28 a 30 action 29 paracrine 30 action 30 action 31 on 30 action 34 , 31 on 33 contraction 32 vsmc 33 contraction 34 , 35 endothelial 34 , 36 or 36 or 37 fibroblast 38 function 40 however 40 however 44 actions 40 however 52 verified 42 their 44 actions 43 paracrine 44 actions 44 actions 45 on 44 actions 48 remain 45 on 47 growth 46 vsmc 47 growth 48 remain 49 to 49 to 50 be 50 be 52 verified 51 directly 52 verified 52 verified 53 . factors such as monocyte chemoattractant protein - 1 , interleukin - 6 , interleukin - 8 , leptin , resistin , plasminogen activator inhibitor type - 1 , adrenomedullin , free fatty acids , glucocorticoids and sex hormones can be released from adipose tissue and can regulate vsmc growth . 0 ###LEFT-WALL### 1 factors 0 ###LEFT-WALL### 5 chemoattractant 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 50 . 1 factors 3 as 1 factors 5 chemoattractant 2 such 3 as 3 as 4 monocyte 5 chemoattractant 6 protein 6 protein 8 1 7 - 8 1 8 1 9 , 9 , 10 interleukin 9 , 11 - 11 - 12 6 11 - 21 , 12 6 14 interleukin 13 , 14 interleukin 14 interleukin 16 8 14 interleukin 21 , 15 - 16 8 16 8 18 leptin 16 8 20 resistin 16 8 21 , 17 , 18 leptin 18 leptin 19 , 19 , 20 resistin 20 resistin 21 , 21 , 25 type 21 , 26 - 22 plasminogen 23 activator 23 activator 25 type 24 inhibitor 25 type 26 - 27 1 26 - 28 , 28 , 36 and 29 adrenomedullin 30 , 30 , 33 acids 30 , 34 , 31 free 33 acids 32 fatty 33 acids 34 , 35 glucocorticoids 34 , 36 and 36 and 38 hormones 36 and 45 and 37 sex 38 hormones 39 can 40 be 39 can 45 and 40 be 41 released 41 released 42 from 42 from 44 tissue 43 adipose 44 tissue 45 and 46 can 45 and 49 growth 46 can 47 regulate 47 regulate 48 vsmc most of them have been verified for their secretion by pvat ; however , their paracrine functions are unknown . 0 ###LEFT-WALL### 3 them 0 ###LEFT-WALL### 6 verified 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 20 . 1 most 2 of 1 most 3 them 2 of 3 them 3 them 4 have 4 have 5 been 5 been 6 verified 6 verified 7 for 6 verified 10 by 7 for 9 secretion 8 their 9 secretion 10 by 11 pvat 12 ; 17 functions 12 ; 18 are 13 however 14 , 13 however 17 functions 15 their 17 functions 16 paracrine 17 functions 17 functions 18 are 18 are 19 unknown obesity , vascular injury , aging and infection may affect pvat , causing adipocyte abnormality and inflammatory cell infiltration , inducing imbalance of pvat - derived growth factors and inhibitors , leading to vsmc growth and finally resulting in development of proliferative vascular disease , including atherosclerosis , restenosis and hypertension . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 10 affect 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 52 . 1 obesity 2 , 2 , 4 injury 2 , 5 , 3 vascular 4 injury 5 , 6 aging 5 , 7 and 7 and 8 infection 7 and 9 may 9 may 10 affect 10 affect 11 pvat 12 , 16 and 12 , 45 , 13 causing 15 abnormality 14 adipocyte 15 abnormality 15 abnormality 16 and 16 and 19 infiltration 16 and 20 , 16 and 21 inducing 17 inflammatory 19 infiltration 18 cell 19 infiltration 21 inducing 22 imbalance 22 imbalance 23 of 22 imbalance 32 leading 23 of 24 pvat 24 pvat 29 and 25 - 29 and 26 derived 27 growth 27 growth 28 factors 28 factors 29 and 29 and 30 inhibitors 29 and 31 , 32 leading 33 to 32 leading 36 and 32 leading 39 in 33 to 34 vsmc 35 growth 36 and 36 and 37 finally 36 and 38 resulting 39 in 40 development 40 development 41 of 41 of 44 disease 42 proliferative 44 disease 43 vascular 44 disease 45 , 50 and 46 including 47 atherosclerosis 47 atherosclerosis 48 , 48 , 49 restenosis 48 , 50 and 50 and 51 hypertension in the future , using cell - specific gene interventions and local treatments may provide definitive evidence for identification of [key] factor [(] [s] ) involved in pvat dysfunction - induced vascular disease and thus may help to develop new therapies . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 22 factor 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 42 . 1 in 6 cell 1 in 7 - 1 in 11 and 2 the 6 cell 3 future 4 , 3 future 6 cell 5 using 6 cell 8 specific 9 gene 9 gene 10 interventions 10 interventions 11 and 11 and 12 local 11 and 13 treatments 11 and 20 of 11 and 22 factor 13 treatments 14 may 14 may 15 provide 15 provide 17 evidence 16 definitive 17 evidence 17 evidence 18 for 18 for 19 identification 19 identification 20 of 22 factor 25 ) 22 factor 26 involved 22 factor 27 in 27 in 29 dysfunction 28 pvat 29 dysfunction 30 - 34 and 31 induced 33 disease 31 induced 34 and 32 vascular 33 disease 34 and 36 may 35 thus 36 may 36 may 37 help 37 help 38 to 37 help 39 develop 38 to 39 develop 39 develop 41 therapies 40 new 41 therapies linked articles : this article is part of a themed section on fat and vascular responsiveness . 0 ###LEFT-WALL### 2 articles 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 17 . 1 linked 2 articles 3 : 5 article 3 : 6 is 4 this 5 article 5 article 6 is 6 is 14 and 7 part 8 of 7 part 14 and 8 of 11 section 9 a 10 themed 9 a 11 section 10 themed 11 section 11 section 12 on 12 on 13 fat 14 and 16 responsiveness 15 vascular 16 responsiveness to view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue - 3 . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 view 0 ###LEFT-WALL### 11 - 1 to 2 view 2 view 5 articles 2 view 6 in 3 the 4 other 4 other 5 articles 6 in 10 http://dx.doi.org/10.1111/bph.2012.165.issue 7 this 10 http://dx.doi.org/10.1111/bph.2012.165.issue 8 section 10 http://dx.doi.org/10.1111/bph.2012.165.issue 9 visit 10 http://dx.doi.org/10.1111/bph.2012.165.issue 11 - 12 3 11 - 13 . mitochondria are cytoplasmic organelles responsible for life and death . 0 ###LEFT-WALL### 1 mitochondria 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 . 1 mitochondria 2 are 2 are 4 organelles 2 are 5 responsible 3 cytoplasmic 4 organelles 5 responsible 6 for 6 for 8 and 7 life 8 and 8 and 9 death extensive evidence from animal models , postmortem brain studies [of] and clinical studies of aging and neurodegenerative diseases suggests that mitochondrial function is defective in aging and neurodegenerative diseases , such as alzheimer 's disease , parkinson 's disease , huntington 's disease , and amyotrophic lateral sclerosis . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 19 suggests 1 extensive 2 evidence 2 evidence 3 from 2 evidence 14 of 2 evidence 19 suggests 3 from 11 and 4 animal 5 models 5 models 6 , 6 , 9 studies 6 , 11 and 7 postmortem 8 brain 8 brain 9 studies 11 and 13 studies 12 clinical 13 studies 14 of 16 and 15 aging 16 and 16 and 18 diseases 17 neurodegenerative 18 diseases 19 suggests 22 function 19 suggests 23 is 20 that 22 function 21 mitochondrial 22 function 22 function 23 is 23 is 29 diseases 23 is 32 as 24 defective 25 in 24 defective 27 and 25 in 26 aging 27 and 28 neurodegenerative 27 and 29 diseases 30 , 32 as 31 such 32 as 32 as 45 and 32 as 49 . 33 alzheimer 34 's 34 's 35 disease 35 disease 36 , 36 , 39 disease 36 , 40 , 37 parkinson 38 's 38 's 39 disease 40 , 43 disease 40 , 45 and 41 huntington 42 's 42 's 43 disease 44 , 45 and 45 and 48 sclerosis 46 amyotrophic 48 sclerosis 47 lateral 48 sclerosis several lines of research suggest that mitochondrial abnormalities , including defects in oxidative phosphorylation , increased accumulation of mitochondrial dna defects , impaired calcium influx , accumulation of mutant proteins in mitochondria , and mitochondrial membrane potential dissipation are important cellular changes in both early and late - onset neurodegenerative diseases . 0 ###LEFT-WALL### 2 lines 0 ###LEFT-WALL### 5 suggest 0 ###LEFT-WALL### 9 , 1 several 2 lines 2 lines 3 of 2 lines 5 suggest 3 of 4 research 5 suggest 8 abnormalities 6 that 7 mitochondrial 7 mitochondrial 8 abnormalities 9 , 34 and 9 , 39 are 9 , 48 - 10 including 11 defects 11 defects 12 in 11 defects 15 , 12 in 14 phosphorylation 13 oxidative 14 phosphorylation 15 , 17 accumulation 15 , 22 , 16 increased 17 accumulation 17 accumulation 18 of 18 of 21 defects 19 mitochondrial 21 defects 20 dna 21 defects 22 , 25 influx 22 , 26 , 23 impaired 24 calcium 24 calcium 25 influx 26 , 27 accumulation 26 , 34 and 27 accumulation 28 of 27 accumulation 31 in 28 of 30 proteins 29 mutant 30 proteins 31 in 32 mitochondria 33 , 34 and 34 and 38 dissipation 34 and 39 are 35 mitochondrial 38 dissipation 36 membrane 38 dissipation 37 potential 38 dissipation 39 are 42 changes 39 are 46 and 40 important 42 changes 41 cellular 42 changes 42 changes 43 in 43 in 44 both 45 early 46 and 46 and 47 late 48 - 51 diseases 48 - 52 . 49 onset 51 diseases 50 neurodegenerative 51 diseases further , emerging evidence suggests that structural changes in mitochondria , including increased mitochondrial fragmentation and decreased mitochondrial fusion , are critical factors associated with mitochondrial dysfunction and cell death in aging and neurodegenerative diseases . 0 ###LEFT-WALL### 4 evidence 0 ###LEFT-WALL### 5 suggests 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 36 . 1 further 2 , 1 further 4 evidence 3 emerging 4 evidence 4 evidence 5 suggests 5 suggests 8 changes 6 that 7 structural 7 structural 8 changes 8 changes 9 in 9 in 10 mitochondria 11 , 12 including 11 , 21 are 12 including 16 and 12 including 21 are 13 increased 15 fragmentation 14 mitochondrial 15 fragmentation 15 fragmentation 16 and 16 and 19 fusion 16 and 20 , 17 decreased 19 fusion 18 mitochondrial 19 fusion 21 are 23 factors 22 critical 23 factors 23 factors 24 associated 23 factors 25 with 25 with 33 and 26 mitochondrial 27 dysfunction 27 dysfunction 28 and 28 and 30 death 28 and 31 in 28 and 33 and 29 cell 30 death 31 in 32 aging 33 and 35 diseases 34 neurodegenerative 35 diseases this paper discusses research that elucidates features of mitochondria that are associated with cellular dysfunction in aging and neurodegenerative diseases and discusses mitochondrial structural and functional changes , and abnormal mitochondrial dynamics in neurodegenerative diseases . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 36 . 1 this 2 paper 2 paper 21 and 3 discusses 4 research 3 discusses 13 with 3 discusses 16 in 3 discusses 21 and 4 research 5 that 4 research 6 elucidates 5 that 6 elucidates 6 elucidates 7 features 7 features 8 of 7 features 10 that 7 features 11 are 8 of 9 mitochondria 10 that 11 are 11 are 12 associated 13 with 15 dysfunction 14 cellular 15 dysfunction 16 in 18 and 17 aging 18 and 18 and 20 diseases 19 neurodegenerative 20 diseases 21 and 22 discusses 21 and 33 in 22 discusses 29 and 23 mitochondrial 27 changes 24 structural 25 and 25 and 26 functional 25 and 27 changes 27 changes 29 and 28 , 29 and 29 and 32 dynamics 30 abnormal 32 dynamics 31 mitochondrial 32 dynamics 33 in 35 diseases 34 neurodegenerative 35 diseases it also outlines mitochondria - targeted therapeutics in neurodegenerative diseases . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 outlines 0 ###LEFT-WALL### 11 . 1 it 3 outlines 2 also 3 outlines 3 outlines 7 therapeutics 3 outlines 8 in 4 mitochondria 5 - 4 mitochondria 7 therapeutics 6 targeted 7 therapeutics 8 in 10 diseases 9 neurodegenerative 10 diseases none the aim of study was to track a cumulative changes of amplitude [-] time parametres of components n1 , n2 and p300 of acoustic evoked potential in experimental situations different in complexity ( at the account and listening of sounds ) and to [compare] the received distinctions at examinees of young and mature age . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 8 track 1 none 3 aim 1 none 7 to 1 none 8 track 2 the 3 aim 3 aim 4 of 3 aim 6 was 4 of 5 study 6 was 7 to 8 track 15 time 9 a 10 cumulative 9 a 15 time 10 cumulative 11 changes 11 changes 12 of 12 of 13 amplitude 15 time 22 and 15 time 26 evoked 16 parametres 17 of 16 parametres 20 , 17 of 19 n1 18 components 19 n1 20 , 21 n2 20 , 22 and 22 and 23 p300 22 and 26 evoked 23 p300 24 of 24 of 25 acoustic 26 evoked 27 potential 26 evoked 28 in 28 in 30 situations 29 experimental 30 situations 30 situations 31 different 31 different 43 and 32 in 33 complexity 32 in 43 and 33 complexity 35 at 34 ( 35 at 35 at 38 and 35 at 42 ) 36 the 37 account 37 account 38 and 38 and 39 listening 39 listening 40 of 40 of 41 sounds 43 and 44 to 44 to 48 distinctions 46 the 48 distinctions 47 received 48 distinctions 48 distinctions 49 at 49 at 50 examinees 50 examinees 51 of 51 of 53 and 52 young 53 and 53 and 55 age 53 and 56 . 54 mature 55 age erp were recorded at 12 healthy subjects from 18 to 22 ages and 12 subjects from 32 to 59 ages . 0 ###LEFT-WALL### 1 erp 0 ###LEFT-WALL### 3 recorded 0 ###LEFT-WALL### 21 . 1 erp 2 were 2 were 3 recorded 3 recorded 4 at 3 recorded 8 from 3 recorded 16 from 4 at 7 subjects 5 12 7 subjects 6 healthy 7 subjects 8 from 13 and 9 18 10 to 10 to 11 22 10 to 12 ages 12 ages 13 and 13 and 15 subjects 14 12 15 subjects 16 from 20 ages 17 32 18 to 18 to 19 59 18 to 20 ages the two [-] stimuli oddball paradigm was used . 0 ###LEFT-WALL### 6 paradigm 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 9 . 1 the 6 paradigm 2 two 4 stimuli 4 stimuli 6 paradigm 5 oddball 6 paradigm 6 paradigm 7 was 7 was 8 used it is revealed that components n1 , n2 and p300 recorded in the situation of the listenings of sounds without any preliminary instruction do not differ at persons of young and mature age . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 34 . 1 it 2 is 2 is 3 revealed 3 revealed 4 that 4 that 5 components 4 that 26 differ 5 components 9 and 5 components 11 recorded 5 components 24 do 6 n1 7 , 7 , 8 n2 7 , 9 and 9 and 10 p300 9 and 11 recorded 11 recorded 12 in 12 in 14 situation 13 the 14 situation 14 situation 15 of 15 of 17 listenings 16 the 17 listenings 17 listenings 18 of 18 of 19 sounds 19 sounds 20 without 20 without 23 instruction 21 any 23 instruction 22 preliminary 23 instruction 24 do 25 not 24 do 26 differ 26 differ 27 at 27 at 28 persons 28 persons 29 of 29 of 33 age 30 young 31 and 31 and 32 mature 31 and 33 age at examinees of younger age the biger amplitude of component n1 is noted at the account of sounds in comparison with listening [whereas] [the] latency of the one do not change depending on complexity of the task . 0 ###LEFT-WALL### 8 amplitude 0 ###LEFT-WALL### 13 noted 0 ###LEFT-WALL### 38 . 1 at 2 examinees 1 at 8 amplitude 2 examinees 3 of 3 of 5 age 4 younger 5 age 6 the 8 amplitude 7 biger 8 amplitude 8 amplitude 9 of 8 amplitude 12 is 9 of 11 n1 10 component 11 n1 12 is 13 noted 13 noted 14 at 13 noted 19 in 13 noted 21 with 14 at 16 account 15 the 16 account 16 account 17 of 17 of 18 sounds 19 in 20 comparison 21 with 25 latency 21 with 30 not 21 with 31 change 22 listening 25 latency 25 latency 26 of 26 of 29 do 27 the 28 one 28 one 29 do 31 change 32 depending 32 depending 33 on 33 on 34 complexity 34 complexity 35 of 35 of 37 task 36 the 37 task it is shown that component n2 has stability of latency in relation to age and an experimental situation . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 shown 0 ###LEFT-WALL### 19 . 1 it 2 is 2 is 3 shown 3 shown 4 that 4 that 6 n2 4 that 7 has 5 component 6 n2 6 n2 7 has 7 has 8 stability 7 has 13 to 8 stability 9 of 9 of 10 latency 11 in 12 relation 12 relation 13 to 13 to 15 and 14 age 15 and 15 and 18 situation 16 an 17 experimental 16 an 18 situation 17 experimental 18 situation the amplitude of component n2 is above at the account of sounds in both age groups . 0 ###LEFT-WALL### 2 amplitude 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 17 . 1 the 2 amplitude 2 amplitude 3 of 2 amplitude 6 is 3 of 5 n2 4 component 5 n2 6 is 7 above 6 is 8 at 6 is 13 in 8 at 10 account 9 the 10 account 10 account 11 of 11 of 12 sounds 13 in 16 groups 14 both 16 groups 15 age 16 groups the amplitude - time parametres of component p300 do not differ at examinees of different age in a problem of listening of sounds . 0 ###LEFT-WALL### 2 amplitude 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 24 . 1 the 2 amplitude 3 - 4 time 4 time 5 parametres 4 time 11 differ 5 parametres 6 of 5 parametres 9 do 6 of 8 p300 7 component 8 p300 9 do 10 not 9 do 11 differ 11 differ 12 at 11 differ 17 in 12 at 13 examinees 13 examinees 14 of 14 of 16 age 15 different 16 age 17 in 19 problem 18 a 19 problem 19 problem 20 of 19 problem 22 of 20 of 21 listening 22 of 23 sounds the revealed features of components n1 , n2 and p300 at examinees of young and mature age in experimental situations different in complexity , allow to assume that with the years at the person adaptive mechanisms which allow carrying out [successfully] of the task . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 45 . 1 the 3 features 2 revealed 3 features 3 features 4 of 3 features 7 , 4 of 6 n1 5 components 6 n1 7 , 8 n2 7 , 9 and 9 and 10 p300 10 p300 11 at 10 p300 13 of 11 at 12 examinees 13 of 15 and 14 young 15 and 15 and 17 age 16 mature 17 age 17 age 18 in 18 in 20 situations 19 experimental 20 situations 20 situations 21 different 21 different 22 in 22 in 23 complexity 24 , 25 allow 25 allow 26 to 25 allow 32 at 25 allow 36 mechanisms 26 to 27 assume 27 assume 28 that 28 that 29 with 29 with 31 years 30 the 31 years 32 at 34 person 33 the 34 person 35 adaptive 36 mechanisms 36 mechanisms 37 which 36 mechanisms 38 allow 37 which 38 allow 38 allow 39 carrying 38 allow 42 of 40 out 42 of 42 of 44 task 43 the 44 task right - handed human subjects of 4 different ages ( 5 - 6 , 8 - 9 , 11 - 12 [yo] ..y and adult subjects [ )(performed simple graphical movements in a cyclic manner [with] maximal possible tempo . 0 ###LEFT-WALL### 1 right 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 23 ..y 0 ###LEFT-WALL### 40 . 1 right 3 handed 1 right 15 8 2 - 3 handed 3 handed 5 subjects 3 handed 12 - 3 handed 14 , 4 human 5 subjects 5 subjects 6 of 6 of 9 ages 7 4 9 ages 8 different 9 ages 10 ( 12 - 11 5 12 - 12 - 13 6 12 - 14 , 15 8 17 9 16 - 17 9 17 9 18 , 18 , 19 11 18 , 20 - 19 11 20 - 20 - 21 12 21 12 23 ..y 23 ..y 24 and 24 and 26 subjects 24 and 28 )(performed 25 adult 26 subjects 26 subjects 28 )(performed 28 )(performed 31 movements 28 )(performed 32 in 29 simple 31 movements 30 graphical 31 movements 32 in 39 tempo 33 a 34 cyclic 33 a 39 tempo 34 cyclic 35 manner 35 manner 39 tempo 37 maximal 39 tempo 38 possible 39 tempo the movements differed with respect to their coordination and serial complexity and were performed by each hand while holding the stylus either by the fingers or the fist . 0 ###LEFT-WALL### 2 movements 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 29 . 1 the 2 movements 2 movements 12 and 3 differed 4 with 3 differed 6 to 3 differed 12 and 4 with 5 respect 6 to 9 and 7 their 8 coordination 8 coordination 9 and 9 and 11 complexity 10 serial 11 complexity 12 and 13 were 13 were 14 performed 14 performed 15 by 14 performed 18 while 14 performed 23 by 15 by 17 hand 16 each 17 hand 18 while 19 holding 19 holding 21 stylus 19 holding 22 either 20 the 21 stylus 23 by 26 or 24 the 25 fingers 25 fingers 26 or 26 or 28 fist 27 the 28 fist the rate of successive submovements neither changed substantially with age nor showed any lateral asymmetry however it did depend on the movement being performed and the grip being used . 0 ###LEFT-WALL### 2 rate 0 ###LEFT-WALL### 11 nor 0 ###LEFT-WALL### 30 . 1 the 2 rate 2 rate 3 of 2 rate 11 nor 3 of 5 submovements 4 successive 5 submovements 6 neither 11 nor 7 changed 8 substantially 7 changed 9 with 7 changed 11 nor 9 with 10 age 11 nor 12 showed 11 nor 20 on 12 showed 15 asymmetry 12 showed 16 however 13 any 15 asymmetry 14 lateral 15 asymmetry 16 however 17 it 16 however 19 depend 17 it 18 did 18 did 19 depend 20 on 25 and 21 the 22 movement 22 movement 23 being 22 movement 25 and 23 being 24 performed 25 and 27 grip 25 and 28 being 26 the 27 grip 28 being 29 used the results show that the age [-] related trend in the cyclic movements can almost entirely be accounted for by a reduction in the number of submovements in a cycle . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 31 . 1 the 2 results 2 results 3 show 3 show 4 that 4 that 9 trend 4 that 19 for 5 the 9 trend 6 age 8 related 8 related 9 trend 9 trend 10 in 9 trend 14 can 10 in 13 movements 11 the 13 movements 12 cyclic 13 movements 14 can 17 be 15 almost 17 be 16 entirely 17 be 17 be 19 for 18 accounted 19 for 19 for 20 by 19 for 28 in 20 by 22 reduction 21 a 22 reduction 22 reduction 23 in 22 reduction 26 of 23 in 25 number 24 the 25 number 26 of 27 submovements 28 in 30 cycle 29 a 30 cycle the results are discussed in the view of the hypothesis that considers submovements to be the building blocks of a graphical movement . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 23 . 1 the 2 results 2 results 3 are 3 are 4 discussed 4 discussed 5 in 4 discussed 14 to 5 in 7 view 6 the 7 view 7 view 8 of 8 of 10 hypothesis 9 the 10 hypothesis 10 hypothesis 11 that 10 hypothesis 12 considers 11 that 12 considers 12 considers 13 submovements 14 to 15 be 15 be 18 blocks 16 the 18 blocks 17 building 18 blocks 18 blocks 19 of 19 of 22 movement 20 a 21 graphical 20 a 22 movement 21 graphical 22 movement chondrocyte aging is associated with cartilage degeneration and senescence impairs the regenerative potential of mesenchymal stem cells ( mscs ) . 0 ###LEFT-WALL### 1 chondrocyte 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 21 . 1 chondrocyte 2 aging 1 chondrocyte 3 is 3 is 4 associated 4 associated 5 with 5 with 7 degeneration 6 cartilage 7 degeneration 8 and 9 senescence 8 and 10 impairs 9 senescence 10 impairs 10 impairs 13 potential 11 the 13 potential 12 regenerative 13 potential 13 potential 14 of 14 of 17 cells 15 mesenchymal 16 stem 16 stem 17 cells 17 cells 19 mscs 18 ( 19 mscs 19 mscs 20 ) estrogen exerts profound effects on human physiology including articular cartilage and mscs . 0 ###LEFT-WALL### 1 estrogen 0 ###LEFT-WALL### 2 exerts 0 ###LEFT-WALL### 13 . 1 estrogen 2 exerts 2 exerts 4 effects 2 exerts 5 on 3 profound 4 effects 5 on 11 and 6 human 7 physiology 7 physiology 8 including 7 physiology 11 and 8 including 10 cartilage 9 articular 10 cartilage 11 and 12 mscs the present study should analyze the effects of pre - and postmenopausal estrogen concentrations on chondrogenic cells . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 5 analyze 0 ###LEFT-WALL### 18 . 1 the 3 study 2 present 3 study 3 study 4 should 4 should 5 analyze 5 analyze 7 effects 5 analyze 15 on 6 the 7 effects 7 effects 8 of 8 of 14 concentrations 9 pre 11 and 10 - 11 and 11 and 12 postmenopausal 11 and 14 concentrations 13 estrogen 14 concentrations 15 on 17 cells 16 chondrogenic 17 cells physiologic premenopausal concentrations of 17β - estradiol [(] e ( 2 ) ) significantly decelerated telomere attrition in mscs and chondrocytes while postmenopausal [e] ( 2 ) concentration had no significant effects . 0 ###LEFT-WALL### 3 concentrations 0 ###LEFT-WALL### 16 telomere 0 ###LEFT-WALL### 33 . 1 physiologic 3 concentrations 2 premenopausal 3 concentrations 3 concentrations 4 of 3 concentrations 15 decelerated 3 concentrations 16 telomere 4 of 5 17β 5 17β 7 estradiol 6 - 7 estradiol 7 estradiol 9 e 7 estradiol 11 2 7 estradiol 13 ) 10 ( 11 2 11 2 12 ) 14 significantly 15 decelerated 16 telomere 17 attrition 16 telomere 18 in 16 telomere 22 while 18 in 20 and 19 mscs 20 and 20 and 21 chondrocytes 22 while 28 concentration 22 while 29 had 23 postmenopausal 26 2 23 postmenopausal 28 concentration 25 ( 26 2 26 2 27 ) 28 concentration 29 had 29 had 32 effects 30 no 32 effects 31 significant 32 effects the estrogen agonist - antagonist tamoxifen did not affect telomere biology , but inhibited the [e] [(] 2 [ )(- stimulated reduction in telomere shortening . 0 ###LEFT-WALL### 3 agonist 0 ###LEFT-WALL### 4 - 1 the 3 agonist 2 estrogen 3 agonist 4 - 6 tamoxifen 4 - 13 but 4 - 20 )(- 4 - 26 . 5 antagonist 6 tamoxifen 6 tamoxifen 13 but 7 did 8 not 7 did 9 affect 7 did 13 but 9 affect 11 biology 10 telomere 11 biology 12 , 13 but 13 but 14 inhibited 14 inhibited 18 2 15 the 18 2 20 )(- 22 reduction 21 stimulated 22 reduction 22 reduction 23 in 23 in 24 telomere 24 telomere 25 shortening [e] [(] 2 [ )(and tamoxifen did not influence cell proliferation [,] cell morphology , and β - galactosidase staining in chondrogenic cells . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 5 )(and 0 ###LEFT-WALL### 24 . 5 )(and 6 tamoxifen 5 )(and 9 influence 6 tamoxifen 7 did 7 did 8 not 7 did 9 influence 9 influence 16 and 10 cell 14 morphology 11 proliferation 14 morphology 13 cell 14 morphology 14 morphology 16 and 15 , 16 and 16 and 19 galactosidase 16 and 20 staining 17 β 18 - 17 β 19 galactosidase 20 staining 21 in 21 in 23 cells 22 chondrogenic 23 cells [e] [(] 2 [ )(treatment did not affect the telomere - associated proteins trf1 and trf2 . 0 ###LEFT-WALL### 5 )(treatment 0 ###LEFT-WALL### 8 affect 0 ###LEFT-WALL### 17 . 3 2 5 )(treatment 5 )(treatment 6 did 6 did 7 not 6 did 8 affect 8 affect 16 trf2 9 the 13 proteins 10 telomere 11 - 10 telomere 13 proteins 12 associated 13 proteins 13 proteins 16 trf2 14 trf1 15 and 15 and 16 trf2 [e] [(] 2 [ )(had no regulatory effects on the expression rates of the cell cycle regulator p21 and the dna repair proteins sirt1 and xrcc5 . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 5 )(had 0 ###LEFT-WALL### 27 . 3 2 5 )(had 5 )(had 8 effects 5 )(had 9 on 6 no 8 effects 7 regulatory 8 effects 9 on 12 rates 10 the 12 rates 11 expression 12 rates 12 rates 13 of 13 of 19 and 14 the 18 p21 15 cell 17 regulator 16 cycle 17 regulator 17 regulator 18 p21 18 p21 19 and 19 and 26 xrcc5 20 the 23 proteins 21 dna 23 proteins 22 repair 23 proteins 23 proteins 26 xrcc5 24 sirt1 25 and 25 and 26 xrcc5 in spite of reducing telomere shortening in aging mscs and chondrocytes , estrogen is not able to prevent somatic cells from replicative exhaustion and from finally entering senescence . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 14 is 0 ###LEFT-WALL### 29 . 1 in 10 and 1 in 14 is 2 spite 3 of 2 spite 10 and 3 of 4 reducing 4 reducing 5 telomere 4 reducing 7 in 5 telomere 6 shortening 7 in 8 aging 8 aging 9 mscs 10 and 11 chondrocytes 10 and 12 , 13 estrogen 14 is 14 is 15 not 14 is 16 able 16 able 17 to 16 able 24 and 17 to 18 prevent 18 prevent 20 cells 19 somatic 20 cells 21 from 23 exhaustion 21 from 24 and 22 replicative 23 exhaustion 24 and 25 from 25 from 27 entering 26 finally 27 entering 27 entering 28 senescence the [fade] [of] telomere shortening under pre - [to] postmenopausal estrogen concentrations suggests , at least [in] [part] , a senescence [-] dependent cause for the onset of osteoarthritis in women [after] [menopause] . 0 ###LEFT-WALL### 4 telomere 0 ###LEFT-WALL### 13 suggests 0 ###LEFT-WALL### 34 . 1 the 4 telomere 4 telomere 5 shortening 4 telomere 13 suggests 5 shortening 6 under 6 under 12 concentrations 7 pre 8 - 7 pre 11 estrogen 10 postmenopausal 11 estrogen 11 estrogen 12 concentrations 13 suggests 16 least 13 suggests 24 cause 13 suggests 25 for 14 , 16 least 15 at 16 least 16 least 19 , 20 a 24 cause 21 senescence 23 dependent 23 dependent 24 cause 25 for 27 onset 26 the 27 onset 27 onset 28 of 28 of 29 osteoarthritis 29 osteoarthritis 30 in 30 in 31 women objective : the aim of this study was to examine lane change strategies in active younger and older drivers . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 examine 0 ###LEFT-WALL### 20 . 2 : 4 aim 2 : 8 was 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 this 7 study 8 was 9 to 9 to 10 examine 10 examine 13 strategies 10 examine 14 in 11 lane 13 strategies 12 change 13 strategies 14 in 19 drivers 15 active 19 drivers 16 younger 17 and 17 and 18 older 17 and 19 drivers visual inspection of mirrors and the blind spot and the control of the vehicle were documented in a simulator environment . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 16 documented 0 ###LEFT-WALL### 21 . 1 visual 2 inspection 2 inspection 3 of 2 inspection 5 and 3 of 4 mirrors 5 and 8 spot 5 and 9 and 6 the 8 spot 7 blind 8 spot 9 and 11 control 9 and 12 of 9 and 15 were 10 the 11 control 12 of 14 vehicle 13 the 14 vehicle 15 were 16 documented 16 documented 17 in 17 in 20 environment 18 a 20 environment 19 simulator 20 environment methods : younger ( n = 10 , 21 - 31 years [ )(and older ( n = 11 , 65 - 75 years ) active drivers drove through a continuous simulated environment including urban and rural sections . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 34 including 0 ###LEFT-WALL### 39 . 1 methods 2 : 2 : 3 younger 3 younger 6 = 3 younger 10 - 3 younger 14 )(and 3 younger 18 = 4 ( 6 = 5 n 6 = 6 = 7 10 6 = 8 , 9 21 10 - 10 - 11 31 12 years 14 )(and 14 )(and 15 older 16 ( 18 = 17 n 18 = 18 = 19 11 19 11 27 drivers 19 11 34 including 20 , 22 - 21 65 22 - 22 - 24 years 22 - 25 ) 22 - 27 drivers 23 75 24 years 26 active 27 drivers 27 drivers 28 drove 28 drove 29 through 29 through 33 environment 30 a 31 continuous 30 a 33 environment 31 continuous 33 environment 32 simulated 33 environment 33 environment 34 including 34 including 38 sections 35 urban 36 and 36 and 37 rural 36 and 38 sections the scenario included events [where] , to negotiate a secure lane change , the driver needed to look at 3 regions of interest ( roi ) [:] ( 1 ) the rearview mirror [,] [(] [2] [ )(the left side mirror , [and] [(] 3 [ )(the left blind spot . 0 ###LEFT-WALL### 2 scenario 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 6 , 1 the 2 scenario 2 scenario 3 included 3 included 4 events 6 , 15 driver 6 , 18 look 7 to 8 negotiate 7 to 13 , 7 to 15 driver 8 negotiate 12 change 9 a 12 change 10 secure 12 change 11 lane 12 change 14 the 15 driver 15 driver 16 needed 16 needed 17 to 17 to 18 look 18 look 19 at 19 at 21 regions 20 3 21 regions 21 regions 22 of 21 regions 32 rearview 21 regions 33 mirror 22 of 23 interest 23 interest 25 roi 23 interest 29 1 24 ( 25 roi 25 roi 26 ) 28 ( 29 1 29 1 30 ) 31 the 32 rearview 32 rearview 33 mirror 33 mirror 41 mirror 38 )(the 41 mirror 39 left 41 mirror 40 side 41 mirror 41 mirror 45 3 42 , 45 3 45 3 48 left 45 3 49 blind 45 3 51 . 47 )(the 48 left 48 left 49 blind 49 blind 50 spot the lane change maneuvers were necessary to avoid a vehicle parked halfway in the rightmost lane that was partially [or] completely blocking the lane or for overtaking a slower moving vehicle . 0 ###LEFT-WALL### 4 maneuvers 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 32 . 1 the 4 maneuvers 2 lane 3 change 3 change 4 maneuvers 4 maneuvers 5 were 5 were 6 necessary 6 necessary 7 to 6 necessary 8 avoid 7 to 8 avoid 8 avoid 10 vehicle 9 a 10 vehicle 10 vehicle 11 parked 10 vehicle 12 halfway 12 halfway 25 or 13 in 16 lane 13 in 25 or 14 the 15 rightmost 14 the 16 lane 16 lane 17 that 16 lane 18 was 17 that 18 was 18 was 22 blocking 19 partially 22 blocking 21 completely 22 blocking 22 blocking 24 lane 23 the 24 lane 25 or 26 for 26 for 27 overtaking 27 overtaking 31 vehicle 28 a 31 vehicle 29 slower 31 vehicle 30 moving 31 vehicle results : compared with younger drivers , older drivers showed a reduced frequency of visual inspection toward the rearview mirror and the blind spot . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 compared 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 25 . 1 results 2 : 2 : 3 compared 3 compared 4 with 4 with 6 drivers 5 younger 6 drivers 7 , 9 drivers 7 , 10 showed 8 older 9 drivers 9 drivers 10 showed 10 showed 13 frequency 10 showed 17 toward 11 a 13 frequency 12 reduced 13 frequency 13 frequency 14 of 14 of 16 inspection 15 visual 16 inspection 17 toward 21 and 18 the 20 mirror 19 rearview 20 mirror 20 mirror 21 and 21 and 24 spot 22 the 24 spot 23 blind 24 spot also , though the older drivers showed a constant frequency of visual inspection across the 2 types of driving maneuvers , the younger drivers increased their frequency of inspection when overtaking a slower vehicle . 0 ###LEFT-WALL### 24 drivers 0 ###LEFT-WALL### 25 increased 0 ###LEFT-WALL### 35 . 1 also 24 drivers 2 , 3 though 3 though 6 drivers 3 though 7 showed 3 though 21 , 3 though 24 drivers 4 the 6 drivers 5 older 6 drivers 6 drivers 7 showed 7 showed 10 frequency 7 showed 14 across 8 a 10 frequency 9 constant 10 frequency 10 frequency 11 of 11 of 13 inspection 12 visual 13 inspection 14 across 20 maneuvers 15 the 16 2 16 2 17 types 17 types 18 of 17 types 20 maneuvers 18 of 20 maneuvers 19 driving 20 maneuvers 22 the 24 drivers 23 younger 24 drivers 24 drivers 25 increased 25 increased 27 frequency 25 increased 30 when 26 their 27 frequency 27 frequency 28 of 28 of 29 inspection 30 when 31 overtaking 31 overtaking 34 vehicle 32 a 34 vehicle 33 slower 34 vehicle control of the car was mostly similar for both groups . 0 ###LEFT-WALL### 1 control 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 11 . 1 control 2 of 1 control 5 was 2 of 4 car 3 the 4 car 5 was 7 similar 6 mostly 7 similar 7 similar 8 for 8 for 10 groups 9 both 10 groups conclusion : a better knowledge of the drivers ' visual search strategies when changing lanes could help in identifying suboptimal strategies at - risk of causing crashes and also serves to develop retraining programs . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 1 conclusion 2 : 2 : 5 knowledge 3 a 5 knowledge 4 better 5 knowledge 5 knowledge 6 of 6 of 11 search 7 the 8 drivers 8 drivers 9 ' 9 ' 11 search 10 visual 11 search 11 search 12 strategies 11 search 22 at 11 search 24 risk 12 strategies 13 when 12 strategies 17 help 13 when 14 changing 13 when 16 could 14 changing 15 lanes 14 changing 16 could 17 help 18 in 18 in 19 identifying 19 identifying 21 strategies 19 identifying 22 at 20 suboptimal 21 strategies 23 - 24 risk 24 risk 25 of 24 risk 35 . 25 of 26 causing 26 causing 28 and 26 causing 31 to 27 crashes 28 and 28 and 29 also 28 and 30 serves 31 to 32 develop 32 develop 34 programs 33 retraining 34 programs it is still an open question whether subjective memory complaints ( smc ) can actually be considered to be clinically relevant predictors for the development of an objective memory impairment and even dementia . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 19 be 0 ###LEFT-WALL### 34 . 1 it 2 is 2 is 3 still 3 still 6 question 3 still 7 whether 3 still 18 to 4 an 6 question 5 open 6 question 7 whether 10 complaints 7 whether 17 considered 8 subjective 9 memory 9 memory 10 complaints 10 complaints 12 smc 10 complaints 14 can 11 ( 12 smc 12 smc 13 ) 14 can 16 be 15 actually 16 be 16 be 17 considered 18 to 19 be 19 be 22 predictors 20 clinically 21 relevant 21 relevant 22 predictors 22 predictors 23 for 23 for 25 development 24 the 25 development 25 development 26 of 26 of 33 dementia 27 an 28 objective 27 an 33 dementia 28 objective 29 memory 29 memory 33 dementia 30 impairment 31 and 31 and 32 even 31 and 33 dementia there is growing evidence that suggests that smc are associated with an increased risk of dementia and with the presence of biological [correlates] [of] early alzheimer 's disease . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 29 . 1 there 2 is 2 is 4 evidence 3 growing 4 evidence 4 evidence 5 that 4 evidence 6 suggests 5 that 6 suggests 6 suggests 8 smc 6 suggests 10 associated 7 that 8 smc 8 smc 9 are 9 are 10 associated 10 associated 17 and 11 with 14 risk 11 with 17 and 12 an 14 risk 13 increased 14 risk 14 risk 15 of 15 of 16 dementia 17 and 18 with 18 with 20 presence 19 the 20 presence 20 presence 21 of 21 of 28 disease 22 biological 26 alzheimer 25 early 26 alzheimer 26 alzheimer 27 's 27 's 28 disease in this paper , in order to shed some light on this issue , we try to discern whether subjects with smc showed a different profile of functional connectivity compared with subjects with mild cognitive impairment ( mci ) and healthy elderly subjects . 0 ###LEFT-WALL### 15 we 0 ###LEFT-WALL### 16 try 0 ###LEFT-WALL### 18 discern 0 ###LEFT-WALL### 44 . 1 in 3 paper 1 in 15 we 2 this 3 paper 3 paper 5 in 4 , 5 in 5 in 6 order 5 in 14 , 6 order 7 to 6 order 8 shed 7 to 8 shed 8 shed 10 light 9 some 10 light 10 light 11 on 11 on 13 issue 12 this 13 issue 15 we 16 try 16 try 17 to 16 try 18 discern 17 to 18 discern 18 discern 19 whether 18 discern 31 with 19 whether 20 subjects 19 whether 23 showed 20 subjects 21 with 20 subjects 23 showed 21 with 22 smc 23 showed 26 profile 23 showed 30 compared 24 a 26 profile 25 different 26 profile 26 profile 27 of 26 profile 30 compared 27 of 29 connectivity 28 functional 29 connectivity 31 with 40 and 32 subjects 33 with 32 subjects 40 and 33 with 36 impairment 34 mild 36 impairment 35 cognitive 36 impairment 36 impairment 38 mci 37 ( 38 mci 38 mci 39 ) 40 and 43 subjects 41 healthy 43 subjects 42 elderly 43 subjects in the present study , we compare the degree of synchronization of brain signals recorded with magnetoencephalography between three groups of subjects ( [56] in total ) : 19 with mci , 12 with smc and 25 healthy controls during a memory task . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 28 : 0 ###LEFT-WALL### 44 . 1 in 4 study 1 in 5 , 1 in 6 we 2 the 4 study 3 present 4 study 6 we 7 compare 7 compare 11 synchronization 7 compare 26 total 8 the 9 degree 9 degree 10 of 9 degree 11 synchronization 10 of 11 synchronization 11 synchronization 12 of 11 synchronization 21 of 12 of 14 signals 13 brain 14 signals 14 signals 15 recorded 15 recorded 16 with 16 with 17 magnetoencephalography 17 magnetoencephalography 18 between 18 between 20 groups 19 three 20 groups 21 of 22 subjects 23 ( 26 total 25 in 26 total 26 total 27 ) 28 : 29 19 28 : 32 , 29 19 30 with 30 with 31 mci 32 , 33 12 32 , 43 task 33 12 34 with 33 12 40 during 33 12 43 task 34 with 36 and 35 smc 36 and 36 and 39 controls 37 25 39 controls 38 healthy 39 controls 40 during 42 memory 41 a 42 memory synchronization likelihood , an index based on the theory of nonlinear dynamical systems , was used to measure functional connectivity . 0 ###LEFT-WALL### 2 likelihood 0 ###LEFT-WALL### 16 used 0 ###LEFT-WALL### 21 . 1 synchronization 2 likelihood 2 likelihood 5 index 2 likelihood 15 was 3 , 5 index 4 an 5 index 5 index 6 based 5 index 14 , 6 based 7 on 7 on 9 theory 8 the 9 theory 9 theory 10 of 10 of 13 systems 11 nonlinear 13 systems 12 dynamical 13 systems 15 was 16 used 16 used 17 to 16 used 18 measure 17 to 18 measure 18 measure 20 connectivity 19 functional 20 connectivity briefly , results show that subjects with smc have a very similar pattern of connectivity to control group , but on average , they present a lower synchronization value . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 30 . 1 briefly 2 , 1 briefly 3 results 3 results 4 show 4 show 5 that 5 that 6 subjects 5 that 9 have 6 subjects 7 with 6 subjects 9 have 7 with 8 smc 9 have 13 pattern 9 have 18 group 10 a 11 very 10 a 13 pattern 11 very 12 similar 12 similar 13 pattern 13 pattern 14 of 14 of 15 connectivity 15 connectivity 16 to 15 connectivity 17 control 16 to 17 control 18 group 20 but 19 , 20 but 20 but 22 average 20 but 23 , 21 on 22 average 23 , 24 they 23 , 25 present 24 they 25 present 25 present 29 value 26 a 29 value 27 lower 28 synchronization 28 synchronization 29 value these results could indicate that smc are representing an initial stage with a hypo - synchronization ( in comparison with the control group ) where the brain system is still not compensating for the failing memory networks , but behaving as controls when compared with the [mci] subjects . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 indicate 1 these 2 results 2 results 3 could 3 could 4 indicate 4 indicate 5 that 5 that 6 smc 5 that 7 are 6 smc 7 are 7 are 8 representing 8 representing 11 stage 9 an 10 initial 9 an 11 stage 10 initial 11 stage 11 stage 12 with 11 stage 25 where 12 with 14 hypo 13 a 14 hypo 14 hypo 16 synchronization 15 - 16 synchronization 16 synchronization 18 in 16 synchronization 24 ) 17 ( 18 in 18 in 19 comparison 18 in 24 ) 19 comparison 20 with 20 with 23 group 21 the 23 group 22 control 23 group 25 where 28 system 25 where 29 is 26 the 28 system 27 brain 28 system 28 system 29 is 29 is 30 still 29 is 31 not 29 is 33 for 31 not 32 compensating 33 for 37 networks 34 the 37 networks 35 failing 37 networks 36 memory 37 networks 37 networks 39 but 38 , 39 but 39 but 40 behaving 39 but 49 . 40 behaving 41 as 40 behaving 43 when 40 behaving 45 with 41 as 42 controls 43 when 44 compared 45 with 48 subjects 46 the 48 subjects telomeres are dna repeats at the ends of linear chromosomes in eukaryotic cells ; they form [cap] - like [specialized] structures at chromosome ends to protect them from digestion and degradation . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 32 . 1 telomeres 2 are 2 are 4 repeats 2 are 5 at 2 are 11 in 3 dna 4 repeats 5 at 7 ends 6 the 7 ends 7 ends 8 of 8 of 10 chromosomes 9 linear 10 chromosomes 11 in 13 cells 12 eukaryotic 13 cells 14 ; 15 they 14 ; 16 form 14 ; 18 - 15 they 16 form 18 - 19 like 19 like 21 structures 19 like 25 to 19 like 26 protect 21 structures 22 at 22 at 24 ends 23 chromosome 24 ends 25 to 26 protect 26 protect 27 them 26 protect 28 from 28 from 30 and 29 digestion 30 and 30 and 31 degradation with each cell division , somatic cell telomeres progressively wear [and] [shorten] , leading to cell senescence . 0 ###LEFT-WALL### 8 telomeres 0 ###LEFT-WALL### 10 wear 0 ###LEFT-WALL### 18 . 1 with 4 division 1 with 5 , 1 with 8 telomeres 2 each 4 division 3 cell 4 division 6 somatic 7 cell 7 cell 8 telomeres 8 telomeres 10 wear 9 progressively 10 wear 10 wear 13 , 10 wear 14 leading 10 wear 15 to 15 to 17 senescence 16 cell 17 senescence various environmental factors , such as oxidative stress and inflammation , can accelerate telomere shortening . 0 ###LEFT-WALL### 3 factors 0 ###LEFT-WALL### 13 accelerate 0 ###LEFT-WALL### 16 . 1 various 3 factors 2 environmental 3 factors 3 factors 6 as 3 factors 12 can 4 , 6 as 5 such 6 as 6 as 9 and 6 as 11 , 7 oxidative 8 stress 8 stress 9 and 9 and 10 inflammation 12 can 13 accelerate 13 accelerate 14 telomere 14 telomere 15 shortening the renin angiotensin system seems to be the key mechanism involved in aging . 0 ###LEFT-WALL### 4 system 0 ###LEFT-WALL### 5 seems 0 ###LEFT-WALL### 14 . 1 the 4 system 2 renin 4 system 3 angiotensin 4 system 4 system 5 seems 5 seems 6 to 5 seems 7 be 6 to 7 be 7 be 10 mechanism 8 the 10 mechanism 9 key 10 mechanism 10 mechanism 11 involved 11 involved 12 in 12 in 13 aging our previous studies demonstrated that treatment of human glomerular mesangial cells ( gmcs ) with angiotensin ii ( angii ) caused cell senescence . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 4 demonstrated 0 ###LEFT-WALL### 24 . 1 our 2 previous 1 our 3 studies 3 studies 4 demonstrated 4 demonstrated 5 that 5 that 6 treatment 5 that 21 caused 6 treatment 7 of 6 treatment 15 with 6 treatment 21 caused 7 of 11 cells 8 human 11 cells 9 glomerular 11 cells 10 mesangial 11 cells 11 cells 13 gmcs 12 ( 13 gmcs 13 gmcs 14 ) 15 with 16 angiotensin 16 angiotensin 17 ii 16 angiotensin 19 angii 18 ( 19 angii 19 angii 20 ) 21 caused 23 senescence 22 cell 23 senescence it is important to understand whether angii accelerates telomere shortening in gmcs and further promotes aging . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 15 promotes 0 ###LEFT-WALL### 17 . 1 it 2 is 2 is 3 important 3 important 4 to 3 important 15 promotes 4 to 13 and 5 understand 6 whether 5 understand 13 and 6 whether 7 angii 6 whether 8 accelerates 7 angii 8 accelerates 8 accelerates 9 telomere 8 accelerates 11 in 9 telomere 10 shortening 11 in 12 gmcs 13 and 15 promotes 14 further 15 promotes 15 promotes 16 aging therefore , this study was designed to investigate the change in telomere length in angii - induced gmc senescence and the role of the angii receptor antagonist losartan in delaying this process . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 6 designed 0 ###LEFT-WALL### 16 - 1 therefore 2 , 1 therefore 4 study 3 this 4 study 4 study 5 was 5 was 6 designed 6 designed 7 to 6 designed 8 investigate 7 to 8 investigate 8 investigate 10 change 8 investigate 14 in 9 the 10 change 10 change 11 in 11 in 13 length 12 telomere 13 length 14 in 15 angii 16 - 20 and 16 - 28 losartan 16 - 33 . 17 induced 19 senescence 18 gmc 19 senescence 19 senescence 20 and 20 and 22 role 20 and 23 of 20 and 28 losartan 21 the 22 role 23 of 27 antagonist 24 the 27 antagonist 25 angii 27 antagonist 26 receptor 27 antagonist 28 losartan 29 in 29 in 30 delaying 30 delaying 32 process 31 this 32 process the cells were synchronized and divided into a normal control group , an angii group ( angii , 10⁻⁶ [mol/l] [ )(and an angii [+] losartan group ( losartan , 10⁻⁵ [mol/l] ) , [and] were then cultured for 72 h . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 11 group 0 ###LEFT-WALL### 12 , 1 the 2 cells 2 cells 5 and 2 cells 7 into 2 cells 11 group 3 were 4 synchronized 3 were 5 and 5 and 6 divided 7 into 10 control 8 a 9 normal 8 a 10 control 9 normal 10 control 12 , 15 group 12 , 19 10⁻⁶ 12 , 22 )(and 13 an 15 group 14 angii 15 group 15 group 17 angii 15 group 19 10⁻⁶ 16 ( 17 angii 17 angii 18 , 22 )(and 27 group 23 an 27 group 24 angii 27 group 26 losartan 27 group 27 group 29 losartan 27 group 36 were 28 ( 29 losartan 29 losartan 31 10⁻⁵ 29 losartan 34 , 30 , 31 10⁻⁵ 31 10⁻⁵ 33 ) 36 were 37 then 36 were 38 cultured 38 cultured 39 for 39 for 41 h 40 72 41 h 41 h 42 . the telomere lengths were analyzed by southern blot analysis , cell morphology was monitored , the cell cycle and β - galactosidase staining were determined , and the expression of p53 and p21 proteins was assessed by western blotting . 0 ###LEFT-WALL### 2 telomere 0 ###LEFT-WALL### 5 analyzed 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 40 . 1 the 2 telomere 2 telomere 3 lengths 2 telomere 4 were 2 telomere 5 analyzed 3 lengths 4 were 5 analyzed 12 morphology 5 analyzed 14 monitored 6 by 9 analysis 6 by 10 , 6 by 12 morphology 7 southern 9 analysis 8 blot 9 analysis 11 cell 12 morphology 12 morphology 13 was 13 was 14 monitored 15 , 19 and 15 , 25 determined 15 , 27 and 16 the 18 cycle 17 cell 18 cycle 18 cycle 19 and 19 and 22 galactosidase 19 and 23 staining 19 and 24 were 20 β 21 - 20 β 22 galactosidase 24 were 25 determined 26 , 27 and 27 and 29 expression 27 and 36 assessed 28 the 29 expression 29 expression 30 of 29 expression 35 was 30 of 34 proteins 31 p53 32 and 32 and 33 p21 32 and 34 proteins 35 was 36 assessed 36 assessed 37 by 37 by 39 blotting 38 western 39 blotting compared with the control group , the angii group exhibited a markedly reduced telomere length , cell cycle arrest , enhanced β - galactosidase staining , and elevated expression of p53 and p21 . 0 ###LEFT-WALL### 9 group 0 ###LEFT-WALL### 10 exhibited 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 34 . 1 compared 2 with 1 compared 6 , 1 compared 9 group 2 with 5 group 3 the 5 group 4 control 5 group 7 the 9 group 8 angii 9 group 9 group 10 exhibited 10 exhibited 15 length 11 a 15 length 12 markedly 13 reduced 13 reduced 15 length 14 telomere 15 length 15 length 19 arrest 16 , 19 arrest 17 cell 18 cycle 18 cycle 19 arrest 19 arrest 20 , 20 , 32 and 21 enhanced 24 galactosidase 22 β 23 - 22 β 24 galactosidase 24 galactosidase 25 staining 24 galactosidase 27 and 26 , 27 and 27 and 29 expression 27 and 30 of 27 and 32 and 28 elevated 29 expression 30 of 31 p53 32 and 33 p21 the angii [+] losartan group displayed longer telomere lengths , further reduced β - galactosidase staining and decreased p53 and p21 expression compared to the angii group . 0 ###LEFT-WALL### 9 lengths 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 28 . 1 the 9 lengths 2 angii 5 group 4 losartan 5 group 5 group 6 displayed 6 displayed 9 lengths 7 longer 9 lengths 8 telomere 9 lengths 10 , 20 and 10 , 27 group 11 further 12 reduced 12 reduced 15 galactosidase 13 β 14 - 13 β 15 galactosidase 15 galactosidase 16 staining 15 galactosidase 17 and 17 and 19 p53 17 and 20 and 18 decreased 19 p53 20 and 22 expression 20 and 23 compared 20 and 27 group 21 p21 22 expression 23 compared 24 to 24 to 26 angii 25 the 26 angii this study confirms that angii induces the shortening of telomere lengths , p53 and p21 expression , cell cycle arrest , and the resulting cell senescence in gmcs . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 confirms 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 29 . 1 this 2 study 2 study 3 confirms 3 confirms 4 that 4 that 5 angii 4 that 6 induces 5 angii 6 induces 6 induces 8 shortening 7 the 8 shortening 8 shortening 9 of 9 of 11 lengths 10 telomere 11 lengths 12 , 22 and 13 p53 14 and 14 and 16 expression 14 and 20 arrest 14 and 22 and 15 p21 16 expression 17 , 20 arrest 18 cell 19 cycle 19 cycle 20 arrest 20 arrest 21 , 21 , 22 and 22 and 26 senescence 22 and 27 in 23 the 26 senescence 24 resulting 26 senescence 25 cell 26 senescence 27 in 28 gmcs in addition , losartan significantly reduced telomere shortening and cell senescence . 0 ###LEFT-WALL### 4 losartan 0 ###LEFT-WALL### 6 reduced 0 ###LEFT-WALL### 12 . 1 in 2 addition 1 in 3 , 1 in 4 losartan 4 losartan 6 reduced 5 significantly 6 reduced 6 reduced 9 and 7 telomere 8 shortening 8 shortening 9 and 9 and 11 senescence 10 cell 11 senescence background/objectives : resting metabolic rate [(] rmr ) contributes 60 - 80 % of total energy expenditure and is consistently lower in populations of african descent compared with populations of european populations . 0 ###LEFT-WALL### 1 background/objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 18 and 3 resting 7 rmr 3 resting 8 ) 3 resting 18 and 4 metabolic 5 rate 5 rate 7 rmr 9 contributes 13 % 9 contributes 18 and 10 60 11 - 11 - 12 80 11 - 13 % 13 % 14 of 14 of 17 expenditure 15 total 17 expenditure 16 energy 17 expenditure 18 and 19 is 19 is 21 lower 20 consistently 21 lower 21 lower 22 in 22 in 23 populations 23 populations 24 of 24 of 26 descent 25 african 26 descent 26 descent 27 compared 27 compared 28 with 28 with 29 populations 29 populations 30 of 30 of 32 populations 31 european 32 populations [determination] of european ancestry [(] ea ) through single nucleotide polymorphism [(] snp ) analysis would provide an initial step for identifying genetic associations that contribute to low rmr . 0 ###LEFT-WALL### 15 analysis 0 ###LEFT-WALL### 28 low 0 ###LEFT-WALL### 30 . 2 of 6 ea 2 of 7 ) 2 of 15 analysis 3 european 6 ea 4 ancestry 6 ea 8 through 13 snp 8 through 14 ) 8 through 15 analysis 9 single 10 nucleotide 10 nucleotide 13 snp 11 polymorphism 13 snp 15 analysis 16 would 16 would 17 provide 17 provide 20 step 17 provide 21 for 18 an 19 initial 18 an 20 step 19 initial 20 step 21 for 22 identifying 22 identifying 24 associations 22 identifying 27 to 23 genetic 24 associations 24 associations 25 that 24 associations 26 contribute 25 that 26 contribute 27 to 28 low 28 low 29 rmr we sought to evaluate the association between rmr and ea in african americans . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 sought 0 ###LEFT-WALL### 14 . 1 we 2 sought 2 sought 3 to 2 sought 4 evaluate 3 to 4 evaluate 4 evaluate 6 association 4 evaluate 7 between 4 evaluate 11 in 5 the 6 association 7 between 9 and 8 rmr 9 and 9 and 10 ea 11 in 13 americans 12 african 13 americans subjects/methods : rmr was measured by indirect calorimetry in 141 african american men and women ( aged 74.7±3.0 years ) enrolled in a substudy of the health , aging and body composition study . 0 ###LEFT-WALL### 1 subjects/methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 3 rmr 2 : 5 measured 2 : 14 and 2 : 28 , 3 rmr 4 was 4 was 5 measured 5 measured 6 by 5 measured 9 in 6 by 8 calorimetry 7 indirect 8 calorimetry 9 in 13 men 10 141 13 men 11 african 13 men 12 american 13 men 14 and 15 women 14 and 21 enrolled 15 women 19 years 15 women 21 enrolled 16 ( 19 years 17 aged 19 years 18 74.7±3.0 19 years 19 years 20 ) 21 enrolled 22 in 22 in 24 substudy 23 a 24 substudy 24 substudy 25 of 25 of 27 health 26 the 27 health 28 , 33 study 29 aging 30 and 30 and 31 body 31 body 32 composition 32 composition 33 study ancestry informative markers were used to estimate individual percent ea . 0 ###LEFT-WALL### 1 ancestry 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 11 . 1 ancestry 3 markers 1 ancestry 4 were 1 ancestry 5 used 2 informative 3 markers 3 markers 4 were 5 used 6 to 5 used 7 estimate 6 to 7 estimate 7 estimate 10 ea 8 individual 10 ea 9 percent 10 ea multivariate regression was used to assess the association between rmr and ea after adjustments for soft tissue fat - free mass [(] stffm ) , fat mass , age , study site , physical activity level and sex . 0 ###LEFT-WALL### 1 multivariate 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 39 . 1 multivariate 2 regression 1 multivariate 3 was 1 multivariate 4 used 2 regression 3 was 4 used 5 to 4 used 6 assess 5 to 6 assess 6 assess 37 and 7 the 8 association 8 association 9 between 8 association 25 , 9 between 12 ea 10 rmr 11 and 11 and 12 ea 12 ea 13 after 12 ea 15 for 12 ea 23 stffm 13 after 14 adjustments 15 for 18 fat 16 soft 17 tissue 17 tissue 18 fat 19 - 23 stffm 20 free 23 stffm 21 mass 23 stffm 23 stffm 24 ) 25 , 27 mass 25 , 28 , 26 fat 27 mass 28 , 29 age 28 , 30 , 30 , 32 site 30 , 33 , 31 study 32 site 33 , 36 level 33 , 37 and 34 physical 36 level 35 activity 36 level 37 and 38 sex results : mean ea was 23.8±16 [%] ( range : 0.1 - 70.7 % ) and there were no differences by sex . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 mean 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 23 . 1 results 2 : 2 : 3 mean 3 mean 4 ea 3 mean 5 was 4 ea 5 was 5 was 6 23.8±16 6 23.8±16 14 % 8 ( 14 % 9 range 10 : 10 : 12 - 11 0.1 12 - 12 - 13 70.7 13 70.7 14 % 14 % 15 ) 16 and 17 there 16 and 18 were 17 there 18 were 18 were 20 differences 19 no 20 differences 20 differences 21 by 21 by 22 sex following adjustments , each percent ea was associated with a 1.6 kcal/day [(] 95 % confidence interval : 0.42 , 2.7 kcal/day [ )(higher rmr ( p=0.008 ) . 0 ###LEFT-WALL### 6 ea 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 18 : 0 ###LEFT-WALL### 29 . 1 following 2 adjustments 1 following 3 , 1 following 6 ea 4 each 5 percent 5 percent 6 ea 6 ea 7 was 7 was 8 associated 8 associated 9 with 9 with 17 interval 10 a 17 interval 11 1.6 12 kcal/day 12 kcal/day 17 interval 14 95 15 % 15 % 17 interval 16 confidence 17 interval 18 : 19 0.42 19 0.42 25 rmr 20 , 25 rmr 21 2.7 22 kcal/day 22 kcal/day 24 )(higher 24 )(higher 25 rmr 25 rmr 27 p=0.008 25 rmr 28 ) 26 ( 27 p=0.008 27 p=0.008 28 ) this equates [to] a 160 kcal/day lower rmr in a population [of] [completely] african ancestry , with one [of] [completely] european ancestry . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 equates 1 this 2 equates 2 equates 8 rmr 2 equates 9 in 4 a 8 rmr 5 160 6 kcal/day 6 kcal/day 7 lower 7 lower 8 rmr 9 in 15 ancestry 10 a 11 population 10 a 15 ancestry 11 population 15 ancestry 14 african 15 ancestry 15 ancestry 17 with 16 , 17 with 17 with 22 ancestry 17 with 23 . 18 one 22 ancestry 21 european 22 ancestry additional adjustment for trunk stffm that partially accounts for high - metabolic rate organs did not affect this association . 0 ###LEFT-WALL### 2 adjustment 0 ###LEFT-WALL### 17 affect 0 ###LEFT-WALL### 20 . 1 additional 2 adjustment 2 adjustment 3 for 2 adjustment 15 did 3 for 5 stffm 4 trunk 5 stffm 5 stffm 6 that 5 stffm 8 accounts 6 that 8 accounts 7 partially 8 accounts 8 accounts 9 for 9 for 14 organs 10 high 11 - 10 high 13 rate 12 metabolic 13 rate 13 rate 14 organs 15 did 16 not 15 did 17 affect 17 affect 19 association 18 this 19 association conclusions : ea in african americans is strongly associated with higher rmr . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 ea 2 : 9 associated 2 : 13 . 3 ea 4 in 3 ea 7 is 4 in 6 americans 5 african 6 americans 7 is 9 associated 8 strongly 9 associated 9 associated 10 with 10 with 12 rmr 11 higher 12 rmr the data suggest that population differences in rmr may be due to genetic variants . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 15 . 1 the 2 data 2 data 3 suggest 3 suggest 4 that 4 that 6 differences 4 that 10 be 5 population 6 differences 6 differences 7 in 6 differences 9 may 7 in 8 rmr 9 may 10 be 10 be 12 to 11 due 12 to 12 to 14 variants 13 genetic 14 variants purpose of review : the present review discusses current concepts of hiv - associated neurocognitive disorders ( hand ) in the era of antiretroviral therapy ( art ) . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 4 : 1 purpose 2 of 2 of 3 review 4 : 7 review 4 : 8 discusses 4 : 29 . 5 the 7 review 6 present 7 review 7 review 8 discusses 8 discusses 10 concepts 8 discusses 20 in 9 current 10 concepts 10 concepts 11 of 10 concepts 16 disorders 11 of 12 hiv 13 - 16 disorders 14 associated 16 disorders 15 neurocognitive 16 disorders 16 disorders 18 hand 16 disorders 19 ) 17 ( 18 hand 18 hand 19 ) 20 in 22 era 21 the 22 era 22 era 23 of 23 of 25 therapy 24 antiretroviral 25 therapy 25 therapy 27 art 26 ( 27 art 27 art 28 ) as the hiv epidemic enters its fourth decade ( the second decade of art ) , research must address evolving factors in hand pathogenesis . 0 ###LEFT-WALL### 4 epidemic 0 ###LEFT-WALL### 5 enters 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 as 3 hiv 1 as 4 epidemic 2 the 3 hiv 4 epidemic 5 enters 5 enters 8 decade 6 its 8 decade 7 fourth 8 decade 8 decade 12 decade 9 ( 12 decade 10 the 11 second 10 the 12 decade 12 decade 13 of 12 decade 15 ) 13 of 14 art 16 , 17 research 16 , 19 address 17 research 18 must 18 must 19 address 19 address 21 factors 19 address 22 in 20 evolving 21 factors 22 in 24 pathogenesis 23 hand 24 pathogenesis these include persistent systemic and central nervous system ( cns ) inflammation , aging in the hiv - infected brain , hiv subtype [(] clade ) distribution , concomitant use of drugs of abuse , and potential neurotoxicity of art drugs . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 42 . 1 these 2 include 2 include 12 inflammation 3 persistent 12 inflammation 4 systemic 5 and 5 and 8 system 5 and 10 cns 5 and 12 inflammation 6 central 8 system 7 nervous 8 system 9 ( 10 cns 10 cns 11 ) 13 , 22 hiv 13 , 23 subtype 13 , 28 , 14 aging 15 in 14 aging 21 , 14 aging 22 hiv 15 in 17 hiv 16 the 17 hiv 17 hiv 20 brain 18 - 20 brain 19 infected 20 brain 20 brain 21 , 22 hiv 23 subtype 23 subtype 27 distribution 25 clade 26 ) 25 clade 27 distribution 28 , 36 and 29 concomitant 30 use 30 use 31 of 30 use 36 and 31 of 32 drugs 32 drugs 33 of 33 of 34 abuse 35 , 36 and 36 and 37 potential 36 and 38 neurotoxicity 36 and 41 drugs 38 neurotoxicity 39 of 38 neurotoxicity 41 drugs 39 of 40 art recent findings : although the severest form of hand , hiv - associated dementia ( had ) , is now rare due to art , the persistence of milder , functionally important hand forms persist in up to half of hiv - infected individuals . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 45 . 1 recent 2 findings 3 : 7 form 3 : 19 is 3 : 42 - 4 although 6 severest 4 although 7 form 5 the 6 severest 7 form 8 of 7 form 11 hiv 7 form 19 is 8 of 9 hand 10 , 11 hiv 11 hiv 14 dementia 11 hiv 18 , 12 - 14 dementia 13 associated 14 dementia 14 dementia 16 had 14 dementia 18 , 15 ( 16 had 16 had 17 ) 19 is 20 now 19 is 21 rare 21 rare 23 to 22 due 23 to 23 to 24 art 24 art 27 persistence 25 , 27 persistence 26 the 27 persistence 27 persistence 28 of 27 persistence 42 - 28 of 33 hand 29 milder 30 , 29 milder 33 hand 31 functionally 32 important 32 important 33 hand 33 hand 34 forms 33 hand 36 in 33 hand 37 up 33 hand 40 of 34 forms 35 persist 35 persist 36 in 37 up 38 to 38 to 39 half 40 of 41 hiv 42 - 44 individuals 43 infected 44 individuals hand prevalence may be higher in areas of africa where different hiv [subtypes] predominate , and art regimens that are more effective in suppressing cns hiv [replication] can improve neurological outcomes . 0 ###LEFT-WALL### 4 be 0 ###LEFT-WALL### 32 . 1 hand 2 prevalence 2 prevalence 3 may 3 may 4 be 4 be 5 higher 5 higher 6 in 5 higher 10 where 6 in 7 areas 7 areas 8 of 8 of 9 africa 10 where 12 hiv 10 where 16 and 11 different 12 hiv 12 hiv 16 and 14 predominate 16 and 15 , 16 and 16 and 29 improve 17 art 18 regimens 18 regimens 19 that 18 regimens 20 are 18 regimens 28 can 19 that 20 are 20 are 22 effective 21 more 22 effective 22 effective 23 in 23 in 24 suppressing 24 suppressing 26 hiv 25 cns 26 hiv 28 can 29 improve 29 improve 31 outcomes 30 neurological 31 outcomes hand are correlated with persistent systemic and cns inflammation , and enhanced neuronal injury due to stimulant abuse ( cocaine and methamphetamine ) , aging , and possibly art drugs themselves . 0 ###LEFT-WALL### 1 hand 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 32 . 1 hand 2 are 2 are 11 and 3 correlated 4 with 3 correlated 11 and 4 with 9 inflammation 5 persistent 9 inflammation 6 systemic 7 and 7 and 8 cns 7 and 9 inflammation 10 , 11 and 11 and 12 enhanced 12 enhanced 27 and 12 enhanced 31 themselves 13 neuronal 14 injury 14 injury 16 to 14 injury 27 and 15 due 16 to 16 to 18 abuse 17 stimulant 18 abuse 18 abuse 21 and 19 ( 21 and 20 cocaine 21 and 21 and 22 methamphetamine 21 and 23 ) 21 and 25 aging 21 and 26 , 24 , 25 aging 25 aging 26 , 26 , 27 and 27 and 28 possibly 27 and 30 drugs 29 art 30 drugs summary : prevention and treatment of hand requires strategies aimed at suppressing cns hiv [replication] and effects of systemic and cns inflammation in aging and substance - abusing hiv populations . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 1 summary 2 : 2 : 4 and 3 prevention 4 and 4 and 5 treatment 4 and 6 of 6 of 7 hand 7 hand 16 and 7 hand 18 of 8 requires 9 strategies 8 requires 16 and 9 strategies 10 aimed 10 aimed 11 at 11 at 12 suppressing 12 suppressing 14 hiv 13 cns 14 hiv 16 and 17 effects 18 of 25 and 19 systemic 20 and 20 and 22 inflammation 20 and 25 and 21 cns 22 inflammation 22 inflammation 23 in 23 in 24 aging 25 and 26 substance 25 and 27 - 25 and 28 abusing 28 abusing 30 populations 29 hiv 30 populations use of improved cns - penetrating art must be accompanied by evaluation [of] potential art neurotoxicity . 0 ###LEFT-WALL### 6 penetrating 0 ###LEFT-WALL### 10 accompanied 0 ###LEFT-WALL### 17 . 1 use 6 penetrating 2 of 4 cns 2 of 5 - 2 of 6 penetrating 3 improved 4 cns 6 penetrating 7 art 6 penetrating 8 must 8 must 9 be 9 be 10 accompanied 10 accompanied 11 by 11 by 16 neurotoxicity 12 evaluation 16 neurotoxicity 14 potential 16 neurotoxicity 15 art 16 neurotoxicity mncs were prepared from the buffy - coats of 59 healthy individual blood donors . 0 ###LEFT-WALL### 1 mncs 0 ###LEFT-WALL### 3 prepared 0 ###LEFT-WALL### 15 . 1 mncs 2 were 2 were 3 prepared 3 prepared 4 from 4 from 8 coats 5 the 8 coats 6 buffy 7 - 6 buffy 8 coats 8 coats 9 of 9 of 14 donors 10 59 14 donors 11 healthy 13 blood 12 individual 13 blood 13 blood 14 donors the results showed that large individual differences exist in the number of hspcs , as well as in the surviving fraction of cells . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 1 the 2 results 2 results 3 showed 3 showed 7 differences 3 showed 8 exist 4 that 5 large 5 large 7 differences 6 individual 7 differences 7 differences 8 exist 8 exist 9 in 9 in 13 hspcs 10 the 11 number 11 number 12 of 11 number 13 hspcs 12 of 13 hspcs 13 hspcs 15 as 14 , 15 as 15 as 16 well 15 as 24 . 16 well 17 as 16 well 22 of 17 as 18 in 18 in 21 fraction 19 the 21 fraction 20 surviving 21 fraction 22 of 23 cells furthermore , the number of progenitor cells strongly correlated with their surviving fraction , suggesting that the radiosensitivity of hematopoietic progenitor cells decreases with the number of cells in the 10 ( 5 ) cells population . 0 ###LEFT-WALL### 7 cells 0 ###LEFT-WALL### 9 correlated 0 ###LEFT-WALL### 37 . 1 furthermore 2 , 1 furthermore 7 cells 3 the 4 number 4 number 5 of 4 number 7 cells 5 of 7 cells 6 progenitor 7 cells 7 cells 9 correlated 8 strongly 9 correlated 9 correlated 10 with 10 with 13 fraction 10 with 36 population 11 their 13 fraction 12 surviving 13 fraction 13 fraction 15 suggesting 14 , 15 suggesting 15 suggesting 16 that 15 suggesting 34 ) 16 that 18 radiosensitivity 16 that 23 decreases 17 the 18 radiosensitivity 18 radiosensitivity 19 of 18 radiosensitivity 23 decreases 19 of 22 cells 20 hematopoietic 21 progenitor 21 progenitor 22 cells 23 decreases 24 with 23 decreases 29 in 24 with 26 number 25 the 26 number 26 number 27 of 27 of 28 cells 29 in 31 10 30 the 31 10 31 10 33 5 32 ( 33 5 33 5 34 ) 35 cells 36 population a statistically significant negative correlation was observed between the surviving fraction observed at a dose of 0.5 gy and the age of an individual , however , none of these correlations were observed after 2 gy irradiation . 0 ###LEFT-WALL### 5 correlation 0 ###LEFT-WALL### 7 observed 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 38 . 1 a 2 statistically 1 a 5 correlation 2 statistically 3 significant 3 significant 5 correlation 4 negative 5 correlation 5 correlation 6 was 6 was 7 observed 7 observed 8 between 7 observed 13 at 8 between 11 fraction 9 the 11 fraction 10 surviving 11 fraction 11 fraction 12 observed 13 at 19 and 14 a 15 dose 15 dose 16 of 15 dose 19 and 16 of 18 gy 17 0.5 18 gy 19 and 21 age 19 and 22 of 20 the 21 age 22 of 24 individual 23 an 24 individual 25 , 28 none 25 , 33 observed 26 however 27 , 26 however 28 none 28 none 29 of 28 none 32 were 29 of 31 correlations 30 these 31 correlations 32 were 33 observed 33 observed 34 after 34 after 37 irradiation 35 2 37 irradiation 36 gy 37 irradiation no statistically significant difference was observed in individual radiosensitivity between males and females at either radiation dose . 0 ###LEFT-WALL### 4 difference 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 18 . 1 no 4 difference 2 statistically 3 significant 3 significant 4 difference 4 difference 5 was 5 was 6 observed 6 observed 7 in 6 observed 10 between 6 observed 14 at 7 in 9 radiosensitivity 8 individual 9 radiosensitivity 10 between 12 and 11 males 12 and 12 and 13 females 14 at 17 dose 15 either 17 dose 16 radiation 17 dose the present results indicated a correlation between the individual responsiveness of hspcs to ionizing irradiation , especially to low dose irradiation , and aging . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 indicated 0 ###LEFT-WALL### 25 . 1 the 3 results 2 present 3 results 3 results 4 indicated 4 indicated 6 correlation 5 a 6 correlation 6 correlation 7 between 7 between 10 responsiveness 8 the 10 responsiveness 9 individual 10 responsiveness 10 responsiveness 11 of 11 of 23 and 12 hspcs 13 to 12 hspcs 23 and 13 to 14 ionizing 14 ionizing 15 irradiation 15 irradiation 18 to 16 , 18 to 17 especially 18 to 18 to 19 low 18 to 22 , 19 low 21 irradiation 20 dose 21 irradiation 23 and 24 aging objective : early studies have indicated that body fat shifts from peripheral stores to central stores with aging . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 studies 2 : 6 indicated 2 : 19 . 3 early 4 studies 4 studies 5 have 5 have 6 indicated 6 indicated 7 that 7 that 9 fat 7 that 10 shifts 8 body 9 fat 9 fat 10 shifts 10 shifts 11 from 10 shifts 14 to 11 from 13 stores 12 peripheral 13 stores 14 to 16 stores 15 central 16 stores 16 stores 17 with 17 with 18 aging the objective of this study was to investigate age - related changes in abdominal fat distribution of japanese men and women of the general population over a wide range of body mass indices ( bmi ) . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 11 related 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 investigate 7 to 8 investigate 8 investigate 9 age 10 - 11 related 11 related 12 changes 11 related 13 in 11 related 26 over 11 related 37 . 13 in 20 and 14 abdominal 16 distribution 15 fat 16 distribution 16 distribution 17 of 16 distribution 20 and 17 of 19 men 18 japanese 19 men 20 and 21 women 20 and 22 of 22 of 25 population 23 the 25 population 24 general 25 population 26 over 29 range 27 a 28 wide 27 a 29 range 28 wide 29 range 29 range 30 of 29 range 35 bmi 30 of 33 indices 31 body 33 indices 32 mass 33 indices 34 ( 35 bmi 35 bmi 36 ) methods : a total of 2,220 [non] - diabetic , apparently healthy japanese adults ( 1,240 men and 980 women ; age range 40 - 69 years ) were included in the study sample . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 ; 0 ###LEFT-WALL### 35 . 1 methods 2 : 2 : 4 total 3 a 4 total 4 total 5 of 4 total 14 adults 5 of 6 2,220 8 - 14 adults 9 diabetic 10 , 9 diabetic 14 adults 11 apparently 12 healthy 12 healthy 14 adults 13 japanese 14 adults 14 adults 18 and 14 adults 21 ; 15 ( 18 and 16 1,240 17 men 17 men 18 and 18 and 20 women 18 and 21 ; 19 980 20 women 21 ; 23 range 21 ; 30 included 22 age 23 range 23 range 24 40 23 range 27 years 23 range 29 were 25 - 27 years 26 69 27 years 27 years 28 ) 29 were 30 included 30 included 31 in 31 in 34 sample 32 the 34 sample 33 study 34 sample all subjects underwent a ct [scan] at the level of the umbilicus , and the areas of visceral adipose tissue ( at ) and subcutaneous at were quantified . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 29 . 1 all 2 subjects 2 subjects 3 underwent 3 underwent 5 ct 3 underwent 7 at 4 a 5 ct 7 at 9 level 8 the 9 level 9 level 10 of 10 of 12 umbilicus 11 the 12 umbilicus 13 , 14 and 14 and 24 and 14 and 28 quantified 15 the 16 areas 16 areas 17 of 16 areas 24 and 17 of 20 tissue 18 visceral 19 adipose 19 adipose 20 tissue 20 tissue 22 at 21 ( 22 at 22 at 23 ) 24 and 26 at 24 and 27 were 25 subcutaneous 26 at 27 were 28 quantified in contrast , subcutaneous at was negatively correlated with age in men with bmis in excess of 23.0 kg/m ( 2 ) ( p<0.01 ) and not at all in women . 0 ###LEFT-WALL### 5 at 0 ###LEFT-WALL### 8 correlated 0 ###LEFT-WALL### 32 . 1 in 2 contrast 1 in 3 , 1 in 5 at 4 subcutaneous 5 at 5 at 6 was 6 was 8 correlated 7 negatively 8 correlated 8 correlated 9 with 8 correlated 11 in 8 correlated 13 with 9 with 10 age 11 in 12 men 13 with 14 bmis 14 bmis 26 and 15 in 16 excess 15 in 26 and 16 excess 17 of 16 excess 21 2 16 excess 24 p<0.01 17 of 19 kg/m 18 23.0 19 kg/m 20 ( 21 2 21 2 22 ) 23 ( 24 p<0.01 24 p<0.01 25 ) 26 and 27 not 26 and 28 at 28 at 29 all 29 all 30 in 30 in 31 women the mean levels of subcutaneous at were over 2 - fold greater than visceral at in women aged 60 - 69 years in any bmi stratum . 0 ###LEFT-WALL### 3 levels 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 27 . 1 the 3 levels 2 mean 3 levels 3 levels 4 of 3 levels 7 were 4 of 6 at 5 subcutaneous 6 at 7 were 8 over 8 over 9 2 10 - 15 at 10 - 18 aged 11 fold 15 at 12 greater 15 at 13 than 14 visceral 14 visceral 15 at 15 at 16 in 15 at 18 aged 16 in 17 women 18 aged 22 years 18 aged 23 in 19 60 20 - 20 - 21 69 20 - 22 years 23 in 26 stratum 24 any 26 stratum 25 bmi 26 stratum conclusion : in japanese men and women , visceral at was increased with age in all bmi strata in both genders , whereas subcutaneous at was decreased with age in men with bmis in excess of 23.0 kg/m ( 2 ) and not at all in women . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 27 decreased 0 ###LEFT-WALL### 48 . 1 conclusion 2 : 2 : 3 in 3 in 6 and 4 japanese 5 men 5 men 6 and 6 and 7 women 8 , 10 at 8 , 18 strata 9 visceral 10 at 10 at 11 was 11 was 12 increased 12 increased 13 with 13 with 14 age 14 age 15 in 15 in 16 all 17 bmi 18 strata 18 strata 19 in 18 strata 23 whereas 19 in 21 genders 20 both 21 genders 22 , 23 whereas 23 whereas 25 at 24 subcutaneous 25 at 25 at 26 was 26 was 27 decreased 27 decreased 28 with 27 decreased 30 in 28 with 29 age 30 in 31 men 31 men 42 and 32 with 33 bmis 32 with 42 and 33 bmis 34 in 33 bmis 36 of 33 bmis 40 2 34 in 35 excess 36 of 38 kg/m 37 23.0 38 kg/m 39 ( 40 2 40 2 41 ) 42 and 43 not 42 and 44 at 44 at 45 all 45 all 46 in 46 in 47 women even with these age - related changes in abdominal fat distribution , women retained the subcutaneous - dominant type of fat distribution up to 70 years . 0 ###LEFT-WALL### 4 age 0 ###LEFT-WALL### 6 related 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 27 . 1 even 2 with 1 even 4 age 2 with 3 these 5 - 6 related 6 related 7 changes 6 related 8 in 6 related 12 , 8 in 11 distribution 9 abdominal 10 fat 10 fat 11 distribution 12 , 13 women 12 , 14 retained 13 women 14 retained 14 retained 20 of 15 the 20 of 16 subcutaneous 17 - 16 subcutaneous 20 of 18 dominant 20 of 19 type 20 of 20 of 22 distribution 20 of 23 up 21 fat 22 distribution 23 up 24 to 24 to 26 years 25 70 26 years the protein tyrosine phosphatase nonreceptor 22 gene ( ptpn22 ) is an important negative regulator of signal transduction through [the] t - cell receptors ( tcr ) . 0 ###LEFT-WALL### 7 gene 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 28 . 1 the 7 gene 2 protein 4 phosphatase 3 tyrosine 4 phosphatase 4 phosphatase 7 gene 5 nonreceptor 7 gene 6 22 7 gene 7 gene 9 ptpn22 7 gene 11 is 8 ( 9 ptpn22 9 ptpn22 10 ) 11 is 15 regulator 12 an 13 important 12 an 15 regulator 13 important 15 regulator 14 negative 15 regulator 15 regulator 16 of 16 of 18 transduction 17 signal 18 transduction 18 transduction 19 through 18 transduction 24 receptors 19 through 21 t 22 - 24 receptors 23 cell 24 receptors 24 receptors 26 tcr 24 receptors 27 ) 25 ( 26 tcr 26 tcr 27 ) recently a single - nucleotide polymorphism ( snp ) 1858 c/t within this gene was shown [to] be a risk factor for several autoimmune diseases , such as rheumatoid arthritis [(] [ra] ) , graves ' disease ( gd ) , systemic lupus erythematosus ( sle ) , wegener 's granulomatosis ( wg ) and type 1 diabetes mellitus ( t1d ) . 0 ###LEFT-WALL### 6 polymorphism 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 63 . 1 recently 6 polymorphism 2 a 6 polymorphism 3 single 4 - 3 single 6 polymorphism 5 nucleotide 6 polymorphism 6 polymorphism 8 snp 6 polymorphism 16 shown 6 polymorphism 18 be 7 ( 8 snp 8 snp 9 ) 10 1858 11 c/t 10 1858 15 was 10 1858 16 shown 11 c/t 12 within 11 c/t 15 was 12 within 14 gene 13 this 14 gene 18 be 59 mellitus 19 a 21 factor 20 risk 21 factor 21 factor 22 for 21 factor 55 and 22 for 25 diseases 23 several 25 diseases 24 autoimmune 25 diseases 25 diseases 28 as 25 diseases 37 disease 26 , 28 as 27 such 28 as 28 as 30 arthritis 28 as 33 ) 29 rheumatoid 30 arthritis 34 , 37 disease 35 graves 36 ' 36 ' 37 disease 37 disease 39 gd 37 disease 44 erythematosus 37 disease 54 ) 38 ( 39 gd 39 gd 40 ) 41 , 44 erythematosus 42 systemic 43 lupus 43 lupus 44 erythematosus 44 erythematosus 46 sle 44 erythematosus 51 granulomatosis 44 erythematosus 54 ) 45 ( 46 sle 46 sle 47 ) 48 , 51 granulomatosis 49 wegener 50 's 50 's 51 granulomatosis 51 granulomatosis 53 wg 51 granulomatosis 54 ) 52 ( 53 wg 53 wg 54 ) 55 and 56 type 55 and 58 diabetes 56 type 57 1 58 diabetes 59 mellitus 59 mellitus 61 t1d 60 ( 61 t1d 61 t1d 62 ) the aim of this study was to analyze a possible association between 1858 c/t snp and a number of autoimmune diseases , including [ra] , gd and t1d in russian population . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 32 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 analyze 7 to 8 analyze 8 analyze 16 and 8 analyze 29 in 9 a 11 association 10 possible 11 association 11 association 12 between 11 association 16 and 12 between 15 snp 13 1858 14 c/t 14 c/t 15 snp 16 and 18 number 16 and 19 of 17 a 18 number 19 of 27 and 20 autoimmune 21 diseases 21 diseases 22 , 22 , 23 including 22 , 25 , 25 , 26 gd 25 , 27 and 27 and 28 t1d 29 in 31 population 30 russian 31 population patients with t1d , gd , ra and healthy controls were genotyped for the 1858 c/t snp in ptpn22 gene . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 12 genotyped 0 ###LEFT-WALL### 21 . 1 patients 2 with 1 patients 8 and 2 with 7 ra 3 t1d 5 gd 4 , 5 gd 5 gd 6 , 5 gd 7 ra 6 , 7 ra 8 and 10 controls 8 and 11 were 9 healthy 10 controls 11 were 12 genotyped 12 genotyped 13 for 13 for 20 gene 14 the 20 gene 15 1858 20 gene 16 c/t 17 snp 17 snp 18 in 17 snp 20 gene 18 in 19 ptpn22 we found a significant association between ptpn22 1858 c/t snp and t1d and gd . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 15 . 1 we 2 found 2 found 5 association 2 found 6 between 3 a 4 significant 3 a 5 association 4 significant 5 association 6 between 11 and 7 ptpn22 8 1858 7 ptpn22 9 c/t 9 c/t 10 snp 10 snp 11 and 11 and 14 gd 12 t1d 13 and 13 and 14 gd no such association was observed [for] [ra] . 0 ###LEFT-WALL### 3 association 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 8 . 1 no 2 such 2 such 3 association 3 association 4 was 4 was 5 observed in concordance with a previous data establishing ptpn22 1858 c/t snp association with several autoimmune diseases , our findings provide further evidence that the ptpn22 gene may play an important role in the susceptibility to some autoimmune diseases . 0 ###LEFT-WALL### 19 findings 0 ###LEFT-WALL### 20 provide 0 ###LEFT-WALL### 39 . 1 in 2 concordance 1 in 17 , 1 in 19 findings 2 concordance 3 with 3 with 12 association 4 a 12 association 5 previous 12 association 6 data 12 association 7 establishing 12 association 8 ptpn22 9 1858 8 ptpn22 10 c/t 10 c/t 11 snp 11 snp 12 association 12 association 13 with 13 with 16 diseases 14 several 16 diseases 15 autoimmune 16 diseases 18 our 19 findings 19 findings 20 provide 20 provide 22 evidence 20 provide 32 in 20 provide 35 to 21 further 22 evidence 22 evidence 23 that 23 that 26 gene 23 that 28 play 24 the 26 gene 25 ptpn22 26 gene 26 gene 27 may 27 may 28 play 28 play 31 role 29 an 30 important 29 an 31 role 30 important 31 role 32 in 34 susceptibility 33 the 34 susceptibility 35 to 38 diseases 36 some 38 diseases 37 autoimmune 38 diseases interpretation of cognitive change has been complicated because different influences on change are not easily distinguished . 0 ###LEFT-WALL### 1 interpretation 0 ###LEFT-WALL### 6 been 0 ###LEFT-WALL### 17 . 1 interpretation 2 of 1 interpretation 5 has 2 of 4 change 3 cognitive 4 change 5 has 6 been 6 been 7 complicated 7 complicated 8 because 8 because 10 influences 8 because 13 are 9 different 10 influences 10 influences 11 on 10 influences 13 are 11 on 12 change 13 are 14 not 13 are 16 distinguished 14 not 15 easily in this study , longitudinal cognitive change was decomposed into a component related to the length of the interval between test occasions ( i.e [.] , time - dependent change [ )(and a component unrelated to the test - [retest] interval ( i.e [.] , time - independent change ) . 0 ###LEFT-WALL### 7 change 0 ###LEFT-WALL### 9 decomposed 1 in 3 study 1 in 4 , 1 in 7 change 2 this 3 study 5 longitudinal 7 change 6 cognitive 7 change 7 change 8 was 8 was 9 decomposed 9 decomposed 10 into 9 decomposed 14 to 10 into 12 component 11 a 12 component 12 component 13 related 14 to 16 length 15 the 16 length 16 length 17 of 16 length 20 between 16 length 22 occasions 16 length 27 time 17 of 19 interval 18 the 19 interval 20 between 21 test 22 occasions 24 i.e 22 occasions 27 time 23 ( 24 i.e 24 i.e 26 , 27 time 39 - 28 - 39 - 29 dependent 30 change 30 change 32 )(and 32 )(and 34 component 32 )(and 39 - 33 a 34 component 34 component 35 unrelated 35 unrelated 36 to 36 to 38 test 37 the 38 test 39 - 41 interval 39 - 51 . 41 interval 46 time 41 interval 49 change 42 ( 46 time 43 i.e 45 , 43 i.e 46 time 46 time 47 - 47 - 49 change 48 independent 49 change 49 change 50 ) influences of age on the two hypothesized components were investigated in a sample of more than 1,500 adults for whom the intervals between test occasions ranged from less than 1 year to more than 8 years . 0 ###LEFT-WALL### 1 influences 0 ###LEFT-WALL### 10 investigated 0 ###LEFT-WALL### 37 . 1 influences 2 of 1 influences 4 on 1 influences 8 components 1 influences 9 were 1 influences 10 investigated 2 of 3 age 4 on 6 two 5 the 6 two 7 hypothesized 8 components 8 components 9 were 10 investigated 11 in 10 investigated 27 from 10 investigated 29 than 11 in 13 sample 12 a 13 sample 13 sample 14 of 13 sample 19 for 14 of 18 adults 15 more 16 than 16 than 17 1,500 17 1,500 18 adults 19 for 20 whom 19 for 22 intervals 19 for 26 ranged 21 the 22 intervals 22 intervals 23 between 22 intervals 26 ranged 23 between 25 occasions 24 test 25 occasions 27 from 28 less 29 than 31 year 29 than 32 to 30 1 31 year 32 to 36 years 33 more 34 than 34 than 35 8 35 8 36 years although overall change was negatively related to age for all seven composite cognitive variables , little or no effect of age was apparent for the time [-] dependent component of change . 0 ###LEFT-WALL### 7 to 0 ###LEFT-WALL### 22 was 0 ###LEFT-WALL### 32 . 1 although 3 change 1 although 6 related 1 although 7 to 2 overall 3 change 3 change 4 was 4 was 6 related 5 negatively 6 related 7 to 8 age 7 to 22 was 8 age 9 for 9 for 17 or 10 all 11 seven 11 seven 14 variables 12 composite 14 variables 13 cognitive 14 variables 14 variables 15 , 15 , 16 little 15 , 17 or 17 or 19 effect 17 or 20 of 18 no 19 effect 20 of 21 age 22 was 23 apparent 23 apparent 24 for 24 for 29 component 25 the 29 component 26 time 29 component 28 dependent 29 component 29 component 30 of 30 of 31 change the results suggest that the relations between age and cognitive change over intervals of less than 8 years are largely influenced by factors operating at or near the initial test occasion . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 32 . 1 the 2 results 2 results 3 suggest 3 suggest 4 that 4 that 6 relations 4 that 11 change 5 the 6 relations 6 relations 7 between 7 between 9 and 8 age 9 and 9 and 10 cognitive 11 change 26 or 12 over 13 intervals 12 over 26 or 13 intervals 14 of 14 of 17 8 15 less 16 than 16 than 17 8 17 8 18 years 17 8 25 at 18 years 19 are 19 are 21 influenced 20 largely 21 influenced 21 influenced 22 by 22 by 23 factors 23 factors 24 operating 24 operating 25 at 26 or 27 near 27 near 31 occasion 28 the 31 occasion 29 initial 30 test 30 test 31 occasion objectives : to compare demographic , social , medical , and health care characteristics [of] home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 38 . 1 objectives 2 : 2 : 3 to 2 : 5 demographic 3 to 4 compare 6 , 7 social 6 , 8 , 8 , 11 and 8 , 29 and 9 medical 11 and 10 , 11 and 11 and 14 characteristics 11 and 29 and 12 health 14 characteristics 13 care 14 characteristics 16 home 18 clients 16 home 29 and 17 care 18 clients 18 clients 19 in 18 clients 23 of 19 in 22 year 20 the 21 last 20 the 22 year 23 of 24 life 24 life 25 by 25 by 26 quintile 26 quintile 27 of 27 of 28 deprivation 29 and 30 examine 29 and 32 between 30 examine 31 associations 32 between 35 and 33 material 34 deprivation 34 deprivation 35 and 35 and 37 characteristics 36 service 37 characteristics method : this retrospective study used administrative data for 700 clients who died while receiving home care services . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 5 study 2 : 6 used 2 : 19 . 3 this 5 study 4 retrospective 5 study 5 study 6 used 6 used 8 data 7 administrative 8 data 8 data 9 for 9 for 11 clients 10 700 11 clients 11 clients 12 who 11 clients 13 died 12 who 13 died 13 died 14 while 14 while 15 receiving 15 receiving 18 services 16 home 18 services 17 care 18 services outcome measures were the receipt of supportive or palliative home care . 0 ###LEFT-WALL### 2 measures 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 12 . 1 outcome 2 measures 2 measures 3 were 3 were 5 receipt 4 the 5 receipt 5 receipt 6 of 6 of 8 or 7 supportive 8 or 8 or 11 care 9 palliative 11 care 10 home 11 care associations were assessed using multiple logistic regression . 0 ###LEFT-WALL### 1 associations 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 8 . 1 associations 2 were 2 were 3 assessed 3 assessed 4 using 4 using 7 regression 5 multiple 7 regression 6 logistic 7 regression result : material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services . 0 ###LEFT-WALL### 1 result 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 deprivation 2 : 5 was 3 material 4 deprivation 4 deprivation 5 was 5 was 6 not 5 was 8 with 6 not 7 associated 8 with 16 or 9 either 16 or 10 the 11 hours 11 hours 14 care 11 hours 15 received 11 hours 16 or 12 of 13 home 12 of 14 care 14 care 15 received 16 or 18 receipt 17 the 18 receipt 18 receipt 19 of 19 of 23 services 20 supportive 21 home 21 home 22 care 22 care 23 services clients with dementia or stroke , those were older than 80 years and those who were single were less likely to receive palliative care services than other groups . 0 ###LEFT-WALL### 4 or 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 29 . 1 clients 2 with 1 clients 4 or 2 with 3 dementia 4 or 5 stroke 6 , 7 those 6 , 8 were 6 , 10 than 7 those 8 were 8 were 9 older 10 than 13 and 10 than 18 were 11 80 12 years 12 years 13 and 13 and 14 those 13 and 15 who 13 and 16 were 13 and 18 were 15 who 16 were 16 were 17 single 18 were 19 less 18 were 20 likely 20 likely 21 to 20 likely 22 receive 21 to 22 receive 22 receive 25 services 22 receive 26 than 23 palliative 24 care 24 care 25 services 26 than 28 groups 27 other 28 groups discussion : inequalities in allocation of home care services based on age , diagnosis , and marital status , but not material deprivation , suggest the need to carefully match service with need at the end of life . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 16 and 2 : 24 , 2 : 39 . 3 inequalities 4 in 3 inequalities 6 of 3 inequalities 10 based 3 inequalities 16 and 4 in 5 allocation 6 of 9 services 7 home 9 services 8 care 9 services 10 based 11 on 11 on 12 age 12 age 14 diagnosis 13 , 14 diagnosis 14 diagnosis 15 , 16 and 18 status 16 and 20 but 17 marital 18 status 19 , 20 but 20 but 21 not 20 but 23 deprivation 20 but 24 , 22 material 23 deprivation 24 , 25 suggest 25 suggest 27 need 26 the 27 need 27 need 28 to 27 need 30 match 28 to 30 match 29 carefully 30 match 30 match 31 service 30 match 32 with 30 match 34 at 32 with 33 need 34 at 36 end 35 the 36 end 36 end 37 of 37 of 38 life the mitochondrial transcription factor a ( tfam ) is required for mitochondrial dna ( mtdna ) replication [and] transcription . 0 ###LEFT-WALL### 4 factor 0 ###LEFT-WALL### 10 required 0 ###LEFT-WALL### 20 . 1 the 4 factor 2 mitochondrial 3 transcription 3 transcription 4 factor 4 factor 5 a 4 factor 7 tfam 4 factor 9 is 6 ( 7 tfam 7 tfam 8 ) 9 is 10 required 10 required 11 for 11 for 19 transcription 12 mitochondrial 19 transcription 13 dna 15 mtdna 13 dna 19 transcription 14 ( 15 mtdna 15 mtdna 16 ) 17 replication 19 transcription disruption of tfam results in heart failure and premature aging in mice . 0 ###LEFT-WALL### 1 disruption 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 13 . 1 disruption 2 of 1 disruption 4 results 2 of 3 tfam 4 results 5 in 4 results 11 in 5 in 8 and 6 heart 7 failure 7 failure 8 and 8 and 9 premature 8 and 10 aging 11 in 12 mice but very little is known about the role of tfam in cancer development . 0 ###LEFT-WALL### 1 but 0 ###LEFT-WALL### 14 . 1 but 3 little 1 but 5 known 2 very 3 little 3 little 4 is 4 is 5 known 5 known 6 about 5 known 11 in 6 about 8 role 7 the 8 role 8 role 9 of 9 of 10 tfam 11 in 13 development 12 cancer 13 development here , we report the identification of frequent frameshift mutations in the coding mononucleotide repeat of tfam in sporadic colorectal [cancer] ( crc ) cell lines and in primary tumors with microsatellite instability ( msi ) , but not in microsatellite stable ( mss ) crc cell lines and tumors . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 51 . 1 here 2 , 1 here 3 we 3 we 4 report 4 report 49 and 5 the 6 identification 6 identification 7 of 6 identification 49 and 7 of 10 mutations 8 frequent 10 mutations 9 frameshift 10 mutations 10 mutations 11 in 10 mutations 16 of 11 in 15 repeat 12 the 15 repeat 13 coding 14 mononucleotide 14 mononucleotide 15 repeat 16 of 17 tfam 17 tfam 27 and 18 in 26 lines 18 in 27 and 19 sporadic 25 cell 20 colorectal 23 crc 20 colorectal 25 cell 22 ( 23 crc 23 crc 24 ) 25 cell 26 lines 27 and 28 in 28 in 30 tumors 29 primary 30 tumors 30 tumors 38 but 31 with 33 instability 31 with 38 but 32 microsatellite 33 instability 33 instability 35 msi 34 ( 35 msi 35 msi 36 ) 37 , 38 but 38 but 39 not 38 but 40 in 40 in 48 lines 41 microsatellite 48 lines 42 stable 44 mss 42 stable 47 cell 43 ( 44 mss 44 mss 45 ) 46 crc 47 cell 47 cell 48 lines 49 and 50 tumors the presence of the tfam truncating mutation , in crc cells with msi , reduced the tfam protein level in vivo and in vitro and correlated with mtdna depletion . 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 30 . 1 the 2 presence 2 presence 3 of 2 presence 25 and 3 of 5 tfam 4 the 5 tfam 5 tfam 6 truncating 5 tfam 9 in 6 truncating 7 mutation 8 , 9 in 9 in 11 cells 9 in 14 , 10 crc 11 cells 11 cells 12 with 12 with 13 msi 15 reduced 19 level 15 reduced 22 and 15 reduced 25 and 16 the 19 level 17 tfam 19 level 18 protein 19 level 20 in 21 vivo 21 vivo 22 and 22 and 24 vitro 23 in 24 vitro 25 and 26 correlated 25 and 27 with 27 with 29 depletion 28 mtdna 29 depletion furthermore , forced overexpression of wild - type tfam in rko cells carrying a tfam truncating mutation suppressed cell proliferation and inhibited rko cell - induced xenograft tumor growth . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 27 xenograft 0 ###LEFT-WALL### 30 . 1 furthermore 2 , 1 furthermore 21 and 3 forced 4 overexpression 4 overexpression 5 of 4 overexpression 21 and 5 of 12 cells 6 wild 7 - 6 wild 8 type 8 type 12 cells 9 tfam 10 in 9 tfam 12 cells 10 in 11 rko 12 cells 13 carrying 13 carrying 20 proliferation 14 a 20 proliferation 15 tfam 17 mutation 16 truncating 17 mutation 17 mutation 18 suppressed 18 suppressed 19 cell 19 cell 20 proliferation 21 and 24 cell 21 and 25 - 21 and 26 induced 21 and 27 xenograft 22 inhibited 24 cell 23 rko 24 cell 27 xenograft 29 growth 28 tumor 29 growth moreover , these cells showed more susceptibility to cisplatin - induced apoptosis due to an increase of cytochrome [b] ( cyt [b] ) expression and its release from mitochondria . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 30 . 1 moreover 2 , 1 moreover 4 cells 3 these 4 cells 4 cells 5 showed 5 showed 7 susceptibility 5 showed 24 expression 5 showed 25 and 6 more 7 susceptibility 7 susceptibility 8 to 8 to 9 cisplatin 9 cisplatin 12 apoptosis 10 - 12 apoptosis 11 induced 12 apoptosis 12 apoptosis 14 to 12 apoptosis 23 ) 13 due 14 to 14 to 16 increase 15 an 16 increase 16 increase 17 of 17 of 18 cytochrome 18 cytochrome 21 cyt 20 ( 21 cyt 21 cyt 23 ) 25 and 27 release 26 its 27 release 27 release 28 from 28 from 29 mitochondria an interaction assay between tfam and the heavy - strand promoter ( hsp ) of mitochondria revealed that mutant tfam exhibited reduced binding to hsp , leading to reduction in cyt [b] transcription . 0 ###LEFT-WALL### 3 assay 0 ###LEFT-WALL### 17 revealed 1 an 3 assay 2 interaction 3 assay 3 assay 4 between 3 assay 15 of 3 assay 17 revealed 4 between 6 and 5 tfam 6 and 6 and 11 promoter 6 and 13 hsp 7 the 11 promoter 8 heavy 9 - 8 heavy 10 strand 10 strand 11 promoter 12 ( 13 hsp 13 hsp 14 ) 15 of 16 mitochondria 17 revealed 20 tfam 18 that 20 tfam 19 mutant 20 tfam 20 tfam 21 exhibited 20 tfam 23 binding 20 tfam 24 to 21 exhibited 22 reduced 24 to 25 hsp 25 hsp 27 leading 26 , 27 leading 27 leading 28 to 27 leading 34 . 28 to 29 reduction 29 reduction 30 in 30 in 33 transcription 31 cyt 33 transcription collectively , these data provide evidence that a high incidence of tfam truncating mutations leads to mitochondrial copy number reduction and mitochondrial instability , distinguishing most crc with msi from mss crc . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 provide 1 collectively 2 , 1 collectively 4 data 3 these 4 data 4 data 5 provide 5 provide 6 evidence 6 evidence 7 that 7 that 10 incidence 7 that 15 leads 8 a 10 incidence 9 high 10 incidence 10 incidence 11 of 10 incidence 15 leads 11 of 12 tfam 12 tfam 13 truncating 13 truncating 14 mutations 15 leads 16 to 15 leads 27 crc 16 to 21 and 17 mitochondrial 18 copy 18 copy 19 number 19 number 20 reduction 20 reduction 21 and 21 and 23 instability 21 and 24 , 21 and 25 distinguishing 22 mitochondrial 23 instability 25 distinguishing 26 most 27 crc 28 with 27 crc 30 from 28 with 29 msi 30 from 32 crc 31 mss 32 crc 32 crc 33 . these mutations may play an important role in tumorigenesis and cisplatin - induced apoptotic resistance of most microsatellite - unstable crcs . 0 ###LEFT-WALL### 2 mutations 0 ###LEFT-WALL### 4 play 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 22 . 1 these 2 mutations 2 mutations 3 may 3 may 4 play 4 play 10 and 5 an 6 important 5 an 7 role 6 important 7 role 7 role 8 in 7 role 10 and 8 in 9 tumorigenesis 10 and 11 cisplatin 10 and 15 resistance 12 - 15 resistance 13 induced 15 resistance 14 apoptotic 15 resistance 15 resistance 16 of 15 resistance 19 - 16 of 18 microsatellite 17 most 18 microsatellite 19 - 21 crcs 20 unstable 21 crcs [none] background : plasma activities of alkaline phosphatase , alanine aminotransferase ( alt ) , aspartate aminotransferase , and [γ] - glutamyl transferase ( ggt ) [are] often increased in cardiometabolic diseases . 0 ###LEFT-WALL### 2 background 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 33 . 2 background 3 : 3 : 5 activities 4 plasma 5 activities 5 activities 6 of 6 of 8 phosphatase 7 alkaline 8 phosphatase 8 phosphatase 11 aminotransferase 8 phosphatase 17 aminotransferase 9 , 11 aminotransferase 10 alanine 11 aminotransferase 11 aminotransferase 13 alt 11 aminotransferase 15 , 12 ( 13 alt 13 alt 14 ) 15 , 17 aminotransferase 16 aspartate 17 aminotransferase 17 aminotransferase 18 , 18 , 19 and 19 and 21 - 19 and 23 transferase 19 and 29 increased 22 glutamyl 23 transferase 23 transferase 25 ggt 23 transferase 29 increased 24 ( 25 ggt 25 ggt 26 ) 28 often 29 increased 29 increased 30 in 30 in 32 diseases 31 cardiometabolic 32 diseases we investigated if [hypertension] [is] associated with increased activities of these plasma markers . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 14 . 1 we 2 investigated 2 investigated 3 if 3 if 6 associated 6 associated 7 with 7 with 9 activities 8 increased 9 activities 9 activities 10 of 10 of 13 markers 11 these 13 markers 12 plasma 13 markers methods : we included 235 hypertensive and 708 normotensive subjects ( mean age 47.3±9.6 and 58.0±10.2 years [respectively] ) from the hong kong cardiovascular risk factor prevalence study - 2 ( crisps - 2 ) in 2000 - 2004 who had drank < 1 / week . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 included 2 : 47 . 3 we 4 included 4 included 7 and 4 included 20 from 4 included 36 in 5 235 7 and 6 hypertensive 7 and 7 and 10 subjects 7 and 17 years 8 708 10 subjects 9 normotensive 10 subjects 11 ( 17 years 12 mean 13 age 13 age 17 years 14 47.3±9.6 15 and 15 and 16 58.0±10.2 15 and 17 years 17 years 19 ) 20 from 28 study 21 the 28 study 22 hong 23 kong 23 kong 24 cardiovascular 24 cardiovascular 25 risk 25 risk 26 factor 26 factor 27 prevalence 27 prevalence 28 study 28 study 30 2 29 - 30 2 30 2 33 - 30 2 35 ) 31 ( 33 - 32 crisps 33 - 33 - 34 2 33 - 35 ) 36 in 38 - 37 2000 38 - 38 - 39 2004 38 - 40 who 38 - 41 had 40 who 41 had 41 had 42 drank 42 drank 46 week 43 < 44 1 44 1 46 week 45 / 46 week in the [follow] [-] up study in 2005 - 2008 ( crisps - 3 ) , 126 out of the 708 subjects had developed [hypertension] . 0 ###LEFT-WALL### 17 126 0 ###LEFT-WALL### 24 developed 0 ###LEFT-WALL### 26 . 1 in 6 study 1 in 16 , 1 in 17 126 2 the 6 study 5 up 6 study 6 study 7 in 7 in 9 - 8 2005 9 - 9 - 10 2008 9 - 12 crisps 11 ( 12 crisps 12 crisps 14 3 12 crisps 16 , 13 - 14 3 14 3 15 ) 17 126 19 of 17 126 23 had 18 out 19 of 19 of 22 subjects 20 the 21 708 21 708 22 subjects 23 had 24 developed among subjects not on anti - hypertensive medications , plasma alp , alt and ggt were related to blood pressure ( p<0.01 ) . 0 ###LEFT-WALL### 10 plasma 0 ###LEFT-WALL### 17 related 0 ###LEFT-WALL### 24 . 1 among 2 subjects 1 among 9 , 1 among 10 plasma 2 subjects 3 not 3 not 4 on 4 on 8 medications 5 anti 6 - 5 anti 8 medications 7 hypertensive 8 medications 10 plasma 14 and 10 plasma 16 were 10 plasma 17 related 11 alp 13 alt 12 , 13 alt 13 alt 14 and 14 and 15 ggt 14 and 16 were 17 related 18 to 18 to 19 blood 19 blood 20 pressure 20 pressure 22 p<0.01 21 ( 22 p<0.01 22 p<0.01 23 ) conclusions : among the 4 plasma markers , increased ggt activity is the strongest predictor for existing and new - onset hypertension in hong kong chinese . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 27 . 1 conclusions 2 : 2 : 3 among 3 among 7 markers 4 the 5 4 5 4 7 markers 6 plasma 7 markers 8 , 11 activity 8 , 12 is 9 increased 11 activity 10 ggt 11 activity 11 activity 12 is 12 is 26 chinese 13 the 14 strongest 13 the 15 predictor 15 predictor 16 for 15 predictor 18 and 16 for 17 existing 18 and 22 hypertension 18 and 23 in 18 and 26 chinese 19 new 20 - 19 new 21 onset 21 onset 22 hypertension 23 in 24 hong 25 kong 26 chinese introduction : the aging of the canadian population is associated with a rising burden of heart failure ( hf ) , a condition associated with significant morbidity , mortality and health service use . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 34 . 1 introduction 2 : 2 : 4 aging 3 the 4 aging 4 aging 5 of 4 aging 19 hf 5 of 7 canadian 6 the 7 canadian 7 canadian 8 population 7 canadian 9 is 7 canadian 10 associated 7 canadian 15 of 8 population 9 is 10 associated 11 with 11 with 14 burden 12 a 14 burden 13 rising 14 burden 15 of 17 failure 16 heart 17 failure 18 ( 19 hf 19 hf 20 ) 21 , 30 and 22 a 23 condition 23 condition 24 associated 23 condition 28 , 24 associated 25 with 25 with 27 morbidity 26 significant 27 morbidity 28 , 29 mortality 28 , 30 and 30 and 33 use 31 health 33 use 32 service 33 use results : compared with other home care clients , hf clients exhibit more health instability , take more medications , experience more comorbid conditions and receive significantly more nursing , homemaking and meal services . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 11 clients 2 : 12 exhibit 2 : 16 , 2 : 35 . 3 compared 4 with 3 compared 9 , 3 compared 11 clients 4 with 8 clients 5 other 8 clients 6 home 8 clients 7 care 8 clients 9 , 10 hf 10 hf 11 clients 11 clients 12 exhibit 12 exhibit 15 instability 13 more 15 instability 14 health 15 instability 16 , 20 , 17 take 19 medications 17 take 20 , 18 more 19 medications 20 , 25 and 21 experience 24 conditions 21 experience 25 and 22 more 23 comorbid 23 comorbid 24 conditions 25 and 26 receive 26 receive 32 and 27 significantly 28 more 28 more 32 and 29 nursing 30 , 30 , 31 homemaking 30 , 32 and 32 and 34 services 33 meal 34 services they are hospitalized more frequently , have significantly more emergency department visits and use more emergent care . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 hospitalized 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 18 . 1 they 2 are 2 are 3 hospitalized 3 hospitalized 5 frequently 4 more 5 frequently 6 , 13 and 7 have 12 visits 7 have 13 and 8 significantly 9 more 9 more 12 visits 10 emergency 12 visits 11 department 12 visits 13 and 14 use 14 use 17 care 15 more 16 emergent 16 emergent 17 care discussion : hf clients are a more complex group than home care clients in general . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 4 clients 2 : 5 are 2 : 16 . 3 hf 4 clients 4 clients 5 are 5 are 9 group 5 are 10 than 5 are 15 general 6 a 9 group 7 more 8 complex 8 complex 9 group 10 than 13 clients 11 home 13 clients 12 care 13 clients 14 in 15 general patient self - care must be tailored to the clinical characteristics , patterns of service use and barriers to self [-] care of the client . 0 ###LEFT-WALL### 2 self 0 ###LEFT-WALL### 3 - 1 patient 2 self 3 - 4 care 3 - 7 tailored 3 - 26 . 4 care 5 must 5 must 6 be 6 be 7 tailored 7 tailored 8 to 7 tailored 19 to 8 to 17 and 9 the 11 characteristics 10 clinical 11 characteristics 11 characteristics 12 , 12 , 13 patterns 12 , 17 and 13 patterns 14 of 14 of 16 use 15 service 16 use 17 and 18 barriers 19 to 22 care 20 self 22 care 22 care 23 of 23 of 25 client 24 the 25 client this is particularly true for older , frail and medically complex hf patients , many of whom [require] home care services . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 1 this 2 is 2 is 3 particularly 2 is 4 true 4 true 5 for 5 for 13 patients 6 older 7 , 6 older 13 patients 8 frail 9 and 9 and 11 complex 9 and 13 patients 10 medically 11 complex 12 hf 13 patients 13 patients 15 many 14 , 15 many 15 many 16 of 15 many 22 . 16 of 17 whom 17 whom 20 care 17 whom 21 services 19 home 20 care 20 care 21 services this work provides a background upon which to base initiatives to help these higher - needs clients manage their hf at home with appropriate support and services . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 28 . 1 this 2 work 2 work 3 provides 3 provides 5 background 3 provides 8 to 4 a 5 background 5 background 6 upon 6 upon 7 which 8 to 9 base 9 base 10 initiatives 10 initiatives 11 to 10 initiatives 18 manage 11 to 12 help 12 help 17 clients 12 help 18 manage 13 these 17 clients 14 higher 15 - 14 higher 17 clients 16 needs 17 clients 18 manage 20 hf 18 manage 21 at 19 their 20 hf 21 at 26 and 22 home 23 with 22 home 26 and 23 with 25 support 24 appropriate 25 support 26 and 27 services polyglutamine diseases , including machado - joseph disease and huntington 's disease , typically appear in midlife and [are] characterized by amyloid accumulations of abnormally expanded polyglutamine proteins . 0 ###LEFT-WALL### 2 diseases 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 29 . 1 polyglutamine 2 diseases 2 diseases 4 including 2 diseases 18 and 3 , 4 including 4 including 5 machado 4 including 13 , 5 machado 9 and 6 - 9 and 7 joseph 8 disease 8 disease 9 and 9 and 12 disease 9 and 13 , 10 huntington 11 's 11 's 12 disease 14 typically 15 appear 15 appear 16 in 15 appear 18 and 16 in 17 midlife 18 and 20 characterized 18 and 21 by 21 by 23 accumulations 22 amyloid 23 accumulations 23 accumulations 24 of 24 of 28 proteins 25 abnormally 26 expanded 26 expanded 27 polyglutamine 27 polyglutamine 28 proteins although there is growing evidence that aging has an important role in the occurrence of such diseases , the role of aging in the late onset of these diseases is not well understood . 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 34 . 1 although 2 there 1 although 3 is 1 although 18 , 2 there 3 is 3 is 5 evidence 4 growing 5 evidence 5 evidence 7 aging 6 that 7 aging 8 has 11 role 8 has 12 in 8 has 18 , 9 an 11 role 10 important 11 role 12 in 14 occurrence 13 the 14 occurrence 14 occurrence 15 of 15 of 17 diseases 16 such 17 diseases 18 , 33 understood 19 the 20 role 20 role 21 of 20 role 30 is 21 of 22 aging 22 aging 23 in 23 in 26 onset 24 the 26 onset 25 late 26 onset 26 onset 27 of 27 of 29 diseases 28 these 29 diseases 30 is 31 not 31 not 32 well 32 well 33 understood recent studies showed that differences in amyloid [conformation] from different brain regions lead to differing toxicity . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 17 . 1 recent 2 studies 2 studies 3 showed 3 showed 4 that 4 that 5 differences 4 that 13 lead 5 differences 6 in 5 differences 9 from 5 differences 13 lead 6 in 7 amyloid 9 from 12 regions 10 different 11 brain 11 brain 12 regions 13 lead 14 to 14 to 16 toxicity 15 differing 16 toxicity we hypothesized that higher amyloid toxicity at later ages might cause the late onset of polyglutamine diseases . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 0 ###LEFT-WALL### 18 . 1 we 2 hypothesized 2 hypothesized 3 that 3 that 6 toxicity 3 that 11 cause 4 higher 6 toxicity 5 amyloid 6 toxicity 6 toxicity 7 at 6 toxicity 10 might 7 at 9 ages 8 later 9 ages 10 might 11 cause 11 cause 14 onset 12 the 14 onset 13 late 14 onset 14 onset 15 of 15 of 17 diseases 16 polyglutamine 17 diseases using a method for temporal and regional gene expression targeting ( target ) in drosophila , we showed that transient polyglutamine expression caused more severe neurodegeneration in older flies than in younger flies . 0 ###LEFT-WALL### 17 we 0 ###LEFT-WALL### 18 showed 0 ###LEFT-WALL### 34 . 1 using 3 method 1 using 13 ) 1 using 17 we 2 a 3 method 3 method 4 for 4 for 10 targeting 5 temporal 6 and 6 and 7 regional 6 and 10 targeting 8 gene 9 expression 9 expression 10 targeting 10 targeting 12 target 11 ( 12 target 12 target 13 ) 14 in 15 drosophila 14 in 16 , 14 in 17 we 17 we 18 showed 18 showed 26 neurodegeneration 18 showed 27 in 18 showed 30 than 19 that 26 neurodegeneration 20 transient 26 neurodegeneration 21 polyglutamine 22 expression 22 expression 23 caused 23 caused 26 neurodegeneration 24 more 25 severe 25 severe 26 neurodegeneration 27 in 29 flies 28 older 29 flies 30 than 31 in 31 in 33 flies 32 younger 33 flies moreover , the polyglutamine amyloids themselves showed distinct characteristics in relation to age ; those from older flies were less resistant to sds and more effective at seeding polymerization than those from younger flies , suggesting that the polyglutamine amyloids in aged individuals may have higher toxicity . 0 ###LEFT-WALL### 5 amyloids 0 ###LEFT-WALL### 7 showed 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 48 . 1 moreover 2 , 1 moreover 5 amyloids 3 the 5 amyloids 4 polyglutamine 5 amyloids 5 amyloids 7 showed 6 themselves 7 showed 7 showed 9 characteristics 7 showed 12 to 8 distinct 9 characteristics 9 characteristics 10 in 10 in 11 relation 12 to 13 age 14 ; 15 those 14 ; 19 were 14 ; 24 and 15 those 16 from 15 those 19 were 16 from 18 flies 17 older 18 flies 19 were 20 less 19 were 21 resistant 21 resistant 22 to 22 to 23 sds 24 and 36 suggesting 24 and 45 have 25 more 26 effective 26 effective 27 at 26 effective 32 from 26 effective 35 , 26 effective 36 suggesting 27 at 28 seeding 28 seeding 29 polymerization 28 seeding 30 than 30 than 31 those 32 from 34 flies 33 younger 34 flies 36 suggesting 37 that 36 suggesting 44 may 37 that 39 polyglutamine 37 that 40 amyloids 38 the 39 polyglutamine 39 polyglutamine 40 amyloids 40 amyloids 41 in 41 in 43 individuals 42 aged 43 individuals 44 may 45 have 45 have 47 toxicity 46 higher 47 toxicity these findings show that age - related changes in amyloid characteristics may be a trigger for late - onset polyglutamine diseases . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 22 . 1 these 2 findings 2 findings 3 show 3 show 4 that 4 that 5 age 4 that 13 be 5 age 12 may 6 - 7 related 7 related 8 changes 7 related 12 may 8 changes 9 in 9 in 11 characteristics 10 amyloid 11 characteristics 12 may 13 be 13 be 15 trigger 14 a 15 trigger 15 trigger 16 for 16 for 21 diseases 17 late 18 - 17 late 19 onset 19 onset 21 diseases 20 polyglutamine 21 diseases background : facial sagging is a well [-] known morphological feature associated with aging and reduced dermal elasticity . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 4 sagging 2 : 5 is 3 facial 4 sagging 4 sagging 5 is 5 is 15 and 6 a 11 feature 7 well 9 known 9 known 11 feature 10 morphological 11 feature 11 feature 12 associated 11 feature 15 and 12 associated 13 with 13 with 14 aging 15 and 18 elasticity 16 reduced 18 elasticity 17 dermal 18 elasticity its morphological characteristics and mechanism have been studied in females , but it is unclear whether or not there is a gender difference . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 8 studied 0 ###LEFT-WALL### 12 but 0 ###LEFT-WALL### 24 . 1 its 3 characteristics 2 morphological 3 characteristics 3 characteristics 4 and 4 and 5 mechanism 4 and 6 have 6 have 7 been 7 been 8 studied 8 studied 9 in 9 in 10 females 11 , 12 but 12 but 13 it 12 but 14 is 13 it 14 is 14 is 15 unclear 15 unclear 18 not 16 whether 17 or 17 or 18 not 18 not 19 there 18 not 20 is 19 there 20 is 20 is 23 difference 21 a 22 gender 21 a 23 difference 22 gender 23 difference aims : the aim of this study was to clarify the morphological characteristics of sagging and the mechanism of sagging formation in male faces as compared with female faces , focusing on changes in dermal elasticity . 0 ###LEFT-WALL### 1 aims 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 26 compared 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 this 7 study 8 was 9 to 8 was 10 clarify 9 to 10 clarify 10 clarify 16 and 10 clarify 22 in 10 clarify 25 as 11 the 16 and 12 morphological 13 characteristics 13 characteristics 14 of 13 characteristics 16 and 14 of 15 sagging 16 and 18 mechanism 16 and 19 of 17 the 18 mechanism 19 of 21 formation 20 sagging 21 formation 22 in 24 faces 23 male 24 faces 25 as 26 compared 26 compared 27 with 27 with 29 faces 28 female 29 faces 29 faces 31 focusing 30 , 31 focusing 31 focusing 32 on 31 focusing 34 in 31 focusing 37 . 32 on 33 changes 34 in 36 elasticity 35 dermal 36 elasticity methods : faces of 98 healthy japanese male volunteers , in [their] 20 s - 60 s , were photographed at an angle of 45 ° . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 1 methods 2 : 2 : 3 faces 3 faces 4 of 4 of 5 98 5 98 7 japanese 5 98 20 photographed 6 healthy 7 japanese 7 japanese 9 volunteers 7 japanese 19 were 7 japanese 20 photographed 8 male 9 volunteers 9 volunteers 11 in 9 volunteers 19 were 10 , 11 in 11 in 15 - 11 in 18 , 13 20 14 s 14 s 15 - 15 - 17 s 16 60 17 s 20 photographed 21 at 21 at 23 angle 22 an 23 angle 23 angle 24 of 24 of 26 ° 25 45 26 ° upper and lower cheek sagging severity was evaluated by using photograph - based grading criteria . 0 ###LEFT-WALL### 11 photograph 0 ###LEFT-WALL### 12 - 1 upper 2 and 2 and 4 cheek 2 and 5 sagging 2 and 6 severity 2 and 10 using 2 and 11 photograph 3 lower 4 cheek 6 severity 7 was 7 was 8 evaluated 8 evaluated 9 by 9 by 10 using 12 - 15 criteria 12 - 16 . 13 based 15 criteria 14 grading 15 criteria in addition , new photograph - based grading criteria of sagging severity at the lower eyelid were established and used . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 3 , 1 in 2 addition 3 , 5 photograph 3 , 6 - 4 new 5 photograph 6 - 9 criteria 6 - 17 were 6 - 21 . 7 based 9 criteria 8 grading 9 criteria 9 criteria 10 of 9 criteria 17 were 10 of 12 severity 11 sagging 12 severity 12 severity 13 at 13 at 16 eyelid 14 the 16 eyelid 15 lower 16 eyelid 17 were 19 and 18 established 19 and 19 and 20 used dermal elasticity was measured using [a] [non] - invasive , in vivo suction skin elasticity meter , cutometer [(] [®] ) . 0 ###LEFT-WALL### 2 elasticity 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 8 - 1 dermal 2 elasticity 2 elasticity 3 was 3 was 5 using 4 measured 5 using 8 - 13 suction 8 - 22 . 9 invasive 10 , 9 invasive 13 suction 11 in 12 vivo 12 vivo 13 suction 13 suction 16 meter 14 skin 16 meter 15 elasticity 16 meter 16 meter 18 cutometer 17 , 18 cutometer 18 cutometer 21 ) furthermore , photographs of 108 healthy japanese female volunteers in [their] 20 s - 60 s were used to compare the difference in the morphological characteristics of sagging between males and females . 0 ###LEFT-WALL### 3 photographs 0 ###LEFT-WALL### 20 compare 0 ###LEFT-WALL### 33 . 1 furthermore 2 , 1 furthermore 3 photographs 3 photographs 4 of 3 photographs 9 volunteers 3 photographs 19 to 3 photographs 20 compare 4 of 7 japanese 5 108 7 japanese 6 healthy 7 japanese 8 female 9 volunteers 9 volunteers 10 in 9 volunteers 17 were 10 in 14 - 12 20 13 s 13 s 14 - 14 - 16 s 15 60 16 s 17 were 18 used 18 used 19 to 20 compare 22 difference 21 the 22 difference 22 difference 23 in 22 difference 27 of 23 in 26 characteristics 24 the 26 characteristics 25 morphological 26 characteristics 27 of 28 sagging 28 sagging 29 between 29 between 31 and 30 males 31 and 31 and 32 females results : male facial sagging was prominent at the lower eyelid , upper cheek and lower cheek . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 sagging 2 : 6 was 2 : 12 , 2 : 18 . 3 male 5 sagging 4 facial 5 sagging 5 sagging 6 was 6 was 7 prominent 7 prominent 8 at 8 at 11 eyelid 9 the 11 eyelid 10 lower 11 eyelid 12 , 15 and 13 upper 14 cheek 14 cheek 15 and 15 and 17 cheek 16 lower 17 cheek sagging severity in the upper and lower cheek was almost the same between males and females at all ages , whereas sagging at the lower eyelid in males was significantly more severe than that in females after middle age . 0 ###LEFT-WALL### 8 cheek 0 ###LEFT-WALL### 9 was 1 sagging 8 cheek 2 severity 3 in 2 severity 6 and 3 in 5 upper 4 the 5 upper 6 and 7 lower 6 and 8 cheek 8 cheek 9 was 9 was 12 same 9 was 13 between 9 was 21 whereas 10 almost 12 same 11 the 12 same 13 between 15 and 14 males 15 and 15 and 16 females 15 and 17 at 17 at 19 ages 18 all 19 ages 20 , 21 whereas 21 whereas 22 sagging 21 whereas 29 was 21 whereas 40 . 22 sagging 23 at 22 sagging 27 in 22 sagging 29 was 23 at 26 eyelid 24 the 26 eyelid 25 lower 26 eyelid 27 in 28 males 29 was 32 severe 30 significantly 31 more 31 more 32 severe 32 severe 33 than 33 than 34 that 33 than 35 in 35 in 36 females 36 females 37 after 37 after 39 age 38 middle 39 age furthermore , as in female faces , male facial sagging was significantly negatively related to dermal elasticity parameters [,] such as [-] [(] u ( f [ )(- u [(] [a] ) [ )(, [u] [(] a )/u [(] [f] [ )(, [u] [(] [r] )/u ( [e] [ )(and [u] [(] [r] )/u [(] [f] ) . 0 ###LEFT-WALL### 10 sagging 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 34 )(, 0 ###LEFT-WALL### 58 . 1 furthermore 10 sagging 2 , 3 as 3 as 4 in 3 as 7 , 3 as 10 sagging 4 in 6 faces 5 female 6 faces 8 male 10 sagging 9 facial 10 sagging 10 sagging 11 was 11 was 14 related 12 significantly 14 related 13 negatively 14 related 14 related 15 to 15 to 18 parameters 16 dermal 17 elasticity 17 elasticity 18 parameters 18 parameters 21 as 18 parameters 28 )(- 20 such 21 as 21 as 24 u 25 ( 28 )(- 26 f 28 )(- 28 )(- 29 u 28 )(- 32 ) 34 )(, 50 )(and 37 a 38 )/u 38 )/u 42 )(, 42 )(, 46 )/u 42 )(, 50 )(and 47 ( 50 )(and 50 )(and 54 )/u 50 )(and 57 ) conclusion : these results indicate that the morphology and areas of sagging in male faces are similar to those in females in the cheek , but sagging at the lower eyelid is more severe in males after middle age . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 indicate 2 : 26 but 2 : 40 . 3 these 4 results 4 results 5 indicate 5 indicate 6 that 6 that 9 and 6 that 16 are 7 the 8 morphology 8 morphology 9 and 9 and 10 areas 9 and 11 of 9 and 16 are 11 of 12 sagging 12 sagging 13 in 13 in 15 faces 14 male 15 faces 16 are 17 similar 17 similar 18 to 17 similar 20 in 18 to 19 those 20 in 21 females 21 females 22 in 22 in 24 cheek 23 the 24 cheek 25 , 26 but 26 but 27 sagging 26 but 32 is 27 sagging 28 at 27 sagging 32 is 28 at 31 eyelid 29 the 31 eyelid 30 lower 31 eyelid 32 is 33 more 32 is 34 severe 34 severe 35 in 35 in 36 males 36 males 37 after 37 after 39 age 38 middle 39 age furthermore , the dermal elasticity of male facial skin decreased with age similar to that of females , and may therefore be associated with the sagging formation in male faces . 0 ###LEFT-WALL### 5 elasticity 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 31 . 1 furthermore 2 , 1 furthermore 5 elasticity 3 the 5 elasticity 4 dermal 5 elasticity 5 elasticity 6 of 5 elasticity 19 and 6 of 9 skin 7 male 8 facial 8 facial 9 skin 10 decreased 11 with 10 decreased 19 and 11 with 12 age 12 age 13 similar 12 age 16 of 13 similar 14 to 14 to 15 that 16 of 17 females 18 , 19 and 19 and 20 may 20 may 22 be 21 therefore 22 be 22 be 23 associated 23 associated 24 with 24 with 27 formation 25 the 27 formation 26 sagging 27 formation 27 formation 28 in 28 in 30 faces 29 male 30 faces multivariate one [-] sided hypotheses testing problems arise frequently in practice . 0 ###LEFT-WALL### 1 multivariate 0 ###LEFT-WALL### 4 sided 0 ###LEFT-WALL### 12 . 1 multivariate 2 one 1 multivariate 4 sided 4 sided 5 hypotheses 5 hypotheses 6 testing 6 testing 7 problems 6 testing 8 arise 7 problems 8 arise 8 arise 9 frequently 8 arise 10 in 10 in 11 practice various tests have been developed . 0 ###LEFT-WALL### 2 tests 0 ###LEFT-WALL### 5 developed 0 ###LEFT-WALL### 6 . 1 various 2 tests 2 tests 3 have 3 have 4 been 4 been 5 developed in practice , there are often missing values in multivariate data . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 12 . 1 in 2 practice 1 in 3 , 1 in 4 there 4 there 5 are 5 are 8 values 6 often 7 missing 7 missing 8 values 8 values 9 in 9 in 11 data 10 multivariate 11 data in this case , standard testing procedures based on complete data may not be applicable or may perform poorly if the missing data are discarded . 0 ###LEFT-WALL### 7 procedures 0 ###LEFT-WALL### 16 or 0 ###LEFT-WALL### 26 . 1 in 3 case 1 in 4 , 1 in 7 procedures 2 this 3 case 5 standard 6 testing 6 testing 7 procedures 7 procedures 8 based 7 procedures 16 or 8 based 9 on 9 on 11 data 10 complete 11 data 12 may 13 not 12 may 14 be 12 may 16 or 14 be 15 applicable 16 or 17 may 17 may 18 perform 18 perform 19 poorly 18 perform 20 if 20 if 23 data 20 if 25 discarded 21 the 23 data 22 missing 23 data 23 data 24 are 24 are 25 discarded in this article , we [propose] several multiple imputation methods for multivariate one - sided testing [problem] with missing data . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 15 sided 0 ###LEFT-WALL### 21 . 1 in 3 article 1 in 15 sided 2 this 3 article 3 article 10 methods 4 , 10 methods 5 we 7 several 7 several 10 methods 8 multiple 10 methods 9 imputation 10 methods 10 methods 11 for 10 methods 14 - 11 for 12 multivariate 12 multivariate 13 one 15 sided 16 testing 16 testing 18 with 18 with 19 missing 19 missing 20 data some theoretical results are presented . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 5 presented 0 ###LEFT-WALL### 6 . 1 some 3 results 2 theoretical 3 results 3 results 4 are 4 are 5 presented the proposed methods are evaluated using simulations . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 5 evaluated 0 ###LEFT-WALL### 8 . 1 the 3 methods 2 proposed 3 methods 3 methods 4 are 4 are 5 evaluated 5 evaluated 6 using 6 using 7 simulations a real data example is presented to illustrate the methods . 0 ###LEFT-WALL### 4 example 0 ###LEFT-WALL### 6 presented 0 ###LEFT-WALL### 11 . 1 a 2 real 1 a 4 example 2 real 3 data 3 data 4 example 4 example 5 is 5 is 6 presented 6 presented 7 to 7 to 8 illustrate 8 illustrate 10 methods 9 the 10 methods abel and kruger ( 2007 ) reported that major league baseball players whose names have positive initials ( such as ace or god ) live an average of 13 years longer than do players [with] negative initials ( such as ass or bad ) or players with neutral initials ( such as ghr or tsw ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 7 reported 0 ###LEFT-WALL### 32 than 0 ###LEFT-WALL### 57 . 1 abel 2 and 2 and 3 kruger 2 and 6 ) 2 and 7 reported 3 kruger 5 2007 4 ( 5 2007 5 2007 6 ) 7 reported 8 that 8 that 12 players 8 that 25 live 9 major 10 league 10 league 12 players 11 baseball 12 players 12 players 13 whose 12 players 20 as 12 players 25 live 13 whose 14 names 14 names 15 have 15 have 17 initials 16 positive 17 initials 18 ( 20 as 19 such 20 as 20 as 22 or 20 as 24 ) 21 ace 22 or 22 or 23 god 25 live 27 average 25 live 31 longer 26 an 27 average 27 average 28 of 28 of 29 13 30 years 31 longer 32 than 33 do 32 than 36 negative 33 do 34 players 33 do 36 negative 36 negative 37 initials 36 negative 40 as 38 ( 40 as 39 such 40 as 40 as 45 or 40 as 56 ) 41 ass 42 or 42 or 43 bad 42 or 44 ) 42 or 45 or 45 or 46 players 45 or 47 with 47 with 49 initials 48 neutral 49 initials 49 initials 52 as 50 ( 52 as 51 such 52 as 52 as 54 or 52 as 56 ) 53 ghr 54 or 54 or 55 tsw however , this conclusion is based on a very small sample , selective initials , and a flawed statistical test . 0 ###LEFT-WALL### 4 conclusion 0 ###LEFT-WALL### 6 based 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 4 conclusion 3 this 4 conclusion 4 conclusion 5 is 5 is 6 based 6 based 7 on 7 on 16 and 8 a 9 very 8 a 11 sample 9 very 10 small 10 small 11 sample 11 sample 12 , 12 , 14 initials 12 , 16 and 13 selective 14 initials 15 , 16 and 16 and 20 test 17 a 18 flawed 17 a 20 test 18 flawed 20 test 19 statistical 20 test there is no statistically significant relationship between initials and longevity for major league baseball players when a correct test is applied to independently selected initials . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 26 . 1 there 2 is 2 is 6 relationship 2 is 7 between 2 is 16 when 3 no 6 relationship 4 statistically 5 significant 5 significant 6 relationship 7 between 9 and 8 initials 9 and 9 and 10 longevity 10 longevity 11 for 11 for 15 players 12 major 13 league 13 league 15 players 14 baseball 15 players 16 when 19 test 16 when 21 applied 17 a 19 test 18 correct 19 test 19 test 20 is 20 is 21 applied 21 applied 22 to 22 to 25 initials 23 independently 24 selected 24 selected 25 initials this study included a total of 234 practically healthy men at the age from 40 to 69 years differing in the regimen of daily locomotor activity . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 27 . 1 this 2 study 2 study 3 included 3 included 5 total 4 a 5 total 5 total 6 of 6 of 10 men 7 234 10 men 8 practically 9 healthy 9 healthy 10 men 10 men 11 at 10 men 19 differing 11 at 13 age 12 the 13 age 13 age 14 from 14 from 18 years 15 40 16 to 16 to 17 69 16 to 18 years 19 differing 20 in 20 in 22 regimen 21 the 22 regimen 22 regimen 23 of 23 of 26 activity 24 daily 25 locomotor 25 locomotor 26 activity they were divided into 4 groups , each comprised of subjects ranged by age with a ten [-] year interval . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 divided 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 21 . 1 they 2 were 2 were 3 divided 3 divided 4 into 4 into 6 groups 5 4 6 groups 7 , 8 each 7 , 12 ranged 8 each 9 comprised 8 each 10 of 8 each 12 ranged 10 of 11 subjects 12 ranged 13 by 12 ranged 15 with 13 by 14 age 15 with 20 interval 16 a 20 interval 17 ten 19 year 19 year 20 interval group 1 included former high - level athletes continuing active physical training , group 2 was comprised of former high - level athletes living a sedentary life style , group 3 consisted of subjects regularly engaged in health - giving physical exercises , and group 4 included subjects who were never engaged in physical exercises . 0 ###LEFT-WALL### 1 group 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 56 . 1 group 2 1 1 group 3 included 3 included 8 athletes 4 former 8 athletes 5 high 6 - 5 high 8 athletes 7 level 8 athletes 8 athletes 9 continuing 9 continuing 12 training 10 active 12 training 11 physical 12 training 13 , 14 group 13 , 17 comprised 13 , 29 , 14 group 15 2 14 group 16 was 16 was 17 comprised 17 comprised 18 of 18 of 23 athletes 19 former 23 athletes 20 high 21 - 20 high 23 athletes 22 level 23 athletes 23 athletes 24 living 24 living 28 style 25 a 26 sedentary 25 a 28 style 26 sedentary 27 life 27 life 28 style 29 , 30 group 29 , 47 included 30 group 31 3 30 group 32 consisted 32 consisted 33 of 33 of 44 and 34 subjects 36 engaged 34 subjects 37 in 34 subjects 44 and 35 regularly 36 engaged 37 in 38 health 38 health 40 giving 39 - 40 giving 40 giving 42 exercises 40 giving 43 , 41 physical 42 exercises 43 , 44 and 44 and 45 group 44 and 46 4 44 and 47 included 46 4 47 included 47 included 48 subjects 47 included 53 in 48 subjects 49 who 48 subjects 50 were 49 who 50 were 50 were 52 engaged 51 never 52 engaged 53 in 55 exercises 54 physical 55 exercises the energy consumption by the members of all four groups was estimated when they were undergoing a stepwise increasing workload on the veloergometer measured with the help of a computerized diagnostic system . 0 ###LEFT-WALL### 3 consumption 0 ###LEFT-WALL### 12 estimated 0 ###LEFT-WALL### 33 . 1 the 3 consumption 2 energy 3 consumption 3 consumption 4 by 3 consumption 7 of 3 consumption 11 was 4 by 6 members 5 the 6 members 7 of 10 groups 8 all 9 four 9 four 10 groups 11 was 12 estimated 12 estimated 13 when 12 estimated 21 on 13 when 14 they 13 when 15 were 14 they 15 were 15 were 16 undergoing 16 undergoing 20 workload 17 a 20 workload 18 stepwise 20 workload 19 increasing 20 workload 21 on 23 veloergometer 22 the 23 veloergometer 23 veloergometer 24 measured 24 measured 25 with 25 with 27 help 26 the 27 help 27 help 28 of 28 of 32 system 29 a 30 computerized 29 a 32 system 30 computerized 32 system 31 diagnostic 32 system the results of the study indicate that the high oxygen consumption at a limiting load in the former high - level athletes is associated with the significant economization of basal metabolism and the reduction of oxygen consumption at rest . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 6 indicate 0 ###LEFT-WALL### 40 . 1 the 2 results 2 results 3 of 2 results 6 indicate 3 of 5 study 4 the 5 study 6 indicate 7 that 7 that 11 consumption 7 that 24 associated 8 the 11 consumption 9 high 11 consumption 10 oxygen 11 consumption 11 consumption 12 at 11 consumption 16 in 11 consumption 23 is 12 at 15 load 13 a 15 load 14 limiting 15 load 16 in 22 athletes 17 the 22 athletes 18 former 22 athletes 19 high 20 - 19 high 22 athletes 21 level 22 athletes 23 is 24 associated 24 associated 25 with 24 associated 38 at 25 with 32 and 26 the 28 economization 27 significant 28 economization 28 economization 29 of 28 economization 32 and 29 of 31 metabolism 30 basal 31 metabolism 32 and 34 reduction 33 the 34 reduction 34 reduction 35 of 35 of 37 consumption 36 oxygen 37 consumption 38 at 39 rest this mechanism accounts for the possibility to retain adequate physical activity of the organism up to the age of 70 years . 0 ###LEFT-WALL### 2 mechanism 0 ###LEFT-WALL### 3 accounts 0 ###LEFT-WALL### 22 . 1 this 2 mechanism 2 mechanism 3 accounts 3 accounts 4 for 3 accounts 7 to 4 for 6 possibility 5 the 6 possibility 7 to 8 retain 8 retain 11 activity 9 adequate 11 activity 10 physical 11 activity 11 activity 12 of 11 activity 15 up 12 of 14 organism 13 the 14 organism 15 up 16 to 16 to 18 age 17 the 18 age 18 age 19 of 19 of 21 years 20 70 21 years background : telomere length reflects biological age and is inversely associated with risk of cardiovascular disease ( cvd ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 length 2 : 8 and 2 : 20 . 3 telomere 4 length 4 length 8 and 5 reflects 7 age 5 reflects 8 and 6 biological 7 age 8 and 9 is 9 is 11 associated 10 inversely 11 associated 11 associated 12 with 12 with 13 risk 13 risk 14 of 14 of 16 disease 15 cardiovascular 16 disease 16 disease 18 cvd 17 ( 18 cvd 18 cvd 19 ) ambient air pollution is associated with cvd , but its effect on telomere length is unknown . 0 ###LEFT-WALL### 3 pollution 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 17 . 1 ambient 2 air 2 air 3 pollution 3 pollution 4 is 4 is 5 associated 5 associated 6 with 6 with 7 cvd 8 , 9 but 9 but 11 effect 9 but 15 is 10 its 11 effect 11 effect 12 on 11 effect 15 is 12 on 14 length 13 telomere 14 length 15 is 16 unknown objective : we investigated whether ambient black carbon ( bc ) , a marker for traffic - related particles , is associated with telomere length in the normative aging study ( nas ) . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 investigated 2 : 34 . 3 we 4 investigated 4 investigated 5 whether 4 investigated 23 with 5 whether 8 carbon 5 whether 22 associated 6 ambient 8 carbon 7 black 8 carbon 8 carbon 10 bc 8 carbon 14 marker 8 carbon 21 is 9 ( 10 bc 10 bc 11 ) 12 , 14 marker 13 a 14 marker 14 marker 15 for 14 marker 17 - 15 for 16 traffic 17 - 18 related 18 related 19 particles 18 related 20 , 18 related 21 is 21 is 22 associated 23 with 25 length 24 telomere 25 length 25 length 26 in 26 in 32 nas 27 the 32 nas 28 normative 29 aging 29 aging 30 study 30 study 32 nas 31 ( 32 nas 32 nas 33 ) methods : among 165 never - smoking men from the nas , leukocyte telomere length ( ltl ) was measured repeatedly approximately every 3 years from 1999 through 2006 using quantitative real - time polymerase chain reaction ( qrt - pcr ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 7 smoking 2 : 19 was 2 : 43 . 3 among 4 165 3 among 7 smoking 5 never 6 - 5 never 7 smoking 7 smoking 8 men 7 smoking 9 from 7 smoking 19 was 9 from 11 nas 10 the 11 nas 11 nas 15 length 12 , 15 length 13 leukocyte 15 length 14 telomere 15 length 15 length 17 ltl 15 length 18 ) 16 ( 17 ltl 17 ltl 18 ) 19 was 20 measured 20 measured 21 repeatedly 20 measured 23 every 20 measured 26 from 20 measured 30 using 22 approximately 23 every 23 every 25 years 24 3 25 years 26 from 27 1999 27 1999 28 through 28 through 29 2006 30 using 37 reaction 31 quantitative 35 polymerase 32 real 33 - 32 real 35 polymerase 34 time 35 polymerase 35 polymerase 36 chain 36 chain 37 reaction 37 reaction 39 qrt 37 reaction 41 pcr 38 ( 39 qrt 39 qrt 40 - 40 - 41 pcr 41 pcr 42 ) bc concentration at their residences during the year before each ltl measurement was estimated based on a spatiotemporal model calibrated with bc measurements from 82 locations within the study area . 0 ###LEFT-WALL### 1 bc 0 ###LEFT-WALL### 15 based 0 ###LEFT-WALL### 31 . 1 bc 2 concentration 1 bc 13 was 1 bc 14 estimated 1 bc 15 based 2 concentration 3 at 2 concentration 6 during 2 concentration 13 was 3 at 5 residences 4 their 5 residences 6 during 8 year 7 the 8 year 8 year 9 before 9 before 12 measurement 10 each 12 measurement 11 ltl 12 measurement 15 based 16 on 15 based 21 with 15 based 23 measurements 15 based 24 from 15 based 27 within 16 on 19 model 17 a 18 spatiotemporal 17 a 19 model 18 spatiotemporal 19 model 19 model 20 calibrated 21 with 22 bc 24 from 26 locations 25 82 26 locations 27 within 30 area 28 the 30 area 29 study 30 area results : the median [ interquartile range ( iqr ) ] annual moving - average bc concentration was 0.32 ( 0.20 - 0.45 [ )(microg/m3 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 17 concentration 2 : 18 was 3 the 17 concentration 4 median 7 range 4 median 12 annual 5 [ 7 range 6 interquartile 7 range 7 range 9 iqr 7 range 11 ] 8 ( 9 iqr 9 iqr 10 ) 12 annual 17 concentration 13 moving 14 - 13 moving 15 average 15 average 17 concentration 16 bc 17 concentration 17 concentration 18 was 18 was 19 0.32 18 was 22 - 20 ( 22 - 21 0.20 22 - 22 - 25 )(microg/m3 22 - 26 . 23 0.45 25 )(microg/m3 ltl , expressed as population - standardized ratio [of] telomere [repeat] to single - copy gene copy numbers , had a geometric mean ( geometric sd ) [of] [1.25] ( 1.42 ) . 0 ###LEFT-WALL### 1 ltl 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 33 . 1 ltl 3 expressed 1 ltl 19 , 2 , 3 expressed 3 expressed 4 as 3 expressed 6 - 4 as 5 population 7 standardized 10 telomere 7 standardized 12 to 7 standardized 19 , 8 ratio 10 telomere 12 to 18 numbers 13 single 14 - 13 single 15 copy 15 copy 16 gene 16 gene 18 numbers 17 copy 18 numbers 19 , 20 had 20 had 23 mean 21 a 23 mean 22 geometric 23 mean 23 mean 26 sd 23 mean 31 1.42 24 ( 26 sd 25 geometric 26 sd 26 sd 27 ) 30 ( 31 1.42 31 1.42 32 ) we [used] linear mixed - effects models including random subject [intercepts] and [adjusted] for several potential confounders . 0 ###LEFT-WALL### 3 linear 0 ###LEFT-WALL### 4 mixed 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 18 . 1 we 3 linear 3 linear 4 mixed 5 - 10 subject 5 - 12 and 6 effects 10 subject 7 models 10 subject 8 including 10 subject 9 random 10 subject 12 and 16 potential 12 and 17 confounders 14 for 15 several 14 for 16 potential 16 potential 17 confounders we used inverse probability of response weighting to adjust for potential selection bias due to loss to follow - up . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 1 we 2 used 2 used 4 probability 2 used 8 to 2 used 10 for 2 used 15 to 2 used 17 to 2 used 18 follow 3 inverse 4 probability 4 probability 5 of 5 of 7 weighting 6 response 7 weighting 8 to 9 adjust 10 for 13 bias 11 potential 12 selection 12 selection 13 bias 14 due 15 to 15 to 16 loss 17 to 18 follow 18 follow 20 up 19 - 20 up 20 up 21 . an iqr increase in annual bc ( 0.25 microg/m3 ) was associated with a 7.6 % decrease [(] 95 % confidence interval , - 12.8 to - 2.1 ) in ltl . 0 ###LEFT-WALL### 3 increase 0 ###LEFT-WALL### 12 associated 0 ###LEFT-WALL### 32 . 1 an 3 increase 2 iqr 3 increase 3 increase 4 in 3 increase 9 microg/m3 3 increase 11 was 4 in 6 bc 5 annual 6 bc 7 ( 9 microg/m3 8 0.25 9 microg/m3 9 microg/m3 10 ) 11 was 12 associated 12 associated 13 with 12 associated 30 in 13 with 22 interval 14 a 22 interval 15 7.6 16 % 16 % 17 decrease 17 decrease 22 interval 19 95 20 % 20 % 22 interval 21 confidence 22 interval 22 interval 26 to 23 , 26 to 24 - 26 to 25 12.8 26 to 26 to 28 2.1 26 to 29 ) 27 - 28 2.1 30 in 31 ltl we found evidence of effect modification , with a stronger association among subjects [>] or = 75 years of age compared with younger participants ( p = 0.050 ) and statin medications appearing protective of the effects of bc on ltl ( p = 0.050 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 47 . 1 we 2 found 2 found 3 evidence 2 found 6 modification 2 found 30 and 2 found 40 on 2 found 44 = 3 evidence 4 of 4 of 5 effect 6 modification 8 with 7 , 8 with 8 with 11 association 8 with 29 ) 9 a 11 association 10 stronger 11 association 11 association 12 among 11 association 19 of 12 among 15 or 13 subjects 15 or 15 or 18 years 16 = 17 75 17 75 18 years 19 of 20 age 20 age 21 compared 20 age 22 with 22 with 24 participants 23 younger 24 participants 24 participants 27 = 25 ( 27 = 26 p 27 = 27 = 28 0.050 27 = 29 ) 30 and 31 statin 30 and 32 medications 32 medications 33 appearing 32 medications 35 of 32 medications 38 of 33 appearing 34 protective 35 of 37 effects 36 the 37 effects 38 of 39 bc 40 on 41 ltl 42 ( 44 = 43 p 44 = 44 = 45 0.050 44 = 46 ) conclusions : telomere attrition , linked to biological aging , may be associated with long - term exposures to airborne particles , particularly those rich in bc , which are primarily related to automobile traffic . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 be 0 ###LEFT-WALL### 36 . 2 : 12 be 3 telomere 4 attrition 4 attrition 6 linked 4 attrition 11 may 5 , 6 linked 6 linked 7 to 6 linked 10 , 7 to 9 aging 8 biological 9 aging 11 may 12 be 12 be 13 associated 13 associated 14 with 13 associated 33 to 14 with 18 exposures 15 long 16 - 15 long 17 term 17 term 18 exposures 18 exposures 19 to 18 exposures 29 which 18 exposures 30 are 19 to 21 particles 20 airborne 21 particles 21 particles 24 those 22 , 23 particularly 22 , 24 those 24 those 25 rich 24 those 28 , 25 rich 26 in 26 in 27 bc 29 which 30 are 30 are 32 related 31 primarily 32 related 33 to 35 traffic 34 automobile 35 traffic background : incidence of epilepsy in elderly patients is higher than in any other group . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 incidence 2 : 9 is 2 : 16 . 3 incidence 4 of 3 incidence 9 is 4 of 5 epilepsy 5 epilepsy 6 in 6 in 8 patients 7 elderly 8 patients 9 is 10 higher 10 higher 11 than 11 than 12 in 12 in 15 group 13 any 14 other 14 other 15 group the diagnosis of epilepsy in old age is particularly challenging and is often overlooked or missed . 0 ###LEFT-WALL### 2 diagnosis 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 17 . 1 the 2 diagnosis 2 diagnosis 3 of 2 diagnosis 11 and 3 of 4 epilepsy 4 epilepsy 5 in 5 in 7 age 6 old 7 age 8 is 10 challenging 8 is 11 and 9 particularly 10 challenging 11 and 15 or 12 is 14 overlooked 12 is 15 or 13 often 14 overlooked 15 or 16 missed selection of appropriate antiepileptic drugs ( aeds ) for this group [of] patient also requires more attention than younger patients . 0 ###LEFT-WALL### 1 selection 0 ###LEFT-WALL### 15 requires 0 ###LEFT-WALL### 21 . 1 selection 2 of 1 selection 9 for 1 selection 15 requires 2 of 5 drugs 3 appropriate 5 drugs 4 antiepileptic 5 drugs 5 drugs 7 aeds 6 ( 7 aeds 7 aeds 8 ) 9 for 13 patient 10 this 13 patient 11 group 13 patient 14 also 15 requires 15 requires 17 attention 15 requires 18 than 16 more 17 attention 18 than 20 patients 19 younger 20 patients objective : to summarise the clinical presentation , aetiology , diagnosis , treatment , and neuropsychiatric complications of epilepsy in old age . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 summarise 2 : 23 . 3 to 4 summarise 4 summarise 15 and 4 summarise 20 in 5 the 15 and 6 clinical 7 presentation 7 presentation 8 , 8 , 9 aetiology 8 , 10 , 10 , 11 diagnosis 10 , 12 , 12 , 13 treatment 12 , 15 and 14 , 15 and 15 and 17 complications 15 and 18 of 16 neuropsychiatric 17 complications 18 of 19 epilepsy 20 in 22 age 21 old 22 age methods : systematic review of existing literature on epilepsy in the elderly was carried out using original articles , review articles , meta - analysis , case reports , standard neurology text and the cochrane library data . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 4 review 2 : 14 carried 3 systematic 4 review 4 review 5 of 4 review 13 was 5 of 6 existing 6 existing 7 literature 6 existing 8 on 6 existing 10 in 8 on 9 epilepsy 10 in 12 elderly 11 the 12 elderly 13 was 14 carried 14 carried 15 out 14 carried 16 using 16 using 33 and 17 original 18 articles 18 articles 19 , 19 , 21 articles 19 , 22 , 20 review 21 articles 22 , 28 reports 22 , 29 , 23 meta 25 analysis 23 meta 26 , 23 meta 27 case 24 - 25 analysis 25 analysis 26 , 27 case 28 reports 29 , 32 text 29 , 33 and 30 standard 32 text 31 neurology 32 text 33 and 37 data 34 the 37 data 35 cochrane 37 data 36 library 37 data results : stroke and neurodegenerative disorders account for most causes of epilepsy in older patients . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 7 account 2 : 16 . 3 stroke 4 and 4 and 6 disorders 4 and 7 account 5 neurodegenerative 6 disorders 7 account 8 for 7 account 13 in 8 for 10 causes 9 most 10 causes 10 causes 11 of 11 of 12 epilepsy 13 in 15 patients 14 older 15 patients simple partial and complex seizures are common modes of clinical manifestation . 0 ###LEFT-WALL### 11 manifestation 0 ###LEFT-WALL### 12 . 1 simple 11 manifestation 2 partial 3 and 3 and 4 complex 3 and 5 seizures 3 and 9 of 3 and 11 manifestation 5 seizures 6 are 6 are 8 modes 7 common 8 modes 8 modes 9 of 10 clinical 11 manifestation post - ictal confusion and memory lapses are particularly prolonged in the elderly . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 prolonged 0 ###LEFT-WALL### 14 . 1 post 2 - 1 post 5 and 3 ictal 4 confusion 4 confusion 5 and 5 and 7 lapses 5 and 8 are 6 memory 7 lapses 8 are 10 prolonged 9 particularly 10 prolonged 10 prolonged 11 in 11 in 13 elderly 12 the 13 elderly the presence of other co - morbidities , age - related changes in pharmacokinetics and possible risk [of] drug - drug interaction needs to be considered before commencement [of] medication . 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 12 changes 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 31 . 1 the 2 presence 2 presence 3 of 2 presence 11 related 2 presence 12 changes 3 of 7 morbidities 4 other 7 morbidities 5 co 6 - 5 co 7 morbidities 7 morbidities 9 age 8 , 9 age 9 age 10 - 12 changes 13 in 13 in 15 and 14 pharmacokinetics 15 and 15 and 19 drug 16 possible 19 drug 17 risk 19 drug 20 - 23 needs 21 drug 22 interaction 22 interaction 23 needs 23 needs 24 to 23 needs 26 considered 24 to 25 be 25 be 26 considered 26 considered 27 before 27 before 30 medication 28 commencement 30 medication older aeds like phenobarbitone and phenytoin should be avoided in the elderly because of their pharmacological profiles . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 avoided 0 ###LEFT-WALL### 18 . 1 older 2 aeds 2 aeds 3 like 2 aeds 5 and 3 like 4 phenobarbitone 5 and 6 phenytoin 5 and 7 should 7 should 8 be 8 be 9 avoided 9 avoided 10 in 9 avoided 13 because 10 in 12 elderly 11 the 12 elderly 13 because 14 of 14 of 17 profiles 15 their 17 profiles 16 pharmacological 17 profiles although newer aeds have better tolerability , [there] is no evidence that they are advantageous over the older ones in terms of seizure control and should be used [as] add - on pills . 0 ###LEFT-WALL### 30 add 1 although 3 aeds 1 although 7 , 1 although 30 add 2 newer 3 aeds 3 aeds 7 , 4 have 5 better 4 have 6 tolerability 4 have 7 , 7 , 25 and 9 is 11 evidence 9 is 12 that 9 is 25 and 10 no 11 evidence 12 that 13 they 12 that 14 are 13 they 14 are 14 are 15 advantageous 15 advantageous 16 over 15 advantageous 20 in 16 over 19 ones 17 the 19 ones 18 older 19 ones 20 in 21 terms 21 terms 22 of 22 of 24 control 23 seizure 24 control 25 and 26 should 26 should 27 be 27 be 28 used 30 add 32 on 31 - 32 on 32 on 33 pills 32 on 34 . the older aeds have the advantages of being cheaper and being readily available in developing countries . 0 ###LEFT-WALL### 3 aeds 0 ###LEFT-WALL### 4 have 0 ###LEFT-WALL### 17 . 1 the 3 aeds 2 older 3 aeds 3 aeds 4 have 4 have 10 and 4 have 14 in 5 the 6 advantages 6 advantages 7 of 6 advantages 10 and 7 of 8 being 8 being 9 cheaper 10 and 11 being 10 and 13 available 12 readily 13 available 14 in 15 developing 15 developing 16 countries conclusion : the goal of epilepsy management in the elderly goes beyond attainment of seizure control but should include improvement in quality of life . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 goal 2 : 17 but 2 : 25 . 3 the 4 goal 4 goal 5 of 4 goal 17 but 5 of 7 management 6 epilepsy 7 management 7 management 8 in 8 in 10 elderly 9 the 10 elderly 11 goes 12 beyond 11 goes 17 but 12 beyond 13 attainment 13 attainment 14 of 14 of 16 control 15 seizure 16 control 17 but 18 should 18 should 19 include 19 include 20 improvement 19 include 21 in 21 in 22 quality 22 quality 23 of 23 of 24 life aeds should be introduced cautiously [based] on patient ['s] frailty and starting with lower dosage . 0 ###LEFT-WALL### 1 aeds 0 ###LEFT-WALL### 4 introduced 0 ###LEFT-WALL### 16 . 1 aeds 2 should 2 should 3 be 3 be 4 introduced 4 introduced 5 cautiously 4 introduced 7 on 4 introduced 13 with 7 on 11 and 8 patient 10 frailty 10 frailty 11 and 11 and 12 starting 13 with 15 dosage 14 lower 15 dosage objective : two studies were conducted to obtain an understanding of the types of items seniors keep in their nightstands and to understand how users feel about the possibility of " smart " furniture . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 studies 2 : 21 and 2 : 35 . 3 two 4 studies 4 studies 5 were 5 were 21 and 6 conducted 7 to 6 conducted 20 nightstands 6 conducted 21 and 7 to 8 obtain 8 obtain 10 understanding 9 an 10 understanding 10 understanding 11 of 10 understanding 16 seniors 10 understanding 17 keep 11 of 13 types 12 the 13 types 13 types 14 of 14 of 15 items 16 seniors 17 keep 17 keep 18 in 19 their 20 nightstands 21 and 22 to 21 and 23 understand 21 and 27 about 22 to 23 understand 23 understand 24 how 24 how 25 users 24 how 26 feel 25 users 26 feel 27 about 29 possibility 28 the 29 possibility 29 possibility 30 of 30 of 31 " 30 of 34 furniture 32 smart 33 " 32 smart 34 furniture background : to enable aging in place and universal design , it is vital to understand the needs of a broad range of aging individuals , especially since there is little research on nightstand usage and design . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 16 understand 1 background 2 : 2 : 3 to 2 : 4 enable 3 to 4 enable 4 enable 5 aging 4 enable 6 in 6 in 8 and 7 place 8 and 8 and 10 design 9 universal 10 design 11 , 12 it 11 , 13 is 12 it 13 is 13 is 14 vital 14 vital 15 to 14 vital 16 understand 15 to 16 understand 16 understand 18 needs 16 understand 28 since 17 the 18 needs 18 needs 19 of 19 of 22 range 20 a 22 range 21 broad 22 range 22 range 23 of 23 of 24 aging 24 aging 25 individuals 26 , 27 especially 26 , 28 since 28 since 29 there 28 since 30 is 28 since 38 . 29 there 30 is 30 is 32 research 31 little 32 research 32 research 33 on 33 on 36 and 34 nightstand 35 usage 35 usage 36 and 36 and 37 design methods : study 1 allowed for the development of a structured inventory of nightstand use today in assisted living and rehabilitation facilities . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 1 methods 2 : 2 : 3 study 2 : 6 for 2 : 16 today 2 : 17 in 3 study 4 1 3 study 5 allowed 6 for 8 development 7 the 8 development 8 development 9 of 9 of 12 inventory 10 a 12 inventory 11 structured 12 inventory 12 inventory 13 of 13 of 15 use 14 nightstand 15 use 17 in 20 and 18 assisted 19 living 19 living 20 and 20 and 22 facilities 21 rehabilitation 22 facilities study 1 led to study 2 , demonstrating the need to conceptualize new ideas for smart nightstands . 0 ###LEFT-WALL### 1 study 0 ###LEFT-WALL### 3 led 1 study 2 1 1 study 3 led 3 led 4 to 4 to 5 study 5 study 6 2 5 study 8 demonstrating 7 , 8 demonstrating 8 demonstrating 10 need 8 demonstrating 18 . 9 the 10 need 10 need 11 to 10 need 12 conceptualize 11 to 12 conceptualize 12 conceptualize 14 ideas 13 new 14 ideas 14 ideas 15 for 15 for 17 nightstands 16 smart 17 nightstands feedback was obtained from intergenerational participants who could discuss their needs and preferences for a smart nightstand . 0 ###LEFT-WALL### 1 feedback 0 ###LEFT-WALL### 3 obtained 0 ###LEFT-WALL### 18 . 1 feedback 2 was 2 was 3 obtained 3 obtained 4 from 4 from 6 participants 5 intergenerational 6 participants 6 participants 7 who 6 participants 8 could 7 who 8 could 8 could 9 discuss 9 discuss 12 and 10 their 11 needs 11 needs 12 and 12 and 13 preferences 12 and 14 for 14 for 17 nightstand 15 a 17 nightstand 16 smart 17 nightstand results : in study 1 , more than 150 items were recorded and categorized into 25 different groups . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 10 items 2 : 11 were 2 : 19 . 3 in 4 study 3 in 6 , 3 in 10 items 4 study 5 1 7 more 8 than 8 than 9 150 9 150 10 items 10 items 11 were 11 were 13 and 12 recorded 13 and 13 and 14 categorized 13 and 15 into 15 into 18 groups 16 25 18 groups 17 different 18 groups the authors found that participants utilized the top portion of their nightstand as opposed to the lower sections ; most items were found on top of the nightstand or in the top drawer . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 19 ; 0 ###LEFT-WALL### 34 . 1 the 2 authors 2 authors 3 found 3 found 4 that 4 that 5 participants 4 that 6 utilized 5 participants 6 utilized 6 utilized 9 portion 6 utilized 15 to 7 the 8 top 7 the 9 portion 9 portion 10 of 10 of 12 nightstand 11 their 12 nightstand 12 nightstand 14 opposed 13 as 14 opposed 15 to 18 sections 16 the 18 sections 17 lower 18 sections 19 ; 21 items 19 ; 23 found 20 most 21 items 21 items 22 were 22 were 23 found 23 found 29 or 24 on 25 top 25 top 26 of 26 of 28 nightstand 26 of 29 or 27 the 28 nightstand 29 or 30 in 30 in 33 drawer 31 the 33 drawer 32 top 33 drawer in study 2 , the authors found that the vast majority of participants are willing to consider the use of a smart nightstand . 0 ###LEFT-WALL### 6 authors 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 24 . 1 in 2 study 1 in 4 , 1 in 6 authors 2 study 3 2 5 the 6 authors 6 authors 7 found 7 found 8 that 8 that 13 participants 8 that 14 are 9 the 11 majority 10 vast 11 majority 11 majority 12 of 11 majority 13 participants 12 of 13 participants 13 participants 14 are 14 are 15 willing 15 willing 16 to 15 willing 17 consider 16 to 17 consider 17 consider 19 use 18 the 19 use 19 use 20 of 20 of 23 nightstand 21 a 23 nightstand 22 smart 23 nightstand participants discussed key functions and design preferences , which included carefully designed storage , the ability to move the nightstand up and down , contemporary design , and interaction through voice activation . 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 33 . 1 participants 4 functions 2 discussed 3 key 3 key 4 functions 4 functions 5 and 5 and 7 preferences 5 and 8 , 5 and 9 which 5 and 10 included 5 and 28 and 6 design 7 preferences 9 which 10 included 10 included 13 storage 11 carefully 12 designed 12 designed 13 storage 13 storage 16 ability 14 , 16 ability 15 the 16 ability 16 ability 17 to 16 ability 23 down 16 ability 26 design 16 ability 27 , 17 to 22 and 18 move 20 nightstand 18 move 21 up 18 move 22 and 19 the 20 nightstand 22 and 23 down 24 , 26 design 25 contemporary 26 design 26 design 27 , 28 and 29 interaction 28 and 30 through 30 through 32 activation 31 voice 32 activation conclusion : existing nightstands do not meet the needs of current users . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 nightstands 2 : 7 meet 2 : 13 . 3 existing 4 nightstands 4 nightstands 5 do 5 do 6 not 5 do 7 meet 7 meet 9 needs 8 the 9 needs 9 needs 10 of 10 of 12 users 11 current 12 users this research provides greater understanding of the existing limitations associated with nightstands . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 13 . 1 this 2 research 2 research 3 provides 3 provides 5 understanding 4 greater 5 understanding 5 understanding 6 of 6 of 9 limitations 7 the 9 limitations 8 existing 9 limitations 9 limitations 10 associated 10 associated 11 with 11 with 12 nightstands study 2 confirmed that user - centered design and the use of technology can be used to enhance daily living . 0 ###LEFT-WALL### 1 study 0 ###LEFT-WALL### 3 confirmed 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 21 . 1 study 2 2 1 study 3 confirmed 3 confirmed 5 user 4 that 5 user 6 - 9 and 6 - 16 used 7 centered 8 design 8 design 9 and 9 and 11 use 9 and 12 of 9 and 14 can 10 the 11 use 12 of 13 technology 14 can 15 be 15 be 16 used 16 used 17 to 16 used 18 enhance 17 to 18 enhance 18 enhance 20 living 19 daily 20 living smart furniture may play a role in promoting the health and independence of diverse user groups . 0 ###LEFT-WALL### 2 furniture 0 ###LEFT-WALL### 4 play 0 ###LEFT-WALL### 17 . 1 smart 2 furniture 2 furniture 3 may 3 may 4 play 4 play 6 role 4 play 7 in 5 a 6 role 7 in 8 promoting 8 promoting 11 and 9 the 10 health 10 health 11 and 11 and 12 independence 11 and 13 of 13 of 16 groups 14 diverse 15 user 15 user 16 groups objective : because studies of crowding in long - term care settings are lacking , the authors sought [to] [:] ( 1 ) generate initial estimates of crowding in nursing homes and assisted living facilities [;] [and] ( 2 ) evaluate two operational approaches to its measurement [.] 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 because 2 : 9 - 3 because 4 studies 4 studies 5 of 4 studies 8 long 5 of 6 crowding 6 crowding 7 in 9 - 12 settings 9 - 13 are 9 - 15 , 10 term 11 care 11 care 12 settings 12 settings 13 are 13 are 14 lacking 15 , 17 authors 15 , 24 generate 16 the 17 authors 17 authors 18 sought 17 authors 22 1 17 authors 24 generate 21 ( 22 1 22 1 23 ) 24 generate 26 estimates 24 generate 29 in 25 initial 26 estimates 26 estimates 27 of 27 of 28 crowding 29 in 32 and 30 nursing 31 homes 31 homes 32 and 32 and 34 living 32 and 35 facilities 32 and 41 evaluate 33 assisted 34 living 35 facilities 39 2 35 facilities 41 evaluate 38 ( 39 2 39 2 40 ) 41 evaluate 44 approaches 41 evaluate 45 to 42 two 44 approaches 43 operational 44 approaches 45 to 47 measurement 46 its 47 measurement background : reactions to density and proximity are complex . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 reactions 2 : 8 are 2 : 10 . 3 reactions 4 to 3 reactions 8 are 4 to 6 and 5 density 6 and 6 and 7 proximity 8 are 9 complex greater density intensifies people 's reaction to a situation in the direction ( positive or negative ) that [they] would react if the situation were to occur under less dense conditions . 0 ###LEFT-WALL### 2 density 0 ###LEFT-WALL### 3 intensifies 0 ###LEFT-WALL### 32 . 1 greater 2 density 2 density 3 intensifies 3 intensifies 6 reaction 4 people 5 's 5 's 6 reaction 6 reaction 7 to 6 reaction 10 in 6 reaction 18 that 6 reaction 20 would 7 to 9 situation 8 a 9 situation 10 in 12 direction 11 the 12 direction 12 direction 15 or 13 ( 15 or 14 positive 15 or 15 or 16 negative 15 or 17 ) 18 that 20 would 20 would 21 react 21 react 22 if 21 react 28 under 22 if 24 situation 22 if 25 were 23 the 24 situation 24 situation 25 were 25 were 26 to 26 to 27 occur 28 under 31 conditions 29 less 30 dense 30 dense 31 conditions people with dementia are especially reactive to the environment . 0 ###LEFT-WALL### 1 people 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 10 . 1 people 2 with 1 people 4 are 2 with 3 dementia 4 are 5 especially 4 are 6 reactive 6 reactive 7 to 7 to 9 environment 8 the 9 environment methods : using a cross - sectional correlational design in nursing homes and assisted living facilities involving 185 participants , multiple observations ( n = 6,455 ) of crowding and other environmental variables were made . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 9 design 2 : 13 and 2 : 30 and 2 : 36 . 3 using 5 cross 3 using 6 - 3 using 9 design 4 a 5 cross 7 sectional 9 design 8 correlational 9 design 9 design 10 in 9 design 13 and 10 in 11 nursing 12 homes 13 and 13 and 14 assisted 13 and 16 facilities 15 living 16 facilities 16 facilities 17 involving 16 facilities 28 of 17 involving 19 participants 18 185 19 participants 19 participants 22 observations 20 , 22 observations 21 multiple 22 observations 22 observations 25 = 22 observations 27 ) 23 ( 25 = 24 n 25 = 25 = 26 6,455 28 of 29 crowding 30 and 33 variables 30 and 35 made 31 other 33 variables 32 environmental 33 variables 33 variables 34 were 34 were 35 made crowding , location , and sound were measured three times per observation ; ambiance was measured once . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 18 . 1 crowding 2 , 2 , 3 location 2 , 5 and 4 , 5 and 5 and 6 sound 5 and 7 were 7 were 8 measured 8 measured 10 times 9 three 10 times 10 times 11 per 11 per 12 observation 13 ; 14 ambiance 13 ; 15 was 14 ambiance 15 was 15 was 16 measured 16 measured 17 once data analyses consisted of descriptive statistics , t - tests , and one - way analysis of variance . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 19 . 1 data 2 analyses 2 analyses 3 consisted 3 consisted 4 of 4 of 6 statistics 5 descriptive 6 statistics 6 statistics 9 - 7 , 9 - 8 t 9 - 9 - 12 and 9 - 14 - 10 tests 12 and 11 , 12 and 12 and 13 one 14 - 16 analysis 15 way 16 analysis 16 analysis 17 of 17 of 18 variance results : crowding estimates were higher for nursing homes and in dining and activity rooms . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 estimates 2 : 5 were 2 : 13 and 2 : 16 . 3 crowding 4 estimates 4 estimates 5 were 5 were 6 higher 6 higher 10 and 7 for 8 nursing 7 for 10 and 8 nursing 9 homes 10 and 11 in 11 in 12 dining 13 and 14 activity 13 and 15 rooms 14 activity 15 rooms crowding also varied across settings and locations by time of day . 0 ###LEFT-WALL### 1 crowding 0 ###LEFT-WALL### 3 varied 0 ###LEFT-WALL### 12 . 1 crowding 3 varied 2 also 3 varied 3 varied 4 across 3 varied 8 by 4 across 6 and 5 settings 6 and 6 and 7 locations 8 by 9 time 9 time 10 of 10 of 11 day crowding had small , direct , and highly significant correlations with sound and with the engaging subscale for ambiance ; a similar , [though] inverse , correlation was seen with the soothing subscale for ambiance . 0 ###LEFT-WALL### 1 crowding 0 ###LEFT-WALL### 2 had 0 ###LEFT-WALL### 20 ; 0 ###LEFT-WALL### 36 . 1 crowding 2 had 2 had 10 correlations 3 small 4 , 3 small 10 correlations 5 direct 7 and 6 , 7 and 7 and 9 significant 7 and 10 correlations 8 highly 9 significant 10 correlations 13 and 10 correlations 17 subscale 11 with 12 sound 11 with 13 and 13 and 14 with 14 with 16 engaging 15 the 16 engaging 17 subscale 18 for 18 for 19 ambiance 20 ; 27 correlation 20 ; 29 seen 21 a 22 similar 21 a 27 correlation 22 similar 25 inverse 22 similar 27 correlation 23 , 25 inverse 25 inverse 26 , 27 correlation 28 was 28 was 29 seen 29 seen 30 with 30 with 32 soothing 31 the 32 soothing 32 soothing 33 subscale 33 subscale 34 for 34 for 35 ambiance conclusions : crowding fluctuates [consistent] with routine activities such as meals in long - term care settings . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 crowding 2 : 4 fluctuates 2 : 18 . 3 crowding 4 fluctuates 4 fluctuates 6 with 4 fluctuates 12 in 6 with 8 activities 7 routine 8 activities 8 activities 10 as 9 such 10 as 10 as 11 meals 12 in 17 settings 13 long 14 - 13 long 15 term 15 term 17 settings 16 care 17 settings furthermore , a relationship between crowding and other physical characteristics of the environment was found . 0 ###LEFT-WALL### 4 relationship 0 ###LEFT-WALL### 15 found 0 ###LEFT-WALL### 16 . 1 furthermore 2 , 1 furthermore 4 relationship 3 a 4 relationship 4 relationship 5 between 4 relationship 14 was 5 between 7 and 6 crowding 7 and 7 and 10 characteristics 7 and 11 of 8 other 10 characteristics 9 physical 10 characteristics 11 of 13 environment 12 the 13 environment 14 was 15 found the ltc - ci is likely to be more sensitive than simple people counts when seeking to evaluate the effects of crowding on the behavior of elders - particularly those with dementia - in long - term care settings [.] aging in place . 0 ###LEFT-WALL### 2 ltc 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 44 . 1 the 2 ltc 3 - 4 ci 3 - 8 be 4 ci 5 is 5 is 6 likely 6 likely 7 to 7 to 8 be 8 be 9 more 8 be 10 sensitive 10 sensitive 11 than 10 sensitive 15 when 10 sensitive 23 on 11 than 14 counts 12 simple 13 people 13 people 14 counts 15 when 16 seeking 16 seeking 17 to 16 seeking 18 evaluate 17 to 18 evaluate 18 evaluate 20 effects 19 the 20 effects 20 effects 21 of 21 of 22 crowding 23 on 25 behavior 24 the 25 behavior 25 behavior 26 of 25 behavior 34 in 25 behavior 41 aging 26 of 27 elders 27 elders 30 those 28 - 29 particularly 28 - 30 those 30 those 31 with 30 those 33 - 31 with 32 dementia 34 in 39 settings 35 long 36 - 35 long 39 settings 37 term 38 care 38 care 39 settings 41 aging 42 in 42 in 43 place objective : to determine differences in the rate of [falls] [,] healthcare - acquired infections ( hais ) , and the degree of social isolation in hospitalized older adults admitted to private [versus] semi - private rooms . 0 ###LEFT-WALL### 30 admitted 1 objective 2 : 2 : 3 to 2 : 4 determine 3 to 4 determine 4 determine 20 and 4 determine 30 admitted 5 differences 6 in 5 differences 20 and 6 in 8 rate 7 the 8 rate 8 rate 9 of 9 of 15 infections 12 healthcare 13 - 12 healthcare 15 infections 14 acquired 15 infections 15 infections 17 hais 16 ( 17 hais 17 hais 18 ) 19 , 20 and 20 and 25 isolation 20 and 26 in 20 and 30 admitted 21 the 22 degree 22 degree 23 of 22 degree 25 isolation 23 of 25 isolation 24 social 25 isolation 26 in 29 adults 27 hospitalized 29 adults 28 older 29 adults 30 admitted 31 to 30 admitted 38 . 31 to 37 rooms 32 private 37 rooms 34 semi 35 - 34 semi 37 rooms 36 private 37 rooms background : the american institute of architects recommends that private rooms become the industry standard for all new construction of acute care hospitals . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 become 0 ###LEFT-WALL### 24 . 2 : 5 institute 2 : 8 recommends 3 the 4 american 4 american 5 institute 5 institute 6 of 5 institute 8 recommends 6 of 7 architects 8 recommends 11 rooms 8 recommends 12 become 9 that 10 private 10 private 11 rooms 12 become 14 industry 13 the 14 industry 14 industry 15 standard 14 industry 20 of 15 standard 16 for 16 for 19 construction 17 all 19 construction 18 new 19 construction 20 of 23 hospitals 21 acute 22 care 22 care 23 hospitals healthcare design researchers contend that private rooms decrease infection , facilitate healthcare workers ' efficiency , provide space for families , and afford greater access to privacy . 0 ###LEFT-WALL### 3 researchers 0 ###LEFT-WALL### 4 contend 0 ###LEFT-WALL### 28 . 1 healthcare 2 design 2 design 3 researchers 3 researchers 4 contend 4 contend 5 that 5 that 7 rooms 5 that 10 , 6 private 7 rooms 7 rooms 10 , 8 decrease 9 infection 8 decrease 10 , 10 , 16 , 11 facilitate 15 efficiency 11 facilitate 16 , 12 healthcare 13 workers 13 workers 14 ' 14 ' 15 efficiency 16 , 22 and 17 provide 18 space 17 provide 19 for 17 provide 22 and 19 for 20 families 21 , 22 and 22 and 23 afford 23 afford 25 access 23 afford 26 to 24 greater 25 access 26 to 27 privacy although links between room type and health outcomes have been described in the literature , the actual relationship between these two variables has not been determined , nor is it clear whether a one - size - fits - all approach [to] hospital design is appropriate for all patient populations , particularly older adults . 0 ###LEFT-WALL### 5 type 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 29 is 1 although 2 links 1 although 5 type 2 links 3 between 3 between 4 room 6 and 8 outcomes 6 and 26 determined 7 health 8 outcomes 8 outcomes 9 have 9 have 10 been 10 been 11 described 11 described 12 in 12 in 14 literature 13 the 14 literature 15 , 26 determined 16 the 18 relationship 17 actual 18 relationship 18 relationship 19 between 18 relationship 23 has 19 between 22 variables 20 these 21 two 21 two 22 variables 23 has 24 not 23 has 25 been 25 been 26 determined 26 determined 27 , 26 determined 28 nor 27 , 28 nor 28 nor 29 is 29 is 30 it 29 is 31 clear 31 clear 32 whether 32 whether 34 one 32 whether 46 appropriate 33 a 34 one 34 one 36 size 34 one 38 fits 35 - 36 size 36 size 37 - 38 fits 40 all 39 - 40 all 40 all 44 design 40 all 46 appropriate 41 approach 44 design 43 hospital 44 design 44 design 45 is 45 is 46 appropriate 46 appropriate 47 for 47 for 50 populations 48 all 50 populations 49 patient 50 populations 50 populations 54 adults 51 , 52 particularly 51 , 54 adults 53 older 54 adults 54 adults 55 . methods : this retrospective case comparative design utilized a sample of patients admitted to the university medical center of princeton in 2006 and received full internal review board approval . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 admitted 0 ###LEFT-WALL### 30 . 1 methods 2 : 2 : 8 utilized 3 this 4 retrospective 4 retrospective 6 comparative 5 case 6 comparative 6 comparative 7 design 7 design 8 utilized 9 a 10 sample 10 sample 11 of 10 sample 13 admitted 11 of 12 patients 13 admitted 14 to 14 to 18 center 15 the 18 center 16 university 17 medical 17 medical 18 center 18 center 19 of 19 of 23 and 20 princeton 21 in 20 princeton 23 and 21 in 22 2006 23 and 29 approval 24 received 27 review 25 full 27 review 26 internal 27 review 27 review 29 approval 28 board 29 approval patient records were randomly selected through the admission/discharge/transfer system of the hospital and then divided into two groups based on room type . 0 ###LEFT-WALL### 2 records 0 ###LEFT-WALL### 22 type 0 ###LEFT-WALL### 23 . 1 patient 2 records 2 records 13 and 2 records 16 into 2 records 22 type 3 were 5 selected 3 were 13 and 4 randomly 5 selected 5 selected 6 through 6 through 9 system 7 the 9 system 8 admission/discharge/transfer 9 system 9 system 10 of 10 of 12 hospital 11 the 12 hospital 13 and 15 divided 14 then 15 divided 16 into 18 groups 17 two 18 groups 18 groups 19 based 19 based 20 on 20 on 21 room data collected included demographics , incidence [of] [falls] , hais , and risk of social isolation . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 17 . 1 data 2 collected 1 data 3 included 3 included 12 and 4 demographics 5 , 5 , 6 incidence 5 , 9 , 9 , 10 hais 9 , 12 and 11 , 12 and 12 and 13 risk 12 and 14 of 14 of 16 isolation 15 social 16 isolation results : all patients were more than 65 years old and had been admitted to the hospital for a variety of diagnoses . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 admitted 0 ###LEFT-WALL### 23 . 2 : 4 patients 2 : 11 and 3 all 4 patients 4 patients 11 and 5 were 10 old 5 were 11 and 6 more 7 than 7 than 8 65 8 65 9 years 9 years 10 old 11 and 12 had 12 had 13 been 13 been 14 admitted 14 admitted 15 to 15 to 17 hospital 16 the 17 hospital 17 hospital 18 for 18 for 20 variety 19 a 20 variety 20 variety 21 of 21 of 22 diagnoses length [of] [stay] was between 3 and 10 days . 0 ###LEFT-WALL### 1 length 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 10 . 1 length 4 was 4 was 5 between 5 between 9 days 6 3 7 and 7 and 8 10 7 and 9 days there was no significant difference between the type of room and the likelihood of falling ( p = [.] 37 ) , however the relative risk of falling in a private room was 4.01 . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 5 difference 3 no 5 difference 4 significant 5 difference 5 difference 6 between 6 between 11 and 7 the 8 type 8 type 9 of 8 type 10 room 9 of 10 room 10 room 11 and 11 and 13 likelihood 11 and 14 of 12 the 13 likelihood 14 of 15 falling 15 falling 18 = 15 falling 23 however 16 ( 18 = 17 p 18 = 18 = 20 37 18 = 21 ) 22 , 23 however 23 however 26 risk 23 however 33 was 23 however 35 . 24 the 26 risk 25 relative 26 risk 26 risk 27 of 26 risk 33 was 27 of 28 falling 28 falling 29 in 29 in 32 room 30 a 32 room 31 private 32 room 33 was 34 4.01 there was no significant difference in the occurrence of hais based on room [type] ( p = 1.0 ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 20 . 1 there 2 was 2 was 5 difference 3 no 5 difference 4 significant 5 difference 5 difference 6 in 5 difference 9 of 6 in 8 occurrence 7 the 8 occurrence 9 of 10 hais 10 hais 11 based 11 based 12 on 12 on 13 room 13 room 17 = 15 ( 17 = 16 p 17 = 17 = 18 1.0 17 = 19 ) the risk [-] [of] [-] social - isolation variable [was] unable to significantly affect [which] hospitalized older adults would suffer a negative outcome , fall , or hai ( p = [.] 52 ) . 1 the 9 variable 2 risk 9 variable 6 social 7 - 6 social 8 isolation 8 isolation 9 variable 9 variable 11 unable 9 variable 19 would 11 unable 12 to 11 unable 14 affect 12 to 14 affect 13 significantly 14 affect 14 affect 18 adults 16 hospitalized 18 adults 17 older 18 adults 19 would 20 suffer 20 suffer 23 outcome 21 a 23 outcome 22 negative 23 outcome 23 outcome 27 or 24 , 27 or 25 fall 27 or 26 , 27 or 27 or 28 hai 27 or 35 . 28 hai 31 = 29 ( 31 = 30 p 31 = 31 = 33 52 31 = 34 ) conclusion : room [type] may play a role in the occurrence of [falls] in hospitalized older adults , but room [type] alone does not increase the chance of acquiring an infection in the hospital . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 room 2 : 6 play 2 : 19 but 2 : 35 . 3 room 5 may 5 may 6 play 6 play 8 role 6 play 9 in 7 a 8 role 9 in 11 occurrence 10 the 11 occurrence 11 occurrence 12 of 12 of 14 in 14 in 17 adults 15 hospitalized 17 adults 16 older 17 adults 18 , 19 but 19 but 20 room 19 but 25 increase 20 room 23 does 22 alone 23 does 23 does 24 not 23 does 25 increase 25 increase 27 chance 25 increase 32 in 26 the 27 chance 27 chance 28 of 28 of 29 acquiring 29 acquiring 31 infection 30 an 31 infection 32 in 34 hospital 33 the 34 hospital nor does the risk of social isolation affect the likelihood of an adverse outcome . 0 ###LEFT-WALL### 1 nor 0 ###LEFT-WALL### 8 affect 0 ###LEFT-WALL### 15 . 1 nor 2 does 2 does 4 risk 2 does 8 affect 3 the 4 risk 4 risk 5 of 5 of 7 isolation 6 social 7 isolation 8 affect 10 likelihood 9 the 10 likelihood 10 likelihood 11 of 11 of 14 outcome 12 an 13 adverse 12 an 14 outcome 13 adverse 14 outcome brassica vegetables are attracting a great deal of attention as healthy foods because of the fact that they contain substantial amounts of secondary metabolite glucosinolates that are converted into isothiocyanates , such as sulforaphane [[] [(] - )1 - isothiocyanato - 4r - ( methylsulfinyl ) - butane ] ( r - sfn ) , through the actions of chopping or chewing the vegetables . 0 ###LEFT-WALL### 1 brassica 0 ###LEFT-WALL### 65 . 1 brassica 2 vegetables 1 brassica 4 attracting 1 brassica 28 converted 2 vegetables 3 are 3 are 4 attracting 4 attracting 7 deal 4 attracting 10 as 4 attracting 13 because 5 a 6 great 5 a 7 deal 6 great 7 deal 7 deal 8 of 8 of 9 attention 10 as 12 foods 11 healthy 12 foods 13 because 14 of 14 of 16 fact 15 the 16 fact 16 fact 17 that 16 fact 19 contain 17 that 18 they 17 that 19 contain 18 they 19 contain 19 contain 21 amounts 20 substantial 21 amounts 21 amounts 22 of 21 amounts 26 that 21 amounts 27 are 22 of 25 glucosinolates 23 secondary 24 metabolite 24 metabolite 25 glucosinolates 26 that 27 are 28 converted 29 into 28 converted 33 as 28 converted 56 through 28 converted 64 vegetables 29 into 30 isothiocyanates 31 , 33 as 32 such 33 as 33 as 38 )1 33 as 55 , 34 sulforaphane 37 - 34 sulforaphane 38 )1 38 )1 40 isothiocyanato 39 - 40 isothiocyanato 40 isothiocyanato 42 4r 40 isothiocyanato 45 methylsulfinyl 40 isothiocyanato 48 butane 40 isothiocyanato 51 r 40 isothiocyanato 53 sfn 40 isothiocyanato 55 , 41 - 42 4r 42 4r 43 - 44 ( 45 methylsulfinyl 45 methylsulfinyl 46 ) 47 - 48 butane 48 butane 49 ] 50 ( 51 r 51 r 52 - 52 - 53 sfn 53 sfn 54 ) 56 through 58 actions 57 the 58 actions 58 actions 59 of 59 of 61 or 60 chopping 61 or 61 or 62 chewing 63 the 64 vegetables several studies have analyzed the biological and molecular mechanisms of the anti - cancer activity of synthetic r,s - sulforaphane , which is thought to be a result of its antioxidant properties and its ability to inhibit histone deacetylase enzymes ( hdac ) . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 analyzed 0 ###LEFT-WALL### 24 thought 0 ###LEFT-WALL### 44 . 1 several 2 studies 2 studies 3 have 3 have 4 analyzed 4 analyzed 9 mechanisms 4 analyzed 24 thought 5 the 9 mechanisms 6 biological 7 and 7 and 8 molecular 7 and 9 mechanisms 9 mechanisms 10 of 9 mechanisms 24 thought 10 of 15 activity 11 the 15 activity 12 anti 13 - 12 anti 15 activity 14 cancer 15 activity 15 activity 16 of 15 activity 22 which 15 activity 23 is 16 of 18 r,s 17 synthetic 18 r,s 18 r,s 20 sulforaphane 19 - 20 sulforaphane 20 sulforaphane 21 , 22 which 23 is 24 thought 25 to 24 thought 36 to 24 thought 43 ) 25 to 26 be 26 be 28 result 27 a 28 result 28 result 29 of 29 of 33 and 30 its 32 properties 31 antioxidant 32 properties 32 properties 33 and 33 and 35 ability 34 its 35 ability 36 to 37 inhibit 37 inhibit 40 enzymes 38 histone 40 enzymes 39 deacetylase 40 enzymes 40 enzymes 42 hdac 41 ( 42 hdac 42 hdac 43 ) few studies have addressed the possible antioxidant effects of r - sfn , which could protect cells from the free radical damage that strongly contribute to aging . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 addressed 1 few 2 studies 2 studies 3 have 3 have 4 addressed 4 addressed 8 effects 5 the 8 effects 6 possible 7 antioxidant 7 antioxidant 8 effects 8 effects 9 of 8 effects 12 sfn 8 effects 14 which 9 of 10 r 11 - 12 sfn 12 sfn 13 , 13 , 14 which 14 which 15 could 14 which 28 . 15 could 16 protect 16 protect 17 cells 17 cells 18 from 17 cells 23 that 17 cells 25 contribute 18 from 22 damage 19 the 22 damage 20 free 22 damage 21 radical 22 damage 23 that 25 contribute 24 strongly 25 contribute 25 contribute 26 to 26 to 27 aging moreover , little is known about the effect of r - sfn on stem cells whose longevity is implicated in human aging . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 23 . 1 moreover 2 , 1 moreover 3 little 3 little 4 is 4 is 5 known 5 known 6 about 6 about 8 effect 7 the 8 effect 8 effect 9 of 9 of 10 r 11 - 12 sfn 12 sfn 13 on 12 sfn 16 whose 13 on 15 cells 14 stem 15 cells 16 whose 17 longevity 17 longevity 18 is 18 is 19 implicated 19 implicated 20 in 20 in 22 aging 21 human 22 aging we evaluated the effects of r - sfn on the biology on human mesenchymal stem cells ( mscs ) , which , in addition to their ability to differentiate into mesenchymal tissues , support hematopoiesis , and contribute to the homeostatic maintenance of many organs and tissues . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 37 and 0 ###LEFT-WALL### 48 . 1 we 37 and 2 evaluated 4 effects 2 evaluated 37 and 3 the 4 effects 4 effects 5 of 4 effects 8 sfn 5 of 6 r 7 - 8 sfn 8 sfn 9 on 8 sfn 12 on 8 sfn 36 , 9 on 11 biology 10 the 11 biology 12 on 16 cells 13 human 16 cells 14 mesenchymal 15 stem 15 stem 16 cells 16 cells 18 mscs 16 cells 21 which 17 ( 18 mscs 18 mscs 19 ) 20 , 21 which 21 which 23 in 21 which 34 support 21 which 36 , 22 , 23 in 23 in 24 addition 23 in 33 , 24 addition 25 to 24 addition 30 into 25 to 27 ability 26 their 27 ability 27 ability 28 to 27 ability 29 differentiate 28 to 29 differentiate 30 into 32 tissues 31 mesenchymal 32 tissues 34 support 35 hematopoiesis 36 , 37 and 37 and 38 contribute 37 and 39 to 39 to 42 maintenance 40 the 42 maintenance 41 homeostatic 42 maintenance 42 maintenance 43 of 43 of 46 and 44 many 45 organs 45 organs 46 and 46 and 47 tissues our investigation found evidence that low doses of r - sfn promote mscs [proliferation] and protect them from apoptosis and senescence , while higher doses have a cytotoxic effect , leading to the induction of cell cycle arrest , programmed cell death and senescence . 0 ###LEFT-WALL### 2 investigation 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 45 . 1 our 2 investigation 2 investigation 3 found 3 found 4 evidence 3 found 7 doses 5 that 6 low 6 low 7 doses 7 doses 8 of 8 of 9 r 10 - 11 sfn 10 - 15 and 11 sfn 15 and 12 promote 13 mscs 12 promote 15 and 15 and 16 protect 15 and 32 to 16 protect 17 them 16 protect 18 from 18 from 20 and 19 apoptosis 20 and 20 and 21 senescence 21 senescence 31 leading 22 , 23 while 23 while 25 doses 23 while 26 have 23 while 30 , 23 while 31 leading 24 higher 25 doses 25 doses 26 have 26 have 29 effect 27 a 28 cytotoxic 27 a 29 effect 28 cytotoxic 29 effect 32 to 43 and 33 the 34 induction 34 induction 35 of 34 induction 39 , 35 of 38 arrest 36 cell 37 cycle 37 cycle 38 arrest 39 , 42 death 39 , 43 and 40 programmed 41 cell 41 cell 42 death 43 and 44 senescence the beneficial effects of r [-] sfn may be ascribed to its antioxidant properties , which were observed when msc cultures were incubated with low doses of r - sfn . 0 ###LEFT-WALL### 3 effects 0 ###LEFT-WALL### 10 ascribed 0 ###LEFT-WALL### 31 . 1 the 3 effects 2 beneficial 3 effects 3 effects 4 of 3 effects 7 sfn 3 effects 9 be 3 effects 10 ascribed 4 of 5 r 7 sfn 8 may 8 may 9 be 10 ascribed 11 to 10 ascribed 30 sfn 11 to 14 properties 12 its 14 properties 13 antioxidant 14 properties 14 properties 16 which 15 , 16 which 16 which 17 were 16 which 29 - 17 were 18 observed 18 observed 19 when 18 observed 24 with 19 when 21 cultures 19 when 23 incubated 20 msc 21 cultures 21 cultures 22 were 22 were 23 incubated 24 with 26 doses 25 low 26 doses 26 doses 27 of 27 of 28 r its cytotoxic effects , which were observed after treating mscs with high doses of r - sfn , could be attributed to its hdac inhibitory activity . 0 ###LEFT-WALL### 3 effects 0 ###LEFT-WALL### 21 attributed 0 ###LEFT-WALL### 27 . 1 its 3 effects 2 cytotoxic 3 effects 3 effects 5 which 3 effects 19 could 4 , 5 which 5 which 6 were 5 which 18 , 6 were 7 observed 7 observed 8 after 7 observed 11 with 8 after 9 treating 9 treating 10 mscs 11 with 13 doses 12 high 13 doses 13 doses 14 of 13 doses 17 sfn 14 of 15 r 16 - 17 sfn 17 sfn 18 , 19 could 20 be 20 be 21 attributed 21 attributed 22 to 22 to 26 activity 23 its 26 activity 24 hdac 26 activity 25 inhibitory 26 activity in summary , we found that r - sfn , like many other dietary supplements , exhibits a hormetic behavior ; it is able to induce biologically opposite effects at different doses . 0 ###LEFT-WALL### 2 summary 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 33 . 1 in 2 summary 3 , 4 we 3 , 5 found 3 , 8 - 4 we 5 found 5 found 6 that 5 found 7 r 8 - 9 sfn 8 - 17 exhibits 8 - 21 ; 9 sfn 11 like 9 sfn 17 exhibits 10 , 11 like 11 like 15 supplements 11 like 16 , 12 many 13 other 13 other 15 supplements 14 dietary 15 supplements 17 exhibits 20 behavior 18 a 19 hormetic 18 a 20 behavior 19 hormetic 20 behavior 21 ; 22 it 21 ; 23 is 22 it 23 is 23 is 24 able 24 able 25 to 24 able 26 induce 25 to 26 induce 26 induce 29 effects 26 induce 30 at 27 biologically 28 opposite 28 opposite 29 effects 30 at 32 doses 31 different 32 doses we analysed the organisation of semantic network using associative mechanisms between different types of information and studied the progression of the use of these associative relations during development . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 . 1 we 16 and 2 analysed 4 organisation 2 analysed 11 between 2 analysed 16 and 3 the 4 organisation 4 organisation 5 of 5 of 10 mechanisms 6 semantic 7 network 7 network 10 mechanisms 8 using 10 mechanisms 9 associative 10 mechanisms 11 between 15 information 12 different 13 types 13 types 14 of 13 types 15 information 14 of 15 information 16 and 17 studied 17 studied 19 progression 17 studied 27 during 18 the 19 progression 19 progression 20 of 20 of 22 use 21 the 22 use 22 use 23 of 23 of 26 relations 24 these 26 relations 25 associative 26 relations 27 during 28 development we aimed to verify the linkage of concepts with the use of semantic associative relations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 16 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 verify 3 to 4 verify 4 verify 6 linkage 4 verify 9 with 5 the 6 linkage 6 linkage 7 of 7 of 8 concepts 9 with 11 use 10 the 11 use 11 use 12 of 12 of 15 relations 13 semantic 15 relations 14 associative 15 relations the goal of this study was to analyse the cognitive ability to use associative relations between various items when describing old [and/or] new concepts . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 13 use 0 ###LEFT-WALL### 25 . 1 the 2 goal 2 goal 3 of 2 goal 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 analyse 7 to 8 analyse 8 analyse 11 ability 8 analyse 12 to 9 the 11 ability 10 cognitive 11 ability 12 to 13 use 13 use 15 relations 13 use 16 between 13 use 19 when 14 associative 15 relations 16 between 18 items 17 various 18 items 19 when 20 describing 20 describing 24 concepts 21 old 24 concepts 23 new 24 concepts we examined the performance of 100 subjects between the ages of 4 and 7 years on an experimental task using five associative relations based on verbal encoding . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 28 . 1 we 2 examined 2 examined 4 performance 2 examined 8 between 3 the 4 performance 4 performance 5 of 5 of 7 subjects 6 100 7 subjects 8 between 10 ages 9 the 10 ages 10 ages 11 of 10 ages 16 on 10 ages 24 based 10 ages 25 on 11 of 15 years 12 4 13 and 13 and 14 7 13 and 15 years 16 on 19 task 17 an 18 experimental 17 an 19 task 18 experimental 19 task 19 task 20 using 20 using 23 relations 21 five 23 relations 22 associative 23 relations 25 on 27 encoding 26 verbal 27 encoding the results showed that children are able to use the five semantic associative relations at age 4 , but performance with each of the different associative relations improves at different times during development . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 34 . 1 the 2 results 2 results 3 showed 3 showed 4 that 4 that 5 children 4 that 6 are 5 children 6 are 6 are 7 able 7 able 8 to 7 able 9 use 8 to 9 use 9 use 14 relations 9 use 15 at 10 the 11 five 11 five 14 relations 12 semantic 14 relations 13 associative 14 relations 15 at 16 age 16 age 17 4 18 , 19 but 19 but 20 performance 19 but 28 improves 20 performance 21 with 20 performance 28 improves 21 with 27 relations 22 each 23 of 22 each 27 relations 23 of 27 relations 24 the 27 relations 25 different 27 relations 26 associative 27 relations 28 improves 29 at 29 at 31 times 30 different 31 times 31 times 32 during 32 during 33 development functional and part/whole relations develop at an early age , whereas the superordinate relations develop later . 0 ###LEFT-WALL### 4 relations 0 ###LEFT-WALL### 5 develop 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 17 . 1 functional 2 and 2 and 3 part/whole 2 and 4 relations 4 relations 5 develop 5 develop 6 at 6 at 9 age 7 an 8 early 7 an 9 age 8 early 9 age 10 , 14 relations 10 , 15 develop 11 whereas 13 superordinate 11 whereas 14 relations 12 the 13 superordinate 14 relations 15 develop 15 develop 16 later our study clarified the characteristics of the progression of semantic associations during development as well as the roles that associative relations play in the structure and improvement of the semantic store . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 clarified 0 ###LEFT-WALL### 32 . 1 our 2 study 2 study 3 clarified 3 clarified 26 and 4 the 5 characteristics 5 characteristics 6 of 5 characteristics 16 as 5 characteristics 26 and 6 of 8 progression 7 the 8 progression 8 progression 9 of 9 of 11 associations 10 semantic 11 associations 11 associations 12 during 12 during 13 development 14 as 15 well 15 well 16 as 16 as 18 roles 17 the 18 roles 18 roles 19 that 18 roles 22 play 19 that 21 relations 19 that 22 play 20 associative 21 relations 21 relations 22 play 22 play 23 in 23 in 25 structure 24 the 25 structure 26 and 27 improvement 27 improvement 28 of 28 of 31 store 29 the 31 store 30 semantic 31 store the incidence and prevalence of chronic dialysis patients in japan is increasing linearly and is currently as high as 300 and 2300 per [million] population , respectively . 0 ###LEFT-WALL### 2 incidence 0 ###LEFT-WALL### 3 and 1 the 2 incidence 3 and 4 prevalence 3 and 14 and 4 prevalence 5 of 4 prevalence 14 and 5 of 8 patients 6 chronic 7 dialysis 7 dialysis 8 patients 8 patients 9 in 9 in 10 japan 11 is 12 increasing 11 is 14 and 12 increasing 13 linearly 14 and 15 is 15 is 16 currently 15 is 18 high 17 as 18 high 18 high 19 as 18 high 27 respectively 19 as 21 and 20 300 21 and 21 and 22 2300 21 and 23 per 23 per 25 population 26 , 27 respectively 27 respectively 28 . the incidence of end [-] stage renal disease is closely related to that of chronic dialysis ; findings which are captured in detail in the japanese society for dialysis therapy registry . 0 ###LEFT-WALL### 2 incidence 0 ###LEFT-WALL### 11 related 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 32 . 1 the 2 incidence 2 incidence 3 of 2 incidence 9 is 3 of 8 disease 4 end 8 disease 6 stage 8 disease 7 renal 8 disease 9 is 10 closely 9 is 11 related 11 related 12 to 12 to 13 that 13 that 14 of 14 of 16 dialysis 15 chronic 16 dialysis 17 ; 18 findings 17 ; 21 captured 18 findings 19 which 18 findings 20 are 18 findings 21 captured 19 which 20 are 21 captured 22 in 21 captured 24 in 21 captured 27 society 22 in 23 detail 24 in 26 japanese 25 the 26 japanese 27 society 28 for 28 for 31 registry 29 dialysis 30 therapy 30 therapy 31 registry cardiac death is the leading cause of death ; however , death due to stroke and acute myocardial infarction is decreasing . 0 ###LEFT-WALL### 2 death 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 22 . 1 cardiac 2 death 2 death 3 is 3 is 6 cause 4 the 6 cause 5 leading 6 cause 6 cause 7 of 7 of 8 death 9 ; 19 infarction 9 ; 20 is 10 however 11 , 10 however 19 infarction 12 death 13 due 12 death 16 and 13 due 14 to 13 due 15 stroke 14 to 15 stroke 16 and 17 acute 16 and 19 infarction 18 myocardial 19 infarction 19 infarction 20 is 20 is 21 decreasing the annual mortality rate is 6.5 % among the dialysis population . 0 ###LEFT-WALL### 4 rate 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 12 . 1 the 4 rate 2 annual 3 mortality 3 mortality 4 rate 4 rate 5 is 5 is 7 % 6 6.5 7 % 7 % 8 among 8 among 11 population 9 the 11 population 10 dialysis 11 population for the past 10 years , the mortality risk has remained high despite the avoidance of blood transfusions by the administration of erythropoiesis - stimulating agents , the use of renin - angiotensin system inhibitors , and improvements in general medical care . 0 ###LEFT-WALL### 8 mortality 0 ###LEFT-WALL### 11 remained 0 ###LEFT-WALL### 32 - 0 ###LEFT-WALL### 43 . 1 for 5 years 1 for 6 , 1 for 8 mortality 2 the 3 past 2 the 4 10 4 10 5 years 7 the 8 mortality 8 mortality 9 risk 8 mortality 10 has 8 mortality 11 remained 9 risk 10 has 11 remained 12 high 11 remained 13 despite 11 remained 19 by 13 despite 15 avoidance 14 the 15 avoidance 15 avoidance 16 of 16 of 18 transfusions 17 blood 18 transfusions 19 by 21 administration 20 the 21 administration 21 administration 22 of 21 administration 25 stimulating 22 of 23 erythropoiesis 24 - 25 stimulating 25 stimulating 26 agents 25 stimulating 32 - 26 agents 29 use 27 , 29 use 28 the 29 use 29 use 30 of 29 use 32 - 30 of 31 renin 32 - 37 and 33 angiotensin 35 inhibitors 34 system 35 inhibitors 35 inhibitors 37 and 36 , 37 and 37 and 38 improvements 37 and 39 in 39 in 42 care 40 general 42 care 41 medical 42 care several studies have confirmed the significance of chronic kidney disease ( ckd ) on the development of cardiovascular disease ( cvd ) and mortality ; [the] lower the estimated glomerular filtration rate ( egfr ) , the higher [the] incidence of cvd . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 confirmed 0 ###LEFT-WALL### 25 ; 1 several 2 studies 2 studies 3 have 3 have 4 confirmed 4 confirmed 6 significance 4 confirmed 14 on 5 the 6 significance 6 significance 7 of 6 significance 12 ckd 7 of 10 disease 8 chronic 9 kidney 9 kidney 10 disease 11 ( 12 ckd 12 ckd 13 ) 14 on 23 and 15 the 16 development 16 development 17 of 16 development 23 and 17 of 19 disease 18 cardiovascular 19 disease 19 disease 21 cvd 20 ( 21 cvd 21 cvd 22 ) 23 and 24 mortality 23 and 25 ; 25 ; 27 lower 27 lower 32 rate 28 the 32 rate 29 estimated 31 filtration 30 glomerular 31 filtration 31 filtration 32 rate 32 rate 34 egfr 32 rate 40 incidence 33 ( 34 egfr 34 egfr 35 ) 36 , 40 incidence 37 the 40 incidence 38 higher 40 incidence 40 incidence 41 of 40 incidence 43 . 41 of 42 cvd the cut - off levels for egfr are not yet clear . 0 ###LEFT-WALL### 2 cut 0 ###LEFT-WALL### 3 - 1 the 2 cut 3 - 4 off 3 - 8 are 3 - 12 . 4 off 8 are 5 levels 6 for 5 levels 8 are 6 for 7 egfr 8 are 9 not 8 are 10 yet 8 are 11 clear ckd is an important predictor of cvd in japan , similar to other parts of the world . 0 ###LEFT-WALL### 1 ckd 0 ###LEFT-WALL### 2 is 1 ckd 2 is 2 is 5 predictor 3 an 4 important 3 an 5 predictor 4 important 5 predictor 5 predictor 6 of 6 of 7 cvd 7 cvd 8 in 8 in 9 japan 9 japan 11 similar 10 , 11 similar 11 similar 12 to 11 similar 18 . 12 to 14 parts 13 other 14 parts 14 parts 15 of 15 of 17 world 16 the 17 world strategies for early detection of ckd are needed because , in many cases , ckd remains asymptomatic until late stages . 0 ###LEFT-WALL### 1 strategies 0 ###LEFT-WALL### 8 needed 0 ###LEFT-WALL### 21 . 1 strategies 2 for 1 strategies 7 are 2 for 4 detection 3 early 4 detection 4 detection 5 of 5 of 6 ckd 7 are 8 needed 8 needed 9 because 9 because 15 ckd 9 because 16 remains 10 , 11 in 11 in 13 cases 11 in 14 , 11 in 15 ckd 12 many 13 cases 15 ckd 16 remains 16 remains 17 asymptomatic 17 asymptomatic 18 until 18 until 20 stages 19 late 20 stages timely treatment for ckd is necessary to minimize costs for unnecessary care and testing . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 15 . 1 timely 2 treatment 2 treatment 3 for 2 treatment 5 is 3 for 4 ckd 5 is 6 necessary 6 necessary 7 to 6 necessary 8 minimize 7 to 8 minimize 8 minimize 9 costs 8 minimize 10 for 10 for 13 and 11 unnecessary 12 care 12 care 13 and 13 and 14 testing unless cdk is properly managed , it will not be possible to maintain quality and longevity of life . 0 ###LEFT-WALL### 7 it 0 ###LEFT-WALL### 10 be 0 ###LEFT-WALL### 19 . 1 unless 2 cdk 1 unless 5 managed 1 unless 7 it 2 cdk 3 is 3 is 5 managed 4 properly 5 managed 5 managed 6 , 7 it 8 will 8 will 9 not 8 will 10 be 10 be 11 possible 11 possible 12 to 11 possible 13 maintain 12 to 13 maintain 13 maintain 15 and 14 quality 15 and 15 and 16 longevity 15 and 17 of 17 of 18 life the japanese population is rapidly aging and will have the largest proportion of elderly people in the world . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 19 . 1 the 3 population 2 japanese 3 population 3 population 7 and 4 is 6 aging 4 is 7 and 5 rapidly 6 aging 7 and 8 will 8 will 9 have 9 have 12 proportion 9 have 16 in 10 the 11 largest 10 the 12 proportion 12 proportion 13 of 13 of 15 people 14 elderly 15 people 16 in 18 world 17 the 18 world a systematic strategy for managing ckd patients is warranted . 0 ###LEFT-WALL### 3 strategy 0 ###LEFT-WALL### 9 warranted 0 ###LEFT-WALL### 10 . 1 a 2 systematic 1 a 3 strategy 2 systematic 3 strategy 3 strategy 4 for 3 strategy 8 is 4 for 5 managing 5 managing 7 patients 6 ckd 7 patients 8 is 9 warranted objective : to demonstrate that hypolipidemia is a typical feature of the mouse model of amyotrophic lateral sclerosis ( als ) [and] to assess the association between hypolipidemia and disease stage , dietary intake , and sex . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 7 is 2 : 38 . 3 to 4 demonstrate 3 to 7 is 4 demonstrate 6 hypolipidemia 5 that 6 hypolipidemia 7 is 10 feature 8 a 10 feature 9 typical 10 feature 10 feature 11 of 10 feature 23 to 10 feature 24 assess 11 of 14 model 12 the 14 model 13 mouse 14 model 14 model 15 of 15 of 18 sclerosis 16 amyotrophic 18 sclerosis 17 lateral 18 sclerosis 18 sclerosis 20 als 19 ( 20 als 20 als 21 ) 23 to 24 assess 24 assess 36 and 25 the 26 association 26 association 27 between 26 association 29 and 27 between 28 hypolipidemia 29 and 31 stage 29 and 32 , 30 disease 31 stage 32 , 34 intake 32 , 36 and 33 dietary 34 intake 35 , 36 and 36 and 37 sex methods : we compared daily dietary intake , body weight , and serumlipid and glucose levels in als mice and wild - type controls at different stages of the disease . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 3 we 2 : 4 compared 3 we 4 compared 4 compared 16 levels 4 compared 25 at 5 daily 16 levels 6 dietary 7 intake 7 intake 8 , 8 , 10 weight 8 , 12 and 9 body 10 weight 11 , 12 and 12 and 13 serumlipid 12 and 14 and 14 and 15 glucose 14 and 16 levels 16 levels 17 in 17 in 20 and 18 als 19 mice 19 mice 20 and 20 and 24 controls 21 wild 22 - 21 wild 23 type 23 type 24 controls 25 at 27 stages 26 different 27 stages 27 stages 28 of 28 of 30 disease 29 the 30 disease findings : total cholesterol low - density lipoprotein ( ldl ) and ldl/high - density lipoprotein ( hdl ) [ratio] were significantly lower in als mice compared with controls . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 30 . 1 findings 2 : 2 : 8 lipoprotein 3 total 8 lipoprotein 4 cholesterol 8 lipoprotein 5 low 6 - 5 low 7 density 7 density 8 lipoprotein 8 lipoprotein 10 ldl 9 ( 10 ldl 10 ldl 11 ) 12 and 13 ldl/high 12 and 21 were 13 ldl/high 16 lipoprotein 13 ldl/high 21 were 14 - 16 lipoprotein 15 density 16 lipoprotein 16 lipoprotein 18 hdl 16 lipoprotein 19 ) 17 ( 18 hdl 18 hdl 19 ) 21 were 22 significantly 21 were 23 lower 23 lower 24 in 24 in 25 als 25 als 26 mice 25 als 27 compared 26 mice 27 compared 27 compared 28 with 28 with 29 controls subgroup analysis revealed that the incidence of hypolipidemia was significantly greater in male , but not female , als mice compared with control mice and that hypolipidemia was present at the presymptomatic stage of the disease . 0 ###LEFT-WALL### 1 subgroup 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 29 present 0 ###LEFT-WALL### 37 . 1 subgroup 2 analysis 1 subgroup 15 but 2 analysis 3 revealed 2 analysis 4 that 2 analysis 12 in 4 that 6 incidence 4 that 9 was 5 the 6 incidence 6 incidence 7 of 6 incidence 9 was 7 of 8 hypolipidemia 9 was 10 significantly 9 was 11 greater 11 greater 12 in 13 male 15 but 14 , 15 but 15 but 16 not 15 but 17 female 16 not 17 female 18 , 25 and 19 als 20 mice 20 mice 21 compared 20 mice 22 with 20 mice 25 and 22 with 24 mice 23 control 24 mice 25 and 26 that 25 and 27 hypolipidemia 25 and 29 present 27 hypolipidemia 28 was 28 was 29 present 29 present 30 at 30 at 33 stage 31 the 33 stage 32 presymptomatic 33 stage 33 stage 34 of 34 of 36 disease 35 the 36 disease this hypolipidemia can be found without a decrease in the serum levels of other energy sources , such as glucose , in the presymptomatic stage . 0 ###LEFT-WALL### 2 hypolipidemia 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 26 . 1 this 2 hypolipidemia 2 hypolipidemia 3 can 3 can 4 be 4 be 5 found 5 found 6 without 5 found 9 in 5 found 22 in 6 without 8 decrease 7 a 8 decrease 9 in 12 levels 10 the 12 levels 11 serum 12 levels 12 levels 13 of 13 of 16 sources 14 other 16 sources 15 energy 16 sources 16 sources 19 as 17 , 19 as 18 such 19 as 19 as 20 glucose 19 as 21 , 22 in 25 stage 23 the 25 stage 24 presymptomatic 25 stage conclusions : hypolipidemia is present at the presymptomatic stage of the als mouse model in the absence of malnutrition , significant neuromuscular degeneration or regeneration , and respiratory difficulty . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 hypolipidemia 2 : 4 is 3 hypolipidemia 4 is 4 is 5 present 5 present 6 at 5 present 15 in 6 at 9 stage 7 the 9 stage 8 presymptomatic 9 stage 9 stage 10 of 10 of 14 model 11 the 14 model 12 als 13 mouse 13 mouse 14 model 15 in 27 and 16 the 17 absence 17 absence 18 of 17 absence 20 , 18 of 19 malnutrition 20 , 23 degeneration 20 , 24 or 21 significant 23 degeneration 22 neuromuscular 23 degeneration 24 or 25 regeneration 24 or 27 and 26 , 27 and 27 and 29 difficulty 28 respiratory 29 difficulty our findings suggest that hypolipidemia might be associated with the pathomechanism of als [and/or] lipid [-] specific metabolism rather than [simply] an epiphenomenon of neuromuscular degeneration or energy imbalance . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 30 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 5 hypolipidemia 4 that 8 associated 5 hypolipidemia 6 might 6 might 7 be 7 be 8 associated 8 associated 9 with 8 associated 20 than 9 with 11 pathomechanism 10 the 11 pathomechanism 11 pathomechanism 12 of 12 of 18 metabolism 13 als 18 metabolism 15 lipid 18 metabolism 17 specific 18 metabolism 19 rather 20 than 20 than 23 epiphenomenon 22 an 23 epiphenomenon 23 epiphenomenon 24 of 24 of 27 or 25 neuromuscular 26 degeneration 26 degeneration 27 or 27 or 29 imbalance 28 energy 29 imbalance background : lamin a ( lmna ) is a component of the nuclear lamina and is mutated in several human diseases , including emery - dreifuss [muscular] [dystrophy] ( edmd [;] omim id# 181350 ) and the premature aging syndrome hutchinson - gilford progeria syndrome ( hgps [;] omim id# 176670 ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 lamin 3 lamin 4 a 3 lamin 6 lmna 3 lamin 15 and 5 ( 6 lmna 6 lmna 7 ) 8 is 10 component 8 is 15 and 9 a 10 component 10 component 11 of 11 of 14 lamina 12 the 14 lamina 13 nuclear 14 lamina 15 and 16 is 15 and 18 in 15 and 21 diseases 16 is 17 mutated 18 in 19 several 20 human 21 diseases 21 diseases 25 - 22 , 25 - 23 including 24 emery 23 including 25 - 25 - 36 and 26 dreifuss 33 id# 26 dreifuss 36 and 29 ( 33 id# 30 edmd 32 omim 32 omim 33 id# 33 id# 34 181350 33 id# 35 ) 36 and 41 hutchinson 36 and 45 syndrome 37 the 40 syndrome 38 premature 40 syndrome 39 aging 40 syndrome 40 syndrome 41 hutchinson 42 - 45 syndrome 43 gilford 44 progeria 44 progeria 45 syndrome 45 syndrome 50 id# 45 syndrome 53 . 46 ( 50 id# 47 hgps 49 omim 49 omim 50 id# 50 id# 51 176670 50 id# 52 ) cells from progeria patients exhibit cell cycle defects in both interphase and mitosis . 0 ###LEFT-WALL### 1 cells 0 ###LEFT-WALL### 5 exhibit 0 ###LEFT-WALL### 14 . 1 cells 2 from 1 cells 5 exhibit 2 from 4 patients 3 progeria 4 patients 5 exhibit 8 defects 5 exhibit 9 in 6 cell 8 defects 7 cycle 8 defects 9 in 12 and 10 both 12 and 11 interphase 12 and 12 and 13 mitosis mouse models with loss of lmna function [have] reduced retinoblastoma protein ( rb1 ) activity , leading to aberrant cell cycle control in interphase , but how mitosis [is] affected [by] lmna is not well understood . 0 ###LEFT-WALL### 1 mouse 0 ###LEFT-WALL### 26 but 0 ###LEFT-WALL### 37 . 1 mouse 26 but 2 models 3 with 2 models 15 activity 2 models 17 leading 2 models 26 but 3 with 4 loss 4 loss 5 of 4 loss 13 rb1 5 of 11 protein 6 lmna 11 protein 7 function 9 reduced 9 reduced 11 protein 10 retinoblastoma 11 protein 12 ( 13 rb1 13 rb1 14 ) 16 , 17 leading 17 leading 18 to 17 leading 25 , 18 to 22 control 19 aberrant 20 cell 20 cell 22 control 21 cycle 22 control 22 control 23 in 23 in 24 interphase 25 , 26 but 26 but 36 understood 27 how 28 mitosis 27 how 30 affected 27 how 33 is 28 mitosis 30 affected 30 affected 32 lmna 33 is 34 not 34 not 35 well 35 well 36 understood results : we examined the cell cycle and structural [phenotypes] of cells from mice with the lmna allele , disheveled hair and ears ( lmna ( dhe ) ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 examined 2 : 19 , 2 : 30 . 3 we 4 examined 4 examined 8 and 4 examined 18 allele 5 the 7 cycle 6 cell 7 cycle 7 cycle 8 and 8 and 9 structural 8 and 11 of 8 and 18 allele 11 of 12 cells 12 cells 13 from 13 from 14 mice 14 mice 15 with 15 with 17 lmna 16 the 17 lmna 19 , 22 and 20 disheveled 21 hair 21 hair 22 and 22 and 23 ears 22 and 25 lmna 24 ( 25 lmna 25 lmna 27 dhe 25 lmna 29 ) 26 ( 27 dhe 27 dhe 28 ) we found that dermal fibroblasts from heterozygous lmna ( dhe ) ( lmna ( dhe/+ ) ) mice exhibit many [phenotypes] of human laminopathy cells . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 26 . 1 we 2 found 2 found 5 fibroblasts 3 that 4 dermal 4 dermal 5 fibroblasts 5 fibroblasts 6 from 5 fibroblasts 18 mice 5 fibroblasts 19 exhibit 6 from 8 lmna 7 heterozygous 8 lmna 8 lmna 10 dhe 8 lmna 13 lmna 9 ( 10 dhe 10 dhe 11 ) 12 ( 13 lmna 13 lmna 15 dhe/+ 13 lmna 17 ) 14 ( 15 dhe/+ 15 dhe/+ 16 ) 18 mice 19 exhibit 19 exhibit 25 cells 20 many 22 of 20 many 25 cells 22 of 25 cells 23 human 25 cells 24 laminopathy 25 cells these include severe perturbations to the nuclear shape and lamina , increased dna damage , and slow growth rates due to mitotic delay . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 24 . 1 these 16 and 2 include 4 perturbations 2 include 5 to 2 include 16 and 3 severe 4 perturbations 5 to 9 and 6 the 8 shape 7 nuclear 8 shape 8 shape 9 and 9 and 14 damage 10 lamina 11 , 10 lamina 14 damage 12 increased 14 damage 13 dna 14 damage 15 , 16 and 16 and 17 slow 16 and 21 to 17 slow 19 rates 18 growth 19 rates 20 due 21 to 21 to 23 delay 22 mitotic 23 delay interestingly , lmna ( dhe/+ ) fibroblasts also had reduced levels of hypophosphorylated rb1 and [the] [non] - smc condensin ii - subunit d3 ( ncap - d3 ) , a mitosis specific centromere condensin subunit that depends on rb1 activity . 0 ###LEFT-WALL### 7 fibroblasts 0 ###LEFT-WALL### 10 reduced 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 23 subunit 1 interestingly 2 , 1 interestingly 7 fibroblasts 3 lmna 5 dhe/+ 3 lmna 7 fibroblasts 4 ( 5 dhe/+ 5 dhe/+ 6 ) 7 fibroblasts 9 had 8 also 9 had 9 had 10 reduced 10 reduced 11 levels 11 levels 12 of 12 of 20 condensin 13 hypophosphorylated 20 condensin 14 rb1 15 and 15 and 19 smc 18 - 19 smc 19 smc 20 condensin 20 condensin 21 ii 22 - 23 subunit 23 subunit 26 ncap 24 d3 26 ncap 25 ( 26 ncap 26 ncap 28 d3 26 ncap 36 subunit 27 - 28 d3 28 d3 29 ) 30 , 36 subunit 31 a 36 subunit 32 mitosis 36 subunit 33 specific 35 condensin 34 centromere 35 condensin 35 condensin 36 subunit 36 subunit 37 that 36 subunit 38 depends 36 subunit 42 . 37 that 38 depends 38 depends 39 on 39 on 41 activity 40 rb1 41 activity mitotic check point control by mitotic arrest deficient [-] like 1 ( mad2l1 ) also was perturbed in lmna ( dhe/+ ) cells . 0 ###LEFT-WALL### 4 control 0 ###LEFT-WALL### 17 perturbed 1 mitotic 4 control 2 check 3 point 3 point 4 control 4 control 5 by 4 control 16 was 5 by 7 arrest 6 mitotic 7 arrest 7 arrest 8 deficient 8 deficient 10 like 10 like 11 1 11 1 13 mad2l1 12 ( 13 mad2l1 13 mad2l1 14 ) 15 also 16 was 16 was 17 perturbed 17 perturbed 18 in 18 in 19 lmna 19 lmna 23 cells 20 ( 23 cells 21 dhe/+ 22 ) 21 dhe/+ 23 cells 23 cells 24 . lmna ( dhe/+ ) fibroblasts were consistently aneuploid and had higher levels of micronuclei and anaphase bridges than normal fibroblasts , consistent with chromosome segregation defects . 0 ###LEFT-WALL### 5 fibroblasts 0 ###LEFT-WALL### 10 had 1 lmna 3 dhe/+ 1 lmna 5 fibroblasts 2 ( 3 dhe/+ 3 dhe/+ 4 ) 5 fibroblasts 9 and 6 were 8 aneuploid 6 were 9 and 7 consistently 8 aneuploid 9 and 10 had 10 had 12 levels 10 had 18 than 11 higher 12 levels 12 levels 13 of 13 of 15 and 14 micronuclei 15 and 15 and 17 bridges 16 anaphase 17 bridges 18 than 20 fibroblasts 19 normal 20 fibroblasts 20 fibroblasts 22 consistent 21 , 22 consistent 22 consistent 23 with 22 consistent 27 . 23 with 26 defects 24 chromosome 25 segregation 25 segregation 26 defects conclusions : these data indicate that rb1 may be a key regulator [of] cellular phenotype in laminopathy - related cells , and suggest that the effects of lmna on rb1 include both interphase and mitotic cell cycle control . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 4 data 2 : 5 indicate 3 these 4 data 4 data 5 indicate 5 indicate 6 that 6 that 7 rb1 6 that 22 and 7 rb1 8 may 8 may 22 and 9 be 15 phenotype 9 be 16 in 9 be 22 and 10 a 15 phenotype 11 key 15 phenotype 12 regulator 15 phenotype 14 cellular 15 phenotype 16 in 17 laminopathy 17 laminopathy 20 cells 18 - 20 cells 19 related 20 cells 20 cells 21 , 22 and 23 suggest 23 suggest 24 that 24 that 26 effects 24 that 31 include 25 the 26 effects 26 effects 27 of 26 effects 31 include 27 of 28 lmna 28 lmna 29 on 29 on 30 rb1 31 include 34 and 32 both 34 and 33 interphase 34 and 34 and 38 control 35 mitotic 36 cell 36 cell 37 cycle 37 cycle 38 control background : variation in the serotonin transporter ( 5 - htt ) [gene] ( slc6a4 ) has been shown to influence a wide range of affective processes . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 variation 2 : 19 shown 2 : 28 . 3 variation 4 in 3 variation 17 has 4 in 7 transporter 5 the 7 transporter 6 serotonin 7 transporter 7 transporter 10 - 7 transporter 15 slc6a4 8 ( 10 - 9 5 10 - 10 - 11 htt 10 - 12 ) 14 ( 15 slc6a4 15 slc6a4 16 ) 17 has 18 been 18 been 19 shown 19 shown 20 to 20 to 21 influence 21 influence 24 range 22 a 23 wide 22 a 24 range 23 wide 24 range 24 range 25 of 25 of 27 processes 26 affective 27 processes low 5 - htt gene - expression has also been suggested to increase the risk of chronic pain . 0 ###LEFT-WALL### 5 gene 0 ###LEFT-WALL### 6 - 1 low 2 5 1 low 4 htt 3 - 4 htt 4 htt 5 gene 6 - 7 expression 6 - 11 suggested 6 - 19 . 7 expression 8 has 8 has 10 been 9 also 10 been 10 been 11 suggested 11 suggested 12 to 12 to 13 increase 13 increase 15 risk 14 the 15 risk 15 risk 16 of 16 of 18 pain 17 chronic 18 pain conditioned pain modulation ( cpm ) -- i.e [.] ['] pain inhibits pain ['] -- is impaired in chronic pain states and , reciprocally , aberrations of cpm may predict the development of chronic pain . 0 ###LEFT-WALL### 3 modulation 0 ###LEFT-WALL### 17 impaired 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 36 . 1 conditioned 2 pain 2 pain 3 modulation 3 modulation 5 cpm 3 modulation 8 i.e 3 modulation 16 is 4 ( 5 cpm 5 cpm 6 ) 7 -- 8 i.e 8 i.e 11 pain 8 i.e 12 inhibits 8 i.e 15 -- 11 pain 12 inhibits 12 inhibits 13 pain 16 is 17 impaired 17 impaired 18 in 18 in 21 states 19 chronic 20 pain 20 pain 21 states 22 and 23 , 22 and 26 aberrations 22 and 30 predict 23 , 24 reciprocally 24 reciprocally 25 , 24 reciprocally 26 aberrations 26 aberrations 27 of 26 aberrations 29 may 27 of 28 cpm 29 may 30 predict 30 predict 32 development 31 the 32 development 32 development 33 of 33 of 35 pain 34 chronic 35 pain therefore we hypothesized that a common variation in the slc6a4 is associated with [inter] [-] individual variation in cpm . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 hypothesized 0 ###LEFT-WALL### 20 . 1 therefore 2 we 2 we 3 hypothesized 3 hypothesized 4 that 4 that 7 variation 4 that 12 associated 5 a 6 common 5 a 7 variation 6 common 7 variation 7 variation 8 in 7 variation 11 is 8 in 10 slc6a4 9 the 10 slc6a4 11 is 12 associated 12 associated 13 with 12 associated 18 in 13 with 17 variation 16 individual 17 variation 18 in 19 cpm forty - five healthy subjects recruited on the basis of tri - allelic [5] - httlpr genotype , with inferred high or low 5 - htt - expression , were included in a double - blind study . 0 ###LEFT-WALL### 5 subjects 0 ###LEFT-WALL### 15 - 1 forty 2 - 2 - 3 five 2 - 5 subjects 4 healthy 5 subjects 5 subjects 6 recruited 6 recruited 7 on 7 on 9 basis 8 the 9 basis 9 basis 10 of 9 basis 13 allelic 10 of 11 tri 12 - 13 allelic 13 allelic 15 - 15 - 16 httlpr 15 - 29 , 15 - 38 . 16 httlpr 29 , 17 genotype 19 with 17 genotype 28 expression 17 genotype 29 , 18 , 19 with 19 with 26 htt 19 with 27 - 20 inferred 26 htt 21 high 22 or 22 or 23 low 22 or 26 htt 24 5 26 htt 25 - 26 htt 29 , 30 were 29 , 37 study 30 were 31 included 31 included 32 in 31 included 35 - 31 included 36 blind 32 in 34 double 33 a 34 double a submaximal - effort tourniquet test was used to provide a standardized degree of conditioning ischemic pain . 0 ###LEFT-WALL### 6 test 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 18 . 1 a 2 submaximal 1 a 6 test 2 submaximal 3 - 2 submaximal 4 effort 4 effort 6 test 5 tourniquet 6 test 6 test 7 was 7 was 8 used 8 used 9 to 8 used 10 provide 9 to 10 provide 10 provide 13 degree 11 a 13 degree 12 standardized 13 degree 13 degree 14 of 14 of 15 conditioning 15 conditioning 17 pain 16 ischemic 17 pain individualized noxious heat and pressure pain thresholds ( ppts ) were used as subjective test - modalities and the nociceptive flexion reflex ( nfr ) was used to provide an objective neurophysiological window into spinal processing . 0 ###LEFT-WALL### 15 test 0 ###LEFT-WALL### 16 - 0 ###LEFT-WALL### 37 . 1 individualized 3 heat 2 noxious 3 heat 3 heat 4 and 4 and 6 pain 4 and 7 thresholds 4 and 11 were 4 and 12 used 5 pressure 6 pain 7 thresholds 9 ppts 7 thresholds 11 were 8 ( 9 ppts 9 ppts 10 ) 12 used 15 test 13 as 14 subjective 14 subjective 15 test 16 - 17 modalities 16 - 18 and 18 and 22 reflex 18 and 27 used 19 the 22 reflex 20 nociceptive 21 flexion 21 flexion 22 reflex 22 reflex 24 nfr 22 reflex 26 was 23 ( 24 nfr 24 nfr 25 ) 26 was 27 used 27 used 28 to 27 used 29 provide 28 to 29 provide 29 provide 33 window 30 an 31 objective 30 an 33 window 31 objective 33 window 32 neurophysiological 33 window 33 window 34 into 34 into 36 processing 35 spinal 36 processing results : the low , as compared to the high , 5 - htt - expressing group exhibited significantly reduced cpm - mediated pain inhibition for ppts ( p = 0.02 ) and heat - pain ( p = 0.02 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 42 . 1 results 2 : 2 : 4 low 2 : 8 to 2 : 13 - 2 : 16 expressing 3 the 4 low 4 low 7 compared 5 , 7 compared 6 as 7 compared 8 to 10 high 9 the 10 high 11 , 13 - 12 5 13 - 13 - 14 htt 13 - 15 - 15 - 16 expressing 16 expressing 21 cpm 16 expressing 41 ) 17 group 18 exhibited 18 exhibited 21 cpm 19 significantly 20 reduced 20 reduced 21 cpm 21 cpm 33 and 22 - 33 and 23 mediated 25 inhibition 24 pain 25 inhibition 25 inhibition 26 for 25 inhibition 33 and 26 for 27 ppts 27 ppts 30 = 28 ( 30 = 29 p 30 = 30 = 31 0.02 30 = 32 ) 33 and 34 heat 33 and 36 pain 33 and 41 ) 35 - 36 pain 36 pain 39 = 36 pain 41 ) 37 ( 39 = 38 p 39 = 39 = 40 0.02 39 = 41 ) the cpm - mediated inhibition of the nfr , gauged by increases in nfr - threshold , did not differ significantly between groups ( p = 0.75 ) . 0 ###LEFT-WALL### 2 cpm 0 ###LEFT-WALL### 20 differ 0 ###LEFT-WALL### 29 . 1 the 2 cpm 2 cpm 5 inhibition 2 cpm 18 did 3 - 5 inhibition 4 mediated 5 inhibition 5 inhibition 6 of 5 inhibition 17 , 6 of 16 threshold 7 the 16 threshold 8 nfr 10 gauged 8 nfr 16 threshold 9 , 10 gauged 10 gauged 11 by 10 gauged 13 in 10 gauged 15 - 11 by 12 increases 13 in 14 nfr 18 did 19 not 18 did 20 differ 20 differ 21 significantly 20 differ 22 between 22 between 23 groups 23 groups 26 = 24 ( 26 = 25 p 26 = 26 = 27 0.75 26 = 28 ) inhibition of ppts and heat - pain were correlated [(] spearman 's rho = 0.35 , p = 0.02 ) , whereas the nfr [-] threshold increase was not significantly correlated with degree [of] inhibition of these subjectively reported modalities . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 31 correlated 0 ###LEFT-WALL### 41 . 1 inhibition 2 of 1 inhibition 4 and 2 of 3 ppts 4 and 5 heat 4 and 6 - 6 - 7 pain 6 - 14 = 7 pain 8 were 8 were 9 correlated 11 spearman 12 's 12 's 13 rho 13 rho 14 = 14 = 15 0.35 14 = 22 whereas 15 0.35 18 = 16 , 18 = 17 p 18 = 18 = 19 0.02 18 = 20 ) 21 , 22 whereas 22 whereas 27 increase 23 the 27 increase 24 nfr 27 increase 26 threshold 27 increase 27 increase 28 was 28 was 29 not 28 was 31 correlated 30 significantly 31 correlated 31 correlated 32 with 32 with 35 inhibition 33 degree 35 inhibition 35 inhibition 36 of 36 of 40 modalities 37 these 40 modalities 38 subjectively 39 reported 39 reported 40 modalities conclusions : our results demonstrate the involvement of the tri - [allelic] 5 - httlpr genotype in explaining clinically relevant [inter] - individual differences in pain perception and regulation . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 genotype 0 ###LEFT-WALL### 30 . 2 : 4 results 2 : 5 demonstrate 2 : 11 - 3 our 4 results 4 results 5 demonstrate 5 demonstrate 7 involvement 6 the 7 involvement 7 involvement 8 of 8 of 10 tri 9 the 10 tri 11 - 13 5 11 - 14 - 13 5 14 - 14 - 15 httlpr 15 httlpr 16 genotype 16 genotype 17 in 16 genotype 19 clinically 16 genotype 24 differences 16 genotype 25 in 17 in 18 explaining 20 relevant 22 - 20 relevant 24 differences 23 individual 24 differences 25 in 28 and 26 pain 27 perception 27 perception 28 and 28 and 29 regulation our results also illustrate [that] shifts in nfr - thresholds do not necessarily correlate to the modulation of experienced pain . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 illustrate 0 ###LEFT-WALL### 9 - 1 our 2 results 2 results 4 illustrate 3 also 4 illustrate 4 illustrate 6 shifts 4 illustrate 7 in 7 in 8 nfr 9 - 10 thresholds 9 - 14 correlate 9 - 21 . 10 thresholds 11 do 11 do 12 not 11 do 14 correlate 13 necessarily 14 correlate 14 correlate 15 to 15 to 17 modulation 16 the 17 modulation 17 modulation 18 of 18 of 20 pain 19 experienced 20 pain we discuss various possible mechanisms underlying these findings and suggest a role of regulation of 5 - ht receptors along the neuraxis as a function of differential 5 - htt - expression . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 33 . 1 we 9 and 2 discuss 5 mechanisms 2 discuss 9 and 3 various 5 mechanisms 4 possible 5 mechanisms 5 mechanisms 6 underlying 6 underlying 8 findings 7 these 8 findings 9 and 10 suggest 9 and 23 as 9 and 32 expression 10 suggest 12 role 10 suggest 20 along 11 a 12 role 12 role 13 of 12 role 15 of 13 of 14 regulation 15 of 19 receptors 16 5 18 ht 17 - 18 ht 18 ht 19 receptors 20 along 22 neuraxis 21 the 22 neuraxis 23 as 25 function 24 a 25 function 25 function 26 of 26 of 27 differential 27 differential 28 5 27 differential 30 htt 29 - 30 htt 30 htt 31 - amyloid β - peptide [(] aβ ) is directly linked to alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 2 β 0 ###LEFT-WALL### 10 linked 0 ###LEFT-WALL### 18 . 1 amyloid 2 β 2 β 6 aβ 2 β 8 is 3 - 6 aβ 4 peptide 6 aβ 6 aβ 7 ) 8 is 9 directly 8 is 10 linked 10 linked 11 to 11 to 14 disease 12 alzheimer 13 's 13 's 14 disease 14 disease 16 ad 15 ( 16 ad 16 ad 17 ) in its monomeric form , aβ aggregates to produce fibrils and a range of oligomers , the latter being [the] most neurotoxic . 0 ###LEFT-WALL### 6 aβ 0 ###LEFT-WALL### 19 being 0 ###LEFT-WALL### 23 . 1 in 4 form 1 in 5 , 1 in 6 aβ 2 its 4 form 3 monomeric 4 form 6 aβ 7 aggregates 7 aggregates 8 to 8 to 9 produce 9 produce 11 and 9 produce 19 being 10 fibrils 11 and 11 and 13 range 11 and 14 of 12 a 13 range 14 of 15 oligomers 16 , 19 being 17 the 18 latter 18 latter 19 being 19 being 22 neurotoxic 21 most 22 neurotoxic dysregulation of ca ( 2+ ) homeostasis in aging brains and in neurodegenerative disorders plays a crucial role in numerous processes and contributes to cell dysfunction and death . 0 ###LEFT-WALL### 7 homeostasis 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 29 . 1 dysregulation 2 of 1 dysregulation 7 homeostasis 2 of 3 ca 3 ca 5 2+ 4 ( 5 2+ 5 2+ 6 ) 7 homeostasis 11 and 7 homeostasis 22 and 8 in 9 aging 8 in 11 and 9 aging 10 brains 11 and 12 in 12 in 14 disorders 13 neurodegenerative 14 disorders 15 plays 18 role 15 plays 22 and 16 a 17 crucial 16 a 18 role 17 crucial 18 role 18 role 19 in 19 in 21 processes 20 numerous 21 processes 22 and 23 contributes 22 and 24 to 24 to 27 and 25 cell 26 dysfunction 26 dysfunction 27 and 27 and 28 death here we postulated that calcium may [enable] or accelerate the aggregation of aβ . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 8 or 0 ###LEFT-WALL### 14 . 1 here 2 we 2 we 8 or 3 postulated 4 that 3 postulated 8 or 4 that 5 calcium 4 that 6 may 5 calcium 6 may 8 or 9 accelerate 9 accelerate 11 aggregation 10 the 11 aggregation 11 aggregation 12 of 12 of 13 aβ we compared the aggregation pattern of aβ ( 1 - 40 ) and that of aβ ( 1 - 40 )e22g , an amyloid peptide carrying the arctic mutation that causes early [onset] of the disease . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 1 we 2 compared 2 compared 13 and 2 compared 19 - 3 the 5 pattern 4 aggregation 5 pattern 5 pattern 6 of 5 pattern 13 and 6 of 7 aβ 7 aβ 10 - 8 ( 10 - 9 1 10 - 10 - 11 40 10 - 12 ) 13 and 14 that 13 and 15 of 15 of 16 aβ 17 ( 19 - 18 1 19 - 19 - 21 )e22g 19 - 37 . 20 40 21 )e22g 21 )e22g 25 peptide 22 , 25 peptide 23 an 25 peptide 24 amyloid 25 peptide 25 peptide 26 carrying 25 peptide 34 of 25 peptide 37 . 26 carrying 29 mutation 26 carrying 32 early 27 the 29 mutation 28 arctic 29 mutation 29 mutation 30 that 29 mutation 31 causes 30 that 31 causes 34 of 36 disease 35 the 36 disease we found that in the presence of ca ( 2+ ) , aβ ( 1 - 40 ) preferentially formed oligomers similar to those formed by aβ ( 1 - 40 )e22g with or without added ca ( 2+ ) , whereas in the absence of added ca ( 2+ ) the aβ ( 1 - 40 ) aggregated to form fibrils . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 63 . 1 we 2 found 2 found 3 that 2 found 4 in 2 found 42 whereas 2 found 60 to 4 in 6 presence 5 the 6 presence 6 presence 7 of 6 presence 17 40 6 presence 20 formed 7 of 8 ca 8 ca 10 2+ 8 ca 13 aβ 9 ( 10 2+ 10 2+ 11 ) 12 , 13 aβ 13 aβ 15 1 13 aβ 16 - 14 ( 15 1 15 1 16 - 16 - 17 40 17 40 18 ) 19 preferentially 20 formed 20 formed 21 oligomers 20 formed 41 , 21 oligomers 22 similar 22 similar 34 or 23 to 24 those 23 to 34 or 24 those 25 formed 24 those 26 by 24 those 31 40 24 those 33 with 26 by 27 aβ 27 aβ 29 1 28 ( 29 1 29 1 30 - 31 40 32 )e22g 32 )e22g 33 with 34 or 35 without 35 without 37 ca 36 added 37 ca 37 ca 39 2+ 38 ( 39 2+ 39 2+ 40 ) 42 whereas 53 aβ 42 whereas 59 aggregated 43 in 45 absence 43 in 53 aβ 44 the 45 absence 45 absence 46 of 45 absence 50 2+ 46 of 48 ca 47 added 48 ca 49 ( 50 2+ 50 2+ 51 ) 52 the 53 aβ 53 aβ 55 1 53 aβ 57 40 53 aβ 59 aggregated 54 ( 55 1 55 1 56 - 56 - 57 40 57 40 58 ) 60 to 62 fibrils 61 form 62 fibrils morphological similarities of the oligomers were confirmed by contact mode atomic force microscopy imaging . 0 ###LEFT-WALL### 2 similarities 0 ###LEFT-WALL### 7 confirmed 0 ###LEFT-WALL### 15 . 1 morphological 2 similarities 2 similarities 3 of 2 similarities 6 were 3 of 5 oligomers 4 the 5 oligomers 6 were 7 confirmed 7 confirmed 8 by 8 by 14 imaging 9 contact 14 imaging 10 mode 14 imaging 11 atomic 12 force 12 force 14 imaging 13 microscopy 14 imaging the distribution of oligomeric and fibrillar species in different samples was detected by gel electrophoresis and western blot analysis , the results of which were further supported by thioflavin t fluorescence experiments . 0 ###LEFT-WALL### 2 distribution 0 ###LEFT-WALL### 18 blot 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 33 . 1 the 2 distribution 2 distribution 3 of 2 distribution 11 was 3 of 7 species 4 oligomeric 5 and 5 and 6 fibrillar 5 and 7 species 7 species 8 in 8 in 10 samples 9 different 10 samples 11 was 12 detected 12 detected 13 by 13 by 14 gel 14 gel 16 and 14 gel 18 blot 15 electrophoresis 16 and 16 and 17 western 16 and 18 blot 18 blot 19 analysis 20 , 22 results 20 , 27 supported 21 the 22 results 22 results 23 of 22 results 25 were 23 of 24 which 25 were 27 supported 26 further 27 supported 27 supported 28 by 28 by 32 experiments 29 thioflavin 30 t 29 thioflavin 31 fluorescence 31 fluorescence 32 experiments in the samples without ca ( 2+ ) , [fourier] transform infrared spectroscopy revealed conversion of oligomers from an anti - parallel β - sheet to the parallel β - sheet conformation characteristic of fibrils . 0 ###LEFT-WALL### 11 transform 0 ###LEFT-WALL### 36 . 1 in 3 samples 1 in 9 , 1 in 11 transform 2 the 3 samples 3 samples 4 without 4 without 5 ca 5 ca 7 2+ 6 ( 7 2+ 7 2+ 8 ) 11 transform 15 conversion 12 infrared 13 spectroscopy 13 spectroscopy 14 revealed 14 revealed 15 conversion 15 conversion 16 of 16 of 17 oligomers 17 oligomers 18 from 18 from 33 characteristic 19 an 20 anti 19 an 33 characteristic 20 anti 21 - 20 anti 31 sheet 22 parallel 31 sheet 23 β 25 sheet 23 β 31 sheet 24 - 25 sheet 25 sheet 26 to 25 sheet 30 - 26 to 29 β 27 the 29 β 28 parallel 29 β 31 sheet 32 conformation 32 conformation 33 characteristic 33 characteristic 34 of 34 of 35 fibrils overall , these results led us to conclude that calcium ions stimulate the formation of oligomers of aβ ( 1 - 40 ) , that have been implicated in the pathogenesis of ad . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 led 0 ###LEFT-WALL### 34 . 1 overall 2 , 1 overall 4 results 3 these 4 results 4 results 5 led 5 led 6 us 5 led 7 to 7 to 8 conclude 8 conclude 9 that 9 that 11 ions 9 that 12 stimulate 10 calcium 11 ions 11 ions 12 stimulate 12 stimulate 14 formation 13 the 14 formation 14 formation 15 of 15 of 16 oligomers 16 oligomers 17 of 16 oligomers 25 that 16 oligomers 26 have 17 of 18 aβ 18 aβ 20 1 19 ( 20 1 20 1 22 40 20 1 24 , 21 - 22 40 22 40 23 ) 25 that 26 have 26 have 27 been 27 been 28 implicated 28 implicated 29 in 29 in 31 pathogenesis 30 the 31 pathogenesis 31 pathogenesis 32 of 32 of 33 ad erythrocyte hyperaggregation , a cardiovascular risk factor , is considered to be caused by an increase in plasma adhesion proteins , particularly fibrinogen . 0 ###LEFT-WALL### 2 hyperaggregation 0 ###LEFT-WALL### 10 considered 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 23 fibrinogen 0 ###LEFT-WALL### 24 . 1 erythrocyte 2 hyperaggregation 2 hyperaggregation 7 factor 2 hyperaggregation 9 is 3 , 7 factor 4 a 5 cardiovascular 4 a 7 factor 5 cardiovascular 7 factor 6 risk 7 factor 7 factor 8 , 9 is 10 considered 10 considered 11 to 10 considered 13 caused 11 to 12 be 12 be 13 caused 13 caused 14 by 13 caused 17 in 14 by 16 increase 15 an 16 increase 17 in 20 proteins 18 plasma 19 adhesion 19 adhesion 20 proteins 21 , 23 fibrinogen 22 particularly 23 fibrinogen we have recently reported a specific binding between fibrinogen and an erythrocyte integrin receptor with a β ( 3 ) or β ( 3 ) - like subunit . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 reported 1 we 2 have 2 have 4 reported 3 recently 4 reported 4 reported 21 or 5 a 14 receptor 6 specific 7 binding 6 specific 10 and 7 binding 8 between 8 between 9 fibrinogen 10 and 12 erythrocyte 10 and 14 receptor 11 an 12 erythrocyte 13 integrin 14 receptor 14 receptor 15 with 14 receptor 21 or 15 with 17 β 16 a 17 β 17 β 19 3 18 ( 19 3 19 3 20 ) 21 or 22 β 21 or 24 3 21 or 27 like 23 ( 24 3 24 3 25 ) 26 - 27 like 27 like 28 subunit 27 like 29 . in this study we evaluate the influence of erythrocyte aging on the fibrinogen binding . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 evaluate 0 ###LEFT-WALL### 15 . 1 in 3 study 1 in 4 we 2 this 3 study 4 we 5 evaluate 5 evaluate 7 influence 6 the 7 influence 7 influence 8 of 7 influence 10 aging 8 of 9 erythrocyte 10 aging 11 on 11 on 13 fibrinogen 12 the 13 fibrinogen 13 fibrinogen 14 binding by atomic force microscopy - based force spectroscopy measurements we found that increasing erythrocyte age , there is a decrease of the binding to fibrinogen by decreasing the frequency of its occurrence but not its force . 0 ###LEFT-WALL### 17 there 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 37 . 1 by 4 microscopy 1 by 17 there 2 atomic 3 force 3 force 4 microscopy 4 microscopy 9 measurements 5 - 9 measurements 6 based 9 measurements 7 force 9 measurements 8 spectroscopy 9 measurements 9 measurements 10 we 9 measurements 11 found 9 measurements 16 , 10 we 11 found 11 found 15 age 12 that 15 age 13 increasing 15 age 14 erythrocyte 15 age 17 there 18 is 18 is 20 decrease 19 a 20 decrease 20 decrease 21 of 20 decrease 24 to 20 decrease 25 fibrinogen 21 of 23 binding 22 the 23 binding 24 to 25 fibrinogen 25 fibrinogen 26 by 26 by 27 decreasing 27 decreasing 33 but 28 the 29 frequency 29 frequency 30 of 29 frequency 33 but 30 of 32 occurrence 31 its 32 occurrence 33 but 34 not 33 but 36 force 35 its 36 force this observation is reinforced by zeta - potential and fluorescence spectroscopy measurements . 0 ###LEFT-WALL### 2 observation 0 ###LEFT-WALL### 4 reinforced 0 ###LEFT-WALL### 7 - 1 this 2 observation 2 observation 3 is 3 is 4 reinforced 4 reinforced 5 by 5 by 6 zeta 7 - 9 and 7 - 13 . 8 potential 9 and 9 and 12 measurements 10 fluorescence 12 measurements 11 spectroscopy 12 measurements we conclude that upon erythrocyte aging the number of fibrinogen molecules bound to each cell decreases significantly , due to the progressive impairment of the specific fibrinogen - erythrocyte receptor interaction . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 1 we 2 conclude 2 conclude 3 that 2 conclude 16 decreases 3 that 4 upon 3 that 16 decreases 4 upon 5 erythrocyte 5 erythrocyte 6 aging 5 erythrocyte 12 bound 6 aging 11 molecules 7 the 8 number 8 number 9 of 8 number 11 molecules 9 of 11 molecules 10 fibrinogen 11 molecules 12 bound 13 to 13 to 15 cell 14 each 15 cell 16 decreases 17 significantly 16 decreases 20 to 18 , 20 to 19 due 20 to 20 to 23 impairment 20 to 32 . 21 the 23 impairment 22 progressive 23 impairment 23 impairment 24 of 23 impairment 31 interaction 24 of 27 fibrinogen 25 the 27 fibrinogen 26 specific 27 fibrinogen 28 - 31 interaction 29 erythrocyte 30 receptor 30 receptor 31 interaction 31 interaction 32 . knowing that younger erythrocytes bind more to fibrinogen , we could presume that this population is the main contributor to the cardiovascular diseases associated with increased fibrinogen content in blood , which could disturb the blood flow . 0 ###LEFT-WALL### 1 knowing 0 ###LEFT-WALL### 24 associated 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 38 . 1 knowing 2 that 1 knowing 24 associated 2 that 4 erythrocytes 2 that 9 , 3 younger 4 erythrocytes 4 erythrocytes 9 , 5 bind 6 more 5 bind 7 to 5 bind 9 , 7 to 8 fibrinogen 9 , 12 presume 9 , 20 to 10 we 11 could 11 could 12 presume 12 presume 13 that 13 that 15 population 13 that 16 is 14 this 15 population 15 population 16 is 16 is 19 contributor 17 the 18 main 17 the 19 contributor 20 to 23 diseases 21 the 23 diseases 22 cardiovascular 23 diseases 24 associated 25 with 24 associated 28 content 24 associated 29 in 25 with 27 fibrinogen 26 increased 27 fibrinogen 29 in 30 blood 31 , 32 which 31 , 34 disturb 32 which 33 could 33 could 34 disturb 34 disturb 37 flow 35 the 37 flow 36 blood 37 flow our data also show that the sialic acids exposed on the erythrocyte membrane contribute for the interaction with fibrinogen , possibly by facilitating its binding to the erythrocyte membrane receptor . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 show 1 our 2 data 2 data 4 show 3 also 4 show 4 show 5 that 5 that 8 acids 5 that 14 contribute 6 the 8 acids 7 sialic 8 acids 8 acids 9 exposed 8 acids 14 contribute 9 exposed 10 on 10 on 13 membrane 11 the 13 membrane 12 erythrocyte 13 membrane 14 contribute 15 for 14 contribute 18 with 15 for 17 interaction 16 the 17 interaction 18 with 19 fibrinogen 19 fibrinogen 22 by 20 , 21 possibly 20 , 22 by 22 by 23 facilitating 22 by 31 . 23 facilitating 25 binding 23 facilitating 26 to 24 its 25 binding 26 to 30 receptor 27 the 30 receptor 28 erythrocyte 29 membrane 29 membrane 30 receptor the primary purpose of this article is to outline the role , opportunities , and benefits of the certified foot and nail care nurse ( cfcn ) . 0 ###LEFT-WALL### 3 purpose 0 ###LEFT-WALL### 28 . 1 the 3 purpose 2 primary 3 purpose 3 purpose 4 of 3 purpose 7 is 4 of 6 article 5 this 6 article 7 is 8 to 7 is 9 outline 8 to 9 outline 9 outline 11 role 10 the 11 role 11 role 21 and 12 , 21 and 13 opportunities 15 and 14 , 15 and 15 and 16 benefits 15 and 17 of 15 and 21 and 17 of 20 foot 18 the 20 foot 19 certified 20 foot 21 and 24 nurse 21 and 26 cfcn 21 and 27 ) 22 nail 23 care 23 care 24 nurse 25 ( 26 cfcn 26 cfcn 27 ) current demographic trends toward an aging population and associated health issues such as diabetes mellitus , arthritis , peripheral arterial disease , dementia , and loss of visual acuity hinder self [-] care of the feet and nails . 0 ###LEFT-WALL### 37 and 0 ###LEFT-WALL### 39 . 1 current 3 trends 2 demographic 3 trends 3 trends 4 toward 3 trends 37 and 4 toward 8 and 5 an 7 population 6 aging 7 population 7 population 8 and 8 and 11 issues 8 and 13 as 9 associated 10 health 10 health 11 issues 12 such 13 as 13 as 14 diabetes 14 diabetes 25 and 14 diabetes 30 hinder 15 mellitus 16 , 16 , 17 arthritis 16 , 18 , 18 , 21 disease 18 , 22 , 19 peripheral 21 disease 20 arterial 21 disease 22 , 23 dementia 22 , 25 and 24 , 25 and 25 and 26 loss 25 and 27 of 25 and 30 hinder 27 of 29 acuity 28 visual 29 acuity 30 hinder 33 care 31 self 33 care 33 care 34 of 34 of 36 feet 35 the 36 feet 37 and 38 nails the resulting foot and nail care needs create opportunities for cfcn to promote health and prevent adverse outcomes such as infection and limb loss . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 25 . 1 the 3 foot 2 resulting 3 foot 3 foot 4 and 4 and 7 needs 4 and 15 and 5 nail 6 care 6 care 7 needs 8 create 9 opportunities 8 create 15 and 9 opportunities 10 for 9 opportunities 12 to 9 opportunities 13 promote 10 for 11 cfcn 12 to 13 promote 13 promote 14 health 15 and 16 prevent 16 prevent 18 outcomes 16 prevent 20 as 17 adverse 18 outcomes 19 such 20 as 20 as 22 and 21 infection 22 and 22 and 24 loss 23 limb 24 loss routine foot and nail assessment , clinically appropriate care , and individualized patient education are essential for achieving positive outcomes . 0 ###LEFT-WALL### 2 foot 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 21 . 1 routine 2 foot 3 and 11 and 3 and 15 are 4 nail 5 assessment 5 assessment 6 , 6 , 9 care 6 , 11 and 7 clinically 8 appropriate 8 appropriate 9 care 10 , 11 and 11 and 14 education 11 and 15 are 12 individualized 14 education 13 patient 14 education 15 are 16 essential 16 essential 17 for 17 for 18 achieving 18 achieving 20 outcomes 19 positive 20 outcomes until recently , individuals had limited options for obtaining needed care and have relied on nonclinicians or podiatry appointments that may not be covered by insurance and , thus , may not be affordable . 0 ###LEFT-WALL### 4 individuals 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 35 . 1 until 2 recently 1 until 3 , 1 until 4 individuals 4 individuals 5 had 5 had 12 and 6 limited 7 options 6 limited 12 and 7 options 8 for 8 for 9 obtaining 9 obtaining 11 care 10 needed 11 care 12 and 13 have 12 and 15 on 13 have 14 relied 15 on 17 or 16 nonclinicians 17 or 17 or 19 appointments 17 or 20 that 17 or 21 may 18 podiatry 19 appointments 20 that 21 may 21 may 22 not 21 may 27 and 23 be 24 covered 23 be 27 and 24 covered 25 by 25 by 26 insurance 27 and 31 may 28 , 29 thus 29 thus 30 , 29 thus 31 may 31 may 32 not 31 may 33 be 33 be 34 affordable through the cfcn certification process , nurses gain knowledge and skills to provide the care that can improve foot health for an aging population . 0 ###LEFT-WALL### 7 nurses 0 ###LEFT-WALL### 8 gain 0 ###LEFT-WALL### 25 . 1 through 5 process 1 through 6 , 1 through 7 nurses 2 the 5 process 3 cfcn 5 process 4 certification 5 process 7 nurses 8 gain 8 gain 10 and 8 gain 12 to 8 gain 21 for 9 knowledge 10 and 10 and 11 skills 12 to 13 provide 13 provide 15 care 14 the 15 care 15 care 16 that 15 care 17 can 16 that 17 can 17 can 18 improve 18 improve 20 health 19 foot 20 health 21 for 24 population 22 an 24 population 23 aging 24 population in response to " evidence - based policy prescription for an aging population , " by chappell and hollander , this paper proposes that efforts be made to execute strategies to build the political momentum and public support necessary for concrete action toward achieving the recommended policies . 0 ###LEFT-WALL### 22 paper 0 ###LEFT-WALL### 23 proposes 0 ###LEFT-WALL### 48 . 1 in 2 response 2 response 3 to 3 to 4 " 3 to 5 evidence 3 to 20 , 3 to 22 paper 5 evidence 9 prescription 6 - 9 prescription 7 based 9 prescription 8 policy 9 prescription 9 prescription 10 for 9 prescription 16 by 9 prescription 20 , 10 for 13 population 11 an 13 population 12 aging 13 population 14 , 15 " 14 , 16 by 16 by 18 and 16 by 20 , 17 chappell 18 and 18 and 19 hollander 21 this 22 paper 22 paper 23 proposes 23 proposes 24 that 24 that 25 efforts 24 that 26 be 26 be 27 made 27 made 28 to 27 made 31 to 27 made 39 necessary 28 to 29 execute 29 execute 30 strategies 31 to 32 build 32 build 36 and 33 the 35 momentum 34 political 35 momentum 35 momentum 36 and 36 and 38 support 37 public 38 support 39 necessary 40 for 39 necessary 43 toward 40 for 42 action 41 concrete 42 action 43 toward 44 achieving 44 achieving 47 policies 45 the 47 policies 46 recommended 47 policies it also suggests the implementation of knowledge translation strategies to assist in disseminating and integrating existing successful programs across the wider health system . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 24 . 1 it 3 suggests 2 also 3 suggests 3 suggests 5 implementation 3 suggests 10 to 3 suggests 12 in 3 suggests 19 across 4 the 5 implementation 5 implementation 6 of 6 of 9 strategies 7 knowledge 9 strategies 8 translation 9 strategies 10 to 11 assist 12 in 14 and 13 disseminating 14 and 14 and 18 programs 15 integrating 16 existing 16 existing 18 programs 17 successful 18 programs 19 across 23 system 20 the 23 system 21 wider 23 system 22 health 23 system finally , this paper proposes a concerted and robust mobilization of forces in order to move from evidence - based agenda setting into active policy implementation . 0 ###LEFT-WALL### 4 paper 0 ###LEFT-WALL### 5 proposes 0 ###LEFT-WALL### 27 . 1 finally 2 , 1 finally 4 paper 3 this 4 paper 4 paper 5 proposes 5 proposes 21 agenda 5 proposes 23 into 6 a 21 agenda 7 concerted 8 and 8 and 10 mobilization 8 and 19 - 8 and 20 based 8 and 21 agenda 9 robust 10 mobilization 10 mobilization 11 of 11 of 12 forces 12 forces 13 in 12 forces 17 from 13 in 14 order 14 order 15 to 14 order 16 move 15 to 16 move 17 from 18 evidence 21 agenda 22 setting 23 into 26 implementation 24 active 25 policy 25 policy 26 implementation a key element of this transition involves placing greater emphasis on interest group activation and public policy deliberation . 0 ###LEFT-WALL### 3 element 0 ###LEFT-WALL### 7 involves 0 ###LEFT-WALL### 19 . 1 a 3 element 2 key 3 element 3 element 4 of 3 element 7 involves 4 of 6 transition 5 this 6 transition 7 involves 8 placing 8 placing 10 emphasis 8 placing 11 on 9 greater 10 emphasis 11 on 15 and 12 interest 14 activation 13 group 14 activation 14 activation 15 and 15 and 18 deliberation 16 public 17 policy 17 policy 18 deliberation such a focus would enable consensus between policy makers , decision [-] makers , interest groups and the public , garnering the political traction necessary to allow for the implementation of healthy public policy that best serves the needs of an aging population . 0 ###LEFT-WALL### 3 focus 0 ###LEFT-WALL### 5 enable 0 ###LEFT-WALL### 10 , 1 such 2 a 2 a 3 focus 3 focus 4 would 4 would 5 enable 5 enable 6 consensus 5 enable 7 between 7 between 9 makers 8 policy 9 makers 10 , 17 and 11 decision 13 makers 13 makers 14 , 14 , 16 groups 14 , 17 and 15 interest 16 groups 17 and 19 public 17 and 21 garnering 18 the 19 public 20 , 21 garnering 21 garnering 24 traction 21 garnering 28 for 21 garnering 44 . 22 the 24 traction 23 political 24 traction 24 traction 25 necessary 25 necessary 26 to 25 necessary 27 allow 26 to 27 allow 28 for 30 implementation 29 the 30 implementation 30 implementation 31 of 30 implementation 35 that 30 implementation 37 serves 31 of 34 policy 32 healthy 33 public 33 public 34 policy 35 that 37 serves 36 best 37 serves 37 serves 39 needs 38 the 39 needs 39 needs 40 of 40 of 43 population 41 an 43 population 42 aging 43 population a necessary component of the prescribed continuing care act should be the creation of a long - term care insurance program in canada . 0 ###LEFT-WALL### 3 component 0 ###LEFT-WALL### 11 be 0 ###LEFT-WALL### 24 . 1 a 2 necessary 1 a 3 component 2 necessary 3 component 3 component 4 of 3 component 10 should 4 of 9 act 5 the 9 act 6 prescribed 8 care 7 continuing 8 care 8 care 9 act 10 should 11 be 11 be 13 creation 12 the 13 creation 13 creation 14 of 14 of 21 program 15 a 16 long 15 a 21 program 16 long 17 - 16 long 18 term 18 term 20 insurance 19 care 20 insurance 20 insurance 21 program 21 program 22 in 22 in 23 canada this social innovation has been implemented in many countries in recent decades to address the aging of the population and associated pandemic of chronic diseases . 0 ###LEFT-WALL### 3 innovation 0 ###LEFT-WALL### 6 implemented 0 ###LEFT-WALL### 26 . 1 this 3 innovation 2 social 3 innovation 3 innovation 4 has 4 has 5 been 5 been 6 implemented 6 implemented 7 in 6 implemented 10 in 6 implemented 13 to 7 in 9 countries 8 many 9 countries 10 in 12 decades 11 recent 12 decades 13 to 14 address 14 address 16 aging 15 the 16 aging 16 aging 17 of 16 aging 23 of 17 of 20 and 18 the 19 population 19 population 20 and 20 and 22 pandemic 21 associated 22 pandemic 23 of 25 diseases 24 chronic 25 diseases a specific autonomy insurance fund would have to be created and funded through transfers of current funding for long - term care , tax credits for disabled individuals and substantial new investment to make the shift from institutional to home care . 0 ###LEFT-WALL### 5 fund 0 ###LEFT-WALL### 7 have 0 ###LEFT-WALL### 42 . 1 a 2 specific 1 a 5 fund 2 specific 5 fund 3 autonomy 4 insurance 4 insurance 5 fund 5 fund 6 would 6 would 7 have 7 have 8 to 7 have 11 and 8 to 11 and 9 be 10 created 9 be 11 and 11 and 12 funded 11 and 18 for 11 and 26 for 12 funded 14 transfers 13 through 14 transfers 14 transfers 15 of 15 of 17 funding 16 current 17 funding 18 for 25 credits 19 long 22 care 19 long 23 , 19 long 24 tax 20 - 22 care 21 term 22 care 22 care 23 , 24 tax 25 credits 26 for 29 and 27 disabled 28 individuals 28 individuals 29 and 29 and 32 investment 29 and 33 to 29 and 37 from 29 and 38 institutional 30 substantial 32 investment 31 new 32 investment 33 to 34 make 34 make 36 shift 34 make 37 from 35 the 36 shift 38 institutional 39 to 38 institutional 40 home 39 to 40 home 40 home 41 care following a standardized assessment by case managers , an autonomy support benefit would be determined to fund " in kind " public or private services or [a] ["] cash - for - care " [allowance] for older people to purchase services . 0 ###LEFT-WALL### 12 benefit 0 ###LEFT-WALL### 14 be 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 42 . 1 following 4 assessment 1 following 8 , 1 following 12 benefit 2 a 4 assessment 3 standardized 4 assessment 4 assessment 5 by 5 by 7 managers 6 case 7 managers 9 an 12 benefit 10 autonomy 11 support 11 support 12 benefit 12 benefit 13 would 13 would 14 be 14 be 15 determined 15 determined 16 to 15 determined 26 or 16 to 26 or 17 fund 18 " 17 fund 20 kind 17 fund 23 or 17 fund 25 services 17 fund 26 or 19 in 20 kind 20 kind 21 " 22 public 23 or 23 or 24 private 26 or 29 cash 30 - 31 for 30 - 40 purchase 31 for 32 - 32 - 33 care 33 care 34 " 33 care 36 for 33 care 39 to 36 for 38 people 37 older 38 people 39 to 40 purchase 40 purchase 41 services case managers would be responsible for coordinating the care , controlling the quality of services and reassessing needs according to changes in individuals ' conditions . 0 ###LEFT-WALL### 2 managers 0 ###LEFT-WALL### 4 be 1 case 2 managers 2 managers 3 would 3 would 4 be 4 be 5 responsible 5 responsible 6 for 5 responsible 11 controlling 6 for 7 coordinating 7 coordinating 9 care 8 the 9 care 10 , 11 controlling 11 controlling 16 and 11 controlling 20 to 11 controlling 22 in 11 controlling 26 . 12 the 16 and 13 quality 14 of 13 quality 16 and 14 of 15 services 16 and 18 needs 17 reassessing 18 needs 19 according 20 to 20 to 21 changes 22 in 25 conditions 23 individuals 24 ' 24 ' 25 conditions funding reform of long - term care would prioritize home care and optimize the functioning of integrated care to improve support for frail older people . 0 ###LEFT-WALL### 1 funding 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 26 . 1 funding 2 reform 1 funding 8 would 2 reform 3 of 3 of 7 care 4 long 5 - 4 long 6 term 6 term 7 care 8 would 12 and 9 prioritize 11 care 9 prioritize 12 and 10 home 11 care 12 and 13 optimize 13 optimize 15 functioning 13 optimize 19 to 14 the 15 functioning 15 functioning 16 of 16 of 18 care 17 integrated 18 care 19 to 20 improve 20 improve 21 support 21 support 22 for 22 for 25 people 23 frail 25 people 24 older 25 people chronic disease management initiatives have thus far focused on single disease entities . 0 ###LEFT-WALL### 3 management 0 ###LEFT-WALL### 8 focused 0 ###LEFT-WALL### 13 . 1 chronic 2 disease 2 disease 3 management 3 management 4 initiatives 3 management 5 have 3 management 8 focused 4 initiatives 5 have 5 have 7 far 6 thus 7 far 8 focused 9 on 9 on 12 entities 10 single 11 disease 11 disease 12 entities the challenge of an aging population is the occurrence of multiple diseases , complicated by geriatric syndromes , in the same person . 0 ###LEFT-WALL### 2 challenge 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 23 . 1 the 2 challenge 2 challenge 3 of 2 challenge 7 is 3 of 6 population 4 an 6 population 5 aging 6 population 7 is 9 occurrence 8 the 9 occurrence 9 occurrence 10 of 9 occurrence 19 in 10 of 12 diseases 11 multiple 12 diseases 12 diseases 14 complicated 13 , 14 complicated 14 complicated 15 by 14 complicated 18 , 15 by 17 syndromes 16 geriatric 17 syndromes 19 in 22 person 20 the 21 same 21 same 22 person the term frailty is used to denote such persons , who are more vulnerable to poor health outcomes when challenged by a health stressor . 0 ###LEFT-WALL### 3 frailty 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 25 . 1 the 3 frailty 2 term 3 frailty 3 frailty 4 is 4 is 5 used 5 used 6 to 5 used 7 denote 6 to 7 denote 7 denote 9 persons 8 such 9 persons 10 , 11 who 10 , 12 are 11 who 12 are 12 are 14 vulnerable 13 more 14 vulnerable 14 vulnerable 15 to 14 vulnerable 19 when 15 to 18 outcomes 16 poor 17 health 17 health 18 outcomes 19 when 20 challenged 20 challenged 21 by 21 by 24 stressor 22 a 23 health 22 a 24 stressor 23 health 24 stressor in this paper , it is argued that frailty is a chronic condition and thus requires a chronic disease management approach . 0 ###LEFT-WALL### 5 it 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 22 . 1 in 3 paper 1 in 4 , 1 in 5 it 2 this 3 paper 5 it 6 is 6 is 14 and 7 argued 8 that 7 argued 14 and 8 that 9 frailty 8 that 10 is 9 frailty 10 is 10 is 13 condition 11 a 12 chronic 11 a 13 condition 12 chronic 13 condition 14 and 16 requires 14 and 21 approach 15 thus 16 requires 17 a 18 chronic 17 a 21 approach 18 chronic 19 disease 19 disease 21 approach 20 management 21 approach hospital [-] based and community interventions for managing frail seniors are discussed , with a focus on enhancing primary care , and with appropriate and targeted support from geriatric specialists in the form of capacity building as well as direct clinical service . 1 hospital 3 based 1 hospital 4 and 4 and 6 interventions 4 and 7 for 4 and 11 are 5 community 6 interventions 7 for 8 managing 8 managing 10 seniors 9 frail 10 seniors 11 are 12 discussed 12 discussed 14 with 13 , 14 with 14 with 16 focus 14 with 43 . 15 a 16 focus 16 focus 22 and 16 focus 28 from 17 on 18 enhancing 17 on 22 and 18 enhancing 20 care 19 primary 20 care 21 , 22 and 22 and 23 with 23 with 25 and 24 appropriate 25 and 25 and 27 support 26 targeted 27 support 28 from 30 specialists 29 geriatric 30 specialists 30 specialists 31 in 30 specialists 34 of 30 specialists 36 building 31 in 33 form 32 the 33 form 34 of 35 capacity 36 building 38 well 36 building 39 as 37 as 38 well 39 as 42 service 40 direct 42 service 41 clinical 42 service finally , a model for integrating individual geriatric interventions into a broader system is proposed . 0 ###LEFT-WALL### 4 model 0 ###LEFT-WALL### 15 proposed 0 ###LEFT-WALL### 16 . 1 finally 2 , 1 finally 4 model 3 a 4 model 4 model 5 for 4 model 14 is 5 for 6 integrating 6 integrating 9 interventions 6 integrating 10 into 7 individual 9 interventions 8 geriatric 9 interventions 10 into 13 system 11 a 13 system 12 broader 13 system 14 is 15 proposed if the healthcare sky is falling , it is because we have not yet grasped the opportunity to do better . 0 ###LEFT-WALL### 8 it 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 21 . 1 if 4 sky 1 if 6 falling 1 if 7 , 1 if 8 it 2 the 4 sky 3 healthcare 4 sky 4 sky 5 is 5 is 6 falling 6 falling 7 , 8 it 9 is 9 is 10 because 9 is 20 better 10 because 11 we 10 because 15 grasped 11 we 12 have 12 have 13 not 12 have 15 grasped 14 yet 15 grasped 15 grasped 17 opportunity 15 grasped 18 to 16 the 17 opportunity 18 to 19 do here we comment on three points in chappell and hollander 's lead article . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 comment 0 ###LEFT-WALL### 14 . 1 here 2 we 2 we 3 comment 3 comment 4 on 3 comment 7 in 4 on 6 points 5 three 6 points 7 in 9 and 8 chappell 9 and 9 and 13 article 10 hollander 11 's 11 's 13 article 12 lead 13 article second , we concur that small things ( e.g [.] , transportation and medication management ) matter in big health systems . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 concur 0 ###LEFT-WALL### 22 . 1 second 2 , 1 second 3 we 3 we 4 concur 4 concur 5 that 5 that 7 things 5 that 17 matter 6 small 7 things 7 things 13 and 7 things 17 matter 8 ( 13 and 9 e.g 11 , 11 , 12 transportation 11 , 13 and 13 and 15 management 13 and 16 ) 14 medication 15 management 17 matter 18 in 18 in 21 systems 19 big 20 health 20 health 21 systems access to a full range of services in integrated systems of care permits cost [-] effective " [downward] substitution " instead of more costly , and often inappropriate " upward substitution " to hospital [and] institutional care . 0 ###LEFT-WALL### 1 access 0 ###LEFT-WALL### 14 cost 0 ###LEFT-WALL### 38 . 1 access 2 to 1 access 6 of 1 access 11 of 1 access 14 cost 2 to 5 range 3 a 5 range 4 full 5 range 6 of 7 services 7 services 8 in 8 in 10 systems 9 integrated 10 systems 11 of 13 permits 12 care 13 permits 14 cost 19 substitution 14 cost 22 of 14 cost 33 to 16 effective 17 " 16 effective 19 substitution 19 substitution 20 " 21 instead 22 of 22 of 31 substitution 23 more 31 substitution 24 costly 26 and 25 , 26 and 26 and 27 often 26 and 28 inappropriate 26 and 31 substitution 28 inappropriate 29 " 28 inappropriate 30 upward 31 substitution 32 " 33 to 37 care 34 hospital 37 care 36 institutional 37 care finally , given the current political climate of fiscal constraint , it is helpful to consider the lessons of successful local initiatives such as supportive housing , which can integrate care " from the ground up " including essential primary and preventive care . 0 ###LEFT-WALL### 12 it 0 ###LEFT-WALL### 16 consider 1 finally 2 , 1 finally 12 it 3 given 7 climate 3 given 11 , 3 given 12 it 4 the 7 climate 5 current 7 climate 6 political 7 climate 7 climate 8 of 8 of 10 constraint 9 fiscal 10 constraint 12 it 13 is 13 is 14 helpful 14 helpful 15 to 15 to 16 consider 16 consider 18 lessons 16 consider 24 as 17 the 18 lessons 18 lessons 19 of 19 of 22 initiatives 20 successful 22 initiatives 21 local 22 initiatives 23 such 24 as 24 as 26 housing 25 supportive 26 housing 26 housing 28 which 27 , 28 which 28 which 29 can 28 which 44 . 29 can 30 integrate 30 integrate 31 care 30 integrate 36 up 31 care 32 " 31 care 33 from 33 from 35 ground 34 the 35 ground 36 up 37 " 36 up 43 care 38 including 43 care 39 essential 43 care 40 primary 41 and 41 and 42 preventive 41 and 43 care rather than seeing an aging population as the harbinger [of] healthcare doom , we suggest seeing it as a motivator to rethink , [refresh] and innovate . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 27 . 1 rather 2 than 2 than 3 seeing 2 than 14 we 3 seeing 6 population 4 an 6 population 5 aging 6 population 7 as 12 doom 7 as 13 , 7 as 14 we 8 the 12 doom 9 harbinger 12 doom 11 healthcare 12 doom 14 we 25 and 15 suggest 16 seeing 15 suggest 25 and 16 seeing 17 it 16 seeing 18 as 18 as 20 motivator 19 a 20 motivator 20 motivator 21 to 20 motivator 22 rethink 21 to 22 rethink 23 , 25 and 25 and 26 innovate canada 's aging population poses a significant challenge for the existing healthcare system . 0 ###LEFT-WALL### 4 population 0 ###LEFT-WALL### 5 poses 0 ###LEFT-WALL### 14 . 1 canada 2 's 2 's 4 population 3 aging 4 population 4 population 5 poses 5 poses 8 challenge 6 a 7 significant 6 a 8 challenge 7 significant 8 challenge 8 challenge 9 for 9 for 13 system 10 the 13 system 11 existing 13 system 12 healthcare 13 system while individuals 65 and older accounted for 13.7 % of the population in 2005 , [they] accounted for 60 % of all acute care service spending . 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 27 . 1 while 4 and 1 while 15 , 2 individuals 3 65 2 individuals 4 and 4 and 5 older 6 accounted 7 for 6 accounted 15 , 7 for 9 % 8 13.7 9 % 9 % 10 of 9 % 13 in 10 of 12 population 11 the 12 population 13 in 14 2005 15 , 17 accounted 17 accounted 18 for 18 for 20 % 19 60 20 % 20 % 21 of 21 of 26 spending 22 all 26 spending 23 acute 24 care 24 care 26 spending 25 service 26 spending this paper further illustrates [how] the heterogeneity of the older population and its impact [on] patterns of healthcare use demonstrate the failings of our current care systems . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 4 illustrates 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 28 . 1 this 2 paper 2 paper 4 illustrates 3 further 4 illustrates 4 illustrates 7 heterogeneity 6 the 7 heterogeneity 7 heterogeneity 8 of 8 of 11 population 9 the 11 population 10 older 11 population 12 and 16 patterns 12 and 20 demonstrate 13 its 16 patterns 14 impact 16 patterns 16 patterns 17 of 16 patterns 20 demonstrate 17 of 19 use 18 healthcare 19 use 20 demonstrate 22 failings 21 the 22 failings 22 failings 23 of 23 of 27 systems 24 our 27 systems 25 current 26 care 26 care 27 systems our outdated acute care models frequently disadvantage the system 's highest users , who are often characterized by factors [such] as poly - morbidity , functional impairment and social frailty . 0 ###LEFT-WALL### 5 models 0 ###LEFT-WALL### 7 disadvantage 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 31 . 1 our 5 models 2 outdated 4 care 3 acute 4 care 4 care 5 models 5 models 7 disadvantage 6 frequently 7 disadvantage 7 disadvantage 12 users 8 the 9 system 9 system 10 's 10 's 11 highest 10 's 12 users 12 users 14 who 12 users 24 morbidity 13 , 14 who 14 who 15 are 14 who 23 - 15 are 16 often 15 are 17 characterized 17 characterized 18 by 17 characterized 22 poly 18 by 19 factors 21 as 22 poly 23 - 24 morbidity 24 morbidity 25 , 25 , 28 and 26 functional 27 impairment 27 impairment 28 and 28 and 30 frailty 29 social 30 frailty understanding how implementing innovative models that challenge deeply ingrained ways of providing care has proven to be a significant challenge , this paper highlights one hospital 's mission to transform current traditional paradigms of care by developing and implementing an elder - friendly hospital integrated service delivery model . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 15 proven 0 ###LEFT-WALL### 49 . 1 understanding 2 how 1 understanding 14 has 2 how 5 models 2 how 13 care 3 implementing 5 models 4 innovative 5 models 5 models 7 challenge 5 models 9 ingrained 5 models 11 of 5 models 13 care 6 that 7 challenge 7 challenge 9 ingrained 8 deeply 9 ingrained 9 ingrained 10 ways 11 of 12 providing 14 has 15 proven 15 proven 16 to 15 proven 36 by 15 proven 48 model 16 to 21 , 17 be 20 challenge 17 be 21 , 18 a 19 significant 18 a 20 challenge 19 significant 20 challenge 21 , 30 transform 22 this 23 paper 23 paper 24 highlights 24 highlights 28 mission 24 highlights 29 to 25 one 26 hospital 26 hospital 27 's 27 's 28 mission 29 to 30 transform 30 transform 33 paradigms 31 current 33 paradigms 32 traditional 33 paradigms 33 paradigms 34 of 34 of 35 care 36 by 38 and 37 developing 38 and 38 and 39 implementing 40 an 48 model 41 elder 42 - 41 elder 44 hospital 43 friendly 44 hospital 44 hospital 48 model 45 integrated 48 model 46 service 48 model 47 delivery 48 model this hospital aims to demonstrate wide - ranging benefits of this model that can contribute toward optimizing the outcomes of hospitalization for older adults and the system as a whole . 0 ###LEFT-WALL### 2 hospital 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 31 . 1 this 2 hospital 2 hospital 3 aims 3 aims 4 to 3 aims 17 optimizing 4 to 5 demonstrate 5 demonstrate 9 benefits 6 wide 7 - 6 wide 9 benefits 8 ranging 9 benefits 9 benefits 10 of 9 benefits 13 that 9 benefits 17 optimizing 10 of 12 model 11 this 12 model 13 that 14 can 14 can 15 contribute 15 contribute 16 toward 16 toward 17 optimizing 17 optimizing 19 outcomes 17 optimizing 22 for 17 optimizing 28 as 18 the 19 outcomes 19 outcomes 20 of 20 of 21 hospitalization 22 for 25 and 23 older 24 adults 24 adults 25 and 25 and 27 system 26 the 27 system 28 as 30 whole 29 a 30 whole the establishment of a national agency that could support the development of a national aging strategy to promote best practice dissemination and implementation could also ensure that the significant health , social and economic benefits that better care models can realize could be more easily achieved . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 26 ensure 0 ###LEFT-WALL### 47 . 1 the 2 establishment 2 establishment 3 of 2 establishment 12 of 2 establishment 22 and 3 of 6 agency 4 a 5 national 4 a 6 agency 5 national 6 agency 6 agency 7 that 6 agency 8 could 7 that 8 could 8 could 9 support 9 support 11 development 10 the 11 development 12 of 14 national 13 a 14 national 14 national 15 aging 15 aging 16 strategy 15 aging 17 to 17 to 18 promote 18 promote 19 best 18 promote 21 dissemination 20 practice 21 dissemination 22 and 23 implementation 22 and 24 could 24 could 26 ensure 25 also 26 ensure 26 ensure 27 that 27 that 33 and 27 that 46 achieved 28 the 30 health 29 significant 30 health 30 health 31 , 31 , 32 social 31 , 33 and 33 and 35 benefits 33 and 36 that 33 and 41 realize 33 and 42 could 34 economic 35 benefits 36 that 39 models 36 that 41 realize 37 better 38 care 38 care 39 models 39 models 40 can 40 can 41 realize 42 could 43 be 43 be 45 easily 43 be 46 achieved 44 more 45 easily chappell and hollander provide support for a set of policy directives formulated for an aging population . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 17 . 1 chappell 2 and 2 and 3 hollander 2 and 4 provide 4 provide 5 support 5 support 6 for 6 for 8 set 7 a 8 set 8 set 9 of 9 of 11 directives 10 policy 11 directives 11 directives 12 formulated 12 formulated 13 for 13 for 16 population 14 an 16 population 15 aging 16 population an integrated [continuum] [of] care model is the fulcrum of the policy prescription , given evidence - based support for its cost - effectiveness [;] improved quality of care and quality of life [;] and the success of similar models found in denmark , japan and other countries . 1 an 6 model 2 integrated 6 model 5 care 6 model 6 model 7 is 7 is 9 fulcrum 7 is 15 given 8 the 9 fulcrum 9 fulcrum 10 of 10 of 13 prescription 11 the 13 prescription 12 policy 13 prescription 14 , 15 given 15 given 16 evidence 16 evidence 23 - 17 - 23 - 18 based 19 support 19 support 20 for 19 support 23 - 20 for 22 cost 21 its 22 cost 23 - 35 and 24 effectiveness 26 improved 26 improved 27 quality 27 quality 28 of 27 quality 30 and 28 of 29 care 30 and 31 quality 30 and 35 and 31 quality 32 of 32 of 33 life 35 and 37 success 35 and 38 of 35 and 41 found 36 the 37 success 38 of 40 models 39 similar 40 models 41 found 42 in 42 in 43 denmark 43 denmark 48 countries 44 , 48 countries 45 japan 46 and 46 and 47 other 46 and 48 countries 48 countries 49 . this commentary addresses the underlying assumptions of these policy recommendations , identifies the major barriers to their implementation and suggests solutions . 0 ###LEFT-WALL### 2 commentary 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 22 . 1 this 2 commentary 2 commentary 11 , 3 addresses 6 assumptions 3 addresses 11 , 4 the 6 assumptions 5 underlying 6 assumptions 6 assumptions 7 of 7 of 10 recommendations 8 these 10 recommendations 9 policy 10 recommendations 11 , 19 and 12 identifies 15 barriers 12 identifies 16 to 12 identifies 19 and 13 the 15 barriers 14 major 15 barriers 16 to 18 implementation 17 their 18 implementation 19 and 20 suggests 20 suggests 21 solutions improving our understanding of the dynamics of population aging as it relates to health and healthcare use is a necessary requirement to reaching the aims set out by the authors . 0 ###LEFT-WALL### 1 improving 0 ###LEFT-WALL### 12 relates 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 31 . 1 improving 3 understanding 1 improving 12 relates 2 our 3 understanding 3 understanding 4 of 3 understanding 9 aging 4 of 6 dynamics 5 the 6 dynamics 6 dynamics 7 of 7 of 8 population 9 aging 10 as 10 as 11 it 12 relates 13 to 13 to 14 health 15 and 17 use 15 and 18 is 16 healthcare 17 use 17 use 18 is 18 is 21 requirement 19 a 20 necessary 19 a 21 requirement 20 necessary 21 requirement 21 requirement 22 to 22 to 23 reaching 23 reaching 25 aims 23 reaching 28 by 24 the 25 aims 25 aims 26 set 26 set 27 out 28 by 30 authors 29 the 30 authors chappell and hollander " offer [an] evidence - based policy prescription to meet the challenges […] [[] of ] an aging society . " 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 offer 0 ###LEFT-WALL### 23 . 1 chappell 2 and 2 and 3 hollander 2 and 5 offer 3 hollander 4 " 5 offer 7 evidence 5 offer 22 society 7 evidence 11 prescription 8 - 11 prescription 9 based 10 policy 10 policy 11 prescription 11 prescription 12 to 11 prescription 18 of 11 prescription 19 ] 12 to 13 meet 13 meet 15 challenges 14 the 15 challenges 15 challenges 18 of 20 an 22 society 21 aging 22 society 23 . 24 " the fallacies of apocalyptic demography are briskly dismissed ; their message is that decades of solid evidence support the critical importance of an integrated system of continuing care for the chronically ill elderly , both health services and home support . 0 ###LEFT-WALL### 2 fallacies 0 ###LEFT-WALL### 8 dismissed 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 41 . 1 the 2 fallacies 2 fallacies 3 of 2 fallacies 6 are 3 of 5 demography 4 apocalyptic 5 demography 6 are 7 briskly 6 are 8 dismissed 9 ; 11 message 10 their 11 message 11 message 12 is 12 is 13 that 13 that 14 decades 13 that 18 support 14 decades 15 of 14 decades 18 support 15 of 17 evidence 16 solid 17 evidence 18 support 21 importance 19 the 21 importance 20 critical 21 importance 21 importance 22 of 21 importance 26 of 22 of 25 system 23 an 25 system 24 integrated 25 system 26 of 27 continuing 27 continuing 28 care 27 continuing 29 for 29 for 40 support 30 the 40 support 31 chronically 32 ill 32 ill 40 support 33 elderly 34 , 33 elderly 40 support 35 both 37 services 36 health 37 services 37 services 38 and 38 and 39 home 38 and 40 support but the paper loses focus with discussions of " ageism " , the compression of morbidity , and healthy communities . 0 ###LEFT-WALL### 1 but 0 ###LEFT-WALL### 21 . 1 but 3 paper 1 but 4 loses 2 the 3 paper 3 paper 4 loses 4 loses 5 focus 4 loses 6 with 6 with 18 and 7 discussions 8 of 7 discussions 18 and 8 of 9 " 8 of 10 ageism 10 ageism 11 " 10 ageism 14 compression 12 , 14 compression 13 the 14 compression 14 compression 15 of 14 compression 17 , 15 of 16 morbidity 17 , 18 and 18 and 20 communities 19 healthy 20 communities the authors might have [explored] [why] [(] [as] they argue [ )(public policy has retreated from their prescription in recent decades . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 4 have 0 ###LEFT-WALL### 22 . 1 the 2 authors 2 authors 3 might 3 might 4 have 4 have 9 they 4 have 10 argue 10 argue 13 policy 10 argue 15 retreated 12 )(public 13 policy 13 policy 14 has 14 has 15 retreated 15 retreated 16 from 15 retreated 19 in 16 from 18 prescription 17 their 18 prescription 19 in 21 decades 20 recent 21 decades that prescription would require either [a] re - allocation of resources ( incomes ) away from politically well [-] entrenched interests , or simply more money . 0 ###LEFT-WALL### 1 that 0 ###LEFT-WALL### 4 require 0 ###LEFT-WALL### 27 . 1 that 2 prescription 1 that 4 require 2 prescription 3 would 3 would 4 require 4 require 5 either 4 require 7 re 4 require 15 away 4 require 16 from 7 re 8 - 7 re 9 allocation 9 allocation 10 of 10 of 11 resources 11 resources 13 incomes 12 ( 13 incomes 13 incomes 14 ) 16 from 26 money 17 politically 20 entrenched 18 well 20 entrenched 20 entrenched 21 interests 21 interests 23 or 22 , 23 or 23 or 24 simply 23 or 25 more 23 or 26 money neither appears currently promising . 0 ###LEFT-WALL### 1 neither 0 ###LEFT-WALL### 2 appears 0 ###LEFT-WALL### 5 . 1 neither 2 appears 2 appears 3 currently 2 appears 4 promising canada 's health and social care system is paralyzed by our decentralized federalist governing structure . 0 ###LEFT-WALL### 7 system 0 ###LEFT-WALL### 9 paralyzed 0 ###LEFT-WALL### 16 . 1 canada 2 's 2 's 7 system 3 health 4 and 4 and 5 social 4 and 7 system 6 care 7 system 7 system 8 is 8 is 9 paralyzed 9 paralyzed 10 by 10 by 13 federalist 11 our 13 federalist 12 decentralized 13 federalist 13 federalist 14 governing 14 governing 15 structure public policy change , such as that suggested by chappell and hollander , will require a new political paradigm that recognizes the need for a multi - sectoral , co - operative approach to integrated systems of care delivery . 0 ###LEFT-WALL### 3 change 0 ###LEFT-WALL### 15 require 0 ###LEFT-WALL### 40 . 1 public 2 policy 2 policy 3 change 3 change 6 as 3 change 14 will 4 , 6 as 5 such 6 as 6 as 11 and 6 as 13 , 7 that 8 suggested 7 that 11 and 8 suggested 9 by 9 by 10 chappell 11 and 12 hollander 14 will 15 require 15 require 19 paradigm 15 require 24 for 16 a 19 paradigm 17 new 19 paradigm 18 political 19 paradigm 19 paradigm 20 that 19 paradigm 21 recognizes 20 that 21 recognizes 21 recognizes 23 need 22 the 23 need 24 for 33 approach 25 a 26 multi 25 a 33 approach 26 multi 30 co 26 multi 31 - 26 multi 33 approach 27 - 30 co 28 sectoral 29 , 28 sectoral 30 co 30 co 31 - 32 operative 33 approach 33 approach 34 to 33 approach 37 of 34 to 36 systems 35 integrated 36 systems 37 of 39 delivery 38 care 39 delivery the federal government must provide the necessary leadership , and the provinces and territories must show the political will to co - operate if canada is to embrace the challenges of an aging population . 0 ###LEFT-WALL### 3 government 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 35 . 1 the 3 government 2 federal 3 government 3 government 4 must 4 must 10 and 5 provide 8 leadership 5 provide 10 and 6 the 8 leadership 7 necessary 8 leadership 9 , 10 and 10 and 16 show 10 and 20 to 11 the 12 provinces 12 provinces 13 and 13 and 14 territories 13 and 15 must 15 must 16 show 16 show 19 will 17 the 19 will 18 political 19 will 20 to 21 co 22 - 23 operate 23 operate 24 if 24 if 25 canada 24 if 26 is 25 canada 26 is 26 is 27 to 27 to 28 embrace 28 embrace 30 challenges 29 the 30 challenges 30 challenges 31 of 31 of 34 population 32 an 34 population 33 aging 34 population [the] extent to which our aging population impacts the health system is , as chappell and hollander suggest , dependent on [(] [1] [ )(how that system is defined [and] organized [and] ( 2 ) [our] attitudes as a society to aging and the elderly . 2 extent 3 to 2 extent 12 is 3 to 4 which 3 to 7 population 3 to 8 impacts 5 our 7 population 6 aging 7 population 7 population 8 impacts 8 impacts 11 system 9 the 11 system 10 health 11 system 12 is 14 as 12 is 20 dependent 13 , 14 as 14 as 18 suggest 14 as 19 , 15 chappell 16 and 16 and 17 hollander 16 and 18 suggest 20 dependent 21 on 21 on 25 )(how 25 )(how 27 system 25 )(how 28 is 26 that 27 system 27 system 28 is 28 is 37 attitudes 28 is 38 as 29 defined 37 attitudes 31 organized 34 2 31 organized 37 attitudes 33 ( 34 2 34 2 35 ) 38 as 43 and 39 a 40 society 40 society 41 to 40 society 43 and 41 to 42 aging 43 and 45 elderly 43 and 46 . 44 the 45 elderly the canadian home care association supports the policy prescription described by chappell and hollander and believes that a paradigm shift from a reactive and episodic system to one that is proactive and supportive is required . 0 ###LEFT-WALL### 5 association 0 ###LEFT-WALL### 15 and 1 the 2 canadian 2 canadian 5 association 3 home 4 care 4 care 5 association 5 association 15 and 6 supports 9 prescription 6 supports 11 by 6 supports 15 and 7 the 9 prescription 8 policy 9 prescription 9 prescription 10 described 11 by 14 hollander 12 chappell 13 and 13 and 14 hollander 15 and 16 believes 16 believes 17 that 17 that 20 shift 17 that 35 required 18 a 20 shift 19 paradigm 20 shift 20 shift 21 from 20 shift 27 to 20 shift 29 that 20 shift 30 is 20 shift 34 is 21 from 26 system 22 a 26 system 23 reactive 24 and 24 and 25 episodic 24 and 26 system 27 to 28 one 29 that 30 is 30 is 32 and 31 proactive 32 and 32 and 33 supportive 34 is 35 required 35 required 36 . this article expands upon the lead essay by further discussing the role of home care and the need for its integration into the healthcare system . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 expands 0 ###LEFT-WALL### 26 . 1 this 2 article 2 article 3 expands 3 expands 4 upon 3 expands 8 by 4 upon 7 essay 5 the 7 essay 6 lead 7 essay 8 by 10 discussing 9 further 10 discussing 10 discussing 12 role 10 discussing 22 into 11 the 12 role 12 role 13 of 12 role 19 for 13 of 16 and 14 home 15 care 15 care 16 and 16 and 18 need 17 the 18 need 19 for 21 integration 20 its 21 integration 22 into 25 system 23 the 25 system 24 healthcare 25 system and the article concludes by asserting that we must change our attitude toward aging by improving our understanding of [and] attention to the needs of older adults . 0 ###LEFT-WALL### 1 and 0 ###LEFT-WALL### 28 . 1 and 3 article 1 and 4 concludes 2 the 3 article 3 article 4 concludes 4 concludes 5 by 4 concludes 16 improving 5 by 6 asserting 6 asserting 7 that 7 that 8 we 7 that 10 change 8 we 9 must 9 must 10 change 10 change 12 attitude 10 change 15 by 11 our 12 attitude 12 attitude 13 toward 13 toward 14 aging 16 improving 18 understanding 17 our 18 understanding 18 understanding 19 of 18 understanding 22 to 18 understanding 25 of 19 of 21 attention 22 to 24 needs 23 the 24 needs 25 of 27 adults 26 older 27 adults in this paper , the authors provide a policy prescription for canada 's aging population . 0 ###LEFT-WALL### 6 authors 0 ###LEFT-WALL### 7 provide 0 ###LEFT-WALL### 16 . 1 in 3 paper 1 in 4 , 1 in 6 authors 2 this 3 paper 5 the 6 authors 6 authors 7 provide 7 provide 10 prescription 8 a 10 prescription 9 policy 10 prescription 10 prescription 11 for 11 for 15 population 12 canada 13 's 13 's 15 population 14 aging 15 population they question the appropriateness of predictions about the lack of sustainability of our healthcare system . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 question 0 ###LEFT-WALL### 16 . 1 they 2 question 2 question 4 appropriateness 2 question 7 about 3 the 4 appropriateness 4 appropriateness 5 of 5 of 6 predictions 7 about 9 lack 8 the 9 lack 9 lack 10 of 10 of 11 sustainability 11 sustainability 12 of 12 of 15 system 13 our 15 system 14 healthcare 15 system the authors note that aging per se will only have a modest impact on future healthcare costs , and that other factors such as increased medical interventions , changes in technology and increases in overall service use will be the main cost drivers . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 note 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 44 . 1 the 2 authors 2 authors 3 note 3 note 4 that 4 that 5 aging 4 that 10 have 5 aging 8 will 6 per 7 se 7 se 8 will 8 will 10 have 9 only 10 have 10 have 13 impact 11 a 12 modest 11 a 13 impact 12 modest 13 impact 13 impact 14 on 14 on 17 costs 15 future 17 costs 16 healthcare 17 costs 18 , 19 and 19 and 20 that 19 and 39 be 20 that 22 factors 20 that 36 service 20 that 38 will 21 other 22 factors 22 factors 24 as 22 factors 36 service 23 such 24 as 24 as 28 , 25 increased 27 interventions 25 increased 28 , 26 medical 27 interventions 28 , 32 and 29 changes 30 in 29 changes 31 technology 29 changes 32 and 32 and 33 increases 32 and 34 in 32 and 35 overall 36 service 37 use 38 will 39 be 39 be 43 drivers 40 the 43 drivers 41 main 42 cost 42 cost 43 drivers they argue that , to increase value for money , government should validate , as a priority , integrated systems of care delivery for older adults and recognize such systems as a major component of canada 's healthcare system , along with hospitals , primary care and public/population health . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 44 , 0 ###LEFT-WALL### 50 . 1 they 27 and 2 argue 3 that 2 argue 27 and 3 that 11 government 3 that 13 validate 4 , 5 to 5 to 7 value 5 to 10 , 5 to 11 government 6 increase 7 value 7 value 8 for 8 for 9 money 11 government 12 should 12 should 13 validate 13 validate 15 as 13 validate 20 systems 14 , 15 as 15 as 17 priority 15 as 18 , 16 a 17 priority 19 integrated 20 systems 20 systems 21 of 20 systems 24 for 21 of 23 delivery 22 care 23 delivery 24 for 26 adults 25 older 26 adults 27 and 28 recognize 28 recognize 30 systems 28 recognize 31 as 29 such 30 systems 31 as 34 component 32 a 33 major 32 a 34 component 33 major 34 component 34 component 35 of 35 of 39 system 36 canada 37 's 37 's 39 system 38 healthcare 39 system 39 system 42 with 40 , 42 with 41 along 42 with 42 with 43 hospitals 42 with 44 , 44 , 47 and 45 primary 46 care 46 care 47 and 47 and 49 health 48 public/population 49 health they also note a range of mechanisms to enhance such systems going forward . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 note 0 ###LEFT-WALL### 14 . 1 they 3 note 2 also 3 note 3 note 5 range 3 note 8 to 4 a 5 range 5 range 6 of 6 of 7 mechanisms 8 to 9 enhance 9 enhance 11 systems 10 such 11 systems 11 systems 12 going 12 going 13 forward the authors present data and policy commentary on the following topics : ageism , healthy communities , prevention , unpaid caregivers and integrated systems of care delivery . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 present 0 ###LEFT-WALL### 12 : 0 ###LEFT-WALL### 28 . 1 the 2 authors 2 authors 3 present 3 present 5 and 3 present 8 on 4 data 5 and 5 and 7 commentary 6 policy 7 commentary 8 on 11 topics 9 the 10 following 9 the 11 topics 12 : 22 and 13 ageism 16 communities 13 ageism 17 , 13 ageism 18 prevention 14 , 16 communities 15 healthy 16 communities 16 communities 17 , 18 prevention 19 , 19 , 21 caregivers 19 , 22 and 20 unpaid 21 caregivers 22 and 24 systems 22 and 25 of 23 integrated 24 systems 25 of 27 delivery 26 care 27 delivery canada 's population is aging , and the authors of this issue 's lead article , neena chappell and marcus hollander , present a policy prescription for [how] to design a healthcare system that better responds to needs of older canadians . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 4 is 1 canada 2 's 2 's 3 population 3 population 4 is 4 is 7 and 5 aging 7 and 6 , 7 and 7 and 9 authors 7 and 10 of 8 the 9 authors 10 of 15 article 11 this 12 issue 12 issue 13 's 13 's 15 article 14 lead 15 article 15 article 17 neena 16 , 17 neena 17 neena 19 and 17 neena 27 for 17 neena 29 to 17 neena 42 . 18 chappell 19 and 19 and 21 hollander 19 and 22 , 19 and 23 present 20 marcus 21 hollander 23 present 26 prescription 23 present 27 for 24 a 26 prescription 25 policy 26 prescription 29 to 30 design 30 design 33 system 30 design 38 needs 30 design 39 of 31 a 32 healthcare 31 a 33 system 32 healthcare 33 system 33 system 34 that 33 system 37 to 33 system 38 needs 34 that 36 responds 35 better 36 responds 36 responds 37 to 39 of 41 canadians 40 older 41 canadians the timing of this issue of healthcare papers is important : the first of the baby boomers turned 65 in january 2011 . 0 ###LEFT-WALL### 2 timing 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 11 : 1 the 2 timing 2 timing 3 of 2 timing 9 is 3 of 5 issue 4 this 5 issue 5 issue 6 of 6 of 8 papers 7 healthcare 8 papers 9 is 10 important 11 : 13 first 11 : 18 turned 11 : 23 . 12 the 13 first 13 first 14 of 13 first 18 turned 14 of 17 boomers 15 the 17 boomers 16 baby 17 boomers 18 turned 19 65 18 turned 20 in 20 in 21 january 21 january 22 2011 there is a pressing need to develop policies and implement sustainable reforms that will allow older adults to stay healthier and maintain their independence longer in their place of choice , while also creating efficiencies and quality improvements in our overall healthcare system that will benefit canadians of all ages . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 51 . 1 there 2 is 2 is 5 need 3 a 5 need 4 pressing 5 need 5 need 6 to 5 need 7 develop 6 to 7 develop 7 develop 8 policies 9 and 12 reforms 9 and 15 allow 10 implement 12 reforms 11 sustainable 12 reforms 12 reforms 13 that 12 reforms 14 will 12 reforms 15 allow 13 that 14 will 15 allow 17 adults 15 allow 18 to 16 older 17 adults 18 to 21 and 19 stay 20 healthier 19 stay 21 and 21 and 22 maintain 21 and 24 independence 23 their 24 independence 24 independence 25 longer 25 longer 26 in 26 in 28 place 27 their 28 place 28 place 49 all 28 place 50 ages 29 of 30 choice 29 of 31 , 29 of 49 all 32 while 34 creating 32 while 49 all 33 also 34 creating 34 creating 36 and 34 creating 39 in 35 efficiencies 36 and 36 and 38 improvements 37 quality 38 improvements 39 in 43 system 40 our 43 system 41 overall 43 system 42 healthcare 43 system 43 system 44 that 43 system 48 of 44 that 45 will 45 will 46 benefit 46 benefit 47 canadians 47 canadians 48 of 49 all 50 ages